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Sample records for chronic effects assessment

  1. Chronic aquatic effect assessment for the fungicide azoxystrobin

    NARCIS (Netherlands)

    Wijngaarden, van R.P.A.; Belgers, J.D.M.; Zafar, M.I.; Matser, A.M.; Boerwinkel, M.C.; Arts, G.H.P.

    2014-01-01

    This study examined ecological effects of a range of chronic exposure concentrations of the fungicide azoxystrobin in freshwater experimental systems (1270 L outdoor microcosms). Intended and environmentally relevant test concentrations of azoxystrobin were 0, 0.33, 1, 3.3, 10, 33 µg ai/L, kept at

  2. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, J

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  3. Symptoms and side effects in chronic non-cancer pain:patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, Jette

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  4. Assessment of chronic sublethal effects of imidacloprid on honey bee colony health

    Science.gov (United States)

    Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 µg/kg over multiple brood cycles. Various endpoints ...

  5. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

    Science.gov (United States)

    Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

  6. Assessment of Chronic Sublethal Effects of Imidacloprid on Honey Bee Colony Health

    Science.gov (United States)

    Dively, Galen P.; Embrey, Michael S.; Kamel, Alaa; Hawthorne, David J.; Pettis, Jeffery S.

    2015-01-01

    Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 μg/kg over multiple brood cycles. Various endpoints of colony performance and foraging behavior were measured during and after exposure, including winter survival. Imidacloprid residues became diluted or non-detectable within colonies due to the processing of beebread and honey and the rapid metabolism of the chemical. Imidacloprid exposure doses up to 100 μg/kg had no significant effects on foraging activity or other colony performance indicators during and shortly after exposure. Diseases and pest species did not affect colony health but infestations of Varroa mites were significantly higher in exposed colonies. Honey stores indicated that exposed colonies may have avoided the contaminated food. Imidacloprid dose effects was delayed later in the summer, when colonies exposed to 20 and 100 μg/kg experienced higher rates of queen failure and broodless periods, which led to weaker colonies going into the winter. Pooled over two years, winter survival of colonies averaged 85.7, 72.4, 61.2 and 59.2% in the control, 5, 20 and 100 μg/kg treatment groups, respectively. Analysis of colony survival data showed a significant dose effect, and all contrast tests comparing survival between control and treatment groups were significant, except for colonies exposed to 5 μg/kg. Given the weight of evidence, chronic exposure to imidacloprid at the higher range of field doses (20 to 100 μg/kg) in pollen of certain treated crops could cause negative impacts on honey bee colony health and reduced overwintering success, but the most likely encountered high range of field doses relevant for seed-treated crops (5 μg/kg) had negligible effects on colony health and are unlikely a sole cause of colony declines. PMID:25786127

  7. Stochastic modelling to assess economic effects of treatment of chronic subclinical mastitis caused by Streptococcus uberis.

    Science.gov (United States)

    Steeneveld, Wilma; Swinkels, Jantijn; Hogeveen, Henk

    2007-11-01

    Chronic subclinical mastitis is usually not treated during the lactation. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of chronic subclinical mastitis caused by Streptococcus uberis. Factors in the model included the probability of cure after treatment, probability of the cow becoming clinically diseased, transmission of infection to other cows, and physiological effects of the infection. Using basic input parameters for Dutch circumstances, the average economic costs per cow of an untreated chronic subclinical mastitis case caused by Str. uberis in a single quarter from day of diagnosis onwards was euro109. With treatment, the average costs were higher (euro120). Thus, for the average cow, treatment was not efficient economically. However, the risk of high costs was much higher when cows with chronic subclinical mastitis were not treated. A sensitivity analysis showed that profitability of treatment of chronic subclinical Str. uberis mastitis depended on farm-specific factors (such as economic value of discarded milk) and cow-specific factors (such as day of diagnosis, duration of infection, amount of transmission to other cows and cure rate). Therefore, herd level protocols are not sufficient and decision support should be cow specific. Given the importance of cow-specific factors, information from the current model could be applied to automatic decision support systems.

  8. Stochastic modelling to assess economic effects of treatment of chronic subclinical mastitis caused by Streptococcus uberis

    NARCIS (Netherlands)

    Steeneveld, W.; Swinkels, J.; Hogeveen, H.

    2007-01-01

    Chronic subclinical mastitis is usually not treated during the lactation. However, some veterinarians regard treatment of some types of subclinical mastitis to be effective. The goal of this research was to develop a stochastic Monte Carlo simulation model to support decisions around treatment of

  9. Effects of chronic mild stress on parameters of bone assessment in adult male and female rats

    Directory of Open Access Journals (Sweden)

    Fabrício L. Valente

    Full Text Available Abstract: Osteoporosis is a multifactorial disease of high prevalence and has great impact on quality of life, because the effects on bone structure increase the risk of fractures, what may be very debilitating. Based on the observation that patients with depression have lower bone mineral density than healthy individuals, many studies have indicated that stress could be an aggravating factor for bone loss. This study evaluates the effect of a protocol of chronic mild stress (CMS on parameters of bone assessment in male and female rats. Five 5-monh-old rats of each sex underwent a schedule of stressor application for 28 days. Stressors included cold, heat, restraint, cage tilt, isolation, overnight illumination, and water and food deprivation. Five rats of each sex were kept under minimum intervention as control group. The animals were weighed at beginning and end of the period, and after euthanasia had their bones harvested. Femur, tibia and lumbar vertebrae were analyzed by bone densitometry. Biomechanical tests were performed in femoral head and diaphysis. Trabecular bone volume was obtained from histomorphometric analysis of femoral head and vertebral body, as well as of femoral midshaft cross-sectional measures. Not all parameters analyzed showed effect of CMS. However, tibial and L4 vertebral bone mineral density and cross-sectional cortical/medullar ratio of femoral shaft were lower in female rats submitted to the CMS protocol. Among male rats, the differences were significant for femoral trabecular bone volume and maximum load obtained by biomechanical test. Thus, it could be confirmed that CMS can affect the balance of bone homeostasis in rats, what may contribute to the establishment of osteopenia or osteoporosis.

  10. Assessing clinically meaningful treatment effects in controlled trials: chronic migraine as an example.

    Science.gov (United States)

    Dodick, David W; Turkel, Catherine C; DeGryse, Ronald E; Diener, Hans-Christoph; Lipton, Richard B; Aurora, Sheena K; Nolan, Marissa E; Silberstein, Stephen D

    2015-02-01

    In addition to headache, persons with chronic migraine (CM) experience multiple symptoms, both ictal and interictal, that may contribute to their suffering. Translating clinical trial results into practice requires assessment of the results' clinical meaningfulness. When examining treatment benefit in this disabled patient population, multiple headache-symptom measures should be considered to fully reflect clinical relevance. Currently, only onabotulinumtoxinA is approved specifically for headache prophylaxis in adults with CM. Topiramate is the only other therapeutic agent with double-blind, placebo-controlled evidence in this population. Herein we evaluate the clinical meaningfulness of onabotulinumtoxinA and topiramate as headache prophylaxis in CM by comparing primary endpoints from the placebo-controlled, double-blind phase of the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program and the topiramate clinical trial (frequency of headache days [primary endpoint in PREEMPT; secondary in topiramate trial] and migraine/migrainous days [primary in topiramate trial, or "migraine/probable-migraine days"; secondary in PREEMPT]). Additionally, outcome measures such as responder rates, health-related quality of life, discontinuation rates, safety, and tolerability profiles are important clinical considerations. The clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate. These data support these treatments as meaningful headache prophylaxis in adults with CM. CM is a chronic pain condition. We sought to determine the clinical relevance of recent trials in this disabled population. Clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate, and support use of these treatments as meaningful headache prophylaxis in CM. Copyright © 2015 American Pain Society. Published

  11. Assessment of chronic neuropsychological effects of mercury vapour poisoning in chloral-alkali plant workers.

    Science.gov (United States)

    Pranjić, Nurka; Sinanović, Osman; Karamehić, Jasenko; Jakubović, Rusid

    2002-12-01

    A prospective case study was conducted in the Department of Occupational Medicine, Tuzla. The purpose of this study was to indicate negative effects from occupational exposure to mercury on behavioural and mental health, memory and psychomotor function that was tested in 46 chloral-alkali plant workers (mean age was 38. 8+/- 5. 7 years; mean age of occupational history 16. 5+/- 6. 0 years). Data on toxicological monitoring on atomic absorption spectrometer, and data on mental health were collected, psychiatric and other subjective symptoms, and behavioural, psychomotor and memory function tested. The data were compared to control group, 32 healthy non exposed workers. The study was designed to assess blood and urine mercury levels and length of occupational exposure and investigate its relationships to effects on the mental health. The mean air mercury levels were 0.23 mg/m3, the mean blood mercury concentrations was 3. 6 mg/ dl and the mean urine mercury concentrations were 151.7 +/- 180.4 mg/l. In 25 (53%) workers exposed to mercury vapour was identified Depression-Hypochondrias Syndrome (p trend 2. 9 mg/ dl, or urine mercury levels > 87 mg/l workers exposed to mercury vapour knew that toxic effects in body resulted in loosing some of intellectual abilities, and that people who handle chemicals had an increased health risk (ESW questionnaire). The occupational mercury exposed workers had introvert behaviour (EPQ). Aggressiveness was found in 71.7% workers. The cognitive disturbances: short-term memory loss, difficult to concentrate on tasks which require attention and thinking, were significantly differed compared to those of controls (p trend < 0. 001). In 24 (52%) exposed to mercury workers we have determined ego strength loss and regressive defensive mechanisms (LB). Handwriting disturbances-micrography we have identified in 27 (58.7%) workers.

  12. Assessment of chronic neuropsychological effects of mercury vapour poisoning in chloral-alkali plant workers

    Directory of Open Access Journals (Sweden)

    Nurka Pranjić

    2002-02-01

    Full Text Available A prospective case study was conducted in the Department of Occupational Medicine, Tuzla. The purpose of this study was to indicate negative effects from occupational exposure to mercury on behavioural and mental health, memory and psychomotor function that was tested in 46 chloral-alkali plant workers (mean age was 38. 8+/- 5. 7 years; mean age of occupational history 16. 5+/- 6. 0 years. Data on toxicological monitoring on atomic absorption spectrometer, and data on mental health were collected, psychiatric and other subjective symptoms, and behavioural, psychomotor and memory function tested. The data were compared to control group, 32 healthy non exposed workers. The study was designed to assess blood and urine mercurylevels and length of occupational exposure and investigate its relationships to effects on the mental health. The mean air mercury levels were 0.23 mg/m3, the mean blood mercury concentrations was 3. 6 mg/ dl and the mean urine mercuryconcentrations were 151.7 +/- 180.4 mg/l. In 25 (53% workers exposed to mercury vapour was identified Depression-Hypochondrias Syndrome (p trend < 0. 001 with higher scores for scales: Hysteria (p trend <0. 001, Schizoid and Psychoastenia (MMPI. All psychological parameters were in highly significantly correlations with mercury levels and length of occupational exposure. Pathological parameters were possible general identified if the concentration of blood mercury levels are >2. 9 mg/ dl, or urine mercury levels > 87 mg/l workers exposed to mercury vapour knew that toxic effects in body resulted in loosing some of intellectual abilities, and that people who handle chemicals had an increased health risk (ESW questionnaire. The occupational mercury exposed workers had introvert behaviour (EPQ. Aggressiveness was found in 71.7% workers. The cognitive disturbances: short-term memory loss, difficult to concentrate on tasks which require attention and thinking

  13. Public assessment of key performance indicators of healthcare in a Canadian province: the effect of age and chronic health problems.

    Science.gov (United States)

    Nurullah, Abu Sadat; Northcott, Herbert C; Harvey, Michael D

    2014-01-15

    This study explores the effect of age and chronic conditions on public perceptions of the health system, as measured by the Key Performance Indicators (KPIs) of healthcare, in the province of Alberta in Canada. Drawing from data collected by Government of Alberta's Department of Health and Wellness, this research examines two key questions: (1) Do people in the 65+ age group rate the KPIs of healthcare (i.e., availability, accessibility, quality, outcome, and satisfaction) more favorably compared to people in younger age groups in Alberta? (2) Does the rating of KPIs of healthcare in Alberta vary with different chronic conditions (i.e., no chronic problem, chronic illnesses without pain, and chronic pain)? The findings indicate that people in the older age group tend to rate the KPIs of healthcare more favorably compared to younger age groups in Alberta, net of socio-demographic factors, self-reported health status, and knowledge and utilization of health services. However, people experiencing chronic pain are less likely to rate the KPIs of healthcare favorably compared to people with no chronic health problem in Alberta. Discussion includes implications of the findings for the healthcare system in the province.

  14. Chronic effects assessment and plasma concentrations of the {beta}-blocker propranolol in fathead minnows (Pimephales promelas)

    Energy Technology Data Exchange (ETDEWEB)

    Giltrow, Emma [Institute for the Environment, Brunel University, Uxbridge, Middlesex UB8 3PH (United Kingdom); Eccles, Paul D. [Institute for the Environment, Brunel University, Uxbridge, Middlesex UB8 3PH (United Kingdom); Biosciences, School of Health Sciences and Social Care, Brunel University, Uxbridge, Middlesex UB8 3PH (United Kingdom); Winter, Matthew J.; McCormack, Paul J. [AstraZeneca Safety, Health and Environment, Brixham Environmental Laboratory, Freshwater Quarry, Brixham, Devon TQ5 8BA (United Kingdom); Rand-Weaver, Mariann [Biosciences, School of Health Sciences and Social Care, Brunel University, Uxbridge, Middlesex UB8 3PH (United Kingdom); Hutchinson, Thomas H. [Natural Environmental Research Council, Plymouth Marine Laboratory, Prospect Place, The Hoe, Plymouth PL1 3DH (United Kingdom); Sumpter, John P., E-mail: john.sumpter@brunel.ac.uk [Institute for the Environment, Brunel University, Uxbridge, Middlesex UB8 3PH (United Kingdom)

    2009-11-27

    The presence of many human pharmaceuticals in the aquatic environment is now a worldwide concern, yet little is known of the chronic effects that these bioactive substances may be having on aquatic organisms. Propranolol, a non-specific beta adrenoreceptor blocker ({beta}-blocker), is used to treat high blood pressure and heart disease in humans. Propranolol has been found in surface waters worldwide at concentrations ranging from 12 to 590 ng/L. To test the potential for ecologically relevant effects in fish in receiving waters, short-term (21 days) adult reproduction studies were conducted, in which fathead minnows were exposed to nominal concentrations of propranolol hydrochloride [CAS number 318-98-9] ranging from 0.001 to 10 mg/L (measured concentrations typically from 78 to 130%). Exposure of fish to 3.4 mg/L (measured) over 3 days caused 100% mortality or severe toxicity requiring euthanasia. The most sensitive endpoints from the studies were a decrease in hatchability (with regard to the number of days to hatch) and a concentration-related increase in female gonadal somatic index (GSI), giving LOEC{sup hatchability} and LOEC{sup female} {sup GSI} values of 0.1 mg/L. Concentration-related decreases in weights of male fish were also observed, with LOEC{sup m}ale wet weight value of 1.0 mg/L, and the LOEC{sup r}eproduction value was 1.0 mg/L. Collectively, these data do not suggest that propranolol was acting as a reproductive toxin. Plasma concentrations of propranolol in male fish exposed to nominal concentrations of 0.1 and 1.0 mg/L were 0.34 and 15.00 mg/L, respectively, which constitutes 436 and 1546% of measured water concentrations. These compare with predicted concentrations of 0.07 and 0.84 mg/L, and thus to a degree support the use of partition coefficient models for predicting concentrations in plasma in fish. In addition, propranolol plasma concentrations in fish exposed to water concentrations of 0.1 and 1.0 mg/L were greater than the human

  15. Chronic effects assessment and plasma concentrations of the β-blocker propranolol in fathead minnows (Pimephales promelas)

    International Nuclear Information System (INIS)

    Giltrow, Emma; Eccles, Paul D.; Winter, Matthew J.; McCormack, Paul J.; Rand-Weaver, Mariann; Hutchinson, Thomas H.; Sumpter, John P.

    2009-01-01

    The presence of many human pharmaceuticals in the aquatic environment is now a worldwide concern, yet little is known of the chronic effects that these bioactive substances may be having on aquatic organisms. Propranolol, a non-specific beta adrenoreceptor blocker (β-blocker), is used to treat high blood pressure and heart disease in humans. Propranolol has been found in surface waters worldwide at concentrations ranging from 12 to 590 ng/L. To test the potential for ecologically relevant effects in fish in receiving waters, short-term (21 days) adult reproduction studies were conducted, in which fathead minnows were exposed to nominal concentrations of propranolol hydrochloride [CAS number 318-98-9] ranging from 0.001 to 10 mg/L (measured concentrations typically from 78 to 130%). Exposure of fish to 3.4 mg/L (measured) over 3 days caused 100% mortality or severe toxicity requiring euthanasia. The most sensitive endpoints from the studies were a decrease in hatchability (with regard to the number of days to hatch) and a concentration-related increase in female gonadal somatic index (GSI), giving LOEC hatchability and LOEC female GSI values of 0.1 mg/L. Concentration-related decreases in weights of male fish were also observed, with LOEC m ale wet weight value of 1.0 mg/L, and the LOEC r eproduction value was 1.0 mg/L. Collectively, these data do not suggest that propranolol was acting as a reproductive toxin. Plasma concentrations of propranolol in male fish exposed to nominal concentrations of 0.1 and 1.0 mg/L were 0.34 and 15.00 mg/L, respectively, which constitutes 436 and 1546% of measured water concentrations. These compare with predicted concentrations of 0.07 and 0.84 mg/L, and thus to a degree support the use of partition coefficient models for predicting concentrations in plasma in fish. In addition, propranolol plasma concentrations in fish exposed to water concentrations of 0.1 and 1.0 mg/L were greater than the human therapeutic plasma concentration

  16. Assessment of antibacterial effect of cinnamon on growth of porphyromons gingivalis from chronic periodontitis patients with deep pockets (in vitro

    Directory of Open Access Journals (Sweden)

    Babak Amoian

    2014-04-01

    Full Text Available   Background and Aims : Antibiotics are commonly used for controlling the growth of porphyromons gingivalis (P.g which is one of the most important etiologic factors in the periodontal diseases. Different side effects of synthetics and chemical drugs such as increasing the drug resistancy in the human pathogens have led to study on the herbal antibacterial effect. The aim of this study was to evaluate the antibacterial effect of cinnamon on the growth of porphyromons gingivalis in chronic periodontitis patients with deep pockets.   Materials and Methods: In this experimental study, samples were provided from patients having pockets. After culturing the microorganism and diagnosis of P.g by gram staining and biochemical tests, cinnamon in different concentrations (10, 50, 100, 250, 500, 750 and 1500 mg/ml with oil solvent were prepared and placed by disks in the cultures medium. Positive controls were amoxicillin, metronidazole, ciprofloxacin, amikacin and gentamycin . Oil was negative control. Then the plates were incubated for 24 hours in 37 0 C and then non-growth halos by disk diffusion method, MIC (Minimum Inhibitory Concentration and MBC (Minimum Bactericidal Concentration were determined. Data were analyzed using One-way ANOVA test.   Results: The results showed that the cinnamon at the concentration of MIC=750 mg/ml had the inhibitory effects of bacteria and at the concentration of MIC=1500 mg/ml had killing effect. However, this antibacterial effect compared with commonly used antibiotics (amoxicillin, metronidazole, was much weaker (P<0.001.   Conclusion: Cinnamon showed an antimicrobial effect on porphyromonas gingivalis in chronic periodontitis patients with deep pockets.

  17. Effect of chronic smoking on lens nucleus as assessed by Pentacam HR lens densitometry in young adults.

    Science.gov (United States)

    Pekel, Gökhan; Cetin, Ebru Nevin; Acer, Semra; Yagci, Ramazan; Altintas, Seher; Ongun, Gülin Tugba

    2014-06-01

    To evaluate the effects of chronic tobacco smoking on lens nucleus by Pentacam HR lens densitometry (LD) in young adults. Prospective cross-sectional case series. Thirty subjects (23 M, 7 F) who were chronic cigarette smokers (≥10 cigarettes/day for at least 2 years) (group 1) and another 30 subjects (23 M, 7 F) who did not smoke (group 2), were included in this study. The patients were matched for age and sex between the groups. The exclusion criteria were any history of ocular surgery, any systemic disorders and any ocular diseases except for mild refractive disorders. Lens densitometry measurements were done with the Pentacam HR (Oculus, Wetzlar, Germany). The Schirmer test and pachymetry measurements were also performed. Mean age of the patients for both groups was 28.90 ± 8.20 years (range: 18-40 years). Mean lens densitometry (LD) measurements of Group 1 (chronic cigarette smoking group) were higher than those of Group 2 (control group) in all LD techniques; however only mean "peak" LD measurements showed a statistically significant difference between these two groups (Group 1: 8.67 ± 0.61, Group 2: 8.44 ± 0.70, p = 0.04). The mean Schirmer test value was 12.43 ± 5.60 mm in Group 1 and 13.00 ± 4.26 mm in Group 2 (p = 0.55). The mean central corneal thickness (CCT) value was 564.23 ± 34.61 µm in Group 1 and 550.47 ± 32.94 µm in Group 2 (p = 0.03). The Pentacam HR LD seems to be an important option for the evaluation of lens nucleus in young adults, because it gives objective and quantitative data. Although chronic smoking increases lens nucleus density in young adults, the effect is not statistically significant when compared with the control group.

  18. TOWARDS RELIABLE AND COST-EFFECTIVE OZONE EXPOSURE ASSESSMENT: PARAMETER EVALUATION AND MODEL VALIDATION USING THE HARVARD SOUTHERN CALIFORNIA CHRONIC OZONE EXPOSURE STUDY DATA

    Science.gov (United States)

    Accurate assessment of chronic human exposure to atmospheric criteria pollutants, such as ozone, is critical for understanding human health risks associated with living in environments with elevated ambient pollutant concentrations. In this study, we analyzed a data set from a...

  19. Assessing the quality, efficacy, and effectiveness of the current evidence base of active self-care complementary and integrative medicine therapies for the management of chronic pain: a rapid evidence assessment of the literature.

    Science.gov (United States)

    Delgado, Roxana; York, Alexandra; Lee, Courtney; Crawford, Cindy; Buckenmaier, Chester; Schoomaker, Eric; Crawford, Paul

    2014-04-01

    Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures that are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management. Active self-care CIM (ACT-CIM) therapies allow for a more diverse, patient-centered treatment of complex symptoms, promote self-management, and are relatively safe and cost-effective. To date, there are no systematic reviews examining the full range of ACT-CIM used for chronic pain symptom management. A systematic review was conducted, using Samueli Institute's Rapid Evidence Assessment of the Literature methodology, to rigorously assess both the quality of the research on ACT-CIM modalities and the evidence for their efficacy and effectiveness in treating chronic pain symptoms. A working group of subject matter experts was also convened to evaluate the overall literature pool and develop recommendations for the use and implementation of these modalities. Following key database searches, 146 randomized controlled trials were included in the review. This article provides an introduction and background to the review, summarizes the methodological processes involved, details the initial results, and identifies strengths and weakness of the review. Specific results of the review as well as overall recommendations for moving this field of research forward are detailed throughout the current Pain Medicine supplement. Wiley Periodicals, Inc.

  20. Effect of lung volume on airway luminal area assessed by computed tomography in chronic obstructive pulmonary disease.

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    Kenta Kambara

    Full Text Available BACKGROUND: Although airway luminal area (Ai is affected by lung volume (LV, how is not precisely understood. We hypothesized that the effect of LV on Ai would differ by airway generation, lung lobe, and chronic obstructive pulmonary disease (COPD severity. METHODS: Sixty-seven subjects (15 at risk, 18, 20, and 14 for COPD stages 1, 2, and 3 underwent pulmonary function tests and computed tomography scans at full inspiration and expiration (at functional residual capacity. LV and eight selected identical airways were measured in the right lung. Ai was measured at the mid-portion of the 3(rd, the segmental bronchus, to 6(th generation of the airways, leading to 32 measurements per subject. RESULTS: The ratio of expiratory to inspiratory LV (LV E/I ratio and Ai (Ai E/I ratio was defined for evaluation of changes. The LV E/I ratio increased as COPD severity progressed. As the LV E/I ratio was smaller, the Ai E/I ratio was smaller at any generation among the subjects. Overall, the Ai E/I ratios were significantly smaller at the 5(th (61.5% and 6(th generations (63.4% and than at the 3(rd generation (73.6%, p<0.001 for each, and also significantly lower in the lower lobe than in the upper or middle lobe (p<0.001 for each. And, the Ai E/I ratio decreased as COPD severity progressed only when the ratio was corrected by the LV E/I ratio (at risk v.s. stage 3 p<0.001, stage 1 v.s. stage 3 p<0.05. CONCLUSIONS: From full inspiration to expiration, the airway luminal area shrinks more at the distal airways compared with the proximal airways and in the lower lobe compared with the other lobes. Generally, the airways shrink more as COPD severity progresses, but this phenomenon becomes apparent only when lung volume change from inspiration to expiration is taken into account.

  1. Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients.

    Science.gov (United States)

    Asemi, Zatollah; Soleimani, Alireza; Bahmani, Fereshteh; Shakeri, Hossein; Mazroii, Navid; Abedi, Fatemeh; Fallah, Melika; Mohammadi, Ali Akbar; Esmaillzadeh, Ahmad

    2016-02-01

    This study was conducted to determine the effects of omega-3 fatty acid plus vitamin E supplementation on subjective global assessment (SGA) score and metabolic profiles in chronic hemodialysis (HD) patients. This randomized double-blind placebo-controlled clinical trial was conducted among 120 chronic HD patients. Participants were randomly divided into four groups to receive: (i) 1250 mg/day omega-3 fatty acid containing 600 mg eicosapentaenoic acid and 300 mg docosahexaenoic acid + vitamin E placebo (n = 30), (ii) 400 IU/day vitamin E + omega-3 fatty acids placebo (n = 30), (iii) 1250 mg omega-3 fatty acids/day + 400 IU/day vitamin E (n = 30), and (iv) omega-3 fatty acids placebo + vitamin E placebo (n = 30) for 12 wk. Fasting blood samples were taken at baseline and after 12-wk intervention to measure metabolic profiles. Patients who received combined omega-3 fatty acids and vitamin E supplements compared with vitamin E, omega-3 fatty acids, and placebo had significantly decreased SGA score (p acids plus vitamin E supplementation for 12 wk among HD patients had beneficial effects on SGA score and metabolic profiles. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Assessing the effectiveness of ‘pulse radiofrequency treatment of dorsal root ganglion’ in patients with chronic lumbar radicular pain: study protocol for a randomized control trial

    Directory of Open Access Journals (Sweden)

    Shanthanna Harsha

    2012-04-01

    Full Text Available Abstract Background Chronic lumbar radicular pain can be described as neuropathic pain along the distribution of a particular nerve root. The dorsal root ganglion has been implicated in its pathogenesis by giving rise to abnormal impulse generation as a result of irritation, direct compression and sensitization. Chronic lumbar radicular pain is commonly treated with medications, physiotherapy and epidural steroid injections. Epidural steroid injections are associated with several common and rarer side effects such as spinal cord infarction and death. It is essential and advantageous to look for alternate interventions which could be effective with fewer side effects. Pulse radio frequency is a relatively new technique and is less destructive then conventional radiofrequency. Safety and effectiveness of pulse radio frequency in neuropathic pain has been demonstrated in animal and humans studies. Although its effects on dorsal root ganglion have been studied in animals there is only one randomized control trial in literature demonstrating its effectiveness in cervical radicular pain and none in lumbar radicular pain. Our primary objective is to study the feasibility of a larger trial in terms of recruitment and methodology. Secondary objectives are to compare the treatment effects and side effects. Methods/designs This is a single-center, parallel, placebo-controlled, triple-blinded (patients, care-givers, and outcome assessors, randomized control trial. Participants will have a history of chronic lumbar radicular pain for at least 4 months in duration. Once randomized, all patients will have an intervention involving fluoroscopy guided needle placement to appropriate dorsal root ganglion. After test stimulation in both groups; the study group will have a pulse radio frequency treatment at 42°C for 120 s to the dorsal root ganglion, with the control group having only low intensity test stimulation for the same duration. Primary outcome is to

  3. Assessment of direct analgesic effect of duloxetine for chronic low back pain: post hoc path analysis of double-blind, placebo-controlled studies

    Directory of Open Access Journals (Sweden)

    Enomoto H

    2017-06-01

    Full Text Available Hiroyuki Enomoto,1 Shinji Fujikoshi,2 Jumpei Funai,3 Nao Sasaki,4 Michael H Ossipov,5 Toshinaga Tsuji,6 Levent Alev,7 Takahiro Ushida8 1Medical Science, Eli Lilly Japan K.K., Tokyo, 2Statistical Science, 3Science Communications, 4Medical Science, Eli Lilly Japan K.K., Kobe, Japan; 5Clinical Division, inVentiv Health, LLC, Blue Bell, PA, USA; 6Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan; 7Medical Department, Lilly Turkey, Istanbul, Turkey; 8Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Aichi, Japan Background: Comorbid depression and depressive symptoms are common in patients with chronic low back pain (CLBP. Duloxetine is clinically effective in major depressive disorder and several chronic pain states, including CLBP. The objective of this post hoc meta-analysis was to assess direct and indirect analgesic efficacy of duloxetine for patients with CLBP in previous clinical trials. Methods: Post hoc path analyses were conducted of 3 randomized, double-blind, clinical studies of patients receiving duloxetine or placebo for CLBP. The primary outcome measure for pain was the Brief Pain Inventory, average pain score. A secondary outcome measure, the Beck Depression Inventory-II, was used for depressive symptoms. The changes in score from baseline to endpoint were determined for each index. Path analyses were employed to calculate the proportion of analgesia that may be attributed to a direct effect of duloxetine on pain.Results: A total of 851 patients (400 duloxetine and 451 placebo were included in this analysis. Duloxetine significantly improved pain scores compared with placebo (p<0.001. It also significantly improved depressive scores compared with placebo (p=0.015. Path analyses showed that 91.1% of the analgesic effect of duloxetine could be attributed to a direct analgesic effect, and 8.9% to its antidepressant effect. Similar results were obtained when data were evaluated at weeks 4 and 7, and when

  4. Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index.

    Science.gov (United States)

    Mammen, Jerry; Vadakkekuttical, Rosamma Joseph; George, Joseraj Manaloor; Kaziyarakath, Jaishid Ahadal; Radhakrishnan, Chandni

    2017-08-01

    A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis. © 2016 John Wiley & Sons Australia, Ltd.

  5. Negative effects of chronic oral chlorpromazine and olanzapine treatment on the performance of tasks designed to assess spatial learning and working memory in rats.

    Science.gov (United States)

    Terry, A V; Warner, S E; Vandenhuerk, L; Pillai, A; Mahadik, S P; Zhang, G; Bartlett, M G

    2008-10-28

    Learning potential and memory capacity are factors that strongly predict the level of rehabilitation and the long-term functional outcome in patients with schizophrenia. Unfortunately, however, the effects of antipsychotic drugs (i.e. the primary treatments for schizophrenia) on these components of cognition are unclear, particularly when they are administered chronically (i.e. a standard clinical practice). In this rodent study we evaluated the effects of different time periods (ranging from 2 weeks to 6 months) of oral treatment with the first generation antipsychotic chlorpromazine (10.0 mg/kg/day), or the second generation antipsychotic olanzapine (10.0 mg/kg/day) on the repeated acquisition of a water maze task (i.e. a method of assessing spatial learning potential in a repeated testing format). We assessed locomotor function (in an open field) and employed a radial arm maze (RAM) task to assess antipsychotic effects (5.0 and 10.0 mg/kg/day doses) on spatial working memory during the treatment period between 15 days and 2 months. Finally, we conducted experiments using liquid chromatography/tandem mass spectrometry (LC-MS/MS) to evaluate the therapeutic relevance of our method of drug delivery (oral administration in drinking water). In the water maze experiments, both antipsychotics were associated with impairments in acquisition in the earlier test sessions that could eventually be overcome with repeated testing while olanzapine also impaired retention in probe trials. Both antipsychotics were also associated with impairments in delayed non-match-to-position trials in the RAM and some impairments of motor function (especially in the case of olanzapine) as indicated by slightly reduced swim speeds in the water maze and decreased activity in some components of the open field assessment. Finally, LC-MS/MS studies indicated that the method of antipsychotic administration generated clinically relevant plasma levels in the rat. These animal data indicate that

  6. Health Technology Assessment of the Negative Pressure Wound Therapy for the treatment of acute and chronic wounds: efficacy, safety, cost effectiveness, organizational and ethical impact

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2012-06-01

    Full Text Available

    Background: the aim of the study was to assess the safety, efficacy and cost-effectiveness of negative Pressure wound therapy (nPT for people with chronic and acute wounds.

    Methods: the scope and the final draft of the report have been submitted to the stakeholders (producers, payers and patients. safety issues were addressed through a systematic review of the meta-literature. efficacy was addressed through a systematic review and meta-analysis of randomized controlled trials (rcTs comparing nPT and other standard therapies in patients with chronic or acute lesions. cost-consequence was analyzed through a systematic review of the existing studies.

    Results: we retrieved 19 studies, 13 of which were included in the meta-analysis. Many studies had biases that may have resulted in a better performance for nPT. nPT showed: a slightly shorter healing time (-10.4 days, p=0.001, with no heterogeneity, apart from one small study with very positive results, and 40% more patients healed (p=0.002, no heterogeneity.We identified 15 original research papers on nPT costs and cost per outcome. The costs-per-patient- treated varied from +29% to -60%, with several studies reporting savings for nPT.

    Conclusions: despite serious methodological flaws, the body of evidence available was sufficient to prove some clinical benefit of nPT in severe chronic and acute wound treatment. There is a need for independent and contextualized cost analyses....

  7. Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease.

    Science.gov (United States)

    Ho, Yi-Lwun; Yu, Jiun-Yu; Lin, Yen-Hung; Chen, Ying-Hsien; Huang, Ching-Chang; Hsu, Tse-Pin; Chuang, Pao-Yu; Hung, Chi-Sheng; Chen, Ming-Fong

    2014-06-10

    Telehealth programs are a growing field in the care of patients. The evolution of information technology has resulted in telehealth becoming a fourth-generation synchronous program. However, long-term outcomes and cost-effectiveness analysis of fourth-generation telehealth programs have not been reported in patients with chronic cardiovascular diseases. We conducted this study to assess the clinical outcomes and cost-effectiveness of a fourth-generation synchronous telehealth program for patients with chronic cardiovascular diseases. We retrospectively analyzed 575 patients who had joined a telehealth program and compared them with 1178 patients matched for sex, age, and Charlson comorbidity index. The program included: (1) instant transmission of biometric data, (2) daily telephone interview, and (3) continuous decision-making support. Data on hospitalization, emergency department (ED) visits, and medical costs were collected from the hospital's database and were adjusted to the follow-up months. The mean age was 64.5 years (SD 16.0). The mean number of monthly ED visits (mean 0.06 SD 0.13 vs mean 0.09 SD 0.23, P<.001), hospitalizations (mean 0.05 SD 0.12 vs mean 0.11 SD 0.21, P<.001), length of hospitalization (mean 0.77 days SD 2.78 vs mean 1.4 SD 3.6, P<.001), and intensive care unit admissions (mean 0.01 SD 0.07 vs mean 0.036 SD 0.14, P<.001) were lower in the telehealth group. The monthly mean costs of ED visits (mean US$20.90 SD 66.60 vs mean US$37.30 SD 126.20, P<.001), hospitalizations (mean US$386.30 SD 1424.30 vs mean US$878.20 SD 2697.20, P<.001), and all medical costs (mean US$587.60 SD 1497.80 vs mean US$1163.60 SD 3036.60, P<.001) were lower in the telehealth group. The intervention costs per patient were US$224.80 per month. Multivariate analyses revealed that age, telehealth care, and Charlson index were the independent factors for ED visits, hospitalizations, and length of hospitalization. A bootstrap method revealed the dominant cost-effectiveness

  8. Health Effects of Chronic Arsenic Exposure

    Directory of Open Access Journals (Sweden)

    Young-Seoub Hong

    2014-09-01

    Full Text Available Arsenic is a unique element with distinct physical characteristics and toxicity whose importance in public health is well recognized. The toxicity of arsenic varies across its different forms. While the carcinogenicity of arsenic has been confirmed, the mechanisms behind the diseases occurring after acute or chronic exposure to arsenic are not well understood. Inorganic arsenic has been confirmed as a human carcinogen that can induce skin, lung, and bladder cancer. There are also reports of its significant association to liver, prostate, and bladder cancer. Recent studies have also suggested a relationship with diabetes, neurological effects, cardiac disorders, and reproductive organs, but further studies are required to confirm these associations. The majority of research to date has examined cancer incidence after a high exposure to high concentrations of arsenic. However, numerous studies have reported various health effects caused by chronic exposure to low concentrations of arsenic. An assessment of the health effects to arsenic exposure has never been performed in the South Korean population; thus, objective estimates of exposure levels are needed. Data should be collected on the biological exposure level for the total arsenic concentration, and individual arsenic concentration by species. In South Korea, we believe that biological exposure assessment should be the first step, followed by regular health effect assessments.

  9. Early chronic obstructive pulmonary disease: definition, assessment, and prevention.

    Science.gov (United States)

    Rennard, Stephen I; Drummond, M Bradley

    2015-05-02

    Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. COPD, however, is a heterogeneous collection of diseases with differing causes, pathogenic mechanisms, and physiological effects. Therefore a comprehensive approach to COPD prevention will need to address the complexity of COPD. Advances in the understanding of the natural history of COPD and the development of strategies to assess COPD in its early stages make prevention a reasonable, if ambitious, goal. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Assessing nutritional status in children with chronic liver disease.

    Science.gov (United States)

    Taylor, Rachel M; Dhawan, Anil

    2005-12-01

    The metabolic changes compounded by anorexia associated with chronic liver disease adversely affect growth in children. In many cases, this requires the administration of artificial nutritional support. It is important in this group of patients that those who are becoming nutritionally depleted are identified quickly and in those receiving artificial nutritional support, the effectiveness is monitored. The current review is an examination of methods available to assess nutritional status. These include anthropometry, methods available in the laboratory and a selection of less commonly used methods undergoing evaluation at research level. A brief discussion accompanies each technique, outlining the limitations of its use in children with chronic liver disease. The review concludes with an outline of how nutritional status should be assessed in this group of children, and suggests further research.

  11. Chronic pelvic pain: Pathogenesis and validated assessment

    Directory of Open Access Journals (Sweden)

    Ali Yosef

    2016-12-01

    Full Text Available Chronic pelvic pain (CPP is a disabling disease that causes distress as the quality of life of CPP patients is vastly diminished. In addition, CPP is a public health crisis and is a burden on healthcare expenditure. In the United States, the annual costs for the diagnosis and treatment of CPP are 2.8 billion US $. Moreover, to the indirect cost resulting from the absence from work and CPP associated family problems add 550 million US $ more making the economic burden more than 3.4 billion US $ (Mathias et al., 1996. Yet, the diagnosis of CPP is usually complicated as there are no gold standard guidelines that clearly define this syndrome. Although we have a limited understanding of its etiology, CPP has been found to be correlated with central sensitization, painful bladder syndrome, irritable bowel syndrome, endometriosis and adhesions. As such, in the evaluation of patients, it is imperative to take a comprehensive patient history. Performing physical examinations and ultrasound imaging is of particular value to elucidate the etiology of pain. As CPP patients are at risk for psychological disorders, psychological assessments are critical to diagnose associated psychological disorders and to take these into account in planning a holistic treatment plan for patients. By such evaluation techniques, we can provide better diagnostic service and patient care to people with CPP.

  12. Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial.

    Science.gov (United States)

    Kimura, Genjiro; Kasahara, Masato; Ueshima, Kenji; Tanaka, Sachiko; Yasuno, Shinji; Fujimoto, Akira; Sato, Toshiya; Imamoto, Miyuki; Kosugi, Shinji; Nakao, Kazuwa

    2017-06-01

    Dyslipidemia is a risk factor for the progression of chronic kidney disease (CKD). While conventional lipid lowering therapy provides a benefit to CKD management, the effect of statins on eGFR remains unclear. A prospective, multi-center, open-labeled, randomized trial. Total of 349 CKD patients with hyperlipidemia were randomized into 2 groups, and followed for 2 years. Group A included patients who were treated with atorvastatin. Group C were treated with conventional lipid lowering drugs other than statin. Primary endpoint was changes in eGFR. Secondary endpoints included changes in urinary albumin excretion, serum LDL-C, serum triglyceride, cardio-vascular events and all-cause mortality. As the primary endpoint, eGFR decreased by 2.3 ml/min/1.73 m 2 in Group A and by 2.6 ml/min/1.73 m 2 in Group C, indicating that there was no difference in change of eGFR between the two groups. As secondary endpoints, atorvastatin succeeded to reduce serum LDL-C level significantly and rapidly, but conventional therapy did not. In fact, mean LDL-C level did not reach the target level of 100 mg/dl in Group C. Serum triglyceride was lowered only by atorvastatin, but not conventional drugs. The number of cardiovascular events and all-cause mortality did not differ between in two groups. The ASUCA (Assessment of Clinical Usefulness in CKD Patients with Atorvastatin) trial demonstrated that atorvastatin failed to exhibit reno-protections compared to conventional therapy in Japanese patients with dyslipidemia and CKD. It would be due in part to the ability of atorvastatin to more potently reduce serum LDL and triglycerides compared to conventional therapy.

  13. Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

    Science.gov (United States)

    Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

    2002-04-01

    Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

  14. Chronic in vivo stability assessment of carbon fiber microelectrode arrays

    Science.gov (United States)

    Patel, Paras R.; Zhang, Huanan; Robbins, Matthew T.; Nofar, Justin B.; Marshall, Shaun P.; Kobylarek, Michael J.; Kozai, Takashi D. Y.; Kotov, Nicholas A.; Chestek, Cynthia A.

    2016-12-01

    Objective. Individual carbon fiber microelectrodes can record unit activity in both acute and semi-chronic (∼1 month) implants. Additionally, new methods have been developed to insert a 16 channel array of carbon fiber microelectrodes. Before assessing the in vivo long-term viability of these arrays, accelerated soak tests were carried out to determine the most stable site coating material. Next, a multi-animal, multi-month, chronic implantation study was carried out with carbon fiber microelectrode arrays and silicon electrodes. Approach. Carbon fibers were first functionalized with one of two different formulations of PEDOT and subjected to accelerated aging in a heated water bath. After determining the best PEDOT formula to use, carbon fiber arrays were chronically implanted in rat motor cortex. Some rodents were also implanted with a single silicon electrode, while others received both. At the end of the study a subset of animals were perfused and the brain tissue sliced. Tissue sections were stained for astrocytes, microglia, and neurons. The local reactive responses were assessed using qualitative and quantitative methods. Main results. Electrophysiology recordings showed the carbon fibers detecting unit activity for at least 3 months with average amplitudes of ∼200 μV. Histology analysis showed the carbon fiber arrays with a minimal to non-existent glial scarring response with no adverse effects on neuronal density. Silicon electrodes showed large glial scarring that impacted neuronal counts. Significance. This study has validated the use of carbon fiber microelectrode arrays as a chronic neural recording technology. These electrodes have demonstrated the ability to detect single units with high amplitude over 3 months, and show the potential to record for even longer periods. In addition, the minimal reactive response should hold stable indefinitely, as any response by the immune system may reach a steady state after 12 weeks.

  15. Effect of Chronic Alcohol Consumption on Phosphatidylcholine ...

    African Journals Online (AJOL)

    Effect of Chronic Alcohol Consumption on Phosphatidylcholine Hydroperoxide Content of Rat Liver and Brain. ... one group was given 20 % ethanol (5 g/kg) and the other the same volume of normal saline, orally once a day for 6 weeks.

  16. Effect of hemodialysis on total antioxidant status of chronic renal ...

    African Journals Online (AJOL)

    Background: Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species and impaired antioxidant defense. Aim: To assess the effect of hemodialysis (by cellulose membrane dialyzer) on plasma total antioxidant status and lipid peroxidation of patients in chronic ...

  17. The importance of psychological assessment in chronic pain.

    Science.gov (United States)

    Williams, David A

    2013-11-01

    Much confusion has surrounded the purpose of the psychological assessment in the context of chronic pain. For many clinicians, the psychological assessment is used to rule out psychiatric illness and to identify the nonmedical causes for pain and disability. In essence, it is used to identify the causes of pain that fall outside of the biomedical model. Supported by over 30 years of evidence, the bio-psycho-social model acknowledges that psychosocial factors are inherent in chronic pain and require assessment if meaningful diagnostics and treatments are to occur. Five broad categories of psychosocial assessment are relevant to chronic pain. These categories have been shown to enhance the diagnosis of the underlying forms of pain, predict the transition from acute to chronic status, and help to phenotype individuals for the discovery of the underlying mechanisms responsible for pain. Informed assessment of chronic pain needs to include relevant biological, psychological, and social domains. This article describes those domains and offers suggestions of specific instruments to use in clinical or research settings.

  18. The effects of chronic marijuana use on circadian entrainment.

    Science.gov (United States)

    Whitehurst, Lauren N; Fogler, Kethera; Hall, Kate; Hartmann, Matthew; Dyche, Jeff

    2015-05-01

    Animal literature suggests a connection between marijuana use and altered circadian rhythms. However, the effect has not yet been demonstrated in humans. The present study examined the effect of chronic marijuana use on human circadian function. Participants consisted of current users who reported smoking marijuana daily for at least a year and non-marijuana user controls. Participants took a neurocognitive assessment, wore actigraphs and maintained sleep diaries for three weeks. While no significant cognitive changes were found between groups, data revealed that chronic marijuana use may act as an additional zeitgeber and lead to increased entrainment in human users.

  19. Psychological Characteristics of Chronic Pain: a Review of Current Evidence and Assessment Tools to Enhance Treatment.

    Science.gov (United States)

    Miller, Rhondene M; Kaiser, Ronald S

    2018-03-14

    The complicated nature of chronic pain involves an interplay between psychological and physical factors, often resulting in increased emotional distress and reduced quality of life. This review is designed to help the medical practitioner who is working with chronic pain patients to be aware of psychological assessment techniques that can add to comprehensive patient understanding and more effectively guide treatment. Enhanced ability to assess and understand the emotional life of the chronic pain patient provides a basis for intervening and treating more successfully. There are a broad range of assessment techniques, some of which require a background in psychology and some that do not, that can identify psychological differences in chronic pain patients and serve to guide intervention strategies. Chronic pain is often comorbid with depression, anxiety, catastrophizing, and various ineffective coping strategies. Some patients, however, have demonstrated more adaptive and effective strategies for cognitively and behaviorally coping with pain and normalizing their lives. Proper assessment enables the individualization of treatment to overcome and/or build upon each patient's psychological frame of mind to maximize the potential for effective functioning. The use of standardized and documented psychological assessment techniques can lead to a better understanding of chronic pain patients and contribute in ways that can enhance response to medical treatment and improve quality of life. It is recommended that certain psychological tools be included to supplement the medical assessment of patients who have chronic pain. A basic assessment can include a short psychological-based clinical interview along with brief measures of depression, anxiety, and coping strategies. It is also recommended that the pain physician have access to professional psychological practitioners as a resource for more complicated assessments and psychological intervention services.

  20. Effect of chronic nonmalignant pain on highway driving performance.

    Science.gov (United States)

    Veldhuijzen, D S; van Wijck, A J M; Wille, F; Verster, J C; Kenemans, J L; Kalkman, C J; Olivier, B; Volkerts, E R

    2006-05-01

    Most pain patients are treated in an outpatient setting and are engaged in daily activities including driving. Since several studies showed that cognitive functioning may be impaired in chronic nonmalignant pain, the question arises whether or not chronic nonmalignant pain affects driving performance. Therefore, the objective of the present study was to determine the effects of chronic nonmalignant pain on actual highway driving performance during normal traffic. Fourteen patients with chronic nonmalignant pain and 14 healthy controls, matched on age, educational level, and driving experience, participated in the study. Participants performed a standardized on-the-road driving test during normal traffic, on a primary highway. The primary parameter of the driving test is the Standard Deviation of Lateral Position (SDLP). In addition, driving-related skills (tracking, divided attention, and memory) were examined in the laboratory. Subjective assessments, such as pain intensity, and subjective driving quality, were rated on visual analogue scales. The results demonstrated that a subset of chronic nonmalignant pain patients had SDLPs that were higher than the matched healthy controls, indicating worse highway driving performance. Overall, there was a statistically significant difference in highway driving performance between the groups. Further, chronic nonmalignant pain patients rated their subjective driving quality to be normal, although their ratings were significantly lower than those of the healthy controls. No significant effects were found on the laboratory tests.

  1. Health effects assessment summary tables

    International Nuclear Information System (INIS)

    1999-01-01

    The document is an excellent pointer system to identify current literature or changes in assessment criteria for many chemicals of interest to Superfund. It was prepared for Superfund use by the Environmental Criteria and Assessment Office (ECAO-Cin) in EPA's Office of Health and Environmental Assessment. Chemicals considered are those for which Health Effects Assessment Documents, Health and Environmental Effects Profiles, Health Assessment Documents or Air Quality Criteria Documents have been prepared by ECAO. Radionuclides considered are those believed to be most common at Superfund sites. Tables summarize reference doses (RfDs) for toxicity from subchronic and chronic inhalation, oral exposure, slope factors and unit risk values for carcinogenicity based on lifetime inhalation and oral exposure, and radionuclide carcinogenicity

  2. Effects of chronic cocaine abuse on postsynaptic dopamine receptors

    International Nuclear Information System (INIS)

    Volkow, N.D.; Fowler, J.S.; Wolf, A.P.; Schlyer, D.; Shiue, C.Y.; Alpert, R.; Dewey, S.L.; Logan, J.; Bendriem, B.; Christman, D.

    1990-01-01

    To assess the effects of chronic cocaine intoxication on dopamine receptors in human subjects, the authors evaluated [ 18 F]N-methylspiroperidol binding using positron emission tomography in 10 cocaine abusers and 10 normal control subjects. Cocaine abusers who had been detoxified for 1 week or less showed significantly lower values for uptake of [ 18 F]N-methylspiroperidol in striatum than the normal subjects, whereas the cocaine abusers who had been detoxified for 1 month showed values comparable to those obtained from normal subjects. The authors conclude that postsynaptic dopamine receptor availability decreases with chronic cocaine abuse but may recover after a drug-free interval

  3. A randomised, double blind, placebo-controlled, multi-centric parallel arm trial to assess the effects of homoeopathic medicines on chronic rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2014-01-01

    Full Text Available Background: Chronic rhinosinusitis (CRS is one of the most common illnesses interfering with patient′s quality of life and work. Observational studies conducted by the Council indicate positive outcome. This protocol has been developed to ascertain the usefulness of homoeopathic intervention in comparison with control group in a randomised control setting. Objectives: Primary objective is to evaluate the changes in TSS (Total Symptoms Score and SNOT-22 (Sino-nasal Outcome Test-22 within the two groups of the study (Homoeopathy + Placebo. Secondary objective is to evaluate changes in SNOT-22 at end of the trial, changes in Lund and Mackay staging of CT scan, rhinoscopy grading, absolute eosinophil count, global assessment by investigator and patient, and number of acute exacerbations of CRS (for frequency, duration and intensity as per TSS scale compared to placebo. Methods/Design: This is a randomised double blind, placebo-controlled, multi-centric parallel arm trial of 6 months (three months treatment and three months observation period with 14 days run-in period. The primary outcome is a composite of the changes in the TSS and SNOT-22 over 3 months from baseline with area under the curve and changes over 3 months in the Sinus Nasal Outcome Test 22 (SNOT-22 from baseline. Prescription shall be made as per the homoeopathic principles. Efficacy data will be analysed in the intention-to-treat population. Discussion: This trial will help to evaluate the efficacy of homoeopathic individualised treatment using LM-potencies versus placebo in patients suffering from CRS as per the homoeopathic dictum.

  4. Effects of Mindfulness Meditation on Chronic Pain

    DEFF Research Database (Denmark)

    la Cour, Peter; Petersen, Marian

    2015-01-01

    OBJECTIVE: This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain. DESIGN: A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR...... randomized patients completed the mindfulness program, while 47 remained in the control group. Data were compared at three time points: at baseline, after completion of the course/waiting period, and at the 6-month follow-up. RESULTS: Significant effect (Cohen's d = 0.39) was found on the primary outcome...... (nonsignificant) effect sizes were found for pain measures. There were no significant differences in the measures just after the intervention vs the 6-month follow-up. CONCLUSION: A standardized mindfulness program (MBSR) contributes positively to pain management and can exert clinically relevant effects...

  5. Chronic pelvic pain syndrome: role of a thorough clinical assessment.

    Science.gov (United States)

    Quaghebeur, Jörgen; Wyndaele, Jean-Jacques

    2015-04-01

    Chronic pelvic pain syndrome (CPPS) presents with a variety of symptoms affecting multiple systems. There is no universal treatment that can be given to all patients with CPPS. The results of treatment depend greatly on an accurate diagnosis. A thorough clinical assessment, including a "four-step plan", should include paying special attention to the musculoskeletal system. This assessment is not difficult to perform and provides valuable information on possible muscular problems and neuropathy.

  6. Use of hydra for chronic toxicity assessment of waters intended for human consumption

    International Nuclear Information System (INIS)

    Arkhipchuk, Victor V.; Blaise, Christian; Malinovskaya, Maria V.

    2006-01-01

    Methods developed with the cnidarian, Hydra attenuata (Pallas), have proven effective for screening acute toxicity in aqueous samples, whereas their use in revealing (sub)chronic toxic effects have had mitigated success. We therefore sought to explore manifestations of hydra mortality and abnormal morphological changes, as well as the reproductive capacity of hydras to further enhance the bioassay sensitivity and to assess (sub)chronic toxicity. These parameters were recorded following the onset of experiments after 8, 12 and 19-21 days of hydra exposure. Results obtained with potable waters (30 brands of bottled waters and artesian waters from 9 wells) showed chronic sublethal and lethal effects or reproduction rate inhibition for most samples. The effectiveness of the hydra toxicity test was demonstrated in comparison with other widely used bioassays. Our previous and present investigations suggest that hydra is a reliable and relevant test organism for the assessment of acute and chronic water toxicity. - Hydra is a reliable and relevant test organism for the assessment of acute and chronic toxicity of waters intended for human consumption

  7. Chronic Neck Pain Assessment using Multi-Frequency Bioimpedance

    DEFF Research Database (Denmark)

    Fener, Dilay Kesgin; Bartels, Else Marie; Elbrønd, Vibeke Sødring

    2016-01-01

    Scope: Chronic neck pain (CNP) is a disabling condition where the cause is often unknown, making treatment difficult. Muscle involvement is suspected in most cases, and assessment of muscle condition and changes following treatment may be possible with multi-frequency bioimpedance (mfBIA). Our aim...... involvement in chronic neck pain patients. AtlasBalans treatment did not show any clear indication as being an efficient form of treatment to relieve muscle tension in CNP patients....... was to test mfBIA as an assessment method of possible involvement of the neck, back and other related muscles in two CNP patients, prior to and following physiotherapy treatment with AtlasBalans. Methods: mfBIA measurements were carried out pre-treatment on m. sternocleidomastoideus, m. trapezius, upper back...

  8. Assessment of drainage techniques for evacuation of chronic subdural hematoma

    DEFF Research Database (Denmark)

    Sjåvik, Kristin; Bartek, Jiri; Sagberg, Lisa Millgård

    2018-01-01

    OBJECTIVE Surgery for chronic subdural hematoma (CSDH) is one of the most common neurosurgical procedures. The benefit of postoperative passive subdural drainage compared with no drains has been established, but other drainage techniques are common, and their effectiveness compared with passive...

  9. Assessment of Chronic Administration of Aloe Vera Gel On ...

    African Journals Online (AJOL)

    The study was designed to investigate the effects of chronic administration of Aloe vera gel extract on markers of hepatic damage, lipid profiles and erythrocyte osmotic fragility using the Wistar rats. Forty male Wistar rats divided into four groups of ten rats per group were used in the study. Group I which served as the control ...

  10. Assessment of diet in chronic kidney disease female predialysis patients

    OpenAIRE

    Dariusz Włodarek; Dominika Głąbska; Jadwiga Rojek-Trębicka

    2014-01-01

    [b]introduction and objective[/b]. Nutrition is important in the therapy of predialysis patients. The aim of the presented single-centre descriptive study was to assess the diet in chronic kidney disease female predialysis patients with no previous dietary intervention, in comparison with recommendations, as well as the analysis of the energy, protein and phosphate intake in correlation with chosen laboratory measurements. [b]materials and methods.[/b] The research was carried out in 31...

  11. [Effectiveness of fenspiride in patients with chronic obstructive bronchitis].

    Science.gov (United States)

    Shorokhova, T D; Medvedeva, I V; Lapik, S V; Solov'eva, O G; Gracheva, E Iu; Iusupova, R S

    2001-01-01

    Patients with chronic obstructive pulmonary disease of moderate severity were investigated for two months for assessment of fenspiride activity. Examination of the patients (age 42.6 +/- 5.3) took place before and after fenspiride therapy. In comparison to the control group, fenspiride patients showed improvement of external respiration function: FEV 1, FVC, FEF 50-75, PEF increased. Dienic conjugates, malonic dialdehyde levels decreased, alpha-tocopherol in platelet membranes rose, functional activity of platelets fell. Side effects were rare and not serious. It is concluded that fenspiride has an antiinflammatory effect, reduces bronchoconstriction and depresses platelet aggregation, is well tolerated. Fenspiride is an effective drug for the treatment of moderate chronic obstructive bronchitis.

  12. Ergonomic Chair Explorative Intervention Study: Effect on Chronic ...

    African Journals Online (AJOL)

    Ergonomic Chair Explorative Intervention Study: Effect on Chronic Upper ... they are associated with a complex relationship between individual, work-related and ... in chronic upper quadrant musculoskeletal dysfunction and work productivity ...

  13. Assessment of Family Functionality Among the Elderly With Chronic Illness

    Directory of Open Access Journals (Sweden)

    Claudia Balula Chaves

    2013-12-01

    Full Text Available The family APGAR scale was developed by Smilkstein, Ashworth, and Montano (1982. The satisfaction assessment of the elderly with chronic illness regarding family is essential. This study aims to describe the socio-demographic and clinical profile of elderly people with chronic illness and correlate with perceived family support. This is a cross-sectional, analytical study of 294 elderly people (51.4% female, patients at the Health Centre in the district of Viseu - Portugal, diagnosed with chronic illness (77.9% cardiovascular; Mean age was 72.22 ± 6.13, 70.7% were married and 52% had 4 years of schooling; Data was gathered using a questionnaire and the Family APGAR (Adaptation, Partnership, Growth, Affection and Resolve. In relation to family functionality, 18.7% perceive families as highly functional, 26.9% mildly dysfunctional and 54.4% severely dysfunction. There is a statistically significant relationship between the family APGAR and the presence of chronic illness (p < 0.001. We found no statistical significance between the family APGAR and gender (p = 0.26, age (p = 0.26, marital status (p = 0.32 and educational level (p = 0.28. Economic, political and social changes in our society has an impact on the family and the support they provide which is manifested among vulnerable groups, as is the case of an elderly person with chronic illness. Thus, we propose specialised psychological support for this age group which is more vulnerable and without the needed support from within the family.

  14. Assessment of Educational Needs and Quality of Life of Chronic Hepatitis Patients.

    Science.gov (United States)

    Chen, Ming-Chuan; Hung, Hung-Chang; Chang, Hsiu-Ju; Yang, Sheng-Shun; Tsai, Wen-Chen; Chang, Shu-Chuan

    2017-02-17

    Patient education is crucial in improving the health-related quality of life (HRQOL) of patients. At the same, understanding the concerns and needs of patients is essential in providing appropriate education. This study assessed the educational needs and HRQOL experienced by chronic hepatitis patients. We developed structured questionnaires with satisfactory validity and reliability to assess the educational needs of patients. HROQL was measured using a generic Short Form 36 (SF-36) and a liver disease-specific Chronic Liver Disease Questionnaire (CLDQ). Descriptive statistic measures and Pearson's correlation analysis were applied for data analysis. A total of 135 subjects were recruited from two regional teaching hospitals in Taiwan. "Disease characteristics and management" exhibited the highest mean score (3.17) among all the subscales of educational needs. In comparison with those without antiviral therapy, chronic hepatitis patients undergoing antiviral treatment scored significantly higher on all subscales of educational needs, especially on "side effects of antiviral treatment" (p educational needs were significantly inversely correlated with the CLDQ and SF-36 subscales. Education is highly required by chronic hepatitis patients, especially those receiving antiviral therapy and patients with poor HRQOL. These findings can serve as a useful reference for nursing personnel who perform needs assessment to develop individual nursing instruction and thereby improve the quality of care for chronic hepatitis patients.

  15. Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial.

    Science.gov (United States)

    Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

    2016-01-01

    Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (PCulturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.

  16. Headache in patients with chronic obstructive pulmonary disease: effects of chronic hypoxaemia.

    Science.gov (United States)

    Ozge, Aynur; Ozge, Cengiz; Kaleagasi, Hakan; Yalin, Osman Ozgür; Unal, Ozgür; Ozgür, Eylem S

    2006-02-01

    The frequency and characteristics of headache in patients with chronic obstructive pulmonary disease (COPD) are not clear and there are only a few studies that have assessed the relationship between chronic hypoxaemia and headache. We performed this study in order to evaluate the frequency and characteristics of headache in COPD patients. A total of 119 patients, with a mean age of 63.4 +/- 8.2 years, diagnosed with moderate or severe stable COPD were included in the study. Overall 31.9% of the patients complained of headache and 45.4% were reported to have sleep disorders. There were significant effects of family history of COPD, having other systemic disorders or sleep disorders (snoring, bruxism, restless leg syndrome, etc.) and laboratory data of chronic hypoxaemia and airway obstruction on headache co-morbidity. In conclusion, possibly being a specific subtype of elderly headache, headache in patients with moderate or severe COPD is a common problem and future studies are needed to obtain more knowledge about its pathophysiological and clinical basis.

  17. Chronic motor cortex stimulation in patients with advanced Parkinson's disease and effects on striatal dopaminergic transmission as assessed by 123I-FP-CIT SPECT: a preliminary report.

    Science.gov (United States)

    Di Giuda, Daniela; Calcagni, Maria L; Totaro, Manuela; Cocciolillo, Fabrizio; Piano, Carla; Soleti, Francesco; Fasano, Alfonso; Cioni, Beatrice; Bentivoglio, Anna R; Giordano, Alessandro

    2012-09-01

    The objective of this study was to assess striatal dopamine transporter availability in patients with advanced Parkinson's disease (PD) before and after 13 months of unilateral extradural motor cortex stimulation (EMCS) with [123I]N-ω-fluoropropyl-2-β-carbo-methoxy-3-β-(4-iodophenyl)nortropane single photon emission computed tomography (123I-FP-CIT SPECT). Six PD patients (five women and one man, aged 63.2 ± 5.6 years) underwent 123I-FP-CIT SPECT and clinical evaluation [Unified Parkinson's Disease Rating Scale (UPDRS) and Parkinson's Disease Quality of Life Scale (PDQL)] preoperatively, 8 and 13 months after EMCS. Striatum-to-occipital cortex, caudate-to-occipital cortex and putamen-to-occipital cortex 123I-FP-CIT uptake ratios were calculated using the region of interest method. Total and part III UPDRS scores significantly decreased at 8 and 13 months after stimulation (P=0.02 and 0.04, respectively); UPDRS part II and PDQL scores improved after 13 months (P=0.02 and 0.04, respectively). No significant differences in 123I-FP-CIT uptake ratios between baseline and follow-up were found in the examined regions. However, a progressive reduction in 123I-FP-CIT uptake ratios in the striatum contralateral to the implant was found. In contrast, no further decrease in 123I-FP-CIT uptake ratios was detected in the striatum ipsilateral to the implant. There were no correlations between changes in 123I-FP-CIT uptake ratios with disease duration, changes in medication dosage and motor UPDRS scores. Despite a small but highly selected sample of advanced PD patients, our results showed that no further dopamine transporter reduction occurred in the striatum ipsilateral to the implant side. This finding could lead to the hypothesis that EMCS might elicit a 'neuroprotective' effect, as suggested by significant clinical benefits.

  18. The differential effects of gratitude and sleep on psychological distress in patients with chronic pain.

    Science.gov (United States)

    Ng, Mei-Yee; Wong, Wing-Sze

    2013-02-01

    This study aimed to examine the possible cross-sectional mediating role of sleep in the relationship of gratitude with depression and anxiety in patients with chronic pain. A total of 224 patients with chronic pain completed structured questionnaires assessing chronic pain, depression and anxiety symptoms, gratitude, and sleep disturbances. Results of multiple regression analyses yielded a modest mediating effect for sleep on the gratitude-depression link whereas a stronger mediating effect was found for sleep on the gratitude-anxiety link. These data show much of the effect of gratitude on depression was direct whereas sleep exerted a stronger mediating effect on the gratitude-anxiety link.

  19. Assessment of Patients with Chronic Liver Diseases using Plasma Adrenomedullin

    International Nuclear Information System (INIS)

    Rasheid, S.A.

    2013-01-01

    Viral hepatitis is among the important health problems in Egypt which lead to chronic hepatitis and liver cirrhosis.Liver cirrhosis is associated with circulatory disturbances which are attributed to arterial vasodilatation that results from overproduction or reduced degradation of vasodilator substances. Adrenomedullin (AM) is responsible for the arteriolar vasodilatation and hyper dynamic circulation in liver cirrhosis. The aim of work was to the assessment patients with chronic hepatitis and liver cirrhosis with or without renal impairment by determining the level of AM and comparing them with healthy controls. 44 patients with chronic liver diseases (14 patients with chronic hepatitis and 30 patients with liver cirrhosis, 16 in Child-Pugh's class A, 8 in Child-Pugh's class B, and 6 in Child-Pugh's class C) were examined clinically, laboratory, ultrasonography and endoscopically. Plasma concentration of adrenomedullin was measured in all patients and 15 normal controls.The mean levels of AM were higher in patients with chronic hepatitis and patients with liver cirrhosis compared to controls (0.52 ± 0.19 ng/ml , 0.67 ± 0.16 ng/ml and 0.35 ± 0.12 ng/ml, respectively; p<0.001). The mean levels of plasma aldosterone concentration were higher in patients with chronic hepatitis and patients with liver cirrhosis compared to controls (256 ± 197 ng/dl 358 ± 264 ng/dl and 179 ± 142 ng/dl, respectively; p<0.001). The mean levels of creatinine clearance were lower in patients with chronic hepatitis and patients with liver cirrhosis compared to controls (0.31±0.19 ml/min 0.25±0.21 ml/min and 0.45±0.37 ml/min, respectively; p<0.001). The mean levels of AM were higher in patients with liver cirrhosis with renal impairment than without. Also there was significant difference in AM levels between patients with and without esophageal varices (0.71 ± 0.22 ng/ml and 0.52 ± 0.17 ng/ml respectively, p<0.05). AM levels between patients with and without ascites

  20. Dose Assessment Model for Chronic Atmospheric Releases of Tritium

    International Nuclear Information System (INIS)

    Shen Huifang; Yao Rentai

    2010-01-01

    An improved dose assessment model for chronic atmospheric releases of tritium was proposed. The proposed model explicitly considered two chemical forms of tritium.It was based on conservative assumption of transfer of tritiated water (HTO) from air to concentration of HTO and organic beam tritium (OBT) in vegetable and animal products.The concentration of tritium in plant products was calculated based on considering dividedly leafy plant and not leafy plant, meanwhile the concentration contribution of tritium in the different plants from the tritium in soil was taken into account.Calculating the concentration of HTO in animal products, average water fraction of animal products and the average weighted tritium concentration of ingested water based on the fraction of water supplied by each source were considered,including skin absorption, inhalation, drinking water and food.Calculating the annual doses, the ingestion doses were considered, at the same time the contribution of inhalation and skin absorption to the dose was considered. Concentrations in foodstuffs and dose of annual adult calculated with the specific activity model, NEWTRI model and the model proposed by the paper were compared. The results indicate that the model proposed by the paper can predict accurately tritium doses through the food chain from chronic atmospheric releases. (authors)

  1. Assessment of diet in chronic kidney disease female predialysis patients.

    Science.gov (United States)

    Włodarek, Dariusz; Głąbska, Dominika; Rojek-Trębicka, Jadwiga

    2014-01-01

    Nutrition is important in the therapy of predialysis patients. The aim of the presented single-centre descriptive study was to assess the diet in chronic kidney disease female predialysis patients with no previous dietary intervention, in comparison with recommendations, as well as the analysis of the energy, protein and phosphate intake in correlation with chosen laboratory measurements. The research was carried out in 31 female predialysis patients with CKD of different etiology, aged 29-79 years (GFR: 19.4±9.7 ml/min/1.73 m2). Main outcome measures were self-reported data from three-day dietary recall. Nutrients content and energy value of diet were compared with guidelines for chronic kidney disease patients or, in case of nutrients when they are not settled, with the recommendations for healthy women. All patients had a lower energy intake than the recommended level. At the same time, 35.8% of patients were characterised by improper protein intake--too low or too high. The majority of patients had low intake of most of vitamins and minerals. The total, animal and plant protein were positively correlated with the energy value of diet and with amount of most of the nutrients. Values of GFR were positively correlated with animal protein intake, while phosphate and creatinine in blood were negatively correlated with total and animal protein intake. The study highlights that diet of CKD predialysis patients with no previous dietary intervention is not properly balanced.

