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Sample records for chronic tension type

  1. Increased muscular and cutaneous pain sensitivity in cephalic region in patients with chronic tension-type headache.

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    Ashina, S; Babenko, L; Jensen, R; Ashina, M; Magerl, W; Bendtsen, L

    2005-07-01

    Increased excitability of the central nervous system generated by repetitive and sustained pericranial myofascial nociception may be responsible for transformation of episodic tension-type headache into chronic form. We aimed to compare mechanical and electrical (intramuscular and cutaneous) pain thresholds in trapezius and anterior tibial regions between 20 patients with chronic tension type headache and 20 healthy controls. Pain thresholds to three types of electrical stimulation (single pulse, 2 and 100 Hz) were significantly lower in patients than in controls in trapezius muscle (P tension-type headache than in healthy controls. Increased sensitivity in nociceptive pathways from cephalic region may be of importance in the pathophysiology of chronic tension type headache.

  2. Vitamin D deficiency mimicking chronic tension-type headache in children.

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    Prakash, Sanjay; Makwana, Prayag; Rathore, Chaturbhuj

    2016-02-02

    Headache, musculoskeletal pain and vitamin D deficiency, with possible inter-relationship, are common in the general population. We report cases of three premenarchal girls presenting with chronic tension-type headache and generalised body pain. The patients did not show any response to conventional therapy for tension headache. Investigations showed a severe vitamin D deficiency and biochemical osteomalacia in all three patients. The headaches and musculoskeletal pain responded markedly to vitamin D therapy. We suggest that musculoskeletal pain and headache together in a patient may be part of a single symptom complex, with vitamin D deficiency being the possible cause.

  3. Altered pain perception in children with chronic tension-type headache: Is this a sign of central sensitisation?

    DEFF Research Database (Denmark)

    Soee, AL; Thomsen, LL; Kreiner, S

    2013-01-01

    The aim of this article is to investigate if children (7-17 years) with frequent episodic tension-type headache (FETTH) or chronic TTH (CTTH) have an altered pain perception compared to healthy controls.......The aim of this article is to investigate if children (7-17 years) with frequent episodic tension-type headache (FETTH) or chronic TTH (CTTH) have an altered pain perception compared to healthy controls....

  4. Morphology of muscular function in chronic tension-type headache: a pilot study.

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    Biyouki, Fariba; Laimi, Katri; Rahati, Saeed; Boostani, Reza; Shoeibi, Ali

    2016-09-01

    Chronic pain has been thought to induce muscular changes in chronic tension-type headache (CTTH) patients. As the knowledge of muscular responses in CTTH is inconsistent, we decided to introduce new electromyogram signal shape descriptors. We also wanted to compare the discriminatory power of proposed indices with classical measures to establish their potential to act as markers for CTTH. Thirty-eight headache patients with twenty healthy volunteers were recruited. Twenty patients had CTTH, while 18 had migraine without aura. Surface electromyogram data were recorded from right sternocleidomastoid and left temporalis muscles during rest and in a headache-free situation. Besides conventional root mean square (RMS) and median frequency (MDF), two morphological-based indices, skewness and kurtosis, were proposed to quantify the shape variations of signal distribution. Results demonstrated that the skewness outperformed RMS and MDF in terms of discriminatory power (p muscular responses in chronic headache sufferers. This finding could be due to adaptation to muscle underuse or sustained contraction, leading to impaired recruitment and muscle fiber-type conversion with dominant type I fibers in CTTH.

  5. Forward head posture and neck mobility in chronic tension-type headache: a blinded, controlled study.

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    Fernández-de-las-Peñas, C; Alonso-Blanco, C; Cuadrado, M L; Pareja, J A

    2006-03-01

    Forward head posture (FHP) and neck mobility were objectively assessed in 25 patients with chronic tension-type headache (CTTH) and 25 healthy controls. Side-view pictures were taken in a sitting position to measure the cranio-vertebral angle. A cervical goniometer was employed to measure the range of all cervical motions. Patients with CTTH showed a smaller cranio-vertebral angle (45.3 degrees +/- 7.6 degrees) than controls (54.1 degrees +/- 6.3 degrees), thus presenting a greater FHP (P neck mobility for all cervical movements, except for right lateral flexion (P angle and neck mobility. Within the CTTH group, a negative correlation was found between the cranio-vertebral angle and headache frequency, but neck mobility did not correlate with headache parameters. Further research is needed to define a potential role of FHP and restricted neck mobility in the origin or maintenance of TTH.

  6. Tender points are not sites of ongoing inflammation -in vivo evidence in patients with chronic tension-type headache

    DEFF Research Database (Denmark)

    Ashina, M; Stallknecht, Bente; Bendtsen, L

    2003-01-01

    Increased muscle tenderness is the most prominent finding in patients with tension-type headache, and it has recently been shown that muscle blood flow is diminished in response to static exercise in tender points in these patients. Although tenderness has been ascribed to local inflammation...... (ATP), glutamate, bradykinin and other metabolites in a tender point of patients with chronic tension-type headache, in the resting state as well as in response to static exercise, and to compare findings with measurements in a matched non-tender point of healthy controls. We recruited 16 patients...... with chronic tension-type headache and 17 healthy control subjects. Two microdialysis catheters were inserted into the trapezius muscle and dialysates were collected at rest, 15 and 30 min after start of static exercise (10% of maximal force) and 15 and 30 min after end of exercise. All samples were coded...

  7. Restricted neck mobility in children with chronic tension type headache: a blinded, controlled study.

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    Fernández-Mayoralas, Daniel M; Fernández-de-las-Peñas, César; Palacios-Ceña, Domingo; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Pareja, Juan A

    2010-10-01

    The main purpose of this study was to analyze the differences in neck mobility between children with chronic tension type headache (CTTH) and healthy children, and to determine the influence of cervical mobility on headache intensity, frequency and duration. Fifty children, 13 boys and 37 girls (mean age 8.5 ± 1.6 years) with CTTH associated to peri-cranial tenderness (IHS 2.3.1) and 50 age- and sex matched children without headache (13 boys, 37 girls, mean age 8.5 ± 1.8 years, P = 0.955) participated. Cervical range of motion (CROM) was objectively assessed with a cervical goniometer by an assessor blinded to the children's condition. Children completed a headache diary for 4 weeks to confirm the diagnosis. Children with CTTH showed decreased CROM as compared to children without headache for flexion (z = -6.170; P 0.125) or gender (P > 0.250) did not influence CROM in either children with CTTH or without headache. Current results support the hypothesis that the cervical spine should be explored in children with headache. Further research is also needed to clearly define the potential role of the cervical spine in the genesis or maintenance of CTTH.

  8. Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache.

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    Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

    2007-05-01

    Referred pain and pain characteristics evoked from the upper trapezius muscle was investigated in 20 patients with chronic tension-type headache (CTTH) and 20 age- and gender-matched controls. A headache diary was kept for 4 weeks in order to confirm the diagnosis and record the pain history. Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold (PPT) were recorded. The results show that referred pain was evoked in 85% and 50% on the dominant and non-dominant sides in CTTH patients, much higher than 55% and 25% in controls (P<0.01). Referred pain spread to the posterior-lateral aspect of the neck ipsi-lateral to the stimulated muscle in both patients and controls, with additional referral to the temple in most patients, but none in controls. Nearly half of the CTTH patients (45%) recognized the referred pain as their usual headache sensation, i.e. active TrPs. CTTH patients with active TrPs in the right upper trapezius muscle showed greater headache intensity and frequency, and longer headache duration than those with latent TrPs. CTTH patients with bilateral TrPs reported significantly decreased PPT than those with unilateral TrP (P<0.01). Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.

  9. Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache.

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    Peñacoba-Puente, Cecilia; Fernández-de-Las-Peñas, César; González-Gutierrez, Jose L; Miangolarra-Page, Juan C; Pareja, Juan A

    2008-10-01

    Our aim was to investigate the mediating or moderating role of anxiety and depression in the relationship between headache clinical parameters and quality of life in Chronic Tension-Type Headache (CTTH). Twenty-five patients diagnosed with CTTH according to the criteria of the International Headache Society were studied. A headache diary was kept for 4 weeks in order to substantiate the diagnosis and record the pain history. Quality of life was assessed by means of the Medical Outcome Study (MOS) 36-Item Short-Form (SF-36) questionnaire. The Beck Depression Inventory (BDI-II) was used to assess depression, and the Trait Anxiety Scale (TA) from the State-Trait Anxiety Inventory was administered in order to assess anxiety. Moderating and mediating analyses were conducted with ordinary least squares multiple regression analysis using the SPSS General Linear Model procedure. Anxiety mediated the effect between headache frequency and quality of life, but not the effect of either headache intensity or duration. Anxiety totally mediated the effects of headache frequency on vitality, social functioning and mental health. On the other hand, depression modulated the effect in the mental health domain. The effect in the mental health domain was a function of the interaction between headache duration and depression (beta=-0.34, p<0.05), after controlling for age, gender, the main effects of headache duration, and depression. We did not find anxiety to be a moderating factor between intensity, frequency or duration of headache and perceived quality of life. Anxiety exerts a mediating effect, conditioning the relationship between headache frequency and some quality of life domains; depression seems to play an inherent role in the reduced quality of life of these patients, that is, it has a moderating effect.

  10. Serotonin transporter gene polymorphisms in patients with chronic tension-type headache: A preliminary study

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    Akcali Aylin

    2008-01-01

    Full Text Available Background and Objectives: This study is designed to understand the pathophysiology of one of the most serious health problems, chronic tension-type headache (CTTH. Two polymorphic sites in serotonin transporter protein gene attracted much interest. These are: the variable number of tandem repeats (VNTR and 5′-flanking promoter region (5-HTTLPR. Materials and Methods: VNTR and 5-HTTLPR polymorphisms were investigated in 126 CTTH patients and 138 healthy control subjects. The patients were being treated with amitripytyline or citalopram or sertraline (SSRI. The polymerase chain reaction (PCR method was used to investigate the polymorphisms in the serotonin transporter protein gene. Results: There were no statistically significant results based on the 5-HTTLPR gene alleles, however, STin 2.12/12 genotype and STin 2.12 allele were seen to predominate the control group. In order to investigate the combined effect of the two polymorphic loci on the 5-HTT gene expression, samples were separated into nine groups. Genotypes (S/S-12/10 and (L/S-12/10 displayed statistically significant frequency in the CTTH group than in the control group. No significant differences were noticed between the 5-HTTLPR and VNTR haplotype groups and success in treatment. Conclusion: It is possible to make reliable comparisons and hypothesis about the homozygous and/or heterozygous presence of S and STin 12/10 alleles which may be in interaction with CTTH. On the other hand, the presence of homozygous L and STin12 alleles may play a protective role against CTTH. It is also possible that heterogeneity among diseases showing the same clinical research will require a lot of effort for individual identification.

  11. Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

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    Berggreen, S.; Wiik, E.; Lund, Hans

    2012-01-01

    The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger...... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire......: 8.8 (95% CI 0.1117.4), p = 0.047). Furthermore, a significant decrease in the number of trigger points was observed in the treatment group compared with the control group. Myofascial trigger point massage has a beneficial effect on pain in female patients with chronic tension-type headache. © 2012...

  12. Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study

    DEFF Research Database (Denmark)

    Buchgreitz, L.; Egsgaard, L.L.; Jensen, R.

    2008-01-01

    Central sensitization caused by prolonged nociceptive input from muscles is considered to play an important role for chronification of tension-type headache. In the present study we used a new high-density EEG brain mapping technique to investigate spatiotemporal aspects of brain activity...... in response to muscle pain in 19 patients with chronic tension-type headache (CTTH) and 19 healthy, age- and sex-matched controls. Intramuscular electrical stimuli (single and train of five pulses delivered at 2 Hz) were applied to the trapezius muscle and somatosensory evoked potentials were recorded...... versus tonic muscle pain: P = 0.001; baseline versus post-tonic muscle pain: P = 0.002) and fifth (baseline versus tonic muscle pain: P = 0.04; baseline versus post-tonic muscle pain: P = 0.04) stimulus in the train. In contrast, there were no differences between the conditions in patients. No consistent...

  13. Low-frequency electrical stimulation induces long-term depression in patients with chronic tension-type headache

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    Lindelof, Kim; Jung, Kerstin; Ellrich, Jens;

    2010-01-01

    Repetitive low-frequency electrical stimulation (LFS) induces pain inhibition in healthy volunteers and in animals, but it is unknown whether it has an analgesic effect in patients with headache. The aim of this study was to investigate if LFS could induce prolonged pain inhibition, called long......-term depression (LTD), in patients with chronic tension-type headache (CTTH). Twenty CTTH patients and 20 healthy volunteers were exposed to 20 min LFS (1 Hz) to the forehead. LTD was measured as a decrease in pain response to electrical stimulation in a 1-h post-LFS period following LFS. The LFS induced...

  14. Analysis of the Change of the Pressure Pain Threshold in Chronic Tension-Type Headache and Control

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    Kim Min-jung

    2009-06-01

    Full Text Available Objectives : Although Chronic tension-type headache(CTTH is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

  15. Behavioral Treatments of Chronic Tension-Type Headache in Adults : Are They Beneficial ?

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    Verhagen, Arianne P.; Damen, Leonie; Berger, Marjolein Y.; Passchier, Jan; Koes, Bart W.

    2009-01-01

    To assess the efficacy of behavioral treatments in patients with tension headache. Medline, Cinahl, EMBASE, and the Cochrane library were searched from inception to October 2007 and reference lists were checked. We selected randomized trials evaluating behavioral treatments (e.g., relaxation, electr

  16. Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

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    Castien, R.F.; Windt, van der D.A.W.M.; Dekker, J.; Mutsaers, B.; Grooten, A.

    2009-01-01

    BACKGROUND: Patients with Chronic Tension Type Headache (CTTH) report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being) and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of post

  17. Unconditioned and conditioned muscular responses in patients with chronic back pain and chronic tension-type headaches and in healthy controls.

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    Klinger, Regine; Matter, Nadia; Kothe, Ralph; Dahme, Bernhard; Hofmann, Ulrich G; Krug, Florian

    2010-07-01

    Muscular tension is assigned an important role in the development and maintenance of chronic pain syndromes. It is seen as a psychophysiological correlate of learned fear and avoidance behavior. Basic theoretical models emphasize classical conditioning of muscular responses as a mechanism of pain chronification. However, the empirical basis for this field is very small. Our aim was to investigate muscular factors in relation to unconditioned and conditioned pain stimuli. An experimental study was conducted using a differential classical conditioning paradigm with 18 patients with chronic back pain (BP) and tension-type headache (TTH), and 18 healthy controls (HC). A high-pitched sound served as the CS+, paired with an intracutaneous electric pain stimulus (US), while a neutral sound was used as the CS-. Simultaneously, integrated surface electromyograms (iEMGs) were recorded for seven muscle sites. Our hypothesis was that the pain patients would demonstrate enhanced conditionability. Baseline values between patients (TTH, BP) and HC showed no significant differences. Although the perception and pain thresholds were balanced, both patient groups revealed a higher number of significant muscular responses to the pain stimulus (UR) than the HC. All participants showed significant conditioned muscular responses, however, the patients displayed a higher number than the healthy controls. Furthermore a significant relation was found between muscular responses and the experience of pain 1day after the experiment. Muscular responses can be learned via classical conditioning. TTH and BP patients revealed a higher number of unconditioned and conditioned responses.

  18. Genetic contribution of catechol-O-methyltransferase polymorphism (Val158Met) in children with chronic tension-type headache.

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    Fernández-de-las-Peñas, César; Ambite-Quesada, Silvia; Rivas-Martínez, Inés; Ortega-Santiago, Ricardo; de-la-Llave-Rincón, Ana Isabel; Fernández-Mayoralas, Daniel M; Pareja, Juan A

    2011-10-01

    Our aim was to investigate the relationship between Val158Met polymorphisms, headache, and pressure hypersensitivity in children with chronic tension-type headache (CTTH). A case-control study with blinded assessor was conducted. Seventy children with CTTH associated with pericranial tenderness and 70 healthy children participated. After amplifying Val158Met polymorphism by polymerase chain reactions, we assessed genotype frequencies and allele distributions. We classified children according to their Val158Met polymorphism: Val/Val, Val/Met, Met/Met. Pressure pain thresholds (PPT) were bilaterally assessed over the temporalis, upper trapezius, second metacarpal, and tibialis anterior muscles. The distribution of Val158Met genotypes was not significantly different (p = 0.335), between children with CTTH and healthy children, and between boys and girls (p = 0.872). Children with CTTH with the Met/Met genotype showed a longer headache history compared with those with Met/Val (p = 0.001) or Val/Val (p = 0.002) genotype. Children with CTTH with Met/Met genotype showed lower PPT over upper trapezius and temporalis muscles than children with CTTH with Met/Val or Val/Val genotype (p < 0.01). The Val158Met catechol-O-methyltransferase (COMT) polymorphism does not appear to be involved in predisposition to suffer from CTTH in children; nevertheless, this genetic factor may be involved in the phenotypic expression, as pressure hypersensitivity was greater in those CTTH children with the Met/Met genotype.

  19. Intra-oral orthosis vs amitriptyline in chronic tension-type headache: a clinical and laser evoked potentials study

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    Sardaro Michele

    2006-05-01

    Full Text Available Abstract Background In the present study, we examined clinical and laser-evoked potentials (LEP features in two groups of chronic tension-type headache (CTTH patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. Methods Eighteen patients with diagnosed CTTH participated in this open label, controlled study. A baseline evaluation was performed for clinical features, Total Tenderness Score (TTS and a topographic analysis of LEPs obtained manually and the pericranial points stimulation in all patients vs. healthy subjects. Thereafter, patients were randomly assigned to a two-month treatment by either amitriptyline or intra-oral appliance. Results and discussion Both the intra-oral appliance and amitriptyline significantly reduced headache frequency. The TTS was significantly reduced in the group treated with the appliance. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment. Both therapies were effective in reducing headache severity, the appliance with a prevalent action on the pericranial muscular tenderness, amitriptyline reducing the activity of the central cortical structures subtending pain elaboration Conclusion The results of this study may suggest that in CTTH both the interventions at the peripheral and central levels improve the outcome of headache.

  20. EMG activity in pericranial muscles during postural variation and mental activity in healthy volunteers and patients with chronic tension type headache.

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    Schoenen, J; Gerard, P; De Pasqua, V; Juprelle, M

    1991-05-01

    EMG activity was recorded over frontalis, temporalis and trapezius muscles in a supine position, a standing position and during a mental task in 32 female patients suffering from chronic tension-type headache and in 20 healthy volunteers. Measurements in patients were made before and after biofeedback therapy. All EMG levels were on average significantly higher in patients than in controls. 62.5% of patients had at least one abnormal EMG level, but only 34% were beyond the normal range, if 1 muscle and 1 recording condition was considered. EMG levels were not correlated with headache severity, anxiety or response to biofeedback treatment. It is therefore suggested that pericranial EMG activity is not pathogenetic in chronic tension type headache, but merely one of several pathophysiologic changes, that are produced by a central dysfunction.

  1. Muscular factors are of importance in tension-type headache.

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    Jensen, R; Bendtsen, L; Olesen, J

    1998-01-01

    Recent studies have indicated that muscular disorders may be of importance for the development of increased pain sensitivity in patients with chronic tension-type headache. The objective of the present study was to investigate this hypothesis by examining the pain perception in tension-type headache with and without muscular disorders defined as increased tenderness. We examined 28 patients with episodic tension-type headache, 28 patients with chronic tension-type headache, and 30 healthy controls. Pericranial myofascial tenderness was recorded with manual palpation, and pressure pain detection and tolerances in cephalic and extracephalic locations with an electronic pressure algometer. In addition, thermal pain sensitivity and electromyographic activity were recorded. The main result was significantly lower pressure pain detection thresholds and tolerances in all the examined locations in patients with chronic tension-type headache with a muscular disorder compared to those without a muscular disorder. There were no such differences in any of the examined locations when the two subgroups of patients with episodic tension-type headache were compared. Thermal pain sensitivity did not differ between patients with and without a muscular disorder, while electromyographic activity levels were significantly higher in patients with chronic tension-type headache with than in those without a muscular disorder. Our results strongly indicate that prolonged nociceptive stimuli from the pericranial myofascial tissue sensitize the central nervous system and, thereby, lead to an increased general pain sensitivity. Muscular factors may, therefore, be of major importance for the conversion of episodic into chronic tension-type headache. The present study complements the understanding of the important interactions between peripheral and central factors in tension-type headache and may lead to a better prevention and treatment of the most prevalent type of headache.

  2. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?

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    Sanjay Prakash

    2013-01-01

    Full Text Available Background: Headache, musculoskeletal symptoms, and vitamin D deficiency are common in the general population. However, the interrelations between these three have not been delineated in the literature. Materials and Methods: We retrospectively studied a consecutive series of patients who were diagnosed as having chronic tension-type headache (CTTH and were subjected to the estimation of serum vitamin D levels. The subjects were divided into two groups according to serum 25(OH D levels as normal (>20 ng/ml or vitamin D deficient (<20 ng/ml. Results: We identified 71 such patients. Fifty-two patients (73% had low serum 25(OH D (<20 ng/dl. Eighty-three percent patients reported musculoskeletal pain. Fifty-two percent patients fulfilled the American College of Rheumatology criteria for chronic widespread pain. About 50% patients fulfilled the criteria for biochemical osteomalacia. Low serum 25(OH D level (<20 ng/dl was significantly associated with headache, musculoskeletal pain, and osteomalacia. Discussion: These suggest that both chronic musculoskeletal pain and chronic headache may be related to vitamin D deficiency. Musculoskeletal pain associated with vitamin D deficiency is usually explained by osteomalacia of bones. Therefore, we speculate a possibility of osteomalacia of the skull for the generation of headache (osteomalacic cephalalgia?. It further suggests that both musculoskeletal pain and headaches may be the part of the same disease spectrum in a subset of patients with vitamin D deficiency (or osteomalacia, and vitamin D deficiency may be an important cause of secondary CTTH.

  3. Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

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    Dekker Joost

    2009-02-01

    Full Text Available Abstract Background Patients with Chronic Tension Type Headache (CTTH report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles. We present the design of a randomised clinical trial (RCT evaluating the effectiveness of manual therapy (MT compared to usual care by the general practitioner (GP in patients with CTTH. Methods and design Patients are eligible for participation if they present in general practice with CTTH according to the classification of the International Headache Society (IHS. Participants are randomised to either usual GP care according to the national Dutch general practice guidelines for headache, or manual therapy, consisting of mobilisations (high- and low velocity techniques, exercise therapy for the cervical and thoracic spine and postural correction. The primary outcome measures are the number of headache days and use of medication. Secondary outcome measures are severity of headache, functional status, sickness absence, use of other healthcare resources, active cervical range of motion, algometry, endurance of the neckflexor muscles and head posture. Follow-up assessments are conducted after 8 and 26 weeks. Discussion This is a pragmatic trial in which interventions are offered as they are carried out in everyday practice. This increases generalisability of results, but blinding of patients, GPs and therapists is not possible. The results of this trial will contribute to clinical decision making of the GP regarding referral to manual therapy in patients with chronic tension headache.

  4. Neurotrophic factors in tension-type headache

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    Renan B. Domingues

    2015-05-01

    Full Text Available Neurotrophic factors (NF are involved in pain regulation and a few studies have suggested that they may play a pathophysiological role in primary headaches. The aim of this study was to investigate NF levels in patients with tension type headache (TTH. We carried out a cross sectional study including 48 TTH patients and 48 age and gender matched controls. Beck Depression and Anxiety Inventories, and Headache Impact Test were recorded. Serum levels of NF were determined by ELISA. There were not significant differences between NF levels between TTH patients and controls. Patients with chronic and episodic TTH had not significant differences in NF levels. The presence of headache at the time of evaluation did not significantly alter the levels of NF. Depression and anxiety scores as well as headache impact did not correlate with NF levels. Our study suggest that the serum levels of NF are not altered in TTH.

  5. Effects of amitriptyline and intra-oral device appliance on clinical and laser-evoked potentials features in chronic tension-type headache.