  2. Effect of early and late rehabilitation onset in a chronic rat model of ischemic stroke- assessment of motor cortex signaling and gait functionality over time.

    Science.gov (United States)

    Nielsen, Rasmus K; Samson, Katrine L; Simonsen, Daniel; Jensen, Winnie

    2013-11-01

    The aim of the present study was to investigate the effects of ischemic stroke and onset of subsequent rehabilitation of gait function in rats. Nine male Sprague-Dawley rats were instrumented with a 16-channel intracortical (IC) electrode array. An ischemic stroke was induced within the hindlimb area of the left motor cortex. The rehabilitation consisted of a repetitive training paradigm over 28 days, initiated on day one ("Early-onset", 5 rats) and on day seven, ("Late-onset", 4 rats). Data were obtained from IC microstimulation tests, treadmill walking tests, and beam walking tests. Results revealed an expansion of the hindlimb representation within the motor cortex area and an increased amount of cortical firing rate modulation for the "Early-onset" group but not for the "Late-onset" group. Kinematic data revealed a significant change for both intervention groups. However, this difference was larger for the "Early-onset" group. Results from the beam walking test showed functional performance deficits following stroke which returned to pre-stroke level after the rehabilitative training. The results from the present study indicate the existence of a critical time period following stroke where onset of rehabilitative training may be more effective and related to a higher degree of true recovery.

  3. Assessing Physician-Patient Dialogues About Chronic Migraine During Routine Office Visits.

    Science.gov (United States)

    Buse, Dawn C; Gillard, Patrick; Arctander, Kaitlyn; Kuang, Amy W; Lipton, Richard B

    2018-05-04

    To assess physician-patient communication and identify the frequency of use of specific communication techniques by analyzing recordings of routinely scheduled medical encounters for patients with clinician-identified chronic migraine. Chronic migraine is an under-diagnosed, under-treated, and highly burdensome disease. Effective medical communication is integral to optimal medical care, including providing accurate diagnoses, creating effective treatment plans, and enhancing patient adherence. Communication patterns during office visits may be a target for intervention to improve outcomes for people with chronic migraine. This was a prospective, observational study based on analysis of audio recordings collected during neurologist-patient chronic migraine dialogues. Twenty neurologists from a US neurology panel maintained by Verilogue, Inc., a research organization specializing in healthcare dialogues, were invited to identify patients with chronic migraine and record clinical encounters with their patients. Both new patient visits and follow-up visits were included in this analysis. Neurologist-patient dialogues were audio-recorded, anonymized, transcribed, and analyzed by a sociolinguist for the presence of prespecified communication parameters, strategies, and specific language indicative of optimal migraine-related medical care. Fourteen out of the 20 invited neurologists (70.0%) accepted the study invitation and recorded 35 encounters with patients eligible for the study. The patient sample was 91.4% female (n = 32/35), with a mean age of 46 years. On average, there were 17 headache-related questions per visit; 82.0% of questions were closed-ended (n = 369/450). Headache/migraine frequency was elicited in 77.1% of the dialogues (n = 27/35), but headache days per month was assessed in only a single dialogue. Only one neurologist utilized the ask-tell-ask technique. Headache-related disability was discussed in 22.9%of the dialogues (n = 8

  4. Adaptation and validation of the patient assessment of chronic illness care in the French context.

    Science.gov (United States)

    Krucien, Nicolas; Le Vaillant, Marc; Pelletier-Fleury, Nathalie

    2014-06-19

    Chronic diseases are major causes of disability worldwide with rising prevalence. Most patients suffering from chronic conditions do not always receive optimal care. The Chronic Care Model (CCM) has been developed to help general practitioners making quality improvements. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was increasingly used in several countries to appraise the implementation of the CCM from the patients' perspective. The objective of this study was to adapt the PACIC questionnaire in the French context and to test the validity of this adaptation in a sample of patients with multiple chronic conditions. The PACIC was translated into French language using a forward/backward procedure. The French version was validated using a sample of 150 patients treated for obstructive sleep apnea syndrome (OSAS) and having multiple chronic co-morbidities. Several forms of validity were analysed: content; face; construct; and internal consistency. The construct validity was investigated with an exploratory factorial analysis. The French-version of the PACIC consisted in 18 items, after merging two pairs of items due to redundancy. The high number of items exhibiting floor/ceiling effects and the non-normality of the ratings suggested that a 5-points rating scale was somewhat inappropriate to assess the patients' experience of care. The construct validity of the French-PACIC was verified and resulted in a bi-dimensional structure. Overall this structure showed a high level of internal consistency. The PACIC score appeared to be significantly related to the age and self-reported health of the patients. A French-version of the PACIC questionnaire is now available to evaluate the patients' experience of care and to monitor the quality improvements realised by the medical structures. This study also pointed out some methodological issues about the PACIC questionnaire, related to the format of the rating scale and to the structure of the

  5. Responsiveness of five condition-specific and generic outcome assessment instruments for chronic pain

    Directory of Open Access Journals (Sweden)

    Verra Martin L

    2008-04-01

    Full Text Available Abstract Background Changes of health and quality-of-life in chronic conditions are mostly small and require specific and sensitive instruments. The aim of this study was to determine and compare responsiveness, i.e. the sensitivity to change of five outcome instruments for effect measurement in chronic pain. Methods In a prospective cohort study, 273 chronic pain patients were assessed on the Numeric Rating Scale (NRS for pain, the Short Form 36 (SF-36, the Multidimensional Pain Inventory (MPI, the Hospital Anxiety and Depression Scale (HADS, and the Coping Strategies Questionnaire (CSQ. Responsiveness was quantified by effect size (ES and standardized response mean (SRM before and after a four week in-patient interdisciplinary pain program and compared by the modified Jacknife test. Results The MPI measured pain more responsively than the SF-36 (ES: 0.85 vs 0.72, p = 0.053; SRM: 0.72 vs 0.60, p = 0.027 and the pain NRS (ES: 0.85 vs 0.62, p Conclusion The MPI was most responsive in all comparable domains followed by the SF-36. The pain-specific MPI and the generic SF-36 can be recommended for comprehensive and specific bio-psycho-social effect measurement of health and quality-of-life in chronic pain.

  6. Assessment of diet in chronic kidney disease female predialysis patients

    Directory of Open Access Journals (Sweden)

    Dariusz Włodarek

    2014-11-01

    Full Text Available [b]introduction and objective[/b]. Nutrition is important in the therapy of predialysis patients. The aim of the presented single-centre descriptive study was to assess the diet in chronic kidney disease female predialysis patients with no previous dietary intervention, in comparison with recommendations, as well as the analysis of the energy, protein and phosphate intake in correlation with chosen laboratory measurements. [b]materials and methods.[/b] The research was carried out in 31 female predialysis patients with CKD of different etiology, aged 29–79 years (GFR: 19.4±9.7ml/min/1.73m [sup]2[/sup] . Main outcome measures were self-reported data from three-day dietary recall. Nutrients content and energy value of diet were compared with guidelines for chronic kidney disease patients or, in case of nutrients when they are not settled, with the recommendations for healthy women. [b]results[/b]. All patients had a lower energy intake than the recommended level. At the same time, 35.8% of patients were characterised by improper protein intake – too low or too high. The majority of patients had low intake of most of vitamins and minerals. The total, animal and plant protein were positively correlated with the energy value of diet and with amount of most of the nutrients. Values of GFR were positively correlated with animal protein intake, while phosphate and creatinine in blood were negatively correlated with total and animal protein intake. [b]conclusions[/b]. The study highlights that diet of CKD predialysis patients with no previous dietary intervention is not properly balanced.

  7. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

    Full Text Available Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management.

  8. Effects in Plant Populations Resulting from Chronic Radiation Exposure

    Energy Technology Data Exchange (ETDEWEB)

    Geras' kin, Stanislav A.; Volkova, Polina Yu.; Vasiliyev, Denis V.; Dikareva, Nina S.; Oudalova, Alla A. [Russian Institute of Agricultural Radiology and Agroecology, 249032, Obninsk (Russian Federation)

    2014-07-01

    Human industrial activities have left behind a legacy of ecosystems strongly impacted by a wide range of contaminants, including radionuclides. Phyto-toxic effects of acute impact are well known, but the consequences of long-term chronic exposure to low pollutant concentrations is neither well understood nor adequately included in risk assessments. To understand effects of real-world contaminant exposure properly we must pay attention to what is actually going on in the field. However, for many wildlife groups and endpoints, there are no, or very few, studies that link accumulation, chronic exposure and biological effects in natural settings. To fill the gaps, results of field studies carried out on different plant species (winter rye and wheat, spring barley, oats, Scots pine, wild vetch, crested hair-grass) in various radioecological situations (nuclear weapon testing, the Chernobyl accident, uranium and radium processing) to investigate effects of long-term chronic exposure to radionuclides are discussed. Because each impacted site developed in its own way due to a unique history of events, the experience from one case study is rarely directly applicable to another situation. In spite of high heterogeneity in response, we have detected several general patterns. Plant populations growing in areas with relatively low levels of pollution are characterized by the increased level of both cytogenetic alterations and genetic diversity. Accumulation of cellular alterations may afterward influence biological parameters important for populations such as health and reproduction. Presented data provide evidence that in plant populations inhabiting heavily contaminated territories cytogenetic damage were accompanied by decrease in reproductive ability. In less contaminated sites, because of the scarcity of data available, it is impossible to establish exactly the relationship between cytogenetic effects and reproductive ability. Radioactive contamination of the plants

  9. Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Poureslami I

    2016-08-01

    Full Text Available Iraj Poureslami,1,2 Susan Kwan,3 Stephen Lam,4,5 Nadia A Khan,6,7 John Mark FitzGerald 8,9 1Respiratory Division, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada; 2Department of Graduate Studies, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada; 3Respiratory Department, Burnaby Hospital, University of British Columbia, Burnaby, Canada; 4Respiratory Division, University of British Columbia, Vancouver, Canada; 5Department of Integrative Oncology, BC Cancer Research Centre, Vancouver, Canada; 6Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada; 7Department of Internal Medicine, Providence Health Care Authority, Vancouver, Canada; 8VGH Divisions of Respiratory Medicine, University of British Columbia, Vancouver, Canada; 9Respiratory Medicine, Vancouver Coastal Health Authority, Vancouver Coastal Health Research Institute, Institute for Heart and Lung Health, The Lung Centre, Gordon and Leslie Diamond Health Care Centre, Vancouver, Canada Background: Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD. Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Methods: Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials, followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet. The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and

  10. Stage effect of chronic kidney disease in erectile function

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues Costa

    Full Text Available ABSTRACT Purpose The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. Materials and Methods This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Results Two hundred and forty five patients with chronic kidney disease in conservative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. Conclusions The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression.

  11. Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease.

    Science.gov (United States)

    Gao, Jing; Perlman, Alan; Kalache, Safa; Berman, Nathaniel; Seshan, Surya; Salvatore, Steven; Smith, Lindsey; Wehrli, Natasha; Waldron, Levi; Kodali, Hanish; Chevalier, James

    2017-11-01

    To evaluate the value of multiparametric quantitative ultrasound imaging in assessing chronic kidney disease (CKD) using kidney biopsy pathologic findings as reference standards. We prospectively measured multiparametric quantitative ultrasound markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with CKD before kidney biopsy and 10 healthy volunteers. Based on all pathologic (glomerulosclerosis, interstitial fibrosis/tubular atrophy, arteriosclerosis, and edema) scores, the patients with CKD were classified into mild (no grade 3 and quantitative ultrasound parameters included kidney length, cortical thickness, pixel intensity, parenchymal shear wave velocity, intrarenal artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index. We tested the difference in quantitative ultrasound parameters among mild CKD, moderate to severe CKD, and healthy controls using analysis of variance, analyzed correlations of quantitative ultrasound parameters with pathologic scores and the estimated glomerular filtration rate (GFR) using Pearson correlation coefficients, and examined the diagnostic performance of quantitative ultrasound parameters in determining moderate CKD and an estimated GFR of less than 60 mL/min/1.73 m 2 using receiver operating characteristic curve analysis. There were significant differences in cortical thickness, pixel intensity, PSV, and EDV among the 3 groups (all P quantitative ultrasound parameters, the top areas under the receiver operating characteristic curves for PSV and EDV were 0.88 and 0.97, respectively, for determining pathologic moderate to severe CKD, and 0.76 and 0.86 for estimated GFR of less than 60 mL/min/1.73 m 2 . Moderate to good correlations were found for PSV, EDV, and pixel intensity with pathologic scores and estimated GFR. The PSV, EDV, and pixel intensity are valuable in determining moderate to severe CKD. The value of shear wave velocity in

  12. Psychosocial assessment and self-management of chronic pain

    NARCIS (Netherlands)

    J.S. Voerman (Jessica)

    2015-01-01

    markdownabstractAbstract Chronic pain is prevalent in both children and adults and has major negative consequences for their daily life, e.g. reduced participation in activities and depressive and anxious feelings. Therefore, it is important to early signal and treat chronic pain. This thesis

  13. Effective physical treatment for chronic low back pain.

    Science.gov (United States)

    Maher, C G

    2004-01-01

    It is now feasible to adopt an evidence-based approach when providing physical treatment for patients with chronic LBP. A summary of the efficacy of a range of physical treatments is provided in Table 1. The evidence-based primary care options are exercise, laser, massage, and spinal manipulation; however, the latter three have small or transient effects that limit their value as therapies for chronic LBP. In contrast, exercise produces large reductions in pain and disability, a feature that suggests that exercise should play a major role in the management of chronic LBP. Physical treatments, such as acupuncture, backschool, hydrotherapy, lumbar supports, magnets, TENS, traction, ultrasound, Pilates therapy, Feldenkrais therapy, Alexander technique, and craniosacral therapy are either of unknown value or ineffective and so should not be considered. Outside of primary care, multidisciplinary treatment or functional restoration is effective; however, the high cost probably means that these programs should be reserved for patients who do not respond to cheaper treatment options for chronic LBP. Although there are now effective treatment options for chronic LBP, it needs to be acknowledged that the problem of chronic LBP is far from solved. Though treatments can provide marked improvements in the patient's condition, the available evidence suggests that the typical chronic LBP patient is left with some residual pain and disability. Developing new, more powerful treatments and refining the current group of known effective treatments is the challenge for the future.

  14. Neurobiological and neurocognitive effects of chronic cigarette smoking and alcoholism.

    Science.gov (United States)

    Durazzo, Timothy C; Meyerhoff, Dieter J

    2007-05-01

    Chronic cigarette smoking is associated with adverse effects on cardiac, pulmonary, and vascular function as well as the increased risk for various forms of cancer. However, little is known about the effects of chronic smoking on human brain function. Although smoking rates have decreased in the developed world, they remain high in individuals with alcohol use disorders (AUD) and other neuropsychiatric conditions. Despite the high prevalence of chronic smoking in AUD, few studies have addressed the potential neurobiological or neurocognitive consequences of chronic smoking in alcohol use disorders. Here, we review the the neurobiological and neurocognitive findings in both AUD and chronic cigarette smoking, followed by a review of the effects of comorbid cigarette smoking on neurobiology and neurocognition in AUD. Recent research suggests that comorbid chronic cigarette smoking modulates magnetic resonance-detectable brain injury and neurocognition in alcohol use disorders and adversely affects neurobiological and neurocognitive recovery in abstinent alcoholics.. Consideration of the potential separate and interactive effects of chronic smoking and alcohol use disorders may have significant implications for pharmacological and behavioral treatment interventions.

  15. Radiation effects after low dose chronic long-term exposure

    International Nuclear Information System (INIS)

    Fliedner, T.M.; Friesecke, I.

    1997-01-01

    This document approaches the radiation effects after low dose chronic long-term exposure, presenting examples occurred, the pathophysiologic mechanisms for cell system tolerance in elevated radiation fields, and the diagnostic and therapeutic possibilities

  16. Chronic diseases are not being managed effectively in either high ...

    African Journals Online (AJOL)

    Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa. M Brand, AJ Woodiwiss, F Michel, HL Booysen, OHI Majane, MJ Maseko, MG Veller, GR Norton ...

  17. Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment.

    Science.gov (United States)

    Tsui, Patricia; Deptula, Andrew; Yuan, Derek Y

    2017-06-01

    This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

  18. Effect of quality chronic disease management for alcohol and drug dependence on addiction outcomes.

    Science.gov (United States)

    Kim, Theresa W; Saitz, Richard; Cheng, Debbie M; Winter, Michael R; Witas, Julie; Samet, Jeffrey H

    2012-12-01

    We examined the effect of the quality of primary care-based chronic disease management (CDM) for alcohol and/or other drug (AOD) dependence on addiction outcomes. We assessed quality using (1) a visit frequency based measure and (2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. The self-reported measure of care-when care was at a CDM clinic-was associated with lower drug addiction severity. The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere) was associated with lower alcohol addiction severity and abstinence. These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes. Quality measures based upon alignment with the chronic care model may better capture features of effective CDM care than a visit frequency measure. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Chronic effects of UV on human skin

    International Nuclear Information System (INIS)

    Cesarini, J.P.

    1996-01-01

    Chronic exposures and acute accidents of the skin to UV has been recognized as an important risk for skin cancers in human. Attempts have been made with mathematical models to correlate the ambient UV dose and occupational irradiations with the risk of skin cancers. Development of accurate global measurements of solar irradiance and personal dosimetry is expected in the future in order to reduce the exposure of the general population, to precise the measures to be taken for indoor and outdoor workers. (author)

  20. Safety assessment of chronic oral exposure to iron oxide nanoparticles

    International Nuclear Information System (INIS)

    Chamorro, Susana; Vaquero, María Pilar; Brenes, Agustín; Gutiérrez, Lucía; Salas, Gorka; Luengo, Yurena; Verdoy, Dolores; José Teran, Francisco

    2015-01-01

    Iron oxide nanoparticles with engineered physical and biochemical properties are finding a rapidly increasing number of biomedical applications. However, a wide variety of safety concerns, especially those related to oral exposure, still need to be addressed for iron oxide nanoparticles in order to reach clinical practice. Here, we report on the effects of chronic oral exposure to low doses of γ-Fe 2 O 3 nanoparticles in growing chickens. Animal observation, weight, and diet intake reveal no adverse signs, symptoms, or mortality. No nanoparticle accumulation was observed in liver, spleen, and duodenum, with feces as the main excretion route. Liver iron level and duodenal villi morphology reflect the bioavailability of the iron released from the partial transformation of γ-Fe 2 O 3 nanoparticles in the acid gastric environment. Duodenal gene expression studies related to the absorption of iron from γ-Fe 2 O 3 nanoparticles indicate the enhancement of a ferric over ferrous pathway supporting the role of mucins. Our findings reveal that oral administration of iron oxide nanoparticles is a safe route for drug delivery at low nanoparticle doses. (paper)

  1. Effects of Chronic Musculoskeletal Pain on Fertility Potential in Lean and Overweight Male Patients

    Directory of Open Access Journals (Sweden)

    Fereshteh Dardmeh

    2017-01-01

    Full Text Available Both chronic pain and obesity are known to affect reproductive hormone profiles in male patients. However, the effect of these conditions, alone or in combination, on male fertility potential has received less attention. 20 chronic musculoskeletal pain patients and 20 healthy controls were divided into lean and overweight subgroups according to their BMI. Current level of chronic pain (visual analogue scale and pressure pain thresholds (PPTs in 16 predefined sites, classically described and tested as painful points on the lower body, were measured. Levels of reproductive hormone and lipid profiles were assessed by ELISA. Sperm concentration and motility parameters were analyzed using a computer-aided sperm analysis system. Sperm concentration, progressive motility, and percentage of hyperactivated sperm were generally lower in the chronic pain patients in both lean and overweight groups. The overweight control and the lean chronic pain groups demonstrated a significantly lower percentage of progressively motile sperm compared with the lean control group, suggesting that musculoskeletal chronic pain may have a negative influence on sperm quality in lean patients. However, due to the potential great negative influence of obesity on the sperm parameters, it is difficult to propose if musculoskeletal chronic pain also influenced sperm quality in overweight patients. Further research in chronic pain patients is required to test this hypothesis.

  2. Effect of uranium chronic exposure on the moult in crayfish

    International Nuclear Information System (INIS)

    Simon, O.; Camilleri, V.; Garnier-Laplace, J.

    2004-01-01

    Throughout any ecological risk assessment, one can try to establish a link between pollutant in the ecosystem and adverse biological effects. A number of methodological approaches are based on the development of the use of bio-markers such as the enzyme activity measurements (biotransformation enzymes, antioxidant enzymes) and/or bioaccumulation markers (metal in target-organs). These data allow obtaining an early-warning signal of exposure and potential involved effects and help risk management. However, the effects at higher hierarchical levels (organism or population) are not frequently considered because they tend to occur after longer exposure periods. On the basis of previous results obtained to quantify uranium biokinetics in the crayfish Orconectes limosus and to understand the influence of the exposure pathway, a chronic exposure experiment was performed for 100 days at an environmentally relevant uranium concentration in water (low level concentration ranging from?? to 100 nM). The main effect studied was focused on the moult; moulted animals being the most sensitive to pollutants. Effects on the moult process were assessed in terms of occurrence, delay, and success. Preliminary results that indicated no induction of the moult by U exposure and better survival rate to uranium exposure must be confirmed. Simultaneously, both enzymatic bio-markers of effect quantifying the oxidative status (catalase, superoxide dismutase and glutathione peroxidases) and markers of exposure (uranium distribution at organs and cellular levels and MET observations) were studied. Results obtained from complementary experiments on the uranium fluxes all over moult states were used to discuss the link between bio-markers responses and observed effects on the moult. (author)

  3. Effect of uranium chronic exposure on the moult in crayfish

    Energy Technology Data Exchange (ETDEWEB)

    Simon, O.; Camilleri, V.; Garnier-Laplace, J. [CEA Cadarache (DEI/SECRE/LRE), Laboratory of Radioecology and Ecotoxicology, Institute for Radioprotection and Nuclear Safety, 13 - Saint-Paul-lez-Durance (France)

    2004-07-01

    Throughout any ecological risk assessment, one can try to establish a link between pollutant in the ecosystem and adverse biological effects. A number of methodological approaches are based on the development of the use of bio-markers such as the enzyme activity measurements (biotransformation enzymes, antioxidant enzymes) and/or bioaccumulation markers (metal in target-organs). These data allow obtaining an early-warning signal of exposure and potential involved effects and help risk management. However, the effects at higher hierarchical levels (organism or population) are not frequently considered because they tend to occur after longer exposure periods. On the basis of previous results obtained to quantify uranium biokinetics in the crayfish Orconectes limosus and to understand the influence of the exposure pathway, a chronic exposure experiment was performed for 100 days at an environmentally relevant uranium concentration in water (low level concentration ranging from?? to 100 nM). The main effect studied was focused on the moult; moulted animals being the most sensitive to pollutants. Effects on the moult process were assessed in terms of occurrence, delay, and success. Preliminary results that indicated no induction of the moult by U exposure and better survival rate to uranium exposure must be confirmed. Simultaneously, both enzymatic bio-markers of effect quantifying the oxidative status (catalase, superoxide dismutase and glutathione peroxidases) and markers of exposure (uranium distribution at organs and cellular levels and MET observations) were studied. Results obtained from complementary experiments on the uranium fluxes all over moult states were used to discuss the link between bio-markers responses and observed effects on the moult. (author)

  4. Enhancing effects of chronic lithium on memory in the rat.

    Science.gov (United States)

    Tsaltas, Eleftheria; Kontis, Dimitrios; Boulougouris, Vasileios; Papakosta, Vasiliki-Maria; Giannou, Haralambos; Poulopoulou, Cornelia; Soldatos, Constantine

    2007-02-12

    In spite of recent enrichment of neurochemical and behavioural data establishing a neuroprotective role for lithium, its primary effects on cognitive functioning remain ambiguous. This study examines chronic lithium effects on spatial working memory and long-term retention. In three discrete experiments, rats subjected to 30 daily intraperitoneal injections (2mmol/kg) of lithium (lithium groups: serum lithium=0.5+/-0.4mEq/l, 12h post-injection) or saline (controls) were trained in 0-s delay T-maze alternation and then tested in 30-, 45- and 60-s delay alternation (Experiments 1, 2, 3, respectively). Animals from Experiment 1 were further tested in one-trial step-through passive avoidance under mild shock parameters (0.5mA, 1s). Retention was assessed 6h later. Daily lithium or saline injections continued throughout behavioural testing. Lithium animals were indistinguishable from controls during 0-delay alternation baseline (Experiments 1-3, accuracy>88%) but showed significantly higher accuracy than controls at 30- and 45-s delays (93% versus 85% and 92% versus 82%, Experiments 1 and 2, respectively). At 60-s delay (Experiment 3) this beneficial effect of lithium was no longer apparent (lithium and control accuracy=78%). In Experiment 4, the shock used did not support 6-h passive avoidance retention in controls, whereas lithium animals showed significant step-through latency increases. Chronic lithium enhanced spatial working memory and promoted long-term retention of a weak aversive contingency. The results suggest that lithium may have potential as a cognitive enhancer.

  5. Establishing the Feasibility of Direct Observation in the Assessment of Tics in Children with Chronic Tic Disorders

    Science.gov (United States)

    Himle, Michael B.; Chang, Susanna; Woods, Douglas W.; Pearlman, Amanda; Buzzella, Brian; Bunaciu, Liviu; Piacentini, John C.

    2006-01-01

    Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration…

  6. Effects of Chronic Central Arginine Vasopressin (AVP) on Maternal Behavior in Chronically Stressed Rat Dams

    Science.gov (United States)

    Coverdill, Alexander J.; McCarthy, Megan; Bridges, Robert S.; Nephew, Benjamin C.

    2012-01-01

    Exposure of mothers to chronic stressors during pregnancy or the postpartum period often leads to the development of depression, anxiety, or other related mood disorders. The adverse effects of mood disorders are often mediated through maternal behavior and recent work has identified arginine vasopressin (AVP) as a key neuropeptide hormone in the expression of maternal behavior in both rats and humans. Using an established rodent model that elicits behavioral and physiological responses similar to human mood disorders, this study tested the effectiveness of chronic AVP infusion as a novel treatment for the adverse effects of exposure to chronic social stress during lactation in rats. During early (day 3) and mid (day 10) lactation, AVP treatment significantly decreased the latency to initiate nursing and time spent retrieving pups, and increased pup grooming and total maternal care (sum of pup grooming and nursing). AVP treatment was also effective in decreasing maternal aggression and the average duration of aggressive bouts on day 3 of lactation. Central AVP may be an effective target for the development of treatments for enhancing maternal behavior in individuals exposed to chronic social stress. PMID:24349762

  7. How general practitioners perceive and assess self-care in patients with multiple chronic conditions

    DEFF Research Database (Denmark)

    Kristensen, Mads Aage Toft; Hølge-Hazelton, Bibi; Waldorff, Frans Boch

    2017-01-01

    Background: It is not known how general practitioners (GPs) perceive the concept of self-care and how they assess self-care ability in patients with multiple chronic conditions. As a part of the strategy to improve the care of people living with chronic conditions, disease management programs...... in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. Methods...

  8. Chronic thromboembolic pulmonary hypertension - assessment by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, Karl-Friedrich; Kunz, R.P.; Oberholzer, Katja; Neeb, Daniel; Gast, Klaus K.; Dueber, Christoph [Johannes-Gutenberg-University, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Ley, Sebastian [Johannes-Gutenberg-University, Department of Diagnostic and Interventional Radiology, Mainz (Germany); German Cancer Research Center, Department of Radiology, Heidelberg (Germany); Heussel, Claus-Peter [Johannes-Gutenberg-University, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Chest Clinic at University of Heidelberg, Department of Radiology, Heidelberg (Germany); Eberle, Balthasar [Johannes-Gutenberg-University, Department of Anesthesiology, Mainz (Germany); Inselspital, Department of Anesthesiology, Bern (Switzerland); Mayer, Eckhard [Johannes-Gutenberg-University, Department of Heart, Thorax and Vascular Surgery, Mainz (Germany); Kauczor, Hans-Ulrich [German Cancer Research Center, Department of Radiology, Heidelberg (Germany)

    2007-01-15

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease that has been ignored for a long time. However, with the development of improved therapeutic modalities, cardiologists and thoracic surgeons have shown increasing interest in the diagnostic work-up of this entity. The diagnosis and management of chronic thromboembolic pulmonary hypertension require a multidisciplinary approach involving the specialties of pulmonary medicine, cardiology, radiology, anesthesiology and thoracic surgery. With this approach, pulmonary endarterectomy (PEA) can be performed with an acceptable mortality rate. This review article describes the developments in magnetic resonance (MR) imaging techniques for the diagnosis of chronic thromboembolic pulmonary hypertension. Techniques include contrast-enhanced MR angiography (ce-MRA), MR perfusion imaging, phase-contrast imaging of the great vessels, cine imaging of the heart and combined perfusion-ventilation MR imaging with hyperpolarized noble gases. It is anticipated that MR imaging will play a central role in the initial diagnosis and follow-up of patients with CTEPH. (orig.)

  9. Chronic thromboembolic pulmonary hypertension - assessment by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kreitner, Karl-Friedrich; Kunz, R.P.; Oberholzer, Katja; Neeb, Daniel; Gast, Klaus K.; Dueber, Christoph; Ley, Sebastian; Heussel, Claus-Peter; Eberle, Balthasar; Mayer, Eckhard; Kauczor, Hans-Ulrich

    2007-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease that has been ignored for a long time. However, with the development of improved therapeutic modalities, cardiologists and thoracic surgeons have shown increasing interest in the diagnostic work-up of this entity. The diagnosis and management of chronic thromboembolic pulmonary hypertension require a multidisciplinary approach involving the specialties of pulmonary medicine, cardiology, radiology, anesthesiology and thoracic surgery. With this approach, pulmonary endarterectomy (PEA) can be performed with an acceptable mortality rate. This review article describes the developments in magnetic resonance (MR) imaging techniques for the diagnosis of chronic thromboembolic pulmonary hypertension. Techniques include contrast-enhanced MR angiography (ce-MRA), MR perfusion imaging, phase-contrast imaging of the great vessels, cine imaging of the heart and combined perfusion-ventilation MR imaging with hyperpolarized noble gases. It is anticipated that MR imaging will play a central role in the initial diagnosis and follow-up of patients with CTEPH. (orig.)

  10. Acute and chronic effects of organophosphate pesticides (Basudin ...

    African Journals Online (AJOL)

    Toxicity of basudin (an organophosphate pesticide) on the larval stages of the dominant amphibian; Ptychadena bibroni of the Niger Delta ecological zone of Nigeria was assessed using acute and chronic toxicity in the laboratory. Mortality and body glycogen levels were used as ecological endpoints. The American society ...

  11. Ocular effects of chronic exposure to welding light on calabar welders

    African Journals Online (AJOL)

    It was generally observed that welders in Calabar, Nigeria did not always wear their protective goggles during welding. Since chronic exposure to welding light can impair vision this study was done to assess the effect of exposure to welding light on ocular function of welders in Calabar, Nigeria. There were 195 subjects ...

  12. Effects of a comprehensive self-management programme in patients with chronic obstructive pulmonary disease.

    NARCIS (Netherlands)

    Monninkhof, E.M.; Valk, P.D.L.P.M. van der; Palen, J.A.M. van der; Herwaarden, C.L.A. van; Zielhuis, G.A.

    2003-01-01

    The aim of this study was to assess the effects of a comprehensive self-management intervention on health-related quality of life (HRQoL), symptoms and walking distance in patients with stable moderately severe chronic obstructive pulmonary disease (COPD). This study was part of the overall COPD

  13. Broad-Spectrum Behavioral Treatment for Chronic Alcoholics: Effects of Training Controlled Drinking Skills.

    Science.gov (United States)

    Foy, David W.; And Others

    1984-01-01

    Assessed unique treatment effects of training controlled drinking skills in a chronic alcoholic population of veterans (N=62). Results of a six-month posttreatment follow-up revealed that subjects in the drinking skills condition had significantly fewer abstinent days and more abusive drinking days than subjects in the untrained condition. (LLL)

  14. Database construction for assessment of chronic radionuclide releases

    International Nuclear Information System (INIS)

    Hively, L.M.; Sjoreen, A.L.; Bledsoe, J.L.

    1986-01-01

    Oak Ridge National Laboratory (ORNL) has developed a comprehensive dose/risk assessment methodology, CRRIS (Computerized Radiological Risk Investigation System), for assessment of atmospheric radionuclide releases (e.g., during decontamination and decommissioning). Radiological effects are calculated for direct atmospheric and ground exposure and for consumption of contaminated agricultural products. Previously, population and agricultural data for CRRIS were tabulated on 1/2-degree square grid cells. This coarse resolution resulted in anomalies such as population in water bodies, agricultural production in city centers, and nonconservation of population over the assessment grid. An even finer mesh (2-minute square grid) is inadequate in densely populated cities where 20,000 or more people live in a square block. These difficulties are overcome by a higher resolution technique using US Census Bureau population data at the most detailed [enumeration district (ED)] level available and by excluding population from unpopulated areas (e.g., water bodies). Agricultural data are available at only the county level and are apportioned to the ED grid according to farm population, conserving the original data. This paper discusses the database construction using Tennessee as an illustration. 10 refs., 2 figs., 1 tab

  15. Investigation of the effects of vanilloids in chronic fatigue syndrome.

    Science.gov (United States)

    Sarvaiya, Kuldeep; Goswami, Sunita

    2016-10-01

    To assess the effectiveness of TRPV1 modulators in animal model of Chronic fatigue syndrome (CFS). To assess central and peripheral behavioral activity of TRPV1 modulators. CFS was induced by forcing the rats to swim for 10min for 21 consecutive days. The rats were treated with capsaicin (TRPV1 agonist, 2.5mg/kg) and n-tert-butylcyclohexanol (TRPV1 antagonist, 10mg/kg) for 21days 30min before the exposure to stress procedure. The behavioral consequence of CFS was measured in terms of immobility time, grip strength, locomotor activity, and anxiety level using Rota rod, Actophotometer, and Elevated plus maze model respectively. The other parameters include Plasma corticosterone, adrenal gland and spleen weight, complete blood count, blood urea niterogen (BUN), Lactate dehydrogenase (LDH), Lipid peroxidation, catalase and reduced glutathione (GSH). TRPV1 modulators reversed (pchronic fatigue syndrome. The mechanism of action can be attributed to inhibition of TRPV1 channel and thereby modulating pain perception, neuroendocrine function, oxidative stress and immune function. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Chronic Low Back Pain: Toward an Integrated Psychosocial Assessment Model.

    Science.gov (United States)

    Strong, Jenny; And Others

    1994-01-01

    Integrated six dimensions of chronic low back pain (pain intensity, functional disability, attitudes toward pain, pain coping strategies, depression, illness behavior) to provide multidimensional patient profile. Data from 100 patients revealed presence of three distinct patient groups: patients who were in control, patients who were depressed and…

  17. Protective effects of antidepressants against chronic fatigue syndrome-induced behavioral changes and biochemical alterations.

    Science.gov (United States)

    Kumar, Anil; Garg, Ruchika

    2009-02-01

    Chronic fatigue syndrome (CFS) is characterized by profound fatigue, which substantially interferes with daily activities. The aim of this study was to explore the protective effects of antidepressants in an animal model of CFS in mice. Male albino mice were forced to swim individually for a period of 6-min session each for 7 days. Imipramine (10 and 20 mg/kg), desipramine (10 and 20 mg/kg) and citalopram (5 and 10 mg/kg) were administered 30 min before forced swimming test on each day. Various behavior tests (immobility time, locomotor activity, anxiety-like behavior by plus maze and mirror chamber) followed by biochemical parameters (lipid peroxidation, reduced glutathione, catalase and nitrite level) were assessed in chronic stressed mice. Chronic forced swimming for 7 days significantly caused increase in immobility period, impairment in locomotor activity, anxiety-like behavior, and oxidative stress (raised lipid peroxidation, nitrite activity and reduced glutathione and catalase activity) as compared with naïve mice (P immobility time, improved locomotor activity and anti-anxiety effect (in both plus maze and mirror chamber test), and attenuated oxidative stress in chronic stressed mice as compared with control (chronic fatigues) (P < 0.05). These results suggested that these drugs have protective effect and could be used in the management of chronic fatigue like conditions.

  18. Hepatic toxicity assessment of cationic liposome exposure in healthy and chronic alcohol fed mice

    DEFF Research Database (Denmark)

    Kermanizadeh, Ali; Jacobsen, Nicklas R.; Roursgaard, Martin

    2017-01-01

    or chronically alcohol fed mice. Additionally, the in vitro material-induced adverse effects (cytotoxicity, inflammation or albumin secretion) were all also minimal. The data from this study demonstrated that the intravenous injection of cationic liposomes does not cause hepatic toxicity. This investigation......, the question of potential toxicological effects needs to be addressed. In the present investigation, a cationic liposome with prospective for medical applications was constructed and thoroughly assessed for any material-induced hepatic adverse effects in vivo − in healthy and alcoholic hepatic disease models...... is important as it investigates the toxicity of a nano-sized material in a model of alcoholic hepatic disease in vitro and in vivo. This is an area of research in the field of nanotoxicology that is currently almost entirely overlooked....

  19. Acute and Sub-Chronic Toxicity Potential Effects of Alchornea ...

    African Journals Online (AJOL)

    The open field test showed that sub-chronic administration increased rearing behavior significantly at the dose of 250 mg/kg/28 days but had no effect on grooming. In conclusion, the ethanolic extract has no toxicological effect as observed on hematological, biochemical and histopathological parameters even at the ...

  20. Studies on chronic effect on radiation

    International Nuclear Information System (INIS)

    Yun, T.K.; Kang, T.U.; Yun, Y.S.; Chung, I.Y.; Koh, J. W.; Kim, J.W.; Ryu, Y.W.

    1983-01-01

    This experiment was carried out to evaluate the chronic harzard of Co-60 low dose irradiation on ICR mice. There is now considerable evidence from human studies that age, both at exposure to radiation and at observation for risk, can be a major determinant of radiation induced cancer risk. For this reason, ICR mice at different ages as specified below were exposed to 60 m rads/week, 500 m rads/biweek of whole body Co-60 radiation at a dose rate of 3.6 rads/min. ICR mice were irradiated during pregnant period and each period from the 1st week to the 3rd week to the 52nd week, from the 6th week to the 52nd week and from the 22nd week to the 52nd week after the birth. All the experimental mice were autopsied immediately after sacrificed at the 52nd week. And all of their major organs were examined grossly and weighed. After fixation histo-pathological preparations were made for microscopical study. Blood cells-W.B.C., R.B.C., Hb-from eye's vein were counted by hemocytometer and hemometer. (Author)

  1. Validation of the Danish version of the Patient Assessment of Care for Chronic Conditions questionnaire (PACIC)

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Maindal, Helle Terkildsen; Vedsted, Peter

    Objective: To evaluate the level of chronic care patients must be involved. The Danish version of the 20-item Patient Assessment of Care for Chronic Conditions PACIC questionnaire consisting of 5 scales and an overall summary score measuring patient reported assessment of structured chronic care ...... the same questionnaire is constructed and applied to different countries with diverse cultural backgrounds and health care systems. It is decisive, that translated questionnaires are validated in country they are used.......Objective: To evaluate the level of chronic care patients must be involved. The Danish version of the 20-item Patient Assessment of Care for Chronic Conditions PACIC questionnaire consisting of 5 scales and an overall summary score measuring patient reported assessment of structured chronic care...... interitem correlation), item-rest correlations. Model fit from confirmatory factor analysis (CFA). Results: We present the psychometric properties of the questionnaire and the first results evaluating chronic care in Danish people with diabetes. Conclusions: The complexity of validation is greater when...

  2. Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain.

    Science.gov (United States)

    Tetsunaga, Tomoko; Tetsunaga, Tomonori; Tanaka, Masato; Nishida, Keiichiro; Takei, Yoshitaka; Ozaki, Toshifumi

    2016-01-01

    Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.

  3. Practical Chronic Pain Assessment Tools in Clinical Practice

    OpenAIRE

    Lončarić-Katušin, Mirjana; Milošević, Milan; Žilić, Antonio; Mišković, Petar; Majerić-Kogler, Višnja; Žunić, Josip

    2016-01-01

    The aim of the study was to show the role of tools in the evaluation of chronic pain (CP) in general practitioner (GP) everyday clinical practice. The study was done by analyzing electronic database of the first visits of 1090 CP patients referred to the Pain Clinic of the Karlovac General Hospital, Karlovac, Croatia, by their GPs. All patient records were analyzed according to the cause of CP, strongest pain a week before the examination, quality of sleep, and the Patients’ Global Impression...

  4. Uranium chronic contamination effects on the cholinergic system: in vivo and in vitro approaches

    International Nuclear Information System (INIS)

    Bensoussan, H.

    2009-01-01

    Uranium (U) is a heavy metal which occurs naturally in the environment. It is both a chemical and a radiological toxicant. The aim of this work was: (i) to assess the effects of U chronic exposure on the cholinergic system (biosynthesis and breakdown enzymes, receptors and on behaviour of adult, young or predisposed to neuro-degenerative illness (ApoE KO) rodents; (ii) to grasp the neurotoxic effects of U on human neuronal cells. In vivo, this work shows a structure- (cortex more sensitive than hippocampus), rodent model- (young more sensitive than adults), time- (sub-chronic exposure more harmful than chronic exposure), exposure level- and isotope-dependent effect of U. In vitro, the study underlined the neuro-cytotoxic U potential and the presence of uranium precipitates in cells. These results show the deleterious impact of U on neuronal cells, and demonstrate that U induces impairments on the cholinergic system and the behaviour of rodents. (author)

  5. Assessment of driving-related performance in chronic whiplash using an advanced driving simulator.

    Science.gov (United States)

    Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Rakotonirainy, Andry; Haines, Andrew; Jull, Gwendolen

    2013-11-01

    Driving is often nominated as problematic by individuals with chronic whiplash associated disorders (WAD), yet driving-related performance has not been evaluated objectively. The purpose of this study was to test driving-related performance in persons with chronic WAD against healthy controls of similar age, gender and driving experience to determine if driving-related performance in the WAD group was sufficiently impaired to recommend fitness to drive assessment. Driving-related performance was assessed using an advanced driving simulator during three driving scenarios; freeway, residential and a central business district (CBD). Total driving duration was approximately 15min. Five driving tasks which could cause a collision (critical events) were included in the scenarios. In addition, the effect of divided attention (identify red dots projected onto side or rear view mirrors) was assessed three times in each scenario. Driving performance was measured using the simulator performance index (SPI) which is calculated from 12 measures. z-Scores for all SPI measures were calculated for each WAD subject based on mean values of the control subjects. The z-scores were then averaged for the WAD group. A z-score of ≤-2 indicated a driving failing grade in the simulator. The number of collisions over the five critical events was compared between the WAD and control groups as was reaction time and missed response ratio in identifying the red dots. Seventeen WAD and 26 control subjects commenced the driving assessment. Demographic data were comparable between the groups. All subjects completed the freeway scenario but four withdrew during the residential and eight during the CBD scenario because of motion sickness. All scenarios were completed by 14 WAD and 17 control subjects. Mean z-scores for the SPI over the three scenarios was statistically lower in the WAD group (-0.3±0.3; Pdriving. There were no differences in the reaction time and missed response ratio in divided

  6. A Biomathematical Model of Lymphopoiesis and Its Application to Acute and Chronic Irradiation Assessment

    Science.gov (United States)

    Hu, Shaowen; Cucinotta, Francis A.

    2010-01-01

    After the events of September 11, 2001, there is an increasing concern of the occurrence of radiological terrorism that may result in significant casualties in densely populated areas. Much effort has been made to establish various biomarkers to rapidly assess radiation dose in mass-casualty and population-monitoring scenarios, which are demanded for effective medical management and treatment of the exposed victims. Among these the count of lymphocytes in peripheral blood and their depletion kinetics are the most important early indicators of the severity of the radiation injury. In this study, we examine a biomathematical model of lymphopoiesis which has been successfully utilized to simulate and interpret experimental data of acute and chronic irradiations on rodents [1]. With revised parameters for humans, we find this model can reproduce several sets of clinical lymphocyte data of accident victims over a wide range of absorbed doses. In addition, the absolute lymphocyte counts and the depletion rate constants calculated by this model also show good correlation with the Guskova formula and the Goans model, the two empirical tools which have been widely recognized for early estimation of the exposed dose after radiation accidents [2]. We also use the model to analyze the hematological data of the Techa River residents which were exposed to chronic low-dose irradiation during 1950-1956 [3]. This model can serve as a computational tool in radiation accident management, military operations involving nuclear warfare, radiation therapy, and space radiation risk assessment.

  7. Prevalence of herpesviruses in gingivitis and chronic periodontitis: relationship to clinical parameters and effect of treatment

    Directory of Open Access Journals (Sweden)

    Rucha Shah

    2016-01-01

    Full Text Available Background: Assess the prevalence of herpesviruses in healthy subjects, gingivitis, and chronic periodontitis patients, to assess the relationship between the prevalence of herpesviruses and periodontal clinical parameters, and to evaluate the effect of phase-I therapy on the level of viral detection. Materials and Methods: Hundred patients consisting of 20 healthy subjects, 40 gingivitis, and 40 chronic periodontitis were included in the study. Clinical parameters recorded included plaque index, gingival index, sulcus bleeding index, probing depth, and clinical attachment level. The gingivitis and chronic periodontitis patients received phase-I periodontal therapy including oral hygiene instructions, full mouth scaling for gingivitis patients and scaling and root planing for chronic periodontitis patients. Gingival crevicular fluid (GCF was collected, and the presence of herpes simplex virus-1 (HSV-1, HSV-2, cytomegalovirus, and Epstein–Barr virus (EBV was analyzed using polymerase chain reaction (PCR. Recording of periodontal parameters as well as GCF collection was performed at baseline and 6 weeks postphase-I therapy. Results: At baseline, the levels of HSV-1 and EBV detection were lower in healthy controls as compared to gingivitis (P < 0.05 and chronic periodontitis cases (P < 0.001. Phase-I therapy led to reduction in the amount of HSV-1 and EBV in gingivitis patients (P < 0.05 and for HSV-1, human cytomegalovirus and EBV in chronic periodontitis patients (P < 0.05 in comparison to baseline. The prevalence of EBV in chronic periodontitis patients was positively associated with increased gingival index, probing depth and loss of clinical attachment (P < 0.05. Conclusions: Higher prevalence of HSV-1 and EBV viruses in GCF of gingivitis and chronic periodontitis suggests a strong association between these viruses and periodontal diseases and periodontal therapy can lead to a reduction in herpesviruses at infected sites.

  8. Assessing the Construct Validity and Internal Reliability of the Screening Tool Test Your Memory in Patients with Chronic Pain

    Science.gov (United States)

    Ojeda, B.; Salazar, A.; Dueñas, M.; Torres, L. M.; Mico, J. A.; Failde, I.

    2016-01-01

    Patients with chronic pain often complain about cognitive difficulties, and since these symptoms represent an additional source of suffering and distress, evaluating the cognitive status of these patients with valid and reliable tests should be an important part of their overall assessment. Although cognitive impairment is a critical characteristic of pain, there is no specific measure designed to detect these effects in this population. The objective was to analyze the psychometric properties of the “Test Your Memory” (TYM) test in patients with chronic pain of three different origins. A cross-sectional study was carried out on 72 subjects free of pain and 254 patients suffering from different types of chronic pain: neuropathic pain (104), musculoskeletal pain (99) and fibromyalgia (51). The construct validity of the TYM was assessed using the Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADs), Index-9 from MOS-sleep, SF-12, and through the intensity (Visual Analogical Scale) and duration of pain. An exploratory factor analysis was also performed and internal reliability was assessed using Cronbach’s alpha. After adjusting for potential confounders the TYM could distinguish between pain and pain-free patients, and it was correlated with the: MMSE (0.89, pmental components (0.55, p valid and reliable screening instrument to assess cognitive function in chronic pain patients that will be of particular value in clinical situations. PMID:27119165

  9. Assessing the Construct Validity and Internal Reliability of the Screening Tool Test Your Memory in Patients with Chronic Pain.

    Science.gov (United States)

    Ojeda, B; Salazar, A; Dueñas, M; Torres, L M; Mico, J A; Failde, I

    2016-01-01

    Patients with chronic pain often complain about cognitive difficulties, and since these symptoms represent an additional source of suffering and distress, evaluating the cognitive status of these patients with valid and reliable tests should be an important part of their overall assessment. Although cognitive impairment is a critical characteristic of pain, there is no specific measure designed to detect these effects in this population. The objective was to analyze the psychometric properties of the "Test Your Memory" (TYM) test in patients with chronic pain of three different origins. A cross-sectional study was carried out on 72 subjects free of pain and 254 patients suffering from different types of chronic pain: neuropathic pain (104), musculoskeletal pain (99) and fibromyalgia (51). The construct validity of the TYM was assessed using the Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADs), Index-9 from MOS-sleep, SF-12, and through the intensity (Visual Analogical Scale) and duration of pain. An exploratory factor analysis was also performed and internal reliability was assessed using Cronbach's alpha. After adjusting for potential confounders the TYM could distinguish between pain and pain-free patients, and it was correlated with the: MMSE (0.89, pmental components (0.55, p reliable screening instrument to assess cognitive function in chronic pain patients that will be of particular value in clinical situations.

  10. A systematic review of the effect of yogurt consumption on chronic diseases risk markers in adults.

    Science.gov (United States)

    Dumas, Audrée-Anne; Lapointe, Annie; Dugrenier, Marilyn; Provencher, Véronique; Lamarche, Benoît; Desroches, Sophie

    2017-06-01

    We reviewed randomised controlled trials (RCTs) that have assessed the effects of yogurt containing Lactobacillus bulgaricus and Streptococcus thermophilus (LBST) on metabolic risk markers of chronic diseases in adults. We performed a systematic search in July 2016 in the scientific databases PubMed, EMBASE and The Cochrane Library. Included studies were RCTs that assessed the impact of consuming yogurt containing LBST as a treatment, and that evaluated at least one metabolic risk marker for chronic diseases compared with a control diet or a diet supplemented in another food/ingredient in healthy or chronically ill adults. Seven RCTs involving 278 participants were included in the review. Studies were conducted in the USA, France, Spain, Iran and Canada. Five studies were undertaken in healthy adults, and two were conducted among lactose malabsorbers. All studies investigated changes in blood lipids and glucose homoeostasis, with different doses of yogurt, durations of the supplementation and risks markers assessed. Consumption of LBST yogurt significantly reduced total cholesterol concentrations, ratio of total cholesterol to HDL-C and plasma glucose compared to a control yogurt-free diet or diet supplemented in another food/ingredient in two out of the seven studies. The majority of included RCTs presented high to unclear methodological risks of bias, which raises questions about the validity of their findings. Data from this systematic review indicate that the consumption of LBST yogurt shows either favourable or neutral effects on metabolic risk markers when compared with a control treatment in controlled research settings. RCTs investigating the effect of LBST yogurt consumption on metabolic risk markers of chronic diseases are scarce and presented considerable variation in methodologies making comparison between studies difficult. Further large-scale, well-designed studies assessing the impact of LBST yogurt, in particular in comparison with a control yogurt

  11. Effect of chronic 85Kr exposure

    International Nuclear Information System (INIS)

    Willard, D.H.; DeFord, H.S.; Ballou, J.E.

    1980-01-01

    Groups of rats exposed continuously for 15 mo to 85 Kr atmospheres have received measured dose rates of 2750, 370, and 38 rad/yr. With more than 75% of the rats still alive, there has been no dose-related effect on weight gain but a probably significant effect on survival

  12. Mechanism, Assessment and Management of Pain in Chronic Pancreatitis: Recommendations of a Multidisciplinary Study Group

    Science.gov (United States)

    Anderson, Michelle A; Akshintala, Venkata; Albers, Kathryn M; Amann, Stephen T.; Belfer, Inna; Brand, Randall; Chari, Suresh; Cote, Greg; Davis, Brian M.; Frulloni, Luca; Gelrud, Andres; Guda, Nalini; Humar, Abhinav; Liddle, Rodger A.; Slivka, Adam; Gupta, Rachelle Stopczynski; Szigethy, Eva; Talluri, Jyothsna; Wassef, Wahid; Wilcox, C Mel; Windsor, John; Yadav, Dhiraj; Whitcomb, David C.

    2015-01-01

    Description Pain in patients with chronic pancreatitis (CP) remains the primary clinical complaint and source of poor quality of life. However, clear guidance on evaluation and treatment is lacking. Methods Pancreatic Pain working groups reviewed information on pain mechanisms, clinical pain assessment and pain treatment in CP. Levels of evidence were assigned using the Oxford system, and consensus was based on GRADE. A consensus meeting was held during PancreasFest 2012 with substantial post-meeting discussion, debate, and manuscript refinement. Results Twelve discussion questions and proposed guidance statements were presented. Conference participates concluded: Disease Mechanism: Pain etiology is multifactorial, but data are lacking to effectively link symptoms with pathologic feature and molecular subtypes. Assessment of Pain: Pain should be assessed at each clinical visit, but evidence to support an optimal approach to assessing pain character, frequency and severity is lacking. Management: There was general agreement on the roles for endoscopic and surgical therapies, but less agreement on optimal patient selection for medical, psychological, endoscopic, surgical and other therapies. Conclusions Progress is occurring in pain biology and treatment options, but pain in patients with CP remains a major problem that is inadequately understood, measured and managed. The growing body of information needs to be translated into more effective clinical care. PMID:26620965

  13. A study of measurement properties of the Life-Space Assessment questionnaire in older adults with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Garcia, Isabel Fialho Fontenele; Tiuganji, Carina Tiemi; Simões, Maria do Socorro Morais Pereira; Lunardi, Adriana Claudia

    2018-06-01

    To test the measurement properties (reliability, interpretability, and validity) of the Life-Space Assessment questionnaire for older adults with chronic obstructive pulmonary disease. Clinimetric study. Pneumology service, ambulatory care, São Paulo, SP, Brazil. Consecutive sample of older adults ( n = 62; 38 (61%) men, 24 (39%) women) with chronic obstructive pulmonary disease. Not applicable. Life-Space Assessment questionnaire assesses five space levels visited by the older adult in four weeks prior to the assessment. We tested the following measurement properties of this questionnaire: reliability (reproducibility assessed by a type-2,1 intraclass correlation coefficient (ICC 2,1 ); internal consistency assessed by the Cronbach's alpha; measurement error by determining the standard error of measurement (SEM)), interpretability (minimum detectable change with 90% confidence (MDC 90 ); ceiling and floor effects by calculating the proportion of participants who achieved the minimum and maximum scores), and validity by Pearson's correlation test between the Life-Space Assessment questionnaire scores and number of daily steps assessed by accelerometry. Reproducibility (ICC 2,1 ) was 0.90 (95% confidence interval (CI): 0.84-0.94), and internal consistency (Cronbach's α) was 0.80 (range = 0.76-0.80 for each item deleted). SEM was 3.65 points (3%), the MDC 90 was 0.20 points, and we observed no ceiling (2%) or floor (6%) effects. We observed an association between the score of the Life-Space Assessment questionnaire and daily steps ( r = 0.43; P = 0.01). Life-Space Assessment questionnaire shows adequate measurement properties for the assessment of life-space mobility in older adults with chronic obstructive pulmonary disease.

  14. Assessment of chronic constipation: colon transit time versus defecography

    International Nuclear Information System (INIS)

    Prokesch, R.W.; Breitenseher, M.J.; Kettenbach, J.; Herbst, F.; Maier, A.; Lechner, G.; Mahieu, P.

    1999-01-01

    Objective: The aim of this study was to determine the value of radiological colon transit time (CTT) measurements in relation to defecography (DFG) in chronically constipated patients. Materials and methods: In 30 patients with chronic constipation, total and segmental CTT was determined using radiopaque markers. In all of these patients defecography (DFG) was obtained. The patients were divided into three groups: In group I, 11 patients were classified with idiopathic constipation based on low stool frequency, normal DFG, or absence of symptoms of abnormal defecation. In group II, ten patients with rectal intussusception were diagnosed by DFG. In group III, there were nine patients with rectal prolapse or spastic pelvic floor syndrome, based on results of DFG. Results: Group I, idiopathic constipation (n=11), showed increased total CTT (mean, 93 h) and segmental CTT (right colon, 33 h (36%), left colon, 31 h (33%), rectosigmoid, 29 h (31%)). In group II, intussusception (n=10), patients had normal mean total CTT (54 h) and a relative decrease in rectosigmoid CTT (mean, 13 h (24%)). In group III (n=9), rectal prolapse (n=5) or spastic pelvic floor syndrome (n=4), patients showed elevated total (mean, 167 h) and rectosigmoidal CTT (mean, 95 h (57%)). Mean total CTT was significantly different between groups I and II and between groups II and III, and mean rectosigmoidal CTT was significantly different between all three groups (P<0.05). Conclusion: The use of total and rectosigmoidal CTT helps to identify the underlying pathophysiology of chronic constipation. Furthermore CTT helps to identify patients, who may benefit from DFG

  15. Assessment of chronic constipation: colon transit time versus defecography

    Energy Technology Data Exchange (ETDEWEB)

    Prokesch, R.W. E-mail: rupert.prokesch@univie.ac.at; Breitenseher, M.J.; Kettenbach, J.; Herbst, F.; Maier, A.; Lechner, G.; Mahieu, P

    1999-12-01

    Objective: The aim of this study was to determine the value of radiological colon transit time (CTT) measurements in relation to defecography (DFG) in chronically constipated patients. Materials and methods: In 30 patients with chronic constipation, total and segmental CTT was determined using radiopaque markers. In all of these patients defecography (DFG) was obtained. The patients were divided into three groups: In group I, 11 patients were classified with idiopathic constipation based on low stool frequency, normal DFG, or absence of symptoms of abnormal defecation. In group II, ten patients with rectal intussusception were diagnosed by DFG. In group III, there were nine patients with rectal prolapse or spastic pelvic floor syndrome, based on results of DFG. Results: Group I, idiopathic constipation (n=11), showed increased total CTT (mean, 93 h) and segmental CTT (right colon, 33 h (36%), left colon, 31 h (33%), rectosigmoid, 29 h (31%)). In group II, intussusception (n=10), patients had normal mean total CTT (54 h) and a relative decrease in rectosigmoid CTT (mean, 13 h (24%)). In group III (n=9), rectal prolapse (n=5) or spastic pelvic floor syndrome (n=4), patients showed elevated total (mean, 167 h) and rectosigmoidal CTT (mean, 95 h (57%)). Mean total CTT was significantly different between groups I and II and between groups II and III, and mean rectosigmoidal CTT was significantly different between all three groups (P<0.05). Conclusion: The use of total and rectosigmoidal CTT helps to identify the underlying pathophysiology of chronic constipation. Furthermore CTT helps to identify patients, who may benefit from DFG.

  16. Chronic intermittent ethanol exposure in early adolescent and adult male rats: effects on tolerance, social behavior, and ethanol intake.

    Science.gov (United States)

    Broadwater, Margaret; Varlinskaya, Elena I; Spear, Linda P

    2011-08-01

    Given the prevalence of alcohol use in adolescence, it is important to understand the consequences of chronic ethanol exposure during this critical period in development. The purpose of this study was to assess possible age-related differences in susceptibility to tolerance development to ethanol-induced sedation and withdrawal-related anxiety, as well as voluntary ethanol intake after chronic exposure to relatively high doses of ethanol during adolescence or adulthood. Juvenile/adolescent and adult male Sprague-Dawley rats were assigned to one of five 10-day exposure conditions: chronic ethanol (4 g/kg every 48 hours), chronic saline (equivalent volume every 24 hours), chronic saline/acutely challenged with ethanol (4 g/kg on day 10), nonmanipulated/acutely challenged with ethanol (4 g/kg on day 10), or nonmanipulated. For assessment of tolerance development, duration of the loss of righting reflex (LORR) and blood ethanol concentrations (BECs) upon regaining of righting reflex (RORR) were tested on the first and last ethanol exposure days in the chronic ethanol group, with both saline and nonmanipulated animals likewise challenged on the last exposure day. Withdrawal-induced anxiety was indexed in a social interaction test 24 hours after the last ethanol exposure, with ethanol-naïve chronic saline and nonmanipulated animals serving as controls. Voluntary intake was assessed 48 hours after the chronic exposure period in chronic ethanol, chronic saline and nonmanipulated animals using an 8-day 2 bottle choice, limited-access ethanol intake procedure. In general, adolescent animals showed shorter durations of LORR and higher BECs upon RORR than adults on the first and last ethanol exposure days, regardless of chronic exposure condition. Adults, but not adolescents, developed chronic tolerance to the sedative effects of ethanol, tolerance that appeared to be metabolic in nature. Social deficits were observed after chronic ethanol in both adolescents and adults

  17. Disease-management partnership functioning, synergy and effectiveness in delivering chronic-illness care.

    Science.gov (United States)

    Cramm, Jane Murray; Nieboer, Anna Petra

    2012-06-01

    This study explored associations among disease-management partnership functioning, synergy and effectiveness in the delivery of chronic-illness care. This study had a cross-sectional design. The study sample consists of 218 professionals (out of 393) participating in 22 disease-management partnerships in various regions of the Netherlands. We assessed the relationships among partnership functioning, synergy and effectiveness in the delivery of chronic-illness care. Partnership functioning was assessed through leadership, resources, administration and efficiency. Synergy was considered the proximal outcome of partnership functioning, which, in turn, influenced the effectiveness of disease-management partnerships [measured with the Assessment of Chronic Illness Care (ACIC) survey instrument]. Overall ACIC scores ranged from 3 to 10, indicating basic/intermediate to optimal/comprehensive delivery of chronic-illness care. The results of the regression analysis demonstrate that partnership effectiveness was positively associated with leadership (β = 0.25; P≤ 0.01), and resources (β = 0.31; P≤ 0.001). No significant relationship was found between administration, efficiency and partnership effectiveness. Partnership synergy acted as a mediator for partnership functioning and was statistically significantly associated with partnership effectiveness (β = 0.25; P≤ 0.001). Disease-management partnerships seemed better able to deliver higher levels of chronic-illness care when synergy is created between partners. Synergy was more likely to emerge with boundary-spanning leaders who understood and appreciated partners' different perspectives, could bridge their diverse cultures and were comfortable sharing ideas, resources and power. In addition, the acknowledgement of and ability to use members' resources are valuable in engaging partners' involvement and achieving synergy in disease-management partnerships.

  18. Differential effect of opioids in patients with chronic pancreatitis

    DEFF Research Database (Denmark)

    Staahl, Camilla; Dimcevski, Georg; Andersen, Søren Due

    2007-01-01

    and morphine on experimental pain in patients with pain caused by chronic pancreatitis. MATERIAL AND METHODS: Ten patients took part in this blinded, cross-over study. The analgesic effects of morphine (30 mg, oral), oxycodone (15 mg, oral) and placebo were tested against multimodal (mechanical, thermal...

  19. effect of chronic consumption of cow's urine concoction on gastric ...

    African Journals Online (AJOL)

    Dr Olaleye

    The effect of chronic consumption of cow's urine concoction (CUC) and the role of tobacco leaves was studied on the gastric ... CUC-T fed group showed 80% reduction but the pyloric glands in group fed with CUC-NT were not reduced. ... The concoction was given orally through a plastic tube as reported by other authors.

  20. effect of chronic consumption of powdered tobacco (snuff)

    African Journals Online (AJOL)

    Uwaifoh

    2012-12-31

    Dec 31, 2012 ... The effect of chronic consumption of tobacco powder on anxiety, fear and social ... only, while the test group received mixed feed of 1gram powdered tobacco per ..... alkaloid, nicotine decrease tension and depressive feelings and promote the ... Ethnologically based animal models of anxiety disorders.

  1. Ameliorative effect of Draba nemorosa extract on chronic heart ...

    African Journals Online (AJOL)

    Purpose: To evaluate the effect of Draba nemorosa extract (DNE) on oxidative stress and hemodynamics in rats with chronic congestive heart failure (CHF). Methods: Adriamycin was used to establish CHF in Sprague Dawley (SD) rat model. Six groups of SD rats were used in this study: control group, CHF group, captopril ...

  2. Chronic acetaminophen overdosing in children: risk assessment and management.

    Science.gov (United States)

    Sztajnkrycer, M J; Bond, G R

    2001-04-01

    Acetaminophen is currently the pediatric analgesic and antipyretic of choice. Although children appear to tolerate single, high-dose ingestions well, the literature is replete with reports of significant morbidity and mortality after repeated supra-therapeutic dosing. Proposed risk factors for injury with chronic use include age, total dose, duration, presence of intercurrent febrile illness, starvation, co-administration of cytochrome P450-inducing drugs, underlying hepatic disease, and unique genetic makeup. Evaluation of these children should include serum acetaminophen concentration, prothrombin time, and serum bilirubin and transaminase concentrations. The Rumack-Mathew nomogram should not be used to estimate the risk of hepatotoxicity in cases of chronic ingestion. Based on history, clinical examination, and laboratory findings, patients may be placed in three categories: those without hepatic injury and with no residual acetaminophen to be metabolized, those without injury but with some acetaminophen to be metabolized, and those with hepatotoxicity. Those without injury and no residual acetaminophen need not be treated or followed. Patients with hepatotoxicity or potential for hepatotoxicity based on residual acetaminophen should be treated with N-acetylcysteine. Most importantly, because so many parents are unaware of the potential risk of inappropriate dosing, education is the key to preventing future cases.