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    de Tommaso, M; Shevel, E; Libro, G; Guido, M; Di Venere, D; Genco, S; Monetti, C; Serpino, C; Barile, G; Lamberti, P; Livrea, P

    2005-05-01

    In the present study, we examined clinical and laser-evoked potentials (LEP) features in two groups of chronic tension-type headache (CTTH) patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. Eighteen patients suffering from CTTH (IHS, 2004) participated in the study. We performed a basal evaluation of clinical features and LEPs in all patients (T0) vs. 12 age- and sex-matched controls; successively, patients were randomly assigned to a two-month treatment by amitriptyline or intra-oral device appliance. The later LEPs, especially the P2 component, were significantly increased in amplitude in the CTTH group. Both the intra-oral prosthesis and amitriptyline significantly reduced headache frequency. Total Tenderness Score was significantly reduced in the group treated by the prosthesis. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment. The results of this study may confirm that pericranial tenderness is primarily a phenomenon initiating a self-perpetuating circuit, favoured by central sensitisation at the level of the cortical nociceptive areas devoted to the attentive and emotive compounds of pain. Both the interventions at the peripheral and central levels may interrupt this reverberating circuit, improving the outcome of headache.

  6. L-Arginine/nitric oxide pathway in chronic tension-type headache: relation with serotonin content and secretion and glutamate content.

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    Sarchielli, Paola; Alberti, Andrea; Floridi, Ardesio; Gallai, Virgilio

    2002-06-15

    Previous research of our group demonstrated an increase in L-arginine/nitric oxide (NO) pathway activity in patients with chronic daily headache (CDH) with a previous history of migraine, which was associated with a reduced platelet serotonin content and increased Ca(2+) levels. In the present work, we assessed the variations in L-arginine/NO pathway activity and platelet cyclic guanosine 3',5'-monophosphate (cGMP) levels in 25 patients affected by chronic tension-type headache (CTTH) (8 M, 17 F; age range: 34-54 years). The NO production, shown spectrophotometrically by stoichiometric transformation of oxyhemoglobin to methemoglobin due to NO synthase (NOS) activity, and inter platelet cGMP concentration, assessed with a RIA method, were determined in parallel to variations of aggregation response to 0.3 microg/ml collagen. The intracellular platelet calcium concentrations were also determined using fluorescence polarisation spectrometry. Platelet serotonin content and collagen-induced secretion as well as glutamate content were also determined with high-performance liquid chromatography (HPLC). The above parameters were compared with those of an age-matched control group. A reduction in aggregation platelet response was found. The reduction in platelet aggregation was coupled with an increased NO and cGMP production (pmyofascial cranial structures contributing to central sensitization. The increase in NOS activity seems to be associated with a hyposerotonergic status, particularly in patients with analgesic abuse, and this can contribute to central sensitization in CTTH patients. The increase in platelet glutamate content in the same patients suggests the implication of the above excitatory amino acid in spinal and supraspinal structures involved in head pain induction and maintenance.

  7. Tension-Type and Other Primary Headaches

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    J Gordon Millichap

    2005-12-01

    Full Text Available A review of the literature on tension-type and other “nonmigrainous” primary headaches is presented from Children’s Hospital of the King’s Daughters, Eastern Virginia Medical School, Norfolk, VA.

  8. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  9. Heat pain thresholds and cerebral event-related potentials following painful CO2 laser stimulation in chronic tension-type headache.

    Science.gov (United States)

    de Tommaso, Marina; Libro, Giuseppe; Guido, Marco; Sciruicchio, Vittorio; Losito, Luciana; Puca, Francomichele

    2003-07-01

    Current opinion concerning the pathophysiology of tension-type headache (TTH) and its related pericranial muscle tenderness proposes a primary role of central sensitization at the level of dorsalhorn/trigeminal nucleus as well as the supraspinal level. Investigation of these phenomena can be conducted using laser-evoked potentials (LEPs), which are objective and quantitative neurophysiological tools for the assessment of pain perception. In the present study we examined features of LEPs, as well as cutaneous heat-pain thresholds to laser stimulation, in relation to the tenderness of pericranial muscles in chronic TTH resulting from pericranial muscle disorder, during a pain-free phase. Twelve patients with TTH and 11 healthy controls were examined using the Total Tenderness Scoring (TTS) system. The stimulus was a laser pulse generated by a CO(2) laser. The dorsum of the hand and the cutaneous zones corresponding to pericranial muscles were stimulated. Subjective perception of stimulus intensity was assessed by a visual analogue scale. Two responses, the earlier named N2a and the last named P2, were considered; the absolute latency was measured at the highest peak of each response. The N2a-P2 components' peak-to-peak amplitude was detected. The heat pain threshold was similar in TTH patients and controls at the level of both the hand and pericranial skin. The TTS scores at almost all pericranial sites were higher in TTH patients than in normal controls. The amplitude of the N2a-P2 complex elicited by stimulation of the pericranial zone was greater in TTH patients than in controls; the amplitude increase was significantly associated with the TTS score. Our findings suggest that pericranial tenderness may be a primary phenomenon that precedes headache, and is mediated by a greater pain-specific hypervigilance at the cortical level.

  10. Calcitonin Gene-Related Peptide in Tension-Type Headache

    Directory of Open Access Journals (Sweden)

    M. Ashina

    2002-01-01

    Full Text Available In the last 10 years there has been increasing interest in the role of calcitonin gene-related peptide (CGRP in primary headaches. Tension-type headache is one of the most common and important types of primary headaches, and ongoing nociception from myofascial tissues may play an important role in the pathophysiology of this disorder. CGRP sensory fibers are preferentially located in the walls of arteries, and nerve fibers containing CGRP accompany small blood vessels in human cranial muscles. It is well established that nociception may lead to release of CGRP from sensory nerve endings and from central terminals of sensory afferents into the spinal cord. It has also been shown that density of CGRP fibers around arteries is increased in persistently inflamed muscle. These findings indicate that ongoing activity in sensory neurons in the cranial muscles may be reflected in changes of plasma levels of neuropeptides in patients with chronic tension-type headache. To explore the possible role of CGRP in tension-type headache, plasma levels of CGRP were measured in patients with chronic tension-type headache. This study showed that plasma levels of CGRP are normal in patients and unrelated to headache state. However, the findings of normal plasma levels of CGRP do not exclude the possibility that abnormalities of this neuropeptide at the neuronal or peripheral (pericranial muscles levels play a role in the pathophysiology of tension-type headache. Investigation of CGRP in other compartments with new sensitive methods of analysis is necessary to clarify its role in tension-type headache.

  11. The trigemino-cervical reflex in tension-type headache.

    Science.gov (United States)

    Nardone, R; Tezzon, F

    2003-05-01

    To investigate the pathophysiology of tension-type headache (TTH) with special reference to central mechanisms and to the involvement of the trigeminal system. Short latency responses can be recorded in tonically active sternocleidomastoid muscle after stimulation of the infraorbital branch of the trigeminal nerve (the trigemino-cervical reflex). This brainstem reflex was studied in 15 healthy subjects, in 15 patients with episodic tension-type headache (ETTH) and in 15 patients with chronic tension-type headache (CTTH) outside of the pain attacks. The trigemino-cervical response was abnormal, in the size or latency, in 13 patients with CTTH and in only one patient with ETTH. This finding strongly suggests that only in the CTTH the underlying pathophysiology involves the trigeminal system. The trigemino-cervical reflex is a sensitive method to evaluate the involvement of the trigeminal brainstem neurones in TTH and their assessment may provide useful diagnostic and prognostic information.

  12. Patients with tension-type headaches feel stigmatized

    Directory of Open Access Journals (Sweden)

    Sanjay Prakash

    2016-01-01

    Full Text Available The author, a sufferer of tension-type headache (TTH, believes that the word "tension" in "tension-type headache" carries a social stigma and that patients do not accept a diagnosis of TTH readily. TTH is the most common primary headache disorder. The disability of TTH as a burden of society is greater than that of migraine. Absenteeism because of TTH is higher than that due to migraine. However, patients with TTH do not go for consultation. Even the prevalence of new daily persistent headache (NDPH is 12 times higher at the headache clinic than that of chronic TTH (CTTH. These points hint that TTH patients probably do not want to visit the clinic. The author believes that it could be because of the stigma attached to "tension." Herein, the author has noted the first responses given by 50 consecutive patients with TTH when they were told that they had been suffering from TTH. The first answer of 64% of patients with TTH was "I do not have any tension/stress ." This denial is similar to the denial declared by patients with depression. Depression and tension are similar in the sense that both are considered as a signs of personal weakness. Such a preconception in the society creates a stigma, and patients deny the diagnosis, conceal symptoms, and become reluctant to seek help and treatment.

  13. Pain perception studies in tension-type headache

    DEFF Research Database (Denmark)

    Bezov, David; Ashina, Sait; Jensen, Rigmor;

    2011-01-01

    Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain perception studies...... to integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has...... been shown to rapidly reverse central sensitization and may be a new modality in treatment of CTTH and other chronic pain disorders....

  14. Guidelines for controlled trials of drugs in tension-type headache: second edition.

    Science.gov (United States)

    Bendtsen, L; Bigal, M E; Cerbo, R; Diener, H C; Holroyd, K; Lampl, C; Mitsikostas, D D; Steiner, T J; Tfelt-Hansen, P

    2010-01-01

    The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed 'to improve the quality of controlled clinical trials in tension-type headache', because 'good quality controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy'. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments in tension-type headache. These Guidelines are intended to assist in the design of well-controlled clinical trials in tension-type headache.

  15. The role of muscles in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Fernández-de-la-Peñas, César

    2011-01-01

    The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation or sensitizat......The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation...... to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle...

  16. Tension-type headache: pain, fatigue, tension, and EMG responses to mental activation.

    Science.gov (United States)

    Bansevicius, D; Westgaard, R H; Sjaastad, O M

    1999-06-01

    Twenty patients with tension-type headache (14 chronic and 6 episodic) and 20 group-matched controls were selected for this study. They participated in a 1-hour, complex, two-choice, reaction-time test, as well as 5-minute pretest and 20-minute posttest periods. Subjects reported any pain in the forehead, temples, neck, and shoulders, as well as any feelings of fatigue and tension during the pretest, and every 10 minutes during the test and posttest by visual analog scales. Superficial electromyography was recorded simultaneously from positions representing the frontal and temporal muscles, neck (mostly splenius), and trapezius muscles. The location of pain corresponded to the position of the electrodes, but extended over a larger area. The test provoked pain in the forehead, neck, and shoulders of patients, i.e., pain scores from these regions increased significantly during the test. The pain scores continued to increase posttest. In patients, the EMG response of the trapezius (first 10 minutes of the test) was elevated relative to pretest. In controls, only the frontal muscles showed an EMG test response. Patients showed significantly higher EMG responses than controls in the neck (whole test period) and trapezius (first 10 minutes of the test period). There were significant differences in pain and fatigue scoring between patients and controls in all three periods and in tension scoring posttest. Fatigue correlated with pain, with increasing significance for all locations examined, while tension was mainly associated with the neck pain. The meaning of the variables "tension" and "fatigue" in headache, and their association with recorded muscle activity in various regions is discussed. The EMG response of the trapezius muscle to the test is discussed in comparison with similar responses observed in patients with other pain syndromes.

  17. BIOFEEDBACK TRAINING AND TENSION-TYPE HEADACHE.

    Science.gov (United States)

    Šecić, Ana; Cvjeticanin, Timon; Kes, Vanja Bašić

    2016-03-01

    Biofeedback is a training method, which connects physiological and psychological processes in a person for the purposes of improving his/her physical, emotional, mental and spiritual health. In biofeedback treatment, an active role of the patient is stressed for him/her to be able to actively control the physiological and emotional processes. The aim of biofeedback is to improve the conscious control of the individual's involuntary physiological activity. Research has shown that biofeedback, either applied alone or in combination with other behavioral therapies (techniques), is an effective treatment for various medical and psychological disorders, from headache and hypertension to temporomandibular and attention deficit disorders. More than 90% of adults experience headache once a year, which makes headache one of the most common symptoms and diagnoses in medicine. Tension-type headaches occur in at least 40% of the population and their impact on the health insurance costs and diminished productivity is significant. Studies have shown that clinical biofeedback training is effective in treating headaches. Moreover, the authors stress the need for additional research and further development of methodology for this kind of research.

  18. The role of muscles in tension-type headache.

    Science.gov (United States)

    Bendtsen, Lars; Fernández-de-la-Peñas, César

    2011-12-01

    The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation or sensitization of myofascial nociceptors could play a role in causing increased pain sensitivity, but firm evidence for a peripheral abnormality still is lacking. Peripheral mechanisms are most likely of major importance in episodic TTH. Sensitization of pain pathways in the central nervous system due to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle relaxation therapy, which are most likely effective. Future studies should aim to identify the source of peripheral nociception.

  19. Guidelines for controlled trials of drugs in tension-type headache: second edition

    DEFF Research Database (Denmark)

    Bendtsen, L; Bigal, M E; Cerbo, R

    2010-01-01

    controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy'. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic......The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed 'to improve the quality of controlled clinical trials in tension-type headache', because 'good quality...... and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments...

  20. Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with aponeurotic blepharoptosis.

    Science.gov (United States)

    Matsuo, Kiyoshi; Ban, Ryokuya

    2013-02-01

    Proprioceptively innervated intramuscular connective tissues in Müller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In aponeurotic blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Müller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with aponeurotic blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Müller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Müller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Müller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical aponeurotic reinsertion to desensitise the mechanoreceptors in Müller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Müller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved aponeurotic blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Müller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Müller's muscle appears to relieve CTTH.

  1. Study on correlation between chronic tension type headache and sleep disturbance%慢性紧张型头痛与睡眠障碍的相关性研究

    Institute of Scientific and Technical Information of China (English)

    郝连玉; 高思山

    2014-01-01

    Objective To study the correlation between chronic tension type headache (CTTH) and sleep disturbance,evaluate the influence of sleep disturbance and CTT'H occurring,developing and pathophysiology.Methods According to the diagnostic criteria of International Headache Society 2004 ISH-Ⅱ,we selected 141 CTTH patients from our neurology department in our hospital from April 2012 to August 2013.According to the level of headache,the patients were divided into three groups including mild,moderate and serious groups.Age,gender,sleep disturbance,headache levels were researched and analyzed respectively to understand the correlation among the aetiological agent of sleep disorders and CTTH level.Results The insomnia incidence rate of CTTH was 49.6%,statistically significant different from the incidence rate of normal people as 9.4% from Yu Shouchen' research (x 2=153.63,P < 0.001).The insomnia incidence rate of moderate and serious patients was higher than that of mild patients (x2=11.017,P < 0.05).There was no correlation between insomnia and gender,family history of CTTH patients.Conclusion There is obvious correlation between CTTH and sleep disturbance.Sleep disturbance is probably the important cause of CTTH.Clinic doctors should pay attention to the sleep problems of CTTH patients.Treating sleep disturbance could probably have positive prevention and treatment effect to CTTH patients.%目的 探讨慢性紧张型头痛(chronic tension type headache,CTTH)与睡眠障碍的关系,评价睡眠障碍对慢性紧张型头痛的发生、发展及头痛病理生理的影响.方法 依据国际头痛学会2004 ISH-Ⅱ头痛性疾病的分类和诊断标准,选取2012年4月至2013年8月我院神经内科门诊及住院符合慢性紧张型头痛诊断的患者141例,根据头痛程度分为轻度头痛、中度头痛、重度头痛三组,对纳入研究患者性别、年龄、失眠情况、疼痛程度、医后随访、健康指导等指标进行研究,分析睡

  2. Nociceptive temporalis inhibitory reflexes evoked by CO2-laser stimulation in tension-type headache.

    Science.gov (United States)

    de Tommaso, M; Guido, M; Libro, G; Losito, L; Sciruicchio, V; Specchio, L M; Puca, F

    2003-06-01

    The aim of the study was to evaluate the laser-induced suppression periods of the temporalis muscle in patients with tension-type headache, compared with the pattern of temporalis activity suppression induced by electrical stimulation. Fifteen patients with chronic and 10 with episodic tension-type headaches were selected. Suppression periods were recorded simultaneously from both temporalis muscles using both electrical stimuli and CO2-laser stimuli. A significant reduction in the later electrically induced suppression period was found in both tension-type headache groups. Laser stimulation induced a first suppression period (LSP1) with a latency of about 50 ms in all patients. The features of LSP1 were similar across groups. The LSP1 should correspond to the first suppression period induced by electrical stimulus, which is partly a nociceptive response, whereas the second period seemed negligibly linked with the activation of pain-related afferents, though probably their activation may contribute to increase the reflex duration and to emphasize abnormalities in tension-type headache.

  3. Treating tension-type headache -- an expert opinion

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Jensen, Rigmor

    2011-01-01

    -behavioral therapy and relaxation training are most likely to be effective. Physical therapy and acupuncture may be valuable options for patients with frequent TTH. Simple analgesics and nonsteroidal anti-inflammatory drugs are recommended for treatment of episodic TTH. Combination analgesics containing caffeine......INTRODUCTION: Tension-type headache (TTH) is a highly prevalent disorder with enormous costs for the individual and the society. AREAS COVERED: Nonpharmacological and pharmacological treatments are reviewed. Electromyographic (EMG) biofeedback has a documented effect in TTH, while cognitive...

  4. Headache characteristics and chronification of migraine and tension-type headache: A population-based study

    DEFF Research Database (Denmark)

    Ashina, Sait; Lyngberg, Ann; Jensen, Rigmor

    2010-01-01

    Migraine and tension-type headache (TTH) can increase in frequency and transform from episodic to chronic forms. The process of transformation of these primary headaches is complex and involves multiple risk factors. In this cross-sectional and longitudinal population study, we aimed to investigate...... the relation of clinical characteristics of primary headaches to poor outcome: new-onset or persistent chronic headache (> or =180 days/year). Individuals who had migraine + / - TTH and those who had pure TTH were studied separately. Of 740 individuals who entered this study in 1989, 673 were eligible...... for follow-up in 2001, and a total of 549 individuals participated in the follow-up study. At baseline in 1989, no difference was found between episodic and chronic migraine headache ( + / - TTH). Duration of headache episodes >72 hours (p = .002) was associated with pure chronic TTH at baseline in 1989...

  5. Precipitating and relieving factors of migraine versus tension type headache

    Directory of Open Access Journals (Sweden)

    Haque Badrul

    2012-08-01

    Full Text Available Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. Results In this study, the female patients predominated (67%. Most of the patients were within 21–30 years age group (58.6%. About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH patients. But significant difference was demonstrated for fatigue (p  Conclusion The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

  6. [Normal tension glaucoma or syndrome of chronic ocular ischemia].

    Science.gov (United States)

    Mocanu, Carmen; Olaru, Andrei; Popa, Denissa; Deca, Andreea; Barascu, Doina

    2012-01-01

    Chronic ischemia related to a manifest ophthalmic artery stenosis, determines extremely rare ischemic chronic modifications at the level of the optic nerve, with progressive optic atrophy and visual fun ction alteration. It is presented the case of a 59 years patient, who was hospitalized in Clinic of Ophthalmology, Emergency Clinic Districtual Hospital, for decreased vision of the left eye. Fundus eye examination reveals normal aspect of papilla of the right eye and glaucomatous like modification of the left eye, confirmed by perimetry and OCT exams, which present typical glaucomatous lesions. Doppler examination revealed an enormous thrombus at the level of the left internal carotid, with more than 90% stenosis. In this context the diagnosis was chronic ocular ischemia, atypical form. lschemic ocular syndrome presents polymorphic clinic aspects, the most frequent are the ischemic lesions of posterior pole of the eye: retinal hemorrhages, neovascularization, ischemic edema, red cherry macula, cotton-wool spots. lschemic optic neuropathy is less frequent presented, and pseudo-glaucomatous lesion of optic nerve with papillary excavation is exceptional.

  7. Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

    DEFF Research Database (Denmark)

    Tornøe, Birte; Andersen, Lars L; Skotte, J H;

    2013-01-01

    Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim...... of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children....

  8. Ibuprofen for acute treatment of episodic tension-type headache in adults

    DEFF Research Database (Denmark)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

    2015-01-01

    2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. SELECTION CRITERIA: We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute......BACKGROUND: Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number...... of analgesics suggested for acute treatment of headaches in frequent episodic TTH. OBJECTIVES: To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January...

  9. 都梁软胶囊联合艾司西酞普兰治疗慢性紧张性头痛的疗效观察%Observation on the Effect of Duliang soft capsules Treating Chronic tension-type headache in Combination with Escitalopram

    Institute of Scientific and Technical Information of China (English)

    彭忠勇; 郑丽; 刘远亮; 孙萍; 陈志斌

    2016-01-01

    Objective To compare the therapeutic effect of escitalopram treating chronic tension-type headache and in combination with Duliang soft capsules.Methods 80 patients clinically diagnosed as chronic tension-type headache were rangomly divided into the Duling soft capsules in combination with escitalopram group (therapeuic group,40cases). Which were treated with oral Duliang soft capsules,3capsules each time,thrice daily for 3 weeks,besides escitalopram.10mg quaque morning for 3 weeks,and the escitalopram group (control group,40cases),which were treated by oral escitalopram,10mg quaque morning for 3 weeks,Each group was compared by severity,duration,and adverse reaction pre and post treatment.Results The total effective rate in therapeutic group was higher(84.39%) than that in control group(65.62%,P<0.05).Conclusion Duliang soft capsules in combination with escitalopram can reduce the severity and duration in patients with chronic tension-type headache.%目的:比较都梁软胶囊联用艾司西酞普兰与单独使用艾司西酞普兰治疗慢性紧张性头痛的治疗效果。方法:将80例临床确诊为慢性紧张性头痛患者随机分成两组,都梁软胶囊联合艾司西酞普兰组(治疗组)40例,单用艾司西酞普兰组(对照组)40例。治疗予都梁软胶囊每次3粒,每日3次,口服;艾司西酞普兰10mg每日早上服1次。对照组单用艾司西酞普兰10mg每日早上服1次。两组均连续治疗3周,观察比较两组患者治疗前后的疼痛严重程度、持续时间以及不良反应情况。结果:治疗组总有效率为84.39%,较对照组65.62%,差异有显著性(P<0.05);在头痛程的缓解上明显优于对照组(P<0.05)。结论:都梁软胶囊联合艾司西酞普兰可改善慢性紧张性头痛患者的头痛程度,减少头痛的持续时间。

  10. 肌筋膜松弛术治疗慢性紧张型头痛的临床研究%Myofascial release in treatment of chronic tension-type headache

    Institute of Scientific and Technical Information of China (English)

    程亭秀; 程广耀; 刘树强; 肖丙龙; 曹景文

    2016-01-01

    Objective To observe the clinical effect of myofascial release on treatment of patients with chronic tention headache. Methods A total of 100 patients with chronic tention headache, admitted to our hospital from January 2012 and January 2014 and met the inclusion criteria, were chosen in our study; According to the will of the patients, they were divided into treatment group (n=50) using myofascial release and control group (n=50) with traditional massage. The treatment time was 30 min per day for 5 days as a therapeutic cycle, interval for 2 days to continue the next cycle, and they received treatment for a total of 8 weeks. The headache index, syndrome improvement, changes of headache times and headache impact scale-6 scores were recorded and analyzed;the clinical efficacies of these two treatment methods were compared. Results The treatment efficacy of treatment group was significantly better as compared with that of control group in the aspects of total effective rate (96%vs. 76%, x2=4.757, P=0.004), changes of headache index (11.11±10.28 vs. 19.37±10.56, t=3.963, P=0.000), changes of headache times at three months after treatment (12.06±5.86 vs. 15.35±6.02, t=2.770, P=0.007) and changes of headache impact-6 scores (44.58±6.50 vs. 52.81±8.02, t=5.637, P=0.000). Conclusion Myofacial release has better efficacy than traditional massage in treating chronic tention headache; the method of myofacial release is simple and easy to apply, with good value of clinical applications.%目的:探讨肌筋膜松弛术治疗慢性紧张型头痛的临床疗效。方法选取自2012年1月至2014年1月东宁市人民医院康复医学科收治的慢性紧张型头痛患者100例,采用随机数字表法分为治疗组50例﹑对照组50例。治疗组采用肌筋膜松弛术治疗,对照组采用传统按摩手法治疗﹔每次30 min,每日1次,5次1疗程,间隔2 d行下一疗程,共治疗8周。对2组患者的临床有效性﹑头痛指数﹑头痛发

  11. Impaired postural control in patients affected by tension-type headache.

    Science.gov (United States)

    Giacomini, P G; Alessandrini, M; Evangelista, M; Napolitano, B; Lanciani, R; Camaioni, D

    2004-12-01

    Sixteen subjects, affected by chronic tension-type headache (TTH) accordingly to the International Headache Society Classification (1988) criteria, in presence of tenderness in pericranial muscles,with a mean age of 37+/-11.8 years, and ten healthy volunteer subjects, age and sex matched, were submitted to postural analysis by Static Posturography (S.Ve.P. Amplaid). Aim of the study was to evaluate whether patients with TTH have disturbed postural control, as compared to normal subjects. Postural analysis considered all posturographic variables but focused on spectral frequency analysis of body sway. In both open (OE) and closed eyes (CE) condition, spectral frequency analysis showed a significantly increased body sway at low (OE= p proprioceptive input seems to be predominant at middle and high frequencies in maintaining posture, our results seem then to suggest a proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contraction and tenderness. Posturography and spectral analysis may help not only in the diagnosis of a postural disturbance but even more in the follow-up of TTH patients, during and after a medical and/or a rehabilitative treatment.

  12. The Impacts of the Migraine and Tension Type Headache on Health Related Quality of Life

    Directory of Open Access Journals (Sweden)

    Abdurrahman Sonmezler

    2013-06-01

    Full Text Available Purpose: Migraine and tension type headache (TTH are common chronic clinical entities. This study is aimed to evaluate the impacts of the migraine and TTH on health related quality of life (HRQoL. Material and Methods: International Headache Society (IHS 2004 criteria were used for classification of headache and 30 migraine, 30 tension-type headache including total 60 cases as well as 30 healthy volunteers were included in the study.Short Form-36 (SF-36 quality of life questionnaire applied to all three groups. participants to evaluate the health related quality of life. Results: Control group consisted of 15 men and 15 women, the average age of the group was 33,30±(8,29. Migraine group consisted of 10 men and 20 women, the average age of the group was 33,93±(11,16. TTH group consisted of 8 men and 22 women, the average age of the group was 35,70±(11,62. Both migraine and TTH groups, in all dimensions of SF-36, had lower scores than the control group. Migraine and TTH groups had similar scores in General health, Bodily pain, Mental health, Vitality and Role-emotional subscales (p>0,05. But migraineurs had significantly lower scores in Physical functioning, Role-physical and Social functioning than patients with TTH (p<0,05. Conclusion: This study shows that migraine and TTH, are important health problems which decrease the quality of life when compared with healthy control groups. [Cukurova Med J 2013; 38(3.000: 374-381

  13. Pain sensitivity and pericranial tenderness in children with tension-type headache

    DEFF Research Database (Denmark)

    Soee, Ann-Britt L; Skov, Liselotte; Kreiner, Svend

    2013-01-01

    To compare tenderness and pain sensitivity in children (aged 7-17 years) with tension-type headache (TTH) and healthy controls using total tenderness score (TTS), pressure pain threshold (PPT), and pain perceived at suprapressure pain threshold (supraPPT).......To compare tenderness and pain sensitivity in children (aged 7-17 years) with tension-type headache (TTH) and healthy controls using total tenderness score (TTS), pressure pain threshold (PPT), and pain perceived at suprapressure pain threshold (supraPPT)....

  14. Flourishing and Freedom: Exploring Their Tensions and Their Relevance to Chronic Disease.

    Science.gov (United States)

    Correia, João Calinas

    2016-06-01

    In this paper I will briefly discuss flourishing and freedom, relating them to health and disease; discuss the tensions between flourishing and freedom; and exemplify how those discussions are relevant to chronic disease suffering. The concept of freedom has significant connections with the concepts of health, disability and disease. Understanding disease and disability in terms of the loss of aspects of freedom may help our understanding of the suffering that arises from chronic disease. On the other hand, flourishing may require a degree of adversity. Therefore disability and disease may be conducive to flourishing. Flourishing may be understood as subordinated to freedom, as a path to freedom, or as transcending freedom. It is suggested that freedom and flourishing are expressed as mutually enhancing cycles, actualized according to the personal circumstances that will ground their expression. In a distant horizon of innocent spontaneous self-expression, flourishing and freedom may become coincident. Regarding chronic disease as a constraint on 'species-typical' abilities to fulfill one's significant life interests, as well as an unwanted intrusion into the patient's life, presents chronic disease suffering as a loss of both positive and negative freedom. The conceptual relation between flourishing and freedom will thus organise the possibilities the sufferer sees as open to their self.

  15. The role of muscles in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Fernández-de-la-Peñas, César

    2011-01-01

    to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle...

  16. Central pain processing in chronic tension-type headache

    DEFF Research Database (Denmark)

    Lindelof, Kim; Ellrich, Jens; Jensen, Rigmor

    2009-01-01

    ) reflects neuronal excitability due to nociceptive input in the brainstem. The aim of this study was to investigate nociceptive processing at the level of the brainstem in an experimental pain model of CTTH symptoms. METHODS: The effect of conditioning pain, 5 min infusion of hypertonic saline into the neck...... muscles, was investigated in 20 patients with CTTH and 20 healthy controls. In addition, a pilot study with isotonic saline was performed with 5 subjects in each group. The BR was elicited by electrical stimuli with an intensity of four times the pain threshold, with a superficial concentric electrode. We...... measured the BR, sensibility to pressure and electrical pain scores before, during and 25 min after the saline infusion. RESULTS: The pain rating of the electrical stimuli and the pain score of the hypertonic saline infusion were significantly higher in CTTH patients than in healthy volunteers. The primary...

  17. 尼麦角林片联合养血清脑颗粒在慢性紧张性头痛的应用研究%Study of combination of Nicergoline and Yangxueqingnao Particles in the treatment of Chronic Tension-Type Headache

    Institute of Scientific and Technical Information of China (English)

    陈敏

    2013-01-01

    目的:观察尼麦角林片联合养血清脑颗粒对慢性紧张性头痛(CTTH)治疗的效果.方法:98例CTTH患者按就诊次序分为观察组和对照组.观察组给予尼麦角林片联合养血清脑颗粒治疗,对照组给予盐酸氟桂利嗪胶囊治疗,均服用4周,治疗后综合评定疗效.治疗前后均行血、尿常规、血生化及心电图常规检查,采用视觉模拟评分法(VAS)评定疼痛程度.结果:治疗前观察组和对照组VAS评分分别为8.09±1.43和8.00±1.40,治疗后观察组和对照组VAS评分分别为3.47±2.23和4.91±2.42,两组治疗前后VAS评分比较差别有统计学意义(P<0.05),两组治疗后VAS评分比较差别亦有统计学意义(P<0.05).观察组总有效率92.10%高于对照组总有效率65.50%,差异有统计学意义(P<0.05).观察组不良反应与对照组比较差异无统计学意义(P>0.05).两组治疗前后血、尿常规,肝功能,肾功能,心电图检查均未见明显异常.结论:尼麦角林片联合养血清脑颗粒治疗CTTH效果较好.%Objective:To observe the effect of nicergoline and Yangxueqingnao particles on chronic tension-type headache. Methods:Ninety-eight patients were divided into observation group and control group. Observation group was given with nicergoline and Yangxueqingnao particles, control group was given with flunarizine. Curative effect were observed in a 4-week follow-up. Blood routine test, urine routine test, blood biochemical and electrocardiogram were examined before and after treatment. Visual analogy score ( VAS) was used for the evaluation of painness. Results:Before treatment, VAS of observation group was 8.09 ± 1.43, control group 8.00 ± 1. 40. After treatment, VAS of observation group was 3. 47 ± 2. 23, control group 4. 91 ±2. 42. The difference of VAS between two groups was statistically significant (P 0. 05 ) . Blood routine test, urine routine test, blood biochemical and electrocardiogram did not show abnormalty. Conclusion

  18. Tension - Type - Headache treated by Positional Release Therapy: a case report.

    Science.gov (United States)

    Mohamadi, Marzieh; Ghanbari, Ali; Rahimi Jaberi, Abbas

    2012-10-01

    Tension Type Headache (T.T.H) is the most prevalent headache. Myofascial abnormalities & trigger points are important in this type of headache which can be managed by Positional Release Therapy (PRT). This is a report of a 47 years old female patient with Tension Type Headache treated by Positional Release Therapy for her trigger points. She had a constant dull headache, which continued all the day for 9 months. A physiotherapist evaluated the patient and found active trigger points in her cervical muscles. Then, she received Positional Release Therapy for her trigger points. After 3 treatment sessions, the patient's headache stopped completely. During the 8 months following the treatment she was without pain, and did not use any medication. Positional Release Therapy was effective in treating Tension Type Headache. This suggests that PRT could be an alternative treatment to medication in patients with T.T.H if the effectiveness of that can be confirmed by further studies.

  19. 加巴喷丁联合星状神经节阻滞治疗慢性紧张性头痛的临床研究%Clinical research on gabapentin and stellate ganglion block in the treatment of chronic tension-type headache

    Institute of Scientific and Technical Information of China (English)

    陈建军; 黄跃金; 邬至平; 黄慧芬

    2015-01-01

    Objective To evaluate the clinical efficacy and safety of gabapentin combined with stellate ganglion block in the treatment of chro-nic tension-type headache.Methods One hundred and sixty-six pa-tients with chronic tension -type headache were randomly divided into experiment group ( n=83 ) and control group ( n=83 ) .All of the sub-jects received oral gabapentin at initial dose of 100-200 mg・ d-1 , the dose could be adjusted gradually according to the therapeutic effect.Pa-tients in experiment group combined with stellate ganglion block, 2 times a week; patients in control group took eperisone 50 mg, orally, three times a day.The pain ( assessed before the treatment and every Friday during treatment period ) , depression and anxiety ( assessed before the treatment and every other Friday during treatment period) , quality of life assessment( assessed before and after the treatment ) of the two groups were observed.Results The pain scores were significantly lower after treatment ( P0.05 ) .The increase of gabapentin in experiment group was obviously less than that in control group ( P0.05);28 d after treatment, depression scores of patients in experiment group were significantly lower than that in control group (P0.05).Conclusion Patients with chronic tension-type headache took gabapentin combined with stellate ganglion block had better curative effect and compliance with less side effect.%目的:探讨加巴喷丁联合星状神经节阻滞对慢性紧张性头痛患者的临床疗效和安全性。方法慢性紧张性头痛患者166例,随机分为试验组83例和对照组83例,所有研究对象均口服加巴喷丁治疗,起始剂量100~200 mg・ d-1,根据疗效逐渐调整。试验组患者联合星状神经节阻滞,每周二、五各1次;对照组患者加服乙哌立松50 mg,每天3次。治疗前及每周五用视觉模糊评分评价疼痛强度,治疗前及治疗第2,4周的周五评价抑郁焦虑情况,治疗前及治疗4

  20. Computer animated relaxation therapy in children between 7 and 13 years with tension-type headache

    DEFF Research Database (Denmark)

    Tornoe, Birte; Skov, Liselotte

    2012-01-01

    This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy...... assisted by computer animated surface EMG provided from the trapezius muscles and with the physiotherapist as a participant observer. Outcome measures were (a) headache frequency and intensity, (b) pericranial tenderness, (c) tension patterns, and (d) evaluations assessed at baseline and at 3 months follow...... participants and in Total Tenderness Score for children with frequent episodic tension-type headache. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. Computer animated SEMG seems an applicable learning strategy for young...

  1. A Case-Control Study of Migraine and Tension-Type Headache’s Risk Factors Among Shiraz Schoolchildren

    Directory of Open Access Journals (Sweden)

    S.M.T. Ayatollahi

    2005-01-01

    Full Text Available Studies of headache risk factors are numerous but their results are based on clinics and hospitals. Few data have been reported in children. No data are available regarding migraine and tension-type headache risk factors among Iranian children. Therefore we determined the sociodemographic risk factors of migraine and tension-type headaches and their correlations in schoolchildren.This study was a matched case-control method using the prevalence study data. The subjects were the patients with migraine and tension-type headache diagnosis (38 schoolchildren with migraine and 122 with tension- type headache. Each case was matched by school, sex and age, for migraine cases three controls and for tension-type headache cases two controls who had never been diagnosed as migraine or tension-type headache were chosen. Cases and controls for migraine and tension-type headache were compared separately for family history of headache , atopic diseases, sleep disorders and socioeconomic class. Conditional logistic regression was used for data analysis. Odds ratio for migraine in schoolchildren who had positive family history of headache was 8.4 (95% CI, 2.8 to 25.4 and for tension-type headache was 2.9 (95% CI, 1.7 to 4.9. The odds ratios for migraine and tension-type headache in students who had abnormal sleeping pattern were 5.6 (95% CI, 1.3 to 20.8 and 4.4 (95% CI, 2.2 to 8.4 times higher than those with normal sleeping pattern. OR of migraine and tension-type headache for atopic diseases were estimated as 15.4, 2.05, respectively. Migraine and tension- type headache were not significantly associated with other factors.It is concluded that family history of headache and sleep disorders had most significant effects on occurrence of migraine and tension-type headache in school children.

  2. Pain sensitivity and pericranial tenderness in children with tension-type headache: a controlled study

    Directory of Open Access Journals (Sweden)

    Soee ABL

    2013-06-01

    Full Text Available Ann-Britt L Soee,1 Liselotte Skov,1 Svend Kreiner,4 Birte Tornoe,1,2 Lise L Thomsen3 1Department of Paediatrics, Children's Headache Clinic, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 2Department of Physiotherapy, Medical Department O, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 3Department of Neuropediatrics, Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen Denmark; 4Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark Purpose: To compare tenderness and pain sensitivity in children (aged 7–17 years with tension-type headache (TTH and healthy controls using total tenderness score (TTS, pressure pain threshold (PPT, and pain perceived at suprapressure pain threshold (supraPPT. Patients and methods: Twenty-three children with frequent episodic TTH, 36 with chronic TTH, and 57 healthy controls were included. TTS was measured bilaterally at seven pericranial myofascial structures. PPT and supraPPT were assessed in the finger, m. temporalis, and m. trapezius by a Somedic® algometer. SupraPPT was defined as the pain perceived at a stimulus calculated as the individual site-specific PPT + 50%. Statistics: The effect of group, sex, age, headache frequency, intensity, and years on TTS, PPT, and supraPPT was analyzed by general linear models. Confirmatory factor analysis was analyzed for mutual relations between measurements. Results and conclusion: Tenderness increased uniformly in both frequent episodic TTH (median 14; interquartile range [IQR] 10–18; P < 0.001 and chronic TTH (median 13; IQR 9–20; P < 0.001 compared to controls (median 5, IQR 3–11. However, the children with frequent episodic TTH and chronic TTH did not show significantly increased sensitivity when measured by PPT or supraPPT. Factor analysis confirmed that the site-specific measurements depended on general latent variables. Consequently, the PPT and supraPPT tests can be assumed to measure

  3. Meta-Analysis of Biofeedback for Tension-Type Headache: Efficacy, Specificity, and Treatment Moderators

    Science.gov (United States)

    Nestoriuc, Yvonne; Rief, Winfried; Martin, Alexandra

    2008-01-01

    The aims of the present meta-analysis were to investigate the short- and long-term efficacy, multidimensional outcome, and treatment moderators of biofeedback as a behavioral treatment option for tension-type headache. A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria.…

  4. Clinical application of trigemino-cervical reflex in migraine without aura and chronic tension-type headache%三叉神经-颈反射在无先兆偏头痛和慢性紧张型头痛中的意义

    Institute of Scientific and Technical Information of China (English)

    吴关娜; 季晓林

    2011-01-01

    目的 研究三叉神经-颈反射(trigemino-cervical reflex,TCR)在无先兆偏头痛(migraine without aura,MWOA)和慢性紧张型头痛(chronic tension-type headache,CTTH)中的意义.方法 选取2009年1月至2010年2月福建省级机关医院门诊25例单侧MWOA患者、25例CTTH患者及36名健康成年对照进行TCR检测.刺激一侧眶下神经(infraorbital nerve,ION),可在同侧胸锁乳突肌(sternocleidomastoid muscle,SCM)上记录到一个短潜伏期正-负波,即TCR.比较各组TCR参数[峰潜伏期(PL)、刺激前后波幅比率的平方根(A值)]的差异.结果 MWOA组和CTTH组双侧PLP19[MWOA右侧(19.81±1.79)ms,左侧(19.49±1.95)ms;CTTH右侧(19.16±1.67)ms,左侧(19.56±2.02)ms]、PLN31[MWOA右侧(30.75±2.35)ms,左侧(30.44±3.75)ms;CTTH右侧(30.32±3.47)ms,左侧(30.11±3.34)ms]较对照组缩短(t=2.027~3.654,P<0.05);CTTH组和MWOA组双侧PLP19、PLN31及A值差异无统计学意义.结论 MWOA组和CTTH组的双侧PLP19、PLN31潜伏期较对照组缩短,提示三叉神经、脑干系统参与MWOA、CTTH的发病机制;但两组病例无明显差异,MWOA和CTTH在内源性疼痛调节系统的某个部位如三叉神经或脑干系统,存在共同的功能障碍.%Objective To study the clinical application of trigemino-cervical reflex(TCR)in migraine without aura(MWOA)and chronic tension-type headache(CTTH).Methods The TCR was recorded using surface electromyographic recordings bilaterally from the sternocleidomastoid muscle after stimulation of infraorbital branch of the trigeminal nerve.The reflex was investigated in 25 patients with unilateral MWOA,25 patients with CTTH and 36 healthy subjects.The patients were outpatients who visited Fujian provincial institution hospitals from January 2009 to February 2010.Results Compared with the healthy subjects,the bilateral peak latency of P19/N31(PLP19 and PLN31)was significantly shortened in the subjects with MWOA(left and fight side were(19.49 ± 1.95)ms and(19.81 ± 1.79)ms

  5. The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid: systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Seely Dugald

    2005-01-01

    Full Text Available Abstract Background Migraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types. Methods We searched English and non-English language articles in the following databases: MEDLINE (1966–February 2004, AMED (1995–February 2004 and Alt HealthWatch (1990–February 2004. Results Nine articles were found to meet the inclusion criteria and were included in this systematic review. Hypothetical reasons for niacin's effectiveness include its vasodilatory properties, and its ability to improve mitochondrial energy metabolism. Important side effects of niacin include flushing, nausea and fainting. Conclusion Although niacin's mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches. Adequately designed randomized trials are required to determine its clinical implications.

  6. Relationship of temporomandibular disorders to muscle tension-type headaches and a neuromuscular orthosis approach to treatment.

    Science.gov (United States)

    Cooper, Barry C; Kleinberg, Israel

    2009-04-01

    A prominent etiological theory proposed for TMD related headache is that it results from a dysfunctional masticatory muscle system, wherein muscle hyperactivity is frequently caused by dental temporomandibular disharmony. The central goal of this article was to determine from a literature review of the subject whether there is significant evidence to support a relationship between headaches and TMD prevalence. A second purpose was to determine from such a review whether any relationship was one of cause and effect and whether treatment of the TMD condition can result in meaningful reduction or resolution of headaches. In the literature, there was a substantial amount of evidence for a positive relationship between TMD and the prevalence of headaches, and most importantly, that these were the muscle tension-type. Evidence for a cause and effect relationship was strong. It generally showed in numerous patients that TMD treatment of a large number of patients resulted in significant improvement in the physiological state of the masticatory system (muscles, joints and dental occlusion). Reduction or resolution of muscle tension-type headaches that were present was clinically significant. The authors concluded that TMD should be considered and explored as a possible causative factor when attempts are made to determine and resolve the cause of headaches in patients with this affliction. A benefit of resolving headaches at an early stage in their development is that it might result in the reduction of its potential for progression to a chronic and possibly migraine headache condition.

  7. Prevalence of migraine and tension-type headache among school children in Yazd, Iran

    Directory of Open Access Journals (Sweden)

    H Fallahzadeh

    2011-01-01

    Full Text Available Objective: The etiology and pathogenesis of migraine and other types of headache are still under discussion. The aim of this study was to investigate the prevalence of migraine and tension-type headache and its association with demographic variables among schoolchildren. Materials and Methods: A cross-sectional study was performed on 930 school children (aged 12-14 years through cluster sampling method. International Headache Society criteria were used for diagnosis. Descriptive statistics and logistic regression were used for data analysis. Results: The prevalence of migraine headache was 12.3% (95% CI: 10.2-14.4 and tension-type headache was 4.2% (95% CI: 2.9-5.6. The factor associated with migraine in multivariate analysis were age and sleep disturbances. Conclusions: Migraine is common among school children, although it may be under-recognized. Because children with migraine and tension-type headache have a high prevalence of sleep disturbances, they should always be evaluated for the presence of sleep problems.

  8. Treatment of tension-type headache: from old myths to modern concepts.

    Science.gov (United States)

    Barbanti, P; Egeo, G; Aurilia, C; Fofi, L

    2014-05-01

    Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is less simple and easy-to-treat than commonly thought. Antidepressants, despite their poor tolerability, are still the first-choice drugs for preventing TTH. The most widely studied non-pharmacological approach to TTH, cognitive-behavioral techniques, effectively relieve pain only in selected patients. The most frequently used and recommended treatments for acute TTH, NSAIDs and paracetamol have scarce efficacy as documented by their low therapeutic gain over placebo in the 2-h pain-free response. Their effectiveness may be increased by a more proper use and by the adjunction of caffeine, antiemetics, myorelaxants or tranquillizers but the risk of medication-overuse headache must be considered. Hence, the need for more effective and tailored treatments in TTH remains.

  9. Migraine and tension-type headache triggers in a Greek population

    Directory of Open Access Journals (Sweden)

    Vasilios Constantinides

    2015-08-01

    Full Text Available Migraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.

  10. Influence of specimen type and reinforcement on measured tension-tension fatigue life of unidirectional GFRP laminates

    DEFF Research Database (Denmark)

    Korkiakoski, Samuli; Brøndsted, Povl; Sarlin, Essi

    2016-01-01

    It is well known that standardised tension-tension fatigue test specimens of unidirectional (UD) glass-fibre-reinforced plastics (GFRP) laminates tend to fail at end tabs. The true fatigue life is then underestimated. The first objective of this study was to find for UD GFRP laminates a test...... specimen that fails in the gauge section. The second objective was to compare fatigue performance of two laminates, one having a newly developed UD powder-bound fabric as a reinforcement and the other having a quasi-UD stitched non-crimp fabric as a reinforcement. In the first phase, a rectangular specimen...... a significant effect on the failure mode and measured fatigue life of the laminates. A significantly higher fatigue life was measured for the laminate with the powder-bound fabric reinforcement when compared to the laminate with the stitched reinforcement....

  11. Coupled dynamic response analysis of a multi-column tension-leg-type floating wind turbine

    Science.gov (United States)

    Zhao, Yong-sheng; Yang, Jian-min; He, Yan-ping; Gu, Min-tong

    2016-07-01

    This paper presents a coupled dynamic response analysis of a multi-column tension-leg-type floating wind turbine (WindStar TLP system) under normal operation and parked conditions. Wind-only load cases, wave-only load cases and combined wind and wave load cases were analyzed separately for the WindStar TLP system to identify the dominant excitation loads. Comparisons between an NREL offshore 5-MW baseline wind turbine installed on land and the WindStar TLP system were performed. Statistics of selected response variables in specified design load cases (DLCs) were obtained and analyzed. It is found that the proposed WindStar TLP system has small dynamic responses to environmental loads and it thus has almost the same mean generator power output under operating conditions as the land-based system. The tension mooring system has a sufficient safety factor, and the minimum tendon tension is always positive in all selected DLCs. The ratio of ultimate load of the tower base fore-aft bending moment for the WindStar TLP system versus the land-based system can be as high as 1.9 in all of the DLCs considered. These results will help elucidate the dynamic characteristics of the proposed WindStar TLP system, identify the difference in load effect between it and land-based systems, and thus make relevant modifications to the initial design for the WindStar TLP system.

  12. The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

    Science.gov (United States)

    Wainwright, Elaine; Wainwright, David; Keogh, Edmund; Eccleston, Christopher

    2015-01-01

    The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing.