  3. Effects of chronic stress on the brain – the evidence from morphological examinations of hippocampus in a chronic unpredictable stress (CUS model in rats

    Directory of Open Access Journals (Sweden)

    Joanna Sekita-Krzak

    2016-12-01

        Abstract Background. Chronic stress exposure deteriorates memory and increases the risk of psychiatric disorders, including depression. Objectives. The objective of this study was to perform morphological studies in experimental model of neuropsychiatric disorder and to assess histologically the effect of chronic unpredictable stress procedure (CUS influence on hippocampus. Material and methods. Chronic unpredictable stress procedure (CUS was applied for 8 weeks in rats by the modified method described by Katz et al. Experimental model of neuropsychiatric disorder was used based on morphological studies of hippocampal formation. Results. Stress-induced alterations were observed in the hippocampus. Nerve cell changes included  neuron shrinkage and dendritic remodeling. The most vulnerable hippocampal cells to chronic stress were CA3 and CA4 pyramidal neurons. In dentate gyrus chronic stress led to granule neuron shrinkage and slight exacerbation of apoptosis in the polygonal cell layer. CUS led to statistically significant changes in quantitative characteristics of the CA3 and CA4 neuron size and nuclei diameter. Conclusions. Chronic stress induces degeneration of hippocampal neurons. The observed neuronal changes indicate the damage of the neurons did not involve neither apoptosis nor necrosis Similarity between histological changes obtained in 8-week long CUS procedure applied in our research and morphological changes described in depressed patients confirms the usefulness of the applied stress procedure as the experimental model of depression.   Key words: stress, depression, hippocampus, chronic unpredictable stress procedure (CUS, animal model, morphology.

  4. Assessing the effect of high-repetitive single limb exercises (HRSLE on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD: study protocol for randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nyberg Andre

    2012-07-01

    Full Text Available Abstract Background Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD. Since the positive local physiological effects of exercise training only occur in the engaged muscle(s, should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. Methods/design Trial design: a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. Participants: stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. Interventions: 1 high-repetitive single limb exercise (HRSLE training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2 the same patient education alone. Outcomes: Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire. Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1:1 allocation to the intervention or control using random

  5. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Jay, Kenneth; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    BACKGROUND: Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. OBJECTIVES: This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal......: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively......, as outcome measures. RESULTS: A significant (P stress was observed (treatment by time P = 0.16). Exploratory analyses for each body...

  6. Effect of chronic 85Kr exposure

    International Nuclear Information System (INIS)

    Willard, D.H.; Deford, H.S.; Gerk, R.E.; Ballou, J.E.

    1979-01-01

    Rats are being exposed continuously for their life span to three concentrations of 85 Kr: 3 x 10 -3 , 3 x 10 -4 , and 3 x 10 -5 μCi/ml. A group of treated controls exposed to room air completes the study. No effects of treatment have been observed up to 70 days postexposure

  7. Effectiveness of LISTEN on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and physical health measures of chronic illness

    Directory of Open Access Journals (Sweden)

    Laurie A. Theeke

    2016-09-01

    Conclusions: LISTEN can effectively diminish loneliness and decrease the systolic blood pressure in community-dwelling, chronically ill, older adults. Results indicate that this population, if left with untreated loneliness, may experience functional impairment over a period as short as 4 months. Further studies on LISTEN are needed with larger samples, in varied populations, and over longer periods of time to assess the long-term effects of diminishing loneliness in multiple chronic conditions.

  8. Patient-Assessed Chronic Illness Care (PACIC scenario in an Indian homeopathic hospital

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    Munmun Koley

    2016-01-01

    Full Text Available Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC 0.57–0.75; positive to strong positive correlations; p0.05; however, monthly household income had a significant influence (p<0.05 on the subscales except for “delivery system or practice design.” Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital.

  9. Acute Effects of Ecstasy on Memory Are more Extensive than Chronic Effects.

    Science.gov (United States)

    Shariati, Mohamad Bakhtiar Hesam; Sohrabi, Maryam; Shahidi, Siamak; Nikkhah, Ali; Mirzaei, Fatemeh; Medizadeh, Mehdi; Asl, Sara Soleimani

    2014-01-01

    Exposure to 3, 4- methylenedioxymethamphetamine (MDMA) could lead to serotonergic system toxicity in the brain. This system is responsible for learning and memory functions. Studies show that MDMA causes memory impairment dose-dependently and acutely. The present study was designed to evaluate the chronic and acute effects of MDMD on spatial memory and acquisition of passive avoidance. Adult male Wistar rats (200-250 g) were given single or multiple injections of MDMA (10 mg/kg, IP). Using passive avoidance and Morris Water Maze (MWM) tasks, learning and spatial memory functions were assessed. The data were analyzed by SPSS 16 software and one- way analysis of variance (ANOVA) test. Our results showed that there were significant differences in latency to enter the dark compartment (STL) between sham and MDMA- treated groups. Acute group significantly showed more STL in comparison with chronic group. Furthermore, MDMA groups spent more time in dark compartment (TDS) than the sham group. Administration of single dose of MDMA significantly caused an increase in TDS compared with the chronic group. In the MWM, MDMA treatment significantly increased the traveled distance and escaped latency compared to the sham group. Like to passive avoidance task, percentage of time spent in the target quadrant in MDMA- treated animals impaired in MWM compared with sham group. These data suggest that MDMA treatment impairs learning and memory functions that are more extensive in acute- treated rats.

  10. Acute Effects of Ecstasy on Memory Are more Extensive than Chronic Effects

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    Mohamad Bakhtiar Hesam Shariati

    2014-07-01

    Full Text Available Introduction: Exposure to 3, 4- methylenedioxymethamphetamine (MDMA could lead to serotonergic system toxicity in the brain. This system is responsible for learning and memory functions. Studies show that MDMA causes memory impairment dose-dependently and acutely. The present study was designed to evaluate the chronic and acute effects of MDMD on spatial memory and acquisition of passive avoidance. Methods: Adult male Wistar rats (200-250 g were given single or multiple injections of MDMA (10 mg/kg, IP. Using passive avoidance and Morris Water Maze (MWM tasks, learning and spatial memory functions were assessed. The data were analyzed by SPSS 16 software and one- way analysis of variance (ANOVA test. Results: Our results showed that there were significant differences in latency to enter the dark compartment (STL between sham and MDMA- treated groups. Acute group significantly showed more STL in comparison with chronic group. Furthermore, MDMA groups spent more time in dark compartment (TDS than the sham group. Administration of single dose of MDMA significantly caused an increase in TDS compared with the chronic group. In the MWM, MDMA treatment significantly increased the traveled distance and escaped latency compared to the sham group. Like to passive avoidance task, percentage of time spent in the target quadrant in MDMA- treated animals impaired in MWM compared with sham group. Discussion: These data suggest that MDMA treatment impairs learning and memory functions that are more extensive in acute- treated rats.

  11. Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies.

    Science.gov (United States)

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

    2018-04-01

    Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.

  12. Effect of chronic (-)-nicotine treatment on rat cerebral benzodiazepine receptors

    International Nuclear Information System (INIS)

    Magata, Yasuhiro; Kitano, Haruhiro; Shiozaki, Toshiki; Iida, Yasuhiko; Nishizawa, Sadahiko; Saji, Hideo; Konishi, Junji

    2000-01-01

    The purpose of this study was to clarify the effect of (-)-nicotine on cerebral benzodiazepine receptors (BzR) with radiotracer methods. The effect of (-)-nicotine on BzR was examined in in vitro studies using chronic (-)-nicotine-treated rats using 3 H-diazepam. The in vitro radioreceptor assay showed a 14% increase in the maximum number of binding sites of BzR in chronic (-)-nicotine-treated rats in comparison with the control rats. Moreover, a convenient in vivo uptake index of 125 I-iomazenil was calculated and a higher uptake of the radioactivity was observed in the chronic (-)-nicotine-treated group than in the control group. Although further studies of the mechanism of (-)-nicotine on such BzR changes are required, an increase in the amount of BzR in the cerebral cortex was found in rats that underwent chronic (-)-nicotine treatment, and this result contributed to the understanding of the effects of (-)-nicotine and smoking on neural functions

  13. Reliability and Validity of Dual-Task Mobility Assessments in People with Chronic Stroke

    Science.gov (United States)

    Yang, Lei; He, Chengqi; Pang, Marco Yiu Chung

    2016-01-01

    Background The ability to perform a cognitive task while walking simultaneously (dual-tasking) is important in real life. However, the psychometric properties of dual-task walking tests have not been well established in stroke. Objective To assess the test-retest reliability, concurrent and known-groups validity of various dual-task walking tests in people with chronic stroke. Design Observational measurement study with a test-retest design. Methods Eighty-eight individuals with chronic stroke participated. The testing protocol involved four walking tasks (walking forward at self-selected and maximal speed, walking backward at self-selected speed, and crossing over obstacles) performed simultaneously with each of the three attention-demanding tasks (verbal fluency, serial 3 subtractions or carrying a cup of water). For each dual-task condition, the time taken to complete the walking task, the correct response rate (CRR) of the cognitive task, and the dual-task effect (DTE) for the walking time and CRR were calculated. Forty-six of the participants were tested twice within 3–4 days to establish test-retest reliability. Results The walking time in various dual-task assessments demonstrated good to excellent reliability [Intraclass correlation coefficient (ICC2,1) = 0.70–0.93; relative minimal detectable change at 95% confidence level (MDC95%) = 29%-45%]. The reliability of the CRR (ICC2,1 = 0.58–0.81) and the DTE in walking time (ICC2,1 = 0.11–0.80) was more varied. The reliability of the DTE in CRR (ICC2,1 = -0.31–0.40) was poor to fair. The walking time and CRR obtained in various dual-task walking tests were moderately to strongly correlated with those of the dual-task Timed-up-and-Go test, thus demonstrating good concurrent validity. None of the tests could discriminate fallers (those who had sustained at least one fall in the past year) from non-fallers. Limitation The results are generalizable to community-dwelling individuals with chronic stroke only

  14. Testicular immunohistochemical and Ultrastructural changes associated with chronic cholestasis in rats: Effect of ursodeoxycholic acid.

    Science.gov (United States)

    Mahmoud, Yomna I

    2015-09-01

    Testicular atrophy has been commonly reported in patients with chronic liver diseases. Ursodeoxycholic acid is the most widely used drug for the treatment of many liver diseases. However, its effect on testicular ultrastructure associated with chronic cholestasis has never been studied. Thus, this study aimed to assess how chronic obstructive jaundice affects the testicular ultrastructure and whether it affects the androgen receptor or the proliferating cell nuclear antigen. The role of ursodeoxycholic acid was also investigated. Cholestasis was induced by bile duct ligation. Samples were collected 4weeks postoperative. Testicular changes were assessed using immunohistochemistry and transmission electron microscopy. Chronic cholestasis resulted in testicular atrophy evidenced by shrinkage and deformation of seminiferous tubules, thickening of peritubular boundaries, vacuolation, disorganization of germ cells, and maturation arrest. This was accompanied by decreased immunoreactivity of androgen receptors and proliferating cell nuclear antigen. Administration of ursodeoxycholic acid improved the testicular morphology and reversed cholestasis-induced immunohistochemical and ultrastructural changes. Ursodeoxycholic acid can improve the testicular ultrastructure and restore the spermatogenic process in rats with chronic cholestasis. These findings support the clinical application of ursodeoxycholic acid in cholestatic patients especially those with hypogonadism. Copyright © 2015. Published by Elsevier Inc.

  15. Assessment of Patient-Reported Outcome Instruments to Assess Chronic Low Back Pain.

    Science.gov (United States)

    Ramasamy, Abhilasha; Martin, Mona L; Blum, Steven I; Liedgens, Hiltrud; Argoff, Charles; Freynhagen, Rainer; Wallace, Mark; McCarrier, Kelly P; Bushnell, Donald M; Hatley, Noël V; Patrick, Donald L

    2017-06-01

     To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims.  Literature review of existing PRO measures.  Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes.  Thirteen instruments were selected and reviewed: Low Back Pain Bothersomeness Scale, Neuropathic Pain Symptom Inventory, PainDETECT, Pain Quality Assessment Scale Revised, Revised Short Form McGill Pain Questionnaire, Low Back Pain Impact Questionnaire, Oswestry Disability Index, Pain Disability Index, Roland-Morris Disability Questionnaire, Brief Pain Inventory and Brief Pain Inventory Short Form, Musculoskeletal Outcomes Data Evaluation and Management System Spine Module, Orebro Musculoskeletal Pain Questionnaire, and the West Haven-Yale Multidimensional Pain Inventory Interference Scale. The instruments varied in the aspects of pain and/or impacts that they assessed, and none of the instruments fulfilled all criteria for use in clinical trials to support labeling claims based on recommendations outlined in the FDA PRO guidance.  There is an unmet need for a validated PRO instrument to evaluate cLBP-related symptoms and impacts for use in clinical trials. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. Development of Toxicological Risk Assessment Models for Acute and Chronic Exposure to Pollutants

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    Elke S. Reichwaldt

    2016-08-01

    Full Text Available Alert level frameworks advise agencies on a sequence of monitoring and management actions, and are implemented so as to reduce the risk of the public coming into contact with hazardous substances. Their effectiveness relies on the detection of the hazard, but with many systems not receiving any regular monitoring, pollution events often go undetected. We developed toxicological risk assessment models for acute and chronic exposure to pollutants that incorporate the probabilities that the public will come into contact with undetected pollution events, to identify the level of risk a system poses in regards to the pollutant. As a proof of concept, we successfully demonstrated that the models could be applied to determine probabilities of acute and chronic illness types related to recreational activities in waterbodies containing cyanotoxins. Using the acute model, we identified lakes that present a ‘high’ risk to develop Day Away From Work illness, and lakes that present a ‘low’ or ‘medium’ risk to develop First Aid Cases when used for swimming. The developed risk models succeeded in categorising lakes according to their risk level to the public in an objective way. Modelling by how much the probability of public exposure has to decrease to lower the risks to acceptable levels will enable authorities to identify suitable control measures and monitoring strategies. We suggest broadening the application of these models to other contaminants.

  17. Effects of obesity and chronic low back pain on gait

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    Galli Manuela

    2011-09-01

    Full Text Available Abstract Background Obesity is often associated with low back pain (LBP. Despite empirical evidence that LBP induces gait abnormalities, there is a lack of quantitative analysis of the combined effect of obesity and LBP on gait. The aim of our study was to quantify the gait pattern of obese subjects with and without LBP and normal-mass controls by using Gait Analysis (GA, in order to investigate the cumulative effects of obesity and LBP on gait. Methods Eight obese females with chronic LBP (OLG; age: 40.5 ± 10.1 years; BMI: 42.39 ± 5.47 Kg/m2, 10 obese females (OG; age: 33.6 ± 5.2 years; BMI: 39.26 ± 2.39 Kg/m2 and 10 healthy female subjects (CG; age: 33.4 ± 9.6 years; BMI: 22.8 ± 3.2 Kg/m2, were enrolled in this study and assessed with video recording and GA. Results and Discussion OLG showed longer stance duration and shorter step length when compared to OG and CG. They also had a low pelvis and hip ROM on the frontal plane, a low knee flexion in the swing phase and knee range of motion, a low dorsiflexion in stance and swing as compared to OG. No statistically significant differences were found in ankle power generation at push-off between OLG and OG, which appeared lower if compared to CG. At hip level, both OLG and OG exhibited high power generation levels during stance, with OLG showing the highest values. Conclusions Our results demonstrated that the association of obesity and LBP affects more the gait pattern than obesity alone. OLG were in fact characterised by an altered knee and ankle strategy during gait as compared to OG and CG. These elements may help optimizing rehabilitation planning and treatment in these patients.

  18. Effects of Pilates and Classical Kinesiotherapy on chronic low back pain: a case study

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    Ivanna Avila Ribeiro

    Full Text Available Abstract Introduction : Chronic low back pain (LBP is characterized by daily lower back pain lasting more than three consecutive months. It may lead to functional disability and can be treated by several physical therapy techniques, including therapeutic exercise. The aim of this study was to investigate the effects of pilates and classical kinesiotherapy on the treatment of pain and functional disability in patients with chronic low back pain. Materials and methods : The study sample consisted of five patients with a diagnosis of chronic low back pain and a mean age of 32.4 ± 15.6 years. A Visual Analogue Scale (VAS was used for pain assessment, and the Oswestry Disability Index was used to assess functional disability at the beginning and at the end of the intervention. Patients were divided into two groups and received 20 individual sessions of therapeutic exercise at a frequency of two sessions per week. Group A was treated with classical kinesiotherapy and group B was treated with pilates exercises. Statistical analysis was performed using Wilcoxon's test. The significance level was set at 5%. Results : There was a significant reduction in pain (p = 043 and functional disability (p = 042 in both groups. We found no significant differences between the effects of pilates and classical kinesiotherapy on pain and functional disability. Conclusions : We conclude that, in the population studied here, both pilates and classical kinesiotherapy were effective in treating chronic low back pain symptoms, with no significant difference between them.

  19. Effects of chronic acceleration on body composition

    Science.gov (United States)

    Pitts, G. C.

    1982-01-01

    Studies of the centrifugation of adult rats showed an unexpected decrease in the mass of fat-free muscle and bone, in spite of the added load induced by centrifugation. It is suggested that the lower but constant fat-free body mass was probably regulated during centrifugation. Rats placed in weightless conditions for 18.5 days gave indirect but strong evidence that the muscle had increased in mass. Other changes in the rats placed in weightless conditions included a smaller fraction of skeletal mineral, a smaller fraction of water in the total fat-free body, and a net shift of fluid from skin to viscera. Adult rats centrifuged throughout the post-weaning growth period exhibited smaller masses of bone and central nervous system (probably attributable to slower growth of the total body), and a larger mass of skin than controls at 1 G. Efforts at simulating the effects of weightlessness or centrifugation on the body composition of rats by regimens at terrestrial gravity were inconclusive.

  20. The Effect of Curanderismo on Chronic Non-malignant Pain: A Case Report.

    Science.gov (United States)

    Kennedy, Laura; Gonzales, Erin; Corbin, Lisa

    2016-01-01

    This case study describes the effects of the use of curanderismo, an indigenous healing modality combining techniques in massage, sound, and aromatherapy, on a patient with chronic pain. Despite being a commonly used health practice in certain populations, little is reported in the medical literature about the use of curanderismo. Case report as part of a larger randomized trial of curanderismo for chronic pain. Setting was a community-based hospital affiliated primary care clinic. An adult patient with chronic, opioid dependent back pain following an injury, and subsequent spinal fusion was treated. Intervention was the patient received 33 curanderismo treatment sessions over 10 months in addition to ongoing conventional treatment at a community-based chronic pain management clinic. Main outcomes measures were self-reported assessments of pain, functional ability, mood, insomnia, and narcotic usage. Secondary outcome measure was qualitative interview. Although there was no change in quantitative self-reported pain measures, the patient reported improved function, mood, and sleep as well as decreased narcotic usage. Curanderismo, in addition to conventional pain management, improved patient reported symptoms and functional ability, led to healthy lifestyle changes, and decreased narcotic usage. Controlled studies are needed to confirm the benefit of curanderismo as safe, non-interventional, and cost-effective adjunct for chronic pain management. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The effect of spasticity, sense and walking aids in falls of people after chronic stroke.

    Science.gov (United States)

    Soyuer, Ferhan; Oztürk, Ahmet

    2007-05-15

    To study the effects of spasticity, sensory impairment, and type of walking aid on falls in community dwellers with chronic stroke. Functional Independence Measure (FIM) Instrument, Joint Position Sense Evaluation (JPS), the Rivermead motor assessment scale (RMA), Ashworth Scale, Tinetti Assessment Tool were used to assess 100 cases. Fifty-three of the cases were grouped as nonfallers, 36 as one-time fallers and 11 as repeat fallers. These 3 groups were found to be different from each other in respect to FIM, Tinetti test and RMA (p cane, 41.9% high cane). According to Ordinal logistic regression analysis, it was found that the possibility of fall increased (p fall of the individuals with stroke decreased (p falls, spasticity is also an indicator for chronic stroke patients, as is motor impairment, functional situation, impairment of balance and walking. Sensory impairment, using a walking aid and the type were found to be ineffective.

  2. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  3. Automated Tissue Classification Framework for Reproducible Chronic Wound Assessment

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    Rashmi Mukherjee

    2014-01-01

    Full Text Available The aim of this paper was to develop a computer assisted tissue classification (granulation, necrotic, and slough scheme for chronic wound (CW evaluation using medical image processing and statistical machine learning techniques. The red-green-blue (RGB wound images grabbed by normal digital camera were first transformed into HSI (hue, saturation, and intensity color space and subsequently the “S” component of HSI color channels was selected as it provided higher contrast. Wound areas from 6 different types of CW were segmented from whole images using fuzzy divergence based thresholding by minimizing edge ambiguity. A set of color and textural features describing granulation, necrotic, and slough tissues in the segmented wound area were extracted using various mathematical techniques. Finally, statistical learning algorithms, namely, Bayesian classification and support vector machine (SVM, were trained and tested for wound tissue classification in different CW images. The performance of the wound area segmentation protocol was further validated by ground truth images labeled by clinical experts. It was observed that SVM with 3rd order polynomial kernel provided the highest accuracies, that is, 86.94%, 90.47%, and 75.53%, for classifying granulation, slough, and necrotic tissues, respectively. The proposed automated tissue classification technique achieved the highest overall accuracy, that is, 87.61%, with highest kappa statistic value (0.793.

  4. Clinical and fiberoptic endoscopic assessment of swallowing in patients with chronic obstructive pulmonary disease

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    Macri, Marina Rodrigues Bueno

    2014-01-01

    Full Text Available Introduction: Chronic obstructive pulmonary disease is characterized by progressive and partially reversible obstruction of pulmonary airflow. Aim: To characterize swallowing in patients with chronic obstructive pulmonary disease and correlate the findings with the degree chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, and smoking. Method: We conducted a prospective cohort study of 19 patients (12 men and 7 women; age range, 50–85 years with confirmed medical diagnosis of chronic obstructive pulmonary disease. This study was performed in 2 stages (clinical evaluation and functional assessment using nasolaryngofibroscopy on the same day. During both stages, vital signs were checked by medical personnel. Results: Clinical evaluation of swallowing in all patients showed the clinical signs of cough. The findings of nasolaryngofibroscopy highlighted subsequent intraoral escape in 5 patients (26.5%. No patient had tracheal aspiration. There was no association of subsequent intraoral escape with degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking. Conclusion: In patients with chronic obstructive pulmonary disease, there was a prevalence of oral dysphagia upon swallowing and nasolaryngofibroscopy highlighted the finding of subsequent intraoral escape. There was no correlation between intraoral escape and the degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

  5. Analgesic effect of clobazam in chronic low-back pain but not in experimentally induced pain.

    Science.gov (United States)

    Schliessbach, J; Vuilleumier, P H; Siegenthaler, A; Bütikofer, L; Limacher, A; Juni, P; Zeilhofer, H U; Arendt-Nielsen, L; Curatolo, M

    2017-09-01

    Chronic pain is frequently associated with hypersensitivity of the nervous system, and drugs that increase central inhibition are therefore a potentially effective treatment. Benzodiazepines are potent modulators of GABAergic neurotransmission and are known to exert antihyperalgesic effects in rodents, but translation into patients are lacking. This study investigates the effect of the benzodiazepine clobazam in chronic low-back pain in humans. The aim of this study is to explore the effect of GABA modulation on chronic low-back pain and on quantitative sensory tests. In this double-blind cross-over study, 49 patients with chronic low-back pain received a single oral dose of clobazam 20 mg or active placebo tolterodine 1 mg. Pain intensity on the 0-10 numeric rating scale and quantitative sensory tests were assessed during 2 h after drug intake. Pain intensity in the supine position was significantly reduced by clobazam compared to active placebo (60 min: 2.9 vs. 3.5, p = 0.008; 90 min: 2.7 vs. 3.3, p = 0.024; 120 min: 2.4 vs. 3.1, p = 0.005). Pain intensity in the sitting position was not significantly different between groups. No effects on quantitative sensory tests were observed. This study suggests that clobazam has an analgesic effect in patients with chronic low-back pain. Muscle relaxation or sedation may have contributed to the effect. Development of substances devoid of these side effects would offer the potential to further investigate the antihyperalgesic action of GABAergic compounds. Modulation of GABAergic pain-inhibitory pathways may be a potential future therapeutic target. © 2017 European Pain Federation - EFIC®.

  6. [The effect of Helicobacter pylori eradication on chronic gastritis].

    Science.gov (United States)

    Kodama, Masaaki; Murakami, Kazunari; Okimoto, Tadayoshi; Fujioka, Toshio

    2013-08-01

    Helicobacter pylori (H. pylori) is a major pathogen of chronic atrophic gastritis, intestinal metaplasia, and gastric cancer. Atrophic gastritis and intestinal metaplasia are recognized as precancerous lesion of gastric cancer. Many studies reported that H. pylori eradication had the preventive effect of gastric cancer. Moreover many studies mentioned the improvement of gastric atrophy and/or intestinal metaplasia. Two meta-analysis indicated the improvement of atrophic gastritis but not of intestinal metaplasia. In our study, intestinal metaplasia improved at lesser curvature of the corpus six years after eradication. H. pylori eradication has benefit for gastric cancer prevention provably due to improvement of the precancerous lesion such as atrophic gastritis and intestinal metaplasia. Especially, H. pylori eradication before the appearance of atrophy and intestinal metaplasia has been considered to be effective in inhibiting the development of gastric cancer. Therefore, improvement or elimination of chronic gastritis with H. pylori eradication might have possibility of gastric cancer inhibition.

  7. SAFETY AND EFFECTIVENESS OF PIDOTIMOD IN ACUTE AND CHRONIC BRONCHITIS

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    A.V. Karaulov

    2010-01-01

    Full Text Available One of effective and safe immunomodulators for prophylaxis and treatment of frequently ailing children is pidotimod (Imunorix. Efficacy of the drug in pediatric practice was studied in more than 3200 patients with acute and recurrent respiratory infections. The article shows reasonability of pidotimod administration in children with acute and chronic bronchitis. This fact was confirmed with doubleblinded placebo-controlled studies. Treatment with pidotimod results in decreased terms of recovery of chronic bronchitis exacerbation, shortening of exacerbation. Realization of stable effect is related to recovery of key functions of inborn and adaptive immunity, it begins in 15 days after intake of the drug in therapeutic dose. Prophylactic doses of pidotimod should be used during next 30–60 days.Key words: children, bronchitis, pidotimod, immunity, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6:139-143

  8. A method for screening for the risk of chronic effects of surface water pollution.

    Science.gov (United States)

    Soldán, Přemysl; Badurová, Jana

    2013-01-01

    The article describes a method for screening for the risk of chronic surface water pollution which was developed at the T. G. Masaryk Water Research Institute. The approach, which is based on exotoxicological analyses, can be classed as a rapid method of assessment. The degree of risk of chronic effects surface water pollution is determined from an evaluation of two major parameters-toxicity and genotoxicity. As the method utilizes relative simple procedures for sample collection, pretreatment of the sample, chemical analyses, bioassays and results assessment, this approach is suitable for widespread practical use. Extensive utilization of this approach for assessing river basins in the Czech Republic has proved its suitability for a more sophisticated detection of the biological impact of surface water pollution. This is documented in the article where the method is used in a study of the Bílina River, and in the overview of the results of the risk assessment of chronic effects of surface water pollution in selected sections of three international river basins in the Czech Republic.

  9. Clinical effects of chronic irradiation in conditions of Chernobyl exclusion zone

    International Nuclear Information System (INIS)

    Nyagu, A.I.; Loganovskij, K.N.; Kostyuchenko, V.G.

    1999-01-01

    Threshold doses for des adaptation syndrome development during chronic external and internal irradiation were found. Effects of small dose accumulation were established. Chronic irradiation is resulted in different dystrophic processes, psychosomatic violations and in increase of stochastic effects

  10. Effects of aquatic walking exercise using a walker in a chronic stroke patient

    OpenAIRE

    Matsuda, Tadashi; Akezaki, Yoshiteru

    2017-01-01

    [Purpose] The aim of this study was to examine the usefulness of aquatic walking exercise using a walker for chronic stroke patients. We also examined the psychological effects on the study subject and the primary caregiver before and after aquatic walking exercise. [Subject and Methods] The subject was a 60-year-old male with bilateral paralysis after a cerebrovascular accident. The Fugl-Meyer Assessment (FMA) total score was 116 on the right and 115 on the left. The intervention combined aq...

  11. The dichotomous effect of chronic stress on obesity

    OpenAIRE

    Razzoli, Maria; Bartolomucci, Alessandro

    2016-01-01

    Obesity and metabolic diseases are linked to chronic stress and low socio-economic status. The mechanistic link between stress and obesity has not been clarified, partly due to the inherent complexity exemplified by the bidirectional effect of stress on eating and body weight. Recent studies focusing on adaptive-thermogenesis and brown adipose tissue (BAT) function support a dichotomous relationship to explain the impact of stress on obesity: stress promotes obesity in the presence of hyperph...

  12. ASSESSMENT AND COMPARISION OF CERVICAL JOINT POSITION SENSE IN SUBJECTS WITH CHRONIC NECK PAIN vs NORMALS

    Directory of Open Access Journals (Sweden)

    Oberoi Mugdha

    2015-06-01

    Full Text Available Background: The abundance of mechanoreceptors in the cervical spine and their central and reflex afferent connections to the vestibular, visual and postural control system suggests that the cervical proprioceptive information provides important somatosensory information influencing postural stability, head orientation and eye movement control. Disturbances to the afferent input from the cervical region is thought to underlie symptoms of dizziness, unsteadiness, visual disturbances and signs of altered postural stability, cervical proprioception and head and eye movement control in people with chronic neck pain. This study aimed to assess and compare cervical joint position sense in subjects with chronic neck pain vs normals. Methods: Total 60 subjects, divided into two groups chronic neck pain group (n=30 (12 males and 18 females with mean age of 40.7 years and control group (n=30 with age and gender matched normal individuals were assessed for baseline data and demographic variables. Head repositioning accuracy test was used to assess cervical joint position sense in degrees. Results: The difference in the head repositioning error values were found to be extremely significant (p<0.0001 for all the neck movements for subjects with chronic neck pain as compared to normals. Conclusion: Cervical joint position sense in subjects with chronic neck pain is found to be altered as compared to age and gender matched normals.

  13. Confronting the effects of smoking and air quality on the development of chronic respiratory diseases

    Energy Technology Data Exchange (ETDEWEB)

    Jedrychowski, W; Krzyzanowski, M W; Wojtyniak, B

    1985-08-01

    The main purpose of the paper was to compare the effects of outdoor and indoor air quality on the development of chronic respiratory diseases measured in the prospective study of chronic chest diseases among the inhabitants of Cracow, Poland. The 5-year follow-up study covered a probability sample of 4355 adult inhabitants. Data on respiratory symptoms and lung function in addition to variables related to environmental and socioeconomic factors were included. To assess the separate and joint effects of the chosen environmental factors on chronic chest problems, the multiple logistic regression analysis has been carried out. As expected, smoking habit was the strongest single of the factors related to the persistence of the respiratory symptoms. The effect of smoking was more marked in men than in women and this can be attributed to longer duration of smoking and more cigarettes smoked daily by men. Out of all considered adverse occupational factors only chemicals increased the risk of chronic bronchitis in men while dust increased the risk of exacerbations in women. The data showed a significant decrease in risk of exacerbations among the women who used a gas stove for cooking. The study also confirmed the harmful effect of smoking on lung function. Against this particular background the importance of variable temperature combined with ambient air pollution appeared to have rather strong detrimental biologic impact.

  14. Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases

    Directory of Open Access Journals (Sweden)

    Burger Helena

    2010-05-01

    Full Text Available Abstract Background The WHODAS-2 is a disability assessment instrument based on the conceptual framework of the International Classification of Functioning, Disability, and Health (ICF. It provides a global measure of disability and 7 domain-specific scores. The aim of this study was to assess WHODAS-2 conceptual model and metric properties in a set of chronic and prevalent clinical conditions accounting for a wide scope of disability in Europe. Methods 1,119 patients with one of 13 chronic conditions were recruited in 7 European centres. Participants were clinically evaluated and administered the WHODAS-2 and the SF-36 at baseline, 6 weeks and 3 months of follow-up. The latent structure was explored and confirmed by factor analysis (FA. Reliability was assessed in terms of internal consistency (Cronbach's alpha and reproducibility (intra-class correlation coefficients, ICC. Construct validity was evaluated by correlating the WHODAS-2 and SF-36 domains, and comparing known groups based on the clinical-severity and work status. Effect size (ES coefficient was used to assess responsiveness. To assess reproducibility and responsiveness, subsamples of stable (at 6 weeks and improved (after 3 moths patients were defined, respectively, according to changes in their clinical-severity. Results The satisfactory FA goodness of fit indexes confirmed a second order factor structure with 7 dimensions, and a global score for the WHODAS-2. Cronbach's alpha ranged from 0.77 (self care to 0.98 (life activities: work or school, and the ICC was lower, but achieved the recommended standard of 0.7 for four domains. Correlations between global WHODAS-2 score and the different domains of the SF-36 ranged from -0.29 to -0.65. Most of the WHODAS-2 scores showed statistically significant differences among clinical-severity groups for all pathologies, and between working patients and those not working due to ill health (p Conclusions The latent structure originally

  15. A literature review on self-care of chronic illness: definition, assessment and related outcomes.

    Science.gov (United States)

    Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

    2014-01-01

    Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.

  16. Effects of stress on heart rate complexity—A comparison between short-term and chronic stress

    OpenAIRE

    Schubert, C.; Lambertz, M.; Nelesen, R.A.; Bardwell, W.; Choi, J.-B.; Dimsdale, J.E.

    2008-01-01

    This study examined chronic and short-term stress effects on heart rate variability (HRV), comparing time, frequency and phase domain (complexity) measures in 50 healthy adults. The hassles frequency subscale of the combined hassles and uplifts scale (CHUS) was used to measure chronic stress. Short-term stressor reactivity was assessed with a speech task. HRV measures were determined via surface electrocardiogram (ECG). Because respiration rate decreased during the speech task (p < .001), thi...

  17. Protracted effects of chronic stress on serotonin dependent thermoregulation

    Science.gov (United States)

    Natarajan, Reka; Northrop, Nicole A.; Yamamoto, Bryan K.

    2016-01-01

    Chronic stress is known to affect serotonin (5HT) neurotransmission in the brain and to alter body temperature. Body temperature is controlled in part, by the medial preoptic area of the hypothalamus (mPOA). To investigate the effect of chronic stress on 5HT and how it affects body temperature regulation, we examined whether exposure to a chronic unpredictable stress paradigm (CUS) produces long-term alterations in thermoregulatory function of the mPOA through decreased 5HT neurotransmission. Adult male Sprague-Dawley rats underwent 21 days of CUS. Four days after last stress exposure, basal body temperature in the home cage and body temperature in a cold room maintained at 10°C were recorded. CUS rats had significantly higher subcutaneous basal body temperature at 13:00 h compared to unstressed (NoStress) rats. Whereas the NoStress rats were able to significantly elevate body temperature from basal levels at 30 and 60 min of exposure to the cold room, the CUS rats showed a hypothermic response to the cold. Treatment during CUS with metyrapone, a corticosterone synthesis inhibitor, blocked stress-induced decrease in body temperature in response to the cold challenge. CUS also decreased 5HT transporter protein immunoreactivity in the mPOA and 5HT2A/C agonist injection into the mPOA after CUS exposure caused stressed rats to exhibit a sensitized hyperthermic response to cold. These results indicate that CUS induced changes to the 5HTergic system alters mPOA function in thermoregulation. These findings help explain mechanisms underlying chronic stress induced disorders such as chronic fatigue syndrome wherein long lasting thermoregulatory deficits are observed. PMID:26414686

  18. Protracted effects of chronic stress on serotonin-dependent thermoregulation.

    Science.gov (United States)

    Natarajan, Reka; Northrop, Nicole A; Yamamoto, Bryan K

    2015-01-01

    Chronic stress is known to affect serotonin (5HT) neurotransmission in the brain and to alter body temperature. The body temperature is controlled in part, by the medial preoptic area (mPOA) of the hypothalamus. To investigate the effect of chronic stress on 5HT and how it affects body temperature regulation, we examined whether exposure to a chronic unpredictable stress (CUS) paradigm produces long-term alterations in thermoregulatory function of the mPOA through decreased 5HT neurotransmission. Adult male Sprague-Dawley rats underwent 21 d of CUS. Four days after the last stress exposure, basal body temperature in the home cage and body temperature in a cold room maintained at 10 °C were recorded. The CUS rats had significantly higher subcutaneous basal body temperature at 13:00 h compared to unstressed (NoStress) rats. Whereas the NoStress rats were able to significantly elevate body temperature from basal levels at 30 and 60 min of exposure to the cold room, the CUS rats showed a hypothermic response to the cold. Treatment during CUS with metyrapone, a corticosterone synthesis inhibitor, blocked stress-induced decrease in body temperature in response to the cold challenge. CUS also decreased 5HT transporter protein immunoreactivity in the mPOA and 5HT2A/C agonist injection into the mPOA after CUS exposure caused stressed rats to exhibit a sensitized hyperthermic response to cold. These results indicate that the CUS induced changes to the 5HTergic system alter mPOA function in thermoregulation. These findings help us to explain the mechanisms underlying chronic stress-induced disorders such as chronic fatigue syndrome wherein long lasting thermoregulatory deficits are observed.

  19. [Nutritional Assessment and Management for Patients with Chronic Liver Disease].

    Science.gov (United States)

    Lee, Tae Hee

    2018-04-25

    When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle. Counselling and oral or enteral nutrition is preferred over parenteral nutrition as in other diseases. If esophageal varices are present, care should be taken when installing a feeding tube, but if there are ascites, percutaneous endoscopic gastrostomy is contraindicated because of the risk of complications. Calories of 30-35 kcal/kg/day and protein from 1.2 to 1.5 g/kg/day are appropriate. Protein restriction is unnecessary unless the hepatic encephalopathy is severe. A late evening snack and branched chain amino acids can be helpful. In the case of cholestasis, the supply of manganese and copper should be restricted. Sarcopenia in patients with liver cirrhosis is also prevalent and associated with the prognosis.

  20. Chlorpyrifos chronic toxicity in broilers and effect of vitamin C

    Directory of Open Access Journals (Sweden)

    A.M. Kammon

    2011-02-01

    Full Text Available An experiment was conducted to study chlorpyrifos chronic toxicity in broilers and the protective effect of vitamin C. Oral administration of 0.8 mg/kg body weight (bw (1/50 LD50 chlorpyrifos (Radar®, produced mild diarrhea and gross lesions comprised of paleness, flaccid consistency and slightly enlargement of liver. Histopathologically, chlorpyrifos produced degenerative changes in various organs. Oral administration of 100 mg/kg bw vitamin C partially ameliorated the degenerative changes in kidney and heart. There was insignificant alteration in biochemical and haematological profiles. It is concluded that supplementation of vitamin C reduced the severity of lesions induced by chronic chlorpyrifos toxicity in broilers.

  1. Infusion dynamic ureteroscintigraphy in assessment of ureteral and pelvic contractivity in renal tuberculosis and chronic pyelonephritis

    International Nuclear Information System (INIS)

    Savin, I.B.; Tovstykh, A.M.; Morozov, N.V.

    1995-01-01

    A novel radionuclide method: infusion dynamic ureterscintigraphy was used in examinations of 42 patients with the initial forms of nephrotuberculosis, 18 patients with chronic nonspecific pyelonephritis, and 51 healthy controls. The new method was shown to be highly sensitive in assessment of ureteral and pelvic contractility in specific and nonspecific involvement of the kidneys. 16 refs.; 3 figs

  2. Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response

    NARCIS (Netherlands)

    Toorians, A. W.; Janssen, E.; Laan, E.; Gooren, L. J.; Giltay, E. J.; Oe, P. L.; Donker, A. J.; Everaerd, W.

    1997-01-01

    BACKGROUND: Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was assessed in a population of 281 patients (20-60 years), and it was attempted to determine whether their mode of treatment (haemodialysis, peritoneal dialysis, or kidney transplantation), or

  3. Fine motor assessment in chronic wrist pain: the role of adapted motor control

    NARCIS (Netherlands)

    Smeulders, M. J.; Kreulen, M.; Bos, K. E.

    2001-01-01

    To show whether a difference in fine motor control exists between patients with chronic, undiagnosed wrist pain (CUWP) and healthy controls. Furthermore, a method to assess fine motor function of the wrist is evaluated. A case-control study. The Academic Medical Center in Amsterdam, the Netherlands.

  4. Reliability of the Life Satisfaction Questionnaire to assess patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    Boonstra, Anne M.; Reneman, Michiel F.; Posthumus, Jitze B.; Stewart, Roy E.; Schiphorst Preuper, Henrica R.

    The aim of this study was to determine the reliability of the Life Satisfaction Questionnaire, Dutch version (LSQ-DV), to assess chronic pain patients. The study was designed as test-retest. The setting was the general rehabilitation centre. There were 51 patients over 18 years of age, suffering

  5. Omalizumab in patients with chronic spontaneous urticaria : A systematic review and GRADE assessment

    NARCIS (Netherlands)

    Urgert, M. C.; Van Den Elzen, M. T.; Knulst, A. C.; Fedorowicz, Z.; Van Zuuren, E. J.

    2015-01-01

    Summary Chronic spontaneous urticaria (CSU) is characterized by the occurrence of hives, angio-oedema or both for a period of at least 6 weeks. Many patients remain symptomatic despite treatment with H1 antihistamines, even at higher doses. This systematic review assessed the quality of

  6. Effects of a chronic stress treatment on vaccinal response in lambs.

    Science.gov (United States)

    Destrez, A; Boissy, A; Guilloteau, L; Andanson, S; Souriau, A; Laroucau, K; Chaillou, E; Deiss, V

    2017-05-01

    Farming systems can expose animals to chronic mild stress which is known to induce negative affective state. Affective state in animals, as in humans, can be assessed through behavioral cues. This study aimed to describe the effect of a chronic mild stress, known to induce a negative affective state, on sheep health through their response to vaccination. The study used 15 lambs subjected to a model of chronic mild stress for 15 weeks and 15 lambs reared under conventional farming as a control group. After 7 weeks of stressful treatment, the lambs were individually exposed to a judgment bias test to assess a putative stress-induced 'pessimism.' After 15 weeks of stressful treatment, antibody immune response was measured after an injection of a live vaccine challenge (Chlamydia abortus attenuated vaccine strain 1B). Stressed lambs displayed a pessimistic-like perception in the judgment bias test, revealing a negative affective state. Stressed and control animals showed different immunological reactions to vaccine challenge: stressed sheep had lower hemoglobin concentrations and higher platelet, granulocyte and acute-phase protein concentrations. Antibody response induced by the vaccine strain was not different between stressed and control sheep. Our results suggest that negative affective state induced by chronic stress treatment may induce a stronger inflammatory response to vaccine challenge in sheep. Improvement of animal health may be achieved through consideration of stressors that may affect the emotional and immunological state of sheep.

  7. The effect of oxytocin on attention to angry and happy faces in chronic depression.

    Science.gov (United States)

    Domes, Gregor; Normann, Claus; Heinrichs, Markus

    2016-04-06

    Chronic depression is characterized by a high degree of early life trauma, psychosocial impairment, and deficits in social cognition. Undisturbed recognition and processing of facial emotions are basic prerequisites for smooth social interactions. Intranasal application of the neuropeptide oxytocin has been reported to enhance emotion recognition in neuropsychiatric disorders and healthy individuals. We therefore investigated whether oxytocin modulates attention to emotional faces in patients with chronic depression. In this double-blind, randomized, controlled study, 43 patients received a single dose of oxytocin or placebo nasal spray and were tested while fulfilling a facial dot probe task. We assessed reaction times to neutral probes presented at the location of one of two faces depicting happy, angry, or neutral expressions as a prime. When comparing reaction times to the congruent (prime and probe at the same location) with incongruent presentation of facial emotions, neither the placebo nor oxytocin group showed an attentional preference for emotional facial expressions in terms of a threat bias. However, oxytocin treatment did reveal two specific effects: it generally reduced the allocation of attention towards angry facial expressions, and it increased sustained attention towards happy faces, specifically under conditions of heightened awareness, i.e. trials with longer primes. We investigated a heterogeneous group of medicated male and female patients. We conclude that oxytocin does modulate basic factors of facial emotion processing in chronic depression. Our findings encourage further investigations assessing the therapeutic potential of oxytocin in chronic depression. EUDRA-CT 2010-020956-69 . Date registered: 23 February 2011.

  8. Effects of chronic lead intoxication on rat serotoninergic system and anxiety behavior.

    Science.gov (United States)

    Sansar, Wafa; Bouyatas, My Mustapha; Ahboucha, Samir; Gamrani, Halima

    2012-01-01

    Chronic lead exposure has been shown to produce behavioral disturbances in human and animal models. These disturbances are associated with alterations in monoaminergic neurotransmission in the central nervous system (CNS), some of which have been attributed to serotonin (5-HT). This study was undertaken to investigate the chronic effects of lead exposure on the serotoninergic system in the dorsal raphe nucleus (DRN) and the consequences of its toxicity on rat behavior. Adult male Wistar rats were chronically exposed for 3 months to 0.5% lead acetate in drinking water. The serotoninergic system was evaluated using immunohistochemistry and the anxiety behavior was assessed by the light/dark box test. The results show that chronic lead exposure induces a significant increase of blood and brain lead levels in treated rats compared with controls. The density of the immunoreactive serotoninergic cell bodies was significantly higher in treated rats in all parts of the DRN. Assessment of animal behavior using the light/dark box test showed that lead-treated rats spent significantly more time in the light chamber compared with controls (P=0.001). These findings suggest that lead exposure may possibly induce increased anxiety as a consequence of changes in neuronal 5-HT content in the DRN. Copyright © 2011 Elsevier GmbH. All rights reserved.

  9. How general practitioners perceive and assess self-care in patients with multiple chronic conditions

    DEFF Research Database (Denmark)

    Kristensen, Mads Aage Toft; Hølge-Hazelton, Bibi; Waldorff, Frans Boch

    2017-01-01

    in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. METHODS...... text condensation. RESULTS: Most GPs in our study had a health-related perception of self-care, but some had a broader perception encompassing the situational context of the patient's life. The GPs' assessments of patients' self-care ability were based on information from the ongoing and often long...... and do not consider whether a relationship with the patient is established. If GPs' perceptions and assessments of self-care ability are not included in chronic disease management models, there is a risk that they vill be insufficiently implemented in general practice....

  10. BENEFICIAL EFFECT OF CHRONIC NIMODIPINE TREATMENT ON BEHAVIORAL DYSFUNCTIONS OF AGED RATS EXPOSED TO PERINATAL ETHANOL TREATMENT

    NARCIS (Netherlands)

    MARKEL, E; FELSZEGHY, K; LUITEN, PGM; NYAKAS, C

    1995-01-01

    The long-term effects of prenatal and early postnatal ethanol exposure were assessed in adult (5-month), aged (24-month), and senescent (30-month) rats on non-aggressive intermale social behavior, and on black-white discrimination and spatial learning behaviors. Furthermore, the effects of chronic

  11. Effects of obesity and chronic low back pain on gait

    OpenAIRE

    Cimolin, Veronica; Vismara, Luca; Galli, Manuela; Zaina, Fabio; Negrini, Stefano; Capodaglio, Paolo

    2011-01-01

    Abstract Background Obesity is often associated with low back pain (LBP). Despite empirical evidence that LBP induces gait abnormalities, there is a lack of quantitative analysis of the combined effect of obesity and LBP on gait. The aim of our study was to quantify the gait pattern of obese subjects with and without LBP and normal-mass controls by using Gait Analysis (GA), in order to investigate the cumulative effects of obesity and LBP on gait. Methods Eight obese females with chronic LBP ...

  12. Chronic pancreatitis: indications to surgery and remote results assessment criteria

    Directory of Open Access Journals (Sweden)

    A. V. Klimenko

    2013-06-01

    Full Text Available Present indications to surgery include intractable pain syndrome, severe dilation of the Wirsung’s duct, strictures and stones in the Wirsung’s duct, pancreatic pseudocysts, duodenal stenosis and obstructive jaundice because of “inflammatory mass” in the pancreatic head. But these absolute indications mean that in the most cases pancreatic exocrine and endocrine functions are already decompensated. Therefore it is important to produce new indications to surgical treatment of the CP in early stages. Also it is necessary to make such remote results assessment criteria that will allow to range among parenchymapreserving and resectional technics according to anatomical and functional parameters. Goal: to adjust indications to surgical treatment of the CP according to leading pathogenetic factors and develop criteria to assess remote results. Patients and methods: 122 CP patients have undergone surgery. There were 103 (84,4% men and – 19 (15,6% women, mean age - 45. Alcohol etiology of the CP was in 79 (64,8% patients, postpancreonecrotic – in 29 (23,8%, biliary – in 6 (4,9%, idiopathic – in 8 (6,6%. Wirsung’s duct diameter of 4 – 8 mm – was in 65 (53,3% patients, 8 – 12 and more – in 57 (46,7%. By Shalimov classification there were “pseudotumorous” – in 39 (31,9%, “calculouse” – in 40 (32,8%, fibrose-cystic – in 17 (13,9%, fibrose-degenerative with adjacent organs involvement and hampering of their function – in 26 (21,4% patients. All patients had pain syndrome and 79 (64,8% – exocrine and endocrine insufficiency. All patients underwent abdominal CT-scan, fecal elastase test, C-peptide, endogenic insulin, glucose, immunehystochemical investigation of biopsy samples taken from body corpus and tale simultaneously etc. Results: We have found that gastroenterologists poorly recognize “surgical” type of CP and restrain patients from being directed to surgical pancreatologists for surgical therapy. We

  13. Longitudinal Liver Stiffness Assessment in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy

    Science.gov (United States)

    Martinez, Stella M.; Foucher, Juliette; Combis, Jean-Marc; Métivier, Sophie; Brunetto, Maurizia; Capron, Dominique; Bourlière, Marc; Bronowicki, Jean-Pierre; Dao, Thong; Maynard-Muet, Marianne; Lucidarme, Damien; Merrouche, Wassil; Forns, Xavier; de Lédinghen, Victor

    2012-01-01

    Background/Aims Liver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC). Methods TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC. Results 323 treated (62.7%) and 192 untreated patients (37.3%) were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study (P<0.0001). The decline was significant for patients with baseline LS ≥ 7.1 kPa (P<0.0001 and P 0.03, for LS ≥9.5 and ≥7.1 kPa vs lower values, respectively). Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change −16%, −10% and −2%, for SVR, RR and NR, respectively, P 0.03 for SVR vs NR). In multivariate analysis, high baseline LS (P<0.0001) and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement. Conclusions LS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS) and suggests an improvement in liver damage. PMID:23082200

  14. Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy.

    Directory of Open Access Journals (Sweden)

    Stella M Martinez

    Full Text Available BACKGROUND/AIMS: Liver stiffness (LS measurement by means of transient elastography (TE is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC. METHODS: TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC. RESULTS: 323 treated (62.7% and 192 untreated patients (37.3% were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study (P<0.0001. The decline was significant for patients with baseline LS ≥ 7.1 kPa (P<0.0001 and P 0.03, for LS ≥ 9.5 and ≥ 7.1 kPa vs lower values, respectively. Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change -16%, -10% and -2%, for SVR, RR and NR, respectively, P 0.03 for SVR vs NR. In multivariate analysis, high baseline LS (P<0.0001 and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement. CONCLUSIONS: LS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS and suggests an improvement in liver damage.

  15. Chronic recurrent hemoptysis: effectiveness of bronchial artery embolization in 25 patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Ik; Shim, Hyung Jin; Wang, Chi Hyung; Hyun, Yu; Kim, Yang Soo; Kim, Young Goo; Kim, Kun Sang [Chungang University College of Medicine, Seoul (Korea, Republic of)

    1994-09-15

    Bronchial artery embolization has been effective in the treatment of massive hemoptysis. The purpose of this study was to report the effectiveness of bronchial artery embolization in patients with chronic recurrent hemoptysis intractable to medical treatment. This study included 25 patients who were admitted for treatment of chronic recurrent hemoptysis with bronchial artery embolization. Chronic recurrent hemoptysis was defined as condition in tractable to medical treatment persistently and occurring over two times per two months The target vessels for embolization were selected in consideration of the results of aortography as well as the finding of chest radiography and bronchoscopy. After selective arteriography for embolization by using 5-French Simmons catheter, embolic agents(mainly polyvinyl alcohol(PVA) and additionally gelfoam and coils) were released through the catheter. The results of the embolization were assessed with review of medical records. The cases of the hemoptysis were pulmonary tuberculosis(n=12.48%), bronchiectasis(n=6.24%), aspergilloma(n=3.12%), chronic obstructive pulmonary disease(n=2.8%), chronic bronchitis(n=1.4%) and lung abscess(n=1.4%). Selective embolization was carried out in 49 sites(42 in bronchial artery and 7 in nonbronchial systemic collaterals). Early success rate within 2 months was 96%. After long-term follow up study (6-30 months, average 15 months), complete remission was 72%, partial remission 12% and recurrence 12% respectively. During and after embolization, major complications such as spinal cord injury or bronchial wall necrosis was not found. Minor complications were chest pain, shoulder pain and chilling sense, which were relieved spontaneously within a few days. High success rate and relatively low recurrence with no significant complication were achieved with bronchial artery embolization in the patients complaining of chronic recurrent hemoptysis.

  16. Assessing the Construct Validity and Internal Reliability of the Screening Tool Test Your Memory in Patients with Chronic Pain.

    Directory of Open Access Journals (Sweden)

    B Ojeda

    Full Text Available Patients with chronic pain often complain about cognitive difficulties, and since these symptoms represent an additional source of suffering and distress, evaluating the cognitive status of these patients with valid and reliable tests should be an important part of their overall assessment. Although cognitive impairment is a critical characteristic of pain, there is no specific measure designed to detect these effects in this population. The objective was to analyze the psychometric properties of the "Test Your Memory" (TYM test in patients with chronic pain of three different origins. A cross-sectional study was carried out on 72 subjects free of pain and 254 patients suffering from different types of chronic pain: neuropathic pain (104, musculoskeletal pain (99 and fibromyalgia (51. The construct validity of the TYM was assessed using the Mini-Mental State Examination (MMSE, Hospital Anxiety and Depression Scale (HADs, Index-9 from MOS-sleep, SF-12, and through the intensity (Visual Analogical Scale and duration of pain. An exploratory factor analysis was also performed and internal reliability was assessed using Cronbach's alpha. After adjusting for potential confounders the TYM could distinguish between pain and pain-free patients, and it was correlated with the: MMSE (0.89, p<0.001; HAD-anxiety (-0.50, p<0.001 and HAD-depression scales (-0.52, p<0.001; MOS-sleep Index-9 (-0.49, p<0.001; and the physical (0.49, p < .001 and mental components (0.55, p < .001 of SF-12. The exploratory structure of the TYM showed an 8-factor solution that explained 53% of the variance, and Cronbach's alpha was 0.66. The TYM is a valid and reliable screening instrument to assess cognitive function in chronic pain patients that will be of particular value in clinical situations.

  17. Beyond Income: A Social Justice Approach to Assessing Poverty among Older Adults with Chronic Kidney Disease.

    Science.gov (United States)

    Caplan, Mary A; Washington, Tiffany R; Swanner, Lauren

    2017-01-01

    How social workers define and assess poverty is a matter of economic and social justice. Recent conceptual and measurement advances point to a multidimensional definition of poverty which captures material, social, and political deprivations. Using data from a survey, this article describes how nephrology social workers assess poverty among older adults living with a chronic kidney disease (N = 52). Results suggest respondents already conceive of poverty as a multidimensional experience, support awareness-raising about poverty, and primarily assess poverty by employment status, income, access to transportation, and education. Opportunities to expand poverty assessment in future work are promising.

  18. Assessment and manifestation of central sensitisation across different chronic pain conditions.

    Science.gov (United States)

    Arendt-Nielsen, L; Morlion, B; Perrot, S; Dahan, A; Dickenson, A; Kress, H G; Wells, C; Bouhassira, D; Mohr Drewes, A

    2018-02-01

    Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based

  19. Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Peiro Meritxell

    2009-02-01

    Full Text Available Abstract Background The diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD in Spain continues to present challenges, and problems are exacerbated when there is a lack of coordinated follow-up between levels of care. This paper sets out the protocol for assessing the impact of an integrated management model for the care of patients with COPD. The new model will be evaluated in terms of 1 improvement in the rational utilization of health-care services and 2 benefits reflected in improved health status and quality of life for patients. Methods/Design A quasi-experimental study of the effectiveness of a COPD management model called COPD PROCESS. The patients in the study cohorts will be residents of neighborhoods served by two referral hospitals in Barcelona, Spain. One area comprises the intervention group (n = 32,248 patients and the other the control group (n = 32,114 patients. The study will include pre- and post-intervention assessment 18 months after the program goes into effect. Analyses will be on two datasets: clinical and administrative data available for all patients, and clinical assessment information for a cohort of 440 patients sampled randomly from the intervention and control areas. The main endpoints will be the hospitalization rates in the two health-care areas and quality-of-life measures in the two cohorts. Discussion The COPD PROCESS model foresees the integrated multidisciplinary management of interventions at different levels of the health-care system through coordinated routine clinical practice. It will put into practice diagnostic and treatment procedures that are based on current evidence, multidisciplinary consensus, and efficient use of available resources. Care pathways in this model are defined in terms of patient characteristics, level of disease severity and the presence or absence of exacerbation. The protocol covers the full range of care from primary prevention to treatment of

  20. The effectiveness of balneotherapy in chronic neck pain.

    Science.gov (United States)

    Koyuncu, Engin; Ökmen, Burcu Metin; Özkuk, Kağan; Taşoğlu, Özlem; Özgirgin, Neşe

    2016-10-01

    The aim of this study was to investigate the effectiveness of balneotherapy (BT), which is applied in addition to physical therapy (PT), in the treatment of chronic neck pain. Sixty patients with chronic neck pain were divided into study (n = 30) and control (n = 30) groups. All of the patients in both groups were treated with a 15-session standard PT program consisting of hot pack, ultrasound, and transcutaneous electrical stimulation. Patients in the study group were also treated with a 15-session BT program lasting 20 min/day in addition to the standard PT program. Visual analogue scale (VAS), modified neck disability index (mNDI), and Nottingham Health Profile (NHP) scores of all patients were evaluated at three different times as pretreatment, posttreatment, and posttreatment third week. There was no statistically significant difference between the clinical and demographic characteristics of the patients in different groups before treatment. Intragroup analysis revealed significant improvement in all parameters for both of the groups at all time intervals. Intergroup analysis uncovered the superiority of the study group. According to the results of this study, BT in combination with PT is superior to PT alone in reducing pain and disability and improving quality of life in patients with chronic neck pain.

  1. Effect of chronic radiation on rape genotype formation

    International Nuclear Information System (INIS)

    Fabry, A.; Hannich, K.; Cerny, J.; Vyvadilova, M.

    1975-01-01

    The F 1 generation of hybrid plants of the Canadian erucic acid-free rape cross-bred with some European winter rape varieties with a high content of erucic acid were chronically irradiated in a gamma-field with doses ranging from 5978 to 329 R er vegetation. In segregating F 2 generations, the irradiation significantly increased the proportion of winter genotypes; a matroclinous influence on the developmental characteristics of plants occurred in irradiated segregating F 2 hybrid populations. As against spring rape, winter rape varieties used as the maternal form during hybridization caused a statistically significant increase in the frequency of winter genotypes. The segregation of half-winter forms in irradiated segregating hybrid populations of the F 2 generation proved the incomplete dominance of the spring habit of oil rape. Chronic irradiation significantly increased erucic-free (0 - 10% of erucic acid) and low-erucic (10 - 20% of erucic acid) genotype frequencies in segregating F 2 generations. Chronic irradiation of the hybrid plants of erucic-free spring rapes and erucic winter rapes with doses ranging from 5978 to 329 R per vegetation, together with the temperature screening of winter forms and with the determination of the fatty acid content, may be considered as an effective method of creating non-erucic and low-erucic winter forms of oil rape. (author)

  2. Study of Heart and Renal Protection (SHARP) : Randomized trial to assess the effects of lowering low-density lipoprotein cholesterol among 9,438 patients with chronic kidney disease

    NARCIS (Netherlands)

    Baigent, C.; Landray, M.; Reith, C.; Dasgupta, T.; Emberson, J.; Herrington, W.; Lewis, D.; Mafham, M.; Collins, R.; Collins, R.; Baigent, C.; Landray, M.; Bray, C.; Chen, Y.; Baxter, A.; Young, A.; Hill, M.; Knott, C.; Cass, A.; Feldt-Rasmussen, B.; Fellstroem, B.; Grobbee, R.; Groenhagen-Riska, C.; Haas, M.; Holdaas, H.; Hooi, L. S.; Jiang, L.; Kasiske, B.; Krairittichai, U.; Levin, A.; Massy, Z.; Tesar, V.; Walker, R.; Wanner, C.; Wheeler, D.; Wiecek, A.; Dasgupta, T.; Lewis, D.; Mafham, M.; Majoni, W.; Reith, C.; Simpson, D.; Strony, J.; Musliner, T.; Agodoa, L.; Armitage, J.; Chen, Z.; Craig, J.; de Zeeuw, D.; Gaziano, M.

    Background Lowering low-density lipoprotein (LDL) cholesterol with statin therapy has been shown to reduce the incidence of atherosclerotic events in many types of patient, but it remains uncertain whether it is of net benefit among people with chronic kidney disease (CKD). Methods Patients with

  3. Study of Heart and Renal Protection (SHARP) : Randomized trial to assess the effects of lowering low-density lipoprotein cholesterol among 9,438 patients with chronic kidney disease

    NARCIS (Netherlands)

    Baigent, C.; Landray, M.; Reith, C.; Dasgupta, T.; Emberson, J.; Herrington, W.; Lewis, D.; Mafham, M.; Collins, R.; Collins, R.; Baigent, C.; Landray, M.; Bray, C.; Chen, Y.; Baxter, A.; Young, A.; Hill, M.; Knott, C.; Cass, A.; Feldt-Rasmussen, B.; Fellstroem, B.; Grobbee, R.; Groenhagen-Riska, C.; Haas, M.; Holdaas, H.; Hooi, L. S.; Jiang, L.; Kasiske, B.; Krairittichai, U.; Levin, A.; Massy, Z.; Tesar, V.; Walker, R.; Wanner, C.; Wheeler, D.; Wiecek, A.; Dasgupta, T.; Lewis, D.; Mafham, M.; Majoni, W.; Reith, C.; Simpson, D.; Strony, J.; Musliner, T.; Agodoa, L.; Armitage, J.; Chen, Z.; Craig, J.; de Zeeuw, D.; Gaziano, M.

    2010-01-01

    Background Lowering low-density lipoprotein (LDL) cholesterol with statin therapy has been shown to reduce the incidence of atherosclerotic events in many types of patient, but it remains uncertain whether it is of net benefit among people with chronic kidney disease (CKD). Methods Patients with

  4. Effect of vitamin D supplementation on chronic liver disease: systematic literature review

    Directory of Open Access Journals (Sweden)

    Hooman Mosannen Mozaffari

    2017-01-01

    Full Text Available Introduction: It is long known that vitamin D deficiency was common in patients with liver disease, but little is known on the therapeutic effects of vitamin D, especially in patients with chronic liver disease. In this study, we aimed to systematically review the literatures and study the evidences in which the effects of vitamin D supplementation had been investigated on the severity of chronic liver disease or liver cirrhosis.Methods: A systematic literature search was performed by using the following key terms “vitamin D supplementation” and “chronic liver disease” in the PubMed, Scopus and Google scholar to find relevant articles. After collecting the eligible documents, data were extracted and described based on the purpose of this review.Result: Of total 196 articles found, only 7 relevant documents with 518 studied patients were included. The results of this study showed that the levels of 25(OH D were considerably lower in patients with chronic liver disease. Findings showed that vitamin D supplementation can rise up the mean serum level of 25(OH D in patients with severe vitamin D deficiency, especially patients with liver cirrhosis.Conclusion:The results of this review showed that vitamin D deficiency is associated with the severity of liver disease and may have prognostic value in the assessment of liver disease. Also, it was shown that vitamin D supplementation may be helpful for the treatment of liver disease at least in certain groups of patients.

  5. Assessment of senses of hearing and balance in chronic suppurative otitis media

    Directory of Open Access Journals (Sweden)

    Babić Borivoj

    2008-01-01

    Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.

  6. Helicobacter pylori-Induced Chronic Gastritis and Assessing Risks for Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Gonzalo Carrasco

    2013-01-01

    Full Text Available Chronic gastritis is an inflammation of the gastric mucosa and has multiple etiologies. Here we discuss the pathological alterations induced by Helicobacter pylori (HP leading to chronic gastritis and the epigenetic bases underlying these changes. We review the histology of the normal gastric mucosa and overview the role of HP in the multistep cascade of GC. We attempt to define the role of the Operative Link for Gastritis Assessment (OLGA staging system in assessing the risk of GC. The epigenetic bases of chronic gastritis, mainly DNA methylation, are presented through examples such as (i the methylation of the promoter region of E-cadherin in HP-induced chronic gastritis and its reversion after HP eradication and (ii the association of methylation of the promoter region of Reprimo, a p53-mediated cell cycle arrest gene, with aggressive HP strains in high risk areas for GC. In addition, we discuss the finding of RPRM as a circulating cell-free DNA, offering the opportunity for noninvasive risk assessment of GC. Finally, the integration of OLGA and tissue biomarkers, by systems pathology approach, suggests that severe atrophy has a greater risk for GC development if, in addition, overexpressed p73. This trial is registered with ClinicalTrials.gov NCT01774266.

  7. Double jeopardy: assessing the association between internal displacement, housing quality and chronic illness in a low-income neighborhood.

    Science.gov (United States)

    Habib, Rima R; Yassin, Nasser; Ghanawi, Joly; Haddad, Pascale; Mahfoud, Ziyad

    2011-04-01

    PURPOSE: This study analyzed associations between war-related internal displacement, housing quality and the prevalence of chronic illness in Nabaa, a low-income neighborhood on the outskirts of Beirut, Lebanon. METHODS: A cross-sectional survey of sociodemographics, household characteristics and health conditions of the study population was carried out in 2002. Using a structured questionnaire, the research team surveyed 1,151 households representing 4,987 residents of all ages. The survey was administered to a proxy respondent from each household in face-to-face interviews. A multiple logistic regression model using the generalized estimation equation method was constructed to assess the simultaneous effect of displacement and housing quality on reported ill health, while adjusting for potential confounders. RESULTS: Housing quality and internal displacement were strongly associated with occurrences of chronic illness. The most vulnerable respondents were older residents, females and internally displaced people, who reported high rates of chronic illnesses. Residents with high levels of education were less likely to report a chronic illness than those that had elementary education or less. CONCLUSION: Nabaa residents' experience of poor health was associated with inadequate housing quality. Moreover, residents who have been displaced experience worse living conditions and were more likely to experience poor health than those who were not displaced. These results reveal a need for policies to improve housing quality and alleviate war-related consequences in low-income neighborhoods.