  13. Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

    Science.gov (United States)

    Rana, Abdul Qayyum; Saeed, Usman; Khan, Osama A.; Qureshi, Abdul Rehman M.; Paul, Dion

    2014-01-01

    Giant cell arteritis (GCA) or Temporal arteritis (TA) is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of  head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA. PMID:25288850

  14. Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Abdul Qayyum Rana

    2014-01-01

    Full Text Available Giant cell arteritis (GCA or Temporal arteritis (TA is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of  head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA.

  15. Mechanical mechanism analysis of tension type anchor based on shear displacement method

    Institute of Scientific and Technical Information of China (English)

    XIAO Shu-jun; CHEN Chang-fu

    2008-01-01

    Based on the fact that the shear stress along anchorage segment is neither linearly nor uniformly distributed, the load transfer mechanism of the tension type anchor was studied and the mechanical characteristic of anchorage segment was analyzed. Shear stress-strain relationship of soil surrounding anchorage body was simplified into three-folding-lines model consisting of elastic phase, elasto-plastic phase and residual phase considering its softening eharaeteristic. Meanwhile, shear displacement method that has been extensively used in the analysis of pile foundation was introduced. Based on elasto-plastic theory, the distributions of displacement, shear stress and axial force along the anchorage segment of tension type anchor were obtained, and the formula for calculating the elastic limit load was also developed accordingly. Finally, an example was given to discuss the variation of stress and displacement in the anchorage segment with the loads exerted on the anchor, and a program was worked out to calculate the anchor maximum bearing capacity. The influence of some parameters on the anchor bearing capacity was discussed, and effective anchorage length was obtained simultaneously. The results show that the shear stress first increases and then decreases and finally trends to theresidual strength with increase of distance from bottom of the anchorage body, the displacement increases all the time with theincrease of distance from bottom of the anchorage body, and the increase of velocity gradually becomes greater.

  16. Clinical Study of Tuina on Tension-type Headache with Syndrome Differentiation

    Institute of Scientific and Technical Information of China (English)

    WANG Jin-gui

    2005-01-01

    本研究采用六点行为评分法和Stead的诊断表计分法.对治疗组和对照组150例患者进行客观、科学的疗效评定.提示"通脉调气"腹部推拿法在治疗紧张性头痛的疗效上远远高于常规推拿法.同时认为消除由"头痛-肌收缩一头痛"程序而引起过度防御反应是疗效显著提高的理论基础.%The 6-point behavioral rating scale and Stead's grading method of diagnostic scale were applied to evaluate objectively the therapeutic effects of Tuina on 150 patients with tension-type headache in the experimental and controlled groups in this study. The results indicated that abdominal Tuina method of invigorating blood circulation and regulating qi had better effect than the routine Tuina method in treating tension type headache. Meantime,it is considered that eliminating the immoderate defensive response caused by the process of headache muscular contraction-headache is the academic basis of the marked effect.

  17. Unravelling the Tensions Between Chronic Disease Management and End-of-Life Planning.

    Science.gov (United States)

    Thorne, Sally; Roberts, Della; Sawatzky, Richard

    2016-01-01

    An increasing appreciation for the burden that chronic conditions represent for people and for societies has triggered an evolving body of popular and professional conceptualizations of the nature of the chronic disease challenge. In this discussion article, we trace the trajectory of thinking about chronic illness care, surfacing underlying assumptions and drivers that have shaped current dominant models of service delivery. We note significant gaps in these conceptualizations, especially with respect to the reality that many chronic conditions are life limiting. Contrasting chronic disease theorizing with the conversations that have arisen around end-of-life care for other kinds of health conditions, we argue for a shift in our thinking to accommodate the implications of life limitation in our service delivery planning. We see significant leadership potential in optimizing the role nurses can play across the chronic disease trajectory by integrating the healthy optimism of self-care management with the profound compassion of a person-centered palliative approach.

  18. [Chronic nicotinamide overload and type 2 diabetes].

    Science.gov (United States)

    Zhou, Shi-Sheng; Li, Da; Zhou, Yi-Ming; Sun, Wu-Ping; Liu, Xing-Xing; Lun, Yong-Zhi

    2010-02-25

    Type 2 diabetes is a major global health problem. It is generally accepted that type 2 diabetes is the result of gene-environmental interaction. However, the mechanism underlying the interaction is unclear. Diet change is known to play an important role in type 2 diabetes. The fact that the global high prevalence of type 2 diabetes has occurred following the spread of food fortification worldwide suggests a possible involvement of excess niacin intake. Our recent study found that nicotinamide overload and low nicotinamide detoxification may induce oxidative stress associated with insulin resistance. Based on the relevant facts, this review briefly summarized the relationship between the prevalence of type 2 diabetes and the nicotinamide metabolism changes induced by excess niacin intake, aldehyde oxidase inhibitors, liver diseases and functional defects of skin. We speculate that the gene-environmental interaction in type 2 diabetes may be a reflection of the outcome of the association of chronic nicotinamide overload-induced toxicity and the relatively low detoxification/excretion capacity of the body. Reducing the content of niacin in foods may be a promising strategy for the control of type 2 diabetes.

  19. Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches.

    Science.gov (United States)

    Eskin, Mehmet; Akyol, Ali; Çelik, Emine Yilmaz; Gültekin, Bülent Kadri

    2013-08-01

    This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life-satisfaction in patients suffering from primary headache.

  20. Prevalence of tension-type headache in adult general population: the PACE study and review of the literature.

    Science.gov (United States)

    Ferrante, T; Manzoni, G C; Russo, M; Camarda, C; Taga, A; Veronesi, L; Pasquarella, C; Sansebastiano, G; Torelli, P

    2013-05-01

    The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE (PArma CEfalea, or "Headache in Parma"), aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma's adult general population. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9), namely 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3). Our study results indicate a TTH prevalence rate (19.4 %) at the lower limit of data ranges currently available for Western countries, and prevalence rates for infrequent forms (9 %) do not appear much different from those of frequent forms (9.8 %).

  1. Risk Factors in Normal-Tension Glaucoma and High-Tension Glaucoma in relation to Polymorphisms of Endothelin-1 Gene and Endothelin-1 Receptor Type A Gene

    Directory of Open Access Journals (Sweden)

    Dominika Wróbel-Dudzińska

    2015-01-01

    Full Text Available The aim of the research is to analyse the influence of polymorphisms of endothelin-1 gene and endothelin-1 receptor type A gene on the clinical condition of patients with primary open angle glaucoma. Methods. 285 Polish patients took part in the research (160 normal-tension glaucoma and 125 high-tension glaucoma. DNA was isolated by standard methods and genotype distributions of four polymorphisms in genes encoding endothelin-1 (K198N and endothelin-1 receptor type A polymorphisms (C1222T, C70G, and G231A were determined. Genotype distributions were compared between NTG and HTG groups. The clinical condition of participants was examined for association with polymorphisms. Results. A similar frequency of occurrence of the polymorphic varieties of the studied genes was observed in patients with NTG and HTG. There is no relation between NTG risk factors and examined polymorphisms. NTG patients with TT genotype of K198N polymorphism presented with the lowest intraocular pressure in comparison to GG + GT genotype (p=0.03. In NTG patients with CC genotype of C1222T polymorphism (p=0.028 and GG of C70G polymorphism (p=0.03 the lowest values of mean blood pressure were observed. Conclusions. The studied polymorphic varieties (K198N, C1222T do have an influence on intraocular pressure as well as arterial blood pressure in NTG patients.

  2. Type A behavior in housewives: relation to work, marital adjustment, stress, tension, health, fear-of-failure and self esteem.

    Science.gov (United States)

    Houston, B K; Kelly, K E

    1987-01-01

    Ninety-five housewives were administered the Framingham Type A Scale and the Jenkins Activity Survey. Information concerning various aspects of their daily lives as well as various psychological and psychosocial variables were obtained via questionnaire and interview. Type As were found to differ from Type Bs in having more stressful work-related experiences. Further, Type As reported poorer marital adjustment and tended to report more marital disharmony than did Type Bs. Type A behavior was also related to more self-reported stress, tension, and physical health problems. Finally, Type As reported lower covert self-esteem and tended to report more fear-of-failure than Type Bs.

  3. Tratamiento de la cefalea tensional con toxina botulínica tipo A Botulinum toxin type A for the treatment of tension-type headache

    Directory of Open Access Journals (Sweden)

    D. Arbaiza

    2006-06-01

    el área total de aplicación, como probables factores en la respuesta analgésica.Objectives: To determine the time of onset of the analgesia, the < ficacy and the security of the application of the botulinu toxin A (BTA in patient with tension-type headache (TH. Material and methods: Inclusion criteria: patients between 18 and 70 yeai diagnosis of TH according to the International Headache S ciety, two or more episodes of TH per month during at lea 3 months, non controlled TH with the standard treatmei normal neurological examination and signed inform consei Variables analyzed: Intensity of headache (IH, frequency presentation of headache (FH, duration of headache (DH sensibility to digit pressure (SDP of the cranial musculatur number of painful points (NPD of the cranial musculatur time of onset of the analgesia (TBA, time until the ma: mum effect of analgesia (TMA and decrease of use of an.gesics (DUA. Evaluations in the days 0, 15 and 30. Fifty units of BT were applied to cranial musculature. The patients could continue with their previous analgesic therapy according to the evolution of the headache. Results: Twenty female patients were included with a median age of 47 years. IH 2.15 in the first evaluation diminished at 1.05 and 0.9 in the second and third evaluations (p=0.009 and 0.008. FH of 10.25 days diminished to 3.6 and 2.75 days (p=0.008 and 0.012. DH of 2.3 daily hours it diminished at 1.3 and 1.1 (p=0.009 in both. SDP 1.55 diminished at 0.5 and 0.55 (p=0.008 in both. NPD 2.65 diminished at 0.8 and 0.6 (p=0.010 and 0.006. TBA was 8 days and TMA was 25 days. DUA 5 diminished at 1.9 and 1.5. Around of 35% of the patients presented a probable adverse event of mild or moderate severity. Conclusion: TB-TO it is a simple, effective treatment and provides control of the TH. The technique is easy to reproduce. More studies are needed to value the number of applications and the total area of application, as probable factors in the analgesic response.

  4. Chronic Mountain Sickness-Phobrang Type

    Directory of Open Access Journals (Sweden)

    C. S. Nath

    1984-10-01

    Full Text Available Clinical0 features of 27 cases of Chronic Mountain Sickness (CMS from the Himalayas are reported. They are compared with 75 native highlanders (NH. All CMS patients were immigrants to high altitude. Mean duration of stay at high altitude was seven years. Mean values for haematocrit and haemoglobin were 80% and 23 G% respectively for the CMS group and 40% and 17.9 G% respectively for the native highlande group. Mean QRS axis in the former was +118 and in the latter +76. Incidence and quantum of protienuria were significantly higher in the CMS group. Cardiac catheteri -sation studies done in eight CMS cases showed elevated Pulmonary Artery (PA pressures even after a mean of 14.2 days at sea level. The disease which has four diagnostic elements-hypoxemia and polycythemia, pulmonary hypertension, right ventricular enlargement and nephropathy with dense proteinuria-is a variant of 'Monge's Disease' and a name CMS Phobrang Type is suggested, along with a new approach to clinical classification which may help in diagnosis before cor pulmonale sets in. Limited therapeutic trials conducted at highaltitude seem to indicate that yogic deep breathing exercises, low-dose aspirin and diamox may be beneficial in the prevention and therapy of CMS Phobrang Type at high  altitude.

  5. IMPACTS OF DIFFERENT JOINT ANGLES AND ADHESIVES ON DIAGONAL TENSION PERFORMANCES OF BOX-TYPE FURNITURE

    Directory of Open Access Journals (Sweden)

    Musa Atar

    2010-02-01

    Full Text Available The goal of this study was to determine the effects of different joint angles and adhesives on diagonal tension performances of the box-type furniture made from solid wood and medium density fiberboard (MDF. After drilling joints of 75º, 78º, 81º, 84º, and 87º degrees on Oriental beech, European oak, Scotch pine, and MDF samples, a diagonal tensile test was applied on corners glued with polyvinyl acetate (PVAc and polyurethane (D-VTKA = Desmodur-Vinyl Trieketonol Acetate according to ASTM D 1037 standard. With reference to the obtained results, the highest tensile strength was obtained in European oak with PVAc glue and joint angle of 84º, while the lowest value was obtained in MDF with D-VTKA glue and joint angle of 75º. Considering the interaction of wood, adhesive, and joint angle, the highest tensile strength was obtained in European oak with joint angle of 81º and D-VTKA glue (1.089 N.mm-2, whereas the lowest tensile strength was determined in MDF with joint angle of 75º and PVAc glue (0.163 N.mm-2. Therefore, PVAc as glue and 81º as joint angle could be suggested to obtain some advantageous on the dovetail joint process for box-type furniture made from both solid wood and MDF.

  6. Psychological distress and tension-type headache among health professional senior students in a historically black university in south africa.

    Directory of Open Access Journals (Sweden)

    S.L. Amosun

    2002-02-01

    Full Text Available Studies in well-defined populations contribute to the body ofevidence that the psychosocial aspects of people’s environment can have a substantial effect on their physical health. Senior students in health professional education programs were interviewed using structured instruments to assess the prevalence of psychological distress and tension-type headaches in a young adult university population.  Almost 70%of the study sample was either at risk of becoming distressed, or already distressed with somatic or depressive symptoms. About two-thirds of thestudents reported symptoms of either tension-type headache or other typesof headache, while over 30% of all the students complained of tension-type headache. Almost 20% of the students whoreported symptoms of tension-type headache were also distressed, while another 47% were at risk of being distressed.The possible impact on the academic performance of the students and their future role as health care professionalsis discussed.

  7. The Use of the Cognitive Behavioral Therapy for the Treatment of Migraine and Tension Type Headaches

    Directory of Open Access Journals (Sweden)

    Yasemin AKKOCA

    2015-03-01

    Full Text Available Headache, which affects a large part of the community and causes loss of workforce, is gaining importance in terms of the burden which it brings on the society, by its function of restricting individuals social activities as well as increasing the health expenditure likewise drug consumption. Migraine and tension headaches are primary headaches which any organic causes can not be determined for them. For the treatment of headaches of this type besides the use of medicine, exercises with bio-feedbacks and acupuncture; in recent years cognitive behavioral treatments (CBT appears to be effective. It’s shown that the negative mode of thinking on individuals which have recurrent headaches, stimulates the headache, increase its severity and complicates the management of it. CBT provides for the person a self-help opportunity even the therapy is terminated, besides behavioral methods such as relaxation exercises, by developing strategies of selfmonitoring, education, abilities of pain management and coping with the maladaptive beliefs and houghts. The purpose of this text is, providing information about the use of the cognitive behavioral therapies on primary headaches and basic principles of treatment.

  8. Abnormalities of masseter inhibitory reflex in patients with episodic tension-type headache

    Institute of Scientific and Technical Information of China (English)

    Plamen TZVETANOV; Rossen Todoroff ROUSSEFF; Zdravka RADIONOVA

    2009-01-01

    Objective: To investigate the masseter inhibitory reflex (MIR) and its eventual changes in patients with episodic tension-type headache (TTH). Methods: MIR was studied in 21 patients with episodic TTH and 30 healthy subjects, with age and sex matched to the study cohort. Median age of patients was 17,0 years (ranged 16~49 years), median duration of disease 12 months (1~5 years), and median frequency of headache 7.5 d per month. Results: The second period of suppression (S2) of MIR was reduced in intensity and duration in 10% of controls and 66.7% (confidence interval (CI)=45.3%~85%; P<0.05) of patients with episodic TTH (χ2=74.9; P<0.001). In 3 (14.3%) of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found. Conclusion: Our results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.

  9. The effect of oxygen tension on porcine embryonic development is dependent on embryo type

    DEFF Research Database (Denmark)

    Booth, Paul J; Holm, Peter; Callesen, Henrik

    2005-01-01

    Reducing oxygen concentration from atmospheric levels during in vitro culture generally, but not invariably, improves embryonic development across a range of species. Since the few published reports of such an action in the pig are contradictory--perhaps a consequence of the derivation of the emb......Reducing oxygen concentration from atmospheric levels during in vitro culture generally, but not invariably, improves embryonic development across a range of species. Since the few published reports of such an action in the pig are contradictory--perhaps a consequence of the derivation...... of the embryos prior to culture--a study was performed to examine the effect of O2 tension during culture on three different types of porcine embryos, namely: in vivo flushed embryos, and in vitro matured oocytes either fertilized in vitro or parthenogenetically activated. In vivo embryos (n=208) were flushed...... at the 2-8 cell stage. Cumulus oocyte complexes (COCs) destined for IVF or parthenogenetic activation were derived from 2 to 6 mm, post-pubertal ovarian follicles and matured for 48 h in TCM-199. Parthenogenones were generated by activating denuded oocytes (n=573) with 10 mM calcium ionophore, followed...

  10. Prevalence of carpal tunnel syndrome in cases with migraine and tension type headache

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    Volkan Solmaz

    2015-02-01

    Full Text Available Background: Carpal Tunnel Syndrome (CTS is the most frequent entrapment neuropathy; also Tension Type Headache (TTH and migraine headache are the most common forms of headaches. The aim of this study is to determine whether there is a relationship between carpal tunnel syndrome and migraine and/or TTH, and if so, to determine the factors causing this relationship. Methods: This study included 201 patients who were electro-physiologically diagnosed with idiopathic CTS and 100 controls. In addition to being examined for headaches, each patient's Body Mass Index (BMI was determined, and each was evaluated with Boston Questionnaire Form (BQF and a Beck Depression Scale (BDS. Results: The CTS group had significantly more patients with TTH and migraine headache than did the control group. In addition, the CTS group had a significantly higher frequency of headaches, and significantly higher BDS and BMI than did the controls. There were no significant differences in headache type and frequency of headache between those with mild CTS and those with mild-serious CTS. In addition, the Boston scores of CTS patients with headache were higher than those CTS patients without headache. Further, the monthly income levels of patients with CTS were lower than those of the control group. Conclusion: We found that primary headache is more frequent in CTS patients than in controls. This may be due to somato-autonomic reflexes and other common risk factors that can be seen in both CTS patients and those with headache, including obesity, depression and low level of income. [Int J Res Med Sci 2015; 3(2.000: 456-460

  11. Anxiety and Depression in Tension-Type Headache: A Population-Based Study

    Science.gov (United States)

    Song, Tae-Jin; Cho, Soo-Jin; Kim, Won-Joo; Yang, Kwang Ik; Yun, Chang-Ho; Chu, Min Kyung

    2016-01-01

    Although tension-type headache (TTH) is a frequent type of headache disorder and imposes a significant burden, there is scant information about the prevalence and impact of comorbid anxiety and depression among individuals with TTH. We investigated the prevalence and clinical impact of anxiety and depression among patients with TTH in the general population. We recruited Korean participants aged 19–69 years using a two-stage clustered random sampling method. To identify the presence of headache type, anxiety, and depression, we used a semi-structured interview using certain questionnaires. To assess the level of anxiety and depression, we used the Goldberg Anxiety Scale and Patient Health Questionnaire-9, respectively. Among 2,695 participants, 570 people (21.2%) had TTH during previous 1 year. In participants with TTH, the prevalence of anxiety (9.5% vs. 5.3%, p = 0.001) and depression (4.2% vs. 1.8%, p = 0.001) was significantly higher than that of non-headache participants. The prevalence of anxiety among TTH participants with >15 attacks per month [21.4%, odds ratio (OR): 4.0] and 1–14 attacks per month (13.1%, OR: 2.2) was higher than that in those with <1 attack per month (6.4%), however this tendency was not observed in participants with depression. Visual Analogue Scale (VAS) score [median 5.0 vs. 4.0, p = 0.010] and Headache Impact Test-6 (HIT-6) score [median 45.5 vs. 42.0, p < 0.001] were significantly higher among those with anxiety. Furthermore, VAS scores [median 5.0 vs. 4.0, p = 0.010] and HIT-6 scores [median 45.5 vs. 42.0, p = 0.027] were also significantly higher among TTH patients with depression than among those without depression. In conclusion, anxiety and depression were more prevalent in participants with TTH than in non-headache participants. These two conditions were associated with an exacerbation of headache symptoms in individuals with TTH. PMID:27783660

  12. A comparative study of psychiatric comorbidity, quality of life and disability in patients with migraine and tension type headache

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    Sagar Chandra Bera

    2014-01-01

    Full Text Available Objectives: To compare psychiatric co-morbidity, quality of life and disability between patients of migraine and tension type headache and healthy controls. Materials and Methods: Study subjects included 40 consecutive adult patients each with migraine and tension type of headache (TTH of either gender fulfilling International Headache Society-II criteria and suffering for 2 years They were recruited from a headache clinic in a tertiary care teaching hospital and were assessed on Mini International Neuropsychiatric Interview (MINI, World Health Organization Quality of Life-BREF (WHOQOL-BREF Hindi version and the Headache Impact Test-6 (HIT-6. Age and sex matched 40 healthy controls were assessed on MINI and WHOQOL-BREF. The three groups were compared for statistical significance on various scales. Results: Depression emerged as the most prevalent psychiatric disorder in both the headache groups. There was significant impairment in quality of life on all domains along with functional disability in subjects with both types of headache. Conclusion: Psychiatric comorbidity, especially depression is common in patients with migraines and tension type headache. Quality of life and functional ability are significantly impaired in these patients. The clinician should remain aware of consequences of prolonged headache, and should provide timely intervention.

  13. Chronic comorbidities in children and adolescents with type 1 diabetes

    NARCIS (Netherlands)

    Fazelifarsani, Soulmaz; Souverein, Patrick C.; Van Der Vorst, Marja M.J.; Knibbe, Catherijne A.J.; De Boer, Anthonius; Mantel-Teeuwisse, Aukje K.

    2014-01-01

    Background: Limited quantitative data exist on the burden of chronic comorbidities in children and adolescents with type 1 diabetes (T1D). Such knowledge is necessary for the development of guidelines and prevention programs. Objectives: To determine the incidence of chronic comorbidities in childre

  14. Serum levels of adiponectin, CCL3/MIP-1α, and CCL5/RANTES discriminate migraine from tension-type headache patients

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    Renan B. Domingues

    2016-08-01

    Full Text Available ABSTRACT Objectives Inflammatory molecules and neurotrophic factors are implicated in pain modulation; however, their role in primary headaches is not yet clear. The aim of this study was to compare the levels of serum biomarkers in migraine and tension-type headache. Methods This was a cross-sectional study. We measured serum levels of adiponectin, chemokines, and neurotrophic factors in patients with migraine and tension-type headache. Depression and anxiety symptoms, headache impact and frequency, and allodynia were recorded. Results We included sixty-eight patients with migraine and forty-eight with tension-type headache. Cutaneous allodynia (p = 0.035, CCL3/MIP-1α (p = 0.041, CCL5/RANTES (p = 0.013, and ADP (p = 0.017 were significantly higher in migraine than in tension-type headache. The differences occurred independently of anxiety and depressive symptoms, frequency and impact of headache, and the presence of pain. Conclusions This study showed higher CCL3/MIP-1α, CCL5/RANTES, and ADP levels in migraine in comparison with tension-type headache. Our findings suggest distinctive roles of these molecules in the pathophysiology of these primary headaches.

  15. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force

    DEFF Research Database (Denmark)

    Bendtsen, L; Kalsmose-Hjelmborg, Simon Evers; Linde, M.

    2010-01-01

    and relaxation training most likely are effective. Physical therapy and acupuncture may be valuable options for patients with frequent TTH, but there is no robust scientific evidence for efficacy. Simple analgesics and non-steroidal anti-inflammatory drugs are recommended for the treatment of episodic TTH...... points. Recommendations: Non-drug management should always be considered although the scientific basis is limited. Information, reassurance and identification of trigger factors may be rewarding. Electromyography (EMG) biofeedback has a documented effect in TTH, whilst cognitive-behavioural therapy...... of first choice for the prophylactic treatment of chronic TTH. Mirtazapine and venlafaxine are drugs of second choice. The efficacy of the prophylactic drugs is often limited, and treatment may be hampered by side effects...

  16. Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

    Directory of Open Access Journals (Sweden)

    Tornøe B

    2013-08-01

    Full Text Available Birte Tornøe,1,2,5,6 Lars L Andersen,3 Jørgen H Skotte,3 Rigmor Jensen,4 Gunvor Gard,1 Liselotte Skov,2 Inger Hallström1 1Department of Health Sciences, Lund University, Scania, Sweden; 2Children's Headache Clinic, Department of Pediatrics, University of Copenhagen, Herlev Hospital, Herlev, Denmark; 3National Research Centre for the Working Environment, Copenhagen, Denmark; 4Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 5Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 6Department of Physiotherapy, Medical Department, University of Copenhagen, Herlev Hospital, Herlev, Denmark Background: Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children. Methods: Twenty-five healthy children, 9 to 18 years of age, participated in test-retest procedures within a 1-week interval. A computerized padded force transducer was used for testing. The tests included the isometric maximal voluntary contraction and force steadiness of neck flexion and extension, and the isometric maximal voluntary contraction and rate of force of the dominant shoulder. Pericranial tenderness was recorded by means of standardized manual palpation, and a submaximal cycle ergometer test predicted maximal oxygen uptake (VO2 max. The measurements were evaluated in steps, using the intraclass correlation coefficient (ICC; changes in the mean between the two test occasions; the levels of agreement, visualized in Bland

  17. STUDY OF THE INFLUENCE OF WOOL TYPE USED IN A YARN, IN TERMS OF TENSION

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    OANA Dorina

    2016-05-01

    Full Text Available The use of yarns for manufacturing textiles is increasing in modern times, and new, better methods for making yarns are employed. Yarns are the elements of which textiles are made. In order to diversify the assortment of textile products, more and more types of yarn are made, called heterogeneous yarns, which are yarns made using different types of fibers or filaments. From a technological standpoint, the purpose of mixing fibers is to seek to improve certain physical and mechanical characteristics such as fineness, strength, uniformity etc., which influence the properties of the textile products. A significant increase in yarn strength is achieved by introducing in a mix of wool fibers a certain percentage of synthetic fibers, such as polyester, which have double or even triple the strength of wool fibers. Synthetic fibers however have the downside of having a low hygroscopicity. For this reason, the yarns commonly used are those which have a a natural component, namely wool. One of the main objectives of mixing is to better use the available raw materials. Thus, from soft yarns one can make soft fabrics and knits, and, with the same quantity of raw material, can obtain a larger surface of fabric or knits, with direct impact on costs. With regard to the quality and properties of the textile products, the decisive element is not only the type of the fiber and the proportion in which it is present in the mix, but, fundamentally, the right choice of characteristics for those components (length, fineness, cross-section.

  18. Piezoresistive effect of n-type -oriented Si nanowires under large tension/compression

    Science.gov (United States)

    Gao, Di; Yang, Zhenyu; Zheng, Lingli; Zheng, Kun

    2017-03-01

    Small-scale samples enable us to understand changes in physical properties under larger strain due to their higher tolerance to deformation. In this study, the piezoresistive character of n-type -oriented Si nanowires under large strain was measured during tensile and compressive deformations. The Si nanowires were directly cut from the wafer using top-down technology and deformed while capturing their electrical properties inside a transmission electron microscope. The experimental results show that both tensile and compressive deformation enhanced their electrical transport properties. The piezoresistance coefficient is of the same order of magnitude as its bulk counterpart, but half as large, which may be attributed to a larger strain magnitude. We also studied the circulatory characteristics and influence of electron beam radiation. This study provided new physical insights into piezoresistive effects under large strain.

  19. Atlanto-Occipital Joint Manipulation and Suboccipital Inhibition Technique in the Osteopathic Treatment of Patients with Tension-Type Headache.

    OpenAIRE

    Espí López, Gemma Victoria; Oliva Pascual-Vaca, Angel

    2012-01-01

    Introducción. La cefalea tensional tiene una elevada prevalencia, con repercusión en el ámbito laboral y social de los sujetos que la padecen. Objetivo. Evaluar la eficacia de dos tratamientos con terapia manual en pacientes con cefalea tensional. Material y métodos. Se ha llevado a cabo un estudio a doble ciego, aleatorio, con 76 pacientes (81,6% mujeres) diagnosticados de cefalea tensional, con edad media de 39,96 años (DT=10,93), distribuidos en 4 grupos (tres de tratamiento y un grupo de ...

  20. Acupuncture for tension-type headache: a multicentre, sham-controlled, patient-and observer-blinded, randomised trial.

    Science.gov (United States)

    Endres, Heinz G; Böwing, Gabriele; Diener, Hans-Christoph; Lange, Stefan; Maier, Christoph; Molsberger, Albrecht; Zenz, Michael; Vickers, Andrew J; Tegenthoff, Martin

    2007-10-01

    Acupuncture treatment is frequently sought for tension-type headache (TTH), but there is conflicting evidence as to its effectiveness. This randomised, controlled, multicentre, patient-and observer-blinded trial was carried out in 122 outpatient practices in Germany on 409 patients with TTH, defined as > or =10 headache days per month of which superficial needling at nonacupuncture points. Acupuncture was administered by physicians with specialist acupuncture training. Ten 30-min sessions were given over a six-week period, with additional sessions available for partial response. Response was defined as >50% reduction in headache days/month at six months and no use of excluded concomitant medication or other therapies. In the intent-to-treat analysis (all 409 patients), 33% of verum patients and 27% of sham controls (p=0.18) were classed as responders. Verum was superior to sham for most secondary endpoints, including headache days (1.8 fewer; 95% CI 0.6, 3.0; p=0.004) and the International Headache Society response criterion (66% vs. 55% response, risk difference 12%, 95% CI: 2%-21%; p=0.024).). The relative risk on the primary and secondary response criterion was very similar ( approximately 0.8); the difference in statistical significance may be due to differences in event rate. TTH improves after acupuncture treatment. However, the degree to which treatment benefits depend on psychological compared to physiological effects and the degree to which any physiological effects depend on needle placement and insertion depth are unclear.

  1. Epidemiologic and Clinical Characteristics of Migraine and Tension-Type Headaches among Hospitals Staffs of Shiraz (Iran

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    Ayatollahi Seyyed Mohammad Taghi

    2009-05-01

    Full Text Available Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH, its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS diagnosis criteria. A random sample of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were collected by screening questionnaire followed by clinical interviews, general physical and neurological examination, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were estimated as 11.2% (115 cases, 19.5% (199 subjects and 3.2% (33 subjects respectively. In this study , clinical characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026. The average of prevalence of migraine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache- related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

  2. Chronic Pancreatitis, Type 3c Diabetes, and Pancreatic Cancer Risk

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    David C Whitcomb

    2014-09-01

    Full Text Available About half of all patients with chronic pancreatitis (CP develop diabetes mellitus (DM due to the loss of islet cell mass, not just beta cells as in Type 1 DM (T1DM, or due to insulin resistance, as in Type 2 DM (T2DM. Patients with DM from loss of islets due to pancreatic disease or resection are diagnosed with pancreatogenic or Type 3c DM (T3cDM. Patients with T3cDM also lose counter-regulatory hormones, such as glucagon and pancreatic polypeptide, and experience maldigestion associated with pancreatic exocrine insufficiency. Patients with T3cDM are therefore more susceptible to hypoglycemia and a mismatch (asynchrony between food ingestion and nutrient absorption. At the same time, the use of incretin therapy is likely useless, since maldigestion leads to the release of higher levels of hind gut hormones, including GLP1. Thus, T3cDM caused by CP or destruction of the islets involves a special class of potential risks and comorbidity that may be overlooked if the CP has not been diagnosed.

  3. End-Tidal CO2 Tension Is Predictive of Effective Nocturnal Oxygen Therapy in Patients with Chronic Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sugimura, Koichiro; Shinozaki, Tsuyoshi; Fukui, Shigefumi; Ogawa, Hiromasa; Shimokawa, Hiroaki

    2016-01-01

    Central sleep apnea (CSA) is characterized by recurring cycles of crescendo-decrescendo ventilation during sleep, and enhances sympathetic nerve activity. Thus CSA has a prognostic impact in patients with chronic heart failure (CHF). Although nocturnal oxygen (O2) therapy decreases frequency of CSA and improves functional exercise capacity, it is also known that some non-responders to the therapy exist. We thus aimed to identify predictors of responders to nocturnal O2 therapy in CHF patients with CSA. In 12 CHF patients with CSA hospitalized at our department, sleep study was performed at 2 consecutive nights. Patients nasally inhaled O2 at either the first or second night in a randomized manner. To predict the percentage reduction in apnea-hypopnea index (%ΔAHI) in response to the nocturnal O2 therapy, we performed multiple regression analysis with a stepwise method with variables including age, brain-natriuretic peptide, circulation time, baseline AHI, hypercapnic ventilatory response and end-tidal carbon dioxide tension (PETCO2). Nocturnal O2 therapy significantly decreased AHI (from 32 ± 13 /h to 12 ± 10 /h, P 50% reduction of AHI), with 88.9% of sensitivity and 66.7% of specificity. In conclusion, PETCO2 is useful to predict the efficacy of O2 therapy in CHF patients with CSA, providing important information to the current nocturnal O2 therapy.

  4. Modelo biopsicossocial e formulação comportamental: compreendendo a cefaléia do tipo tensional Modelo biopsicosocial y formulación comportamental: comprendiendo la cefalea del tipo tensional The bio-psychosocial model and behavioral formulation: understanding the tension-type headache

    Directory of Open Access Journals (Sweden)

    Adriana Mayon Neiva Flores

    2008-03-01

    Full Text Available A cefaléia do tipo tensional constitui um tipo freqüente de dor de cabeça, que tende a ocasionar uma série de comportamentos de evitação, com prejuízos físicos, sociais e psicológicos aos indivíduos afetados. O presente trabalho descreve algumas contribuições do modelo biopsicossocial de saúde para a compreensão da cefaléia do tipo tensional, descreve os tratamentos mais freqüentemente oferecidos e discute as vantagens de modalidades terapêuticas que utilizam a formulação comportamental. Destaca-se a relevância da consideração de fatores psicossociais presentes nas formas mais comuns de evolução da cefaléia do tipo tensional, o que contribui para a elaboração de planos de tratamento mais eficientes e coerentes com uma proposta realmente sistêmica e idiográfica.La cefalea del tipo tensional constituye un tipo frecuente de dolor de cabeza, que tiene la tendencia a ocasionar una serie de comportamientos de evitación, con daños físicos, sociales y psicológicos a los individuos afectados. El presente trabajo describe algunas contribuciones del modelo biopsicosocial de salud para la comprensión de la cefalea del tipo tensional, describe los tratamientos más frecuentemente ofrecidos y discute las ventajas de modalidades terapéuticas que utilizan la formulación comportamental. Se destaca la relevancia de la consideración de factores psicosociales presentes en las formas más comunes de evolución de la cefalea del tipo tensional, lo que contribuye para la elaboración de planes de tratamiento más eficientes y coherentes con una propuesta realmente sistémica e idiográfica.Tension-type headache are a frequent source of complaints in health assistance units. It tends to cause avoidance behaviors with adverse consequences in physical, psychological and social aspects. Contributions from the Bio-Psychosocial perspective are described for a better understanding of the tension-type headache problem. Study also analyzes

  5. Increased Risk of Dementia in Patients with Tension-Type Headache: A Nationwide Retrospective Population-Based Cohort Study.

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    Fu-Chi Yang

    Full Text Available The association between primary headaches, including tension-type headache (TTH as one of the most common primary headache disorders, and dementia remains controversial. In this nationwide, population-based, retrospective, cohort study, we explored the potential association between TTH and dementia and examined sex, age, and comorbidities as risk factors for dementia.Using the Taiwan National Health Insurance Research Database (NHIRD claims data, the sample included 13908 subjects aged ≥20 years with newly-diagnosed TTH in 2000-2006. The non-TTH group included 55632 randomly selected sex- and age-matched TTH-free individuals. All subjects were followed until dementia diagnosis, death, or the end of 2011. Patients with dementia, including vascular and non-vascular (including Alzheimer's subtypes, were identified using International Classification of Diseases Ninth Revision, Clinical Modification codes. Multivariate Cox proportional hazards regression models were used to assess the risk of dementia and dementia-associated risk factors, such as migraine and other medical comorbidities.During the average follow-up of 8.14 years, the incidence density rates of dementia were 5.30 and 3.68/1,000 person-years in the TTH and non-TTH groups, respectively. Compared with the non-TTH group, the risks of dementia were 1.25 (95% confidence interval [CI], 1.11-1.42 and 1.13 (95% CI, 1.01-1.27 times higher in the women and >65-year-old TTH group, respectively. TTH patients with comorbidities had a higher risk of dementia. TTH patients had a greater risk of non-vascular dementia (hazard ratio, 1.21; 95% CI, 1.09-1.34 than the non-TTH group.TTH patients have a future risk of dementia, indicating a potentially linked disease pathophysiology that warrants further study. The association between TTH and dementia is greater in women, older adults, and with comorbidities. Clinicians should be aware of potential dementia comorbidity in TTH patients.

  6. Cefaléia do tipo tensional episódica: avaliação clínica de 50 pacientes Episodic tension-type headache: clinical evaluation of 50 patients

    Directory of Open Access Journals (Sweden)

    André Palma da Cunha Matta

    2006-03-01

    Full Text Available Com o objetivo de estudar os aspectos clínicos, a história familiar e o impacto da dor nas atividades laborativas, foi conduzido estudo de série de casos de 50 pacientes portadores de cefaléia do tipo tensional episódica (CTTE. Foram avaliados 40 mulheres e 10 homens, com idade média de 30 (±12 anos. Dor constrictiva esteve presente em 40 pacientes (80%. O enjôo foi o principal fenômeno acompanhante (20%. A dor bilateral predominou; entretanto, a localização unilateral também esteve presente (10%. Embora classicamente descrita como uma dor leve, observou-se que a CTTE pode se manifestar como crises de forte intensidade (16%. A história familiar foi positiva em 12 pacientes (24%. O impacto nas atividades laborativas foi detectado em 14% da amostra. Os achados a respeito das características da dor estão de acordo com a literatura. O impacto representado pela CTTE a nível individual e na sociedade deve, entretanto, ser reconsiderado.A case series study of 50 consecutive patients with episodic tension type headache (ETTH was conducted. Clinical aspects, family history and impact on work activities were studied. The casuistry was made up of 40 women and 10 men. The average age was 30 (±12 years. Constrictive pain was present in 40 patients (80%. Sickness was the most commonly reported related phenomenon (20%. As expected, bilateral pain predominated; however, unilateral location was also present (10%. Although classically described as a mild pain, we observed that ETTH can come in intense crisis (16%. Family history of tension type headache was positive in 12 patients. The impact on work activities was substantial (14%. Our findings regarding to clinical aspects are in agreement with the literature. It is important to mention that the impact of ETTH on the individual and society should be reconsidered, and is more substantial than has been reported to date.

  7. Discussion on tension-type of schizophrenia and its treatment%试论精神分裂症紧张型及其治疗

    Institute of Scientific and Technical Information of China (English)

    丁德正

    2011-01-01

    文章就其家对精神分裂症紧张型独到的病因病机认识、临床表现与辨证做了论述;同时,还提出了其家临床治疗的经验方药与针灸疗法.文章指出,紧张型病久,其致病因子痰多继生瘀,痰瘀互结,致病情增重,愈加难治;且使原典型的紧张型症状变得模糊混乱.文末,就紧张型之防复问题,笔者提出了其家之认识与巩固治疗方法.%Article author discussed the awareness of tension-type of schizophrenia on etiology and pathogenesis,clinical manifestation and differentiation; meanwhile, also proposed its square prescription of clinical treatment and acupucture and moxibustion. The author pointed out that long term of tension could cause the phlegm changing into stasis, and then become the intermin-gled phlegm and blood stasis which was more difficult to manage; and made the tension-type symptoms of the original disease fuzzy and confused. At the end of the article, the author put forward the view to prevent recurrence and consolidation treatment methods.

  8. Computed tomography scan of the head in patients with migraine or tension-type headache Tomografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional

    Directory of Open Access Journals (Sweden)

    Marcelo Moraes Valença

    2002-09-01

    Full Text Available A retrospective study was performed in order to evaluate the frequency of abnormalities found by computed tomography (CT scan of the head in 78 patients with migraine or tension-type headache. In the present study CT scan was normal in 61.5% of the patients with migraine or tension-type headache. A number of abnormalities were encountered in more than one third of the patients studied, including inflammatory sinus disease (19.2%, cysticercosis (3.9%, unruptuted cerebral aneurysm (2.6%, basilar impression (2.6%, intracranial lipoma (2.6%, arachnoid cyst (2.6%, empty sella (2.6%, intracranial neoplasm (2.6%, and others (2.6%. None of these lesions were symptomatic or responsible by the headache picture, therefore, considered incidental findings. In conclusion, the fortuitous encounter of some abnormalities on CT scan of the head is often higher than what we could predict in patients suffering migraine or tension-type headache. We briefly discuss clinical, epidemiologic, and practical management of some of the abnormalities detected by CT scan as well as the indication to request a neuroimaging investigation.Um estudo retrospectivo foi realizado visando avaliar a frequência de anormalidades encontradas durante a realização de estudo por tomografia computadorizada (TC em 78 pacientes com migrânea ou cefaléia do tipo tensional. A TC foi normal em 61,5% dos pacientes examinados. Em um terço dos pacientes estudados foram detectadas anormalidades, como doença inflamatória dos seios paranasais (19,2%, cisticercose (3,9%, aneurisma cerebral não-roto (2,6%, impressão basilar (2,6%, lipoma intracraniano (2,6%, cisto aracnoideo (2,6%, sela vazia (2,6%, neoplasia intracraniana (2,6% e outras afecções (2,6%. Nenhuma destas lesões era sintomática (achado incidental. Concluindo, o encontro fortuito de algumas anormalidades na TC é frequentemente mais elevado do que se prediz em pacientes com cefaléia primária. Nós discutimos brevemente alguns

  9. Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tornøe B

    2016-05-01

    Full Text Available Birte Tornøe,1–4 Lars L Andersen,5,6 Jørgen H Skotte,5 Rigmor Jensen,7 Claus Jensen,8 Bjarne K Madsen,7 Gunvor Gard,1 Liselotte Skov,2 Inger Hallström,11Department of Health Sciences, Lund University, Lund, Sweden; 2Department of Pediatrics E, Children’s Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; 3Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; 4Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; 5National Research Centre for the Working Environment, Copenhagen, Denmark; 6Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 7Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; 8Huge Consulting, ApS, Haslev, Denmark Background: Childhood tension-type headache (TTH is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH. Methods: Forty-nine girls aged 9–18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck–shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL questionnaires were assessed at baseline and after 24 months. Results: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having

  10. Eletromiograma de superfície durante stress experimental como subsídio no diagnóstico da cefaléia tensional: resultados em 100 casos Surface scalp and neck electromyography with stress as diagnostic criterion in chronic tension headache: results in 100 cases

    Directory of Open Access Journals (Sweden)

    Ceme Ferreira Jordy

    1995-09-01

    Full Text Available Eletromiograma de superfície foi realizado no crânio e pescoço, durante stress provocado por frio, em 100 pacientes sofrendo cefaléia crônica isolada. Os resultados de diagnóstico obtidos com a eletromiografia revelaram erro de 24% a 32% na avaliação clínica da cefaléia tensional segundo os critérios anamnésicos referendados pelo Comitê de Classificação das Cefaléias, da Sociedade Internacional de Cefaléia (1988. A eletromiografia durante stress é proposta como novo critério de diagnóstico da Cefaléia tensional.We report the use of surface scalp and neck electromyography during experimental stress state in a series of 100 out-patients suffering from chronic tension headache. Results revealed a 24% to 32% of diagnostic errors in the diagnostic obtained by routine anamnestic procedures and following the criteria recommended by the Headache Classification Commitee of the International Headache Society (1988. The electromyography with stress is proposed as a new diagnostic criterion for tension headache.

  11. Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Langemark, M; Andersson, P G

    1990-01-01

    Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain...... criteria and in 8 (4 migraine, 4 tension headache) they did not fulfill the criteria for accompanying symptoms. Overall the IHS criteria are sensitive and specific, but they may possibly be improved with regard to accompanying symptoms. The present study suggests that recording of frequency and graded...

  12. Advances in the diagnosis and treatment of tension-type headache%紧张型头痛的诊断与治疗进展

    Institute of Scientific and Technical Information of China (English)

    朱珠; 王毅

    2013-01-01

    紧张型头痛是最常见的原发性头痛,其发病率高,临床表现非特异,诊断需注意与继发性头痛及其他原发性头痛鉴别.综合疗法对改善患者症状及生活质量具有重要作用,本文综述各种紧张型头痛的治疗方法,包括急性发作期的止痛药物及预防性的药物、行为与物理治疗.%Tension-type headache is the most common type of primary headache with nonspecific clinical presentations.Its diagnosis needs to exclude secondary headache and other primary headache,such as migraine.This review describes the treatment of tension-type headache including acute management with analgesics and several preventive therapies.

  13. Tension Structure

    Science.gov (United States)

    1978-01-01

    The fabric structure pictured is the Campus Center of La Verne College, La Verne, California. Unlike the facilities shown on the preceding pages, it is not air-supported. It is a "tension structure," its multi-coned fabric membrane supported by a network of cables attached to steel columns which function like circus tent poles. The spider-web in the accompanying photo is a computer graph of the tension pattern. The designers, Geiger-Berger Associates PC, of New York City, conducted lengthy computer analysis to determine the the best placement of columns and cables. The firm also served as structural engineering consultant on the Pontiac Silverdome and a number of other large fabric structures. Built by Birdair Structures, Inc., Buffalo, New York, the La Verne Campus Center was the first permanent facility in the United States enclosed by the space-spinoff fabric made of Owens-Corning Beta fiber glass coated with Du Pont Teflon TFE. The flexible design permits rearrangement of the interior to accommodate athletic events, student activities, theatrical productions and other recreational programs. Use of fabric covering reduced building cost 30 percent below conventional construction.

  14. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

    Directory of Open Access Journals (Sweden)

    Ariovaldo Alberto da Silva Júnior

    2014-02-01

    Full Text Available Clinical differentiation between the primary headaches and temporomandibular disorders (TMD can be challenging. Objectives : To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Method : Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Results : Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001. Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001. Conclusion : TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

  15. Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial.

    Science.gov (United States)

    Martin, Paul R; Aiello, Rachele; Gilson, Kathryn; Meadows, Graham; Milgrom, Jeannette; Reece, John

    2015-10-01

    Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is a limited research literature evaluating interventions designed for comorbid headaches and depression. Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Routine Primary Care control group or a Cognitive Behavior Therapy group that also received routine primary care. The treatment program involved 12 weekly 50-min sessions administered by clinical psychologists. Participants in the treatment group improved significantly more than participants in the control group from pre-to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. Comorbid anxiety disorders were not a predictor of response to treatment, and the only significant predictor was gender (men improved more than women). The new integrated treatment program appears promising and worthy of further investigation.

  16. Intravenous dipyrone for the acute treatment of episodic tension-type headache: A randomized, placebo-controlled, double-blind study

    Directory of Open Access Journals (Sweden)

    M.E. Bigal

    2002-10-01

    Full Text Available Acute headaches are responsible for a significant percentage of the case load at primary care units and emergency rooms in Brazil. Dipyrone (metamizol is easily available in these settings, being the most frequently used drug. We conducted a randomized, placebo-controlled, double-blind study to assess the effect of dipyrone in the acute treatment of episodic tension-type headache. Sixty patients were randomized to receive placebo (intravenous injection of 10 ml saline or 1 g dipyrone in 10 ml saline. We used seven parameters of analgesic evaluation. The patients receiving dipyrone showed a statistically significant improvement (P<0.05 of pain compared to placebo up to 30 min after drug administration. The therapeutic gain was 30% in 30 min and 40% in 60 min. The number of patients needed to be treated for at least one to have benefit was 3.3 in 30 min and 2.2 in 60 min. There were statistically significant reductions in the recurrence (dipyrone = 25%, placebo = 50% and use of rescue medication (dipyrone = 20%, placebo = 47.6% for the dipyrone group. Intravenous dipyrone is an effective drug for the relief of pain in tension-type headache and its use is justified in the emergency room setting.