  8. Feasibility of a smartphone-based balance assessment system for subjects with chronic stroke.

    Science.gov (United States)

    Hou, You-Ruei; Chiu, Ya-Lan; Chiang, Shang-Lin; Chen, Hui-Ya; Sung, Wen-Hsu

    2018-07-01

    Stroke is a cerebral artery disease that may lead to long-term disabilities or death. Patients that survive a stroke usually suffer balance impairments, which affect their performance in activities of daily living (ADLs) and quality of life (QoL). In recent years, smartphones have become very popular and have many capabilities. Smartphone built-in sensors have shown their ability and potential in balance performance assessment. However, the feasibility of smartphones on subjects with chronic strokes remains to be proved. Therefore, the purpose of this study is to evaluate the feasibility of a smartphone-based balance assessment system for subjects with chronic stroke. Ten subjects with chronic stroke and thirteen healthy adults were recruited in the study. The smartphone HTC 10 (HTC Corporation, Taiwan) was used to perform the balance assessment, and its built-in accelerometer and gyroscope were used to record data from the subjects. Six postures were tested for thirty seconds each: shoulder-width stance (SWS) with eyes opened (E/O) and eyes closed (E/C), feet-together stance (FTS) with E/O and E/C, and semi-tandem stance (STS) with E/O and E/C. The smartphone was fixed to the back of subjects at the second sacral spine (S2) level. The changes registered in the accelerometer and gyroscope data were used to represent the balance performance, in which higher values indicate more instability. Data was analyzed using the independent t-test with the software SPSS 20, and the statistical significance level was set to α balance performances between healthy adults and subjects with chronic stroke. This study shows that smartphones are feasible to assess balance for subjects with chronic stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Long-Term Effects of Chronic Oral Ritalin Administration on Cognitive and Neural Development in Adolescent Wistar Kyoto Rats

    Directory of Open Access Journals (Sweden)

    Jennifer L. Cornish

    2012-09-01

    Full Text Available The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD often results in chronic treatment with psychostimulants such as methylphenidate (MPH, Ritalin®. With increases in misdiagnosis of ADHD, children may be inappropriately exposed to chronic psychostimulant treatment during development. The aim of this study was to assess the effect of chronic Ritalin treatment on cognitive and neural development in misdiagnosed “normal” (Wistar Kyoto, WKY rats and in Spontaneously Hypertensive Rats (SHR, a model of ADHD. Adolescent male animals were treated for four weeks with oral Ritalin® (2 × 2 mg/kg/day or distilled water (dH2O. The effect of chronic treatment on delayed reinforcement tasks (DRT and tyrosine hydroxylase immunoreactivity (TH-ir in the prefrontal cortex was assessed. Two weeks following chronic treatment, WKY rats previously exposed to MPH chose the delayed reinforcer significantly less than the dH2O treated controls in both the DRT and extinction task. MPH treatment did not significantly alter cognitive performance in the SHR. TH-ir in the infralimbic cortex was significantly altered by age and behavioural experience in WKY and SHR, however this effect was not evident in WKY rats treated with MPH. These results suggest that chronic treatment with MPH throughout adolescence in “normal” WKY rats increased impulsive choice and altered catecholamine development when compared to vehicle controls.

  10. Evaluation and Adaption of the Trier Inventory for Chronic Stress (TICS) for Assessment in Competitive Sports

    Science.gov (United States)

    Sallen, Jeffrey; Hirschmann, Florian; Herrmann, Christian

    2018-01-01

    The demands of a career in competitive sports can lead to chronic stress perception among athletes if there is a non-conformity of requirements and available coping resources. The Trier Inventory for Chronic Stress (TICS) (Schulz et al., 2004) is said to be thoroughly validated. Nevertheless, it has not yet been subjected to a confirmatory factor analysis. The present study aims (1) to evaluate the factorial validity of the TICS within the context of competitive sports and (2) to adapt a short version (TICS-36). The total sample consisted of 564 athletes (age in years: M = 19.1, SD = 3.70). The factor structure of the original TICS did not adequately fit the present data, whereas the short version presented a satisfactory fit. The results indicate that the TICS-36 is an economical instrument for gathering interpretable information about chronic stress. For assessment in competitive sports with TICS-36, we generated overall and gender-specific norm values. PMID:29593611

  11. Evaluation and Adaption of the Trier Inventory for Chronic Stress (TICS) for Assessment in Competitive Sports.

    Science.gov (United States)

    Sallen, Jeffrey; Hirschmann, Florian; Herrmann, Christian

    2018-01-01

    The demands of a career in competitive sports can lead to chronic stress perception among athletes if there is a non-conformity of requirements and available coping resources. The Trier Inventory for Chronic Stress (TICS) (Schulz et al., 2004) is said to be thoroughly validated. Nevertheless, it has not yet been subjected to a confirmatory factor analysis. The present study aims (1) to evaluate the factorial validity of the TICS within the context of competitive sports and (2) to adapt a short version (TICS-36). The total sample consisted of 564 athletes (age in years: M = 19.1, SD = 3.70). The factor structure of the original TICS did not adequately fit the present data, whereas the short version presented a satisfactory fit. The results indicate that the TICS-36 is an economical instrument for gathering interpretable information about chronic stress. For assessment in competitive sports with TICS-36, we generated overall and gender-specific norm values.

  12. Effects of stress on heart rate complexity--a comparison between short-term and chronic stress.

    Science.gov (United States)

    Schubert, C; Lambertz, M; Nelesen, R A; Bardwell, W; Choi, J-B; Dimsdale, J E

    2009-03-01

    This study examined chronic and short-term stress effects on heart rate variability (HRV), comparing time, frequency and phase domain (complexity) measures in 50 healthy adults. The hassles frequency subscale of the combined hassles and uplifts scale (CHUS) was used to measure chronic stress. Short-term stressor reactivity was assessed with a speech task. HRV measures were determined via surface electrocardiogram (ECG). Because respiration rate decreased during the speech task (pshort-term stress decreased HR D2 (calculated via the pointwise correlation dimension PD2) (pshort-term stress. Partial correlation adjusting for respiration rate showed that HR D2 was associated with chronic stress (r=-.35, p=.019). Differential effects of chronic and short-term stress were observed on several HRV measures. HR D2 decreased under both stress conditions reflecting lowered functionality of the cardiac pacemaker. The results confirm the importance of complexity metrics in modern stress research on HRV.

  13. Effect of total lymphoid irradiation in chronic progressive multiple sclerosis

    International Nuclear Information System (INIS)

    Cook, S.D.; Devereux, C.; Troiano, R.; Hafstein, M.P.; Zito, G.; Hernandez, E.; Lavenhar, M.; Vidaver, R.; Dowling, P.C.

    1986-01-01

    Total lymphoid irradiation (TLI; 1980 cGy) or sham irradiation was given to 40 patients with chronic progressive multiple sclerosis (MS) in a prospective, randomised, double-blind study. During mean follow-up of 21 months, MS patients treated with TLI has less functional decline than sham-irradiated MS patients (p<0.01). A significant relation was noted between absolute blood lymphocyte counts in the first year after TLI and subsequent course, patients with higher lymphocyte counts generally having a worse prognosis (p<0.01). TLI was well tolerated and associated with only mild short-term, and to date, long-term side-effects. (author)

  14. Tools to assess living with a chronic illness: A systematic review.

    Science.gov (United States)

    Ambrosio, Leire; Portillo, Mari Carmen

    2018-05-16

    To analyse the currently available instruments to assess living with a chronic illness and related aspects. A review of the evidence was made using the databases: Medline, CINHAL, PsycINFO, Cochrane Library, Embase and Cuiden. The criteria that limited the search were: the language, English and / or Spanish and studies carried out in an adult population. Years of article publication were not used as a limit. A total of 16 instruments were identified and analysed that apparently measured the concept of living with a chronic illness and/or related aspects. According to the name of the instrument, four seemed to evaluate the concept of living with a chronic illness while the rest of the instruments evaluated aspects intrinsically related to the concept of "living with", such as attributes or the meaning of living with a chronic illness. Different instruments were identified to evaluate daily living for the chronically ill patient, as well as related aspects. According to this review, further validation studies are required in other populations and/or contexts in order to achieve valid and reliable instruments that could be used in clinical practice. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  15. Assessing ecological effects of radionuclides: data gaps and extrapolation issues

    International Nuclear Information System (INIS)

    Garnier-Laplace, Jacqueline; Gilek, Michael; Sundell-Bergman, Synnoeve; Larsson, Carl-Magnus

    2004-01-01

    By inspection of the FASSET database on radiation effects on non-human biota, one of the major difficulties in the implementation of ecological risk assessments for radioactive pollutants is found to be the lack of data for chronic low-level exposure. A critical review is provided of a number of extrapolation issues that arise in undertaking an ecological risk assessment: acute versus chronic exposure regime; radiation quality including relative biological effectiveness and radiation weighting factors; biological effects from an individual to a population level, including radiosensitivity and lifestyle variations throughout the life cycle; single radionuclide versus multi-contaminants. The specificities of the environmental situations of interest (mainly chronic low-level exposure regimes) emphasise the importance of reproductive parameters governing the demography of the population within a given ecosystem and, as a consequence, the structure and functioning of that ecosystem. As an operational conclusion to keep in mind for any site-specific risk assessment, the present state-of-the-art on extrapolation issues allows us to grade the magnitude of the uncertainties as follows: one species to another > acute to chronic = external to internal = mixture of stressors> individual to population> ecosystem structure to function

  16. Effect of rajyoga meditation on chronic tension headache.

    Science.gov (United States)

    Kiran; Girgla, Kawalinder K; Chalana, Harsh; Singh, Harjot

    2014-01-01

    Chronic tension-type headache (CTTH) is the most common type of headache with no truly effective treatment. This study was designed to correlate the additive effect of meditation on CTTH patients receiving medical treatment. 50 patients (aged 18-58 years) presenting with a clinical diagnosis of CCTH, were divided in 2 groups. Group 1 (n=30) received 8 lessons and practical demonstration of Brahmakumaris spiritual based meditation known as Rajyoga meditation for relaxation therapy, in addition to routine medical treatment (analgesics and muscle relaxants). Group 2 (n=20) patients received analgesics and muscle relaxants twice a day but no relaxation therapy in the form of meditation. Both groups were followed up for 8 weeks period. The parameters studied were severity, frequency and duration of CCTH, and their headache index calculated. Patients in both groups showed a highly significant reduction in headache variables (Pheadache, duration & frequency in Group 1 was 94%, 91% and 97% respectively whereas in Group 2 it was 36%, 36% and 49% respectively. Headache relief as calculated by headache index was 99% in Group 1 as compared to 51% in Group 2. Even Short term spiritual based relaxation therapy (Rajyoga meditation) was highly effective in causing earlier relief in chronic tension headache as measured by headache parameter.

  17. The assessment of cognitive function in older adult patients with chronic kidney disease: an integrative review.

    Science.gov (United States)

    Hannan, Mary; Steffen, Alana; Quinn, Lauretta; Collins, Eileen G; Phillips, Shane A; Bronas, Ulf G

    2018-05-25

    Chronic kidney disease (CKD) is a common chronic condition in older adults that is associated with cognitive decline. However, the exact prevalence of cognitive impairment in older adults with CKD is unclear likely due to the variety of methods utilized to assess cognitive function. The purpose of this integrative review is to determine how cognitive function is most frequently assessed in older adult patients with CKD. Five electronic databases were searched to explore relevant literature related to cognitive function assessment in older adult patients with CKD. Inclusion and exclusion criteria were created to focus the search to the assessment of cognitive function with standardized cognitive tests in older adults with CKD, not on renal replacement therapy. Through the search methods, 36 articles were found that fulfilled the purpose of the review. There were 36 different types of cognitive tests utilized in the included articles, with each study utilizing between one and 12 tests. The most commonly utilized cognitive test was the Mini Mental State Exam (MMSE), followed by tests of digit symbol substitution and verbal fluency. The most commonly assessed aspect of cognitive function was global cognition. The assessment of cognitive function in older adults with CKD with standardized tests is completed in various ways. Unfortunately, the common methods of assessment of cognitive function may not be fully examining the domains of impairment commonly found in older adults with CKD. Further research is needed to identify the ideal cognitive test to best assess older adults with CKD for cognitive impairment.

  18. Effect of surface sensory and motor electrical stimulation on chronic poststroke oropharyngeal dysfunction.

    Science.gov (United States)

    Rofes, L; Arreola, V; López, I; Martin, A; Sebastián, M; Ciurana, A; Clavé, P

    2013-11-01

    Chronic poststroke oropharyngeal dysfunction (OD) is a common condition, leading to severe complications, including death. Treatments for chronic poststroke OD are scarce. The aim of our study was to assess and compare the efficacy and safety of treatment with surface electrical stimulation (e-stim) at sensory and motor intensities in patients with chronic poststroke OD. Twenty chronic poststroke patients with OD were randomly assigned to (i) sensory e-stim (treatment intensity: 75% of motor threshold) or (ii) motor e-stim (treatment intensity: motor threshold). Patients were treated during 10 days, 1 h/day. Videofluoroscopy was performed at the beginning and end of the study to assess signs of impaired efficacy and safety of swallow and timing of swallow response. Patients presented advanced age (74.95 ± 2.18), 75% were men. The mean days poststroke was 336.26 ± 89.6. After sensory stimulation, the number of unsafe swallows was reduced by 66.7% (p swallows was reduced by 62.5% (p = 0.002), the laryngeal vestibule closure time by 38.26% (p = 0.009) and maximal vertical hyoid extension time by 24.8% (p = 0.008). Moreover, the motor stimulus reduced the pharyngeal residue by 66.7% (p = 0.002), the upper esophageal sphincter opening time by 39.39% (p = 0.009), and increased bolus propulsion force by 211.1% (p = 0.008). No serious adverse events were detected during the treatment. Surface e-stim is a safe and effective treatment for chronic poststroke dysphagic patients. © 2013 John Wiley & Sons Ltd.

  19. Clinical assessment, staging, and epidemiology of chronic obstructive pulmonary disease exacerbations

    DEFF Research Database (Denmark)

    Vestbo, Jørgen

    2006-01-01

    Patients presenting with an exacerbation of chronic obstructive pulmonary disease (COPD) are initially assessed to ensure that a proper diagnosis has been made and that relevant differential diagnoses are excluded. Although guidelines provide indicators for use, very little systematic research has...... been done in initial assessment of COPD exacerbations. Next, the assessment should aim at stratifying patients for risk of poor outcome. For this, predictors of poor prognosis as well as knowledge of favorable treatments can be used. However, no formal and validated staging system exists today. Given...... the frequency and impact of COPD exacerbations, there seems to be a need for systematic research in this area....

  20. Effect Of Ventilation On Chronic Health Risks In Schools And Offices

    Energy Technology Data Exchange (ETDEWEB)

    Parthasarathy, Srinandini [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McKone, Thomas E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-04

    This study provides a risk assessment for chronic health risks from inhalation exposure to indoor air pollutants in offices and schools with a focus how ventilation impacts exposures to, and risks from, volatile organic compounds (VOCs) and particulate matter (PM2.5). We estimate how much health risks could change with varying ventilation rates under two scenarios: (i) halving the measured ventilation rates and (ii) doubling the measured ventilation rates. For the hazard characterization we draw upon prior papers that identified pollutants potentially affecting health with indoor air concentrations responsive to changes in ventilation rates. For exposure assessment we determine representative concentrations of pollutants using data available in current literature and model changes in exposures with changes in ventilation rates. As a metric of disease burden, we use disability adjusted life years (DALYs) to address both cancer and non-cancer effects. We also compare exposures to guidelines published by regulatory agencies to assess chronic health risks. Chronic health risks are driven primarily by particulate matter exposure, with an estimated baseline disease burden of 150 DALYs per 100,000 people in offices and 140 DALYs per 100,000 people in schools. Study results show that PM2.5-related DALYs are not very sensitive to changes in ventilation rates. Filtration is more effective at controlling PM2.5 concentrations and health effects. Non-cancer health effects contribute only a small fraction of the overall chronic health burden of populations in offices and schools (<1 DALY per 100,000 people). Cancer health effects dominate the disease burden in schools (3 DALYs per 100,000) and offices (5 DALYs per 100,000), with formaldehyde being the primary risk driver. In spite of large uncertainties in toxicological data and dose-response modeling, our results support the finding that ventilation rate changes do not have significant impacts on estimated chronic disease

  1. Development and Validation of an Instrument for Assessing Patient Experience of Chronic Illness Care

    Directory of Open Access Journals (Sweden)

    José Joaquín Mira

    2016-08-01

    Full Text Available Introduction: The experience of chronic patients with the care they receive, fuelled by the focus on patient-centeredness and the increasing evidence on its positive relation with other dimensions of quality, is being acknowledged as a key element in improving the quality of care. There are a dearth of accepted tools and metrics to assess patient experience from the patient’s perspective that have been adapted to the new chronic care context: continued, systemic, with multidisciplinary teams and new technologies. Methods: Development and validation of a scale conducting a literature review, expert panel, pilot and field studies with 356 chronic primary care patients, to assess content and face validities and reliability. Results: IEXPAC is an 11+1 item scale with adequate metric properties measured by Alpha Chronbach, Goodness of fit index, and satisfactory convergence validity around three factors named: productive interactions, new relational model and person’s self-management. Conclusions: IEXPAC allows measurement of the patient experience of chronic illness care. Together with other indicators, IEXPAC can determine the quality of care provided according to the Triple Aim framework, facilitating health systems reorientation towards integrated patient-centred care.

  2. The Timed 180° Turn Test for Assessing People with Hemiplegia from Chronic Stroke

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    Regan L. Robinson

    2018-01-01

    Full Text Available Background. Turning is ubiquitous in activities of daily living. For people with hemiplegia, persistent impairments in strength, balance, and coordination will affect their ability to turn safely. Consequently, turning retraining should be addressed in rehabilitation programs. To measure turning for these individuals, a reliable clinical tool is required. Objective. To investigate (i the intrarater, interrater, and test-retest reliability of the timed 180° turn test; (ii the correlation of the timed 180° turn test with other measures of stroke-specific impairments; and (iii the cut-off time that best discriminates individuals with hemiplegia from chronic stroke and healthy older adults. Methods. 33 individuals with hemiplegia due to chronic stroke and 32 healthy elderly individuals participated in this cross-sectional study. The timed 180° turn test was administered along with other measures of stroke-specific impairment. Results. The timed 180° turn test demonstrated excellent intrarater, interrater, and test-retest reliability in individuals with hemiplegia from chronic stroke. The timed 180° turn test (times significantly correlated with the Fugl-Meyer Assessment of the Lower Extremities (FMA-LE, affected ankle plantar flexion strength, the 5-Times-Sit-To-Stand test, the Berg Balance Scale (BBS, and the Timed Up and Go (TUG test. Conclusion. The timed 180° turn test is a reliable clinical tool to assess the turning ability of subjects with hemiplegia from chronic stroke.

  3. Effects of low-level chronic irradiation on aquatic organisms

    Energy Technology Data Exchange (ETDEWEB)

    Etoh, H. (National Inst. of Radiological Sciences, Chiba (Japan))

    1980-10-01

    Effects of continual irradiation for a long term on fishes and aquatic invertebrates were outlined. Effects of low-level chronic irradiation on aquatic organisms were less than acute effects induced when the same dose was irradiated once. The radiosensitivity of the genital organ to continual irradiation was high. There was a difference in radiosensitivity of the genital organ between female and male, and the degree of the difference varied according to kinds of animals. In an experiment on continual irradiation of adult killifishes, ova recovered from radiation damage, but spermatozoa did not recover. Incubation rates of eggs obtained from aquatic organisms which lived in water where radioactive sewage flowed into decreased significantly, and the frequency of reverse position of salivary gland chromosomes which were peculiar to exposed organisms increased in larvae of Chironomus tentans.

  4. Curative effect of sesame oil in a rat model of chronic kidney disease.

    Science.gov (United States)

    Liu, Chuan-Teng; Chien, Se-Ping; Hsu, Dur-Zong; Periasamy, Srinivasan; Liu, Ming-Yie

    2015-12-01

    Chronic kidney disease causes a progressive and irreversible loss of renal function. We investigated the curative effect of sesame oil, a natural, nutrient-rich, potent antioxidant, in a rat model of chronic kidney disease. Chronic kidney disease was induced by subcutaneously injecting uni-nephrectomized rats with deoxycorticosterone acetate (DOCA) and 1% NaCl [DOCA/salt] in drinking water. Four weeks later, the rats were gavaged with sesame oil (0.5 or 1 mL/kg per day) for 7 days. Renal injury, histopathological changes, hydroxyl radical, peroxynitrite, lipid peroxidation, Nrf2, osteopontin expression, and collagen were assessed 24 h after the last dose of sesame oil. Blood urea nitrogen, creatinine, urine volume, and albuminuria were significantly higher in the DOCA/salt treated rats than in control rats. Sesame oil significantly decreased these four tested parameters in DOCA/salt treated rats. In addition, creatinine clearance rate and nuclear Nrf2 expression were significantly decreased in the DOCA/salt treated rats compared to control rats. Sesame oil significantly decreased hydroxyl radical, peroxynitrite level, lipid peroxidation, osteopontin, and renal collagen deposition, but increased creatinine clearance rate and nuclear Nrf2 expression in DOCA/salt treated rats. We conclude that supplementation of sesame oil mitigates DOCA/salt induced chronic kidney disease in rats by activating Nrf2 and attenuating osteopontin expression and inhibiting renal fibrosis in rats. © 2015 Asian Pacific Society of Nephrology.

  5. The Effect of Weight Loss in Obese Patients with Chronic Stable Plaque-Type Psoriasis

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    Wanjarus Roongpisuthipong

    2013-01-01

    Full Text Available Background. Chronic plaque psoriasis is frequently associated with obesity. The effect of a low-calorie diet on psoriasis has not been investigated. Objective. The objective was to investigate whether moderate weight loss increases the therapeutic response to topical treatment in obese patients with chronic stable plaque-type psoriasis. Material and Method. A 24-week clinical trial was conducted in 10 patients. The efficacy of a low-calorie diet with topical treatment was compared with baseline in obese patients with chronic stable plaque-type psoriasis. The primary measure of clinical response was the Psoriasis Area and Severity Index at weeks 12 and 24. Results. At week 12, the mean reduction in body weight was 9.6 percent. There was an improvement from baseline of 50 percent or more in the Psoriasis Area and Severity Index in 50 percent of the patients. The responses as measured by improvements in the Psoriasis Area and Severity Index were paralleled by improvements in global assessments by the physician and the patients and in the Dermatology Life Quality Index. Conclusion. Obese patients with chronic stable plaque-type psoriasis increase their response to a low-calorie diet. Lifestyle modifications, including a low-calorie diet, may supplement the pharmacologic treatment of obese psoriasis patients.

  6. The effectiveness of balneotherapy in chronic low back pain.

    Science.gov (United States)

    Onat, Şule Şahin; Taşoğlu, Özlem; Güneri, Fulya Demircioğlu; Özişler, Zuhal; Safer, Vildan Binay; Özgirgin, Neşe

    2014-01-01

    The aim of this study is to determine the effectiveness of balneotherapy plus physical therapy versus only physical therapy in patients with chronic low back pain. In this trial, 81 patients with low back pain were followed up in two groups. Patients in group I (n = 44) were treated with physical therapy alone. Patients in group II (n = 37) were treated with balneotherapy in addition to the same physical therapy protocol in group I. Patients in both groups were given a home-based standardized exercise program. The following parameters were measured: visual analog scale (0-10 cm), fingertip-to-floor distance (cm), Oswestry Disability Index, and Short Form 36 quality of life scale. First evaluations were done at the time of enrollment, and second evaluations were done after accomplishment of a 3-week treatment program. There were no significant differences between the two groups for the sociodemographic features. All of the measured parameters improved in both groups. However, improvements in pain, functionality, and quality of life scores were found to be superior in the balneotherapy plus physical therapy group. For the patients with chronic low back pain, balneotherapy plus physical therapy is more effective, compared to physical therapy alone.

  7. The effects of chronic ketorolac tromethamine (toradol) on wound healing.

    Science.gov (United States)

    Haws, M J; Kucan, J O; Roth, A C; Suchy, H; Brown, R E

    1996-08-01

    Intramuscular ketorolac is a commonly used nonsteroidal anti-inflammatory (NSAI) agent for analgesia in surgical patients. Increasing numbers of surgical patients are chronically taking some form of an NSAI drug. We examined the effects of "chronic" intramuscular ketorolac on the healing of a closed linear surgical wound in the rat. Wistar rats were pretreated with 4 mg per kilogram per day ketorolac intramuscularly prior to receiving dorsal incisional wounds. The ketorolac treatment was continued and after 2 weeks the wounds were excised and separated with a tensiometer to measure mechanical properties. Breaking strength was directly measured, tensile strength was calculated, and collagen concentrations at the wound site were determined. A significant decrease in the mean breaking strength was seen in the ketorolac-treated animals when compared to controls. The ketorolac-treated animals had a mean tensile strength less than the controls, although this difference did not reach statistical significance. The mean collagen concentration of the ketorolac-treated wounds was significantly less than the untreated wounds. Use of ketorolac for just 1 week prior to surgery in rats produced a significant decrease in the breaking strength of their wounds. With the increasing use of ketorolac in surgical patients as well as the increasing use of oral NSAI drugs, more study of this effect is warranted.

  8. Omitting cytogenetic assessment from routine treatment response monitoring in chronic myeloid leukemia is safe.

    Science.gov (United States)

    Geelen, Inge G P; Thielen, Noortje; Janssen, Jeroen J W M; Hoogendoorn, Mels; Roosma, Tanja J A; Valk, Peter J M; Visser, Otto; Cornelissen, Jan J; Westerweel, Peter E

    2018-04-01

    The monitoring of response in chronic myeloid leukemia (CML) is of great importance to identify patients failing their treatment in order to adjust TKI choice and thereby prevent progression to advanced stage disease. Cytogenetic monitoring has a lower sensitivity, is expensive, and requires invasive bone marrow sampling. Nevertheless, chronic myeloid leukemia guidelines continue to recommend performing routine cytogenetic response assessments, even when adequate molecular diagnostics are available. In a population-based registry of newly diagnosed CML patients in the Netherlands, all simultaneous cytogenetic and molecular assessments performed at 3, 6, and 12 months were identified and response of these matched assessments was classified according to European Leukemia Net (ELN) recommendations. The impact of discrepant cytogenetic and molecular response classifications and course of patients with additional chromosomal abnormalities were evaluated. The overall agreement of 200 matched assessments was 78%. In case of discordant responses, response at 24 months was consistently better predicted by the molecular outcome. Cytogenetic response assessments provided relevant additional clinical information only in some cases of molecular "warning." The development of additional cytogenetic abnormalities was always accompanied with molecular failure. We conclude that it is safe to omit routine cytogenetics for response assessment during treatment and to only use molecular monitoring, in order to prevent ambiguous classifications, reduce costs, and reduce the need for invasive bone marrow sampling. Cytogenetic re-assessment should still be performed when molecular response is suboptimal. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. The Assessment of Hedge Effectiveness

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    Cristina BUNEA-BONTAS

    2012-04-01

    Full Text Available Earnings volatility can be a significant source of concern for a company, putting pressure on its capital base and share price. Prudent management of the company’s exposure to different risks typically involves hedging solutions. Hedging is important for corporate risk management, involving reducing the exposure of the company to specific risks. The aim of this paper is to examine the basic requirements for assessing the hedge effectiveness, this being a vital stage in applying hedge accounting, that gives the possibility to assess if the companies match the timing of the gains and losses of hedged items and their hedging derivatives. The article identifies some difficulties encountered by companies and choices that they must make in assessing hedge effectiveness.

  10. Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review.

    Science.gov (United States)

    Lee, Jung-Ah; Choi, Mona; Lee, Sang A; Jiang, Natalie

    2018-02-20

    Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

  11. Functional assessment of chronic illness therapy—the fatigue scale exhibits stronger associations with clinical parameters in chronic dialysis patients compared to other fatigue-assessing instruments

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    Chia-Ter Chao

    2016-03-01

    Full Text Available Background. Patients with end-stage renal disease (ESRD have a high symptom burden, among which fatigue is highly prevalent. Many fatigue-assessing instruments exist, but comparisons among instruments in this patient population have yet to be investigated. Methods. ESRD patients under chronic hemodialysis were prospectively enrolled and seven types of fatigue instruments were administered: Brief Fatigue Inventory (BFI, Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F, Fatigue Severity Scale (FSS, Lee Fatigue Scale (LFS, Fatigue Questionnaire (FQ, Fatigue Symptom Inventory (FSI, and Short-Form 36-Vitality (SF36-V. Using these instruments, we investigated the correlation between fatigue severity and clinical/biochemical parameters, including demographic/comorbidity profile, dialysis-related complications, and frailty severity. We used regression analysis with serum albumin and frailty severity as the dependent variables to investigate the independent correlations. Results. A total of 46 ESRD patients were enrolled (average age of 67 ± 11.6 years, and 50% of them had type 2 diabetes mellitus. Results from the seven tested instruments showed high correlation with each other. We found that the fatigue severity by FACIT-F was significantly associated with age (p = 0.03, serum albumin (p = 0.003 and creatinine (p = 0.02 levels, while SF36-V scores were also significantly associated with age (p = 0.02 and serum creatinine levels (p = 0.04. However, the fatigue severity measured by the FSS, FSI, FQ, BFI, and LFS did not exhibit these associations. Moreover, regression analysis showed that only FACIT-F scores were independently associated with serum albumin levels and frailty severity in ESRD patients. Conclusion. Among the seven fatigue-assessing instruments, only the FACIT-F yielded results that demonstrated significant and independent associations with important outcome-related features in ESRD patients.

  12. Sex differences in chronic stress effects on cognition in rodents.

    Science.gov (United States)

    Luine, Victoria; Gomez, Juan; Beck, Kevin; Bowman, Rachel

    2017-01-01

    Chronic stress causes deleterious changes in physiological function in systems ranging from neural cells in culture to laboratory rodents, sub-human primates and humans. It is notable, however, that the vast majority of research in this area has been conducted in males. In this review, we provide information about chronic stress effects on cognition in female rodents and contrast it with responses in male rodents. In general, females show cognitive resilience to chronic stressors which impair male cognitive function using spatial tasks including the radial arm maze, radial arm water maze, Morris water maze, Y-maze and object placement. Moreover, stress often enhances female performance in some of these cognitive tasks. Memory in females is not affected by stress in non-spatial memory tasks like recognition memory and temporal order recognition memory while males show impaired memory following stress. We discuss possible bases for these sex-dependent differences including the use of different strategies by the sexes to solve cognitive tasks. Whether the sex differences result from changes in non-mnemonic factors is also considered. Sex-dependent differences in alcohol and drug influences on stress responses are also described. Finally, the role of neurally derived estradiol in driving sex differences and providing resilience to stress in females is shown. The importance of determining the nature and extent of sex differences in stress responses is that such differences may provide vital information for understanding why some stress related diseases have different incidence rates between the sexes and for developing novel therapeutic treatments. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain

    NARCIS (Netherlands)

    Rubinstein, Sidney M; van Middelkoop, Marienke; Kuijpers, Ton; Ostelo, Raymond; Verhagen, Arianne P; de Boer, Michiel R; Koes, Bart W; van Tulder, Maurits W

    2010-01-01

    The purpose of this systematic review was to assess the effects of spinal manipulative therapy (SMT), acupuncture and herbal medicine for chronic non-specific LBP. A comprehensive search was conducted by an experienced librarian from the Cochrane Back Review Group (CBRG) in multiple databases up to

  14. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain

    NARCIS (Netherlands)

    S.M. Rubinstein (Sidney); M. van Middelkoop (Marienke); T. Kuijpers (Ton); R.W.J.G. Ostelo (Raymond); A.P. Verhagen (Arianne); M.R. de Boer (Michiel Robert); B.W. Koes (Bart); M.W. van Tulder (Maurits)

    2010-01-01

    textabstractThe purpose of this systematic review was to assess the effects of spinal manipulative therapy (SMT), acupuncture and herbal medicine for chronic non-specific LBP. A comprehensive search was conducted by an experienced librarian from the Cochrane Back Review Group (CBRG) in multiple

  15. Advances in Remote Respiratory Assessments for People with Chronic Obstructive Pulmonary Disease: A Systematic Review.

    Science.gov (United States)

    Baroi, Sidney; McNamara, Renae J; McKenzie, David K; Gandevia, Simon; Brodie, Matthew A

    2018-06-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. Advances in remote technologies and telemedicine provide new ways to monitor respiratory function and improve chronic disease management. However, telemedicine does not always include remote respiratory assessments, and the current state of knowledge for people with COPD has not been evaluated. Systematically review the use of remote respiratory assessments in people with COPD, including the following questions: What devices have been used? Can acute exacerbations of chronic obstructive pulmonary disease (AECOPD) be predicted by using remote devices? Do remote respiratory assessments improve health-related outcomes? The review protocol was registered (PROSPERO 2016:CRD42016049333). MEDLINE, EMBASE, and COMPENDEX databases were searched for studies that included remote respiratory assessments in people with COPD. A narrative synthesis was then conducted by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifteen studies met the inclusion criteria. Forced expiratory volume assessed daily by using a spirometer was the most common modality. Other measurements included resting respiratory rate, respiratory sounds, and end-tidal carbon dioxide level. Remote assessments had high user satisfaction. Benefits included early detection of AECOPD, improved health-related outcomes, and the ability to replace hospital care with a virtual ward. Remote respiratory assessments are feasible and when combined with sufficient organizational backup can improve health-related outcomes in some but not all cohorts. Future research should focus on the early detection, intervention, and rehabilitation for AECOPD in high-risk people who have limited access to best care and investigate continuous as well as intermittent monitoring.

  16. [Development of a Conceptual Framework for the Assessment of Chronic Care in the Spanish National Health System].

    Science.gov (United States)

    Espallargues, Mireia; Serra-Sutton, Vicky; Solans-Domènech, Maite; Torrente, Elena; Moharra, Montse; Benítez, Dolors; Robles, Noemí; Domíngo, Laia; Escarrabill Sanglas, Joan

    2016-07-07

    The aim was to develop a conceptual framework for the assessment of new healthcare initiatives on chronic diseases within the Spanish National Health System. A comprehensive literature review between 2002 and 2013, including systematic reviews, meta-analysis, and reports with evaluation frameworks and/or assessment of initiatives was carried out; integrated care initiatives established in Catalonia were studied and described; and semistructured interviews with key stakeholders were performed. The scope and conceptual framework were defined by using the brainstorming approach.Of 910 abstracts identified, a total of 116 studies were included. They referred to several conceptual frameworks and/or assessment indicators at a national and international level. An overall of 24 established chronic care initiatives were identified (9 integrated care initiatives); 10 in-depth interviews were carried out. The proposed conceptual framework envisages: 1)the target population according to complexity levels; 2)an evaluation approach of the structure, processes, and outcomes considering the health status achieved, the recovery process and the maintenance of health; and 3)the dimensions or attributes to be assessed. The proposed conceptual framework will be helpful has been useful to develop indicators and implement them with a community-based and result-oriented approach and a territorial or population-based perspective within the Spanish Health System. This will be essential to know which are the most effective strategies, what are the key elements that determine greater success and what are the groups of patients who can most benefit.

  17. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.

    Science.gov (United States)

    Louw, Adriaan; Diener, Ina; Butler, David S; Puentedura, Emilio J

    2011-12-01

    To evaluate the evidence for the effectiveness of neuroscience education (NE) for pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain. Systematic searches were conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search. All experimental studies including randomized controlled trials (RCTs), nonrandomized clinical trials, and case series evaluating the effect of NE on pain, disability, anxiety, and stress for chronic MSK pain were considered for inclusion. Additional limitations: studies published in English, published within the last 10 years, and patients older than 18 years. No limitations were set on specific outcome measures of pain, disability, anxiety, and stress. Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach. Methodological quality was assessed by 2 reviewers using the Critical Review Form-Quantitative Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT, and 1 comparative study involving 401 subjects. Most articles were of good quality, with no studies rated as poor or fair. Heterogeneity across the studies with respect to participants, interventions evaluated, and outcome measures used prevented meta-analyses. Narrative synthesis of results, based on effect size, established compelling evidence that NE may be effective in reducing pain ratings, increasing function, addressing catastrophization, and improving movement in chronic MSK pain. For chronic MSK pain disorders, there is compelling evidence that an educational strategy addressing neurophysiology and neurobiology of pain can have a positive effect on pain, disability, catastrophization, and

  18. Application of transtheoretical model to assess the compliance of chronic periodontitis patients to periodontal therapy

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    Shilpa Emani

    2016-01-01

    Full Text Available Background: The present cross-sectional survey study was conducted to assess whether the transtheoretical model for oral hygiene behavior was interrelated in theoretically consistent directions in chronic periodontitis patients and its applicability to assess the compliance of the chronic periodontitis patients to the treatment suggested. Materials and Methods: A total of 150 chronic periodontitis patients were selected for the proposed study. The selected patients were given four questionnaires that were constructed based on transtheoretical model (TTM, and the patients were divided subsequently into five different groups (precontemplation, contemplation, preparation, action, and maintenance groups based on their answers to the questionnaires. Then, each patient was given four appointments for their periodontal treatment spaced with a time gap of 10 days. The patients visit for each appointments scheduled to them was documented. The results obtained were assessed using TTM. Results: Higher mean pro scores of decisional balance, self-efficacy, and process of change scores was recorded in maintenance group followed by action group, preparation group, contemplation group, and precontemplation group, respectively, whereas higher mean cons score was recorded in precontemplation group followed by contemplation group, preparation group, action group, and maintenance group, respectively. The difference scores of TTM constructs were statistically highly significant between all the five groups. Furthermore, the number of appointment attended in were significantly more than maintenance group followed by action group, preparation group, contemplation group, and precontemplation group. Conclusion: Within the limitations of this study, it can be concluded that transtheoretical model can be successfully applied to chronic periodontitis patients to assess their compliance to the suggested periodontal treatment.

  19. The mediation effect of experiential avoidance between coping and psychopathology in chronic pain.

    Science.gov (United States)

    Costa, Joana; Pinto-Gouveia, José

    2011-01-01

    This study explores experiential avoidance as a mediator in the relationship between coping (rational coping, avoidant coping and detached/ emotional coping) and psychopathology (depression, anxiety and stress). A battery of self-report questionnaires was used to assess coping, experiential avoidance and depression, anxiety and stress in 70 participants with a chronic pain from Portuguese primary health care units. Regression analyses were performed and showed preliminary evidence supporting the mediation role of experiential avoidance in a Portuguese sample with chronic pain. Results show that experiential avoidance partially or fully mediate the effects of rational coping and detached/emotional coping on depression and stress. Implications for clinical practice were discussed and suggest that psychopathology is not necessary direct product of coping and other processes, such as experiential avoidance, are likely involved. Copyright © 2010 John Wiley & Sons, Ltd.

  20. The Dichotomous Effect of Chronic Stress on Obesity.

    Science.gov (United States)

    Razzoli, Maria; Bartolomucci, Alessandro

    2016-07-01

    Obesity and metabolic diseases are linked to chronic stress and low socioeconomic status. The mechanistic link between stress and obesity has not been clarified, partly due to the inherent complexity exemplified by the bidirectional effect of stress on eating and body weight. Recent studies focusing on adaptive thermogenesis and brown adipose tissue (BAT) function support a dichotomous relation to explain the impact of stress on obesity: stress promotes obesity in the presence of hyperphagia and unchanged BAT function; stress results in weight loss and/or obesity resistance in the presence of hypophagia, or when hyperphagia is associated with BAT recruitment and enhanced thermogenesis. Mechanistically dissecting the bidirectional effects of stress on metabolic outcomes might open new avenues for innovative pharmacotherapies for the treatment of obesity-associated diseases. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Assessment of the Sustainability Capacity of a Coordinated Approach to Chronic Disease Prevention.

    Science.gov (United States)

    Moreland-Russell, Sarah; Combs, Todd; Polk, LaShaun; Dexter, Sarah

    2017-12-07

    This article outlines some factors that influenced the sustainability capacity of a coordinated approach to chronic disease prevention in state and territory health departments. This study involved a cross-sectional design and mixed-methods approach. Quantitative data were collected using the Program Sustainability Assessment Tool (PSAT), a 40-item multiple-choice instrument that assesses 8 domains of sustainability capacity (environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, communications, and strategic planning). Qualitative data were collected via phone interviews. The PSAT was administered to staff and stakeholders from public health departments in 50 US states, District of Columbia, and Puerto Rico, who were involved in the implementation of coordinated chronic disease programs. Phone interviews were conducted with program coordinators in each state. Sustainability score patterns and state-level categorical results, as well as strengths and opportunities for improvement across the 8 program sustainability domains, were explored. On average, programs reported the strongest sustainability capacity in the domains of program adaptation, environmental support, and organizational capacity, while funding stability, strategic planning, and communications yielded lowest scores, indicating weakest capacity. Scores varied the most by state in environmental support and strategic planning. The PSAT results highlight the process through which states approached the sustainability of coordinated chronic disease initiatives. This process included an initial focus on program evaluation and partnerships with transfer of priority to long-term strategic planning, communications, and funding stability to further establish coordinated chronic disease efforts. Qualitative interviews provided further context to PSAT results, indicating that leadership, communications, partnerships, funding stability, and policy

  2. The effects of chronic achievement motivation and achievement primes on the activation of achievement and fun goals.

    Science.gov (United States)

    Hart, William; Albarracín, Dolores

    2009-12-01

    This research examined the hypothesis that situational achievement cues can elicit achievement or fun goals depending on chronic differences in achievement motivation. In 4 studies, chronic differences in achievement motivation were measured, and achievement-denoting words were used to influence behavior. The effects of these variables were assessed on self-report inventories, task performance, task resumption following an interruption, and the pursuit of means relevant to achieving or having fun. Findings indicated that achievement priming (vs. control priming) activated a goal to achieve and inhibited a goal to have fun in individuals with chronically high-achievement motivation but activated a goal to have fun and inhibited a goal to achieve in individuals with chronically low-achievement motivation.

  3. The in vitro effect of xylitol on chronic rhinosinusitis biofilms.

    Science.gov (United States)

    Jain, R; Lee, T; Hardcastle, T; Biswas, K; Radcliff, F; Douglas, R

    2016-12-01

    Biofilms have been implicated in chronic rhinosinusitis (CRS) and may explain the limited efficacy of antibiotics. There is a need to find more effective, non-antibiotic based therapies for CRS. This study examines the effects of xylitol on CRS biofilms and planktonic bacteria. Crystal violet assay and spectrophotometry were used to quantify the effects of xylitol (5% and 10% solutions) against Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus. The disruption of established biofilms, inhibition of biofilm formation and effects on planktonic bacteria growth were investigated and compared to saline and no treatment. Xylitol 5% and 10% significantly reduced biofilm biomass (S. epidermidis), inhibited biofilm formation (S. aureus and P. aeruginosa) and reduced growth of planktonic bacteria (S. epidermidis, S. aureus, and P. aeruginosa). Xylitol 5% inhibited formation of S. epidermidis biofilms more effectively than xylitol 10%. Xylitol 10% reduced S. epidermidis planktonic bacteria more effectively than xylitol 5%. Saline, xylitol 5% and 10% disrupted established biofilms of S. aureus when compared with no treatment. No solution was effective against established P. aeruginosa biofilm. Xylitol has variable activity against biofilms and planktonic bacteria in vitro and may have therapeutic efficacy in the management of CRS.

  4. Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qinghai; Li, Jinning; Zhang, Lan; Chen, Ying; Zhang, Minming [Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009 (China); Yan, Fuhua, E-mail: zemylife@163.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China)

    2014-05-15

    Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal–Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r = −0.633, P < 0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F = 19.512, P < 0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ{sup 2} = 9.929, P = 0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t = −4.586, P = 0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up.

  5. Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

    International Nuclear Information System (INIS)

    Li, Qinghai; Li, Jinning; Zhang, Lan; Chen, Ying; Zhang, Minming; Yan, Fuhua

    2014-01-01

    Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal–Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r = −0.633, P < 0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F = 19.512, P < 0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ 2 = 9.929, P = 0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t = −4.586, P = 0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up

  6. Effectiveness of an organized bowel management program in the management of severe chronic constipation in children.

    Science.gov (United States)

    Russell, Katie W; Barnhart, Douglas C; Zobell, Sarah; Scaife, Eric R; Rollins, Michael D

    2015-03-01

    Chronic constipation is a common problem in children. The cause of constipation is often idiopathic, when no anatomic or physiologic etiology can be identified. In severe cases, low dose laxatives, stool softeners and small volume enemas are ineffective. The purpose of this study was to assess the effectiveness of a structured bowel management program in these children. We retrospectively reviewed children with chronic constipation without a history of anorectal malformation, Hirschsprung's disease or other anatomical lesions seen in our pediatric colorectal center. Our bowel management program consists of an intensive week where treatment is assessed and tailored based on clinical response and daily radiographs. Once a successful treatment plan is established, children are followed longitudinally. The number of patients requiring hospital admission during the year prior to and year after initiation of bowel management was compared using Fisher's exact test. Forty-four children with refractory constipation have been followed in our colorectal center for greater than a year. Fifty percent had at least one hospitalization the year prior to treatment for obstructive symptoms. Children were treated with either high-dose laxatives starting at 2mg/kg of senna or enemas starting at 20ml/kg of normal saline. Treatment regimens were adjusted based on response to therapy. The admission rate one-year after enrollment was 9% including both adherent and nonadherent patients. This represents an 82% reduction in hospital admissions (phospital admissions in children with severe chronic constipation. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Effect of diet and tylosin on chronic diarrhea in beagles.

    Science.gov (United States)

    Westermarck, Elias; Frias, Rafael; Skrzypczak, Teresa

    2005-01-01

    Seven beagles in a colony of dogs had chronic diarrhea for at least 30 days. The dogs were subsequently treated with tylosin 20 mg/kg BW q24h PO for 10 days. During the treatment period, the feces became firmer but remained loose. When the treatment was discontinued, the diarrhea reappeared in 3 weeks. The feces remained abnormally loose in all dogs treated with metronidazole, trimethoprim-sulfadiazine, or doxycycline and prednisone. The diet was then changed for 10 days from a highly digestible moist pet food to a dry food developed for normal adult dogs. The feces again became firmer, although still loose in some dogs. The period was then extended to 3 month, but the fecal consistency continued to fluctuate from ideal to diarrhea. The dogs were treated a 2nd time with tylosin 20 mg/kg BW q24h PO for 10 days. The feces then became significantly firmer and remained so throughout a 3-month follow-up. We conclude that the combination of diet and tylosin was more effective than either agent alone in control of chronic diarrhea.

  8. Chronic and acute risk assessment of human exposed to novaluron-bifenthrin mixture in cabbage.

    Science.gov (United States)

    Shi, Kaiwei; Li, Li; Li, Wei; Yuan, Longfei; Liu, Fengmao

    2016-09-01

    Based on the dissipation and residual level in cabbage determined by gas chromatography coupled with an electron capture detector (GC-ECD), chronic and acute risk assessments of the novaluron and bifenthrin were investigated. At different spiked levels, mean recoveries were between 81 and 108 % with relative standard deviations (RSDs) from 1.1 to 6.8 %. The limit of quantification (LOQ) was 0.01 mg kg(-1), and good linearity with correlation coefficient (>0.9997) were obtained. The half-lives of novaluron and bifenthrin in cabbage were in the range of 3.2~10 days. Based on the consumption data in China, the risk quotients (RQs) of novaluron and bifenthrin were all below 100 %. The chronic and acute risk of novaluron in cabbage was relatively low, while bifenthrin exerts higher acute risk to humans than chronic risk. The obtained results indicated that the use of novaluron-bifenthrin mixture does not seem to pose any chronic or acute risk to humans even if cabbages are consumed at high application dosages and short preharvest interval (PHI).

  9. Diffusion imaging and transcranial magnetic stimulation assessment of transcallosal pathways in chronic stroke.

    Science.gov (United States)

    Mang, Cameron S; Borich, Michael R; Brodie, Sonia M; Brown, Katlyn E; Snow, Nicholas J; Wadden, Katie P; Boyd, Lara A

    2015-10-01

    To examine the relationship of transcallosal pathway microstructure and transcallosal inhibition (TCI) with motor function and impairment in chronic stroke. Diffusion-weighted magnetic resonance imaging and transcranial magnetic stimulation (TMS) data were collected from 24 participants with chronic stroke and 11 healthy older individuals. Post-stroke motor function (Wolf Motor Function Test) and level of motor impairment (Fugl-Meyer score) were evaluated. Fractional anisotropy (FA) of transcallosal tracts between prefrontal cortices and the mean amplitude decrease in muscle activity during the ipsilateral silent period evoked by TMS over the non-lesioned hemisphere (termed NL-iSPmean) were significantly associated with level of motor impairment and motor function after stroke (p<0.05). A regression model including age, post-stroke duration, lesion volume, lesioned corticospinal tract FA, transcallosal prefrontal tract FA and NL-iSPmean accounted for 84% of variance in motor impairment (p<0.01). Both transcallosal prefrontal tract FA (ΔR(2)=0.12, p=0.04) and NL-iSPmean (ΔR(2)=0.09, p=0.04) accounted for unique variance in motor impairment level. Prefrontal transcallosal tract microstructure and TCI are each uniquely associated with motor impairment in chronic stroke. Utilizing a multi-modal approach to assess transcallosal pathways may improve our capacity to identify important neural substrates of motor impairment in the chronic phase of stroke. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Effect of pain neurophysiology education on physiotherapy students' understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial.

    Science.gov (United States)

    Colleary, G; O'Sullivan, K; Griffin, D; Ryan, C G; Martin, D J

    2017-12-01

    To investigate the effect of pain neurophysiology education (PNE) on student physiotherapists': (1) knowledge of chronic pain; (2) attitudes towards patients with chronic pain; and (3) clinical recommendations for patients with chronic pain. Multicentre single-blind randomised controlled trial. One UK and one Irish university. Seventy-two student physiotherapists. Participants received either PNE (intervention) or a control education. Both were delivered in a 70-minute group lecture. (1) The Revised Pain Neurophysiology Quiz to assess knowledge; (2) the Health Care Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) to assess attitudes; and (3) a case vignette to assess the appropriateness of clinical recommendations. Post education, the PNE group had a greater increase in pain neurophysiology knowledge [mean difference 4.0 (95% confidence interval 3.2 to 4.7), Pstudents in the PNE group were more likely to make appropriate recommendations regarding work (94% vs 56%), exercise (92% vs 56%), activity (94% vs 67%) and bed rest (69% vs 33%) compared with those in the control group (Pphysiotherapy students, and could be used on a more widespread basis. There is a need to investigate whether these findings can be replicated in other healthcare professions, and how well these reported changes lead to changes in actual clinical behaviour and the clinical outcomes of patients. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  11. Effect of Low-Dose Aspirin on Chronic Acid Reflux Esophagitis in Rats.

    Science.gov (United States)

    Masuda, Takahiro; Yano, Fumiaki; Omura, Nobuo; Tsuboi, Kazuto; Hoshino, Masato; Yamamoto, Se Ryung; Akimoto, Shunsuke; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2018-01-01

    Clinical role of low-dose aspirin (LDA) in pathogenesis of gastroesophageal reflux disease is by far controversial. This can be attributed to the paucity of basic research detailing the mechanism of LDA-induced esophageal mucosal injury (EI) on underlying chronic acid reflux esophagitis (RE). The aim of this study was to clarify the effect of LDA on chronic RE in rats. Esophagitis was induced in 8-week-old male Wistar rats by ligating the border between forestomach and glandular portion with a 2-0 silk tie and covering the duodenum with a small piece of 18-Fr Nélaton catheter. Seventy-eight chronic RE rat models were divided into five treatment groups, consisting of orally administered vehicle (controls), and aspirin doses of 2, 5, 50 or 100 mg/kg once daily for 28 days. EI was assessed by gross area of macroscopic mucosal injury, severity grade of esophagitis and microscopic depth of infiltration by inflammatory cells. Area of esophagitis in animals with aspirin dose of 100 mg/kg/day showed a 36.5% increase compared with controls, although it failed to achieve statistical significance (p = 0.812). Additionally, the rate of severe EI was increased in animals with aspirin dose of 100 mg/kg/day as compared with controls (p aspirin (100 mg/kg/day) contributed in exacerbating preexisting EI. LDA (2 and 5 mg/kg/day), on the other hand, did not affect chronic RE in this model. LDA seems to be safe for use in patients with chronic RE.

  12. Effects of a supplemented hypoproteic diet in chronic kidney disease.

    Science.gov (United States)

    Mircescu, Gabriel; Gârneaţă, Liliana; Stancu, Simona Hildegard; Căpuşă, Cristina

    2007-05-01

    We assessed the effect of a severe hypoproteic diet supplemented with ketoanalogues (SVLPD) for 48 weeks on certain metabolic disorders of chronic kidney disease (CKD). We performed a prospective, open-label, parallel, randomized, controlled trial. The study took place in the Nephrology Department at the Dr Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania. A total of 53 nondiabetic patients with CKD with an estimated glomerular filtration rate less than 30 mL/min/1.73 m(2) (Modification of Diet in Renal Disease formula), proteinuria less than 1 g/g urinary creatinine, good nutritional status, and anticipated good compliance with the diet were randomly assigned to two groups. Group I (n = 27) received the SVLPD (0.3 g/kg/d of vegetable proteins and ketoanalogues, 1 capsule for every 5 kg of ideal body weight per day). Group II (n = 26) continued a conventional low mixed protein diet (0.6 g/kg/d). Nitrogen waste products retention and calcium-phosphorus and acid-base disturbances were primary efficacy parameters, and "death" of the kidney or the patient and the estimated glomerular filtration rate were secondary efficacy parameters. The nutritional status and compliance with the diet were predefined as safety variables. There were no differences between groups in any parameter at baseline. In the SVLPD group, serum urea significantly decreased (56 +/- 7.9 mmol/L vs. 43.2 +/- 10 mmol/L), and significant improvements in serum bicarbonate (23.4 +/- 2.1 mmol/L vs. 18.1 +/- 1.5 mmol/L), serum calcium (1.10 +/- 0.17 mmol/L vs. 1.00 +/- 0.15 mmol/L at baseline), serum phosphates (1.45 +/- 0.66 mmol/L vs. 1.91 +/- 0.68 mmol/L), and calcium-phosphorus product (1.59 +/- 0.11 mmol(2)/L(2) vs. 1.91 +/- 0.10 mmol(2)/L(2)) were noted after 48 weeks. No death was registered in any group. Significantly lower percentages of patients in group I required renal replacement therapy initiation (4% vs. 27%). After 48 weeks, estimated glomerular filtration rate did not

  13. [Clinical effect of clarithromycin therapy in patients with chronic rhinosinusitis].

    Science.gov (United States)

    Luo, Qing; Deng, Jie; Xu, Rui; Zuo, Kejun; Li, Huabin; Shi, Jianbo

    2014-02-01

    To evaluate the efficacy of clarithromycin (CAM) treatment in adult Chinese patients suffering from chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP). A prospective, open and self-controlled clinical trial on patients with CRS was conducted. Fifty patients met inclusion criteria. Of 50 patients, there were 33 patients with CRSsNP and 17 patients with CRSwNP. CAM was administered at 250 mg/d and the duration of administration was 12 weeks. Outcome measures included assessments of visual analogue scale (VAS), the sino-nasal outcome test-20(SNOT-20), the medical outcomes study short-form 36 items(SF-36), Lund-Kennedy endoscopy score, and Lund-Mackay computed tomography score. Before starting the treatment, 2 months after treatment and at the end of treatment, each patient had to complete all the measures except Lund-Mackay computed tomography score, which was only conducted before and after treatment. In order to evaluate the safety of CAM, liver function and renal function in all patients were detected before and after treatment. SPSS 16.0 software was used to analyze the data. Forty-five patients completed 3 months follow-up and 5 patients withdrew due to different reasons. The results were as follows: (1) Thirty-three patients with CRSsNP's VAS scores of four time point were 5.81 ± 1.69, 3.76 ± 1.94, 2.98 ± 1.95, 2.06 ± 2.13, respectively, there were statistically significant improvements in turn (t values were 5.910, 8.090, 8.932, all P 0.05). Endoscopy score of four time point were 10.65 ± 1.77, 9.35 ± 1.93, 8.65 ± 2.76, 8.47 ± 2.76, respectively, there were statistically significant improvements in turn(t values were 4.068, 4.863, 5.156, all P CAM treatment, 1 patient reported a tolerable headache and weakness and 1 patient had abdominal pain after two months treatment, all the symptoms disappeared while they were asked to stop the drug. Liver function and renal function were detected in 40 patients, the differences

  14. Effects of portion size on chronic energy intake

    Directory of Open Access Journals (Sweden)

    Pentel Paul R

    2007-06-01

    Full Text Available Abstract Background This study experimentally examined the effects of repeated exposure to different meal portion sizes on energy intake. Methods Nineteen employees of a county medical center were given free box lunches for two months, one month each of 1528 and 767 average kcal. Foods were identical in the two conditions, but differed in portion size. Meals averaged 44% calories from fat. Participants self-reported how much of each lunch was eaten. Unannounced 24-hour dietary recalls were also conducted by phone twice per week during each exposure period. Results Mean energy intake at the lunch meal was 332 kcal/day higher in large lunch than in small lunch periods (p Conclusion This study suggests that chronic exposure to large portion size meals can result in sustained increases in energy intake and may contribute to body weight increases over time.

  15. The effects of chronic low dose irradiation on drosophila melanogaster

    International Nuclear Information System (INIS)

    Zajnullin, V.G.; Moskalev, A.A.; Shaposhnikov, M.V.; Yuraneva, I.N.; Taskaev, A.I.

    2001-01-01

    It was investigated the influence of the chronic gamma-irradiation in the dose rate of 0.17 cGy/h on the rate of genetic variability and on the life-span in the laboratory strains of Drosophila melanogaster with genotypic distinguishes in mobile genetic elements and defects in the DNA repair processes. It is shown that the radiation-induced alteration of the traits under study depends from genotype of investigated strains. In the different strains we have observed an increase as well as a decrease of the mutation rate and life-span. Also it was established that irradiation leads to the frequencies of the GD-sterility and mutability of the snw and h(w+) in the P-M and H-E dysgenic crosses. The obtained results suggest that mobile genetic elements play an important role in the forming of genetic effects in response to low dose irradiation. (author)

  16. Effect of scaling and root planing on blood counts in patients with chronic generalized periodontitis

    Directory of Open Access Journals (Sweden)

    Devinder Singh Kalsi

    2017-01-01

    Full Text Available Background: Many systemic diseases have been implicated as risk factors in periodontal disease. Studies suggest that periodontal infection can adversely affect systemic health; by inference periodontal disease will also have an effect on blood values, but the data available is not conclusive. Aim: This clinical study was designed to evaluate the effect of treatment of plaque induced periodontitis on commonly assessed blood parameters. Materials and Method: 37 males and 31 females aged between 20 and 50 years in good general health but suffering from plaque induced chronic periodontitis were selected for the study. The selected patients were assessed for ESR, TLC, PMN count, lymphocyte count from DLC, HB, BT and their periodontal condition before the start of the study. SCRP was carried out and patients were reassessed for the same clinical and hematological parameters 21 days after the periodontal therapy (SCRP. Results: A highly significant reduction in the counts of PMNs and the values of ESI was seen after SCRP. Furthermore a significant reduction in TLC, lymphocytes count, and BT and a non significant decrease in Hb were also observed. Conclusion: SCRP done in patients of chronic periodontitis has a considerable affect on the assessed blood parameters.

  17. [Effectiveness and tolerance of fenspiride treatment in chronic sinusitis. Results of the Polish multicenter study].

    Science.gov (United States)

    Zawisza, Edward

    2005-01-01

    During this randomized, double blind study versus placebo efficacy of 3 month treatment of patients with chronic sinusitis was assessed. Main efficacy criterion was defined as the change in computed tomography of paranasal sinuses, measured in V. Lund scale. In fenspiride group, overall score changed from 8.54 to 7.57 points (0.97 points i.e. 11.4% decrease, p=0.008), while in placebo group no statistically significant change was observed (change from 9.25 to 9.27 points--0.02 points i.e. 0.2% increase). Percentage of patients who experienced worsening (defined as at least 1 point increase between the beginning and the end of the study) in the placebo group was twice as big as in the fenspiride group (35.4% and 15.2% respectively; p=0.025). Clinical symptoms of chronic sinusitis--sneezing, itchy nose and purulent character of sputum--were decreasing in the fenspiride group significantly more than in the placebo group. Data from previous studies demonstrated beneficial effect of fenspiride treatment of patients with chronic sinusitis. During this study fenspiride treatment was proved to be relatively effective in terms of computed tomography results, and well tolerated during three month therapy.

  18. Effect of chronic exposure to aspartame on oxidative stress in the brain of albino rats.

    Science.gov (United States)

    Iyyaswamy, Ashok; Rathinasamy, Sheeladevi

    2012-09-01

    This study was aimed at investigating the chronic effect of the artificial sweetener aspartame on oxidative stress in brain regions of Wistar strain albino rats. Many controversial reports are available on the use of aspartame as it releases methanol as one of its metabolite during metabolism. The present study proposed to investigate whether chronic aspartame (75 mg/kg) administration could release methanol and induce oxidative stress in the rat brain. To mimic the human methanol metabolism, methotrexate (MTX)-treated rats were included to study the aspartame effects. Wistar strain male albino rats were administered with aspartame orally and studied along with controls and MTX-treated controls. The blood methanol level was estimated, the animal was sacrificed and the free radical changes were observed in brain discrete regions by assessing the scavenging enzymes, reduced glutathione, lipid peroxidation (LPO) and protein thiol levels. It was observed that there was a significant increase in LPO levels, superoxide dismutase (SOD) activity, GPx levels and CAT activity with a significant decrease in GSH and protein thiol. Moreover, the increases in some of these enzymes were region specific. Chronic exposure of aspartame resulted in detectable methanol in blood. Methanol per se and its metabolites may be responsible for the generation of oxidative stress in brain regions.

  19. Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

    Science.gov (United States)

    Parikh, Pathik; Ryan, John D.

    2017-01-01

    Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide. While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated. The detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust non-invasive blood- and imaging-based algorithms which can reliably stage disease in many cases. These tests are now incorporated into International guidelines for HBV management and relied upon daily to inform clinical judgement. Both blood- and imaging-based approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This review outlines the methods of fibrosis assessment in chronic HBV infection and focuses on the most commonly used blood- and imaging-based non-invasive tests, reviewing their diagnostic performance and applicability to patient care. PMID:28251119

  20. Effectiveness of Telephone-Based Health Coaching for Patients with Chronic Conditions: A Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Martin Härter

    Full Text Available Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death and disability. These conditions are at least partially preventable or modifiable, e.g. by enhancing patients' self-management. We aimed to examine the effectiveness of telephone-based health coaching (TBHC in chronically ill patients.This prospective, pragmatic randomized controlled trial compares an intervention group (IG of participants in TBHC to a control group (CG without TBHC. Endpoints were assessed two years after enrolment. Three different groups of insurees with 1 multiple conditions (chronic campaign, 2 heart failure (heart failure campaign, or 3 chronic mental illness conditions (mental health campaign were targeted. The telephone coaching included evidence-based information and was based on the concepts of motivational interviewing, shared decision-making, and collaborative goal setting. Patients received an average of 12.9 calls. Primary outcome was time from enrolment until hospital readmission within a two-year follow-up period. Secondary outcomes comprised the probability of hospital readmission, number of daily defined medication doses (DDD, frequency and duration of inability to work, and mortality within two years. All outcomes were collected from routine data provided by the statutory health insurance. As informed consent was obtained after randomization, propensity score matching (PSM was used to minimize selection bias introduced by decliners. For the analysis of hospital readmission and mortality, we calculated Kaplan-Meier curves and estimated hazard ratios (HR. Probability of hospital readmission and probability of death were analysed by calculating odds ratios (OR. Quantity of health service use and inability to work were analysed by linear random effects regression models. PSM resulted in patient samples of 5,309 (IG: 2,713; CG: 2,596 in the chronic campaign, of 660 (IG: 338; CG: 322 in the heart failure campaign, and of

  1. Observation-based assessment of functional ability in patients with chronic widespread pain

    DEFF Research Database (Denmark)

    Amris, Kirstine; Wæhrens, Eva Ejlersen; Jespersen, Anders

    2011-01-01

    Knowledge about functional ability, including activities of daily living (ADL), in patients with chronic widespread pain (CWP) and fibromyalgia (FMS) is largely based on self-report. The purpose of this study was to assess functional ability by using standardised, observation-based assessment...... of ADL performance and to examine the relationship between self-reported and observation-based measures of disability. A total of 257 women with CWP, 199 (77%) fulfilling the American College of Rheumatology tender point criteria for FMS, were evaluated with the Assessment of Motor and Process Skills...... (AMPS), an observation-based assessment providing linear measures of ADL motor and ADL process skill ability (unit: logits). A cutoff for effortless and independent ADL task performance is set at 2.0 for the motor scale and 1.0 for the process scale. A total of 248 (96.5%) had ability measures below...

  2. Potential for Self-Management in Chronic Care: Nurses' Assessments of Patients.

    Science.gov (United States)

    Bos-Touwen, Irene; Dijkkamp, Evelien; Kars, Marijke; Trappenburg, Jaap; De Wit, Niek; Schuurmans, Marieke

    2015-01-01

    Although self-management interventions are, to some extent, individualized in clinical practice, the decision-making process is not fully understood. Exploring nurses' clinical reasoning about how and to what extent they currently tailor self-management support can provide new insights, enhancing process and outcome of chronic care. The aim of this study was to explore how nurses assess chronic patients concerning the potential of self-management and clinical reasoning with regard to tailoring care to the individual patient. A qualitative study was conducted using grounded theory. Semistructured interviews were held with 15 nurses working within chronic care. All interviews were carried out from February to July 2013. All nurses provided individualized care; however, a nurse's view of self-management influenced how tailoring was performed. Substantial differences were seen in patient assessments and how care was individualized. Patients' motivation, capacities, mindset, needs, and preferences were obtained through communication, experience, intuition, and trusting relationships. A typology with four patient types emerged: the unmotivated patient, the patient with limited capacities, the oblivious patient, and the ideal patient. Nurses elaborated on using different approaches for patients in each of these groups. A nurse's perception of self-management substantially impacted how care was individualized. Patient assessment was the key driver of tailoring, which was performed in various ways, and influenced how and the extent to which care was individualized. To enable responding to the unique wishes and needs of individual patients, both scientific and educational efforts need to be directed toward systematic assessments of patient capacity to self-manage their disease.

  3. Affect School for chronic benign pain patients showed improved alexithymia assessments with TAS-20

    Directory of Open Access Journals (Sweden)

    Thulesius Hans O

    2010-06-01

    Full Text Available Abstract Background Alexithymia is a disturbance associated with psychosomatic disorders, pain syndromes, and a variety of psychiatric disorders. The Affect School (AS based on Tomkins Affect Theory is a therapy focusing on innate affects and their physiological expressions, feelings, emotions and scripts. In this pilot study we tried the AS-intervention method in patients with chronic benign pain. Methods The AS-intervention, with 8 weekly group sessions and 10 individual sessions, was offered to 59 patients with chronic non-malignant pain at a pain rehabilitation clinic in Sweden 2004-2005. Pre and post intervention assessments were done with the Hospital Anxiety and Depression scale (HAD, the Toronto Alexithymia Scale-20 (TAS-20, the Visual Analogue Scale for pain assessment (VAS-pain, the European Quality of Life health barometer (EQoL and the Stress and Crisis Inventory-93 (SCI-93. After the group sessions we used Bergdahl's Questionnaire for assessing changes in interpersonal relations, general well-being and evaluation of AS. Results The AS intervention was completed by 54 out of 59 (92% patients. Significant reductions in total TAS-20 post-test scores (p = 0.0006 as well as TAS-20 DIF and DDF factors (Difficulties Identifying Feelings, and Difficulties Describing Feelings were seen (p = 0.0001, and p = 0.0008 while the EOT factor (Externally Oriented Thinking did not change. Improvements of HAD-depression scores (p = 0.04, EQoL (p = 0.02 and self-assessed changes in relations to others (p Conclusions This pilot study involving 59 patients with chronic benign pain indicates that the alexithymia DIF and DDF, as well as depression, social relations and quality of life may be improved by the Affect School therapeutic intervention.

  4. Chronic obstructive pulmonary disease history assessment in Spain: a multidimensional chronic obstructive pulmonary disease evaluation. Study methods and organization.

    Science.gov (United States)

    López-Campos, José Luis; Peces-Barba, Germán; Soler-Cataluña, Juan José; Soriano, Joan B; de Lucas Ramos, Pilar; de-Torres, Juan P; Marín, José M; Casanova, Ciro

    2012-12-01

    This present paper describes the method and the organization of the study known as the COPD History Assessment In SpaiN (CHAIN), whose main objective is to evaluate the long-term natural history of a chronic obstructive pulmonary disease (COPD) patient cohort from a multidimensional standpoint and to identify clinical phenotypes, in comparison with another non-COPD control cohort. CHAIN is a multicenter, observational study of prospective cohorts carried out at 36 Spanish hospitals. Both cohorts will be followed-up during a 5-year study period with complete office visits every 12 months and telephone interviews every 6 months in order to evaluate exacerbations and the vital state of the subjects. The recruitment period for cases was between 15 January 2010 and 31 March 2012. At each annual visit, information will be collected on: (i) clinical aspects (socio-economic situation, anthropometric data, comorbidities, smoking, respiratory symptoms, exacerbations, quality of life, anxiety-depression scale, daily life activities, treatments); (ii) respiratory function (spirometry, blood gases, hyperinflation, diffusion, respiratory pressures); (iii) BODE index (main study variable); (iv) peripheral muscle function, and (v) blood work-up (including IgE and cardiovascular risk factors). In addition, a serum bank will be created for the future determination of biomarkers. The data of the patients are anonymized in a database with a hierarchical access control in order to guarantee secure information access. The CHAIN study will provide information about the progression of COPD and it will establish a network of researchers for future projects related with COPD. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  5. Evaluation of Occupational and Environmental Factors in the Assessment of Chronic Cough in Adults: A Systematic Review.

    Science.gov (United States)

    Tarlo, Susan M; Altman, Kenneth W; French, Cynthia T; Diekemper, Rebecca L; Irwin, Richard S

    2016-01-01

    Several recent cough guidelines have advised consideration of occupational or environmental causes for chronic cough, but it is unclear how frequently this recommendation has been routinely applied. Therefore, we undertook a systematic review to address this aspect. Cough guidelines and protocols were reviewed to identify recommendations for assessment of occupational and environmental aspects of chronic cough. The systematic search previously used to identify intervention fidelity to the use of protocols for diagnosis and management of chronic cough in adults was used for this review after extension to June 2015. PubMed, Scopus, and the Cochrane Library were searched using the same search terms and inclusion criteria as previously. Papers that met our criteria were then reviewed to identify methods used to assess occupational and environmental aspects of chronic cough and the outcomes of these assessments. Among the 10 general chronic cough guidelines and protocols identified, only the three published since 2006 included details advising detailed occupational and environmental assessments. One additional cough statement focused entirely on occupational cough. Of the 28 cohort studies of patients with chronic cough that specifically noted that they followed guidelines or protocols, none provided details of occupational and environmental assessments. Despite published recommendations, it is not apparent that occupational and environmental causes for chronic cough are addressed in detail during assessments of patients with chronic cough. This leaves open to speculation whether lack of recognition of an occupational cause may delay important preventive measures, put additional workers at risk, and/or be the reason why a chronic cough may remain unexplained. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  6. Effects of chronic exposure to clothianidin on the earthworm Lumbricus terrestris.

    Science.gov (United States)

    Basley, Kate; Goulson, Dave

    2017-01-01

    Although neonicotinoids are targeted at insects, their predominant use as a seed dressing and their long persistence in soils mean that non-target soil organisms such as earthworms are likely to be chronically exposed to them. Chronic exposure may pose risks that are not evaluated in most toxicity tests. We experimentally tested the effect of field-realistic concentrations of a commonly used neonicotinoid, clothianidin, on mortality, weight gain, and food consumption to assess the impacts of chronic exposure over four months on fitness of L. terrestris individuals. We undertook three separate experiments, each with different exposure routes: treated soil only (experiment A), treated food and soil combined (experiment B) and treated food only (experiment C). Mortality was negatively affected by exposure from treated soil only with greatest mortality observed in the groups exposed to the two highest concentrations (20 ppb and 100 ppb), but no clear effect on mortality was found in the other two experiments. When clothianidin was present in the food, an anti-feedant effect was present in months one and two which subsequently disappeared; if this occurs in the field, it could result in reduced rates of decomposition of treated crop foliage. We found no significant effects of any treatment on worm body mass. We cannot rule out stronger adverse effects if worms come into close proximity to treated seeds, or if other aspects of fitness were examined. Overall, our data suggest that field-realistic exposure to clothianidin has a significant but temporary effect on food consumption and can have weak but significant impacts on mortality of L. terrestris.

  7. Effects of chronic exposure to clothianidin on the earthworm Lumbricus terrestris

    Directory of Open Access Journals (Sweden)

    Kate Basley

    2017-04-01

    Full Text Available Although neonicotinoids are targeted at insects, their predominant use as a seed dressing and their long persistence in soils mean that non-target soil organisms such as earthworms are likely to be chronically exposed to them. Chronic exposure may pose risks that are not evaluated in most toxicity tests. We experimentally tested the effect of field-realistic concentrations of a commonly used neonicotinoid, clothianidin, on mortality, weight gain, and food consumption to assess the impacts of chronic exposure over four months on fitness of L. terrestris individuals. We undertook three separate experiments, each with different exposure routes: treated soil only (experiment A, treated food and soil combined (experiment B and treated food only (experiment C. Mortality was negatively affected by exposure from treated soil only with greatest mortality observed in the groups exposed to the two highest concentrations (20 ppb and 100 ppb, but no clear effect on mortality was found in the other two experiments. When clothianidin was present in the food, an anti-feedant effect was present in months one and two which subsequently disappeared; if this occurs in the field, it could result in reduced rates of decomposition of treated crop foliage. We found no significant effects of any treatment on worm body mass. We cannot rule out stronger adverse effects if worms come into close proximity to treated seeds, or if other aspects of fitness were examined. Overall, our data suggest that field-realistic exposure to clothianidin has a significant but temporary effect on food consumption and can have weak but significant impacts on mortality of L. terrestris.

  8. Sublingual buprenorphine is effective in the treatment of chronic pain syndrome.

    Science.gov (United States)

    Malinoff, Herbert L; Barkin, Robert L; Wilson, Geoffrey

    2005-01-01

    Many patients with chronic pain have less than optimal therapeutic outcomes after prolonged treatment with opiate analgesics. Worsening of pain perception, functional capacity, and mood often result. Medical detoxification is often undertaken in this situation. Ninety-five consecutive patients (49 men and 46 women; age range, 26-84) with chronic noncancer pain (maldynia) were referred by local pain clinics for detoxification from long-term opiate analgesic (LTOA) therapy. All patients had failed treatment as manifest by increasing pain levels, worsening functional capacity, and, in 8%, the emergence of opiate addiction. Length of prior LTOA therapy ranged from 1.5 to 27 years (mean, 8.8 years). After a minimum of 12 hours of abstinence from all opiate analgesics, patients were given low doses of sublingual (SL) buprenorphine or buprenorphine/naloxone (Reckitt Benckiser). Maintenance dosing was individualized to treat chronic pain. Daily SL dose of buprenorphine ranged from 4 to 16 mg (mean, 8 mg) in divided doses. Mean duration of treatment is 8.8 months (range, 2.4-16.6 months). At clinic appointments, patients were assessed for pain reports, functional capacity, and mood inventory. Eighty-six percent of patients experienced moderate to substantial relief of pain accompanied by both improved mood and functioning. Patient and family satisfaction was robust. Only 6 patients discontinued therapy secondary to side effects and/or exacerbation of pain. In this open-label study, SL buprenorphine and buprenorphine/naloxone were well tolerated and safe and appeared to be effective in the treatment of chronic pain patients refractory to LTOA.

  9. Chronic coffee and caffeine ingestion effects on the cognitive function and antioxidant system of rat brains.

    Science.gov (United States)

    Abreu, Renata Viana; Silva-Oliveira, Eliane Moretto; Moraes, Márcio Flávio Dutra; Pereira, Grace Schenatto; Moraes-Santos, Tasso

    2011-10-01

    Coffee is a popular beverage consumed worldwide and its effect on health protection has been well studied throughout literature. This study investigates the effect of chronic coffee and caffeine ingestion on cognitive behavior and the antioxidant system of rat brains. The paradigms of open field and object recognition were used to assess locomotor and exploratory activities, as well as learning and memory. The antioxidant system was evaluated by determining the activities of glutathione reductase (GR), glutathione peroxidase (GPx) and superoxide dismutase (SOD), as well as the lipid peroxidation and reduced glutathione content. Five groups of male rats were fed for approximately 80 days with different diets: control diet (CD), fed a control diet; 3% coffee diet (3%Co) and 6% coffee diet (6%Co), both fed a diet containing brewed coffee; 0.04% caffeine diet (0.04%Ca) and 0.08% caffeine diet (0.08%Ca), both fed a control diet supplemented with caffeine. The estimated caffeine intake was approximately 20 and 40 mg/kg per day, for the 3%Co-0.04%Ca and 6%Co-0.08%Ca treatments, respectively. At 90 days of life, the animals were subjected to the behavioral tasks and then sacrificed. The results indicated that the intake of coffee, similar to caffeine, improved long-term memory when tested with object recognition; however, this was not accompanied by an increase in locomotor and exploratory activities. In addition, chronic coffee and caffeine ingestion reduced the lipid peroxidation of brain membranes and increased the concentration of reduced-glutathione. The activities of the GR and SOD were similarly increased, but no change in GPx activity could be observed. Thus, besides improving cognitive function, our data show that chronic coffee consumption modulates the endogenous antioxidant system in the brain. Therefore, chronic coffee ingestion, through the protection of the antioxidant system, may play an important role in preventing age-associated decline in the cognitive

  10. Chronic nausea in advanced cancer patients: a retrospective assessment of a metoclopramide-based antiemetic regimen.

    Science.gov (United States)

    Bruera, E; Seifert, L; Watanabe, S; Babul, N; Darke, A; Harsanyi, Z; Suarez-Almazor, M

    1996-03-01

    The purpose of this retrospective study is to assess the frequency and intensity of chronic nausea in patients admitted to the Palliative Care Unit and the results of a metoclopramide-based treatment regimen. We reviewed the medical records of 100 consecutive patients admitted to the Palliative Care Unit at the Edmonton General Hospital until death during 1992-1993. All patients had terminal cancer and normal cognitive function. All patients completed the Functional Analogue Scale for appetite, nausea, pain, activity, shortness of breath, and sensation of well-being at 1000 and 1600 hours every day. Patients who complained of nausea initially received metoclopramide 10 mg every 4 hr orally or subcutaneously (Step 1). If nausea persisted, dexamethasone 10 mg twice daily was added (Step 2). Step 3 consisted of a continuous subcutaneous infusion of metoclopramide of 60-120 mg/day plus dexamethasone. If no response was observed, other antiemetics were administered (Step 4). Upon admission to the unit, 32 patients (32%) presented with nausea. During the average admission of 25 +/- 13 days, 98 patients (98%) developed nausea. Twenty-five patients (25%) required other antiemetics because of bowel obstruction (18), extrapyramidal side effects (3), or other reasons (4). Most patients without bowel obstruction achieved excellent control of nausea using the metoclopramide-based regimen. During the first 5 days and last 5 days of admission, nausea had significantly lower intensity than the rest of the symptoms that were monitored. Our results suggest that, although nausea is very frequent, it can be well controlled in the majority of patients using safe and simple antiemetic regimens.

  11. Chronic Obstructive Pulmonary Disease heterogeneity: challenges for health risk assessment, stratification and management.

    Science.gov (United States)

    Roca, Josep; Vargas, Claudia; Cano, Isaac; Selivanov, Vitaly; Barreiro, Esther; Maier, Dieter; Falciani, Francesco; Wagner, Peter; Cascante, Marta; Garcia-Aymerich, Judith; Kalko, Susana; De Mas, Igor; Tegnér, Jesper; Escarrabill, Joan; Agustí, Alvar; Gomez-Cabrero, David

    2014-11-28

    Heterogeneity in clinical manifestations and disease progression in Chronic Obstructive Pulmonary Disease (COPD) lead to consequences for patient health risk assessment, stratification and management. Implicit with the classical "spill over" hypothesis is that COPD heterogeneity is driven by the pulmonary events of the disease. Alternatively, we hypothesized that COPD heterogeneities result from the interplay of mechanisms governing three conceptually different phenomena: 1) pulmonary disease, 2) systemic effects of COPD and 3) co-morbidity clustering, each of them with their own dynamics. To explore the potential of a systems analysis of COPD heterogeneity focused on skeletal muscle dysfunction and on co-morbidity clustering aiming at generating predictive modeling with impact on patient management. To this end, strategies combining deterministic modeling and network medicine analyses of the Biobridge dataset were used to investigate the mechanisms of skeletal muscle dysfunction. An independent data driven analysis of co-morbidity clustering examining associated genes and pathways was performed using a large dataset (ICD9-CM data from Medicare, 13 million people). Finally, a targeted network analysis using the outcomes of the two approaches (skeletal muscle dysfunction and co-morbidity clustering) explored shared pathways between these phenomena. (1) Evidence of abnormal regulation of skeletal muscle bioenergetics and skeletal muscle remodeling showing a significant association with nitroso-redox disequilibrium was observed in COPD; (2) COPD patients presented higher risk for co-morbidity clustering than non-COPD patients increasing with ageing; and, (3) the on-going targeted network analyses suggests shared pathways between skeletal muscle dysfunction and co-morbidity clustering. The results indicate the high potential of a systems approach to address COPD heterogeneity. Significant knowledge gaps were identified that are relevant to shape strategies aiming at

  12. Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies.

    Science.gov (United States)

    Gevers, Josette; van Erven, Pierre; de Jonge, Jan; Maas, Maaike; de Jong, Jos

    2010-07-01

    This paper is a report of a study conducted to determine the combined effect of acute and chronic job demands on acute job strains experienced during medical emergencies, and its consequences for individual teamwork behaviour. Medical emergency personnel have to cope with high job demands, which may cause considerable work stress (i.e. job strains), particularly when both acute and chronic job demands are experienced to be high. This may interfere with effective individual teamwork behaviour. A cross-sectional survey study was conducted in 2008, involving 48 members (doctors and nurses) of medical emergency teams working in the emergency department of a Dutch general hospital. Data were analyzed by means of hierarchical regression analyses. High acute job demands impeded effective teamwork behaviour, but only when they resulted in acute job strain. Acute emotional demands were more likely to result in acute job strain when chronic emotional job demands were also experienced as high. Although acute cognitive and physical strains were also detrimental, effective teamwork behaviour was particularly impeded by acute emotional strain. Acute job strains impair effective individual teamwork behaviour during medical emergencies, and there is urgent need to prevent or reduce a build-up of job strain from high acute and chronic demands, particularly of the emotional kind.

  13. Epidemiology and treatment effects in Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    A.S.M. Afonso (Ana)

    2011-01-01

    textabstractChronic obstructive pulmonary disease (COPD) is a major health epidemic, which has important consequences for patients and community, and still receives insufficient attention from the health care professionals and scientists. COPD is a leading cause of chronic morbidity (affects 210

  14. School Organizational Effectiveness and Chronic Absenteeism: Implications for Accountability

    Science.gov (United States)

    Lenhoff, Sarah Winchell; Pogodzinski, Ben

    2018-01-01

    Chronic absenteeism in K-12 schools is strongly associated with critical educational outcomes such as student achievement and graduation. Yet, the causes of chronic absenteeism are complex, with environmental, family/individual, and school factors all affecting the likelihood of a student attending school regularly. This exploratory study examines…

  15. Chronic hepatitis C--assessment in civil law: a case study.

    Science.gov (United States)

    Santos, Bruno Miguel; Sousa, Paula; Mena, Filomena; Costa, Graça Santos; Corte-Real, Francisco; Vieira, Duarte Nuno

    2010-02-01

    This article describes the case of a 58-year-old man who asked for an assessment of physical damage of a civil nature, having been diagnosed with chronic hepatitis C for which he blamed a blood transfusion, supposedly contaminated with hepatitis C virus (HCV). After studying the documentary information, a number of presuppositions were drawn up with a view to determining the causal nexus, but this could not be proved. The assessment of situations like this is not common in civil law. This article is intended to add to the body of information on the forensic assessment of similar cases. Copyright 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. Published by Elsevier Ltd. All rights reserved.

  16. The effect of acupuncture treatment for insomnia in chronic hemodialysis patients

    Science.gov (United States)

    Widjaja, J. A.; Simadibrata, C.; Srilestari, A.; Marbun, M. B. H.

    2017-08-01

    Insomnia is a problem often experienced by patients on chronic dialysiswhich reduces their quality of life. Current management of insomnia with this specific group of patients has yet to produce optimum results. In this study, we explored the roleof acupuncture as a treatment for symptoms of insomnia in patients on chronic dialysis. Twenty-eight hemodialysis patients suffering from insomnia were divided randomly into two groups, an acupuncture group (n = 15) who received acupuncture treatment at the points HT7 Shenmen, PC6 Neiguan, GV20 Baihui, and EX-HN1 Sishenchong, anda control group (n = 13) who underwenta sham procedure in which a needle was inserted into an elastic bandage at the same points. The acupuncture treatment was done during hemodialysis twice a week for five weeks. PSQI scores and the WHOQOL-BREF were assessed before treatment, after the fifth treatment, and at the end of the treatment. Significant differences were found in the PSQI score ((4.20±2.27 vs. 11.23±3.37) p = 0.000) and in the WHOQOL-BREF ((94.53±10.08 vs. 82.69±11.90) p = 0.008) between the acupuncture group and the control group by the end of the period of treatment. Acupuncture treatment effectively improved the quality of sleep and the quality of life for these chronic hemodialysis patients.

  17. Effects of chronic occupational exposure to anaesthetic gases on the rate of neutrophil apoptosis among anaesthetists.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND AND OBJECTIVE: Volatile anaesthetic agents are known to influence neutrophil function. The aim was to determine the effect of chronic occupational exposure to volatile anaesthetic agents on the rate of neutrophil apoptosis among anaesthetists. To test this hypothesis, we compared the rate of neutrophil apoptosis in anaesthetists who had been chronically exposed to volatile anaesthetic agents with that in unexposed volunteers. METHODS: Venous blood (20 mL) was withdrawn from 24 ASA I-II volunteers, from which neutrophils were isolated, and maintained in culture. At 1, 12 and 24 h in culture, the percentage of neutrophil apoptosis was assessed by dual staining with annexin V-FITC and propidium iodide. RESULTS: At 1 h (but not at 12 and 24 h) in culture, the rate of neutrophil apoptosis was significantly less in the anaesthetists--13.8 (12.9%) versus 34.4 (12.1%) (P = 0.001). CONCLUSIONS: Chronic occupational exposure to volatile anaesthetic agents may inhibit neutrophil apoptosis. This may have implications for anaesthetists and similarly exposed healthcare workers in terms of the adequacy of their inflammatory response.

  18. Effectiveness of Physical Therapy as an Adjunctive Treatment for Trauma-induced Chronic Torticollis in Raptors.

    Science.gov (United States)

    Nevitt, Benjamin N; Robinson, Narda; Kratz, Gail; Johnston, Matthew S

    2015-03-01

    Management of trauma-induced chronic torticollis in raptors has historically been challenging. Euthanasia is common in affected birds because of their inability to maintain normal cervical position, although they may be able to function normally. To assess effectiveness of physical therapy of the neck and head as an adjunct treatment for this condition, a case-control study was done in raptors admitted to the Rocky Mountain Raptor Program from 2003 to 2010. Eleven cases were identified with a diagnosis of chronic torticollis resulting from traumatic brain injury. Five cases were treated with physical therapy of the head and neck, and 6 control cases did not receive any physical therapy for the torticollis. Of the control cases, 0 of 6 had resolution of the torticollis, 0 of 6 were released, and 5 of 6 were euthanatized. Of the treated cases, 4 of 5 had complete resolution of the torticollis and 5 of 5 were released. Resolution of torticollis differed significantly between cases receiving physical therapy and controls. These results indicate that physical therapy should be used as an adjunctive therapy in cases of chronic torticollis induced by trauma in raptors because it results in better resolution of the torticollis and increased likelihood of release.

  19. Ecological Momentary Assessment Methodology in Chronic Pain Research: A Systematic Review.

    Science.gov (United States)

    May, Marcella; Junghaenel, Doerte U; Ono, Masakatsu; Stone, Arthur A; Schneider, Stefan

    2018-01-31

    Self-reported pain intensity assessments are central to chronic pain research. Ecological momentary assessment (EMA) methodologies are uniquely positioned to collect these data, and are indeed being used in the field. However, EMA protocols are complex, and many decisions are necessary in the design of EMA research studies. A systematic literature review identified 105 articles drawing from 62 quantitative EMA research projects examining pain intensity in adult chronic pain patients. Study characteristics were tabulated to summarize and describe the use of EMA, with an emphasis placed on various dimensions of decision-making involved in executing EMA methodologies. Most identified studies considered within-person relationships between pain and other variables, and a few examined interventions on chronic pain. There was a trend toward the use of smartphones as EMA data collection devices more recently, and completion rates were not reported in nearly one third of studies. Pain intensity items varied widely with respect to number of scale points, anchor labels, and length of reporting period; most used numeric rating scales. Recommendations are provided for reporting to improve reproducibility, comparability, and interpretation of results, and for opportunities to clarify the importance of design decisions. Studies that use EMA methodologies to assess pain intensity are heterogeneous. Aspects of protocol design, including data input modality and pain item construction, have the potential to influence the data collected. Thorough reporting on design features and completion rates therefore facilitates reproducibility, comparability, and interpretation of study results. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  20. Fibroscore for the non-invasive assessment of liver fibrosis in chronic viral hepatitis

    International Nuclear Information System (INIS)

    Ashraf, S.; Ahmed, S.A.

    2012-01-01

    Objective: To evaluate the predictive value of a set of laboratory markers for the assessment of liver fibrosis in chronic viral hepatitis patients. Study Design: Cross-sectional study. Place and Duration of Study: Baqai Medical University, Combined Military Hospital, Malir, Karachi, from November 2006 to May 2008. Methodology: Twenty laboratory parameters were measured in 100 treatment-native chronic viral hepatitis patients who also had liver biopsy performed. Descriptive statistics, areas under the ROC's curves, and multivariate logistic regression analysis identified a fibrosis panel, a set of five most useful markers, for the assessment of stages of fibrosis, stage 0 to stage 4. The fibrosis index, FibroScore, consisted of bilirubin, Gamma glutamyl transferase, Hyaluronic acid, alpha 2 macroglobulin, and platelets evaluation. Results: A score of > 0.5 predicted stages 2, 3 and 4, with a sensitivity of 82%, and specificity of 92%. A score > 0.5 for stages 3 and 4 had a sensitivity of 85%, and specificity of 89%. At a score of > 0.80, for stages 3 and 4, the sensitivity was 70%, specificity was 97%, and PPV 87% (there was > 85% possibility of presence of stage 3 or 4). A score of < 0.20 predicted the absence of stages 2, 3, and 4 with a sensitivity of 91%, specificity of 86%, and NPV of 96%. Scores from 0.00 to 0.10 almost certainly ruled out the presence of stages 2-4 (NPV=98%). The areas under the ROC curve were: 0.808 for stage 2; 0.938 for stage 3; and 0.959 for stage 4. Conclusion: A combination of 5 markers is very useful in predicting various stages of liver fibrosis, and is helpful in the non-invasive assessment of liver fibrosis in chronic viral hepatitis patients. (author)

  1. Direct and indirect assessment of skeletal muscle blood flow in chronic congestive heart failure

    International Nuclear Information System (INIS)

    LeJemtel, T.H.; Scortichini, D.; Katz, S.

    1988-01-01

    In patients with chronic congestive heart failure (CHF), skeletal muscle blood flow can be measured directly by the continuous thermodilution technique and by the xenon-133 clearance method. The continuous thermodilution technique requires retrograde catheterization of the femoral vein and, thus, cannot be repeated conveniently in patients during evaluation of pharmacologic interventions. The xenon-133 clearance, which requires only an intramuscular injection, allows repeated determination of skeletal muscle blood flow. In patients with severe CHF, a fixed capacity of the skeletal muscle vasculature to dilate appears to limit maximal exercise performance. Moreover, the changes in peak skeletal muscle blood flow noted during long-term administration of captopril, an angiotensin-converting enzyme inhibitor, appears to correlate with the changes in aerobic capacity. In patients with CHF, resting supine deep femoral vein oxygen content can be used as an indirect measurement of resting skeletal muscle blood flow. The absence of a steady state complicates the determination of peak skeletal muscle blood flow reached during graded bicycle or treadmill exercise in patients with chronic CHF. Indirect assessments of skeletal muscle blood flow and metabolism during exercise performed at submaximal work loads are currently developed in patients with chronic CHF

  2. Assessment of fructosamine concentrations in cats with acute and chronic stress

    Directory of Open Access Journals (Sweden)

    Lívia Fagundes Moraes

    2011-10-01

    Full Text Available Fructosamine are glycated serum proteins that are formed continuously due to the reaction between glucose and circulating proteins, and corresponding to the blood glucose control assessment over the last one to two weeks in cats. The fructosamine concentration has been used for differentiation between persistent and transient hyperglycemia. Therefore, the determination of fructosamine is considered the gold standard for monitoring glycemia into control in diabetic cats. The objective of this study was to evaluate the influence of acute and chronic stress of cats on serum fructosamine. 62 cats were selected from the Veterinary Hospital of FMVZ - UNESP, Botucatu campus. They were distributed into three groups: cats with a history of any illness or stress condition, excluding Diabetes Mellitus (DM, for a maximum of 48 hours (Group A, n = 21 or for a period exceeding 120 hours (Group B n = 27. The third group (Group C = control was formed by 14 health cats. The groups were evaluated for serum fructosamine, glucose, protein and albumin. In this study, there was a significant increase in the values of fructosamine in animals subjected to acute and chronic stress, but these values remained within the reference range. The animals were, on average, normoglycemic, despite the positive correlation between fructosamine and glucose concentrations. We conclude that the fructosamine concentration is influenced by acute and chronic stress in cats, remaining, however, within the reference range, and therefore, still useful in the diagnosis of DM.

  3. Rethinking Iron Regulation and Assessment in Iron Deficiency, Anemia of Chronic Disease, and Obesity: Introducing Hepcidin

    Science.gov (United States)

    Tussing-Humphreys, Lisa; Pustacioglu, Cenk; Nemeth, Elizabeta; Braunschweig, Carol

    2012-01-01

    Adequate iron availability is essential to human development and overall health. Iron is a key component of oxygen-carrying proteins, has a pivotal role in cellular metabolism, and is essential to cell growth and differentiation. Inadequate dietary iron intake, chronic and acute inflammatory conditions, and obesity are each associated with alterations in iron homeostasis. Tight regulation of iron is necessary because iron is highly toxic and human beings can only excrete small amounts through sweat, skin and enterocyte sloughing, and fecal and menstrual blood loss. Hepcidin, a small peptide hormone produced mainly by the liver, acts as the key regulator of systemic iron homeostasis. Hepcidin controls movement of iron into plasma by regulating the activity of the sole known iron exporter ferroportin-1. Downregulation of the ferroportin-1 exporter results in sequestration of iron within intestinal enterocytes, hepatocytes, and iron-storing macrophages reducing iron bioavailability. Hepcidin expression is increased by higher body iron levels and inflammation and decreased by anemia and hypoxia. Importantly, existing data illustrate that hepcidin may play a significant role in the development of several iron-related disorders, including the anemia of chronic disease and the iron dysregulation observed in obesity. Therefore, the purpose of this article is to discuss iron regulation, with specific emphasis on systemic regulation by hepcidin, and examine the role of hepcidin within several disease states, including iron deficiency, anemia of chronic disease, and obesity. The relationship between obesity and iron depletion and the clinical assessment of iron status will also be reviewed. PMID:22717199

  4. The Effect of Chronic Administration of Buspirone on 6-Hydroxydopamine-Induced Catalepsy in Rats

    Directory of Open Access Journals (Sweden)

    Hamdolah Sharifi

    2012-06-01

    Full Text Available Purpose: Several evidences show that serotonergic neurons play a role in the regulation of movements executed by the basal ganglia. Recently we have reported that single dose of buspirone improved 6-hydroxydopamine (6-OHDA and haloperidol-induced catalepsy. This study is aimed to investigate effect of chronic intraperitoneal (i.p. administration of buspirone on 6-OHDA-induced catalepsy in male Wistar rats. Methods: Catalepsy was induced by unilateral infusion of 6-OHDA (8 μg/2 μl/rat into the central region of the SNc and was assayed by the bar-test method 5, 60, 120 and 180 min after drugs administration in 10th day. The effect of buspirone (0.5, 1 and 2 mg/kg, i.p. for 10 days was assessed in 6-OHDA-lesioned rats. Results: The results showed that chronic injection of buspirone (0.5, 1 and 2 mg/kg, i.p. for 10 days decreased catalepsy when compared with the control group. The best anticataleptic effect was observed at the dose of 1 mg/kg. The catalepsy-improving effect of buspirone was reversed by 1-(2-methoxyphenyl- 4-[4-(2-phthalimido butyl]piperazine hydrobromide (NAN-190, 0.5 mg/kg, i.p.,as a 5-HT1A receptor antagonist. Conclusion: Our study indicates that chronic administration of buspirone improves catalepsy in a 6-OHDA-induced animal model of parkinson's disease (PD. We also suggest that buspirone may be used as an adjuvant therapy to increase effectiveness of antiparkinsonian drugs. In order to prove this hypothesis, further clinical studies should be done.

  5. Emotionality Modulates the Effect of Chronic Stress on Feeding Behaviour in Birds

    Science.gov (United States)

    Favreau-Peigné, Angélique; Calandreau, Ludovic; Constantin, Paul; Gaultier, Bernard; Bertin, Aline; Arnould, Cécile; Laurence, Agathe; Richard-Yris, Marie-Annick; Houdelier, Cécilia; Lumineau, Sophie; Boissy, Alain; Leterrier, Christine

    2014-01-01

    Chronic stress is a long-lasting negative emotional state that induces negative consequences on animals’ psycho-physiological state. This study aimed at assessing whether unpredictable and repeated negative stimuli (URNS) influence feeding behaviour in quail. Sixty-four quail were exposed to URNS from day 17 to 40, while 64 quail were undisturbed. Two lines divergently selected on their inherent emotionality were used to assess the effect of genetic factors on the sensitivity to URNS. All quail were submitted to a sequential feeding procedure (using two diets of different energetic values) which placed them in a contrasting situation. Behavioural tests were performed to assess the emotional reactivity of the two lines. Results confirmed that differences exist between them and that their emotional reactivity was enhanced by URNS. Diet preferences, motivation and daily intake were also measured. URNS did not change the preferences for the hypercaloric diet compared to the hypocaloric diet in choice tests, but they reduced daily intakes in both lines. Motivations for each diet were differently affected by URNS: they decreased the motivation to eat the hypercaloric diet in quail selected for their low inherent fearfulness whereas they increased the motivation to eat the hypocaloric diet in quail selected for their high inherent fearfulness, which suggested a devaluation process in the former and a compensatory behaviour in the later. Growth was furthermore reduced and laying delayed by URNS in both lines. In conclusion, the exposure to URNS induced interesting changes in feeding behaviour added with an increase in emotional reactivity and an alteration of production parameters. This confirms that both lines of quail experienced a chronic stress state. However differences in feed motivation and emotional reactivity between lines under chronic stress suggested that they experienced different emotional state and use different ways to cope with it depending on their

  6. Emotionality modulates the effect of chronic stress on feeding behaviour in birds.

    Directory of Open Access Journals (Sweden)

    Angélique Favreau-Peigné

    Full Text Available Chronic stress is a long-lasting negative emotional state that induces negative consequences on animals' psycho-physiological state. This study aimed at assessing whether unpredictable and repeated negative stimuli (URNS influence feeding behaviour in quail. Sixty-four quail were exposed to URNS from day 17 to 40, while 64 quail were undisturbed. Two lines divergently selected on their inherent emotionality were used to assess the effect of genetic factors on the sensitivity to URNS. All quail were submitted to a sequential feeding procedure (using two diets of different energetic values which placed them in a contrasting situation. Behavioural tests were performed to assess the emotional reactivity of the two lines. Results confirmed that differences exist between them and that their emotional reactivity was enhanced by URNS. Diet preferences, motivation and daily intake were also measured. URNS did not change the preferences for the hypercaloric diet compared to the hypocaloric diet in choice tests, but they reduced daily intakes in both lines. Motivations for each diet were differently affected by URNS: they decreased the motivation to eat the hypercaloric diet in quail selected for their low inherent fearfulness whereas they increased the motivation to eat the hypocaloric diet in quail selected for their high inherent fearfulness, which suggested a devaluation process in the former and a compensatory behaviour in the later. Growth was furthermore reduced and laying delayed by URNS in both lines. In conclusion, the exposure to URNS induced interesting changes in feeding behaviour added with an increase in emotional reactivity and an alteration of production parameters. This confirms that both lines of quail experienced a chronic stress state. However differences in feed motivation and emotional reactivity between lines under chronic stress suggested that they experienced different emotional state and use different ways to cope with it

  7. Effect of Hedera helix on lung histopathology in chronic asthma.

    Science.gov (United States)

    Hocaoglu, Arzu Babayigit; Karaman, Ozkan; Erge, Duygu Olmez; Erbil, Guven; Yilmaz, Osman; Kivcak, Bijen; Bagriyanik, H Alper; Uzuner, Nevin

    2012-12-01

    Hedera helix is widely used to treat bronchial asthma for many years. However, effects of this herb on lung histopathology is still far from clear. We aimed to determine the effect of oral administration of Hedera helix on lung histopathology in a murine model of chronic asthma.BALB/c mice were divided into four groups; I (Placebo), II (Hedera helix), III (Dexamethasone) and IV (Control). All mice except controls were sensitized and challenged with ovalbumin. Then, mice in group I received saline, group II 100 mg/kg Hedera helix and group III 1 mg/kg dexamethasone via orogastic gavage once daily for one week. Airway histopathology was evaluated by using light and electron microscopy in all groups.Goblet cell numbers and thicknesses of basement membrane were found significantly lower in group II, but there was no statistically significant difference in terms of number of mast cells, thicknesses of epithelium and subepithelial smooth muscle layers between group I and II. When Hedera helix and dexamethasone groups were compared with each other, thickness of epithelium, subepithelial muscle layers, number of mast cells and goblet cells of group III were significantly ameliorated when compared with the group II. Although Hedera helix administration reduced only goblet cell counts and the thicknesses of basement membrane in the asthmatic airways, dexamethasone ameliorated all histopathologic parameters except thickness of basement membrane better than Hedera helix.

  8. Differential effects of childhood trauma subtypes on fatigue and physical functioning in chronic fatigue syndrome.

    Science.gov (United States)

    De Venter, Maud; Illegems, Jela; Van Royen, Rita; Moorkens, Greta; Sabbe, Bernard G C; Van Den Eede, Filip

    2017-10-01

    There is wide consensus that childhood trauma plays an important role in the aetiology of chronic fatigue syndrome (CFS). The current study examines the differential effects of childhood trauma subtypes on fatigue and physical functioning in individuals suffering from CFS. Participants were 155 well-documented adult, predominantly female CFS patients receiving treatment at the outpatient treatment centre for CFS of the Antwerp University Hospital in Belgium. Stepwise regression analyses were conducted with outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the scores on the physical functioning subscale of the Medical Outcomes Short Form 36 Health Status Survey (SF-36) as the dependent variables, and the scores on the five subscales of the Traumatic Experiences Checklist (TEC) as the independent variables. The patients' fatigue (β=1.38; p=0.025) and physical functioning scores (β=-1.79; p=0.034) were significantly predicted by childhood sexual harassment. There were no significant effects of emotional neglect, emotional abuse, bodily threat, or sexual abuse during childhood. Of the childhood trauma subtypes investigated, sexual harassment emerged as the most important predictor of fatigue and poor physical functioning in the CFS patients assessed. These findings have to be taken into account in further clinical research and in the assessment and treatment of individuals coping with chronic fatigue syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The cost-effectiveness of using chronic kidney disease risk scores to screen for early-stage chronic kidney disease.

    Science.gov (United States)

    Yarnoff, Benjamin O; Hoerger, Thomas J; Simpson, Siobhan K; Leib, Alyssa; Burrows, Nilka R; Shrestha, Sundar S; Pavkov, Meda E

    2017-03-13

    Better treatment during early stages of chronic kidney disease (CKD) may slow progression to end-stage renal disease and decrease associated complications and medical costs. Achieving early treatment of CKD is challenging, however, because a large fraction of persons with CKD are unaware of having this disease. Screening for CKD is one important method for increasing awareness. We examined the cost-effectiveness of identifying persons for early-stage CKD screening (i.e., screening for moderate albuminuria) using published CKD risk scores. We used the CKD Health Policy Model, a micro-simulation model, to simulate the cost-effectiveness of using CKD two published risk scores by Bang et al. and Kshirsagar et al. to identify persons in the US for CKD screening with testing for albuminuria. Alternative risk score thresholds were tested (0.20, 0.15, 0.10, 0.05, and 0.02) above which persons were assigned to receive screening at alternative intervals (1-, 2-, and 5-year) for follow-up screening if the first screening was negative. We examined incremental cost-effectiveness ratios (ICERs), incremental lifetime costs divided by incremental lifetime QALYs, relative to the next higher screening threshold to assess cost-effectiveness. Cost-effective scenarios were determined as those with ICERs less than $50,000 per QALY. Among the cost-effective scenarios, the optimal scenario was determined as the one that resulted in the highest lifetime QALYs. ICERs ranged from $8,823 per QALY to $124,626 per QALY for the Bang et al. risk score and $6,342 per QALY to $405,861 per QALY for the Kshirsagar et al. risk score. The Bang et al. risk score with a threshold of 0.02 and 2-year follow-up screening was found to be optimal because it had an ICER less than $50,000 per QALY and resulted in the highest lifetime QALYs. This study indicates that using these CKD risk scores may allow clinicians to cost-effectively identify a broader population for CKD screening with testing for albuminuria

  10. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    Salem, E.S; Tawfik, M.S; ELaseily, E.S.

    2013-01-01

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  11. The impact of age and gender on the ICF-based assessment of chronic low back pain.

    Science.gov (United States)

    Fehrmann, Elisabeth; Kotulla, Simone; Fischer, Linda; Kienbacher, Thomas; Tuechler, Kerstin; Mair, Patrick; Ebenbichler, Gerold; Paul, Birgit

    2018-01-12

    To evaluate the impact of age and gender on the international classification of functioning, disability and health (ICF)-based assessment for chronic low back pain. Two hundred forty-four chronic low back pain patients (52% female) with a mean age of 49 years (SD =17.64) were interviewed with the comprehensive ICF core set for activities and participation, and environmental factors. After conducting explorative factor analysis, the impact of age and gender on the different factors was analyzed using analyzes of variances. Results revealed that older patients experienced more limitations within "self-care and mobility" and "walking" but less problems with "transportation" compared to younger patients. Older or middle-aged low back pain patients further perceived more facilitation through "architecture and products for communication", "health services", and "social services and products for mobility" than younger patients. Regarding gender differences, women reported more restriction in "housework" than men. An interaction effect between age and gender was found for "social activities and recreation" with young male patients reporting the highest impairment. The study demonstrated that the comprehensive ICF core set classification for chronic low back pain is influenced by age and gender. This impact is relevant for ICF-based assessments in clinical practice, and should be considered in intervention planning for rehabilitative programs. Implications for rehabilitation It is important to consider age and gender differences when classifying with the ICF. The intervention planning based on the ICF should focus on improvement of bodily functioning and mobility in older patients, facilitation of household activities in women, consideration of work-life balance and recreation (e.g., through mindfulness based stress reduction), and reduction of dissatisfaction with rehabilitation in younger patients. It is important to offer patients the opportunity to participate in

  12. Effect of Chronic Lead Intoxication on Risky Behavior in Mice

    Directory of Open Access Journals (Sweden)

    L Mohammadyar

    2010-08-01

    Full Text Available Introduction: With industrialization of human societies, pollutants like lead have entered in the life cycle, causing harmful effects on body organs. No sufficient studies have been done on the effects of pollutants on behavior. The aim of this study was to investigate possible effects of lead on some measurable behaviors of an animal model. Methods: Forty eight male adult mice were divided into 4 groups of 12 each. Lead acetate was added at concentrations of 0, 5, 50, or 500 ppm to the drinking water of the animals for 4 weeks (28 days. On day 29, animals were placed on an Elevated Plus maze (EPM for 5 min and the time in sec spent was measured on closed arms, open arms and the end 1/3rd of the open arms. Increased time on open arms, particularly the end 1/3rd was considered to reflect an enhanced risk-accepting behavior. Results: In this study, it was shown that lead exposure caused an increased number of entrance (P=0.006 and time spent (P=0.034 by mice on open arms of the EPM. There was a positive correlation between the concentration of lead acetate and those two effects. Conclusion: The present study demonstrated that lead poisoning may decrease normal anxiety in mice and increase risky behavior in this species. Clinical studies on human subjects with risky behavior are strongly suggested in order to find a possible relation between chronic exposures to lead as well as plasma concentration of lead with the extent of this kind of behavior.

  13. Effects of a Self-Directed Nutrition Intervention among Adults with Chronic Health Conditions

    Science.gov (United States)

    Baruth, Meghan; Wilcox, Sara; Jake-Schoffman, Danielle E.; Schlaff, Rebecca A.; Goldufsky, Tatum M.

    2018-01-01

    Chronic diseases are common among adults. A healthy diet may be beneficial for managing the consequences of such conditions. The purpose of this study was to evaluate the effects of a self-directed nutrition program on dietary behaviors among adults with chronic health conditions. As part of a larger trial examining the effects of a self-directed…

  14. THERAPEUTIC EFFECTS OF ELECTROACUPUNCTURE PLUS POINT-PENETRATION FOR CHRONIC ANKLE JOINT SPRAIN

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-zao

    2005-01-01

    Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group (n=33).In teatment group, penetration needling from Qiuxu (丘墟 GB 40) to Zhaohai (照海 KI 6) was performed, combined with electrical stimulation for 30 min. Patients of control group were ordered to take Antinfan (50 mg,b.I.d.),supplemented with local external application of Votalin cream (b.I.d.).After 14 treatments (two courses), the therapeutic effect was assessed. Results: Following two courses of treatment, of the 43 cases and 33 cases in treatment and control groups,33 (76.7%) and 15 (45.5%) were cured, 4 (9.3%) and 7 (21.2%) had marked improvement in their symptoms, 3 (7.0%) and 2 (6.1%) had improvement, and 3 (7.0%) and 9(27.3%) failed, with the effective rates being 93.0% and 72.7% respectively. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). Conclusion: Penetrative needling plus EA is significantly superior to medication in relieving chronic ankle spain patient's clinical symptoms and signs.

  15. An assessment of the relationships between overweight, obesity, related chronic health conditions and worker absenteeism.

    Science.gov (United States)

    Howard, Jeffrey T; Potter, Lloyd B

    2014-01-01

    Worker absenteeism is an important area of study within the field of occupational health. Prior studies have linked the presence of obesity to higher rates of absenteeism, but have not examined whether or not the relationship is moderated by the presence of other chronic health conditions or whether or not the relationships have been stable over time. Data from the 2000 and 2010 National Health Interview Survey, a nationally representative sample of the US population, were analyzed to determine the extent to which the presence of 5 obesity-related chronic health conditions moderates the relationship between overweight/obesity and worker absenteeism, and whether or not these relationships are stable over time. Logistic regression was used to examine the relationships between overweight/obesity, the obesity-related chronic health conditions and worker absenteeism, while controlling for demographic, socio-economic, occupational, health related and behavioral variables. The findings suggest that obesity (p absenteeism, and that the effect is doubled for those with both class III obesity (BMI ≥ 40) and diabetes. The moderating effect between class III obesity and diabetes was observed only in 2010, indicating that this may be a relatively new phenomenon. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  16. The Importance of Assessing Nutritional Status to Ensure Optimal Recovery during the Chronic Phase of Stroke.

    Science.gov (United States)

    Serra, Monica C

    2018-01-01

    Despite evidence that many of the consequences of stroke that hinder recovery (i.e., obesity, muscle atrophy, and functional declines) have nutritionally modifiable behavior components, little attention has been focused on the significance of nutrition beyond the acute phase of stroke. This literature review summarizes the evidence for and against the influence of nutrition on optimal recovery and rehabilitation in chronic (>6 months) stroke. The literature, which is mainly limited to cross-sectional studies, suggests that a suboptimal nutritional status, including an excess caloric intake, reduced protein intake, and micronutrient deficiencies, particularly the B-vitamins, vitamin D, and omega 3 fatty acids, may have deleterious effects on metabolic, physical, and psychological functioning in chronic stroke survivors. Careful evaluation of dietary intake, especially among those with eating disabilities and preexisting malnutrition, may aid in the identification of individuals at increased nutritional risk through which early intervention may benefit recovery and rehabilitation and prevent further complications after stroke.

  17. Effect of a low-carbohydrate diet on respiratory quotient of infants with chronic lung disease.

    Science.gov (United States)

    Suteerojntrakool, Orapa; Sanguanrungsirikul, Sompol; Sritippayawan, Suchada; Jantarabenjakul, Watsamon; Sirimongkol, Pathama; Chomtho, Sirinuch

    2015-01-01

    To compare the respiratory quotient in infants with chronic lung disease before and after receiving a modular diet with slightly lower carbohydrate content. Infants with chronic lung disease from the King Chulalongkorn Memorial Hospital were enrolled and assessed for nutritional status, severity of chronic lung disease and dietary intake. Indirect calorimetry was performed using a custom-made airtight canopy with O2 and CO2 sensors. Respiratory quotient (RQ) was calculated from VCO2/VO2 during the period they were fed low carbohydrates (37% of total calories) for at least 24 hours vs. a standard diet (47% carbohydrate). These two formulas were similar in terms of caloric density and protein content. Each patient received at least 100-150 kcal/ kg/day during the study period. Respiratory quotients of the same patient receiving the two diets were compared by using Wilcoxon signed-rank test. A total of 14 patients (median age 7 months, range 1-26 months) were recruited. Twelve children had weight for age Z-score below-2SD. Their median weight for age Z-score, length for age Z-score and weight for length Z-score were -2.89, -3.08 and -1.24, respectively. The median RQ measured during the low carbohydrate diet was 0.96 (interquartile range 0.95-0.97), significantly lower than the median RQ during the standard diet, which was 1.04 (0.97-1.10). However, the respiratory rate revealed no significant difference. Two participants with underlying gastroesophageal reflux disease showed higher RQ after low carbohydrate formula feeding, which might be a result of hypersecretion due to its high fat content. Diet with slightly lower carbohydrate content can reduce the RQ in infants with chronic lung disease compared to the standard enteral formula. A 10-percent reduction of carbohydrate content may provide a sizeable effect in this group of patients. Nevertheless, the clinical significance of this finding requires further investigation.

  18. Hierarchical evaluation of electrical stimulation protocols for chronic wound healing: An effect size meta-analysis.

    Science.gov (United States)

    Khouri, Charles; Kotzki, Sylvain; Roustit, Matthieu; Blaise, Sophie; Gueyffier, Francois; Cracowski, Jean-Luc

    2017-09-01

    Electrical stimulation (ES) has been tested for decades to improve chronic wound healing. However, uncertainty remains on the magnitude of the efficacy and on the best applicable protocol. We conducted an effect size meta-analysis to assess the overall efficacy of ES on wound healing, to compare the efficacy of the different modalities of electrical stimulation, and to determine whether efficacy differs depending on the wound etiology, size, and age of the chronic wound. Twenty-nine randomized clinical trials with 1,510 patients and 1,753 ulcers were selected. Overall efficacy of ES on would healing was a 0.72 SMD (95% CI: 0.48, 1) corresponding to a moderate to large effect size. We found that unidirectional high voltage pulsed current (HVPC) with the active electrode over the wound was the best evidence-based protocol to improve wound healing with a 0.8 SMD (95% CI: 0.38, 1.21), while evaluation of the efficacy of direct current was limited by the small number of studies. ES was more effective on pressure ulcers compared to venous and diabetic ulcers, and efficacy trended to be inversely associated with the wound size and duration. This study confirms the overall efficacy of ES to enhance healing of chronic wounds and highlights the superiority of HVPC over other type of currents, which is more effective on pressure ulcers, and inversely associated with the wound size and duration. This will enable to standardize future ES practices. © 2017 by the Wound Healing Society.

  19. Chronic effects of ionizing radiation on animals and humans

    International Nuclear Information System (INIS)

    Drozd, Yi.P.

    2013-01-01

    Numerous experimental radiobiological studies and medical observations were conducted after the Chernobyl disaster based on the published results; patterns and characteristics influence of the fission products of nuclear materials on the body of mammals, including humans were analyzed. Chronic exposure to low doses leads to the changes in the hemopoietic system was founded and increases the risk of myeloproliferative diseases. The consequence of radiation-related immunodeficiency is the autoimmune disease and chronic fatigue syndrome. Radiation damage leads to endocrine system disruption of the body and of polipatologycal states. High radiosensitivity of the central nervous system was founded. Genotoxic chronic radiation exposure threatens the stability of the genome

  20. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Guiting Lin

    2016-07-01

    Full Text Available Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS is one of the most common urologic diseases, and no curative treatments have been identified. Low-intensity pulsed ultrasound (LIPUS has been successfully used in promoting tissue healing, inhibiting inflammation and pain, differentiating stem cells, and stimulating nerve regeneration/muscle regeneration, as well as enhancing angiogenesis. Very recently, LIPUS has been proven an effective approach for CP/CPPS. This review summarizes the possible mechanisms responsible for the therapeutic effect of LIPUS for CP/CPPS. To search publications relevant to the topics of this review, the search engine for life sciences of Entrez was used. We reviewed the available evidence from 1954 through 2015 concerning LIPUS for CP/CPPS. According to the literature, both transrectal and transperineal approaches of LIPUS are effective for CP/CPPS.

  1. Studies on chronic effects of lower dose level irradiation

    International Nuclear Information System (INIS)

    Yun, T.G.; Yun, Y.S.; Yun, M.S.

    1980-01-01

    This experiment is being carried out to elucidate the chronic effects of Co 60 (γ-ray) - low doses irradiation on JCR mice at 3rd week, 6th week, and 5th month after their birth. Experimental mice at 3rd week of age have been irradiated with Co 60 - 60mR weekly, Co 60 - 500mR weekly and Co 60 - 61R biweekly at the dose rate of 60mR per second for 23 weeks until now. Co 60 - 61R irradiated mice were subdivided into Co 60 - alone group and Co 60 combined with red ginseng extracts group. In their survivor's rate and their body weight etc., no significant differences between control groups and test groups in these experimental mice. Experimented mice at 6 weeks and 5 months of age are also being irradiated with Co 60 in the same doses as the above for 14 weeks and 8 weeks until present. In these experimental groups, there are also no significant differences between control groups and experimental groups in their survivor's rate and their body weight

  2. Treatment of chronic myeloid leukemia: assessing risk, monitoring response, and optimizing outcome.

    Science.gov (United States)

    Shanmuganathan, Naranie; Hiwase, Devendra Keshaorao; Ross, David Morrall

    2017-12-01

    Over the past two decades, tyrosine kinase inhibitors have become the foundation of chronic myeloid leukemia (CML) treatment. The choice between imatinib and newer tyrosine kinase inhibitors (TKIs) needs to be balanced against the known toxicity and efficacy data for each drug, the therapeutic goal being to maximize molecular response assessed by BCR-ABL RQ-PCR assay. There is accumulating evidence that the early achievement of molecular targets is a strong predictor of superior long-term outcomes. Early response assessment provides the opportunity to intervene early with the aim of ensuring an optimal response. Failure to achieve milestones or loss of response can have diverse causes. We describe how clinical and laboratory monitoring can be used to ensure that each patient is achieving an optimal response and, in patients who do not reach optimal response milestones, how the monitoring results can be used to detect resistance and understand its origins.

  3. Assessment on separate effect tests

    International Nuclear Information System (INIS)

    Bernard, M.; Kukita, Y.; Renault, C.

    1985-01-01

    In the general frame of Cathare assessment this operation is aimed to qualify the set of constitutive laws by reconstitution of experimental tests. The experimental tests are selected following 2 objectives: to be able to qualify separately (as far as possible) the constitutive laws, and, to cover the entire parameter range which is of interest for safety studies. This selection has led to a set of 135 separate effect tests taken from 15 experimental facilities and which can be arranged in 3 main categories: Adiabatic flow tests, without significant external heat exchange; non adiabatic flow tests, in which external heating or cooling is applied to the test section but not being driven by wall heat exchange; and, heat transfer tests, in which wall heat transfer plays the dominant role

  4. The Treatment Effectiveness Assessment (TEA

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-09-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers.  View original paper by Ling W, Farabee D, Liepa D, Wu LT. 

  5. Chronic prostatitis presenting with dysfunctional voiding and effects of pelvic floor biofeedback treatment.

    Science.gov (United States)

    He, Wei; Chen, Minfeng; Zu, Xiongbing; Li, Yuan; Ning, Keping; Qi, Lin

    2010-04-01

    To investigate the features of chronic prostatitis presenting with dysfunctional voiding (DV) and the effects of pelvic floor biofeedback (PFB). The study included 21 patients, diagnosed by having symptoms for > or =3 months, including urinary frequency and urgency, voiding difficulty, upper abdominal or perineal discomfort, and with a score of > or =1 on the first and second part of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Patients with bacterial prostatitis, urethritis, interstitial cystitis, urethral stricture and neurogenic bladder were excluded. All patients had a urodynamic examination, to assess the uroflow curve, maximum urinary flow rate (Q(max)), maximum detrusor pressure during the storage phase (P(det.max)), maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) were recorded. PFB was carried out in patients with non-neurogenic detrusor sphincter dyssynergia, and the effects evaluated after 10 weeks. Before and after PFB treatment the mean (sd) Q(max), P(det.max), MUP, MUCP were 8.2 (4.1) vs 15.1 (7.3) mL/s, 125.1 (75.3) vs 86.3 (54.2) cmH(2)O, 124.3 (23.3) vs 65.4 (23.0) cmH(2)O and 101.5 (43.6) vs 43.5 (16.7) cmH(2)O, all significantly different (P PFB had satisfactory short-term effects on these patients.

  6. Effect of Inhaling Bergamot Oil on Depression-Related Behaviors in Chronic Stressed Rats.

    Science.gov (United States)

    Saiyudthong, Somrudee; Mekseepralard, Chantana

    2015-10-01

    Bergamot essential oil (BEO) possesses sedation and anxiolytic properties similar to diazepam. After long period of exposure to stressors, including restrained stress, depressive-like behavior can be produced. BEO has been suggested to reduce depression. However, there is no scientific evidence supporting this property. To investigate the effect of BEO in chronic stressed rats on: 1) behavior related depressive disorder, 2) hypothalamic pituitary adrenal (HPA) axis response, and iii) brain-derived neurotrophic factor (BDNF) protein levels in hippocampus. Male Wistar rats, weighing 200 to 250 g, were induced chronic restrained stress 15 minutes dailyfor two weeks. For the next two weeks, these rats were divided intofour groups, control-i.p., fluoxetine-i.p., control-inhale, and BEO-inhale. Fluoxetine (10 mg/kg i.p.) or saline was intraperitoneally administered daily while 2.5% BEO or saline was inhaled daily. At the end of the treatment, rats were assessed for depressive-like behavior using the forced swimming test (FST). After the behavioral test, the animals were immediately decapitated and trunk blood samples were collected for the measurement ofcorticosterone and adrenocorticotropic hormone (ACTH) levels and hippocampus was dissected and stored in afreezer at -80 °C until assay for BDNF protein. BEO andfluoxetine significantly decreased the immobility time in the FST (p BDNF protein determination, neither BEO norfluoxetine had any effect on BDNF protein levels in hippocampus compared to their controls. The inhalation ofBEO decrease behavior related depressive disorder similar tofluoxetine but has no effect on HPA axis response and BDNF protein levels in chronic restrained stress.

  7. The effects of music-supported therapy on motor, cognitive, and psychosocial functions in chronic stroke.

    Science.gov (United States)

    Fujioka, Takako; Dawson, Deirdre R; Wright, Rebecca; Honjo, Kie; Chen, Joyce L; Chen, J Jean; Black, Sandra E; Stuss, Donald T; Ross, Bernhard

    2018-05-24

    Neuroplasticity accompanying learning is a key mediator of stroke rehabilitation. Training in playing music in healthy populations and patients with movement disorders requires resources within motor, sensory, cognitive, and affective systems, and coordination among these systems. We investigated effects of music-supported therapy (MST) in chronic stroke on motor, cognitive, and psychosocial functions compared to conventional physical training (GRASP). Twenty-eight adults with unilateral arm and hand impairment were randomly assigned to MST (n = 14) and GRASP (n = 14) and received 30 h of training over a 10-week period. The assessment was conducted at four time points: before intervention, after 5 weeks, after 10 weeks, and 3 months after training completion. As for two of our three primary outcome measures concerning motor function, all patients slightly improved in Chedoke-McMaster Stroke Assessment hand score, while the time to complete Action Research Arm Test became shorter in the MST group. The third primary outcome measure for well-being, Stroke Impact Scale, was improved for emotion and social communication earlier in MST and coincided with the improved executive function for task switching and music rhythm perception. The results confirmed previous findings and expanded the potential usage of MST for enhancing quality of life in community-dwelling chronic-stage survivors. © 2018 New York Academy of Sciences.

  8. Curcumin reverses the effects of chronic stress on behavior, the HPA axis, BDNF expression and phosphorylation of CREB.

    Science.gov (United States)

    Xu, Ying; Ku, Baoshan; Tie, Lu; Yao, Haiyan; Jiang, Wengao; Ma, Xing; Li, Xuejun

    2006-11-29

    Curcuma longa is a major constituent of the traditional Chinese medicine Xiaoyao-san, which has been used to effectively manage stress and depression-related disorders in China. Curcumin is the active component of curcuma longa, and its antidepressant effects were described in our prior studies in mouse models of behavioral despair. We hypothesized that curcumin may also alleviate stress-induced depressive-like behaviors and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Thus in present study we assessed whether curcumin treatment (2.5, 5 and 10 mg/kg, p.o.) affects behavior in a chronic unpredictable stress model of depression in rats and examined what its molecular targets may be. We found that subjecting animals to the chronic stress protocol for 20days resulted in performance deficits in the shuttle-box task and several physiological effects, such as an abnormal adrenal gland weight to body weight (AG/B) ratio and increased thickness of the adrenal cortex as well as elevated serum corticosterone levels and reduced glucocorticoid receptor (GR) mRNA expression. These changes were reversed by chronic curcumin administration (5 or 10 mg/kg, p.o.). In addition, we also found that the chronic stress procedure induced a down-regulation of brain-derived neurotrophic factor (BDNF) protein levels and reduced the ratio of phosphorylated cAMP response element-binding protein (pCREB) to CREB levels (pCREB/CREB) in the hippocampus and frontal cortex of stressed rats. Furthermore, these stress-induced decreases in BDNF and pCREB/CREB were also blocked by chronic curcumin administration (5 or 10 mg/kg, p.o.). These results provide compelling evidence that the behavioral effects of curcumin in chronically stressed animals, and by extension humans, may be related to their modulating effects on the HPA axis and neurotrophin factor expressions.

  9. Effect of Hepatitis B Vaccination in Patients with Chronic Hepatitis C

    International Nuclear Information System (INIS)

    Khokhar, N; Niazi, T. K.; Qureshi, M. O.

    2014-01-01

    Objective: To assess the effects of hepatitis B vaccination on the antibody titer in patients with chronic hepatitis C and to compare it with response in normal healthy subjects. Study Design: Interventional study. Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, from January 2007 to January 2012. Methodology: Hepatitis vaccination (Heberbiovac-HB 20) was given intramuscularly to the patients of chronic hepatitis C (HCV group) and normal healthy subjects (control group) at 0, 1 and 6 months intervals. Anti-HBs titer was determined after second and third injection to assess the antibody response. Results: There were 46 patients in the HCV group and 45 patients in the control group. Mean age was 40.9 A +- 9.8 years in the HCV group and 33.18 A +- 8.35 years in the control group. Weight was 67.04 A +- 13.5 kg in the HCV group and 71.78 A +- 14.63 kg in the control group. Height was 162.45 A +- 9.06 cm in the HCV group and 167.03 A +- 7.83 cm in the control group. Anti-HBs antibody levels after the second injection were 253.89 A +- 76.76 mlU/mL in the HCV group and 245.81 A +- 72.65 mlU/mL in the control group (p=0.172). After third injection, the antibody levels were slightly higher in both groups. Conclusion: In patients with chronic hepatitis C and normal healthy subjects, Heberbiovac HB in standard dosage gave sero-protective levels in both groups and antibody titers were not significantly different in control and HCV group. (author)

  10. The chronic toxicity of molybdate to marine organisms. I. Generating reliable effects data

    International Nuclear Information System (INIS)

    Heijerick, D.G.; Regoli, L.; Stubblefield, W.

    2012-01-01

    A scientific research program was initiated by the International Molybdenum Association (IMOA) which addressed identified gaps in the environmental toxicity data for the molybdate ion (MoO 4 2− ). These gaps were previously identified during the preparation of EU-REACH-dossiers for different molybdenum compounds (European Union regulation on Registration, Evaluation, Authorization and Restriction of Chemical substances; EC, 2006). Evaluation of the open literature identified few reliable marine ecotoxicological data that could be used for deriving a Predicted No-Effect Concentration (PNEC) for the marine environment. Rather than calculating a PNEC marine using the assessment factor methodology on a combined freshwater/marine dataset, IMOA decided to generate sufficient reliable marine chronic data to permit derivation of a PNEC by means of the more scientifically robust species sensitivity distribution (SSD) approach (also called the statistical extrapolation approach). Nine test species were chronically exposed to molybdate (added as sodium molybdate dihydrate, Na 2 MoO 4 ·2H 2 O) according to published standard testing guidelines that are acceptable for a broad range of regulatory purposes. The selected test organisms were representative for typical marine trophic levels: micro-algae/diatom (Phaeodactylum tricornutum, Dunaliella tertiolecta), macro-alga (Ceramium tenuicorne), mysids (Americamysis bahia), copepod (Acartia tonsa), fish (Cyprinodon variegatus), echinoderms (Dendraster exentricus, Strongylocentrotus purpuratus) and molluscs (Mytilus edulis, Crassostrea gigas). Available NOEC/EC 10 levels ranged between 4.4 mg Mo/L (blue mussel M. edulis) and 1174 mg Mo/L (oyster C. gigas). Using all available reliable marine chronic effects data that are currently available, a HC 5,50% (median hazardous concentration affecting 5% of the species) of 5.74 (mg Mo)/L was derived with the statistical extrapolation approach, a value that can be used for national and

  11. The chronic toxicity of molybdate to marine organisms. I. Generating reliable effects data

    Energy Technology Data Exchange (ETDEWEB)

    Heijerick, D.G., E-mail: Dagobert.heijerick@arche-consulting.be [ARCHE - Assessing Risks of Chemicals, Stapelplein 70 Bus 104, Gent (Belgium); Regoli, L. [International Molybdenum Association, 4 Heathfield Terrace, London, W4 4JE (United Kingdom); Stubblefield, W. [Oregon State University, Department of Environmental and Molecular Toxicology, 421 Weniger Hall, Corvallis, OR 97331 (United States)

    2012-07-15

    A scientific research program was initiated by the International Molybdenum Association (IMOA) which addressed identified gaps in the environmental toxicity data for the molybdate ion (MoO{sub 4}{sup 2-}). These gaps were previously identified during the preparation of EU-REACH-dossiers for different molybdenum compounds (European Union regulation on Registration, Evaluation, Authorization and Restriction of Chemical substances; EC, 2006). Evaluation of the open literature identified few reliable marine ecotoxicological data that could be used for deriving a Predicted No-Effect Concentration (PNEC) for the marine environment. Rather than calculating a PNEC{sub marine} using the assessment factor methodology on a combined freshwater/marine dataset, IMOA decided to generate sufficient reliable marine chronic data to permit derivation of a PNEC by means of the more scientifically robust species sensitivity distribution (SSD) approach (also called the statistical extrapolation approach). Nine test species were chronically exposed to molybdate (added as sodium molybdate dihydrate, Na{sub 2}MoO{sub 4}{center_dot}2H{sub 2}O) according to published standard testing guidelines that are acceptable for a broad range of regulatory purposes. The selected test organisms were representative for typical marine trophic levels: micro-algae/diatom (Phaeodactylum tricornutum, Dunaliella tertiolecta), macro-alga (Ceramium tenuicorne), mysids (Americamysis bahia), copepod (Acartia tonsa), fish (Cyprinodon variegatus), echinoderms (Dendraster exentricus, Strongylocentrotus purpuratus) and molluscs (Mytilus edulis, Crassostrea gigas). Available NOEC/EC{sub 10} levels ranged between 4.4 mg Mo/L (blue mussel M. edulis) and 1174 mg Mo/L (oyster C. gigas). Using all available reliable marine chronic effects data that are currently available, a HC{sub 5,50%} (median hazardous concentration affecting 5% of the species) of 5.74 (mg Mo)/L was derived with the statistical extrapolation approach, a

  12. Effects of the I-kr-blocker almokalant and predictors of conversion of chronic atrial tachyarrhythmias to sinus rhythm. A prospective study

    NARCIS (Netherlands)

    Houltz, B; Darpo, B; Swedberg, K; Blomstrom, P; Brachmann, J; Crijns, Harry J. G. M.; Jensen, Steen M.; Svernhage, E; Vallin, H; Edvardsson, N

    Purpose: To assess the efficacy of the I-kr-blocker almokalant attempting to convert chronic atrial tachyarrhythmias, and to find predictors of conversion, to sinus rhythm. Methods: The electrophysiological effects of a 6-hour infusion of almokalant, to a total dose of 25 +/- 4 mg, were assessed by

  13. Chronic Sublethal Effects of Cantharidin on the Diamondback Moth Plutella xylostella (Lepidoptera: Plutellidae

    Directory of Open Access Journals (Sweden)

    Zhengyu Huang

    2015-05-01

    Full Text Available The diamondback moth, Plutella xylostella (Linnaeus (Lepidoptera: Plutellidae, is a major pest of cruciferous vegetables worldwide. Cantharidin, a natural toxin isolated from blister beetles, has been reported to be toxic to P. xylostella. However, little is known on the chronic sublethal effects of cantharidin on this species. In this study, we assessed the changes of susceptibility, development, reproduction and other demographic parameters in both the selected P. xylostella strain (Sub, selected by LC25 cantharidin for consecutive 12 generations and the revertant strain (SubR, derived from the Sub strain without being exposed to cantharidin for 12 generations. Results revealed that the two strains maintained a relatively high-level susceptibility to cantharidin. Severe adverse effects on the population dynamics and fitness in Sub strain were observed. In addition, repeated exposure of P. xylostella to sublethal concentration of cantharidin resulted in negative effects on adult performance and deformities in adults. Although morphologically normal for individuals, the SubR strain exhibited a disadvantage in population growth rate. Our results showed that sublethal concentration of cantharidin exhibited severe negative effects on population growth for longtime. These findings would be useful for assessing the potential effects and risk of cantharidin on P. xylostella and for developing effective integrated pest management.