  17. Pressure pain thresholds assessed over temporalis, masseter, and frontalis muscles in healthy individuals, patients with tension-type headache, and those with migraine--a systematic review.

    Science.gov (United States)

    Andersen, Sanne; Petersen, Marie Weinreich; Svendsen, Anette Sand; Gazerani, Parisa

    2015-08-01

    A systematic review was conducted to identify and summarize the available scientific literature addressing pressure pain threshold (PPT) values over the temporalis, masseter, and frontalis muscles in healthy humans, patients with tension-type headache (TTH), and those with migraine both in males and females. Six relevant medical databases for the literature search were included: PubMed, Web of Science, Cochrane, CINAHL, BioMed Central, and Embase. The search strategy was performed applying 15 keywords (eg, pressure pain threshold, temporalis muscle, tension type headache, pressure algometer) and their combinations. A total of 156 articles were identified, and 40 relevant articles were included. The main outcomes of the systematic review were extracted, and it was demonstrated that the PPT values in general were lower in patients compared with healthy subjects, and this was especially noted for temporalis in both females (migraine: 231.2 ± 38.3 kPa craniofacial muscles of healthy subjects, patients with TTH, and those with migraine to provide the PPT value ranges. Based on these findings, a set of guidelines was established to assist future studies including PPT assessments over craniofacial muscles.

  18. Risk factors and treatment of pediatric chronic diseases : Type 1 diabetes, asthma and allergy

    NARCIS (Netherlands)

    Ahmadizar, F.

    2016-01-01

    Chronic diseases such as type 1 diabetes (T1DM) and asthma are leading causes of morbidity and mortality worldwide. The increase in the number of children with chronic diseases is a major concern. Early detection through improved screening and diagnostic tests, better diagnosis based on updated guid

  19. Type D personality and cardiac mortality in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Smith, Otto R F; Pedersen, Susanne S.

    2010-01-01

    Clinical predictors of cardiac mortality in chronic heart failure (CHF) are established, but less is known about chronic psychological predictors. Therefore, we examined the prognostic value of Type D personality (tendency to experience negative feelings and inhibit self-expression) in CHF patients....

  20. The Comparison of The Efficacy of Three Different Treatment Protocols on The Type 3 Chronic Prostatitis (Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Fikret Erdemir

    2010-05-01

    Full Text Available  Aim: In this study, the effect of three different treatment protocols on the type 3 chronic prostatitis was evaluated. In addition to our knowledge, the comparative studies which related CPPS are limited in Turkish literature. Material and Methods: Between January 2004 and December 2008 a total of 87 male patients with diagnosed of type 3 chronic prostatitis, were evaluated in our clinic. According to treatment protocols patients with type 3 chronic prostatitis, were randomized into three groups as fallows group 1; antibiotic+antiinflammatory+ α-blocker, group 2; α-blocker and group 3; antibiotic+antiinflammatory. Pretreatment and post treatment results were compared. Results: The mean age of all patients was 34.14±7.68 years. The mean age of the patients was 34.13±7.39 years, 34.76±7.99 years, and 33.72±8.25 years in group 1, group 2 and group 3, respectively (p>0.05. While the improvement rates after treatment was detected 68% in group 1, these rates were found as 35.3% and 52% in group 2 and group 3, respectively.This difference was statitistically significant in combined group when  compared to other groups (p=0.047. Conclusion:Although alternative treatment researches have still been continue in type 3 chronic prostatitis which consist of 90-95% of all prostatitis. It is seen that combined treatment is beneficial. However, studies in larger, randomized and controlled series are needed to prove the effect of treatment on type 3 chronic prostatitis.

  1. No Influence of Type 2 Diabetes on Chronic Inflammation and Oxidative Stress in Obese Patients

    Directory of Open Access Journals (Sweden)

    Adriana Florinela CĂTOI

    2014-03-01

    Full Text Available Obesity per se carries the features of chronic inflammation and oxidative stress that interrelate in a complex network and exert an important role in the onset of several complications such as type 2 diabetes, atherosclerosis and cardiovascular events. On the other hand, it seems that hyperglycemia per se as well as insulin resistance (independent of hyperglycemia, both induce increased oxidative stress. The aim of our study was to analyze proinflammatory and oxidative stress markers in obese patients with and without type 2 diabetes and to verify the hypothesis that type 2 diabetes associated with obesity would promote a higher chronic inflammation and oxidative stress state as compared to obesity alone. We found no differences between the two groups of patients regarding chronic inflammation and oxidative stress markers. Therefore we may conclude that there is no influence of type 2 diabetes on chronic inflammation and oxidative stress in obese patients.

  2. Myeloprolipherative disorder type chronic myeloid leukemia--eosinophilic form.

    Science.gov (United States)

    Arnautovic-Custovic, Aida; Hasic, Samira; Kopic, Emina; Jahic, Azra; Jovic, Svetlana

    2011-01-01

    Chronic eosinophilic leukemia (CEL) is a very rare form of leucemia in the western world. Adequate response is seldomly achieved after treatment with corticosteroids, interferon-alfa (INF-alfa) and medications containing hydroxi-urea (Litalir). The study presents a patient with CEL with no initial therapeutic response to the use of corticosteroids, INF-alfa and hydroxy-urea, and with neither clinical nor hematological response. After setting a diagnosis of CEL, patient was ordinated Imatinib (Glivec tabbletes) in a daily dose of 200 mg. Two days afterwards there was an evident withdrawal of subjective and clinical symptoms of disease, and the complete blood count showed significant amendment.

  3. Low-frequency electrical stimulation induces long-term depression in patients with chronic tension-type headache

    DEFF Research Database (Denmark)

    Lindelof, Kim; Jung, Kerstin; Ellrich, Jens;

    2010-01-01

    Repetitive low-frequency electrical stimulation (LFS) induces pain inhibition in healthy volunteers and in animals, but it is unknown whether it has an analgesic effect in patients with headache. The aim of this study was to investigate if LFS could induce prolonged pain inhibition, called long-t...

  4. Memantine for prophylaxis of chronic tension-type headache--a double-blind, randomized, crossover clinical trial

    DEFF Research Database (Denmark)

    Lindelof, K; Bendtsen, L

    2009-01-01

    -effects were dizziness and nausea. In conclusion, although no statistically significant effect was seen in the primary end-point, some beneficial effects of memantine were observed in women. Memantine was shown to reduce pain intensity in CTTH patients, albeit to a limited extent. Future NMDA antagonists...

  5. The effects of cervical traction, cranial rhythmic impulse, and Mckenzie exercise on headache and cervical muscle stiffness in episodic tension-type headache patients.

    Science.gov (United States)

    Choi, Sung-Yong; Choi, Jung-Hyun

    2016-03-01

    [Purpose] The purpose of this study was to examine the effects of cervical traction treatment, cranial rhythmic impulse treatment, a manual therapy, and McKenzie exercise, a dynamic strengthening exercise, on patients who have the neck muscle stiffness of the infrequent episodic tension-type (IETTH) headache and frequent episodic tension-type headache(FETTH), as well as to provide the basic materials for clinical interventions. [Subjects] Twenty-seven subjects (males: 15, females: 12) who were diagnosed with IETTH and FETTH after treatment by a neurologist were divided into three groups: (a cervical traction group (CTG, n=9), a cranial rhythmic contractiongroup (CRIG, n=9), and a McKenzie exercise group (MEG, n=9). An intervention was conducted for each group and the differences in their degrees of neck pain and changes in muscle tone were observed. [Results] In the within-group comparison of each group, headache significantly decreased in CTG. According to the results of the analysis of the muscle tone of the upper trapezius, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. According to the results of the analysis of the muscle tone of the sternocleidomastoid muscle, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. [Conclusion] In the comparison of the splenius capitis muscle between the groups, there was a statistically significant difference on the right side. Hence, compared to the other methods, cervical traction is concluded to be more effective at reducing headaches in IETTH and FETTH patients.

  6. [Correction of dyslipidemia in patients with chronic hepatitis C, combined with diabetes type 2].

    Science.gov (United States)

    Derbak, M; Boldizhar, P

    2014-01-01

    The article shows the results of treatment of 118 patients with chronic hepatitis C (CHC) which is associated with type 2 diabetes mellitus (DM). When planning therapeutic interventions in chronic hepatitis C in patients with diabetes, it is considered the presence of visceral obesit , dyslipidemia, and hepatic steatosis. The efficacy of different treatment regimens was studied. Found that the usage of ursodeoxycholic acid and ademetionin in HCV patients with diabetes type 2 receiving standard antiviral therapy (SAVT), significantly make a positive effect on the level of dyslipidemia. The normalization of lipid profile allows for a full course of SAVT, which reduces the frequency of relapse. It is also noted that the simultaneous use of ademetionin and ursodeoxycholic acid in treatment of chronic hepatitis C leads to a reduction of side effects of SAVT. Metabolic therapy may be recommended for patients with chronic hepatitis C in combination with type 2 diabetes in case of SAVT, and at its contraindications or intolerance.

  7. Study of sleep disorders and polysomnographic evaluation among primary chronic daily headache patients

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2016-01-01

    Full Text Available Objective: Studies related to sleep disorders and polysomnography (PSG among chronic daily headache patients are rare. We studied this and compared chronic migraine (CM with chronic tension-type headache. Methods: Eighty-three patients were recruited. They were evaluated by semi-structured interview, headache, and sleep diaries along with Epworth Sleepiness Scale score and insomnia symptom score. Overnight PSG was performed and data compared. Results: Chronic tension-type headache was more common than CM, both having female preponderance. Insomnia followed by excessive daytime sleepiness was prevalent sleep disorder. Sleep efficiency and Stage 3 sleep were lower in CM compared to chronic tension-type. ESSS was significantly increased among chronic tension-type patients. No significant correlation was found among PSG parameters in patients with or without sleep disorders. Conclusion: Insomnia being most common sleep disorder among chronic headache population. Chronic tension-type headache had slightly better slow-wave sleep than CM and significantly increased daytime sleepiness.

  8. Piezoresistive effect of n-type 〈111〉-oriented Si nanowires under large tension/compression.

    Science.gov (United States)

    Gao, Di; Yang, Zhenyu; Zheng, Lingli; Zheng, Kun

    2017-03-03

    Small-scale samples enable us to understand changes in physical properties under larger strain due to their higher tolerance to deformation. In this study, the piezoresistive character of n-type 〈111〉-oriented Si nanowires under large strain was measured during tensile and compressive deformations. The Si nanowires were directly cut from the wafer using top-down technology and deformed while capturing their electrical properties inside a transmission electron microscope. The experimental results show that both tensile and compressive deformation enhanced their electrical transport properties. The piezoresistance coefficient is of the same order of magnitude as its bulk counterpart, but half as large, which may be attributed to a larger strain magnitude. We also studied the circulatory characteristics and influence of electron beam radiation. This study provided new physical insights into piezoresistive effects under large strain.

  9. Oxygen tension level and human viral infections.

    Science.gov (United States)

    Morinet, Frédéric; Casetti, Luana; François, Jean-Hugues; Capron, Claude; Pillet, Sylvie

    2013-09-01

    The role of oxygen tension level is a well-known phenomenon that has been studied in oncology and radiotherapy since about 60 years. Oxygen tension may inhibit or stimulate propagation of viruses in vitro as well as in vivo. In turn modulating oxygen metabolism may constitute a novel approach to treat viral infections as an adjuvant therapy. The major transcription factor which regulates oxygen tension level is hypoxia-inducible factor-1 alpha (HIF-1α). Down-regulating the expression of HIF-1α is a possible method in the treatment of chronic viral infection such as human immunodeficiency virus infection, chronic hepatitis B and C viral infections and Kaposi sarcoma in addition to classic chemotherapy. The aim of this review is to supply an updating concerning the influence of oxygen tension level in human viral infections and to evoke possible new therapeutic strategies regarding this environmental condition.

  10. Superoxide dismutase type 1 in monocytes of chronic kidney disease patients

    DEFF Research Database (Denmark)

    Scholze, Alexandra; Krueger, Katharina; Diedrich, Madeleine

    2011-01-01

    We analyzed proteomic profiles in monocytes of chronic kidney disease (CKD) patients and healthy control subjects. Two-dimensional electrophoresis (2-DE) and silver staining indicated differences in protein pattern. Among the analyzed proteins, superoxide dismutase type 1 (SOD1), which was identi......We analyzed proteomic profiles in monocytes of chronic kidney disease (CKD) patients and healthy control subjects. Two-dimensional electrophoresis (2-DE) and silver staining indicated differences in protein pattern. Among the analyzed proteins, superoxide dismutase type 1 (SOD1), which...

  11. Detection of bacterial biofilms in different types of chronic otitis media.

    Science.gov (United States)

    Gu, Xingzhi; Keyoumu, Youlidusi; Long, Li; Zhang, Hua

    2014-11-01

    Biofilms are organized bacterial communities that may be homogeneous or heterogeneous. They play a significant role in the pathogenesis of chronic nasal sinusitis, chronic tonsillitis, cholesteatomas, and device-related infections. Despite this, few studies have been done that examine the presence of bacterial biofilms in tissues from patients with different types of COM or middle ear cholesteatomas. In the current study, we examined the presence of biofilms in surgical tissue specimens from humans with chronic ear infections using scanning electron microscopy (SEM). We hypothesize that bacterial biofilms present differently in patients with different types of chronic otitis media. Our results provide new insights regarding treatment of chronic otitis media. A prospective study was conducted in which middle ear tissues were obtained from 38 patients who underwent tympanoplasty and/or tympanomastoid surgery due to chronic ear infections. A total of 50 middle and mastoid tissue samples were processed for SEM analysis. In addition, 38 middle ear secretion specimens were obtained for routine bacterial culture analysis. Bacterial biofilms were present in 85 % (11 of 13) of patients with middle ear cholesteatoma, 92 % (12/13) of patients with chronic otitis suppurative media (CSOM), and 16 % of patients (2/12) with tympanic membrane perforation (TMP). Fungal biofilms were found in two cases of cholesteatoma. The positive coincidence rate between bacterial biofilms visualized by SEM and bacteria detected by culture was 82 %. Our findings suggest that bacterial biofilms are very common in CSOM and middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and cholesteatomas. As such, our results provide new insights regarding treatment of chronic otitis media.

  12. The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

    Directory of Open Access Journals (Sweden)

    Vestri Anna R

    2009-12-01

    Full Text Available Abstract Background This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects. Methods The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ. One-hundred healthy volunteers were recruited as a control group. Results The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result and 2.2% in the control group (p Conclusions Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.

  13. Induction of prolonged tenderness in patients with tension-type headache by means of a new experimental model of myofascial pain.

    Science.gov (United States)

    Mørk, H; Ashina, M; Bendtsen, L; Olesen, J; Jensen, R

    2003-05-01

    Tenderness is the most prominent abnormal finding in patients with tension-type headache (TTH). Recently we developed a model of myofascial tenderness using intramuscular infusion of a combination of bradykinin, serotonin, histamine and prostaglandin E2. We aimed to examine tenderness after this combination in patients with episodic TTH (ETTH). Fifteen patients and 15 healthy controls completed the study. Participants received the combination into the non-dominant trapezius muscle in a randomized, double-blinded and placebo-controlled design. Local tenderness and stimulus-response functions, mechanical pain thresholds (PPDT) in the temporal region and on the finger, and total tenderness score (TTS) were recorded. A local, prolonged, and mild to moderate tenderness was reported both in patients (P = 0.001) and in controls (P = 0.001) after the combination compared with the placebo. The response to the combination tended to be increased in patients. The stimulus-response function was leftward shifted after the combination, compared with baseline in both groups. No changes in PPDT or TTS were found after the infusions, whereas baseline PPDTs were decreased in ETTH compared with controls (PPDTfinger: P = 0.033; PPDTtemporal: P = 0.015). Intramuscular infusion of a combination of endogenous substances induced prolonged tenderness in both patients with episodic TTH and healthy subjects. The present results suggest an increased excitability of peripheral muscle afferents in TTH.

  14. Skin tension related to tension reduction sutures.

    Science.gov (United States)

    Hwang, Kun; Kim, Han Joon; Kim, Kyung Yong; Han, Seung Ho; Hwang, Se Jin

    2015-01-01

    The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer.The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures.

  15. Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease

    OpenAIRE

    Yale, J-F; Bakris, G.; B. Cariou; Yue, D; David-Neto,E.; Xi, L; Figueroa, K; Wajs, E; Usiskin, K; Meininger, G

    2013-01-01

    Aims Canagliflozin is a sodium glucose co-transporter 2 inhibitor in development for treatment of type 2 diabetes mellitus (T2DM). This study evaluated the efficacy and safety of canagliflozin in subjects with T2DM and stage 3 chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR) ≥30 and

  16. A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease

    NARCIS (Netherlands)

    Pfeffer, Marc A.; Burdmann, Emmanuel A.; Chen, Chao-Yin; Cooper, Mark E.; de Zeeuw, Dick; Eckardt, Kai-Uwe; Feyzi, Jan M.; Ivanovich, Peter; Kewalramani, Reshma; Levey, Andrew S.; Lewis, Eldrin F.; McGill, Janet B.; McMurray, John J. V.; Parfrey, Patrick; Parving, Hans-Henrik; Remuzzi, Giuseppe; Singh, Ajay K.; Solomon, Scott D.; Toto, Robert

    2009-01-01

    BACKGROUND Anemia is associated with an increased risk of cardiovascular and renal events among patients with type 2 diabetes and chronic kidney disease. Although darbepoetin alfa can effectively increase hemoglobin levels, its effect on clinical outcomes in these patients has not been adequately te

  17. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease

    DEFF Research Database (Denmark)

    Pfeffer, Marc A; Burdmann, Emmanuel A; Chen, Chao-Yin

    2009-01-01

    BACKGROUND: Anemia is associated with an increased risk of cardiovascular and renal events among patients with type 2 diabetes and chronic kidney disease. Although darbepoetin alfa can effectively increase hemoglobin levels, its effect on clinical outcomes in these patients has not been adequatel...

  18. [Colon biopsy--histological characteristics in different types of chronic colitis].

    Science.gov (United States)

    Arévalo, F; Arias Stella Castillo, J; Monge, E; Arias Stella, J

    2008-01-01

    In the last few years a variety of new forms of chronic colitis have been described with defined histological characteristics. It is important both for the gastroenterologists and pathologists to be acquainted with this new clinic pathological entities. The present article is a review of the anatomo-pathological characteristics of the different types of colitis.

  19. Impact of diabetes type II and chronic inflammation on pancreatic cancer

    OpenAIRE

    Zechner, Dietmar; Radecke, Tobias; Amme, Jonas; Bürtin, Florian; Albert, Ann-Christin; Partecke, Lars Ivo; Vollmar, Brigitte

    2015-01-01

    Background We explored if known risk factors for pancreatic cancer such as type II diabetes and chronic inflammation, influence the pathophysiology of an established primary tumor in the pancreas and if administration of metformin has an impact on tumor growth. Methods Pancreatic carcinomas were assessed in a syngeneic orthotopic pancreas adenocarcinoma model after injection of 6606PDA cells in the pancreas head of either B6.V-Lepob/ob mice exhibiting a type II diabetes-like syndrome or normo...

  20. Crevicular Fluid and Serum Concentrations of Progranulin and High Sensitivity CRP in Chronic Periodontitis and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    N. Priyanka

    2013-01-01

    Full Text Available Introduction. This study was designed to correlate the serum and gingival crevicular fluid (GCF levels of progranulin (PGRN and high sensitivity C-reactive protein (hs CRP in chronic periodontitis and type 2 diabetes mellitus (DM. Design. PGRN and hs CRP levels were estimated in 3 groups: healthy, chronic periodontitis, and type 2 DM with chronic periodontitis. Results. The mean PGRN and hs CRP concentrations in serum and GCF were the highest for group 3 followed by group 2 and the least in group 1. Conclusion. PGRN and hs CRP may be biomarkers of the inflammatory response in type 2 DM and chronic periodontitis.

  1. Cognitive Disorders, Depressive Status and Chronic Complications of Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Tache Mirela

    2014-12-01

    Full Text Available Background and aims: Depression and cognitive disorders were reported more frequently in patients with diabetes mellitus (DM. Our aim was to analyze the association of cognitive disorders and depression association with chronic complications of DM in a group of Romanian patients. Materials and methods: The data was analyzed from 181 patients, with a mean age of 58,3 years to whom we applied the MMSE (Mini- Mental State Examination and MADRS (Montgomery-Asberg Depression Rating Scale questionnaires. We also analyzed the presence of chronic DM complications, HbA1c and lipid profile. Results: Most patients with type 2 diabetes mellitus (T2DM had mild cognitive impairment (92%, more common in the age group 50-59 years. Chronic macrovascular complications were present in 74.58%, while chronic microvascular complications were present in 61.87% of patients with T2DM who associated mild and moderate cognitive impairment (p = 0.013. The most common form of depression was mild depression (90.2%, present in most patients with DM, regardless of progression and type of treatment. MADRS depression test scores were statistically significant correlated with the presence of peripheral artery disease - PAD (p <0.001, ischemic heart disease - IHD (p <0.001 and chronic kidney disease - CKD (p =0.05. We did not find a statistically significant correlation with HbA1c and serum lipid values (p˃0,05. Conclusion: Chronic diabetes macrovascular complications (PAD, IHD and CKD were more frequently associated with cognitive disorders and depression in patients with T2DM independent of the degree of metabolic control.

  2. Chronic effects of a Salmonella type III secretion effector protein AvrA in vivo.

    Directory of Open Access Journals (Sweden)

    Rong Lu

    Full Text Available BACKGROUND: Salmonella infection is a common public health problem that can become chronic and increase the risk of inflammatory bowel diseases and cancer. AvrA is a Salmonella bacterial type III secretion effector protein. Increasing evidence demonstrates that AvrA is a multi-functional enzyme with critical roles in inhibiting inflammation, regulating apoptosis, and enhancing proliferation. However, the chronic effects of Salmonella and effector AvrA in vivo are still unknown. Moreover, alive, mutated, non-invasive Salmonella is used as a vector to specifically target cancer cells. However, studies are lacking on chronic infection with non-pathogenic or mutated Salmonella in the host. METHODS/PRINCIPAL FINDINGS: We infected mice with Salmonella Typhimurium for 27 weeks and investigated the physiological effects as well as the role of AvrA in intestinal inflammation. We found altered body weight, intestinal pathology, and bacterial translocation in spleen, liver, and gallbladder in chronically Salmonella-infected mice. Moreover, AvrA suppressed intestinal inflammation and inhibited the secretion of cytokines IL-12, IFN-gamma, and TNF-alpha. AvrA expression in Salmonella enhanced its invasion ability. Liver abscess and Salmonella translocation in the gallbladder were observed and may be associated with AvrA expression in Salmonella. CONCLUSION/SIGNIFICANCE: We created a mouse model with persistent Salmonella infection in vivo. Our study further emphasizes the importance of the Salmonella effector protein AvrA in intestinal inflammation, bacterial translocation, and chronic infection in vivo.

  3. Oxygen tension level and human viral infections

    Energy Technology Data Exchange (ETDEWEB)

    Morinet, Frédéric, E-mail: frederic.morinet@sls.aphp.fr [Centre des Innovations Thérapeutiques en Oncologie et Hématologie (CITOH), CHU Saint-Louis, Paris (France); Université Denis Diderot, Sorbonne Paris Cité Paris, Paris (France); Casetti, Luana [Institut Cochin INSERM U1016, Paris (France); François, Jean-Hugues; Capron, Claude [Institut Cochin INSERM U1016, Paris (France); Laboratoire d' Hématologie, Hôpital Ambroise Paré, Boulogne (France); Université de Versailles Saint-Quentin en Yvelynes, Versailles (France); Pillet, Sylvie [Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Saint-Etienne, Saint-Etienne (France); Université de Lyon et Université de Saint-Etienne, Jean Monnet, GIMAP EA3064, F-42023 Saint-Etienne, Lyon (France)

    2013-09-15

    The role of oxygen tension level is a well-known phenomenon that has been studied in oncology and radiotherapy since about 60 years. Oxygen tension may inhibit or stimulate propagation of viruses in vitro as well as in vivo. In turn modulating oxygen metabolism may constitute a novel approach to treat viral infections as an adjuvant therapy. The major transcription factor which regulates oxygen tension level is hypoxia-inducible factor-1 alpha (HIF-1α). Down-regulating the expression of HIF-1α is a possible method in the treatment of chronic viral infection such as human immunodeficiency virus infection, chronic hepatitis B and C viral infections and Kaposi sarcoma in addition to classic chemotherapy. The aim of this review is to supply an updating concerning the influence of oxygen tension level in human viral infections and to evoke possible new therapeutic strategies regarding this environmental condition. - Highlights: • Oxygen tension level regulates viral replication in vitro and possibly in vivo. • Hypoxia-inducible factor 1 (HIF-1α) is the principal factor involved in Oxygen tension level. • HIF-1α upregulates gene expression for example of HIV, JC and Kaposi sarcoma viruses. • In addition to classical chemotherapy inhibition of HIF-1α may constitute a new track to treat human viral infections.