  14. Chronic Sublethal Effects of Cantharidin on the Diamondback Moth Plutella xylostella (Lepidoptera: Plutellidae).

    Science.gov (United States)

    Huang, Zhengyu; Zhang, Yalin

    2015-05-29

    The diamondback moth, Plutella xylostella (Linnaeus) (Lepidoptera: Plutellidae), is a major pest of cruciferous vegetables worldwide. Cantharidin, a natural toxin isolated from blister beetles, has been reported to be toxic to P. xylostella. However, little is known on the chronic sublethal effects of cantharidin on this species. In this study, we assessed the changes of susceptibility, development, reproduction and other demographic parameters in both the selected P. xylostella strain (Sub, selected by LC25 cantharidin for consecutive 12 generations) and the revertant strain (SubR, derived from the Sub strain without being exposed to cantharidin for 12 generations). Results revealed that the two strains maintained a relatively high-level susceptibility to cantharidin. Severe adverse effects on the population dynamics and fitness in Sub strain were observed. In addition, repeated exposure of P. xylostella to sublethal concentration of cantharidin resulted in negative effects on adult performance and deformities in adults. Although morphologically normal for individuals, the SubR strain exhibited a disadvantage in population growth rate. Our results showed that sublethal concentration of cantharidin exhibited severe negative effects on population growth for longtime. These findings would be useful for assessing the potential effects and risk of cantharidin on P. xylostella and for developing effective integrated pest management.

  15. Chronic Sublethal Effects of Cantharidin on the Diamondback Moth Plutella xylostella (Lepidoptera: Plutellidae)

    Science.gov (United States)

    Huang, Zhengyu; Zhang, Yalin

    2015-01-01

    The diamondback moth, Plutella xylostella (Linnaeus) (Lepidoptera: Plutellidae), is a major pest of cruciferous vegetables worldwide. Cantharidin, a natural toxin isolated from blister beetles, has been reported to be toxic to P. xylostella. However, little is known on the chronic sublethal effects of cantharidin on this species. In this study, we assessed the changes of susceptibility, development, reproduction and other demographic parameters in both the selected P. xylostella strain (Sub, selected by LC25 cantharidin for consecutive 12 generations) and the revertant strain (SubR, derived from the Sub strain without being exposed to cantharidin for 12 generations). Results revealed that the two strains maintained a relatively high-level susceptibility to cantharidin. Severe adverse effects on the population dynamics and fitness in Sub strain were observed. In addition, repeated exposure of P. xylostella to sublethal concentration of cantharidin resulted in negative effects on adult performance and deformities in adults. Although morphologically normal for individuals, the SubR strain exhibited a disadvantage in population growth rate. Our results showed that sublethal concentration of cantharidin exhibited severe negative effects on population growth for longtime. These findings would be useful for assessing the potential effects and risk of cantharidin on P. xylostella and for developing effective integrated pest management. PMID:26035491

  16. [The effectiveness of fenspiride in the treatment of patients with chronic obstructive pulmonary disease].

    Science.gov (United States)

    Butorov, S I; Muntianu, V I

    2007-01-01

    The purpose of the study was to assess the effectiveness and safety of long-term application of fenspiride, an anti-inflammatory drug, in patients with chronic obstructive pulmonary disease (COPD) under outpatient conditions. The drug was studied on 24 COPD patients. Fenspiride application resulted in improvement in bronchoobstructive syndrome and external respiration parameters, as well as a significant increase in exercise tolerance. In patients with stable stage I COPD, the use of fenspiride as a part of therapeutic regimen leads to better clinical results than in stage II patients. Long-term application of fenspiride in medium therapeutic doses under outpatient conditions is associated with positive clinical effects and leads to significant improvement in quality of life.

  17. Effects on alcohol use and anxiety of the September 11, 2001, attacks and chronic work stressors: a longitudinal cohort study.

    Science.gov (United States)

    Richman, Judith A; Wislar, Joseph S; Flaherty, Joseph A; Fendrich, Michael; Rospenda, Kathleen M

    2004-11-01

    We hypothesized that chronic stressors associated with an everyday social role (work) would interact with a traumatic macrosocial stressor (the terrorist attacks of September 11, 2001) in predicting mental health status (during the fall of 2001). We used mail surveys returned as part of wave 3 of a workplace cohort study, both before and after September 11, 2001, to assess decision latitude, sexual harassment, generalized workplace abuse, psychological distress, and alcohol use. We also used regression analyses to assess the main effect of September 11 and interactions between September 11 and stressors, after control for baseline mental health. The main effect of September 11 on elevated alcohol use was significant for women but not for men. For women, work stressors significantly interacted with experiencing the events of September 11 to affect alcohol use and anxiety outcomes. Women experiencing chronic work stressors were most vulnerable to elevated psychological distress and alcohol use after September 11, 2001.

  18. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease : the updated BODE index and the ADO index

    NARCIS (Netherlands)

    Puhan, Milo A.; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Anto, Josep M.; Agusti, Alvar G.; Gomez, Federico P.; Rodriguez-Roisin, Roberto; Moons, Karel G. M.; Kessels, Alphons G.; Held, Ulrike

    2009-01-01

    Background The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted

  19. Ecological risk assessment for the terrestrial ecosystem under chronic radioactive pollution - Ecological risk assessment for the biota on regional radioactive waste storage

    Energy Technology Data Exchange (ETDEWEB)

    Lavrentyeva, G.V.; Synzynys, B.I.; Shoshina, R.R.; Mirzeabasov, O.A. [Obninsk Institute for Nuclear Power Engineering, branch of the National Research Nuclear University MEPhI, Department of Ecology, Studgorodok,1, 249040 Obninsk, Kaluga region (Russian Federation)

    2014-07-01

    Now the methods of ecological regulation of a radiation factor from risk assessment are developed poorly. The paper attempts to assess and forecast the terrestrial ecosystem conditions under chronic ionizing radiation by calculating the critical loads. The paper is aimed at developing a methodology to assess the ecological risk for a terrestrial ecosystem under chronic radioactive pollution in a biotope of a regional radioactive waste storage. Objects and Methods: Biotope monitoring of a radioactive waste storage makes clear that the radioecological situation in this territory is stipulated by technogenic {sup 90}Sr found in soil, ground water and biota. Terrestrial mollusks of a shrubby Snail type (Bradybaena fruticum) were chosen as reference species due to their activity to accumulate {sup 90}Sr in shells and the number of colony-forming soil units (CFU) as reference indices. The number of CFU was determined by inoculation of solid medium. Soil and mollusk samples have been collected at most representative sites identified in the previous studies. To assess {sup 90}Sr content in the samples collected, radiochemical separation was used with further radionuclide activity measurements by a 'BETA-01C' scintillation beta-ray spectrometer according to a standard procedure of {sup 90}Sr content assessment from beta-radiation of its daughter radionuclide {sup 90}Y. Ecological risk was calculated from analyzed critical loads using a 'dose-effect' dependence. Statistical data processing was realized with Excell 2007 and R software programs [R Development Core Team, 2010]. The software R was also used for GIS creation. Results and Discussion: A methodology of ecological risk assessment for the terrestrial ecosystem under chronic radioactive pollution of a biotope near a regional radioactive waste storage has been developed in terms of the critical environmental loads analyzed. It consists of five stages: determination of effect indicators and assessment

  20. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    Directory of Open Access Journals (Sweden)

    Nelson LM

    2014-09-01

    Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

  1. NEUROCHEMICAL EFFECTS OF CHRONIC DIETARY AND REPEATED HIGH-LEVEL ACUTE EXPOSURE TO CHLORPYRIFOS IN RATS.

    Science.gov (United States)

    Lots of information is available surrounding the acute toxicity of anticholinesterase pesticides, but these have been very few detailed studies on the chronic effects of these pesticides. Humans are exposed on a chronic basis and some humans believe that have been affected advers...

  2. The effect of control and self-medication of chronic gout in a developing country.

    NARCIS (Netherlands)

    Darmawan, John; Rasker, Johannes J.; Nuralim, Hendri

    2003-01-01

    Objective:: We describe a 10 year observation of the effect of control of hyperuricemia compared with self-medication alone in patients with chronic gout. Methods: We studied 299 consecutively self-referred Malayo-Polynesian men with chronic gout, mean age 35 ± 14.3 SD years. Subjects comprised 228

  3. Effect of Melatonin on Sleep, Behavior, and Cognition in ADHD and Chronic Sleep-Onset Insomnia

    Science.gov (United States)

    Van der Heijden, Kristiaan B.; Smits, Marcel G.; Van Someren, Eus J. W.; Ridderinkhof, K. Richard; Gunning, W. Boudewijn

    2007-01-01

    Objective: To investigate the effect of melatonin treatment on sleep, behavior, cognition, and quality of life in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia. Method: A total of 105 medication-free children, ages 6 to 12 years, with rigorously diagnosed ADHD and chronic sleep onset insomnia…

  4. Comorbidity of chronic diseases: effects of disease pairs on physical and mental functioning

    NARCIS (Netherlands)

    Rijken, M.; Kerkhof, van de M.; Dekker, J.; Schellevis, F.G.

    2005-01-01

    Although much research has been done on the impact of chronic illness on quality of life, still relatively little is known about the role of comorbidity. Given the growing number of (older) people with multiple chronic conditions, more information is needed on the effects of specific disease

  5. Comorbidity of chronic diseases: effects of disease pairs on physical and mental functioning.

    NARCIS (Netherlands)

    Rijken, M.; Kerkhof, M. van; Dekker, J.; Schellevis, F.G.

    2005-01-01

    Although much research has been done on the impact of chronic illness on quality of life, still relatively little is known about the role of comorbidity. Given the growing number of (older) people with multiple chronic conditions, more information is needed on the effects of specific disease

  6. Effects of electric stimulation-assisted cycling training in people with chronic stroke

    NARCIS (Netherlands)

    Janssen, T.W.J.; Beltman, J.M.; Elich, P.; Koppe, P.A.; Konijnenbelt, H.; de Haan, A.; Gerrits, K.H.L.

    2008-01-01

    Janssen TW, Beltman JM, Elich P, Koppe PA, Konijnenbelt H, de Haan A, Gerrits KH. Effects of electric stimulation-assisted cycling training in people with chronic stroke. Objective: To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance, aerobic

  7. Chronic Absenteeism and Its Effects on Students' Academic and Socioemotional Outcomes

    Science.gov (United States)

    Gottfried, Michael A.

    2014-01-01

    Recent policy dialogue suggests that chronic absenteeism is not only underdocumented, but is also detrimental to the success of students as early as kindergarten. That said, almost no empirical research has examined the effects of chronic absenteeism on student outcomes. This study addresses this underresearched issue in more depth. Using a…

  8. A Novel Chronic Opioid Monitoring Tool to Assess Prescription Drug Steady State Levels in Oral Fluid.

    Science.gov (United States)

    Shaparin, Naum; Mehta, Neel; Kunkel, Frank; Stripp, Richard; Borg, Damon; Kolb, Elizabeth

    2017-11-01

    Interpretation limitations of urine drug testing and the invasiveness of blood toxicology have motivated the desire for the development of simpler methods to assess biologically active drug levels on an individualized patient basis. Oral fluid is a matrix well-suited for the challenge because collections are based on simple noninvasive procedures and drug concentrations better correlate to blood drug levels as oral fluid is a filtrate of the blood. Well-established pharmacokinetic models were utilized to generate oral fluid steady state concentration ranges to assess the interpretive value of the alternative matrix to monitor steady state plasma oxycodone levels. Paired oral fluid and plasma samples were collected from patients chronically prescribed oxycodone and quantitatively analyzed by liquid chromatography tandem mass spectrometry. Steady state plasma concentration ranges were calculated for each donor and converted to an equivalent range in oral fluid. Measured plasma and oral fluid oxycodone concentrations were compared with respective matrix-matched steady state ranges, using each plasma steady state classification as the control. A high degree of correlation was observed between matrices when classifying donors according to expected steady state oxycodone concentration. Agreement between plasma and oral fluid steady state classifications was observed in 75.6% of paired samples. This study supports novel application of basic pharmacokinetic knowledge to the pain management industry, simplifying and improving individualized drug monitoring and risk assessment through the use of oral fluid drug testing. Many benefits of established therapeutic drug monitoring in plasma can be realized in oral fluid for patients chronically prescribed oxycodone at steady state. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Assessment of activity limitations and participation restrictions with persons with chronic fatigue syndrome: a systematic review.

    Science.gov (United States)

    Vergauwen, Kuni; Huijnen, Ivan P J; Kos, Daphne; Van de Velde, Dominique; van Eupen, Inge; Meeus, Mira

    2015-01-01

    To summarize measurement instruments used to evaluate activity limitations and participation restrictions in patients with chronic fatigue syndrome (CFS) and review the psychometric properties of these instruments. General information of all included measurement instruments was extracted. The methodological quality was evaluated using the COSMIN checklist. Results of the measurement properties were rated based on the quality criteria of Terwee et al. Finally, overall quality was defined per psychometric property and measurement instrument by use of the quality criteria by Schellingerhout et al. A total of 68 articles were identified of which eight evaluated the psychometric properties of a measurement instrument assessing activity limitations and participation restrictions. One disease-specific and 37 generic measurement instruments were found. Limited evidence was found for the psychometric properties and clinical usability of these instruments. However, the CFS-activities and participation questionnaire (APQ) is a disease-specific instrument with moderate content and construct validity. The psychometric properties of the reviewed measurement instruments to evaluate activity limitations and participation restrictions are not sufficiently evaluated. Future research is needed to evaluate the psychometric properties of the measurement instruments, including the other properties of the CFS-APQ. If it is necessary to use a measurement instrument, the CFS-APQ is recommended. Chronic fatigue syndrome (CFS). Chronic fatigue syndrome causes activity limitations and participation restrictions in one or more areas of life. Standardized, reliable and valid measurement instruments are necessary to identify these limitations and restrictions. Currently, no measurement instrument is sufficiently evaluated with persons with CFS. If a measurement instrument is needed to identify activity limitations and participation restrictions with persons with CFS, it is recommended to use

  10. USE OF REMICADE® IN PATIENTS WITH CHRONIC TOPHACEOUS GOUT: THEORETICAL RATIONALE AND ASSESSMENT OFOWN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    M S Eliseyev

    2009-01-01

    Full Text Available The paper deals with the clinical experience in using Remicade®, a tumor necrosis factor-a (TNF-а inhibitor, in patients with chronic tophaceous gout resistant to therapy with glucocorticoids and nonsteroidal anti-inflammatory drugs. The agent is noted to have a good long-acting clinical effect in reducing the number of tender and swollen joints, as confirmed by the theoretical rationale for the use of anticytokine agents, TNF- а inhibitors in particular, in gouty patients.

  11. Effects of chronic low-level irradiation on Gambusia affinis

    International Nuclear Information System (INIS)

    Blaylock, B.G.; Frank, M.L.

    1979-01-01

    Since 1944, White Oak Lake (WOL), located on the Oak Ridge Reservation, has served as a final settling basin for low-level radioactive effluents from the Oak Ridge National Laboratory. Organisms inhabiting the lake have been exposed for many generations to chronic low-level radiation significantly higher than background. During the past decade, studies on Gambusia affinis from WOL have been carried out to relate estimated radiation doses to effects on the fitness of the Gambusia population. Results of studies on fecundity, temperature tolerance, and embryonic mortality have led to the conclusion that the Gambusia population in White Oak Lake has an increased frequency of deleterious and recessive lethal genes which may be attributed to the radiation exposure history. The frequency of nonviable embryos from WOL Gambusia did not change significantly from 1966 to 1978; however, it was still significantly greater than that of a control population. In July 1977, Gambusia from a control population were stocked into a 0.45-ha pond which had served as a low-level waste settling basin. The beta and gamma dose rate in this pond averaged from 37 rad/yr at the water surface, 394 rad/yr at mid-depth, and 1150 rad/yr at the surface of the sediments. Preliminary results from samples taken in August 1978 showed that although the frequency of nonviable embryos increased, the frequency was not significantly greater than that of the control parent population. Additional sampling of future generations of Gambusia in this pond will determine whether the frequency of nonviable embryos increases as succeeding generations are exposed to dose rates that are higher than the dose rates in WOL

  12. Effects of chronic treatment with 7-nitroindazole in hyperthyroid rats.

    Science.gov (United States)

    Wangensteen, Rosemary; Rodríguez-Gómez, Isabel; Moreno, Juan Manuel; Alvarez-Guerra, Miriam; Osuna, Antonio; Vargas, Félix

    2006-11-01

    This study analyzed the contribution of neuronal nitric oxide synthase (nNOS) to the hemodynamic manifestations of hyperthyroidism. The effects on hyperthyroid rats of the chronic administration of 7-nitroindazole (7-NI), an inhibitor of nNOS, were studied. Six groups of male Wistar rats were used: control, 7-NI (30 mg.kg-1.day-1 by gavage), T(4)50, T(4)75 (50 or 75 microg thyroxine.rat-1.day-1, respectively), T(4)50+7-NI, and T(4)75+7-NI. All treatments were maintained for 4 wk. Body weight, tail systolic blood pressure (SBP), and heart rate (HR) were recorded weekly. Finally, SBP, pulse pressure (PP), and HR were measured in conscious rats, and morphological, metabolic, plasma, and renal variables were determined. Expression of nNOS in the hypothalamus of T(4)75 and control rats was analyzed by Western blot analysis. The response of mean arterial pressure (MAP) to pentolinium (10 mg/kg iv) was used to evaluate the sympathetic contribution to BP in T(4)75 and T(4)75+7-NI rats. T(4) produced an increased hypothalamic nNOS expression and dose-related increases in blood pressure (BP), HR, and PP vs. control rats. 7-NI did not modify BP or any other hemodynamic variable in normal rats. However, 7-NI produced a marked reduction in BP, HR, PP, and food and water intake in both hyperthyroid groups and improved creatinine clearance in the T(4)75 group. Pentolinium produced a greater MAP decrease in the T(4)75+7-NI than in the T(4)75 group. In conclusion, administration of 7-NI attenuates the hemodynamic and metabolic manifestations of hyperthyroidism, suggesting that nNOS contributes to the hyperdynamic circulation of this endocrine disease by modulating sympathetic activity.

  13. The Effect of Chronic Alcoholism on the Conjunctival Flora.

    Science.gov (United States)

    Gunduz, Göksel; Gunduz, Abuzer; Polat, Nihat; Cumurcu, Birgul Elbozan; Yakupogulları, Yusuf

    2016-06-01

    We aimed to investigate the effect of alcohol abuse on the conjunctival flora. The cases were evaluated as two groups. The study group consisted of 55 heavy-drinking males diagnosed with alcohol abuse, while the control group consisted of 55 males without a history of alcohol abuse. Samples were taken from the inferior fornix conjunctiva with sterile cotton-tipped swabs (Amies transport medium) for culture. The samples were inoculated into blood agar, chocolate agar, eosine methylene blue agar and Saboraud-Dextrose agar (Oxoid/UK) with the dilution method. The microorganisms that grew in study group subjects were Coagulase Negative Staphylococcus (CNS) in 30 (54.5%), Staphylococcus aureus in 14 (25.5%), Moraxella spp. in 3 (5.5%), Streptococcus spp. in 3 (5.5), Bacillus spp. in 3 (5.5%), Corynebacterium spp. in 3 (5.5%), Candida spp. in 3 (5.5%), Haemophilus spp. in 2 (3.6%), Acinetobacter spp. in 2 (3.6%), Neisseria spp. in 1 (1.8%) and Micrococcus spp. in 1 (1.8%). The results for control group were CNS in 31 (56.4%), Bacillus spp. in 7 (12.7%), S. aureus in 5 (9.1%), and Corynebacterium spp. in 2 (3.6%). Moraxella spp., Streptococcus spp., Candida spp., Haemophilus spp., Acinetobacter spp., Neisseria spp. and Micrococcus spp. microorganisms grew in the conjunctival flora samples of the study group but not in the control group. S. aureus colonization was significantly higher in the study group than the control group (p chronic alcoholism is different than the normal population.

  14. Chronic Effects of Boxing: Diffusion Tensor Imaging and Cognitive Findings.

    Science.gov (United States)

    Wilde, Elisabeth A; Hunter, Jill V; Li, Xiaoqi; Amador, Cristian; Hanten, Gerri; Newsome, Mary R; Wu, Trevor C; McCauley, Stephen R; Vogt, Gregory S; Chu, Zili David; Biekman, Brian; Levin, Harvey S

    2016-04-01

    We used magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to evaluate the effects of boxing on brain structure and cognition in 10 boxers (8 retired, 2 active; mean age = 45.7 years; standard deviation [SD] = 9.71) and 9 participants (mean age = 43.44; SD = 9.11) in noncombative sports. Evans Index (maximum width of the anterior horns of the lateral ventricles/maximal width of the internal diameter of the skull) was significantly larger in the boxers (F = 4.52; p = 0.050; Cohen's f = 0.531). Word list recall was impaired in the boxers (F(1,14) = 10.70; p = 0.006; f = 0.84), whereas implicit memory measured by faster reaction time (RT) to a repeating sequence of numbers than to a random sequence was preserved (t = 2.52; p boxing had the most consistent, negative correlations with FA, ranging from -0.65 for the right ventral striatum to -0.92 for the right cerebral peduncle. Years of boxing was negatively related to the number of words consistently recalled over trials (r = -0.74; p = 0.02), delayed recall (r = -0.83; p = 0.003), and serial RT (r = 0.66; p = 0.05). We conclude that microstructural integrity of white matter tracts is related to declarative memory and response speed in boxers and to the extent of boxing exposure. Implications for chronic traumatic encephalopathy are discussed.

  15. Mediators of the effects on fatigue of pragmatic rehabilitation for chronic fatigue syndrome.

    Science.gov (United States)

    Wearden, Alison J; Emsley, Richard

    2013-10-01

    To examine potential mediators of the effect of pragmatic rehabilitation on improvements in fatigue following a randomized controlled trial for patients with chronic fatigue syndrome (CFS/ME) in primary care (IRCTN 74156610). Patients fulfilled the Oxford criteria for CFS. Ninety-five patients were randomized to pragmatic rehabilitation and 100 to general practitioner (GP) treatment as usual. The outcome was the Chalder fatigue scale score (0123 scoring) at end of treatment (20 weeks) and 1-year follow up (70 weeks). First, the effect of treatment on potential mediators was assessed. Then fatigue was regressed on significant mediators, treatment allocation, and baseline measures of fatigue and significant mediators. Reduction in limiting activities at 20 weeks mediated the positive effect of pragmatic rehabilitation on fatigue at 70 weeks (mediated effect size = -2.64, SE = 0.81, p = .001, proportion of effect mediated = 82.0%). Reduction in catastrophizing at 20 weeks mediated the positive effect of pragmatic rehabilitation on fatigue at 70 weeks (mediated effect size = -1.39, SE = 0.61, p = .023, proportion of effect mediated = 43.2%). Reductions in 70-week measures of fear avoidance, embarrassment avoidance, limiting activities, and all-or-nothing behavior all mediated improvement in fatigue at 70 weeks, although the causal direction of these cross-sectional effects cannot be determined. There were no between-group differences on measures of exercise capacity (a timed step test). Improvements in fatigue following pragmatic rehabilitation are related to changes in behavioral responses to and beliefs about fatigue.

  16. Beneficial effects of fucoidan in patients with chronic hepatitis C virus infection

    Institute of Scientific and Technical Information of China (English)

    Naoki Mori; Kazunori Nakasone; Koh Tomimori; Chie Ishikawa

    2012-01-01

    AIM:To evaluate the effects of fucoidan,a complex sulfated polysaccharide extract from marine seaweed,on hepatitis C virus (HCV) RNA load both in vitro and in vivo.METHODS:HCV-1b replicon-expressing cells were cultured in the presence of fucoidan obtained from Cladosiphon okamuranus Tokida cultivated in Okinawa,Japan,and quantified the level of HCV replication.In an open-label uncontrolled study,15 patients with chronic hepatitis C,and HCV-related cirrhosis and hepatocellular carcinoma were treated with fucoidan (0.83 g/d) for 12 mo.The clinical symptoms,biochemical tests,and HCV RNA levels were assessed before,during,and after treatment.RESULTS:Fucoidan dose-dependently inhibited the expression of HCV replicon.At 8-10 mo of treatment with fucoidan,HCV RNA levels were significantly lower relative to the baseline.The same treatment also tended to lower serum alanine aminotransferase levels,and the latter correlated with HCV RNA levels.However,the improved laboratory tests did not translate into significant clinical improvement.Fucoidan had no serious adverse effects.CONCLUSION:Our findings suggest that fucoidan is safe and useful in the treatment of patients with HCV-related chronic liver diseases.Further controlled clinical trials are needed to confirm the present findings.

  17. Effect of pulmonary rehabilitation on balance in persons with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Beauchamp, Marla K; O'Hoski, Sachi; Goldstein, Roger S; Brooks, Dina

    2010-09-01

    To describe within-subject effects of pulmonary rehabilitation (PR) on balance in persons with chronic obstructive pulmonary disease (COPD) and to determine whether any observed changes in balance were associated with change in exercise tolerance or health-related quality of life. Single-arm longitudinal study. Inpatient PR center. Subjects with COPD (N=29; mean +/- SD age, 69.8+/-10.3y; forced expiratory volume in 1 second, 46.3%+/-22.3% predicted; 59% men [n=17]). A standardized 6-week multidisciplinary PR program (exercise training, breathing exercises, education, and psychologic support). Balance was assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and the Activities-Specific Balance Confidence (ABC) scale. Exercise tolerance was determined from the 6-minute walk test (6MWT), and health-related quality of life from the Chronic Respiratory Questionnaire (CRQ). Subjects showed small improvements in BBS (2.8+/-2.8 points; P.05). There was a weak relationship between change in BBS and change in CRQ scores (r=.40; P=.045) and no relationship with change in 6MWT. PR contributed to minor improvements in balance and had no effect on balance confidence in subjects with COPD. Further work is warranted to determine the optimal intervention for improving balance in this population.

  18. Effects of aquatic walking exercise using a walker in a chronic stroke patient.

    Science.gov (United States)

    Matsuda, Tadashi; Akezaki, Yoshiteru

    2017-07-01

    [Purpose] The aim of this study was to examine the usefulness of aquatic walking exercise using a walker for chronic stroke patients. We also examined the psychological effects on the study subject and the primary caregiver before and after aquatic walking exercise. [Subject and Methods] The subject was a 60-year-old male with bilateral paralysis after a cerebrovascular accident. The Fugl-Meyer Assessment (FMA) total score was 116 on the right and 115 on the left. The intervention combined aquatic and land walking exercise. A U-shaped walker was used for both water and land exercise. Continuous walking distance was the measure used to evaluate land walking ability. The psychological effects on the study subject and the primary caregiver were examined with the questionnaire. [Results] In aquatic walking, the mean time to walk 5 m showed an increase from the intervention after two months. After the aquatic walking and land walking combination, continuous walking distance also showed a prolonged trend. In the survey given to the main caregivers, improvements were observed. [Conclusion] Aquatic walking practice using a walker improved motivation in a chronic stroke patient, leading to improved walking ability, with a positive psychological influence on the participant and family caregiver.

  19. Effects of unstable shoes on chronic low back pain in health professionals: a randomized controlled trial.

    Science.gov (United States)

    Armand, Stéphane; Tavcar, Ziva; Turcot, Katia; Allet, Lara; Hoffmeyer, Pierre; Genevay, Stéphane

    2014-12-01

    The aim of this study was to evaluate the effectiveness of unstable shoes in reducing low back pain in health professionals. Of a volunteer sample of 144 participants, 40 with nonspecific chronic low back pain were eligible and enrolled in this study. Participants were randomized to an intervention group, who wore unstable shoes (model MBT Fora), or a control group, who wore conventional sports shoes (model Adidas Bigroar). The participants had to wear the study shoes during their work hours, and at least 6 hours per workday, over a period of 6 weeks. The primary outcome was low back pain assessed on a Visual Analog Scale. The secondary outcomes were patient satisfaction, disability evaluated using Roland-Morris questionnaire and quality of life evaluated using EQ-VAS. The intervention group showed a significant decrease in pain scores compared to the control group. The rate of satisfaction was higher in the intervention group (79%) compared to the control group (25%). There was no significant difference for the Roland-Morris disability questionnaire score and the EQ-VAS scale. The results of this clinical trial suggest that wearing unstable shoes for 6 weeks significantly decreases low back pain in patients suffering from chronic low back pain but had no significant effect on quality of life and disability scores. Copyright © 2014 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  20. Application of the chronic constriction injury of the partial sciatic nerve model to assess acupuncture analgesia

    Directory of Open Access Journals (Sweden)

    Zhi MJ

    2017-09-01

    Full Text Available Mu-Jun Zhi,1,2,* Kun Liu,1,* Zhou-Li Zheng,1,3 Xun He,1 Tie Li,2 Guang Sun,1,2 Meng Zhang,4 Fu-Chun Wang,2 Xin-Yan Gao,1 Bing Zhu1 1Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 2College of Acupuncture and Moxibustion, Changchun University of Chinese Medicine, Changchun, People’s Republic of China; 3College of Acupuncture and Moxibution, Shaanxi University of Chinese Medicine, People’s Republic of China; 4Department of Chinese Medicine, Dongli Hospital of Traditional Chinese Medicine, Tianjin, People’s Republic of China *These authors contributed equally to this work Purpose: To validate and explore the application of a rat model of chronic constriction injury to the partial sciatic nerve in investigation of acupuncture analgesia.Methods: Chronic constriction injury of the sciatic nerve (CCI and chronic constriction injury of the partial sciatic nerve (CCIp models were generated by ligating either the sciatic nerve trunk or its branches in rats. Both models were evaluated via paw mechanical withdrawal latency (PMWL, paw mechanical withdrawal threshold (PMWT, nociceptive reflex-induced electromyogram (C-fiber reflex EMG, and dorsal root ganglion immunohistochemistry. Electroacupuncture (EA was performed at GB30 to study the analgesic effects on neuropathic pain and the underlying mechanisms.Results: Following ligation of the common peroneal and tibial nerves, CCIp rats exhibited hindlimb dysfunction, hind paw shrinkage and lameness, mirroring those of CCI rats (generated by ligating the sciatic nerve trunk. Compared to presurgery measurements, CCIp and CCI modeling significantly decreased the PMWL and PMWT. EA at GB30 increased the PMWL and PMWT in both CCI and CCIp rats. Calcitonin gene-related polypeptide and substance P expressions were apparently increased in both CCI and CCIp groups, but were not different from each other. The C

  1. Tl-201 per rectum scintigraphy in chronic liver disease: assessment of Tl-201 uptake indices

    International Nuclear Information System (INIS)

    Moon, Won Jin; Choi, Yun Young; Cho, Suk Shin; Lee, Min Ho

    1999-01-01

    Heart to liver ratio on Tl-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent Tl-201 per rectum scintigraphy after instillation of 18.5 MBq of Tl-201 into the upper rectum. We evaluated hepatic uptake (type 1: homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 mim) and shunt index (heart to liver uptake ratio). Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 was correlated with the pathologic diagnosis and shunt index. Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC: 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH (0.110±0.111) was significantly higher than that of LC (0.014±0.090)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on Tl-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease

  2. Chronic effects of ionizing radiation on animals and humans

    Directory of Open Access Journals (Sweden)

    I. P. Drozd

    2013-03-01

    Full Text Available Numerous experimental radiobiological studies and medical observations were conducted after the Chernobyl disaster based on the published results; patterns and characteristics influence of the fission products of nuclear materials on the body of mammals, including humans were analyzed. Chronic exposure to low doses leads to the changes in the hemopoietic system was founded and increases the risk of myeloproliferative diseases. The con-sequence of radiation-related immunodeficiency is the autoimmune disease and chronic fatigue syndrome. Radi-ation damage leads to endocrine system disruption of the body and of polipatologycal states. High radiosensitivi-ty of the central nervous system was founded. Genotoxic chronic radiation exposure threatens the stability of the genome.

  3. Effect of ancestry on interleukin-10 haplotypes in chronic periodontitis.

    Science.gov (United States)

    Lopes, Camile de Barros; Barroso, Regina Fatima Feio; Burbano, Rommel Mario Rodrigues; Garcia, Patricia Aleixo; Pinto, Pablo Diego do Carmo; Santos, Ney Pereira Carneiro Dos; Santos, Sidney Emanuel Batista; Ribeiro-Dos-Santos, Andrea Kely Campos

    2017-06-01

    Chronic periodontitis is caused by an inflammatory reaction of the periodontal tissues and alveolar bone. This inflammation is caused by periodontopathic bacteria located in the subgingival biofilm, resulting in inflammatory reactions that may lead to loss of attachment. This tissue destruction is a consequence of host immune and inflammatory responses to specific periodontal pathogens and their metabolic products. Cytokines modulate the immune response, altering its efficiency in the competition against pathogens and increasing periodontal susceptibility. This study investigated genetic polymorphisms in Interleukin 10 (A-1082G, C-819T and C-592A) in 205 individuals from an admixed Brazilian population. A significantly increased risk of developing chronic periodontitis was observed in individuals with low IL-10 production and Amerindian ancestry. These results suggest that the polymorphisms A-1082G, C-819T, and C-592A, which are associated with ancestry, are involved in the susceptibility to the development of chronic periodontitis in an admixed northern Brazilian population.

  4. Ameliorative effect of ethyl pyruvate in neuropathic pain induced by chronic constriction injury of sciatic nerve

    Directory of Open Access Journals (Sweden)

    Varsha J. Bansode

    2014-01-01

    Full Text Available Objective: The present study was designed to investigate the ameliorative effects of ethyl pyruvate (EP in chronic constriction injury (CCI-induced painful neuropathy in rats. Materials and Methods: EP 50 and 100 mg/kg was administered for 21 consecutive days starting from the day of surgery. The effects of EP in the paw pressure, acetone drop, and tail heat immersion tests were assessed, reflecting the degree of mechanical hyperalgesia, cold allodynia, and spinal thermal sensation, respectively. Axonal degeneration of the sciatic nerve was assessed histopathologically. The levels of thiobarbituric acid reactive species, reduced glutathione (GSH, catalase (CAT, and superoxide dismutase (SOD were determined to assess oxidative stress. Key Findings: Administration of 50 and 100 mg/kg EP attenuated the reduction of nociceptive threshold in the paw pressure, acetone drop, and tail heat immersion tests. EP 100 mg/kg significantly attenuated reactive changes in histopathology and increase in oxidative stress. Conclusion: EP 100 mg/kg showed beneficial activity against nerve trauma-induced neuropathy. Hence, it can be used as a better treatment option in neuropathic pain (NP. The observed antinociceptive effects of EP may possibly be attributed to its antioxidant and anti-inflammatory activity.

  5. Effectiveness of active self-care complementary and integrative medicine therapies: options for the management of chronic pain symptoms.

    Science.gov (United States)

    Crawford, Cindy; Lee, Courtney; Freilich, Daniel

    2014-04-01

    Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures that are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management. Active self-care CIM (ACT-CIM) therapies allow for a more diverse, patient-centered treatment of complex symptoms, promote self-management, and are relatively safe and cost-effective. To date, there are no systematic reviews examining the full range of ACT-CIM used for chronic pain symptom management. A systematic review was conducted, using Samueli Institute's Rapid Evidence Assessment of the Literature methodology, to rigorously assess both the quality of the research on ACT-CIM modalities and the evidence for their efficacy and effectiveness in treating chronic pain symptoms. A working group of subject matter experts was also convened to evaluate the overall literature pool and develop recommendations for the use and implementation of these modalities. Following key database searches, 146 randomized controlled trials were included in the review, 18 of which directly compared ACT-CIM approaches with one another. This article summarizes the current evidence, quality, effectiveness, and safety of these modalities. Recommendations and next steps to move this field of research forward are also discussed. The entire scope of the review is detailed throughout the current Pain Medicine supplement. Wiley Periodicals, Inc.

  6. Encouraging couples to change: a motivational assessment to promote well-being in people with chronic pain and their partners.

    Science.gov (United States)

    Miller-Matero, Lisa Renee; Cano, Annmarie

    2015-02-01

    Motivating people with chronic pain to engage in therapy can be difficult, especially when individuals have not experienced adequate pain management. Therefore, it may be useful for clinicians to use a motivational assessment as a part of treatment to help patients achieve immediate benefits. Additionally, because the social context impacts chronic illness, the significant other should be included in the assessment. This article describes a motivational assessment that was developed for people with chronic pain and their partners. The motivational assessment begins with gathering information from questionnaires that each partner completes, conducting a semi-structured interview about the couples' relationship and pain history, and observing the couples converse about pain coping. Next, tailored feedback is provided to each couple regarding their strengths and weaknesses with suggestions for how to improve their relationship and pain coping skills. This tailored feedback engages the couple in this conversation by adhering to the principles of motivational interviewing. A case example of a couple who completed this motivational assessment is described. This assessment resulted in immediate improvements in marital satisfaction, pain severity, and mood for the couple. This article provides a guide to clinicians for using a motivational assessment to help patients with a chronic illness achieve immediate benefits. Wiley Periodicals, Inc.

  7. Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease (COPD) Using an Ontario Policy Model

    Science.gov (United States)

    Chandra, K; Blackhouse, G; McCurdy, BR; Bornstein, M; Campbell, K; Costa, V; Franek, J; Kaulback, K; Levin, L; Sehatzadeh, S; Sikich, N; Thabane, M; Goeree, R

    2012-01-01

    Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive

  8. Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain.

    Science.gov (United States)

    Diwan, Sudhir; Manchikanti, Laxmaiah; Benyamin, Ramsin M; Bryce, David A; Geffert, Stephanie; Hameed, Haroon; Sharma, Manohar Lal; Abdi, Salahadin; Falco, Frank J E

    2012-01-01

    Chronic persistent neck pain with or without upper extremity pain is common in the general adult population with prevalence of 48% for women and 38% for men, with persistent complaints in 22% of women and 16% of men. Multiple modalities of treatments are exploding in managing chronic neck pain along with increasing prevalence. However, there is a paucity of evidence for all modalities of treatments in managing chronic neck pain. Cervical epidural injections for managing chronic neck pain are one of the commonly performed interventions in the United States. However, the literature supporting cervical epidural steroids in managing chronic pain problems has been scant. A systematic review of cervical interlaminar epidural injections for cervical disc herniation, cervical axial discogenic pain, cervical central stenosis, and cervical postsurgery syndrome. To evaluate the effect of cervical interlaminar epidural injections in managing various types of chronic neck and upper extremity pain emanating as a result of cervical spine pathology. The available literature on cervical interlaminar epidural injections in managing chronic neck and upper extremity pain were reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status

  9. QRS slopes for assessment of myocardial damage in chronic chagasic patients

    International Nuclear Information System (INIS)

    Pueyo, E; Laciar, E; Anzuola, E; Laguna, P; Jane, R

    2007-01-01

    In this study the slopes of the QRS complex are evaluated for determination of the degree of myocardial damage in chronic chagasic patients. Previous studies have demonstrated the ability of the slope indices to reflect alterations in the conduction velocity of the cardiac impulse. Results obtained in the present study show that chronic chagasic patients have significantly flatter QRS slopes as compared to healthy subjects. Not only that but the extent of slope lessening turns out to be proportional to the degree of myocardial damage caused by the disease. Additionally, when incorporating the slope indices into a classification analysis together with other indices indicative of the presence of ventricular late potentials obtained from high resolution electrocardiography, results show that the percentages of correct classification increase up to 62.5%, which means eight points above the percentages obtained prior to incorporation of the slope indices. It can be concluded that QRS slopes have great potential for assessing the degree of severity associated with Chagas' disease

  10. A preliminary spatial assessment of risk: Marine birds and chronic oil pollution on Canada's Pacific coast.

    Science.gov (United States)

    Fox, C H; O'Hara, P D; Bertazzon, S; Morgan, K; Underwood, F E; Paquet, P C

    2016-12-15

    Chronic oil pollution poses substantial risks to marine birds and other marine wildlife worldwide. On Canada's Pacific coast, the negative ecological consequences to marine birds and marine ecosystems in general remain poorly understood. Using information relating to oil spill probability of occurrence, areas of overall importance to marine birds, and the at-sea distribution and density of 12 marine bird species and seven bird groups, including multiple Species at Risk, we undertook a spatial assessment of risk. Our results identify two main areas important to marine birds potentially at higher risk of exposure to oil. For individual bird species or species groups, those predicted to have elevated bird densities near the mainland and the northeast coast of Vancouver Island were identified as being at higher potential risk of exposure. Our results, however, should be considered preliminary. As with other anthropogenic stressors, in order to better understand and subsequently mitigate the consequences of chronic oil pollution on marine birds, improved information relating to marine birds and the occurrence of oil spills on Canada's Pacific coast is needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. The effectiveness of acupuncture for chronic pain with depression: A systematic review protocol.

    Science.gov (United States)

    Yang, Ziyi; Zhao, Ling; Xie, Xianze; Xu, Tao; Zhang, Yutong; Wang, Xing; Du, Jiarong; Wang, Ziwen; Zhou, Mengyuan; Li, Ying; Zhou, Siyuan

    2017-11-01

    Chronic pain is a major public health problem and 30% to 45% of sufferers experience severe depression. Acupuncture is often used to treat both depression and a range of pain disorders. We aim to conduct a systematic review of randomized controlled trials (RCTs) to evaluate the efficacy of acupuncture for patients experiencing chronic pain with depression. To identify relevant RCTs, the following databases will be searched electronically from their inception to July 1, 2017: PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, the Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, Chinese medical databases, and others. Manual retrieval will also be conducted. RCTs that evaluated acupuncture as the sole or adjunct treatment for patients with chronic pain and depression will be included. The primary outcomes will be based on a visual analog pain measurement scale and the Hamilton Depression Scale. The secondary outcomes will include scores on a numerical rating scale, verbal rating scale, and the Hospital Anxiety and Depression Scale. The study selection, data extraction, and study quality evaluation will be performed independently by 2 researchers. If the data permit, meta-analysis will be performed using RevMan V5.3 statistical software. If the data are not appropriate for meta-analysis, descriptive analysis or subgroup analysis will be conducted. The methodological quality of the included trials will be assessed using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture checklist. This study will provide a high-quality synthesis of current evidence of acupuncture for chronic pain with depression from several scales including visual analog pain measurement scale, the Hamilton Depression Scale, a numerical rating scale, verbal rating scale and the Hospital Anxiety and Depression Scale. The conclusion of our study will provide

  12. Effectiveness of biofeedback therapy in patients with chronic constipation

    Directory of Open Access Journals (Sweden)

    Univaldo Etsuo Sagae

    2012-03-01

    Full Text Available PURPOSE: The purpose of this study was to evaluate the effect of physical therapy in women diagnosed with chronic constipation using functional training of the pelvic floor (biofeedback. PATIENTS AND METHODS: From March 2009 to March 2010, 67 women with chronic constipation were prospectively evaluated. The patients were evaluated and the constipation score proposed by Agachan et al. was applied. Then, they were sent to biofeedback. These patients were divided into 2 groups: with anismus (group I: mean age of 46.90 years old and without anismus (group II: mean age of 44.89 years old and diagnosed by anorectal electromanometry. The treatment was performed with different exercises for each group, associated with some hygieno-dietetic directions. At the end of treatment, the constipation score was reapplied. RESULTS: Pre-biofeedback constipation score in group I was 15.04 (standard deviation - SD=2.48 and post-biofeedback constipation score was 3.39 (SD=1.62 (pOBJETIVO: Este trabalho objetivou avaliar o efeito do tratamento fisioterapêutico, em mulheres diagnosticadas com constipação crônica, utilizando treinamento funcional do assoalho pélvico (biofeedback. CASUÍSTICA E MÉTODO: No período de março de 2009 a março de 2010, foram avaliadas, prospectivamente, 67 mulheres com constipação intestinal. As pacientes foram avaliadas e o escore de constipação, proposto por Agachan et al., foi aplicado; então, foram encaminhadas ao biofeedback. Essas pacientes foram divididas em 2 grupos: com anismus (56 pacientes do grupo I: média de idade 46,90 anos e sem anismus (11 pacientes do grupo II: média de idade 44,89 anos, diagnosticadas pela eletromanometria anorretal. Para o tratamento, foram estipulados exercícios diferentes para cada grupo, associados com orientações higienodietéticas. Ao fim do tratamento, foi reaplicado o escore de constipação. RESULTADOS: O escore de constipação do grupo I, na avaliação pré-biofeedback, foi 15

  13. Acute and chronic effects of treatment with mesenchymal stromal cells on LPS-induced pulmonary inflammation, emphysema and atherosclerosis development.

    Directory of Open Access Journals (Sweden)

    P Padmini S J Khedoe

    Full Text Available COPD is a pulmonary disorder often accompanied by cardiovascular disease (CVD, and current treatment of this comorbidity is suboptimal. Systemic inflammation in COPD triggered by smoke and microbial exposure is suggested to link COPD and CVD. Mesenchymal stromal cells (MSC possess anti-inflammatory capacities and MSC treatment is considered an attractive treatment option for various chronic inflammatory diseases. Therefore, we investigated the immunomodulatory properties of MSC in an acute and chronic model of lipopolysaccharide (LPS-induced inflammation, emphysema and atherosclerosis development in APOE*3-Leiden (E3L mice.Hyperlipidemic E3L mice were intranasally instilled with 10 μg LPS or vehicle twice in an acute 4-day study, or twice weekly during 20 weeks Western-type diet feeding in a chronic study. Mice received 0.5x106 MSC or vehicle intravenously twice after the first LPS instillation (acute study or in week 14, 16, 18 and 20 (chronic study. Inflammatory parameters were measured in bronchoalveolar lavage (BAL and lung tissue. Emphysema, pulmonary inflammation and atherosclerosis were assessed in the chronic study.In the acute study, intranasal LPS administration induced a marked systemic IL-6 response on day 3, which was inhibited after MSC treatment. Furthermore, MSC treatment reduced LPS-induced total cell count in BAL due to reduced neutrophil numbers. In the chronic study, LPS increased emphysema but did not aggravate atherosclerosis. Emphysema and atherosclerosis development were unaffected after MSC treatment.These data show that MSC inhibit LPS-induced pulmonary and systemic inflammation in the acute study, whereas MSC treatment had no effect on inflammation, emphysema and atherosclerosis development in the chronic study.

  14. Protective effect of epigallocatechin gallate in murine water-immersion stress model of chronic fatigue syndrome.

    Science.gov (United States)

    Sachdeva, Anand Kamal; Kuhad, Anurag; Tiwari, Vinod; Arora, Vipin; Chopra, Kanwaljit

    2010-06-01

    Chronic fatigue syndrome (CFS) is a specific clinical condition that characterizes unexplained disabling fatigue. In the present study, chronic fatigue was produced in mice by subjecting them to forced swim inside a rectangular jar of specific dimensions for 6 min. daily for 15 days. Epigallocatechin gallate (EGCG; 25, 50 and 100 mg/kg, p.o.) was administered daily 30 min. before forced swim session. Immobility period and post-swim fatigue was assessed on alternate days. On the 16th day, after assessment of various behavioural parameters, mice were killed to harvest the brain, spleen and thymus. There was significant increase in oxidative-nitrosative stress and tumour necrosis factor-alpha levels in the brain of mice subjected to water-immersion stress as compared with naive group. These behavioural and biochemical alterations were restored after chronic treatment with EGCG. The present study points out that EGCG could be of therapeutic potential in the treatment of chronic fatigue.

  15. Lymphocytosis after treatment with dasatinib in chronic myeloid leukemia: Effects on response and toxicity.

    Science.gov (United States)

    Schiffer, Charles A; Cortes, Jorge E; Hochhaus, Andreas; Saglio, Giuseppe; le Coutre, Philipp; Porkka, Kimmo; Mustjoki, Satu; Mohamed, Hesham; Shah, Neil P

    2016-05-01

    The proliferation of clonal cytotoxic T-cells or natural killer cells has been observed after dasatinib treatment in small studies of patients with chronic myeloid leukemia (CML). The incidence of lymphocytosis and its association with response, survival, and side effects were assessed in patients from 3 large clinical trials. Overall, 1402 dasatinib-treated patients with newly diagnosed CML in chronic phase (CML-CP), CML-CP refractory/intolerant to imatinib, or with CML in accelerated or myeloid-blast phase were analyzed. Lymphocytosis developed in 32% to 35% of patients and persisted for >12 months. This was not observed in the patients who received treatment with imatinib. Dasatinib-treated patients in all stages of CML who developed lymphocytosis were more likely to achieve a complete cytogenetic response, and patients who had CML-CP with lymphocytosis were more likely to achieve major and deep molecular responses. Progression-free and overall survival rates were significantly longer in patients with CML-CP who were refractory to or intolerant of imatinib and had lymphocytosis. Pleural effusions developed more commonly in patients with lymphocytosis. Overall, lymphocytosis occurred and persisted in many dasatinib-treated patients in all phases of CML. Its presence was associated with higher response rates, significantly longer response durations, and increased overall survival, suggesting an immunomodulatory effect. Prospective studies are warranted to characterize the functional activity of these cells and to assess whether an immunologic effect against CML is detectable. Cancer 2016;122:1398-1407. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  16. Improving cumulative effects assessment in Alberta: Regional strategic assessment

    International Nuclear Information System (INIS)

    Johnson, Dallas; Lalonde, Kim; McEachern, Menzie; Kenney, John; Mendoza, Gustavo; Buffin, Andrew; Rich, Kate

    2011-01-01

    The Government of Alberta, Canada is developing a regulatory framework to better manage cumulative environmental effects from development in the province. A key component of this effort is regional planning, which will lay the primary foundation for cumulative effects management into the future. Alberta Environment has considered the information needs of regional planning and has concluded that Regional Strategic Assessment may offer significant advantages if integrated into the planning process, including the overall improvement of cumulative environmental effects assessment in the province.

  17. Noninvasive radiographic assessment of cardiovascular function in acute and chronic respiratory failure

    International Nuclear Information System (INIS)

    Berger, H.J.; Matthay, R.A.

    1981-01-01

    Noninvasive radiographic techniques have provided a means of studying the natural history and pathogenesis of cardiovascular performance in acute and chronic respiratory failure. Chest radiography, radionuclide angiocardiography and thallium-201 imaging, and M mode and cross-sectional echocardiography have been employed. Each of these techniques has specific uses, attributes and limitations. For example, measurement of descending pulmonary arterial diameters on the plain chest radiograph allows determination of the presence or absence of pulmonary arterial hypertension. Right and left ventricular performance can be evaluated at rest and during exercise using radionuclide angiocardiography. The biventricular response to exercise and to therapeutic interventions also can be assessed with this approach. Evaluation of the pulmonary valve echogram and echocardiographic right ventricular dimensions have been shown to reflect right ventricular hemodynamics and size. Each of these noninvasive techniques has been applied to the study of patients with respiratory failure and has provided important physiologic data

  18. Assessment of adenosine deaminase (ADA) activity and oxidative stress in patients with chronic tonsillitis.

    Science.gov (United States)

    Garca, Mehmet Fatih; Demir, Halit; Turan, Mahfuz; Bozan, Nazım; Kozan, Ahmet; Belli, Şeyda Bayel; Arslan, Ayşe; Cankaya, Hakan

    2014-06-01

    To emphasize the effectiveness of adenosine deaminase (ADA) enzyme, which has important roles in the differentiation of lymphoid cells, and oxidative stress in patients with chronic tonsillitis. Serum and tissue samples were obtained from 25 patients who underwent tonsillectomy due to recurrent episodes of acute tonsillitis. In the control group, which also had 25 subjects, only serum samples were taken as obtaining tissue samples would not have been ethically appropriate. ADA enzyme activity, catalase (CAT), carbonic anhydrase (CA), nitric oxide (NO) and malondialdehyde (MDA) were measured in the serum and tissue samples of patients and control group subjects. The serum values of both groups were compared. In addition, the tissue and serum values of patients were compared. Serum ADA activity and the oxidant enzymes MDA and NO values of the patient group were significantly higher than those of the control group (p ADA activity (p > 0.05). Elevated ADA activity may be effective in the pathogenesis of chronic tonsillitis both by impairing tissue structure and contributing to SOR formation.

  19. Effect of chronic kidney disease on serum resistin level | Dan ...

    African Journals Online (AJOL)

    ... between two groups was statistically significant. Conclusion: Our study is probably the first study in India comparing serum resistin levels of CKD patients vis-à-vis control subjects. Further cellular research may be needed to explore this relation. Key words: Chronic kidney disease, HOMA-IR, insulin resistance, resistin ...

  20. effect of chronic administration of indomethacin on haematological

    African Journals Online (AJOL)

    Dr Olaleye

    Department of Veterinary Physiology and Pharmacology, University of Ibadan. Ibadan, Nigeria. Chronic treatment with ... been used widely as a rodenticide in the local community and the drug is potent in causing death ... 0.05) when compared with the untreated control (Group. C). On the other hand the total leucocyte count ...

  1. The effect of chronic periodontitis on serum levels of matrix ...

    African Journals Online (AJOL)

    A complex network of chemokines and pro- and anti-inflammatory mediators is involved in the initiation and progression of chronic periodontitis. Matrix metalloproteinases (MMPs), the main enzymes responsible for matrix degradation, are important for periodontal tissue destruction, but their activity can be inhibited by tissue ...

  2. Chronic effects of clofibric acid in zebrafish (Danio rerio): A multigenerational study

    Energy Technology Data Exchange (ETDEWEB)

    Coimbra, Ana M., E-mail: acoimbra@utad.pt [Centre for The Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real (Portugal); Department of Biology and Environment, Life Sciences and Environment School (ECVA), University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real (Portugal); Peixoto, Maria João [CIMAR/CIIMAR, Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Rua dos Bragas 177, 4050-123 Porto (Portugal); Department of Biology and Environment, Life Sciences and Environment School (ECVA), University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real (Portugal); Coelho, Inês; Lacerda, Ricardo [CIMAR/CIIMAR, Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Rua dos Bragas 177, 4050-123 Porto (Portugal); Carvalho, António Paulo [CIMAR/CIIMAR, Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Rua dos Bragas 177, 4050-123 Porto (Portugal); FCUP, Faculty of Sciences University of Porto, Department of Biology, Rua do Campo Alegre, 4169-007 Porto (Portugal); Gesto, Manuel [CIMAR/CIIMAR, Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Rua dos Bragas 177, 4050-123 Porto (Portugal); Department of Functional Biology and Health Sciences, Faculty of Biology, University of Vigo, As Lagoas-Marcosende s/n, 36310, Vigo (Spain); Lyssimachou, Angeliki; Lima, Daniela; Soares, Joana; André, Ana; Capitão, Ana [CIMAR/CIIMAR, Interdisciplinary Centre for Marine and Environmental Research, University of Porto, Rua dos Bragas 177, 4050-123 Porto (Portugal); and others

    2015-03-15

    Highlights: • Clofibric acid (CA) induces multigenerational effects in zebrafish (Danio rerio). • CA impacts fish lipid metabolism, with similarities to those reported in mammals. • Weight is impacted in F1 and F2 generations, thought with opposite patterns. - Abstract: Clofibric acid (CA) is an active metabolite of the blood lipid lowering agent clofibrate, a pharmaceutical designed to work as agonist of peroxisome proliferator-activated receptor alpha (PPARa). It is the most commonly reported fibrate in aquatic environments with low degradation rate and potential environmental persistence. Previous fish exposures showed that CA may impact spermatogenesis, growth and the expression of fat binding protein genes. However, there are limited data on the effects of chronic multigenerational CA exposures. Here, we assessed chronic multigenerational effects of CA exposure using zebrafish (Danio rerio) as a teleost model. Zebrafish were exposed through the diet to CA (1 and 10 mg/g) during their whole lifetime. Growth, reproduction-related parameters and embryonic development were assessed in the exposed fish (F1 generation) and their offspring (F2 generation), together with muscle triglyceride content and gonad histology. In order to study the potential underlying mechanisms, the transcription levels of genes coding for enzymes involved in lipid metabolism pathways were determined. The results show that chronic life-cycle exposure to CA induced a significant reduction in growth of F1 generation and lowered triglyceride muscle content (10 mg/g group). Also, an impact in male gonad development was observed together with a decrease in the fecundity (10 mg/g group) and higher frequency of embryo abnormalities in the offspring of fish exposed to the lowest CA dose. The profile of the target genes was sex- and tissue-dependent. In F1 an up-regulation of male hepatic pparaa, pparb and acox transcript levels was observed, suggesting an activation of the fatty acid

  3. Chronic effects of clofibric acid in zebrafish (Danio rerio): A multigenerational study

    International Nuclear Information System (INIS)

    Coimbra, Ana M.; Peixoto, Maria João; Coelho, Inês; Lacerda, Ricardo; Carvalho, António Paulo; Gesto, Manuel; Lyssimachou, Angeliki; Lima, Daniela; Soares, Joana; André, Ana; Capitão, Ana

    2015-01-01

    Highlights: • Clofibric acid (CA) induces multigenerational effects in zebrafish (Danio rerio). • CA impacts fish lipid metabolism, with similarities to those reported in mammals. • Weight is impacted in F1 and F2 generations, thought with opposite patterns. - Abstract: Clofibric acid (CA) is an active metabolite of the blood lipid lowering agent clofibrate, a pharmaceutical designed to work as agonist of peroxisome proliferator-activated receptor alpha (PPARa). It is the most commonly reported fibrate in aquatic environments with low degradation rate and potential environmental persistence. Previous fish exposures showed that CA may impact spermatogenesis, growth and the expression of fat binding protein genes. However, there are limited data on the effects of chronic multigenerational CA exposures. Here, we assessed chronic multigenerational effects of CA exposure using zebrafish (Danio rerio) as a teleost model. Zebrafish were exposed through the diet to CA (1 and 10 mg/g) during their whole lifetime. Growth, reproduction-related parameters and embryonic development were assessed in the exposed fish (F1 generation) and their offspring (F2 generation), together with muscle triglyceride content and gonad histology. In order to study the potential underlying mechanisms, the transcription levels of genes coding for enzymes involved in lipid metabolism pathways were determined. The results show that chronic life-cycle exposure to CA induced a significant reduction in growth of F1 generation and lowered triglyceride muscle content (10 mg/g group). Also, an impact in male gonad development was observed together with a decrease in the fecundity (10 mg/g group) and higher frequency of embryo abnormalities in the offspring of fish exposed to the lowest CA dose. The profile of the target genes was sex- and tissue-dependent. In F1 an up-regulation of male hepatic pparaa, pparb and acox transcript levels was observed, suggesting an activation of the fatty acid

  4. Assessment of renal fibrosis in chronic kidney disease using diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Zhao, J.; Wang, Z.J.; Liu, M.; Zhu, J.; Zhang, X.; Zhang, T.; Li, S.; Li, Y.

    2014-01-01

    Aim: To assess the performance of diffusion-weighted magnetic resonance imaging (MRI) for the assessment of renal fibrosis in chronic kidney disease (CKD), with histopathology as a reference standard. Materials and methods: Forty patients with CKD and 30 healthy volunteers were recruited for the study. All participants underwent diffusion-weighted MRI. Renal biopsy was performed in 25 patients with CKD. Mean renal medullary and cortical apparent diffusion coefficient (ADC) values were compared between CKD patients and the healthy volunteers. Pearson's correlation coefficient was calculated to investigate the relationship between ADC values, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), 24 h urinary protein (24h-UPRO), and renal histopathological scores. Results: Cortical and medullary ADC values in the CKD group were significantly lower compared to those in the healthy controls. In the CKD group, a significant negative correlation was found between cortical ADC values and SCr/24h-UPRO, and significant positive correlation was found between cortical ADC and eGFR. There was also a significant negative correlation between medullary ADC values and SCr. Both cortical and medullary ADC values were significantly correlated with histopathological fibrosis score. Conclusion: Renal ADC values strongly correlate with histological measures of fibrosis, and have the potential to enhance the non-invasive monitoring of chronic kidney disease. - Highlights: • Renal ADC values in the CKD patients were lower than those in controls. • Renal ADC values were strongly correlated with histological fibrosis score. • Renal ADC values have the potential to enhance the noninvasive monitoring of CKD

  5. Words that describe chronic musculoskeletal pain: implications for assessing pain quality across cultures.

    Science.gov (United States)

    Sharma, Saurab; Pathak, Anupa; Jensen, Mark P

    2016-01-01

    People from different cultures who speak different languages may experience pain differently. This possible variability has important implications for evaluating the validity of pain quality measures that are directly translated into different languages without cultural adaptations. The aim of this study was to evaluate the impact of language and culture on the validity of pain quality measures by comparing the words that individuals with chronic pain from Nepal use to describe their pain with those used by patients from the USA. A total of 101 individuals with chronic musculoskeletal pain in Nepal were asked to describe their pain. The rates of the different pain descriptor domains and phrases used by the Nepali sample were then compared to the published rates of descriptors used by patients from the USA. The content validity of commonly used measures for assessing pain quality was then evaluated. While there was some similarity between patients from Nepal and the USA in how they describe pain, there were also important differences, especially in how pain quality was described. For example, many patients from Nepal used metaphors to describe their pain. Also, the patients from Nepal often used a category of pain descriptor - which describes a physical state - not used by patients from the USA. Only the original McGill Pain Questionnaire was found to have content validity for assessing pain quality in patients from Nepal, although other existing pain quality measures could be adapted to be content valid by adding one or two additional descriptors, depending on the measure in question. The findings indicate that direct translations of measures that are developed using samples of patients from one country or culture are not necessarily content valid for use in other countries or cultures; some adaptations may be required in order for such measures to be most useful in new language and culture.

  6. Development and validation of the functional assessment of chronic illness therapy treatment satisfaction (FACIT TS) measures.

    Science.gov (United States)

    Peipert, John D; Beaumont, Jennifer L; Bode, Rita; Cella, Dave; Garcia, Sofia F; Hahn, Elizabeth A

    2014-04-01

    To develop and validate a new functional assessment of chronic illness therapy (FACIT) measure of satisfaction with treatment for chronic illnesses such as cancer and HIV/AIDS. To define domains and generate items, a literature review informed creation of semi-structured interview guides for patients and an international expert panel of clinicians and researchers. Patients and experts also rated 15 areas of satisfaction for relevance. The final list of items underwent further refinement by the original expert panel and a new group of clinical experts. Items were tested in four studies (primarily lung cancer) and data were pooled for analysis. Exploratory and confirmatory factor analyses (CFA), and item response theory modeling were conducted to evaluate dimensionality. Internal consistency reliability and test-retest reliability were both evaluated. Validity was evaluated by correlating the FACIT subscale scores and measures of comparable concepts and by testing the scales' ability to distinguish people according to their overall treatment satisfaction. Two instruments were created: the FACIT TS-general (G), an overall evaluation of current treatment, and the FACIT TS-patient satisfaction (PS), a measure of patient satisfaction. CFA results were not optimal for a five-factor solution for PS. Internal consistency reliability met psychometric standards (≥0.70) for all PS subscales. Construct validity was established for the PS subscales: Physician Communication, Treatment Staff Communication, Technical Competence, Confidence and Trust, and Nurse Communication. The two instruments generated here offer a new way to assess several key dimensions of patient satisfaction with treatment, especially for people with lung cancer.

  7. The effects of chronic alcohol consumption and exercise on the skeleton of adult male rats

    Science.gov (United States)

    Reed, Adam H.; McCarty, Heidi L.; Evans, Glenda L.; Turner, Russell T.; Westerlind, Kim C.

    2002-01-01

    BACKGROUND: Lifestyle factors are known to affect skeletal development and integrity. Specifically, running has been reported to increase risk of fatigue fractures, whereas chronic alcohol consumption has been shown to reduce bone formation and bone mass. The combined effect of exercise and alcohol on the skeleton has yet to be explored, although alcohol consumption is common among certain physically active populations (e.g., military recruits, college athletes). It was hypothesized that chronic alcohol consumption would accentuate the inherent risk associated with endurance running exercise. METHODS: Six-month-old male Sprague Dawley rats were assigned to one of five groups: baseline, exercise-alcohol diet, exercise-normal diet, sham-alcohol diet, and sham-normal diet. Alcohol-fed rats (35% caloric intake) received a liquid diet ad libitum. Normal animals were pair-fed the identical diet with a maltose dextrin caloric substitute. Exercise was conducted on a motorized treadmill 5 days/wk for 16 weeks. Sham rats were placed on a stationary treadmill for matching time periods. Fluorochrome labels were administered 3 days before baseline and at 10 and 2 days before animals were killed. Heart, soleus, and rectus femoris muscles were wet weighed to assess the effects of training. Tibiae were collected for static and dynamic histomorphometric measurements on cancellous and cortical bone. RESULTS: Muscle weights were larger in the exercised rats versus the sham rats. Alcohol had no significant effect on skeletal muscle weight but did result in larger heart weights in both alcohol-treated groups. Cancellous and periosteal bone formation rates were significantly decreased in the alcohol-fed rats versus rats on the normal diet and were associated with a significant reduction in trabecular thickness in the tibial metaphysis. Cortical and cross-sectional areas were also significantly lower in the alcohol-fed groups compared with the non-alcohol-fed groups. Exercise had no

  8. Psychometric Properties of the Psychosocial Assessment Tool-Chronic Pain Version in Families of Children With Headache.

    Science.gov (United States)

    Woods, Kristine; Ostrowski-Delahanty, Sarah

    2017-07-01

    Children with headache disorders are at increased psychosocial risk, and no validated screening measures exist to succinctly assess for risk. This study examined the psychometric properties of the Psychosocial Assessment Tool-Chronic Pain, a previously adapted screening measure of risk, in a retrospective sample of families of children diagnosed with headaches. Participants included 127 children and caregivers presenting for behavioral health evaluation of headache. Children and their primary caregivers completed several psychosocial assessment measures. Internal consistency for the Psychosocial Assessment Tool-Chronic Pain total score was high (α = 0.80), and all subscale scores had moderate to high internal consistency (α = 0.597-0.88), with the exception of the caregiver beliefs subscale (α = 0.443). The total score and the majority of subscale scores on the Psychosocial Assessment Tool-Chronic Pain were correlated with caregiver- and child-reported scores on study measures. The results demonstrate that the Psychosocial Assessment Tool-Chronic Pain has adequate psychometric properties, and because of the brief administration time, ease of scoring, and accessibility of the measure, it is a promising measure of screening for psychosocial risk in this population.

  9. [Patient reported outcome of tyrosine kinase inhibitor related side effects and their impact on daily life in Chinese patients with chronic myeloid leukemia in the chronic phase].

    Science.gov (United States)

    Yu, L; Wang, H B; Jiang, Q

    2016-11-14

    Objective: To explore the impact of patient reported outcome of tyrosine kinase inhibitor (TKI) related side effects on daily life in Chinese patients with chronic myeloid leukemia (CML) in the chronic phase (CP). Methods: From May to November in 2014, anonymous questionnaires were distributed to adult CML patients who were receiving TKI treatment in China. The impact of TKI-related side effects on daily life were assessed by the score of 1 (no impact) to 5 (high impact) from patient self-report. Results: Data from 731 respondents in the CP who reported the score of the impact of TKI-related side effects on daily life were collected. 407 (56%) were male. The median age was 41 years (range, 18 to 88 years). 560 (77%) started TKI treatment within 1 year after diagnosis. With a median treatment duration of 3 years (range, effects were edema ( n =323, 44% ), fatigue ( n =277, 38% ), gastrointestinal disorders ( n =235, 32% ), skin color changes ( n =142, 19% ), muscle cramps ( n =137, 19% ), rash ( n =105, 14% ), hepatic function abnormalities ( n =91, 12%), weight gain ( n =86, 12%), and cytopenia ( n =59, 8%). Multivariate analyses showed that TKI treatment duration effects on daily life in 218 (30%)respondents (1 score). 375 (51%)respondents reported their daily life were slightly or moderately decreased (2 or 3 score), while 138 (19%) significantly decreased (4 or 5 score). Multivariate analyses showed that female, ≥40 years old, use of generic TKI, TKI treatment duration negative effect on their daily life. When taking TKI related side-effects into considderation, secondary school and below, use of generic TKI, TKI treatment duration negative effect on their daily life. Conclusion: Edema, fatigue, gastrointestinal disorders, rash, skin color changes and hepatic function abnormalities were common TKI-related side effects and influenced CML patients' daily life in China. In addition, female, older age, lower education level, use of generic TKI and shorter TKI

  10. Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    McCormack, Meredith C; Belli, Andrew J; Waugh, Darryn; Matsui, Elizabeth C; Peng, Roger D; Williams, D'Ann L; Paulin, Laura; Saha, Anik; Aloe, Charles M; Diette, Gregory B; Breysse, Patrick N; Hansel, Nadia N

    2016-12-01

    There is limited evidence of the effect of exposure to heat on chronic obstructive pulmonary disease (COPD) morbidity, and the interactive effect between indoor heat and air pollution has not been established. To determine the effect of indoor and outdoor heat exposure on COPD morbidity and to determine whether air pollution concentrations modify the effect of temperature. Sixty-nine participants with COPD were enrolled in a longitudinal cohort study, and data from the 601 participant days that occurred during the warm weather season were included in the analysis. Participants completed home environmental monitoring with measurement of temperature, relative humidity, and indoor air pollutants and simultaneous daily assessment of respiratory health with questionnaires and portable spirometry. Participants had moderate to severe COPD and spent the majority of their time indoors. Increases in maximal indoor temperature were associated with worsening of daily Breathlessness, Cough, and Sputum Scale scores and increases in rescue inhaler use. The effect was detected on the same day and lags of 1 and 2 days. The detrimental effect of temperature on these outcomes increased with higher concentrations of indoor fine particulate matter and nitrogen dioxide (P pollution concentrations. For patients with COPD who spend the majority of their time indoors, indoor heat exposure during the warmer months represents a modifiable environmental exposure that may contribute to respiratory morbidity. In the context of climate change, adaptive strategies that include optimization of indoor environmental conditions are needed to protect this high-risk group from the adverse health effects of heat.

  11. Acute stress does not affect the impairing effect of chronic stress on memory retrieval

    Science.gov (United States)

    Ozbaki, Jamile; Goudarzi, Iran; Salmani, Mahmoud Elahdadi; Rashidy-Pour, Ali

    2016-01-01

    Objective(s): Due to the prevalence and pervasiveness of stress in modern life and exposure to both chronic and acute stresses, it is not clear whether prior exposure to chronic stress can influence the impairing effects of acute stress on memory retrieval. This issue was tested in this study. Materials and Methods: Adult male Wistar rats were randomly assigned to the following groups: control, acute, chronic, and chronic + acute stress groups. The rats were trained with six trials per day for 6 consecutive days in the water maze. Following training, the rats were either kept in control conditions or exposed to chronic stress in a restrainer 6 hr/day for 21 days. On day 22, a probe test was done to measure memory retention. Time spent in target and opposite areas, platform location latency, and proximity were used as indices of memory retention. To induce acute stress, 30 min before the probe test, animals received a mild footshock. Results: Stressed animals spent significantly less time in the target quadrant and more time in the opposite quadrant than control animals. Moreover, the stressed animals showed significantly increased platform location latency and proximity as compared with control animals. No significant differences were found in these measures among stress exposure groups. Finally, both chronic and acute stress significantly increased corticosterone levels. Conclusion: Our results indicate that both chronic and acute stress impair memory retrieval similarly. Additionally, the impairing effects of chronic stress on memory retrieval were not influenced by acute stress. PMID:27635201

  12. Late health effects of chronic radiation exposure of bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Yarmoshenko, Ilia V.; Malinovsky, Georgy P.; Konshina, Lidia G.; Zhukovsky, Michael V. [Institute of Industrial Ecology UB RAS, 620219, 20, Sophy Kovalevskoy St., Ekaterinburg (Russian Federation); Tuzankina, Irina A. [Institute of Immunology and Physiology UB RAS, 620049, 106, Pervomayskaya St., Ekaterinburg (Russian Federation)

    2014-07-01

    infectious etiology, which are unexpected due to low doses absorbed in those organs and tissues. To analyze the unexpected results recent findings on strong attributability of stomach, liver and cervix cancers to bacterial and viral infections was taken into account. According to IARC, stomach cancer relative risk associated with helicobacter pillory is 5.6, liver cancer relative risks associated with HBV and HCV are 23 and 17 respectively, cervix cancer relative risk associated with HPV is >100. At the same time association of lung cancer, colon cancer and some other common malignancies with infections is either not established or of low significance. To explain observed effects we suggested that excess mortality due to cancer and non-cancer diseases of infectious etiology is associated with radiation exposure of bone marrow due to Sr-90. Irradiation of hematopoietic stem cells and progenitor cells damages hematopoiesis and suppresses the immune response. Secondary immune deficiency induced by chronic radiation increases susceptibility to the bacterial and viral infections. Such late effect of radiation exposure can be considered within the concept of deterministic tissue reactions. (Under support of UB RAS project 12-P-2-1033). (authors)

  13. The effect of chronic digitalization on pump function in systolic heart failure.

    Science.gov (United States)

    Hassapoyannes, C A; Easterling, B M; Chavda, K; Chavda, K K; Movahed, M R; Welch, G W

    2001-10-01

    Short- and intermediate-term use of cardiac glycosides promotes inotropy and improves the ejection fraction in systolic heart failure. To determine whether chronic digitalization alters left ventricular function and performance. Eighty patients with mild-to-moderate systolic heart failure (baseline ejection fraction < or =45%) participated from our institution in a multi-center, chronic, randomized, double-blind study of digitalis vs. placebo. Of the 40 survivors, 38 (20 allocated to the digitalis arm and 18 to the placebo arm) were evaluated at the end of follow-up (mean, 48.4 months). Left ventricular systolic function was assessed by both nuclear ventriculography and echocardiography. The ejection fraction was measured scintigraphically, while the ventricular volumes were computed echocardiographically. The groups did not differ, at baseline or end-of-study, with respect to the ejection fraction and the loading conditions (arterial pressure, ventricular volumes and heart rate) by either intention-to-treat or actual-treatment-received analysis. Over the course of the trial, the digitalis arm exhibited no significant increase in the use of diuretics (18%, P=0.33), in distinction from the placebo group (78%, P=0.004), and a longer stay on study drug among those patients who withdrew from double-blind treatment (28.6 vs. 11.4 months, P=0.01). Following chronic use of digitalis for mild-to-moderate heart failure, cross-sectional comparison with a control group from the same inception cohort showed no appreciable difference in systolic function or performance. Thus, the suggested clinical benefit cannot be explained by an inotropic effect.

  14. Effects of coffee consumption in chronic hepatitis C: a randomized controlled trial.

    Science.gov (United States)

    Cardin, Romilda; Piciocchi, Marika; Martines, Diego; Scribano, Laura; Petracco, Marino; Farinati, Fabio

    2013-06-01

    Coffee is associated with a reduced risk of hepatocellular carcinoma in patients with chronic C hepatitis. This prospective trial was aimed at assessing the mechanisms underlying coffee-related protective effects. Forty patients with chronic hepatitis C were randomized into two groups: the first consumed 4 cups of coffee/day for 30 days, while the second remained coffee "abstinent". At day 30, the groups were switched over for a second month. At baseline, aspartate aminotransferase and alanine aminotransferase were lower in patients drinking 3-5 (Group B) than 0-2 cups/day (Group A) (56 ± 6 vs 74 ± 11/60 ± 3 vs 73 ± 7 U/L p=0.05/p=0.04, respectively). HCV-RNA levels were significantly higher in Group B [(6.2 ± 1.5) × 10(5)vs (3.9 ± 1.0) × 10(5)UI/mL, p=0.05]. During coffee intake, 8-hydroxydeoxyguanosine and collagen levels were significantly lower than during abstinence (15 ± 3 vs 44 ± 16 8-hydroxydeoxyguanosine/10(5)deoxyguanosine, p=0.05 and 56 ± 9 vs 86 ± 21 ng/mL, p=0.04). Telomere length was significantly higher in patients during coffee intake (0.68 ± 0.06 vs 0.48 ± 0.04 Arbitrary Units, p=0.006). Telomere length and 8-hydroxydeoxyguanosine were inversely correlated. In chronic hepatitis C coffee consumption induces a reduction in oxidative damage, correlated with increased telomere length and apoptosis, with lower collagen synthesis, factors that probably mediate the protection exerted by coffee with respect to disease progression. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Anti-stress effect of ethyl acetate soluble fraction of Morus alba in chronic restraint stress.

    Science.gov (United States)

    Nade, Vandana S; Yadav, Adhikrao V

    2010-09-01

    Restraint stress is a well-known method to induce chronic stress which leads to alterations in various behavioral and biochemical parameters. The present work was designed to study anti-stress effects of Morus alba in chronic restraint stress (RS)-induced perturbations in behavioral, biochemical and brain oxidative stress status. The stress was produced by restraining the animals inside an adjustable cylindrical plastic tube for 3 h once daily for ten consecutive days. The ethyl acetate soluble fraction of Morus alba (EASF) 25, 50, 100 mg/kg and diazepam (1 mg/kg) per day was administered 60 min prior to the stress procedure. The behavioral and biochemical parameters such as open field, cognitive dysfunction; leucocytes count; blood glucose and corticosteroid levels were determined. On day 10, the rats were sacrificed and biochemical assessment of superoxide dismutase (SOD), lipid peroxidation (LPO), catalase (CAT), and glutathione reductase (GSH) in whole rat brain were performed. Chronic restraint stress produced cognitive dysfunction, altered behavioral parameters, increased leucocytes count, SOD, LPO, glucose and corticosterone levels, with concomitant decrease in CAT and GSH activities. Gastric ulceration, adrenal gland and spleen weights were also used as the stress indices. All these RS induced perturbations were attenuated by EASF of Morus alba. The results of the study suggest that in addition to its classically established pharmacological activities, the plant also has immense potential as an anti-stress agent of great therapeutic relevance. This study indicates the beneficial role of Morus alba for the treatment of oxidative stress-induced disorders.

  16. Effects of limited access dressing in chronic wounds: A biochemical and histological study

    Directory of Open Access Journals (Sweden)

    Thittamaranahalli Muguregowda Honnegowda

    2015-01-01

    Full Text Available Background: Negative pressure wound therapy has emerged as an attractive treatment modality for the management and healing of chronic ulcers. Though numerous clinical studies are available, there is a lack of biochemical and histological studies evaluating the healing of chronic wounds. Materials and Methods: In the present study, a total 60 patients were divided into two groups: Limited access dressing (LAD group (n = 30 and conventional dressing group (n = 30. Various biochemical parameters such as hydroxyproline, total protein and antioxidants such as reduced glutathione (GSH, glutathione peroxidase (GPx, catalase (CAT and oxidative biomarker malondialdhyde (MDA are measured in the granulation tissue. Histologically amount of inflammatory infiltrate, angiogenesis, and collagen deposition are studied to assess wound healing. Results: Patients treated with LAD have shown significant increase in the mean (±standard deviation hydroxyproline (77.3 ± 30.1 vs. 32.3 ± 16.18; P = 0.026, total protein (13.89 ± 9.0 vs. 8.9 ± 4.59; P = 0.004, GSH (7.4 ± 1.91 vs. 5.1 ± 1.28; P = 0.039, GPx (122.3 ± 59.3 vs. 88.7 ± 34.11; P = 0.030, CAT (1.80 ± 1.14 vs. 0.9 ± 0.71; P = 0.002 and decrease in MDA (13.4 ± 5.5 vs. 8.6 ± 3.8; P = 0.004. Histological study showed comparatively fewer inflammatory cells, increased and well organised collagen bundles, and more angiogenesis in the LAD group when compared with that with conventional dressing after 10 days of treatment. Conclusion: In the present study, we have found beneficial effect of newer intermittent negative pressure therapy in combination with moist environment (LAD on chronic wound healing by increasing collagen deposition and angiogenesis; and reducing oxidative stress and inflammatory infiltrate.

  17. A Growth Curve Analysis of the Course of Dysthymic Disorder: The Effects of Chronic Stress and Moderation by Adverse Parent-Child Relationships and Family History

    Science.gov (United States)

    Dougherty, Lea R.; Klein, Daniel N.; Davila, Joanne

    2004-01-01

    Using mixed effects models, the authors examined the effects of chronic stress, adverse parent-child relationships, and family history on the 7.5-year course of dysthymic disorder. Participants included 97 outpatients with early-onset dysthymia who were assessed with semistructured interviews at baseline and 3 additional times at 30-month…

  18. Longitudinal study of the effects of chronic hypothyroidism on skeletal muscle in dogs.

    Science.gov (United States)

    Rossmeisl, John H; Duncan, Robert B; Inzana, Karen D; Panciera, David L; Shelton, G Diane

    2009-07-01

    To study the effects of experimentally induced hypothyroidism on skeletal muscle and characterize any observed myopathic abnormalities in dogs. 9 female, adult mixed-breed dogs; 6 with hypothyroidism induced with irradiation with 131 iodine and 3 untreated control dogs. Clinical examinations were performed monthly. Electromyographic examinations; measurement of plasma creatine kinase, alanine aminotransferase, aspartate aminotransferase, lactate, and lactate dehydrogenase isoenzyme activities; and skeletal muscle morphologic-morphometric examinations were performed prior to and every 6 months for 18 months after induction of hypothyroidism. Baseline, 6-month, and 18-month assessments of plasma, urine, and skeletal muscle carnitine concentrations were also performed. Hypothyroid dogs developed electromyographic and morphologic evidence of myopathy by 6 months after treatment, which persisted throughout the study, although these changes were subclinical at all times. Hypothyroid myopathy was associated with significant increases in plasma creatine kinase, aspartate aminotransferase, and lactate dehydrogenase 5 isoenzyme activities and was characterized by nemaline rod inclusions, substantial and progressive predominance of type I myofibers, decrease in mean type II fiber area, subsarcolemmal accumulations of abnormal mitochondria, and myofiber degeneration. Chronic hypothyroidism was associated with substantial depletion in skeletal muscle free carnitine. Chronic, experimentally induced hypothyroidism resulted in substantial but subclinical phenotypic myopathic changes indicative of altered muscle energy metabolism and depletion of skeletal muscle carnitine. These abnormalities may contribute to nonspecific clinical signs, such as lethargy and exercise intolerance, often reported in hypothyroid dogs.

  19. Effect of chronic alcohol ingestion on the progression of periodontitis induced in Fisher-344 rats

    Directory of Open Access Journals (Sweden)

    Éder Ricardo Biasoli

    2009-01-01

    Full Text Available Objective: Understand the effect of chronic alcohol on the progression of periodontitis induced in Fischer-344 rats.Methods: For the study, 22 Fischer-344 rats, two months old were used, divided into groups: alcohol (n=8, ligature (n=7 and control (n=7. On the first day, the animals in the alcohol group were exposed to ingestion of a water solution containing 20% alcohol (size/size, up to day 90. After thirty days from the beginning of the experiment, the animals in the alcohol group and the ligature group were submitted to the placement of a silk thread around the right maxillary second molar. Nothing was performed on the left side, serving as control. All the groups were submitted to euthanasia 60 days after ligature placement. To assess the destruction of periodontitis, a radiographic exam was used to measure the destruction of bone height. Results: The results of the study showed that on the side in which periodontitis was induced, the group that ingested alcohol suffered an increase in destruction, with statistical differences when compared with the ligature and control groups and increased bone destruction in the ligature group when compared to control. Conclusion: Within the limitations of the study, it was concluded that chronic alcohol consumption by Fischer-344 rats led to greater progression of induced periodontitis.

  20. Evaluation of protective effect of Aegle marmelos Corr. in an animal model of chronic fatigue syndrome.

    Science.gov (United States)

    Lalremruta, Vanphawng; Prasanna, Gurunath S

    2012-05-01

    To evaluate ethanolic extract of leaves of Aegle marmelos in an experimental animal model of chronic fatigue syndrome for potential therapeutic benefit. Age/weight-matched female Wistar albino rats were grouped into five groups. (Group I- V) (n = 8). Group I served as naïve control and II served as stress control. Except for group I animals, other group animals were subjected to forced swimming every day for 15 minutes to induce a state of chronic fatigue and simultaneously treated with ethanolic extract of Aegle marmelos (EEAM) 150 and 250 mg/kg b.w. and Imipramine (20 mg.kg b.w.), respectively. Duration of immobility, anxiety level and locomotor activity were assessed on day 1, 7, 14 and 21 followed by biochemical estimation of oxidative biomarkers at the end of the study. Treatment with EEAM (150 and 250 mg/kg b.w.) resulted in a statistically significant and dose dependent reduction (P immobility, reduction in anxiety and increase in locomotor activity. Dose dependent and significant reduction in LPO level and increase in CAT and SOD was observed in extract treated animals. The results are suggestive of potential protective effect of A. marmelos against experimentally induced CFS.

  1. Effects of defibrotide in patients with chronic deep insufficiency. The PROVEDIS study.

    Science.gov (United States)

    Coccheri, S; Andreozzi, G M; D'Addato, M; Gensini, G F

    2004-06-01

    In the present study the effect of defibrotide, an antithrombotic and profibrinolytic agent, was investigated in patients with chronic venous insufficiency (CVI) due to deep vein obstruction and/or reflux (chronic deep vein insufficiency, CDVI). The study was a multicenter, randomized, double blind placebo controlled trial in which only patients with CDVI confirmed by ultrasound were enrolled. All patients were treated with adequate elastic compression and randomized to receive either oral defibrotide (800 mg/die) or matching placebo for 1 year. Patients with active or previous leg ulcer were excluded. A total of 288 patients were randomized and 159 completed the study. At baseline ultrasound investigation, obstructive changes were found in 2/3 of all patients thus ascertaining a post-thrombotic syndrome (PTS). The primary endpoint, ankle circumference, was significantly reduced under defibrotide from day 120 throughout 360. Scores for pain and edema were improved. The number of episodes of superficial thrombophlebitis and deep vein thrombosis was significantly lower under defibrotide (n=2) than under placebo (n=10). The majority of these events occurred in the subset of patients with documented PTS. Treatment with defibrotide in addition to elastic compression in patients with objectively assessed CDVI, mostly due to PTS, resulted in clinical benefits and prevented thrombotic complications harmful to the limb conditions.

  2. Effects of electroacupuncture on corticotropin-releasing hormone in rats with chronic visceral hypersensitivity.

    Science.gov (United States)

    Liu, Hui-Rong; Fang, Xiao-Yi; Wu, Huan-Gan; Wu, Lu-Yi; Li, Jing; Weng, Zhi-Jun; Guo, Xin-Xin; Li, Yu-Guang

    2015-06-21

    To investigate the effect of electroacupuncture on corticotropin-releasing hormone (CRH) in the colon, spinal cord, and hypothalamus of rats with chronic visceral hypersensitivity. A rat model of chronic visceral hypersensitivity was generated according to the internationally accepted method of colorectal balloon dilatation. In the 7(th) week after the procedure, rats were randomly divided into a model group (MG), electroacupuncture group (EA), and sham electroacupuncture group (S-EA). After treatment, the abdominal withdrawal reflex (AWR) score was used to assess the behavioral response of visceral hyperalgesia. Immunohistochemistry (EnVision method), ELISA, and fluorescence quantitative PCR methods were applied to detect the expression of CRH protein and mRNA in the colon, spinal cord, and hypothalamus. The sensitivity of the rats to the colorectal distension stimulus applied at different strengths (20-80 mmHg) increased with increasing stimulus strength, resulting in increasing AWR scores in each group. Compared with NG, the AWR score of MG was significantly increased (P 0.05) compared with normal rats (NG). However, the decrease in EA compared with MG rats was statistically significant (P 0.05). Electroacupuncture at the Shangjuxu acupoint was able to significantly reduce the visceral hypersensitivity in rats, and regulated the expression of CRH protein and mRNA in the colon, spinal cord and hypothalamus at different levels, playing a therapeutic role in this model of irritable bowel syndrome.

  3. Chronic consumption of distilled sugarcane spirit induces anxiolytic-like effects in mice.

    Science.gov (United States)

    Sena, Maria Clecia P; Nunes, Fabíola C; Salvadori, Mirian G S Stiebbe; Carvalho, Cleyton Charles D; Morais, Liana Clebia S L; Braga, Valdir A

    2011-01-01

    Chronic ethanol consumption is a major public health problem throughout the world. We investigated the anxiolytic-like effects and the possible ever injury induced by the chronic consumption of ethanol or sugarcane spirit in mice. Adult mice were exposed to a two-bottle free-choice paradigm for 6 weeks. The mice in Group A (n = 16) had access to sugarcane spirit + distilled water, the mice in Group B (n = 15) had access to ethanol + distilled water, and the mice in Group C (control, n = 14) had access to distilled water + distilled water. The ethanol content in the beverages offered to Groups A and B was 2% for the first week, 5% for the second week and 10% for the remaining four weeks. At the end of the experimental period, the mice were evaluated using the elevated-plus maze and the hole-board test to assess their anxiety-related behaviors. We also determined the serum aspartate aminotransferase and alanine aminotransferase levels. In the elevated-plus maze, the time spent in the open arms was increased in the mice exposed to chronic ethanol (32 ± 8 vs. 7 ± 2 s, n = 9) or sugarcane spirit (36 ± 9 vs. 7 ± 2 s, n = 9) compared to the controls. In the hole-board test, the mice exposed to ethanol or sugarcane spirit displayed increases in their head-dipping frequency (16 ± 1 for the control group, 27 ± 2 for the ethanol group, and 31 ± 3 for the sugarcane-spirit group; n = 9 for each group). In addition, the mice exposed to sugarcane spirit displayed an increase in the aspartate aminotransferase / alanine aminotransferase ratio compared to the ethanol group (1.29 ± 0.17 for the control group and 2.67 ± 0.17 for the sugarcane spirit group; n = 8 for each group). The chronic consumption of sugarcane-spirit produces liver injury and anxiolytic-like effects and the possible liver injury in mice.

  4. Chronic consumption of distilled sugarcane spirit induces anxiolytic-like effects in mice

    Directory of Open Access Journals (Sweden)

    Maria Clecia P. Sena

    2011-01-01

    Full Text Available OBJECTIVE: Chronic ethanol consumption is a major public health problem throughout the world. We investigated the anxiolytic-like effects and the possible ever injury induced by the chronic consumption of ethanol or sugarcane spirit in mice. METHOD: Adult mice were exposed to a two-bottle free-choice paradigm for 6 weeks. The mice in Group A (n = 16 had access to sugarcane spirit + distilled water, the mice in Group B (n = 15 had access to ethanol + distilled water, and the mice in Group C (control, n = 14 had access to distilled water + distilled water. The ethanol content in the beverages offered to Groups A and B was 2% for the first week, 5% for the second week and 10% for the remaining four weeks. At the end of the experimental period, the mice were evaluated using the elevated-plus maze and the hole-board test to assess their anxiety-related behaviors. We also determined the serum aspartate aminotransferase and alanine aminotransferase levels. RESULTS: In the elevated-plus maze, the time spent in the open arms was increased in the mice exposed to chronic ethanol (32 + 8 vs. 7 + 2 s, n = 9 or sugarcane spirit (36 + 9 vs. 7 + 2 s, n = 9 compared to the controls. In the hole-board test, the mice exposed to ethanol or sugarcane spirit displayed increases in their head-dipping frequency (16 + 1 for the control group, 27 + 2 for the ethanol group, and 31 + 3 for the sugarcane-spirit group; n = 9 for each group. In addition, the mice exposed to sugarcane spirit displayed an increase in the aspartate aminotransferase / alanine aminotransferase ratio compared to the ethanol group (1.29 + 0.17 for the control group and 2.67 + 0.17 for the sugarcane spirit group; n = 8 for each group. CONCLUSION: The chronic consumption of sugarcane-spirit produces liver injury and anxiolytic-like effects and the possible liver injury in mice.

  5. chronic sleep deprevation and ventricular arrhythmias: effect of symphatic nervous system

    Directory of Open Access Journals (Sweden)

    Samira Choopani

    2016-04-01

    Full Text Available Introduction: We assessed the effect of chronic sleep deprivation on incidence of ischemia/reperfusion-induced ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation and the role of the sympathetic nervous system in this respect. Material and methods: Rats were randomly divided into four groups; 1 ischemia/reperfusion group (IR: 30 minutes ischemia followed by 60 minutes reperfusion was induced, 2 control group (CON: rats has been placed in large multiple platforms for 72h prior to ischemia and reperfusion, 3 Chronic sleep deprivation group( SD: 72h sleep deprivation was induced by using small  multiple platform prior to ischemia and reperfusion, 4 Sympathectomy group (SYM: chemical sympathectomy was done 24h before to chronic sleep deprivation and then underwent ischemia and reperfusion. The heart isolated and perfused by langendorff apparatus. After thoracotomy and aorta cannulation, the hearts perfused in the langendorff apparatus using krebs-Henseleit buffer. Hearts were allowed to recovery for 15 min. After recovery period, 15 minutes was considered as baseline prior to 30 minutes ischemia followed by 60 minutes reperfusion.Tow thin stainless stell electrodes fixed on the ventricular apex and right atrium for recording the lead II of electrocardiogram (ECG.Results: There were no significant differences between heart rates between groups, and ventricular tachycardia significantly increased in chronic sleep deprivation group As compared with IR group in ischemia period. Sympathectomy significantly reduced ventricular tachycardia incidence when compared with SD. There is no difference in incidence of ventricular tachycardia between control group and IR group. The incidence of ventricular fibrillation during early reperfusion was significantly augmented (P<0.05 in sleep deprivation group as compared with IR group and Sympathectomy significantly could reverse ventricular fibrillation incidence to IR group level as

  6. CHRONIC EFFECTS OF THE HERBICIDE DIURON ON FRESHWATER CLADOCERANS,AMPHIPODS,MIDGES,MINNOWS,WORMS, AND SNAILS

    Science.gov (United States)

    The chronic effects of the herbicide diuron on survival and reproduction of Daphnia pulex, and survival and growth of the amphipod Hyalella azteca, the midge Chironomus tentans, juvenile and embro/larval fathead minnows, Pimephales promelas, annelid worms, Lumbriculus variegatus,...

  7. Effects of chronic alcohol consumption on neuronal function in the non-human primate BNST

    Science.gov (United States)

    Alterations in hypothalamic–pituitary–adrenal axis function contribute to many of the adverse behavioral effects of chronic voluntary alcohol drinking, including alcohol dependence and mood disorders; limbic brain structures such as the bed nucleus of the stria termin...

  8. Effects on body size and composition of chronic exposure to altered gravity. [centrifuging stress in mammals

    Science.gov (United States)

    Pitts, G. C.

    1977-01-01

    The effects of chronic centrifugation on body composition and growth of rats, mice, monkeys, and man are studied. The benefits of exercise and restraint during acceleration are investigated. Physiological regulation and energy balance are also discussed.

  9. EFFECTS OF CORTICOSTEROIDS ON BRONCHODILATOR ACTION IN CHRONIC OBSTRUCTIVE LUNG-DISEASE

    NARCIS (Netherlands)

    WEMPE, JB; POSTMA, DS; BREEDERVELD, N; KORT, E; VANDERMARK, TW; KOETER, GH

    Background Short term treatment corticosteroids does not usually reduce airflow limitation and airway responsiveness in patients with chronic obstructive lung disease. We investigated whether corticosteroids modulate the effects of inhaled salbutamol and ipratropium bromide. Methods Ten non-allergic

  10. Acute and chronic effects of acidic pH on four subtropical frog species

    African Journals Online (AJOL)

    . Even protected areas such as Kruger National Park receive acid rain which may lead to possible negative effects on the park's natural amphibian populations. We conducted acute (LC50) and chronic acid tolerance bioassays on embryos ...

  11. A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

    Directory of Open Access Journals (Sweden)

    Maria B Ospina

    2013-01-01

    Full Text Available BACKGROUND: Reliable evidence detailing effective treatments and management practices for chronic noncancer pain exists. However, little is known about which knowledge translation (KT interventions lead to the uptake of this evidence in practice.

  12. Psychosocial effects of workplace physical exercise among workers with chronic pain

    Science.gov (United States)

    Andersen, Lars L.; Persson, Roger; Jakobsen, Markus D.; Sundstrup, Emil

    2017-01-01

    Abstract While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain. The trial design was a 2-armed parallel-group randomized controlled trial with allocation concealment. A total of 66 slaughterhouse workers (51 men and 15 women, mean age 45 years [standard deviation (SD) 10]) with upper limb chronic musculoskeletal pain were randomly allocated to group-based strength training (physical exercise group) or individual ergonomic training and education (reference group) for 10 weeks. Social climate was assessed with the General Nordic Questionnaire for Psychological and Social Factors at Work, and vitality and mental health were assessed with the 36-item Short Form Health Survey. All scales were converted to 0 to 100 (higher scores are better). Between-group differences from baseline to follow-up were determined using linear mixed models adjusted for workplace, age, gender, and baseline values of the outcome. Mean baseline scores of social climate, mental health, and vitality were 52.2 (SD 14.9), 79.5 (SD 13.7), and 53.9 (SD 19.7), respectively. Complete baseline and follow-up data were obtained from 30 and 31 from the physical exercise and reference groups, respectively. The between-group differences from baseline to follow-up between physical exercise and reference were 7.6 (95% CI 0.3 to 14.9), −2.3 (95% CI -10.3 to 5.8), and 10.1 (95% CI 0.6 to 19.5) for social climate, mental health, and vitality, respectively. For social climate and vitality, this corresponded to moderate effect sizes (Cohen d = 0.51 for both) in favor of physical exercise. There were no reported adverse events. In conclusion, workplace physical exercise performed together with colleagues improves social climate and vitality among workers with chronic

  13. Psychosocial effects of workplace physical exercise among workers with chronic pain: Randomized controlled trial.

    Science.gov (United States)

    Andersen, Lars L; Persson, Roger; Jakobsen, Markus D; Sundstrup, Emil

    2017-01-01

    While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain.The trial design was a 2-armed parallel-group randomized controlled trial with allocation concealment. A total of 66 slaughterhouse workers (51 men and 15 women, mean age 45 years [standard deviation (SD) 10]) with upper limb chronic musculoskeletal pain were randomly allocated to group-based strength training (physical exercise group) or individual ergonomic training and education (reference group) for 10 weeks. Social climate was assessed with the General Nordic Questionnaire for Psychological and Social Factors at Work, and vitality and mental health were assessed with the 36-item Short Form Health Survey. All scales were converted to 0 to 100 (higher scores are better). Between-group differences from baseline to follow-up were determined using linear mixed models adjusted for workplace, age, gender, and baseline values of the outcome.Mean baseline scores of social climate, mental health, and vitality were 52.2 (SD 14.9), 79.5 (SD 13.7), and 53.9 (SD 19.7), respectively. Complete baseline and follow-up data were obtained from 30 and 31 from the physical exercise and reference groups, respectively. The between-group differences from baseline to follow-up between physical exercise and reference were 7.6 (95% CI 0.3 to 14.9), -2.3 (95% CI -10.3 to 5.8), and 10.1 (95% CI 0.6 to 19.5) for social climate, mental health, and vitality, respectively. For social climate and vitality, this corresponded to moderate effect sizes (Cohen d = 0.51 for both) in favor of physical exercise. There were no reported adverse events.In conclusion, workplace physical exercise performed together with colleagues improves social climate and vitality among workers with chronic musculoskeletal

  14. Chronic effects of clofibric acid in zebrafish (Danio rerio): a multigenerational study.

    Science.gov (United States)

    Coimbra, Ana M; Peixoto, Maria João; Coelho, Inês; Lacerda, Ricardo; Carvalho, António Paulo; Gesto, Manuel; Lyssimachou, Angeliki; Lima, Daniela; Soares, Joana; André, Ana; Capitão, Ana; Castro, Luís Filipe C; Santos, Miguel M

    2015-03-01

    Clofibric acid (CA) is an active metabolite of the blood lipid lowering agent clofibrate, a pharmaceutical designed to work as agonist of peroxisome proliferator-activated receptor alpha (PPARa). It is the most commonly reported fibrate in aquatic environments with low degradation rate and potential environmental persistence. Previous fish exposures showed that CA may impact spermatogenesis, growth and the expression of fat binding protein genes. However, there are limited data on the effects of chronic multigenerational CA exposures. Here, we assessed chronic multigenerational effects of CA exposure using zebrafish (Danio rerio) as a teleost model. Zebrafish were exposed through the diet to CA (1 and 10mg/g) during their whole lifetime. Growth, reproduction-related parameters and embryonic development were assessed in the exposed fish (F1 generation) and their offspring (F2 generation), together with muscle triglyceride content and gonad histology. In order to study the potential underlying mechanisms, the transcription levels of genes coding for enzymes involved in lipid metabolism pathways were determined. The results show that chronic life-cycle exposure to CA induced a significant reduction in growth of F1 generation and lowered triglyceride muscle content (10mg/g group). Also, an impact in male gonad development was observed together with a decrease in the fecundity (10mg/g group) and higher frequency of embryo abnormalities in the offspring of fish exposed to the lowest CA dose. The profile of the target genes was sex- and tissue-dependent. In F1 an up-regulation of male hepatic pparaa, pparb and acox transcript levels was observed, suggesting an activation of the fatty acid metabolism (provided that transcript level change indicates also a protein level change). Interestingly, the F2 generation, raised with control diet, displayed a response pattern different from that observed in F1, showing an increase in weight in the descendants of CA exposed fish, in

  15. [The impact of Glivec related side effects on daily life in Chinese patients with chronic myeloid leukemia in the chronic phase].

    Science.gov (United States)

    Yu, L; Wang, H B; Huang, X J; Jiang, Q

    2016-07-01

    To explore the impact of Glivec related side effects on daily life in Chinese patients with chronic myeloid leukemia (CML) in the chronic phase (CP). From May to November in 2014, anonymous questionnaires were distributed to adult CML patients who were receiving tyrosine kinase inhibitors (TKI) treatment in China. The impact of TKI related side effects on daily life were assessed by the score of 1 (no impact) to 5 (high impact) from patient self- report. Data from 548 respondents in the CP on Glivec were collected. 303(55%) cases were male with the median age of 40 years (range, 18 to 88 years). 437 (80% ) cases started Glivec treatment within one year after diagnosis with a median treatment duration of 3 years (range, effects were edema (n=278, 51% ), fatigue (n=218, 40% ), gastrointestinal disorders (n=190, 35%), muscle cramps (n=118, 22%), skin color changes (n=118, 22%), weight gain (n=71, 13%), rash (n=60, 11%), hepatic function abnormality (n=55, 10%), and cytopenia (n=38, 7%). Among the 548 respondents, the mean score of Glivec-related side effects on daily life was 2.4±1.2. There was no negative impact of Glivec related side effects on daily life in 161(29%) respondents. 295 (54% ) and 92 (17% ) respondents reported slightly or moderately (2- 3 score) and significantly decreased (4-5 score) daily life, respectively. Multivariate analysis showed that Glivec treatment duration effects including fatigue (OR=2.9, 95% CI 2.1-4.1;Pnegative effect on daily life. Daily life was impaired seriously in a minority of Chinese CML patients who received Glivec, especially in the first 4 years of treatment. Fatigue, edema, gastrointestinal disorders, rash and hepatic function abnormality were side effects associated with negative impact on patients' daily life.

  16. The Importance of Assessing Nutritional Status to Ensure Optimal Recovery during the Chronic Phase of Stroke

    Directory of Open Access Journals (Sweden)

    Monica C. Serra

    2018-01-01

    Full Text Available Background. Despite evidence that many of the consequences of stroke that hinder recovery (i.e., obesity, muscle atrophy, and functional declines have nutritionally modifiable behavior components, little attention has been focused on the significance of nutrition beyond the acute phase of stroke. Objective. This literature review summarizes the evidence for and against the influence of nutrition on optimal recovery and rehabilitation in chronic (>6 months stroke. Results. The literature, which is mainly limited to cross-sectional studies, suggests that a suboptimal nutritional status, including an excess caloric intake, reduced protein intake, and micronutrient deficiencies, particularly the B-vitamins, vitamin D, and omega 3 fatty acids, may have deleterious effects on metabolic, physical, and psychological functioning in chronic stroke survivors. Conclusions. Careful evaluation of dietary intake, especially among those with eating disabilities and preexisting malnutrition, may aid in the identification of individuals at increased nutritional risk through which early intervention may benefit recovery and rehabilitation and prevent further complications after stroke.

  17. A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

    OpenAIRE

    Ospina, Maria B; Taenzer, Paul; Rashiq, Saifee; MacDermid, Joy C; Carr, Eloise; Chojecki, Dagmara; Harstall, Christa; Henry, James L

    2013-01-01

    BACKGROUND: Reliable evidence detailing effective treatments and management practices for chronic noncancer pain exists. However, little is known about which knowledge translation (KT) interventions lead to the uptake of this evidence in practice.OBJECTIVES: To conduct a systematic review of the effectiveness of KT interventions for chronic noncancer pain management.METHODS: Comprehensive searches of electronic databases, the gray literature and manual searches of journals were undertaken. Ra...

  18. Effects of Pilates Exercise Programs in People With Chronic Low Back Pain

    OpenAIRE

    Patti, Antonino; Bianco, Antonino; Paoli, Antonio; Messina, Giuseppe; Montalto, Maria Alessandra; Bellafiore, Marianna; Battaglia, Giuseppe; Iovane, Angelo; Palma, Antonio

    2015-01-01

    Abstract The Pilates method has recently become a fast-growing popular way of exercise recommended for healthy individuals and those engaged in rehabilitation. Several published studies have examined the effects of Pilates method in people with chronic low back pain (LBP). The objective of this study is to describe and provide an extensive overview of the scientific literature comparing the effectiveness of the Pilates method on pain and disability in patients with chronic nonspecific LBP. Th...

  19. Effect of Chronic Diseases on Work Productivity: A Propensity Score Analysis.

    Science.gov (United States)

    Fouad, Ahmed Mahmoud; Waheed, Amani; Gamal, Amira; Amer, Shaimaa Ahmed; Abdellah, Rasha Farouk; Shebl, Fatma Mohamed

    2017-05-01

    The aim of this study was to evaluate the effect of chronic disease(s) on work productivity. Using the Health & Work Performance Questionnaire, information was collected from 516 workers on chronic disease status and work productivity. Propensity-score matching was performed to identify matched-pairs of workers. In the propensity-score matched sample, workers with chronic diseases were more likely to have increased absenteeism and presenteeism rates, 6.34 and 2.36 times the rates if no chronic diseases, respectively. In addition, they had greater odds for getting negative critical work incidents and less odds for positive incidents than none or balanced status. Multimorbidity showed more significant increase in absenteeism and presenteeism rates, as well as increased odds for excess negative critical work incidents. Chronic disease(s) can significantly reduce work productivity by increasing absenteeism, presenteeism, and net negative critical incidents.

  20. An ontology-based approach to patient follow-up assessment for continuous and personalized chronic disease management.

    Science.gov (United States)

    Zhang, Yi-Fan; Gou, Ling; Zhou, Tian-Shu; Lin, De-Nan; Zheng, Jing; Li, Ye; Li, Jing-Song

    2017-08-01

    Chronic diseases are complex and persistent clinical conditions that require close collaboration among patients and health care providers in the implementation of long-term and integrated care programs. However, current solutions focus partially on intensive interventions at hospitals rather than on continuous and personalized chronic disease management. This study aims to fill this gap by providing computerized clinical decision support during follow-up assessments of chronically ill patients at home. We proposed an ontology-based framework to integrate patient data, medical domain knowledge, and patient assessment criteria for chronic disease patient follow-up assessments. A clinical decision support system was developed to implement this framework for automatic selection and adaptation of standard assessment protocols to suit patient personal conditions. We evaluated our method in the case study of type 2 diabetic patient follow-up assessments. The proposed framework was instantiated using real data from 115,477 follow-up assessment records of 36,162 type 2 diabetic patients. Standard evaluation criteria were automatically selected and adapted to the particularities of each patient. Assessment results were generated as a general typing of patient overall condition and detailed scoring for each criterion, providing important indicators to the case manager about possible inappropriate judgments, in addition to raising patient awareness of their disease control outcomes. Using historical data as the gold standard, our system achieved a rate of accuracy of 99.93% and completeness of 95.00%. This study contributes to improving the accessibility, efficiency and quality of current patient follow-up services. It also provides a generic approach to knowledge sharing and reuse for patient-centered chronic disease management. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox.

    Science.gov (United States)

    Orava, Taryn; Provvidenza, Christine; Townley, Ashleigh; Kingsnorth, Shauna

    2018-06-08

    Though high numbers of children with cerebral palsy experience chronic pain, it remains under-recognized. This paper describes an evaluation of implementation supports and adoption of the Chronic Pain Assessment Toolbox for Children with Disabilities (the Toolbox) to enhance pain screening and assessment practices within a pediatric rehabilitation and complex continuing care hospital. A multicomponent knowledge translation strategy facilitated Toolbox adoption, inclusive of a clinical practice guideline, cerebral palsy practice points and assessment tools. Across the hospital, seven ambulatory care clinics with cerebral palsy caseloads participated in a staggered roll-out (Group 1: exclusive CP caseloads, March-December; Group 2: mixed diagnostic caseloads, August-December). Evaluation measures included client electronic medical record audit, document review and healthcare provider survey and interviews. A significant change in documentation of pain screening and assessment practice from pre-Toolbox (<2%) to post-Toolbox adoption (53%) was found. Uptake in Group 2 clinics lagged behind Group 1. Opportunities to use the Toolbox consistently (based on diagnostic caseload) and frequently (based on client appointments) were noted among contextual factors identified. Overall, the Toolbox was positively received and clinically useful. Findings affirm that the Toolbox, in conjunction with the application of integrated knowledge translation principles and an established knowledge translation framework, has potential to be a useful resource to enrich and standardize chronic pain screening and assessment practices among children with cerebral palsy. Implications for Rehabilitation It is important to engage healthcare providers in the conceptualization, development, implementation and evaluation of a knowledge-to-action best practice product. The Chronic Pain Toolbox for Children with Disabilities provides rehabilitation staff with guidance on pain screening and assessment

  2. The effect of occupational therapy in patients with chronic obstructive pulmonary disease: A randomized controlled trial.

    Science.gov (United States)

    Martinsen, Unni; Bentzen, Hege; Holter, Morag Kelly; Nilsen, Tove; Skullerud, Hallvard; Mowinckel, Petter; Kjeken, Ingvild

    2017-03-01

    Aim The main aim of this study was to evaluate the effect of individualized occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Additionally, the authors wanted to explore the occupational problems experienced in daily life by individuals with COPD. Methods A total of 52 patients were randomly assigned to the intervention group (occupational therapy) or control group (treatment as usual). The primary outcome was assessed using the Canadian Occupational Performance Measure (COPM), and participants were assessed at baseline and after four and 12 months. Results There were no treatment effects on occupational performance or satisfaction with performance, as measured by the COPM. However, we found a significant effect in favour of the intervention group at exertion when performing an individually chosen activity, and in the activity dimension of St George's Respiratory Questionnaire. A total of 595 occupational problems were reported, most frequently within mobility, active recreation, and household management. Conclusions The results show that, compared with the usual care, individualized occupational therapy did not improve occupational performance or satisfaction with performance. Small but significant changes in activity performance in favour of the intervention group were found in some of the secondary outcomes.

  3. Effect of communication style and physician-family relationships on satisfaction with pediatric chronic disease care.

    Science.gov (United States)

    Swedlund, Matthew P; Schumacher, Jayna B; Young, Henry N; Cox, Elizabeth D

    2012-01-01

    Over 8% of children have a chronic disease and many are unable to adhere to treatment. Satisfaction with chronic disease care can impact adherence. We examine how visit satisfaction is associated with physician communication style and ongoing physician-family relationships. We collected surveys and visit videos for 75 children ages 9-16 years visiting for asthma, diabetes, or sickle cell disease management. Raters assessed physician communication style (friendliness, interest, responsiveness, and dominance) from visit videos. Quality of the ongoing relationship was measured with four survey items (parent-physician relationship, child-physician relationship, comfort asking questions, and trust in the physician), while a single item assessed satisfaction. Correlations and chi square were used to assess association of satisfaction with communication style or quality of the ongoing relationship. Satisfaction was positively associated with physician to parent (p relationships (p communication style and the quality of the ongoing relationship contribute to pediatric chronic disease visit satisfaction.

  4. Effective? Engaging? Secure? Applying the ORCHA-24 framework to evaluate apps for chronic insomnia disorder.

    Science.gov (United States)

    Leigh, Simon; Ouyang, Jing; Mimnagh, Chris

    2017-11-01

    Mobile health offers many opportunities; however, the 'side-effects' of health apps are often unclear. With no guarantee health apps first do no harm, their role as a viable, safe and effective therapeutic option is limited. To assess the quality of apps for chronic insomnia disorder, available on the Android Google Play Store, and determine whether a novel approach to app assessment could identify high-quality and low-risk health apps in the absence of indicators such as National Health Service (NHS) approval. The Organisation for the Review of Care and Health Applications- 24 Question Assessment (ORCHA-24), 24 app assessment criteria concerning data privacy, clinical efficacy and user experience, answered on a 'yes' or 'no' and evidence-driven basis, was applied to assess 18 insomnia apps identified via the Android Google Play Store, in addition to the NHS-approved iOS app Sleepio. 63.2% of apps (12/19) provided a privacy policy, with seven (36.8%) stating no user data would be shared without explicit consent. 10.5% (2/19) stated they had been shown to be of benefit to those with insomnia, with cognitive behavioural therapy apps outperforming hypnosis and meditation apps (p=0.046). Both the number of app downloads (p=0.29) and user-review scores (p=0.23) were unrelated to ORCHA-24 scores. The NHS-approved app Sleepio, consistently outperformed non-accredited apps across all domains of the ORCHA-24. Apps for chronic insomnia disorder exhibit substantial variation in adherence to published data privacy, user experience and clinical efficacy standards, which are not clearly correlated with app downloads or user-review scores. In absence of formal app accreditation, the ORCHA-24 could feasibly be used to highlight the risk-benefit profiles of health apps prior to downloading. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Predicting the effects of dietary manipulation in chronic renal disease

    International Nuclear Information System (INIS)

    El Nahas, A.M.; Brady, S.A.; Masters-Thomas, A.; Wilkinson, V.; Hilson, A.J.W.; Moorhead, J.F.

    1984-01-01

    It has been suggested that the progressive fall in renal function in some patients with CRF is due to hyperfusion of the remnant nephrons in response to the relatively high protein diet of modern life. The authors attempted to assess this and to see what was the shortest time in which any effect could be demonstrated. In the first phase, 39 patients with CRF had their renal function followed for 6 months on their normal diet and 6 months on a low-protein diet (LPD). The patients on LPD all showed an improvement in the rate of fall of renal function. This was marked in patients with mainly tubular disease, and poor in those with glomerular and vascular disease. In the second phase, 11 of these patients (and 1 other) were started on a high protein diet (HPD) for two weeks, and then switched back to a LPD for 2 weeks. There was no change in GFR during this period, but there were marked changes in ERPF, which correlated well with the changes in renal function in the first phase (r = 0.76, rho < 0.01); 4/4 patients with tubular disease showed a rise in ERPF on HPD and a fall on LPD, while only 4/8 with glomerular or vascular disease responded. In the third phase, they assessed the effect of a single high-protein meal in normal volunteers. This showed that there are major changes in hemodynamics following a meal, such that it is not possible to make any statement about renal function using the single-shot methods. The authors conclude that a 2-week period of HPD followed by LPD allows prediction of the possible beneficial response to diet in CRF; that this is best monitored by ERPF; and that a single meal may invalidate renal function measurement

  6. PROPHYLACTIC EFFECTIVENESS OF FUSAFUNGINE IN CHILDREN WITH CHRONIC TONSILLITIS

    Directory of Open Access Journals (Sweden)

    T.I. Garashchenko

    2010-01-01

    Full Text Available In 2008/2009, at the time of influenza epidemic, the study of ambulatory prophylactic treatment of fusafungine (Bioparox in 50 children 7–15 years old with chronic tonsillitis was performed. All these children underwent regular ENT check-up. The control group included 50 schoolchildren the same age without chronic diseases of upper airways. After the treatment with intranasal fusafungine, the amount of patients with Streptococcus pyogenes was decreased 1,6 times low (and after 3 months of treatment it was decreased 3,5 times low. The sanation of palatine tonsils from Candida albicans was detected (eradication of microorganism was achieved in 58% of cases, and the amount of patients with pharyngomycosis was decreased 2,4 times low. Patient’s quality of life significantly increased, and ENT-specialists met less complaints (in 4,5–15 times low. The morbidity with respiratory infections in 3 months after the treatment with fusafungine was 7,5 times low than in control group.Key words: schoolchildren, chronic tonsillitis, acute respiratory infection, fusafungine.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:26-31

  7. The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.

    Science.gov (United States)

    Engbert, Kai; Weber, Michaela

    2011-05-15

    A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]). Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being. For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception. The benefits of therapeutic climbing were comparable with those of

  8. Assessment of goals and priorities in patients with a chronic condition: a secondary quantitative analysis of determinants across 11 countries.

    Science.gov (United States)

    Vermunt, Neeltje P C A; Westert, Gert P; Olde Rikkert, Marcel G M; Faber, Marjan J

    2018-03-01

    To assess the impact of patient characteristics, patient-professional engagement, communication and context on the probability that healthcare professionals will discuss goals or priorities with older patients. Secondary analysis of cross-sectional data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults. 11 western countries. Community-dwelling adults, aged 55 or older. Assessment of goals and priorities. The final sample size consisted of 17,222 respondents, 54% of whom reported an assessment of their goals and priorities (AGP) by healthcare professionals. In logistic regression model 1, which was used to analyse the entire population, the determinants found to have moderate to large effects on the likelihood of AGP were information exchange on stress, diet or exercise, or both. Country (living in Sweden) and continuity of care (no regular professional or organisation) had moderate to large negative effects on the likelihood of AGP. In model 2, which focussed on respondents who experienced continuity of care, country and information exchange on stress and lifestyle were the main determinants of AGP, with comparable odds ratios to model 1. Furthermore, a professional asking questions also increased the likelihood of AGP. Continuity of care and information exchange is associated with a higher probability of AGP, while people living in Sweden are less likely to experience these assessments. Further study is required to determine whether increasing information exchange and professionals asking more questions may improve goal setting with older patients. Key points   A patient goal-oriented approach can be beneficial for older patients with chronic conditions or multimorbidity; however, discussing goals with these patients is not a common practice. The likelihood of discussing goals varies by country, occurring most commonly in the USA, and least often in Sweden. Country-level differences in continuity of care and questions asked by a

  9. Effects of acute and chronic psychological stress on platelet aggregation in mice.

    Science.gov (United States)

    Matsuhisa, Fumikazu; Kitamura, Nobuo; Satoh, Eiki

    2014-03-01

    Although psychological stress has long been known to alter cardiovascular function, there have been few studies on the effect of psychological stress on platelets, which play a pivotal role in cardiovascular disease. In the present study, we investigated the effects of acute and chronic psychological stress on the aggregation of platelets and platelet cytosolic free calcium concentration ([Ca(2+)]i). Mice were subjected to both transportation stress (exposure to novel environment, psychological stress) and restraint stress (psychological stress) for 2 h (acute stress) or 3 weeks (2 h/day) (chronic stress). In addition, adrenalectomized mice were subjected to similar chronic stress (both transportation and restraint stress for 3 weeks). The aggregation of platelets from mice and [Ca(2+)]i was determined by light transmission assay and fura-2 fluorescence assay, respectively. Although acute stress had no effect on agonist-induced platelet aggregation, chronic stress enhanced the ability of the platelet agonists thrombin and ADP to stimulate platelet aggregation. However, chronic stress failed to enhance agonist-induced increase in [Ca(2+)]i. Adrenalectomy blocked chronic stress-induced enhancement of platelet aggregation. These results suggest that chronic, but not acute, psychological stress enhances agonist-stimulated platelet aggregation independently of [Ca(2+)]i increase, and the enhancement may be mediated by stress hormones secreted from the adrenal glands.

  10. Regulation of brain-derived neurotrophic factor (BDNF) in the chronic unpredictable stress rat model and the effects of chronic antidepressant treatment

    DEFF Research Database (Denmark)

    Larsen, Marianne H; Mikkelsen, Jens D; Hay-Schmidt, Anders

    2010-01-01

    Chronic unpredictable stress (CUS) is a widely used animal model of depression. The present study was undertaken to investigate behavioral, physiological and molecular effects of CUS and/or chronic antidepressant treatment (venlafaxine or imipramine) in the same set of animals. Anhedonia, a core ...

  11. The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

    Science.gov (United States)

    Lim, Hee Sung; Kim, You Lim; Lee, Suk Min

    2016-01-01

    [Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke. PMID:27390424

  12. [Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

    Science.gov (United States)

    Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

    2015-04-01

    The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

  13. Assessment of pathological changes associated with chronic allograft rejection and tolerance in two experimental models of rat lung transplantation.

    Science.gov (United States)

    Matsumura, Y; Marchevsky, A; Zuo, X J; Kass, R M; Matloff, J M; Jordan, S C

    1995-06-15

    Lung transplantation is now routinely performed for a wide range of end-stage cardiopulmonary disorders. Despite overcoming the problems associated with early acute rejection, chronic rejection (CR) in the form of obliterative bronchiolitis has emerged as the primary cause of late graft loss. The mechanisms involved in the development of CR of lung allografts are poorly understood, and no effective therapy is currently available. To better understand the pathological events associated with CR and tolerance, we examined two models of lung allograft rejection established in our laboratory. First, we exchanged left lung allografts between moderately histoincompatible inbred rat strains (WKY-->F344: n = 42 and F344-->WKY: n = 40). The WKY-->F344 model was previously shown to develop spontaneous tolerance, while the converse model (F344-->WKY) showed persistent acute rejection. The purpose of this investigation was to assess histopathological changes associated with long-term grafts left in place up to 140 days after transplant. To confirm that tolerance had developed, skin-grafting experiments were performed. Five skin grafts from each strain were placed on lung allograft recipients on day 35 after transplant and skin allograft survival was assessed and compared with controls. Acute rejection (AR) was graded histologically (stage O-IV) and the pathologic intensity of inflammation and CR were graded (0-4: 0 = 0%, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = 76-100%) on percentage of involvement with the following categories being examined: (a) lymphocytic infiltration (perivascular, peribronchial, and peribronchiolar) and (b) vasculitis, edema, hemorrhage, and necrosis. Finally, chronic rejection was diagnosed by the presence of intimal hyperplasia, interstitial fibrosis, peribronchiolar fibrosis, bronchiolitis obliterans, and bronchiectasis. The WKY-->F344 animals showed progressive AR (stage III, day 21). Thereafter, the AR subsided spontaneously and was stage 0 on day

  14. Effect of chronic pain on fentanyl self-administration in mice.

    Directory of Open Access Journals (Sweden)

    Carrie L Wade

    Full Text Available The development of opioid addiction in subjects with established chronic pain is an area that is poorly understood. It is critically important to clearly understand the neurobiology associated with propensity toward conversion to addiction under conditions of chronic pain. To pose the question whether the presence of chronic pain influences motivation to self-administer opioids for reward, we applied a combination of rodent models of chronic mechanical hyperalgesia and opioid self-administration. We studied fentanyl self-administration in mice under three conditions that induce chronic mechanical hyperalgesia: inflammation, peripheral nerve injury, and repeated chemotherapeutic injections. Responding for fentanyl was compared among these conditions and their respective standard controls (naïve condition, vehicle injection or sham surgery. Acquisition of fentanyl self-administration behavior was reduced or absent in all three conditions of chronic hyperalgesia relative to control mice with normal sensory thresholds. To control for potential impairment in ability to learn the lever-pressing behavior or perform the associated motor tasks, all three groups were evaluated for acquisition of food-maintained responding. In contrast to the opioid, chronic hyperalgesia did not interfere with the reinforcing effect of food. These studies indicate that the establishment of chronic hyperalgesia is associated with reduced or ablated motivation to seek opioid reward in mice.

  15. Treatment of chronically depressed patients: A multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP for chronic depressions versus usual secondary care

    Directory of Open Access Journals (Sweden)

    Penninx Brenda WJH

    2008-03-01

    Full Text Available Abstract Background 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP is a form of psychotherapy specifically developed for patients with chronic depression. In a study in the U.S., remarkable favorable effects of CBASP have been demonstrated. However, no other studies have as yet replicated these findings and CBASP has not been tested outside the United States. This protocol describes a randomized controlled trial on the effectiveness of CBASP in the Netherlands. Methods/Design The purpose of the present paper is to report the study protocol of a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP for chronic depression in the Netherlands. In this study, CBASP in combination with medication, will be tested versus usual secondary care in combination with medication. The aim is to recruit 160 patients from three mental health care organizations. Depressive symptoms will be assessed at baseline, after 8 weeks, 16 weeks, 32 weeks and 52 weeks, using the 28-item Inventory for Depressive Symptomatology (IDS. Effect modification by co morbid anxiety, alcohol consumption, general and social functioning and working alliance will be tested. GEE analyses of covariance, controlling for baseline value and center will be used to estimate the overall treatment effectiveness (difference in IDS score at post-treatment and follow up. The primary analysis will be by 'intention to treat' using double sided tests. An economic analysis will compare the two groups in terms of mean costs and cost-effectiveness from a societal perspective. Discussion The study will provide an answer to the question whether the favorable effects of CBASP can be replicated outside the US. Trial Registration The Dutch Cochrane Center, NTR1090.

  16. Effect of General Health Status on Chronicity of Low Back Pain in Industrial Workers

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Seyedmehdi

    2016-04-01

    Full Text Available Recognizing patients at a higher risk of developing chronic low back pain (LBP is important in industrial medicine. This study aimed to assess the power and quality of General Health Questionnaire (GHQ for prediction of the odds of chronicity of acute LBP. This study was conducted on industrial workers. All subjects with acute LBP who met the inclusion criteria were enrolled. Demographic characteristics, occupational, physical, and mental parameters and the general health status of subjects were evaluated;  they were followed up for developing chronic LBP for one year. Cigarette smoking, high body mass index, job stress, physical load and high GHQ scores were found to be the risk factors for the progression of acute LBP to chronic LBP (P<0.05. Standing position while working, age, work experience, exercise, level of education, weekly work hours and shift work were not the risk factors for chronic LBP (P>0.05.High GHQ score can be a risk factor for progression of acute LBP to chronic LBP. The GHQ in combination with the Job Content Questionnaire can be used as a quick and simple screening tool for detection of subjects at high risk of chronic LBP when evaluating acute LBP in an occupational setting.

  17. Assessing Chronic Stress, Coping Skills, and Mood Disorders through Speech Analysis: A Self-Assessment 'Voice App' for Laptops, Tablets, and Smartphones.

    Science.gov (United States)

    Braun, Silke; Annovazzi, Chiara; Botella, Cristina; Bridler, René; Camussi, Elisabetta; Delfino, Juan P; Mohr, Christine; Moragrega, Ines; Papagno, Costanza; Pisoni, Alberto; Soler, Carla; Seifritz, Erich; Stassen, Hans H

    2016-01-01

    Computerized speech analysis (CSA) is a powerful method that allows one to assess stress-induced mood disturbances and affective disorders through repeated measurements of speaking behavior and voice sound characteristics. Over the past decades CSA has been successfully used in the clinical context to monitor the transition from 'affectively disturbed' to 'normal' among psychiatric patients under treatment. This project, by contrast, aimed to extend the CSA method in such a way that the transition from 'normal' to 'affected' can be detected among subjects of the general population through 10-20 self-assessments. Central to the project was a normative speech study of 5 major languages (English, French, German, Italian, and Spanish). Each language comprised 120 subjects stratified according to gender, age, and education with repeated assessments at 14-day intervals (total n = 697). In a first step, we developed a multivariate model to assess affective state and stress-induced bodily reactions through speaking behavior and voice sound characteristics. Secondly, we determined language-, gender-, and age-specific thresholds that draw a line between 'natural fluctuations' and 'significant changes'. Thirdly, we implemented the model along with the underlying methods and normative data in a self-assessment 'voice app' for laptops, tablets, and smartphones. Finally, a longitudinal self-assessment study of 36 subjects was carried out over 14 days to test the performance of the CSA method in home environments. The data showed that speaking behavior and voice sound characteristics can be quantified in a reproducible and language-independent way. Gender and age explained 15-35% of the observed variance, whereas the educational level had a relatively small effect in the range of 1-3%. The self-assessment 'voice app' was realized in modular form so that additional languages can simply be 'plugged in' once the respective normative data become available. Results of the longitudinal

  18. A multicenter family practitioners' research on Chronic Obstructive Pulmonary Disease screening using the COPD Assessment Test.

    Science.gov (United States)

    Demirci, Hakan; Eniste, Koncuy; Basaran, Ebru Onuker; Ocakoglu, Gokhan; Yilmaz, Zeynep; Tuna, Sumeyye

    2017-11-01

    Spirometry is known to be a gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD). COPD Assessment Test (CAT) is an eight-item questionnaire currently in use to evaluate patients with COPD. In the present study, we aimed to evaluate if CAT is an adequate tool for screening COPD. In total, 600 persons aging ⩾40 years old were randomly selected from three different family practice units located in the city center. CAT was asked to the participants and a spirometry was used to assess pulmonary obstruction. Pulmonary obstruction was defined as forced expiratory volume in first second/forced vital capacity (FEV1/FVC)COPD diagnosis was confirmed with the reversibility test. The relationship between CAT results and pulmonary function test values was evaluated. In this sampling, the prevalence of COPD was 4.2%. Reliability of the CAT in the study group was acceptable (Cronbach's α: 0.84). The CAT scores was significantly higher in patients with COPD (PCOPD. CAT is a reliable questionnaire and there is an apparent relationship between the total CAT scores and COPD. However, CAT's ability to screen COPD is limited since it may miss the symptom-free cases.

  19. Cost-effectiveness analysis of tenofovir disoproxil fumarate for treatment of chronic hepatitis B in China.

    Science.gov (United States)

    Ke, Weixia; Zhang, Chi; Liu, Li; Gao, Yanhui; Yao, Zhenjiang; Ye, Xiaohua; Zhou, Shudong; Yang, Yi

    2016-11-01

    Tenofovir disoproxil fumarate (TDF) is newly available for treatment of chronic hepatitis B patients in China. To date, no study has been conducted to examine the cost-effectiveness of this treatment. The aim of this study was to estimate the cost-effectiveness of TDF versus four oral nucleos(t)ide analogs [lamivudine (LAM), adefovir (ADV), telbivudine (LdT), and entecavir (ETV)] and from a pharmacoeconomic perspective to assess current drug pricing for TDF. Based on Chinese healthcare perspectives, a Markov model was applied to simulate the lifetime (40-year time span) costs and quality-adjusted life-years (QALYs) for five different monotherapy strategies. Two kinds of rescue combination strategies (base-case: LAM + ADV then ETV + ADV; alternative: directly using ETV + ADV) were separately considered for treatment of patients refractory to monotherapy. Model parameters (including disease transition, cost, and utility) were obtained from previous Chinese population studies. Both branded and generic drugs were separately analyzed. Study model uncertainties were assessed by one-way and probabilistic sensitivity analyses. Two-way sensitivity analysis was used to explore uncertainties between efficacy and price of TDF. In the base-case analysis, the lowest lifetime cost and the best cost-effectiveness ratio were obtained by ETV, which was considered the reference treatment. LAM, ADV, and LdT treatments had significantly greater costs and lower efficacies. Compared to ETV, TDF was more effective but also more expensive. The incremental cost-effectiveness ratios of TDF versus ETV were much higher than the willing-to-pay threshold of $20,466 US dollars (USD) per QALY gained (3 × gross domestic product per capita of China, 2014). TDF would be the most cost-effective strategy if the annual cost did not exceed $2260 USD and $1600 USD for branded and generic drugs, respectively. For Chinese chronic hepatitis B patients, ETV is still the most cost-effective

  20. Effects of Stress and Relaxation on Central Pain Modulation in Chronic Whiplash and Fibromyalgia Patients Compared to Healthy Controls.

    Science.gov (United States)

    Coppieters, Iris; Cagnie, Barbara; Nijs, Jo; van Oosterwijck, Jessica; Danneels, Lieven; De Pauw, Robby; Meeus, Mira

    2016-03-01

    Compelling evidence has demonstrated that impaired central pain modulation contributes to persistent pain in patients with chronic whiplash associated disorders (WAD) and fibromyalgia (FM). However, there is limited research concerning the influence of stress and relaxation on central pain modulation in patients with chronic WAD and FM. The present study aims to investigate the effects of acute cognitive stress and relaxation on central pain modulation in chronic WAD and FM patients compared to healthy individuals. A randomized crossover design was employed. The present study took place at the University of Brussels, the University Hospital Brussels, and the University of Antwerp. Fifty-nine participants (16 chronic WAD patients, 21 FM, 22 pain-free controls) were enrolled and subjected to various pain measurements. Temporal summation (TS) of pain and conditioned pain modulation (CPM) were evaluated. Subsequently, participants were randomly allocated to either a group that received progressive relaxation therapy or a group that performed a battery of cognitive tests (= cognitive stressor). Afterwards, all pain measurements were repeated. One week later participant groups were switched. A significant difference was found between the groups in the change in TS in response to relaxation (P = 0.008) and cognitive stress (P = 0.003). TS decreased in response to relaxation and cognitive stress in chronic WAD patients and controls. In contrast, TS increased after both interventions in FM patients. CPM efficacy decreased in all 3 groups in response to relaxation (P = 0.002) and cognitive stress (P = 0.001). The obtained results only apply for a single session of muscle relaxation therapy and cognitive stress, whereby no conclusions can be made for effects on pain perception and modulation of chronic cognitive stress and long-term relaxation therapies. A single relaxation session as well as cognitive stress may have negative acute effects on pain modulation in patients with

  1. Neurochemical Effects of Chronic Administration of Calcitriol in Rats

    Directory of Open Access Journals (Sweden)

    Pei Jiang

    2014-12-01

    Full Text Available Despite accumulating data showing the various neurological actions of vitamin D (VD, its effects on brain neurochemistry are still far from fully understood. To further investigate the neurochemical influence of VD, we assessed neurotransmitter systems in the brain of rats following 6-week calcitriol (1,25-dihydroxyvitamin D administration (50 ng/kg/day or 100 ng/kg/day. Both the two doses of calcitriol enhanced VDR protein level without affecting serum calcium and phosphate status. Rats treated with calcitriol, especially with the higher dose, exhibited elevated γ-aminobutyric acid (GABA status. Correspondingly, the mRNA expression of glutamate decarboxylase (GAD 67 was increased. 100 ng/kg of calcitriol administration also increased glutamate and glutamine levels in the prefrontal cortex, but did not alter glutamine synthetase (GS expression. Additionally, calcitriol treatment promoted tyrosine hydroxylase (TH and tryptophan hydroxylase 2 (TPH2 expression without changing dopamine and serotonin status. However, the concentrations of the metabolites of dopamine and serotonin were increased and the drug use also resulted in a significant rise of monoamine oxidase A (MAOA expression, which might be responsible to maintain the homeostasis of dopaminergic and serotonergic neurotransmission. Collectively, the present study firstly showed the effects of calcitriol in the major neurotransmitter systems, providing new evidence for the role of VD in brain function.