  4. Type the title of your paper here Effect of the focused light from the xenon arc lamp on the surface tension of the molten enamel

    Science.gov (United States)

    Aleutdinov, A. D.; Ghyngazov, S. A.; Mylnikova, T. S.; Aleutdinov, K. A.

    2016-02-01

    The effect of exposure to the focused light from the xenon arc lamp on the surface tension of molten enamels was studied with a designed light beam setup as compared to that observed in conventional heating in a resistance furnace. The objects under investigation were enamels No. 261, UES-200 and UES-300. The power density of the light beam was varied in the range of (30-80) W/cm2. When exposed to light, the surface tension is shown to be an order of magnitude lower than that obtained in conventional furnace heating.

  5. Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child

    OpenAIRE

    2013-01-01

    Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated...

  6. [Associations of chronic obstructive pulmonary disease, bronchial asthma, and type 1 diabetes mellitus].

    Science.gov (United States)

    Kobylianskiĭ, V I; Babadzhanova, G Iu; Suntsov, Iu I

    2009-01-01

    The aim of the study was to clarify the relationships between bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), and type 1 diabetes mellitus. Reduced prevalence of concomitant BA and DM1 suggests inverse relation between the two conditions and their mutually exclusive nature. The problem needs further studies. Taking into account age-specific and other features of COPD and DM1 pathological processes elucidation of their interrelation appears impractical.

  7. [Investigation into relationship between chronic obstructive pulmonary disease, bronchial asthma, and type 2 diabetes].

    Science.gov (United States)

    Kobylianskiĭ, V N; Babadzhanova, G Iu; Suntsov, Iu I

    2009-01-01

    We studied the relationship between bronchopulmonary pathology (chronic pulmonary disease, CPD, and bronchial asthma, BA) and type 2 diabetes (DM2). The two conditions were shown to be underlain by inflammation of different character. In patients with CPD it leads to DM2. Concomitant CPD and BA significantly increase the risk of DM2 and require the development of measures for its diagnosis and prevention.

  8. Iontophoresis Versus Cyriax-Type exercises in Chronic Tennis Elbow among industrial workers

    OpenAIRE

    2015-01-01

    Introduction: Tennis elbow (TE) is one of the most commonly encountered upper limb conditions. It mainly affects people who use the hand grip against resistance frequently, resulting in microtrauma to the wrist extensors tendon, causing pain. This study was conducted to compare the application of iontophoresis of 0.4% dexamethasone and Cyriax-type exercises in the treatment of chronic tennis elbow (CTE). Methods: Twenty-two industrial worker diagnosed as having CTE participated in this study,...

  9. Serum leveis of inflammatory markers in type 2 diabetes patients with chronic periodontitis

    OpenAIRE

    Longo, Priscila Larcher; Artese,Hilana Paula Carillo; RABELO,Marianade Sousa; KAWAMOTO, Dione; Foz, Adriana Moura; ROMITO, Giuseppe Alexandre; Dib, Sérgio Atala; Mayer, Marcia Pinto Alves

    2014-01-01

    Diabetes has been associated with periodontitis, but the mechanisms through which periodontal diseases affect the metabolic control remain unclear. Objective: This study aimed to evaluate serum leveis of inflammatory markers, IL-8, IL-6 and monocyte chemoattractant protein 1 (MCP-1), in type 2 diabetic patients in the presence of chronic periodontitis. Material and Methods: Forty two individuals were enrolled in this study and assigned to one of five groups: diabetes mellitus with inade...

  10. Lignification and tension wood.

    Science.gov (United States)

    Pilate, Gilles; Chabbert, Brigitte; Cathala, Bernard; Yoshinaga, Arata; Leplé, Jean-Charles; Laurans, Françoise; Lapierre, Catherine; Ruel, Katia

    2004-01-01

    Hardwood trees are able to reorient their axes owing to tension wood differentiation. Tension wood is characterised by important ultrastructural modifications, such as the occurrence in a number of species, of an extra secondary wall layer, named gelatinous layer or G-layer, mainly constituted of cellulose microfibrils oriented nearly parallel to the fibre axis. This G-layer appears directly involved in the definition of tension wood mechanical properties. This review gathers the data available in the literature about lignification during tension wood formation. Potential roles for lignin in tension wood formation are inferred from biochemical, anatomical and mechanical studies, from the hypotheses proposed to describe tension wood function and from data coming from new research areas such as functional genomics.

  11. Update on normal tension glaucoma

    Directory of Open Access Journals (Sweden)

    Jyotiranjan Mallick

    2016-01-01

    Full Text Available Normal tension glaucoma (NTG is labelled when typical glaucomatous disc changes, visual field defects and open anterior chamber angles are associated with intraocular pressure (IOP constantly below 21 mmHg. Chronic low vascular perfusion, Raynaud's phenomenon, migraine, nocturnal systemic hypotension and over-treated systemic hypertension are the main causes of normal tension glaucoma. Goldmann applanation tonometry, gonioscopy, slit lamp biomicroscopy, optical coherence tomography and visual field analysis are the main tools of investigation for the diagnosis of NTG. Management follows the same principles of treatment for other chronic glaucomas: To reduce IOP by a substantial amount, sufficient to prevent disabling visual loss. Treatment is generally aimed to lower IOP by 30% from pre-existing levels to 12-14 mmHg. Betaxolol, brimonidine, prostaglandin analogues, trabeculectomy (in refractory cases, systemic calcium channel blockers (such as nifedipine and 24-hour monitoring of blood pressure are considered in the management of NTG. The present review summarises risk factors, causes, pathogenesis, diagnosis and management of NTG.

  12. Prevalence of chronic complications of type 2 diabetes mellitus in a secondary health centre in Niger Delta, Nigeria

    Directory of Open Access Journals (Sweden)

    Ufuoma Chukwuani

    2016-04-01

    Conclusions: Chronic complications are common among type 2 diabetes in central hospital Warri, Nigeria. Implementation of timely and appropriate screening strategies could decrease the burden of diabetes chronic complications. [Int J Res Med Sci 2016; 4(4.000: 1080-1085

  13. Type-I Interferon responses: From Friend to Foe in the Battle against Chronic Viral Infection

    Directory of Open Access Journals (Sweden)

    Armstrong Murira

    2016-12-01

    Full Text Available Type I interferons (IFN-I have long been heralded as key contributors to effective antiviral responses. More widely understood in the context of acute viral infection, the role of this pleiotropic cytokine has been characterized as triggering antiviral states in cells and potentiating adaptive immune responses. Upon induction in the innate immune response, IFN-I triggers the expression of interferon-stimulated genes (ISGs, which upregulate the effector function of immune cells (e.g., dendritic cells, B cells and T cells towards successful resolution of infections. However, emerging lines of evidence reveal that viral persistence in the course of chronic infections could be driven by deleterious immunomodulatory effects upon sustained IFN-I expression. In this setting, elevation of IFN-I and ISGs is directly correlated to viral persistence and elevated viral loads. It is important to note that the correlation among IFN-I expression, ISGs and viral persistence may be a cause or effect of chronic infection and this is an important distinction to make towards establishing the dichotomous nature of IFN-I responses. The aim of this mini-review is to (i summarize the interaction between IFN-I and downstream effector responses and therefore (ii delineate the function of this cytokine on positive and negative immunoregulation in chronic infection. This is a significant consideration given the current therapeutic administration of IFN-I in chronic viral infections whose therapeutic significance is projected to continue despite emergence of increasingly efficacious antiviral regimens. Furthermore, elucidation of the interplay between virus and the antiviral response in the context of IFN-I will elucidate avenues towards more effective therapeutic and prophylactic measures against chronic viral infections.

  14. [Quantification of gait using insole type foot pressure monitor : clinical application for chronic hemiplegia].

    Science.gov (United States)

    Naito, Yutaro; Kimura, Yoshiko; Hashimoto, Takashi; Mori, Masao; Takemoto, Yoshimi

    2014-03-01

    Home-based stroke hemiplegia patients tend to fall easily. Poor toe clearance is reported to be one of the causes of falling, although there are many other related factors. We developed a low-priced insole type portable foot pressure measurement device, and measured the foot pressure distribution and the foot pressure-time curve of 20 chronic hemiplegia patients and compared them with 36 healthy controls. We also analyzed the outdoor gait of a chronic hemiplegia patient on flat ground, on rough terrain, walking up stairs and on a downward slope. The result was that the load rate of the unaffected heel was significantly increased in hemiplegic gait, and there was a significant negative correlation between the affected side stance phase rate and gait time for 10 m distance (r = -0.73, P hemiplegia patients tend to be highly dependent on their unaffected side during indoor and outdoor gait.

  15. [Chronic type A aortic dissection associated with Turner syndrome; report of a case].

    Science.gov (United States)

    Tanaka, Hideyuki; Kozaki, Tomofumi; Kume, Masazumi; Miyamoto, Shinji

    2014-12-01

    Aortic dissection is a critical but rare complication of Turner syndrome. This report describes a case of chronic aortic dissection in a patient with Turner syndrome. A 54-year-old woman, suffering from mild back pain for 1 month, was referred to our hospital with a diagnosis of Stanford type A chronic aortic dissection and a bicuspid aortic valve with moderate regurgitation. Computed tomography revealed aortic dissection, involving all arch branches, extending from the ascending to the abdominal aorta. The true lumen of the brachial artery was nearly obstructed by the thrombosed false lumen. Elective aortic arch repair and aortic valve replacement were successfully performed. The patient was diagnosed with 45, XO Turner syndrome after surgery. Taking aortopathy of Turner syndrome into consideration, surveillance of the residual aorta was performed. No rapidly progressive dilatation of the residual aorta was detected during the 6 years' follow-up.

  16. Renal tubular acidosis type II associated with vitamin D deficiency presenting as chronic weakness.

    Science.gov (United States)

    Ali, Yaseen; Parekh, Amila; Baig, Mirza; Ali, Taseen; Rafiq, Tazeen

    2014-08-01

    Chronic vitamin D deficiency, though common in the elderly, is often under diagnosed and when progressing to renal tubular acidosis type II (RTA 2) can cause several simultaneous electrolyte imbalances that may present with weakness and pain as chief symptoms. We present such a case that after months of evaluation and symptomatic treatment did not lead to an effective establishment of the etiology causing chronic weakness and body pain in an elderly female patient. Eventually, after a careful review of the patient's history, repeat physical examinations, laboratory data evaluation, and diagnostic testing led to the establishment of the diagnosis of proximal RTA 2 associated with vitamin D deficiency, which caused the patient to develop several remarkable secondary electrolyte imbalances such as hypokalemia, hypocalcemia, hypophosphatemia, acidemia, hyperparathyroidism, with weakness and body pain.

  17. Clinical Guidance on Screening Chronic Kidney Disease in Type 2 Diabetic Patients for Family Physicians

    Directory of Open Access Journals (Sweden)

    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Incidence of diabetes is increasing in developing countries as well as Iran. Half of the patients are not aware of their disease so screening of diabetes is necessary. Lifestyle changes in society, high-saturated fat diet and decreased physical activity are the factors that influence the growing rate of diabetes in Iran.1 The need for addressing type 2 diabetes has been clarified for family physicians.2 Diabetes is a common disease that is associated with significant morbidity and mortality. It has an asymptomatic stage that may be present for up to several years before diagnosis.3 Diabetes is the leading cause of kidney disease.4 In a study among patients over 45 years with type 2 diabetes, these results were reported: 22% suffered from retinopathy, 7% had impaired vision, 6% had kidney diseases, 9% had clinical symptoms, and 19.1% were at risk for foot ulcers.5 Early treatment of type 2 diabetes can reduce or delay complications.6 Optimal glycemia and BP are important in the prevention of diabetic chronic kidney disease (CKD.4 Therapeutic goals in patients with complications, such as CKD, include maintaining renal function and stopping the trend of renal deterioration.5 Progression of diabetic nephropathy can be slowed through the use of some medications.4 How to screen and manage chronic kidney disease in patients with type 2 diabetes is shown in Figure 1.

  18. Optimal treatment of chronic angina in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kaur H

    2014-07-01

    Full Text Available Harjinder Kaur,1 Kully Sandhu,2 Awais Jabbar,3 Azfar G Zaman3,4 1City Hospitals Sunderland, Sunderland, UK; 2University Hospital of North Staffordshire, Stoke-on-Trent, UK; 3Freeman Hospital, Newcastle-upon-Tyne, UK; 4Institute of Cellular Medicine, Newcastle University, Newcastle, UK Abstract: Type 2 diabetes mellitus (T2DM trebles the risk of developing coronary artery disease (CAD; once CAD has developed, the risk of acute coronary syndromes (ACS and clinical risk associated with a coronary event, both double in diabetic patients. Patients with T2DM have more extensive CAD and present at a younger age; therefore, identification and management of chronic angina in these patients presents an opportunity to limit both cardiovascular symptoms and adverse outcomes. This article reviews the role of screening and treatment for chronic angina in patients with T2DM. There is a strong evidence base for modifying lifestyle as a way of reducing adverse cardiovascular outcomes in the diabetic population and this article reviews evidence of lifestyle modification as an important and necessary adjunct to pharmacologic intervention. Management of chronic stable angina is addressed by looking at treatments that reduce ischemic symptoms and those that reduce adverse cardiovascular outcomes. Trials specific to the diabetic population are limited, with information largely obtained from the diabetic subgroup analysis of large intervention trials. The growing diabetic population with increased propensity to cardiovascular disease mandates trials specifically in this patient population. Revascularization in patients with diabetes is associated with more complications than in the non-diabetic population. Recent trials specific to this population suggest surgical revascularization to be associated with better long-term outcomes and therefore, this article reviews the evidence for the optimal mode of revascularization in this population. Keywords: type 2 diabetes

  19. Chronic inflammation of the prostate type IV with respect to risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Antonio B. Porcaro

    2014-09-01

    Full Text Available Background: Chronic inflammatory infiltrate (CII might be involved in prostate cancer (PCA and benign hyperplasia (BPH; however, its significance is controversial. Chronic inflammatory prostatitis type IV is the most common non cancer diagnosis in men undergoing biopsy because of suspected PCA. Objective: To evaluate potential associations of coexistent CII and PCA in biopsy specimens after prostate assessment. Design, setting, and participants: Between January 2007 and December 2008, 415 consecutive patients who underwent prostate biopsy were retrospectively evaluated. The investigated variables included Age (years and PSA (ug/l; moreover, CII+, glandular atrophy (GA+, glandular hyperplasia (GH+, prostate Intraepithelial neoplasm (PIN+, atypical small acinar cell proliferation (ASAP+ and PCA positive cores (P+ were evaluated as categorical and continuous (proportion of positive cores. Outcome measurements and statistical analysis: Associations of CII+ and PCA risk were assessed by statistical methods. Results and limitations: In the patient population, a biopsy core positive for PCA was detected in 34.2% of cases and the rate of high grade PCA (HGPCA: bGS ! 8 resulted 4.82%. CII+ significantly and inversely associated with a positive biopsy core P+ (P < 0.0001; OR = 0.26 and HGPCA (P = 0.0005; OR = 0.05. Moreover, the associations indicated that patients with coexistent CII+ on needle biopsy were 74% less likely to have coexistent PCA than men without CII+ as well as 95% less likely to have HGPCA in the biopsy core than men without coexistent CII+. There were limits in our study which was single centre and included only one dedicated pathologist. Conclusions: There was an inverse association of chronic inflammation of the prostate type IV and risk of PCA; moreover, HGPCA was less likely to be detected in cancers associated with coexistent CII. In prostate microenvironment, prostate chronic inflammation may be protective; however, its role in

  20. Rationale and trial design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes

    DEFF Research Database (Denmark)

    de Zeeuw, Dick; Akizawa, Tadao; Agarwal, Rajiv

    2013-01-01

    Chronic kidney disease (CKD) associated with type 2 diabetes mellitus constitutes a global epidemic complicated by considerable renal and cardiovascular morbidity and mortality, despite the provision of inhibitors of the renin-angiotensin-aldosterone system (RAAS). Bardoxolone methyl, a synthetic...

  1. [Intrathecal interferon therapy in chronic echovirus meningoencephalitis in Bruton type agammaglobulinemia].

    Science.gov (United States)

    von der Wense, A; Herrmann, B; Deppermann, R; Harms, F; Wehinger, H

    1998-01-01

    A 9-year-old body with X-linked agammaglobulinemia developed chronic enteroviral meningoencephalitis (CEMA) caused by echovirus type 6. Intravenous treatment with selected immunoglobulin charges containing high titers against echovirus type 6 or combination with beta-interferon did not result in improvement. After implantation of a Rickham reservoir and periodical administration of intraventricular and intravenous immunoglobulin the virus recurred rapidly each time treatment was stopped. After 20 months of treatment the patient received a combined therapy with beta-interferon and selected immunoglobulin. Both drugs were given by lumbar puncture, intravenously and via Rickham reservoir. Subsequently echovirus type 6 could not be isolated in culture or PCR. Cerebrospinal fluid pleocytosis disappeared. The remission is lasting for more than three years. Intrathecal and intraventricular beta-interferon therapy for CEMA is being reported for the first time. Facing the unfavourable prognosis of the disease this mode of treatment is a new therapeutic approach following failure of other therapies.

  2. The Relationship between Smoking as a Modifiable Risk Factor and Chronic Complications on Elderly with Type 2 Diabetes Mellitus

    OpenAIRE

    Indang Trihandini

    2015-01-01

    Smoking is known as a variable that can be changed through a specific intervention activity. Recently in Indonesia, research related to chronic complication among elderly with type 2 Diabetes Mellitus (DM) was not available. This research has objective in exploring the risk of smoking towards chronic complication among elderly with type 2 DM. This research was using Riset Kesehatan Dasar (Riskesdas) in 2007. Riskesdas is a representative Indonesia Health Survey. 1,565 elderly (aged 60++ years...

  3. Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child.

    Science.gov (United States)

    Gera, D N; Ghuge, P P; Gandhi, S; Vanikar, A V; Shrimali, J D; Kute, V B; Trivedi, H L

    2013-11-01

    Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.

  4. [PECULIARITES OF SIMULTANT INTERVENTIONS FOR SOME TYPES OF CHRONIC PHTHISIC PLEURITIS, COEXISTENT WITH PULMONARY TUBERCULOSIS].

    Science.gov (United States)

    Duzhiy, I D; Grehsko, I Ya; Kravets, O V; Oleshchenko, G P; Glazunova, N I

    2016-01-01

    In coincidence of chronic phthisic pleuritis in a rigid stage with pulmonary tuberculosis operative intervention is indicated of a pleuropulmonectomy type, what is a complex situation for performance and preservation of the patient's functional state. Pleuropulmonectomy in some patients is complicated by empyema and pathological processes in bronchi. Possibilities of operative interventions application, alternative to pleuropulmonectomy, were studied. Of 48 patients, to whom pleuropulmonectomy is indicated in accordance to data of clinic-roentgenological investigations, in 7--simultant operative treatment were conducted with positive results.

  5. Chronic lymphocytic lymphoma and concomitant renal cell carcinoma (Clear Cell Type: Review of the literature

    Directory of Open Access Journals (Sweden)

    Burak Uz

    2016-01-01

    Full Text Available In the present report, a 73 years-old male patient who developed clear cell type renal cell carcinoma (RCC 5 years after the diagnosis of chronic lymphocytic lymphoma (CLL and plausible explanations for this association were discussed by the authors. The incidence of CLL and RCC occurring in the same patient is higher than that expected in the general population. Various explicative hypotheses of this concurrence include treatment-related development of a second malignancy, immunomodulatory mechanisms, viral aetiology, cytokine (interleukin 6 release from a tumor, and common genetic mutations. Further investigations are warranted.

  6. Lower grade chronic inflammation is associated with obstructive sleep apnea syndrome in type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    朱宏霞

    2014-01-01

    Objective To investigate whether the existence of obstructive sleep apnea syndrome(OSAS)in patients with type 2 diabetes(T2DM) is associated with low grade chronic inflammation.Methods Fifty-four patients hospitalized for poor glycemic control from 12/2008 to 12/2009 were divided into 2 groups,OSAS group(T2DM with OSAS,27 cases)and NOSAS group(T2DM without OSAS,27 cases).The control group consisted of 26people from a health check-up program without diabetes

  7. Effects of acute and chronic physical exercise and stress on different types of memory in rats.

    Science.gov (United States)

    Mello, Pâmela Billig; Benetti, Fernando; Cammarota, Martín; Izquierdo, Iván

    2008-06-01

    Here we study the effect of acute and chronic physical exercise in a treadmill and of daily stress (because forced exercise involves a degree of stress) during 2 or 8 weeks on different types of memory in male Wistar rats. The memory tests employed were: habituation in an open field, object recognition and spatial learning in the Morris water maze. Daily foot-shock stress enhanced habituation learning after 2 but not after 8 weeks; it hindered both short- (STM) and long-term memory (LTM) of the recognition task at 2 weeks but only STM after 8 weeks and had no effect on spatial learning after either 2 or 8 weeks. Acute but not chronic exercise also enhanced habituation in the open field and hindered STM and LTM in the recognition task. Chronic exercise enhanced one important measure of spatial learning (latency to escape) but not others. Our findings indicate that some care must be taken when interpreting effects of forced exercise on brain parameters since at least part of them may be due to the stress inherent to the training procedure.

  8. Avaliação da utilização do placebo nas crises agudas de migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks

    Directory of Open Access Journals (Sweden)

    Marcelo Eduardo Bigal

    2001-09-01

    Full Text Available O presente estudo apresenta a avaliação do efeito placebo no tratamento agudo da migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica. Foram estudados pacientes que deram entrada entre 1 de março de 1997 a 31 de novembro de 1999 em dois pronto-socorros. Definiram-se três grupos, cada um com 30 pacientes: 1 - migrânea sem aura (MSA; 2 -- migrânea com aura (MCO; 3 -- cefaléia do tipo tensional episódica (CTTE. Os pacientes participavam de estudo randomizado para avaliar a eficácia de 4 drogas; aqueles randomizados para o placebo foram incluídos também. Os parâmetros avaliados foram: 1 -- dor; 2 - sintomas associados. Avaliados uma hora após a administração do placebo, 50% dos pacientes do grupo MSA, 23,3% dos pacientes do grupo MCA e 26,7% dos pacientes do grupo CTTE apresentavam melhora da dor. A melhora, avaliada pela escala numérica da dor foi, em média, de 41,6%, 23,1% e 36%, respectivamente. Houve também redução significativa de todos os sintomas associados. A utilização do placebo é, portanto, essencial na avaliação de drogas utilizadas no tratamento de cefaléias agudas.This study presents an evaluation of placebo response in the acute treatment of migraine with or without aura and episodic tension type headache. We studied patients admitted between March 1st,1997 and November 31st,1999 in two Emergency Room Units. Three groups had been defined, each one with 30 participants: migraine without aura (MWOA, migraine with aura (MWA and episodic tension-type headache (ETTH. Patients were participating of a randomized study to evaluate efficacy of 4 different drugs; those randomized to receive placebo were included. We evaluated pain and associated symptoms. After one hour of placebo administration, 50% of MWOA patients, 23.3% of MWA and 26.7% of ETTH had presented pain relief. The mean of this relief, evaluated by the numerical pain scale, was 41.6%, 23.1% and 36%, respectively. Use of placebo

  9. PREVALENCE OF DIABETES MELLITUS TYPE 2 IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION

    Directory of Open Access Journals (Sweden)

    Ranjeet

    2015-01-01

    Full Text Available BACKGROUND: There is a growing body of literature on the relationship of Hepatitis C Virus (HCV infection and diabetes mellitus type 2 as its unique extrahepatic manifestation. This association was for the first time made by Allison et al. in 1994 . [1] Since then a number of observational studies have been published on the prevalence of diabetes in HCV infection and also the link between association of cirrhosis with diabetes mellitus. AIMS : To study the prevalence of diabetes mellitus type 2 in patients diagnosed to have chronic hepatitis C virus infection. To compare it with the prevalence of diabetes mellitus type 2 in general population. SETTINGS AND DESIGN : A case control study. Participants were the subjects attending the OPD / indoor of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. PATIENTS AND METHODS : 50 patients older than 18 years, with chronic HCV infection confirmed by ELISA, were investigated for their blood counts, LFTs, prothrombin time , serum proteins, glycosylated hemoglobin levels and abdominal ultrasonography after applying the exclusion criteria. Detailed clinical examination was done to assess for signs of encephalopathy and ascites. An equal number of age and sex matched , HCV seronegative patients with normal liver function tests were taken as controls. The prevalence of diabetes mellitus was then determined among the two groups. A relationship between HCV and Diabetes mellitus type 2 was then established. STATISTICAL ANALYSIS USED: Data was expressed as mean + SD. For categorical variables a chi square test was applied and p value was calculated. For the comparison of continuous data, the student t – test was used. Probability levels less than 0.05 were considered significant. RESULTS : 50% ( 25 out of 50 patients with chronic hepatitis C infection were diabetic while 30% (15 out of 50 of the controls were diabetic. The difference was statistically significant ( p=0.041 . Further , of the

  10. Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?