  2. Conceptualising the effectiveness of impact assessment processes

    International Nuclear Information System (INIS)

    Chanchitpricha, Chaunjit; Bond, Alan

    2013-01-01

    This paper aims at conceptualising the effectiveness of impact assessment processes through the development of a literature-based framework of criteria to measure impact assessment effectiveness. Four categories of effectiveness were established: procedural, substantive, transactive and normative, each containing a number of criteria; no studies have previously brought together all four of these categories into such a comprehensive, criteria-based framework and undertaken systematic evaluation of practice. The criteria can be mapped within a cycle/or cycles of evaluation, based on the ‘logic model’, at the stages of input, process, output and outcome to enable the identification of connections between the criteria across the categories of effectiveness. This framework is considered to have potential application in measuring the effectiveness of many impact assessment processes, including strategic environmental assessment (SEA), environmental impact assessment (EIA), social impact assessment (SIA) and health impact assessment (HIA). -- Highlights: • Conceptualising effectiveness of impact assessment processes. • Identification of factors influencing effectiveness of impact assessment processes. • Development of criteria within a framework for evaluating IA effectiveness. • Applying the logic model to examine connections between effectiveness criteria

  3. Conceptualising the effectiveness of impact assessment processes

    Energy Technology Data Exchange (ETDEWEB)

    Chanchitpricha, Chaunjit, E-mail: chaunjit@g.sut.ac.th [School of Environmental Health, Suranaree University of Technology, 111 University Avenue, Maung District, Nakhon Ratchasima 30000 (Thailand); Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Unit for Environmental Sciences and Management School of Geo and Spatial Sciences, Internal Box 375, North West University (Potchefstroom campus) (South Africa)

    2013-11-15

    This paper aims at conceptualising the effectiveness of impact assessment processes through the development of a literature-based framework of criteria to measure impact assessment effectiveness. Four categories of effectiveness were established: procedural, substantive, transactive and normative, each containing a number of criteria; no studies have previously brought together all four of these categories into such a comprehensive, criteria-based framework and undertaken systematic evaluation of practice. The criteria can be mapped within a cycle/or cycles of evaluation, based on the ‘logic model’, at the stages of input, process, output and outcome to enable the identification of connections between the criteria across the categories of effectiveness. This framework is considered to have potential application in measuring the effectiveness of many impact assessment processes, including strategic environmental assessment (SEA), environmental impact assessment (EIA), social impact assessment (SIA) and health impact assessment (HIA). -- Highlights: • Conceptualising effectiveness of impact assessment processes. • Identification of factors influencing effectiveness of impact assessment processes. • Development of criteria within a framework for evaluating IA effectiveness. • Applying the logic model to examine connections between effectiveness criteria.

  4. Development of a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain

    Science.gov (United States)

    Nikaido, Takuya; Fukuma, Shingo; Wakita, Takafumi; Sekiguchi, Miho; Yabuki, Shoji; Onishi, Yoshihiro; Fukuhara, Shunichi; Konno, Shin-ichi

    2017-01-01

    Chronic pain is a manifestation of interactions among physical, psychological, and social conditions, but the latter two, that is, the nonphysical correlates of chronic pain, are only rarely measured. This study aimed to develop a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain. An expert panel chose social and psychological domains considered to be relevant to patients with chronic pain and wrote questions asking about each of those domains. The questionnaire was completed by 252 patients with chronic musculoskeletal pain. Factor analysis was used to select questionnaire items for each domain. Associations and interactions of pain severity and each domain score with pain-related quality of life (PRQOL) were examined using linear regression models. Five domains were chosen: work, family, sleep, mental health, and PRQOL. Then, a total of 17 questions were created for the work, family, and sleep domains. Using the likelihood-ratio test, we found significant interactions with PRQOL in four pairs: severity–family, severity–mental, family–sleep, and work–mental. The association between pain severity and PRQOL was related to each patient’s social and psychological situation. These results suggest that interventions for patients with chronic pain may be personalized to account for each individual’s psychosocial situation. PMID:28814896

  5. Effect of steam corrosion on core post strength loss: I. Low, chronic steam ingress rates

    International Nuclear Information System (INIS)

    Wichner, R.P.

    1976-10-01

    The purpose of the study was to assess the effect of chronic, low levels of steam ingress into the primary system of the HTGR on the corrosion, and consequent strength loss of the core support posts. The assessment proceeded through the following three steps: (1) The impurity composition in the primary system was estimated as a function of a range of steady ingress rates of from 0.001 to 1.0 g/sec, both by means of an analysis of the Dragon steam ingress experiment and a computer code, TIMOX, which treats the primary system as a well-mixed pot. (2) The core post burnoffs which result from 40-year exposures to these determined impurity atmospheres were then estimated using a corrosion rate expression derived from published ATJ-graphite corrosion rate data. Burnoffs were determined for both the core posts at the nominal and the maximum sustained temperature, estimated to be 90 0 C above nominal. (3) The final step involved assessment of the degree of strength loss resulting from the estimated burnoffs. An empirical equation was developed for this purpose which compares reasonably well with strength loss data for a number of different graphites and specimen geometries

  6. Effects of Pilates and yoga in patients with chronic neck pain: A sonographic study

    Directory of Open Access Journals (Sweden)

    Naime Uluğ

    2017-10-01

    Full Text Available Background: Various studies have shown the efficacy of conventional isometric, Pilates and yoga exercises. However, data on the effects and comparison of these specific exercises on the cervical muscle morphology are insufficient or lacking. Objective: To investigate the effects of different exercise treatments on neck muscles in patients with chronic neck pain. Design: A randomized study. Methods: Fifty-six patients with chronic neck pain were randomized into 3 groups as follows: Pilates group (n = 20, yoga group (n = 18 and isometric group (n = 18. Demographics and background information were recorded. The thickness and cross-sectional area of neck muscles were evaluated by ultrasound imaging. Cervical motions were measured with a goniometer. Pain severity was evaluated with the McGill Pain Scale, disability with the Neck Disability Index, quality of life with the Nottingham Health Profile, and emotional status with the Beck Depression Inventory. In addition to a conventional physio-therapy programme, 15 sessions of physical therapy, including hot pack, ultrasound, and transcutaneous electrical nerve stimulation (TENS, were provided to all patients. All groups performed the exercises for 6 weeks. The aforementioned assessments were performed before and 6 weeks after the treatment. Results: Although pain, disability, depression and quality of life improved similarly within all groups (all p < 0.05, muscle thickness values as regards the semispinalis capitis were increased only in the Pilates group (p = 0.022. Study limitations: The lack of complex (progressive resistive exercise treatment protocols, short treatment duration and partial supervision. Conclusion: All 3 types of exercise had favourable effects on pain and functional scores, but no differences were found among the groups, except for the Pilates group, in which the semispinalis capitis muscle increased in thickness.

  7. Comparative Effectiveness of Proactive Tobacco Treatment among Smokers with and without Chronic Lower Respiratory Disease.

    Science.gov (United States)

    Melzer, Anne C; Clothier, Barbara A; Japuntich, Sandra J; Noorbaloochi, Siamak; Hammett, Patrick; Burgess, Diana J; Joseph, Anne M; Fu, Steven S

    2018-03-01

    Adults with chronic lower respiratory disease differ in their barriers to smoking cessation but also suffer from tobacco-related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without chronic lower respiratory disease. We examined the effectiveness of a proactive outreach program for cessation among smokers with and without chronic lower respiratory disease. Subgroup analysis of the Veterans Victory over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared with usual care. Smokers identified via the electronic medical record were proactively offered phone-based counseling and care coordination to receive medication from their Veterans Affairs providers or in-person care. We compared the response among those with and without an International Classification of Diseases, 9th Revision diagnosis of a chronic lower respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma). We used stratification by propensity scores to adjust for imbalanced covariates between groups with and without chronic lower respiratory disease within each treatment arm, using complete case analysis accounting for the stratified sampling by site. The study participants were predominantly older, white, male smokers. Overall, 19.6% had chronic lower respiratory disease. A total of 3,307 had outcome data with the following assignments to the intervention: proactive care: n = 1,272 without chronic lower respiratory disease, n = 301 with chronic lower respiratory disease; usual care: n = 1,387 without chronic lower respiratory disease, n = 347 with chronic lower respiratory disease. A total of 1,888 had both complete baseline and outcome data and were included in the primary analysis. In unadjusted analyses (n = 3,307), among individuals with

  8. Motor unit properties of biceps brachii in chronic stroke patients assessed with high-density surface EMG

    NARCIS (Netherlands)

    Kallenberg, L.A.C.; Hermens, Hermanus J.

    2009-01-01

    The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii in post-stroke patients, using high-density surface electromyography (sEMG). Eighteen chronic hemiparetic stroke patients took part. The Fugl-Meyer score for the upper extremity was assessed. Subjects

  9. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Elisabet Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self...

  10. Assessment of a Business-to-Consumer (B2C) model for Telemonitoring patients with Chronic Heart Failure (CHF)

    NARCIS (Netherlands)

    A.S. Grustam (Andrija); Vrijhoef, H.J.M. (Hubertus J. M.); R. Koymans (Ron); Hukal, P. (Philipp); J.L. Severens (Hans)

    2017-01-01

    textabstractBackground: The purpose of this study is to assess the Business-to-Consumer (B2C) model for telemonitoring patients with Chronic Heart Failure (CHF) by analysing the value it creates, both for organizations or ventures that provide telemonitoring services based on it, and for society.

  11. Initial Psychometric Properties of a Brief Parent-Report Instrument for Assessing Tic Severity in Children with Chronic Tic Disorders

    Science.gov (United States)

    Chang, Susanna; Himle, Michael B.; Tucker, Benjamin T. P.; Woods, Douglas W.; Piacentini, John

    2009-01-01

    This article describes the development and initial psychometric properties of the Parent Tic Questionnaire (PTQ)--a new measure assessing the number, frequency, and intensity of motor and vocal tics in children and adolescents with Chronic Tic Disorder (CTD). Parents of 40 children with a CTD completed the PTQ as part of a larger assessment…

  12. Patient-reported outcomes assessment in chronic hepatitis C treated with sofosbuvir and ribavirin: the VALENCE study

    NARCIS (Netherlands)

    Younossi, Zobair M.; Stepanova, Maria; Zeuzem, Stefan; Dusheiko, Geoffrey; Esteban, Rafael; Hezode, Christophe; Reesink, Hendrik W.; Weiland, Ola; Nader, Fatema; Hunt, Sharon L.

    2014-01-01

    Interferon (IFN) negatively impacts patients' well-being and patient-reported outcomes (PROs). Our aim was to assess PROs during treatment with an IFN-free regimen [sofosbuvir (SOF)+ribavirin (RBV)]. Four PRO questionnaires [Short Form-36 (SF-36), Chronic Liver Disease Questionnaire-HCV (CLDQ-HCV),

  13. Multimodal assessment of painful peripheral neuropathy induced by chronic oxaliplatin-based chemotherapy in mice

    Directory of Open Access Journals (Sweden)

    Dorsey Susan G

    2011-04-01

    Full Text Available Abstract Background A major clinical issue affecting 10-40% of cancer patients treated with oxaliplatin is severe peripheral neuropathy with symptoms including cold sensitivity and neuropathic pain. Rat models have been used to describe the pathological features of oxaliplatin-induced peripheral neuropathy; however, they are inadequate for parallel studies of oxaliplatin's antineoplastic activity and neurotoxicity because most cancer models are developed in mice. Thus, we characterized the effects of chronic, bi-weekly administration of oxaliplatin in BALB/c mice. We first studied oxaliplatin's effects on the peripheral nervous system by measuring caudal and digital nerve conduction velocities (NCV followed by ultrastructural and morphometric analyses of dorsal root ganglia (DRG and sciatic nerves. To further characterize the model, we examined nocifensive behavior and central nervous system excitability by in vivo electrophysiological recording of spinal dorsal horn (SDH wide dynamic range neurons in oxaliplatin-treated mice Results We found significantly decreased NCV and action potential amplitude after oxaliplatin treatment along with neuronal atrophy and multinucleolated DRG neurons that have eccentric nucleoli. Oxaliplatin also induced significant mechanical allodynia and cold hyperalgesia, starting from the first week of treatment, and a significant increase in the activity of wide dynamic range neurons in the SDH. Conclusions Our findings demonstrate that chronic treatment with oxaliplatin produces neurotoxic changes in BALB/c mice, confirming that this model is a suitable tool to conduct further mechanistic studies of oxaliplatin-related antineoplastic activity, peripheral neurotoxicity and pain. Further, this model can be used for the preclinical discovery of new neuroprotective and analgesic compounds.

  14. The effect of chronic pain on life satisfaction: evidence from Australian data.

    Science.gov (United States)

    McNamee, Paul; Mendolia, Silvia

    2014-11-01

    Chronic pain is associated with significant costs to individuals directly affected by this condition, their families, the healthcare system, and the society as a whole. This paper investigates the relationship between chronic pain and life satisfaction using a sample of around 90,000 observations from the first ten waves of the Household, Income and Labour Dynamics of Australia Survey (HILDA), which is a representative survey of the Australian population that started in 2000. We estimate the negative impact on life satisfaction and examine the persistence of the effect over multiple years. Chronic pain is associated with poor health conditions, disability, decreased participation in the labour market and lower quality of life. We calculate the compensating income variation of chronic pain, based on the measurement of chronic pain, the life satisfaction of individuals and the income of households. Panel data models with random and fixed effects are used to control for characteristics of individuals that do not vary over time. Further, we investigate whether individuals who experience chronic pain exhibit adaptation and recovery in life satisfaction after 3 years. Overall, we find that chronic pain has a large negative association with life satisfaction, and that the compensating income variation is substantial (around 640 US$ per day). Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Effect of Smoking on Peripheral Blood Lymphocyte Subsets of Patients With Chronic Renal Failure.

    Science.gov (United States)

    Düvenci Birben, Özlem; Akçay, Şule; Sezer, Siren; Şirvan, Şale; Haberal, Mehmet

    2016-11-01

    Smoking is known to suppress the immune system. It is also known that chronic renal failure affects the immune system. However, the number of studies investigating the effects of chronic renal failure and smoking together is limited. In our study, we examined whether smoking affects the diminished response of the immune system in patients with chronic renal failure. We compared peripheral blood lymphocyte subsets in smoking and nonsmoking patients with chronic renal failure. We also used the Fagerström Test for Nicotine Dependence to evaluate its correlation with the lymphocyte subset count in patients who are current smokers. Our study included 126 patients with chronic renal failure. According to their smoking habits, patients were divided into 2 groups: smokers and nonsmokers. The average age of patients who were smokers was 53.2 ± 1.5 years, with average age of nonsmokers being 59.2 ± 2.2 years. The average duration of smoking in smokers was 30.7 ± 2.7 packyears. We found that the percentage of cluster of differentiation 16-56 cells (natural killer cells) and lymphocyte percentage were significantly lower among smokers in our study (P chronic renal failure, similar to that shown in healthy smokers. According to our findings, patients with chronic renal failure, where infection is the primary reason for mortality and morbidity, must be questioned for smoking and referred to smoking cessation clinics. Because of its immunosuppressive effects, smoking behaviors must be solved preoperatively in transplant candidates.

  16. Effects of chronic inflammatory bowel diseases on left ventricular structure and function: a study protocol

    Directory of Open Access Journals (Sweden)

    Botti Fiorenzo

    2002-09-01

    Full Text Available Abstract Background Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD. In particular, large amounts of collagen type I, III and V have been described and correlated to the development of intestinal fibrotic lesions. No information has been available until now about the possible increased collagen deposition far from the main target organ. In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splancnic and systemic collagen metabolism (procollagen III assay, deposition (ultrasonic tissue characterization, and cardiac function (echocardiography in patients with different long standing history of IBD, before and after surgery. Methods Thirty patients affected by active IBD, 15 with Crohn and 15 with Ulcerative Colitis, submitted to surgery will be enrolled in the study in a double blind fashion. They will be studied before the surgical operation and 6, 12 months after surgery. A control group of 15 healthy age and gender-matched subjects will also be studied. At each interval blood samples will be collected in order to assess the collagen metabolism; a transthoracic echocardiogram will be recorded for the subsequent determination of cardiac function and collagen deposition. Discussion From this study protocol we expect additional information about the association between IBD and cardiovascular disorders; in particular to address the question if chronic inflammation, through the altered collagen metabolism, could affect left ventricular structure and function in a manner directly related to the estimated duration of the disease.

  17. Task force report on health effects assessment

    International Nuclear Information System (INIS)

    Anderson, C.; Hushon, J.

    1978-08-01

    From April to August, 1978 MITRE supported the Health Effects Assessment Task Force sponsored by the Office of the Assistant Secretary for the Environment at DOE. The findings of that Task Force are incorporated in this report and include a detailed definition of health effects assessment, a survey of the mandates for health effects assessments within DOE/EV, a review of current DOE-EV health effects assessment activities, an analysis of the constraints affecting the health effects assessment process and a discussion of the Task Force recommendations. Included as appendices are summaries of two workshops conducted by the Task Force to determine the state-of-the-art of health effects assessment and modeling and a review of risk assessment activities in other federal agencies. The primary recommendation of the panel was that an office be designated or created under the Office of the Assistant Secretary for the Environment to coordinate the Health Effects Risk Assessment effort covering up to 40 program and policy areas; a similar need was expressed for the environmental effects assessment area. 1 tab

  18. Effects of chronic radiation exposure on the reproduction of dogs

    International Nuclear Information System (INIS)

    Shifrine, M.; Kawakami, T.G.; Rasmussen, C.

    1984-01-01

    During studies on radiation leukemogenesis 7 dogs were exposed to 4.4 R/day starting at 150 days of age. Three of these dogs were females. To determine whether the exposure to chronic irradiation affected their reproductive capacity the three bitches were bred. Two of the bitches did not conceive, and one of these died shortly thereafter from myeloproliferative disease (MPD) which could have been a factor. The third bitch whelped 7 pups, one of which died shortly after birth, and the other 6 are healthy 2 months after birth. 1 table

  19. Safety assessment of widely used fermented virgin coconut oil (Cocos nucifera) in Malaysia: Chronic toxicity studies and SAR analysis of the active components.

    Science.gov (United States)

    Ibrahim, Ahmad H; Khan, Md Shamsuddin Sultan; Al-Rawi, Sawsan S; Ahamed, Mohamed B Khadeer; Majid, Aman Shah Bin Abdul; Al-Suede, Fouad Saleih R; Ji, Dan; Majid, Amin Malik Shah Abdul

    2016-11-01

    Fermented Virgin Coconut Oil (FVCO) is widely used in the Southeast Asia as food and traditional medicine. The objective of the present study is the evaluation of chronic safety of the commercialized FVCO of Malaysia and other Southeast Asian countries. A single dose of 5000 mg/kg of FVCO was administered orally in rats (each group, n = 5) for the acute toxicity study and 175, 550 and 2000 mg/kg for sub-chronic and chronic studies (each group, n = 10), respectively. The behavior, mortality, and body weight of the rats were assessed to determine the toxic effects of FVCO. The haematology, biochemistry and histopathology of the treated rats were evaluated. The treated rats were safe with the dose of 5000 mg/kg in acute, sub-chronic and chronic indication. Abnormal clinical signs and morphology (gross necroscopy), changes of organ weight, anomalous haematology and biochemistry indexes were not found in comparison with the control (p > 0.05). In general, food and water intake were higher in the treated rats related to control. It was concluded that the presence of the antioxidant active compounds of FVCO might be the reason of safety. The structure activity relationship (SAR) provides a comprehensive mechanism to determine the safety that is the presence of the electron donating phenolic groups, carbonyl groups, and carboxylic acid in the ortho and meta position of the aromatic rings. The SAR showed the antioxidant properties of myristic acid and lauric acid determined by GC-MS analysis. This result suggests the safety of FVCO for chronic use, nutritional activity that FVCO formulation complies the requirements of regulatory agencies. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Diastolic effects of chronic digitalization in systolic heart failure.

    Science.gov (United States)

    Hassapoyannes, C A; Bergh, M E; Movahed, M R; Easterling, B M; Omoigui, N A

    1998-10-01

    The efficacy of short-term digitalization on exercise tolerance may, in part, reflect enhanced diastolic performance. However, cardiac glycosides can impair ventricular relaxation from cytosolic Ca++ overload. To detect any time-dependent adverse effect, we assessed the diastolic function after long-term use of digitalis in patients with mild to moderate systolic left ventricular failure. From a cohort of 80 patients who received long-term, randomized, double-blind treatment with digitalis versus placebo at the WJB Dorn Veterans Affairs Medical Center, 38 survivors were evaluated at the end of follow-up (mean 48.4 months) with evaluators blinded to treatment used. Each survivor underwent equilibrium scintigraphic and echocardiographic assessment of diastolic function. Peak and mean filling rates normalized with filling volume (FV), diastolic phase durations normalized with duration of diastole, and filling fractions were measured from the time-activity curve. The isovolumic relaxation period and ventricular dimensions were computed echocardiographically. By actual-treatment-received analysis, treated versus untreated patients manifested a trend toward longer isovolumic relaxation (80.76 ms vs 61.54 ms, P = .06) but a markedly lower peak rapid filling rate (6.39 FV/sec vs 10.56 FV/sec, P = .02) despite comparable loading conditions. In addition, treated patients exhibited a lower mean rate of rapid filling (2.75 FV/sec vs 3.78 FV/sec, P = .05) in the absence of a longer rapid filling duration. However, the end-diastolic ventricular dimension did not differ between the 2 groups. Similar results were obtained by intention-to-treat analysis. Importantly, the mortality rate from worsening heart failure in the inception cohort was lower in the digitalis group versus the placebo group (P = .05) with no difference in total cardiac or all-cause mortality. After long-term digitalization for systolic left ventricular failure, cross-sectional comparison with a control group

  1. Noninvasive Assessment of Excessive Erythrocytosis as a Screening Method for Chronic Mountain Sickness at High Altitude.

    Science.gov (United States)

    Vyas, Kaetan J; Danz, David; Gilman, Robert H; Wise, Robert A; León-Velarde, Fabiola; Miranda, J Jaime; Checkley, William

    2015-06-01

    Vyas, Kaetan J., David Danz, Robert H. Gilman, Robert A. Wise, Fabiola León-Velarde, J. Jaime Miranda, and William Checkley. Noninvasive assessment of excessive erythrocytosis as a screening method for chronic mountain sickness at high altitude. High Alt Med Biol 16:162-168, 2015.--Globally, over 140 million people are at risk of developing chronic mountain sickness, a common maladaptation to life at high altitude (>2500 meters above sea level). The diagnosis is contingent upon the identification of excessive erythrocytosis (EE). Current best practices to identify EE require a venous blood draw, which is cumbersome for large-scale surveillance. We evaluated two point-of-care biomarkers to screen for EE: noninvasive spot-check tests of total hemoglobin and oxyhemoglobin saturation (Pronto-7, Masimo Corporation). We conducted paired evaluations of total serum hemoglobin from a venous blood draw and noninvasive, spot-check testing of total hemoglobin and oxyhemoglobin saturation with the Pronto-7 in 382 adults aged ≥35 years living in Puno, Peru (3825 meters above sea level). We used the Bland-Altman method to measure agreement between the noninvasive hemoglobin assessment and the gold standard lab hemoglobin analyzer. Mean age was 58.8 years and 47% were male. The Pronto-7 test was unsuccessful in 21 (5%) participants. Limits of agreement between total hemoglobin measured via venous blood draw and the noninvasive, spot-check test ranged from -2.8 g/dL (95% CI -3.0 to -2.5) to 2.5 g/dL (95% CI 2.2 to 2.7), with a bias of -0.2 g/dL (95% CI -0.3 to -0.02) for the difference between total hemoglobin and noninvasive hemoglobin concentrations. Overall, the noninvasive spot-check test of total hemoglobin had a better area under the receiver operating characteristic curve compared to oxyhemoglobin saturation for the identification of EE as measured by a gold standard laboratory hemoglobin analyzer (0.96 vs. 0.82; p<0.001). Best cut-off values to screen for EE with

  2. Assessment and management of chronic pain in patients with stable total hip arthroplasty

    OpenAIRE

    Classen, Tim; Zaps, Daniela; Landgraeber, Stefan; Li, Xinning; Jäger, Marcus

    2012-01-01

    Total hip arthroplasty (THA) is one of the most successful operations that can restore function and relieve pain. Although a majority of the patients achieve significant pain relief after THA, there are a number of patients that develop chronic pain for unknown reasons. A literature search was performed looking for chronic pain after total hip arthroplasty and stable THA. Major causes of chronic pain include aseptic loosening or infection. However, there is a subset of patients with a stable ...

  3. Intensity dependent effects of transcranial direct current stimulation on corticospinal excitability in chronic spinal cord injury.

    Science.gov (United States)

    Murray, Lynda M; Edwards, Dylan J; Ruffini, Giulio; Labar, Douglas; Stampas, Argyrios; Pascual-Leone, Alvaro; Cortes, Mar

    2015-04-01

    To investigate the effects of anodal transcranial direct current stimulation (a-tDCS) intensity on corticospinal excitability and affected muscle activation in individuals with chronic spinal cord injury (SCI). Single-blind, randomized, sham-controlled, crossover study. Medical research institute and rehabilitation hospital. Volunteers (N = 9) with chronic SCI and motor dysfunction in wrist extensor muscles. Three single session exposures to 20 minutes of a-tDCS (anode over the extensor carpi radialis [ECR] muscle representation on the left primary motor cortex, cathode over the right supraorbital area) using 1 mA, 2 mA, or sham stimulation, delivered at rest, with at least 1 week between sessions. Corticospinal excitability was assessed with motor-evoked potentials (MEPs) from the ECR muscle using surface electromyography after transcranial magnetic stimulation. Changes in spinal excitability, sensory threshold, and muscle strength were also investigated. Mean MEP amplitude significantly increased by approximately 40% immediately after 2mA a-tDCS (pre: 0.36 ± 0.1 mV; post: 0.47 ± 0.11 mV; P = .001), but not with 1 mA or sham. Maximal voluntary contraction measures remained unaltered across all conditions. Sensory threshold significantly decreased over time after 1mA (P = .002) and 2mA (P = .039) a-tDCS and did not change with sham. F-wave persistence showed a nonsignificant trend for increase (pre: 32% ± 12%; post: 41% ± 10%; follow-up: 46% ± 12%) after 2 mA stimulation. No adverse effects were reported with any of the experimental conditions. The a-tDCS can transiently raise corticospinal excitability to affected muscles in patients with chronic SCI after 2 mA stimulation. Sensory perception can improve with both 1 and 2 mA stimulation. This study gives support to the safe and effective use of a-tDCS using small electrodes in patients with SCI and highlights the importance of stimulation intensity. Copyright © 2015 American Congress of Rehabilitation

  4. Acute and chronic effects of erythromycin exposure on oxidative stress and genotoxicity parameters of Oncorhynchus mykiss

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, S., E-mail: up201208875@fc.up.pt [Departamento de Biologia da Faculdade de Ciências da Universidade do Porto (FCUP), Rua do Campo Alegre s/n, 4169–007 Porto (Portugal); Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Rua dos Bragas 289, 4050–123 Porto (Portugal); Antunes, S.C. [Departamento de Biologia da Faculdade de Ciências da Universidade do Porto (FCUP), Rua do Campo Alegre s/n, 4169–007 Porto (Portugal); Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Rua dos Bragas 289, 4050–123 Porto (Portugal); Correia, A.T. [Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Rua dos Bragas 289, 4050–123 Porto (Portugal); Faculdade de Ciências da Saúde da Universidade Fernando Pessoa (FCS-UFP), Rua Carlos da Maia, 296, 4200–150, Porto (Portugal); Nunes, B. [Centro de Estudos do Ambiente e do Mar (CESAM), Campus de Santiago, Universidade de Aveiro, 3810–193 Aveiro (Portugal); Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810–193 Aveiro (Portugal)

    2016-03-01

    Erythromycin (ERY) is a macrolide antibiotic used in human and veterinary medicine, and has been detected in various aquatic compartments. Recent studies have indicated that this compound can exert biological activity on non-target organisms environmentally exposed. The present study aimed to assess the toxic effects of ERY in Oncorhynchus mykiss after acute and chronic exposures. The here adopted strategy involved exposure to three levels of ERY, the first being similar to concentrations reported to occur in the wild, thus ecologically relevant. Catalase (CAT), total glutathione peroxidase (GPx), glutathione reductase (GRed) activities and lipid peroxidation (TBARS levels) were quantified as oxidative stress biomarkers in gills and liver. Genotoxic endpoints, reflecting different types of genetic damage in blood cells, were also determined, by performing analysis of genetic damage (determination of the genetic damage index, GDI, measured by comet assay) and of erythrocytic nuclear abnormalities (ENAs). The results suggest the occurrence of a mild, but significant, oxidative stress scenario in gills. For acutely exposed organisms, significant alterations were observed in CAT and GRed activities, and also in TBARS levels, which however are modifications with uncertain biological interpretation, despite indicating involvement of an oxidative effect and response. After chronic exposure, a significant decrease of CAT activity, increase of GPx activity and TBARS levels in gills was noticed. In liver, significant decrease in TBARS levels were observed in both exposures. Comet and ENAs assays indicated significant increases on genotoxic damage of O. mykiss, after erythromycin exposures. This set of data (acute and chronic) suggests that erythromycin has the potential to induce DNA strand breaks in blood cells, and demonstrate the induction of chromosome breakage and/or segregational abnormalities. Overall results indicate that both DNA damaging effects induced by

  5. Acute and chronic effects of erythromycin exposure on oxidative stress and genotoxicity parameters of Oncorhynchus mykiss

    International Nuclear Information System (INIS)

    Rodrigues, S.; Antunes, S.C.; Correia, A.T.; Nunes, B.

    2016-01-01

    Erythromycin (ERY) is a macrolide antibiotic used in human and veterinary medicine, and has been detected in various aquatic compartments. Recent studies have indicated that this compound can exert biological activity on non-target organisms environmentally exposed. The present study aimed to assess the toxic effects of ERY in Oncorhynchus mykiss after acute and chronic exposures. The here adopted strategy involved exposure to three levels of ERY, the first being similar to concentrations reported to occur in the wild, thus ecologically relevant. Catalase (CAT), total glutathione peroxidase (GPx), glutathione reductase (GRed) activities and lipid peroxidation (TBARS levels) were quantified as oxidative stress biomarkers in gills and liver. Genotoxic endpoints, reflecting different types of genetic damage in blood cells, were also determined, by performing analysis of genetic damage (determination of the genetic damage index, GDI, measured by comet assay) and of erythrocytic nuclear abnormalities (ENAs). The results suggest the occurrence of a mild, but significant, oxidative stress scenario in gills. For acutely exposed organisms, significant alterations were observed in CAT and GRed activities, and also in TBARS levels, which however are modifications with uncertain biological interpretation, despite indicating involvement of an oxidative effect and response. After chronic exposure, a significant decrease of CAT activity, increase of GPx activity and TBARS levels in gills was noticed. In liver, significant decrease in TBARS levels were observed in both exposures. Comet and ENAs assays indicated significant increases on genotoxic damage of O. mykiss, after erythromycin exposures. This set of data (acute and chronic) suggests that erythromycin has the potential to induce DNA strand breaks in blood cells, and demonstrate the induction of chromosome breakage and/or segregational abnormalities. Overall results indicate that both DNA damaging effects induced by

  6. Aging and extrapulmonary effects of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Tudorache E

    2017-08-01

    Full Text Available Emanuela Tudorache,1 Ariadna Petronela Fildan,2 Mirela Frandes,3 Elena Dantes,4 Doina Ecaterina Tofolean2 1Department of Pulmonology, University of Medicine and Pharmacy “Victor Babeş”, Timişoara, 2Faculty of Medicine, Internal Medicine Discipline, Medical Clinical Disciplines I, “Ovidius” University of Constanta, Constanţa, 3Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timişoara, 4Faculty of Medicine, Pneumophtisiology Department, Medical Clinical Disciplines II, “Ovidius” University Constanta, Constanţa, Romania Introduction: People with COPD have a decline in functional status, but little is known about the rate of decline and factors that contribute. Of particular concern is the decline in cognitive and functional performance. Decrease in cognitive and functional performance will finally lead to decreased health status, sedentary life style and premature frailty. Aim: The aim of this study is to compare functional performance and cognitive status in patients with COPD of different ages and to examine the changes in extrapulmonary effects. Patients and methods: This study included 62 patients with COPD risk class D who were divided into two groups (<70 years, N=30 and >70 years, N=32. Patients first completed the Montreal Cognitive Assessment (MoCA, which is a 30-point test that assesses different cognitive domains, while isometric knee extension (IKE was measured using a digital handheld dynamometer, and functional exercise level was assessed using the 6-minute walking distance (6MWD test. Results: The patients’ older age (age higher than 70 years was associated with a significantly lower body mass index (BMI, 27.50 vs 24.24 kg/m2; P=0.020, higher vital capacity parameters, forced vital capacity (FVC, 2.74 vs 2.82 L; P=0.799, FVC (% (73.00 vs 66.50, P=132, forced expiratory volume in the first second (FEV1, 0.93 vs 1.13 L; P=0.001 and FEV1 (% (28.50 vs 30.50, P=0.605. In

  7. Effects of Temperature on Chronic Trapezius Myofascial Pain Syndrome during Dry Needling Therapy

    Directory of Open Access Journals (Sweden)

    Gang Wang

    2014-01-01

    Full Text Available The purpose of this study was to investigate the effects of temperature on chronic trapezius myofascial pain syndrome during dry needling therapy. Sixty patients were randomized into two groups of dry needling (DN alone (group A and DN combined with heat therapy group (group B. Each patient was treated once and the therapeutic effect was assessed by the visual analogue scale (VAS, pressure pain threshold (PPT, and the 36-item short form health survey (SF-36 at seven days, one month, and three months after treatment. Evaluation based on VAS and PPT showed that the pain of patients in groups A and B was significantly (P<0.05 relieved at seven days, one month, and three months after treatment Compared to before treatment. There was significantly (P<0.05 less pain in group B than group A at one and three months after treatment. The SF-36 evaluation demonstrated that the physical condition of patients in both groups showed significant (P<0.05 improvement at one month and three months after treatment than before treatment. Our study suggests that both DN and DN heating therapy were effective in the treatment of trapezius MPS, and that DN heating therapy had better long-term effects than DN therapy.

  8. Effect of caudal epidural steroid or saline injection in chronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial

    DEFF Research Database (Denmark)

    Iversen, Trond; Solberg, Tore K; Romner, Bertil

    2011-01-01

    To assess the efficacy of caudal epidural steroid or saline injection in chronic lumbar radiculopathy in the short (6 weeks), intermediate (12 weeks), and long term (52 weeks).......To assess the efficacy of caudal epidural steroid or saline injection in chronic lumbar radiculopathy in the short (6 weeks), intermediate (12 weeks), and long term (52 weeks)....

  9. Acute and chronic environmental effects of clandestine methamphetamine waste.

    Science.gov (United States)

    Kates, Lisa N; Knapp, Charles W; Keenan, Helen E

    2014-09-15

    The illicit manufacture of methamphetamine (MAP) produces substantial amounts of hazardous waste that is dumped illegally. This study presents the first environmental evaluation of waste produced from illicit MAP manufacture. Chemical oxygen demand (COD) was measured to assess immediate oxygen depletion effects. A mixture of five waste components (10mg/L/chemical) was found to have a COD (130 mg/L) higher than the European Union wastewater discharge regulations (125 mg/L). Two environmental partition coefficients, K(OW) and K(OC), were measured for several chemicals identified in MAP waste. Experimental values were input into a computer fugacity model (EPI Suite™) to estimate environmental fate. Experimental log K(OW) values ranged from -0.98 to 4.91, which were in accordance with computer estimated values. Experimental K(OC) values ranged from 11 to 72, which were much lower than the default computer values. The experimental fugacity model for discharge to water estimates that waste components will remain in the water compartment for 15 to 37 days. Using a combination of laboratory experimentation and computer modelling, the environmental fate of MAP waste products was estimated. While fugacity models using experimental and computational values were very similar, default computer models should not take the place of laboratory experimentation. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Hypercaloric diet modulates effects of chronic stress: a behavioral and biometric study on rats.

    Science.gov (United States)

    Oliveira, Carla de; Oliveira, Cleverson Moraes de; de Macedo, Isabel Cristina; Quevedo, Alexandre S; Filho, Paulo Ricardo Marques; Silva, Fernanda Ribeiro da; Vercelino, Rafael; de Souza, Izabel C Custodio; Caumo, Wolnei; Torres, Iraci L S

    2015-01-01

    Obesity is a chronic disease that has been associated with chronic stress and hypercaloric diet (HD) consumption. Increased ingestion of food containing sugar and fat ingredients (comfort food) is proposed to "compensate" chronic stress effects. However, this eating habit may increase body fat depositions leading to obesity. This study evaluated behavioral/physiological parameters seeking to establish whether there is an association between the effects of HD intake and stress, and to test the hypothesis that the development of anxious behavior and obesity during chronic stress periods depends on the type of diet. Sixty-day-old male Wistar rats (n = 100) were divided into four groups: standard chow, hypercaloric diet, chronic stress/standard chow and chronic stress/hypercaloric diet. Chronic stress was induced by restraint stress exposure for 1 h/day, for 80 d. At the end of this period, rat behavior was evaluated using open-field and plus-maze tests. The results showed that HD alone increased weight gain and adipose deposition in subcutaneous and mesenteric areas. However, stress reduced weight gain and adipose tissue in these areas. HD also increased naso-anal length and concurrent stress prevented this. Behavioral data indicated that stress increased anxiety-like behaviors and comfort food reduced these anxiogenic effects; locomotor activity increased in rats fed with HD. Furthermore, HD decreased corticosterone levels and stress increased adrenal weight. The data indicate that when rats are given HD and experience chronic stress this association reduces the pro-obesogenic effects of HD, and decreases adrenocortical activity.

  11. Acute and Chronic Effects of Tributyltin on the Mysid Acanthomysis sculpta (Crustacea, Mysidacea).

    Science.gov (United States)

    1986-05-01

    juveniles . . . 19 12. Summary of chronic values in pg/L TBT . . . 26 viii INTRODUCTION Tributyltin ( TBT ) is commonly used as an antifouling toxicant in...juveniles was determined at 0 42-jig L TBT . Reproductive effects were the most sensitive sublethal indicator of TBT toxicity . A chronic value of 0.14-pgL...SI[CUmITV CLAShIFICATION OF THIS PASU M DAI &W- A comparison of TBT toxicity was performed using a TBT solution leached from painted panels

  12. Effect of Chronic Athletic Activity on Brown Fat in Young Women

    OpenAIRE

    Singhal, Vibha; Maffazioli, Giovana D.; Ackerman, Kate E.; Lee, Hang; Elia, Elisa F.; Woolley, Ryan; Kolodny, Gerald; Cypess, Aaron M.; Misra, Madhusmita

    2016-01-01

    Background: The effect of chronic exercise activity on brown adipose tissue (BAT) is not clear, with some studies showing positive and others showing negative associations. Chronic exercise is associated with increased resting energy expenditure (REE) secondary to increased lean mass and a probable increase in BAT. Many athletes are in a state of relative energy deficit suggested by lower fat mass and hypothalamic amenorrhea. States of severe energy deficit such as anorexia nervosa are associ...

  13. Effects of Pilates and Classical Kinesiotherapy on chronic low back pain: a case study

    OpenAIRE

    Ribeiro,Ivanna Avila; Oliveira,Tiago Damé de; Blois,Cleci Redin

    2015-01-01

    Abstract Introduction : Chronic low back pain (LBP) is characterized by daily lower back pain lasting more than three consecutive months. It may lead to functional disability and can be treated by several physical therapy techniques, including therapeutic exercise. The aim of this study was to investigate the effects of pilates and classical kinesiotherapy on the treatment of pain and functional disability in patients with chronic low back pain. Materials and methods : The study sample cons...

  14. An over-the-counter central sensitization therapy: a chronic back pain registry study of pain relief, medication use and their adverse effects.

    Science.gov (United States)

    Staelin, Richard; Koneru, Sree N; Rawe, Ian M

    2017-03-01

    Back pain, the most prevalent musculoskeletal chronic pain condition, is usually treated with analgesic medications of questionable efficacy and frequent occurrence of adverse side effects. The objective was to determine the effectiveness of the ActiPatch medical devices in reducing chronic back pain, document medication related adverse side effects and establish their impact on quality of life. Upon completing a 7-day trial, subjects were contacted via email with an assessment form using the Constant Contact email program. A total of 1394 responses were collected from subjects who used the device for back pain. Medication adverse effects are common and impact quality of life in the lay population. ActiPatch is an effective intervention for the majority of subjects for treating chronic back pain, although this requires further investigation in randomized clinical trials.

  15. Effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depression: a systematic review (METACHRON

    Directory of Open Access Journals (Sweden)

    von Wolff Alessa

    2010-11-01

    Full Text Available Abstract Background Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. Yet, a systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing. Methods/Design Aim of this project is to summarize empirical evidence on efficacy and effectiveness of treatments for chronic depression by means of a systematic review. The primary objectives of the study are to examine, which interventions are effective; to examine, if any differences in effectiveness between active treatment options exist; and to find possible treatment effect modifiers. Psychotherapeutic, pharmacological, and combined treatments will be considered as experimental interventions and no treatment, wait-list, psychological/pharmacological placebo, treatment as usual, and other active treatments will be seen as comparators. The population of patients will include adults with chronic major depression, dysthymia, double depression, or recurrent depression without complete remission between episodes. Outcomes of the analyses are depressive symptoms, associated consequences, adverse events, and study discontinuation. Only randomized controlled trials will be considered. Discussion Given the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance. Special attention will be given to the use of current methodological standards. Findings are likely to provide crucial information that may help clinicians to choose the appropriate treatment for chronically depressed patients.

  16. Effect of fibular repositioning taping in adult basketball players with chronic ankle instability: a randomized, placebo-controlled, crossover trial.

    Science.gov (United States)

    Alves, Yanina; Ribeiro, Fernando; Silva, Anabela G

    2017-07-05

    Chronic ankle instability presents a high incidence and prevalence in basketbal players. It's important to develop strategies to reduce the functional and mechanical limitations resulting from this condition. To compare the effect of Mulligan ́s fibular repositioning taping with a placebo taping immediatly after application and after a running test (Yo-Yo IRT). 16 adult basketball players (10 male, 6 female) with chronic ankle instability and mean age 21.50 ± 2.76 years old. Assessment of static postural control (15 seconds of unipedal stance test with eyes closed in a force platform), functional performance (figure 8 hop test and lateral hop test) and neuromuscular control (peroneus longus latency time in sudden inversion) in two conditions: Mulligan and Placebo. No significant effect was found for the intervantion factor in both hop tests (p>0.170), but there was a significant effect for the time factor (p<0.03). For the peroneus longus latency time, there was a significant interaction between factors (p=0.028) and also for time (p=0.042). No significant effect was found for any of the static postural control variables (area, speed and total displacement) (p≥0.10). There was no differences between Mulligan's fibular repositioning taping and Placebo taping in postural control and functional performance in basketball players with chronic ankle instability. However, Mulligan's taping appears to reduce peroneus longus latency time after a running when compared with a placebo taping.

  17. Noninvasive Assessment of Oxygen Extraction Fraction in Chronic Ischemia Using Quantitative Susceptibility Mapping at 7 Tesla.

    Science.gov (United States)

    Uwano, Ikuko; Kudo, Kohsuke; Sato, Ryota; Ogasawara, Kuniaki; Kameda, Hiroyuki; Nomura, Jun-Ichi; Mori, Futoshi; Yamashita, Fumio; Ito, Kenji; Yoshioka, Kunihiro; Sasaki, Makoto

    2017-08-01

    The oxygen extraction fraction (OEF) is an effective metric to evaluate metabolic reserve in chronic ischemia. However, OEF is considered to be accurately measured only when using positron emission tomography (PET). Thus, we investigated whether OEF maps generated by magnetic resonance quantitative susceptibility mapping (QSM) at 7 Tesla enabled detection of OEF changes when compared with those obtained with PET. Forty-one patients with chronic stenosis/occlusion of the unilateral internal carotid artery or middle cerebral artery were examined using 7 Tesla-MRI and PET scanners. QSM images were obtained from 3-dimensional T2*-weighted images, using a multiple dipole-inversion algorithm. OEF maps were generated based on susceptibility differences between venous structures and brain tissues on QSM images. OEF ratios of the ipsilateral middle cerebral artery territory against the contralateral side were calculated on the QSM-OEF and PET-OEF images, using an anatomic template. The OEF ratio in the middle cerebral artery territory showed significant correlations between QSM-OEF and PET-OEF maps ( r =0.69; P 1.09, as determined by receiver operating characteristic analysis, showed a sensitivity and specificity of 0.82 and 0.86, respectively, for the substantial increase in the PET-OEF ratio. Absolute QSM-OEF values were significantly correlated with PET-OEF values in the patients with increased PET-OEF. OEF ratios on QSM-OEF images at 7 Tesla showed a good correlation with those on PET-OEF images in patients with unilateral steno-occlusive internal carotid artery/middle cerebral artery lesions, suggesting that noninvasive OEF measurement by MRI can be a substitute for PET. © 2017 American Heart Association, Inc.

  18. Effects of Ramadan fasting on the symptoms of chronic heart failure.

    Science.gov (United States)

    Abazid, Rami M; Khalaf, Hassan H; Sakr, Haitham I; Altorbak, Nora A; Alenzi, Habiba S; Awad, Zaki M; Smettei, Osama A; Elsanan, Moataz A; Widyan, Adel M; Azazy, Ahmed S; Chamsi-Pasha, Hassan W

    2018-04-01

    To investigate the effect of Ramadan fasting on the symptoms of chronic heart failure with a reduced ejection fraction (HFrEF). Globally, more than one billion Muslims fast during Ramadan. Data regarding the effect of fasting in heart failure patients with a reduced ejection fraction are limited. We prospectively studied 249 outpatients with HFrEF who undertook Ramadan fasting at tertiary care cardiac center in Saudi Arabia in 2017. We obtained information regarding the clinical assessment, diagnosis, emergency department visits, and hospitalization during and in the month preceding Ramadan. We enrolled 249 patients, 227 (91%) undertook the fast for the entire month. During Ramadan, 209 (92%) patients remained hemodynamically stable, whereas 18 (8%) developed instability. The mean New York Heart Association (NYHA) functional class was significantly lower in the stable than in the unstable group (1.46±0.7 vs. 3.22±0.55, p less than 0.0001), although no intergroup differences were observed before Ramadan. Patients from the unstable vs. the stable group showed significantly less adherence to medications (67% vs. 94%, p less than 0.0001) and to diet (39% vs. 79%, p less than 0.0001), and a lower likelihood of demonstrating ischemic cardiomyopathy as an underlying etiology of HFrEF (33% vs. 57%, p=0.046). Dependent t-test analysis including all patients showed that the NYHA classification before Ramadan was significantly higher than during Ramadan (2.19±0.9 vs. 1.6±0.8, t-value 8.5, p less than 0.0001). In most patients with chronic HFrEF, Ramadan fasting is considered safe. Non-adherence to medication and diet are significantly associated with decompensated heart failure during Ramadan.

  19. Saphenofemoral ligation as a safe and effective alternative for the treatment of chronic venous leg ulcer

    International Nuclear Information System (INIS)

    El-Hafez, Emad A.; Seleem, Mohamed I.

    2004-01-01

    To evaluate the effectiveness and safety of isolated saphenofemoral junction ligation for the treatment of chronic venous leg ulcer in comparison to traditional stripping procedure. 36 patients (28 men and 8 women) with mean age of 42.3+-8.7, presented with a venous leg ulcer. After taking the full history, they underwent examination for presence of edema, cellulitis or local ulcer infection. The site and size of ulceration were recorded and ankle-brachial pressure index (ABPI) was measured, Venous valvular incompetence was assessed using Valsalva testand calf compression. Patients were divided into 2 groups. Group I, (n=10) assigned for long saphenous stripping, while group II (n=26) assigned for saphenofemoral ligationan and divided combined with ligation of major tributaries under local infiltration anesthesia. Mean operative time, postoperative complications and hospital stay were recorded. The study was carried out in Benha University Hospital, Egypt and Armed Forces Hospital, Southern Region, Khamis Mushayt, Sadi Arabia between January 2000 and December 2001. The mean operative time and the hospital stay were significantly (p<0.05) reduced in group II compared to group I. The postoperative complications were signficantly (x=7.5, p<0.05) reduced in group II. Ulcer healing started after 3 months in group II and six months in group I, but by 12 month, group II had significant (x=6.7, p<0.05) number of healed ulcers (n=22, 84.6%), compared to group I (n=7, 70%). The isolated ligation of of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considerd to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general anesthesia. (author)

  20. Assessing the perception of trunk movements in military personnel with chronic non-specific low back pain using a virtual mirror

    NARCIS (Netherlands)

    Roosink, M.; McFadyen, B.J.; Hebert, L.J.; Jackson, P.L.; Bouyer, L.J.; Mercier, C.

    2015-01-01

    Chronic pain, including chronic non-specific low back pain (CNSLBP), is often associated with body perception disturbances, but these have generally been assessed under static conditions. The objective of this study was to use a "virtual mirror" that scaled visual movement feedback to assess body

  1. Assessment of bone mineral density in adults with a history of juvenile chronic arthritis: a cross-sectional long-term followup study

    DEFF Research Database (Denmark)

    Zak, M; Hassager, C; Lovell, D J

    1999-01-01

    To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD.......To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD....

  2. Effects of prenatal exposure to chronic mild stress and toluene in rats

    DEFF Research Database (Denmark)

    Hougaard, K. S.; Andersen, Maud Bering; Hansen, A. M.

    2005-01-01

    The aim of the present study was to elucidate whether prenatal chronic stress, in combination with exposure to a developmental neurotoxicant, would increase effects in the offspring compared with the effects of either exposure alone. Development and neurobehavioral effects were investigated in fe...

  3. Effect and safety of spinal cord stimulation for treatment of chronic pain caused by diabetic neuropathy

    NARCIS (Netherlands)

    de Vos, C.; de Vos, Cecile C.; Rajan, Vinayakrishnan; Steenbergen, Wiendelt; van der Aa, Hans E.; Buschman, H.P.J.

    2009-01-01

    Aim: Spinal cord stimulation (SCS) has been shown effective as a therapy for different chronic painful conditions, but the effectiveness of this treatment for pain as a result of peripheral diabetic neuropathy is not well established. The primary objectives of this study were to evaluate the effect

  4. Pre-clinical efficacy assessment of Malva sylvestris on chronic skin inflammation.

    Science.gov (United States)

    Prudente, Arthur S; Sponchiado, Graziela; Mendes, Daniel A G B; Soley, Bruna S; Cabrini, Daniela A; Otuki, Michel F

    2017-09-01

    In the search for improved quality of life, the treatment of skin diseases like psoriasis (hyperproliferative disease) is valid, since it causes huge social discomfort to the patient. In this context, earlier studies showed that Malva sylvestris L. has anti-inflammatory activity demonstrated by acute animal models of skin inflammation, becoming a promising target for further studies. The present investigation aimed to verify the effect of hydroalcoholic extract of M. sylvestris (HEMS) on the chronic inflammatory and hyperproliferative response caused by multiple applications of 12-O-tetradecanoylphorbol-13-acetate (TPA) on mouse ears. Topical application of HEMS reduced oedema, leukocyte migration (mono- and polymorphonuclear cells) and keratinocyte hyperproliferation, confirmed by histology and proliferating cell nuclear antigen (PCNA) immunostaining. It was found that the anti-inflammatory effects of the extract did not involve the glucocorticoid system, and its incubation with HaCaT keratinocytes caused low toxicity and reduced cell proliferation by apoptosis. Thus, HEMS proved to be effective as an anti-psoriatic therapy, with the ability to prevent keratinocyte hyperproliferation and with low toxicity by topical application. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. [Damage effects of chronic hypoxia on medulla oblongata associated with oxidative stress and cell apoptosis].

    Science.gov (United States)

    Hou, Xuefei; Ding, Yan; Nie, Zheng; Li, Hui; Tang, Yuhong; Zhou, Hua; Chen, Li; Zheng, Yu

    2012-08-01

    The aim of this study is to study the damage effects of chronic hypoxia on medulla oblongata and to explore whether the damage is associated with oxidative stress and cell apoptosis. Adult male SD rats were randomly divided into two groups: control group and chronic hypoxia group. Medulla oblongata was obtained for the following methods of analyses. Nissl's staining was used to examine the Niss bodies of neurons in medullary respiratory related nuclei, biochemistry methods were utilized to examine oxidant stress damage induced by chronic hypoxia on medulla oblongata through measuring malondialdehyde (MDA) content and superoxide dismutase (SOD) activity, and RT-PCR technique was used to study the influence of apoptosis induced by chronic hypoxia on medulla oblongata through analyzing the levels of Bax mRNA and Bcl-2 mRNA. The results showed the optical densities of Nissl's staining in pre-BötC, NA, NTS, FN, and 12N were significantly decreased in chronic hypoxia group in comparison with that in control group (P 0.05). Bax mRNA expression had no obvious change and Bcl-2 mRNA expression significantly decreased in chronic hypoxia group in comparison with that in control group (P < 0.05). The results suggest that chronic hypoxia could bring about serious damage to medullary respiratory centers through aggravating oxidative stress and increasing cell apoptosis.

  6. Effects of acute and chronic administration of methylprednisolone on oxidative stress in rat lungs

    Directory of Open Access Journals (Sweden)

    Ronaldo Lopes Torres

    2014-06-01

    Full Text Available Objective: To determine the effects of acute and chronic administration of methylprednisolone on oxidative stress, as quantified by measuring lipid peroxidation (LPO and total reactive antioxidant potential (TRAP, in rat lungs. Methods: Forty Wistar rats were divided into four groups: acute treatment, comprising rats receiving a single injection of methylprednisolone (50 mg/kg i.p.; acute control, comprising rats i.p. injected with saline; chronic treatment, comprising rats receiving methylprednisolone in drinking water (6 mg/kg per day for 30 days; and chronic control, comprising rats receiving normal drinking water. Results: The levels of TRAP were significantly higher in the acute treatment group rats than in the acute control rats, suggesting an improvement in the pulmonary defenses of the former. The levels of lung LPO were significantly higher in the chronic treatment group rats than in the chronic control rats, indicating oxidative damage in the lung tissue of the former. Conclusions: Our results suggest that the acute use of corticosteroids is beneficial to lung tissue, whereas their chronic use is not. The chronic use of methylprednisolone appears to increase lung LPO levels.

  7. Short- and long-term antidepressant effects of ketamine in a rat chronic unpredictable stress model.

    Science.gov (United States)

    Jiang, Yinghong; Wang, Yiqiang; Sun, Xiaoran; Lian, Bo; Sun, Hongwei; Wang, Gang; Du, Zhongde; Li, Qi; Sun, Lin

    2017-08-01

    This research was aimed to evaluate the behaviors of short- or long-term antidepressant effects of ketamine in rats exposed to chronic unpredictable stress (CUS). Ketamine, a glutamate noncompetitive NMDA receptor antagonist, regulates excitatory amino acid functions, such as anxiety disorders and major depression, and plays an important role in synaptic plasticity and learning and memory. After 42 days of CUS model, male rats received either a single injection of ketamine (10 mg/kg; day 43) or 15 daily injections (days 43-75). The influence of ketamine on behavioral reactivity was assessed 24 hr (short-term) or 7 weeks after ketamine treatment (long-term). Behavioral tests used to assess the effects of these treatments included the sucrose preference (SP), open field (OF), elevated plus maze (EPM), forced swimming (FS), and water maze (WM) to detect anxiety-like behavior (OF and EPM), forced swimming (FS), and water maze (WM). Results: Short-term ketamine administration resulted in increases of body weight gain, higher sensitivity to sucrose, augmented locomotor activity in the OF, more entries into the open arms of the EPM, along increased activity in the FS test; all responses indicative of reductions in depression/despair in anxiety-eliciting situations. No significant differences in these behaviors were obtained under conditions of long-term ketamine administration ( p  > .05). The CUS + Ketamine group showed significantly increased activity as compared with the CUS + Vehicle group for analysis of the long-term effects of ketamine (* p   .05). Taken together these findings demonstrate that a short-term administration of ketamine induced rapid antidepressant-like effects in adult male rats exposed to CUS conditions, effects that were not observed in response to the long-term treatment regime.

  8. Assessment of printed patient-educational materials for chronic kidney disease.

    Science.gov (United States)

    Tuot, Delphine S; Davis, Elizabeth; Velasquez, Alexandra; Banerjee, Tanushree; Powe, Neil R

    2013-01-01

    Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (superior = 70-100; adequate = 40-69; inadequate = 6th grade) was associated with an 11.7 point higher mean rating. Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD. Copyright © 2013 S. Karger AG, Basel.

  9. Comprehensive assessment of peripheral blood TCRβ repertoire in infectious mononucleosis and chronic active EBV infection patients.

    Science.gov (United States)

    Liu, Shenglin; Zhang, Qian; Huang, Dongli; Zhang, Wenli; Zhong, Fengluan; Feng, Jia; Chen, Xueru; Meng, Qingxiang; Chen, Xiaofan; Zhang, Wei; Zhang, Hongyu

    2017-04-01

    Epstein-Barr virus (EBV) primary infection is usually asymptomatic, but it sometimes progresses to infectious mononucleosis (IM). Occasionally, some people develop chronic active EBV infection (CAEBV) with underlying immunodeficiency, which belongs to a continuous spectrum of EBV-associated lymphoproliferative disorders (EBV + LPD) with heterogeneous clinical presentations and high mortality. It has been well established that T cell-mediated immune response plays a critical role in the disease evolution of EBV infection. Recently, high-throughput sequencing of the hypervariable complementarity-determining region 3 (CDR3) segments of the T cell receptor (T cell receptor β (TCRβ)) has emerged as a sensitive approach to assess the T cell repertoire. In this study, we fully characterized the diversity of peripheral blood TCRβ repertoire in IM (n = 6) and CAEBV patients (n = 5) and EBV-seropositive controls (n = 5). Compared with the healthy EBV-seropositive controls, both IM and CAEBV patients demonstrate a significant decrease in peripheral blood TCRβ repertoire diversity, basically, including narrowed repertoire breadth, highly expanded clones, and skewed CDR3 length distribution. However, there is no significant difference between IM and CAEBV patients. Furthermore, we observed some disease-related preferences in TRBV/TRBJ usage and combinations, as well as lots of T cell clones shared by different groups (unique or overlapped) involved in public T cell responses, which provide more detailed insights into the divergent disease evolution.

  10. Assessment of chronic kidney disease using skin texture as a key parameter: for South Indian population.

    Science.gov (United States)

    Udhayarasu, Madhanlal; Ramakrishnan, Kalpana; Periasamy, Soundararajan

    2017-12-01

    Periodical monitoring of renal function, specifically for subjects with history of diabetic or hypertension would prevent them from entering into chronic kidney disease (CKD) condition. The recent increase in numbers may be due to food habits or lack of physical exercise, necessitates a rapid kidney function monitoring system. Presently, it is determined by evaluating glomerular filtration rate (GFR) that is mainly dependent on serum creatinine value and demographic parameters and ethnic value. Attempted here is to develop ethnic parameter based on skin texture for every individual. This value when used in GFR computation, the results are much agreeable with GFR obtained through standard modification of diet in renal disease and CKD epidemiology collaboration equations. Once correlation between CKD and skin texture is established, classification tool using artificial neural network is built to categorise CKD level based on demographic values and parameter obtained through skin texture (without using creatinine). This network when tested gives almost at par results with the network that is trained with demographic and creatinine values. The results of this Letter demonstrate the possibility of non-invasively determining kidney function and hence for making a device that would readily assess the kidney function even at home.

  11. MRI assessed pancreatic morphology and exocrine function are associated with disease burden in chronic pancreatitis.

    Science.gov (United States)

    Madzak, Adnan; Olesen, Søren Schou; Lykke Poulsen, Jakob; Bolvig Mark, Esben; Mohr Drewes, Asbjørn; Frøkjær, Jens Brøndum

    2017-11-01

    The aim of this study was to explore the association between morphological and functional secretin-stimulated MRI parameters with hospitalization, quality of life (QOL), and pain in patients with chronic pancreatitis (CP). This prospective cohort study included 82 patients with CP. Data were obtained from clinical information, QOL, and pain as assessed by questionnaires (The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and modified Brief Pain Inventory short form). Secretin-stimulated MRI morphological parameters included pancreatic gland volume, main pancreatic duct diameter, the modified Cambridge Classification of Duct Abnormality, apparent diffusion coefficient, fat signal fraction, and the pancreatic secretion volume as a functional parameter. The primary outcomes were time to first hospitalization related to the CP, as well as annual hospitalization frequency and duration. The secondary outcomes were pain severity, QOL, and pain interference scores. A main pancreatic duct diameter below 5 mm was associated with reduced time to first hospitalization (hazard ratio=2.06; 95% confidence interval: 1.02-4.17; P=0.043). Pancreatic secretion volume was correlated with QOL (r=0.31; P=0.0072) and pain interference score (r=-0.27; P=0.032), and fecal elastase was also correlated with QOL (r=0.28; P=0.017). However, functional and morphological findings were not related to pain intensity. Advanced pancreatic imaging techniques may be a highly sensitive tool for prognostication and monitoring of disease activity and its consequences.

  12. Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain.

    Science.gov (United States)

    Turk, Dennis C

    2002-01-01

    Chronic pain is a prevalent and costly problem. This review addresses the question of the clinical effectiveness and cost-effectiveness of the most common treatments for patients with chronic pain. Representative published studies that evaluate the clinical effectiveness of pharmacological treatments, conservative (standard) care, surgery, spinal cord stimulators, implantable drug delivery systems (IDDSs), and pain rehabilitation programs (PRPs) are examined and compared. The cost-effectiveness of these treatment approaches is also considered. Outcome criteria including pain reduction, medication use, health care consumption, functional activities, and closure of disability compensation cases are examined. In addition to clinical effectiveness, the cost-effectiveness of PRPs, conservative care, surgery, spinal cord stimulators, and IDDSs are compared using costs to return a treated patient to work to illustrate the relative expenses for each of these treatments. There are limitations to the success of all the available treatments. The author urges caution in interpreting the results, particularly in comparisons between treatments and across studies, because there are broad differences in the pain syndromes and inclusion criteria used, the drug dosages, comparability of treatments, the definition of "chronic" used, the outcome criteria selected to determine success, and societal differences. None of the currently available treatments eliminates pain for the majority of patients. Pain rehabilitation programs provide comparable reduction in pain to alternative pain treatment modalities, but with significantly better outcomes for medication use, health care utilization, functional activities, return to work, closure of disability claims, and with substantially fewer iatrogenic consequences and adverse events. Surgery, spinal cord stimulators, and IDDSs appear to have substantial benefits on some outcome criteria for carefully selected patients. These modalities are

  13. The lifestyle of patients with chronic fatigue syndrome and the effect on fatigue and functional impairments

    NARCIS (Netherlands)

    Goedendorp, M. M.; Knoop, H.; Schippers, G. M.; Bleijenberg, G.

    2009-01-01

    Background: Little is known about the lifestyle of patients with chronic fatigue syndrome (CFS) and its influence on symptoms of CFS. The present study aimed to investigate the lifestyle of patients with CFS, and to assess whether lifestyle factors are related to fatigue and functional impairments.

  14. The lifestyle of patients with chronic fatigue syndrome and the effect on fatigue and functional impairments.

    NARCIS (Netherlands)

    Goedendorp, M.M.; Knoop, H.; Schippers, G.M.; Bleijenberg, G.

    2009-01-01

    BACKGROUND: Little is known about the lifestyle of patients with chronic fatigue syndrome (CFS) and its influence on symptoms of CFS. The present study aimed to investigate the lifestyle of patients with CFS, and to assess whether lifestyle factors are related to fatigue and functional impairments.

  15. Chronic sleep reduction in adolescents with Delayed Sleep Phase Disorder and effects of melatonin treatment

    NARCIS (Netherlands)

    van Maanen, Annette; Dewald-Kaufmann, Julia F.; Smits, Marcel G.; Oort, Frans J.; Meijer, Anne Marie

    2013-01-01

    Homeostatic and circadian changes that occur during adolescence can result in chronic sleep reduction. This may particularly be true for adolescents with Delayed Sleep Phase Disorder (DSPD), which is associated with late Dim Light Melatonin Onset (DLMO). This study assessed the influence of

  16. No effects of PRP on ultrasonographic tendon structure and neovascularisation in chronic midportion Achilles tendinopathy

    NARCIS (Netherlands)

    de Vos, R. J.; Weir, A.; Tol, J. L.; Verhaar, J. A. N.; Weinans, H.; van Schie, H. T. M.

    2011-01-01

    To assess whether a platelet-rich plasma (PRP) injection leads to an enhanced tendon structure and neovascularisation, measured with ultrasonographic techniques, in chronic midportion Achilles tendinopathy. Double-blind, randomised, placebo-controlled clinical trial. Sports medical department of The

  17. Effect Evaluation of a Self-Management Program for Dutch Workers with a Chronic Somatic Disease: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Frank van Dijk; Josephine Engels; Sarah Detaille; Yvonne Heerkens; Joost van der Gulden

    2013-01-01

    Purpose: The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. Methods: In a

  18. Clinical global assessment of nutritional status as predictor of mortality in chronic kidney disease patients.

    Science.gov (United States)

    Dai, Lu; Mukai, Hideyuki; Lindholm, Bengt; Heimbürger, Olof; Barany, Peter; Stenvinkel, Peter; Qureshi, Abdul Rashid

    2017-01-01

    The value of subjective global assessment (SGA) as nutritional assessor of protein-energy wasting (PEWSGA) in chronic kidney disease (CKD) patients depends on its mortality predictive capacity. We investigated associations of PEWSGA with markers of nutritional status and all-cause mortality in CKD patients. In 1031 (732 CKD1-5 non-dialysis and 299 dialysis) patients, SGA and body (BMI), lean (LBMI) and fat (FBMI) body mass indices, % handgrip strength (% HGS), serum albumin, and high sensitivity C-reactive protein (hsCRP) were examined at baseline. The five-year all-cause mortality predictive strength of baseline PEWSGA and during follow-up were investigated. PEWSGA was present in 2% of CKD1-2, 16% of CKD3-4, 31% of CKD5 non-dialysis and 44% of dialysis patients. Patients with PEWSGA (n = 320; 31%) had higher hsCRP and lower BMI, LBMI, FBMI, %HGS and serum albumin. But, using receiver operating characteristics-derived cutoffs, these markers could not classify (by kappa statistic) or explain variations of (by multinomial logistic regression analysis) presence of PEWSGA. In generalized linear models, SGA independently predicted mortality after adjustments of multiple confounders (RR: 1.17; 95% CI: 1.11-1.23). Among 323 CKD5 patients who were re-assessed after median 12.6 months, 222 (69%) remained well-nourished, 37 (11%) developed PEWSGA de novo, 40 (12%) improved while 24 (8%) remained with PEWSGA. The latter independently predicted mortality (RR: 1.29; 95% CI: 1.13-1.46). SGA, a valid assessor of nutritional status, is an independent predictor of all-cause mortality both in CKD non-dialysis and dialysis patients that outperforms non-composite nutritional markers as prognosticator.

  19. Etiopathophysiological assessment of cases with chronic daily headache: A functional magnetic resonance imaging included investigation

    Science.gov (United States)

    Hashemi, Akram; Nami, Mohammad Torabi; Oghabian, Mohammad Ali; Ganjgahi, Habib; Vahabi, Zahra

    2012-01-01

    Background Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology of this type of headache. Methods We recruited four CDH cases for comprehensive assessments, including history taking, physical examinations and neuropsychological evaluations (The Addenbrooke's Cognitive Evaluation, Beck's Anxiety and Depression Inventories, Pittsburg Sleep Quality Index and Epworth Sleepiness Scale). Visual analogue scale (VAS) was used to self-rate the intensity of headache. Patients then underwent electroencephalography (EEG), transcranial Doppler (TCD) and functional magnetic resonance imaging (fMRI) evaluations during maximal (VAS = 8-10/10) and off-headache (VAS = 0-3/10) conditions. Data were used to compare in both conditions. We also used BOLD (blood oxygen level dependent) -group level activation map fMRI to poss