    Science.gov (United States)

    Vanni, Ester; Bugianesi, Elisabetta; Saracco, Giorgio

    2016-02-01

    Chronic hepatitis C is a systemic disease inducing metabolic alterations leading to extrahepatic consequences. In particular, hepatitis C virus (HCV) infection seems to increase the risk of incident type 2 diabetes mellitus in predisposed individuals, independently of liver disease stage. The mechanisms through which hepatitis C induces T2DM involve direct viral effects, insulin resistance, pro-inflammatory cytokines and other immune-mediated processes. Many studies have reported the clinical consequences of type 2 diabetes mellitus on hepatitis C outcome, but very few studies have addressed the issue of microangiopathic complications among patients with hepatitis C only, who develop type 2 diabetes mellitus. Moreover, clinical trials in HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment; recent studies have suggested that this metabolic amelioration might have a clinical impact on type 2 diabetes mellitus-related complications. These observations raise the question as to whether the HCV eradication may also have an impact on the future morbidity and mortality due to type 2 diabetes mellitus. The scope of this review is to summarise the current evidence linking successful antiviral treatment and the prevention of type 2 diabetes mellitus and its complications in hepatitis C-infected patients.

  11. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  12. Helicobacter Pylori in periodontal pockets of chronic periodontitis patients with and without type II diabetes mellitus: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Savita Sambashivaiah

    2011-09-01

    Full Text Available This randomized controlled study evaluated the association of Helicobacter pylori (H. pylori with chronic periodontitis patients with and without type II Diabetes Mellitus. H. pylori is considered to be a pathogen responsible for gastritis, peptic ulcers and a risk factor for gastric cancer. The aim of the present study was to evaluate the association of H. pylori with chronic periodontitis patients with and without type II diabetes mellitus before and after treatment. The prevalence of H. pylori in periodontal pockets was determined by rapid urease test in a 36 patients, which were grouped as Group 1 (Healthy subjects, Group II (chronic periodontitis patients and Group III (Chronic periodontitis patients with Type II Diabetes Mellitus, 12 in each group before treatment by collecting plaque samples. After treatment, 12 plaque samples were collected and prevalence H. pylori was detected. Group II and Group III had a significantly higher rate of positive results for H. pylori compared to healthy subjects before treatment. After treatment, H. pylori were not detected in Group II and in Group III Only one of 12 chronic periodontitis patients with Type II diabetes mellitus had H. pylori in the periodontal pocket. The prevalence of H. pylori did not differ significantly between the chronic periodontitis patients with and without type II diabetes mellitus. Meticulous scaling and root planning will reduce the prevalence of H. pylori in periodontal pockets.

  13. Transcriptional Dysregulation of Upstream Signaling of IFN Pathway in Chronic HCV Type 4 Induced Liver Fibrosis.

    Science.gov (United States)

    Ibrahim, Marwa K; Salum, Ghada Maher; Bader El Din, Noha G; Dawood, Reham M; Barakat, Ahmed; Khairy, Ahmed; El Awady, Mostafa K

    2016-01-01

    IFN orchestrates the expression of various genes to halt hepatitis C virus (HCV) replication with the possibility of either reduced or increased liver fibrosis; due to controlled viral replication or overproduction of inflammatory mediators, repectively. In this study, we examined the transcriptional profiling of type I IFN related genes in HCV-chronically infected patients with varying degrees of liver fibrosis. PCR array was used to examine the expression of 84 type I IFN related genes in peripheral blood mononuclear cells (PBMCs) RNA from 12 treatment-naïve chronic HCV patients (5 F0-F1 and 7 F2-F4) and 5 healthy subjects. We further validated our results by quantitative real time PCR (qRT-PCR) in 103 treatment-naïve chronic HCV patients (43 F0-F1 and 60 F2-F4) and 15 controls. PCR array data revealed dysregulation in TLR7 pathway. The expression of TLR7 was decreased by 4 folds and MyD88 was increased by 3 folds in PBMCs of F2-F4 patients when compared to the healthy volunteers (p = 0.03 and 0.002, respectively). In addition, IRF7 and TLR7 showed dramatic downregulation (6 and 8 folds, respectively) in F2-F4 patients when compared to F0-F1 ones. qRT-PCR confirmed the altered expression patterns of TLR7 and MyD88 in F2-F4 patients when compared to either controls or F0-F1 patients. However, by qRT-PCR, IRF7 and NF-κB1 (TLR7 pathway transcription factors) exhibited similar mRNA abundance among F2-F4 and F0-F1 patients. These results suggest that TLR7 and MyD88 are possible candidates as biomarkers for the progression of HCV-induced liver fibrosis and/ or targets for therapeutic intervention.

  14. Transcriptional Dysregulation of Upstream Signaling of IFN Pathway in Chronic HCV Type 4 Induced Liver Fibrosis

    Science.gov (United States)

    Ibrahim, Marwa K.; Salum, Ghada Maher; Bader El Din, Noha G.; Dawood, Reham M.; Barakat, Ahmed; Khairy, Ahmed; El Awady, Mostafa K.

    2016-01-01

    IFN orchestrates the expression of various genes to halt hepatitis C virus (HCV) replication with the possibility of either reduced or increased liver fibrosis; due to controlled viral replication or overproduction of inflammatory mediators, repectively. In this study, we examined the transcriptional profiling of type I IFN related genes in HCV-chronically infected patients with varying degrees of liver fibrosis. PCR array was used to examine the expression of 84 type I IFN related genes in peripheral blood mononuclear cells (PBMCs) RNA from 12 treatment-naïve chronic HCV patients (5 F0-F1 and 7 F2-F4) and 5 healthy subjects. We further validated our results by quantitative real time PCR (qRT-PCR) in 103 treatment-naïve chronic HCV patients (43 F0-F1 and 60 F2-F4) and 15 controls. PCR array data revealed dysregulation in TLR7 pathway. The expression of TLR7 was decreased by 4 folds and MyD88 was increased by 3 folds in PBMCs of F2-F4 patients when compared to the healthy volunteers (p = 0.03 and 0.002, respectively). In addition, IRF7 and TLR7 showed dramatic downregulation (6 and 8 folds, respectively) in F2-F4 patients when compared to F0-F1 ones. qRT-PCR confirmed the altered expression patterns of TLR7 and MyD88 in F2-F4 patients when compared to either controls or F0-F1 patients. However, by qRT-PCR, IRF7 and NF-κB1 (TLR7 pathway transcription factors) exhibited similar mRNA abundance among F2-F4 and F0-F1 patients. These results suggest that TLR7 and MyD88 are possible candidates as biomarkers for the progression of HCV-induced liver fibrosis and/ or targets for therapeutic intervention. PMID:27135246

  15. 正常眼压性青光眼病因学相关因素与分型%Types and pathogenesis of normal tension glaucoma

    Institute of Scientific and Technical Information of China (English)

    陈燕云; 梁远波; 乔利亚

    2012-01-01

    正常眼压性青光眼(NTG)的青光眼性视神经损伤和视野丢失在临床表现和发病机制上与原发性开角型青光眼(POAG)有一定差异.我们将NTG的发病机制可分为缺血缺氧型(存在低血压,合并心肌缺血、头痛和偏头痛、血浆内皮素-1水平增加、血小板聚集能力增加、缺血性颅脑病变等)、免疫异常型(存在单克隆丙种球蛋白血症以及抗视紫红质抗体、热休克蛋白的自身抗体、神经元特异性烯醇酶抗体、抗磷脂抗体异常)、神经退行性病变相关型(如Alzheimer病、Parkinson病)、内分泌异常型(如甲状腺功能低下)、眼压与颅内压失衡等,这将有助于NTG患者临床治疗方式的转变.(眼科,2012,21:19-23)%The clinical manifestation (including glaucomatous optic nerve damage and visual Held damage) and pathogenesis of normal tension glaucoma are in some degree different from primary open angle glaucoma. In this review, the hypothesis of normal tension glaucoma pathogenesis is divided into different subgroups, including hypoxia ischemia subgroup (a link with arterial hypotension, myocardial ischemia, headache and migraine, increased plasma levels of endothelin-1, increased platelet aggregation, or ischemia en- cephalopathy, etc), abnormal autoimmunity subgroup (with monoclonal gammopathy, anti-rhodopsin antibody, autoantibodies to Heat Shock Proteins , neuron-specific enolase autoantibodies, or antiphospholipid antibodies), neurodegenerative diseases related subgroup (Alzheimer disease, Parkinson disease), abnormal endoorinological subgroup (e.g., hypothyroidism). The hypothesis of normal tension glaucoma pathogenesis subgroups will benefit for the clinical management. (Ophthalnwl CHN, 2012, 21: 19-23)

  16. 局部麻醉下疝环充填式无张力疝修补术治疗腹股沟疝%Under local anesthesia hernia ring without tension hernia repair filling type surgical treatment the groin hernia

    Institute of Scientific and Technical Information of China (English)

    李旭; 邢壮杰

    2012-01-01

    目的 评价应用局部麻醉下疝环充填式无张力疝修补术治疗腹股沟疝的临床价值.方法 回顾性分析256例腹股沟疝在局部麻醉下行疝环充填式无张力疝修补术患者的临床资料.结果 所有患者手术均顺利完成,麻醉效果满意,无明显疼痛与不适感.无一例使用止痛药,仅1例出现尿潴留,2例切口脂肪液化,经对症处理后痊愈.术后随访无复发.结论 局部麻醉下疝环充填式无张力疝修补术安全可靠,操作简便,符合人体解剖结构,对无法耐受硬膜外麻醉的患者,是一种理想选择.%Objective To evaluate the way of under local anesthesia hernia ring without tension hernia repair filling type surgical treatment the groin hernia surgery value of clinical application.Methods The clinical data of 256 cases were analyzed retrospectively for inguinal hernia in local anesthesia downside hernia ring filling type without tension hernia repair.Results All patients were recovered,under local anesthesia hernia ring without tension filling type hernia repair operation convenient operation,postoperative pain were light,the recurrence rate was low,less complications.Only 2 cases appeared the liquefaction of fat,1 case appeared urinary retention.Follow-up so far without recurrence.Conclusion Local anesthesia hernia ring without tension hernia method is safe and rehable,simple operation,and complex human anatomy,it is a kind of ideal choice to the ones who can't tolerate epidural anesthesia patients.

  17. [New markers of progression of chronic heart failure in patients with myocardial infarction, type 2 diabetes and obesity].

    Science.gov (United States)

    Kravchun, P P; Kadykova, O I; Gabisonia, T N

    2015-01-01

    Currently identified a large number of biomarkers that are closely linked with the development of chronic heart failure, some of which are clusterin and fractalkine. Accordingly, the purpose of our study was - to evaluate the role of clusterin and fractalkine in progression of chronic heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. We investigated 71 patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. All patients with postinfarction cardiosclerosis, diabetes and obesity were divided into groups according to the functional class of chronic heart failure (CHF). It was found that an increase the level of fractalkine and reduced clusterin leads due to the development of systolic dysfunction and heart failure progression in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity. Fractalkine and clusterin play an important role in progression of the heart failure in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity, and this gives them the right to be considered indicators of the severity of CHF.

  18. [Association between the frequency and duration, but not the intensity, of headache with mechanical hypersensitivity and the health of patients with tension-type headache].

    Science.gov (United States)

    Palacios-Cena, M; Fernandez-Munoz, J J; Cigaran-Mendez, M; Moron-Verdasco, A; Fernandez-de-Las-Penas, C

    2015-03-16

    Introduccion. La asociacion entre las variables clinicas de la cefalea y otras variables neurofisiologicas o de salud es controvertida. Objetivo. Determinar la asociacion de la frecuencia, duracion e intensidad del dolor con la sensibilidad mecanica craneocervical, considerando el efecto de otras variables de salud y fisicas. Pacientes y metodos. Se incluyeron 72 pacientes con cefalea de tension. Se mantuvo un diario mensual para determinar la frecuencia, duracion e intensidad del dolor. Se calcularon los umbrales de dolor a la presion (UDP) y la sensibilidad a la palpacion sobre la region craneocervical, calidad de vida (Short Form-36), discapacidad, depresion y movilidad cervical. Se introdujeron todas las variables en modelos de regresion logistica jerarquica para determinar las interacciones. Resultados. Se encontraron correlaciones entre la frecuencia y duracion de la cefalea, pero no la intensidad, con el resto de variables. El analisis de regresion mostro que la combinacion del UDP sobre el temporal, dolor corporal, edad y rol fisico explicaba el 22,3% de la varianza de la frecuencia, mientras que la combinacion de salud general, UDP sobre el trapecio superior y frecuencia del dolor explicaba el 20% de la varianza de la duracion (p < 0,001). Conclusiones. Este estudio ha encontrado que la frecuencia y la duracion de la cefalea, pero no la intensidad, se encuentran asociadas con variables neurofisiologicas, como el UDP sobre el cuello/cabeza o la percepcion de dolor generalizado en la cefalea tensional. Otras variables, como la edad, el rol fisico y la salud general tambien mostraron una asociacion con la frecuencia y la duracion de la cefalea.

  19. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  20. Ultrastructural characteristics of novel epithelial cell types identified in human pathologic liver specimens with chronic ductular reaction.

    OpenAIRE

    De Vos, R; Desmet, V

    1992-01-01

    Previous immunohistochemical studies on human liver biopsies with chronic ductular reaction revealed the presence of "small cells" with bile-duct type cytokeratin profile in the periportal area. This study identified similar cells by electron microscopy. The authors studied 13 human liver specimens with various liver diseases, but all characterized by chronic ductular reaction. In all specimens, variable numbers of "small cells" with common epithelial characteristics were identified in the pe...

  1. Blood Vessel Tension Tester

    Science.gov (United States)

    1978-01-01

    In the photo, a medical researcher is using a specially designed laboratory apparatus for measuring blood vessel tension. It was designed by Langley Research Center as a service to researchers of Norfolk General Hospital and Eastern Virginia Medical School, Norfolk, Virginia. The investigators are studying how vascular smooth muscle-muscle in the walls of blood vessels-reacts to various stimulants, such as coffee, tea, alcohol or drugs. They sought help from Langley Research Center in devising a method of measuring the tension in blood vessel segments subjected to various stimuli. The task was complicated by the extremely small size of the specimens to be tested, blood vessel "loops" resembling small rubber bands, some only half a millimeter in diameter. Langley's Instrumentation Development Section responded with a miniaturized system whose key components are a "micropositioner" for stretching a length of blood vessel and a strain gage for measuring the smooth muscle tension developed. The micropositioner is a two-pronged holder. The loop of Mood vessel is hooked over the prongs and it is stretched by increasing the distance between the prongs in minute increments, fractions of a millimeter. At each increase, the tension developed is carefully measured. In some experiments, the holder and specimen are lowered into the test tubes shown, which contain a saline solution simulating body fluid; the effect of the compound on developed tension is then measured. The device has functioned well and the investigators say it has saved several months research time.

  2. A type I interferon signature characterizes chronic antibody-mediated rejection in kidney transplantation.

    Science.gov (United States)

    Rascio, Federica; Pontrelli, Paola; Accetturo, Matteo; Oranger, Annarita; Gigante, Margherita; Castellano, Giuseppe; Gigante, Maddalena; Zito, Anna; Zaza, Gianluigi; Lupo, Antonio; Ranieri, Elena; Stallone, Giovanni; Gesualdo, Loreto; Grandaliano, Giuseppe

    2015-09-01

    Chronic antibody-mediated rejection (CAMR) represents the main cause of kidney graft loss. To uncover the molecular mechanisms underlying this condition, we characterized the molecular signature of peripheral blood mononuclear cells (PBMCs) and, separately, of CD4(+) T lymphocytes isolated from CAMR patients, compared to kidney transplant recipients with normal graft function and histology. We enrolled 29 patients with biopsy-proven CAMR, 29 stable transplant recipients (controls), and 8 transplant recipients with clinical and histological evidence of interstitial fibrosis/tubular atrophy. Messenger RNA and microRNA profiling of PBMCs and CD4(+) T lymphocytes was performed using Agilent microarrays in eight randomly selected patients per group from CAMR and control subjects. Results were evaluated statistically and by functional pathway analysis (Ingenuity Pathway Analysis) and validated in the remaining subjects. In PBMCs, 45 genes were differentially expressed between the two groups, most of which were up-regulated in CAMR and were involved in type I interferon signalling. In the same patients, 16 microRNAs were down-regulated in CAMR subjects compared to controls: four were predicted modulators of six mRNAs identified in the transcriptional analysis. In silico functional analysis supported the involvement of type I interferon signalling. To further confirm this result, we investigated the transcriptomic profiles of CD4(+) T lymphocytes in an independent group of patients, observing that the activation of type I interferon signalling was a specific hallmark of CAMR. In addition, in CAMR patients, we detected a reduction of circulating BDCA2(+) dendritic cells, the natural type I interferon-producing cells, and their recruitment into the graft along with increased expression of MXA, a type I interferon-induced protein, at the tubulointerstitial and vascular level. Finally, interferon alpha mRNA expression was significantly increased in CAMR compared to control

  3. Bovine papillomavirus type 2 detection in the urinary bladder of cattle with chronic enzootic haematuria

    Directory of Open Access Journals (Sweden)

    Sheila R Wosiacki

    2006-09-01

    Full Text Available The bovine papillomavirus type 2 (BPV-2 involvement in the aetiology of chronic enzootic haematuria associated to bracken fern ingestion has been suggested for a long time. However, a few reports have shown the presence of the BPV-2 in urinary bladder tumors of cattle. The aim of this study was to investigate the presence of the BPV-2 infection in the urinary bladder of cattle with chronic enzootic haematuria in Brazilian cattle herds. Sixty-two urinary bladders were collected from adult cattle in beef herds from the north region of the state of Paraná, Brazil. According to clinical and pathological finds the specimens were distributed in three groups: the group A was constituted by 22 urinary bladders with macroscopic lesions collected at necropsy of cattle with clinical signs of chronic enzootic haematuria; the group B by 30 urinary bladders with macroscopic lesions collected in a slaughterhouse of cows coming from bracken fern-endemic geographical region; and the group C (control by 10 urinary bladders without macroscopic lesions collected from asymptomatic cattle in a bracken fern-free geographical region. By a semi-nested polymerase chain reaction (PCR assay, with an internal control, a fragment of the BPV-2 L1 gene with 386 bp length was amplified in 36 (58% urinary bladder. The rate of BPV-2 positive urinary bladders was 50% (11/22 for group A, 80% (24/30 for group B, and 10% (1/10 for group C (control. The rate of the positive results found in groups A and B that included urinary bladder samples with macroscopic lesions was 67% (35/52 and the detection of the BPV-2 in both groups was significantly higher (P < 0.05 than in the control group. RFLP with Rsa I and Hae III enzymes evaluated the specificity of the BPV-2 amplicons. The PCR internal control that amplified a 626 bp fragment of the ND5 gene of the bovine mitochondrial genome was amplified in all analyzed samples and excluded false-negatives or invalid results in the semi

  4. An investigation survey on migraine and tension-type headache among undergraduates from Guangzhou Medical University%广州医科大学本科生偏头痛及紧张型头痛的调查

    Institute of Scientific and Technical Information of China (English)

    向慧; 潘英; 李现亮; 廖伟峰; 潘泽林; 张少填; 魏佳娜

    2016-01-01

    目的:分析广州医科大学本科生偏头痛和紧张型头痛负担情况及二者之间分布的差异。方法:2014年12月1日至2015年3月1日,采取横断面调查的方法,以WHO头痛问卷、HIT-6评分量表、焦虑抑郁自评量表( SAS/SDS)、匹兹堡睡眠质量指数( PSQI)对广州医科大学6812名学生中随机抽取的900名本科生进行调查。结果:818名学生完成调查,应答率为90.8%。偏头痛患病率23.9%,紧张型头痛24.6%,偏头痛伴睡眠障碍为77.0%,紧张型头痛伴睡眠障碍占66.3%,偏头痛伴焦虑、抑郁分别为23.5%、39.8%,紧张型头痛伴焦虑、抑郁分别为17.3%、35.1%。二者的分布仅家族史、合并睡眠障碍及HIT-6评分方面差异有统计学意义( P<0.05)。结论:偏头痛和紧张性头痛在样本人群中的患病率高。两种头痛仅在家族史、HIT-6评分及伴睡眠障碍的分布存在显著差异。%Objective:To investigate the burden of migraine and tension-type headache among undergraduates from Guangzhou Medical University,and the difference in score domains between the both. Methods:Between December 1 of 2014 and March 1 of 2015,a cross-sectional survey was conducted using the WHO headache questionnaire,HIT-6 scale,self-rating anxiety and depression scales( SAS/SDS)and Pittsburgh Sleep Quality index(PSQI),among a randomly selected cohort(n = 900)of 6812 undergraduates from Guangzhou Medical University. Results:In total,818 students completed the survey,yielding a response rate of 90.8%. The overall prevalence of migraine was 23.9% vs 24.6% for tension-type headache. Sleep disorders were noted in 77% of subjects with migraine,and in 66. 3% of subjects with tension-type headache. In subjects with migraine,the rates of anxiety and depression were 23. 5% and 39. 8%,respectively,compared with 17. 3% and 35. 1% in subjects with tension-type headache. As regard to distribution of score domains,the two

  5. Surface Tension of Spacetime

    Science.gov (United States)

    Perko, Howard

    2017-01-01

    Concepts from physical chemistry and more specifically surface tension are introduced to spacetime. Lagrangian equations of motion for membranes of curved spacetime manifold are derived. The equations of motion in spatial directions are dispersion equations and can be rearranged to Schrodinger's equation where Plank's constant is related to membrane elastic modulus. The equation of motion in the time-direction has two immediately recognizable solutions: electromagnetic waves and corpuscles. The corpuscular membrane solution can assume different genus depending on quantized amounts of surface energy. A metric tensor that relates empty flat spacetime to energetic curved spacetime is found that satisfies general relativity. Application of the surface tension to quantum electrodynamics and implications for quantum chromodynamics are discussed. Although much work remains, it is suggested that spacetime surface tension may provide a classical explanation that combines general relativity with field theories in quantum mechanics and atomic particle physics.

  6. Chronic pain in hypermobility syndrome and Ehlers–Danlos syndrome (hypermobility type: it is a challenge

    Directory of Open Access Journals (Sweden)

    Scheper MC

    2015-08-01

    Full Text Available Mark C Scheper,1,2 Janneke E de Vries,1–3 Jeanine Verbunt,3,4 Raoul HH Engelbert1,2 1School of Physiotherapy, Amsterdam University of Applied Sciences, Amsterdam, 2Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, 3Department of Rehabilitation Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht; 4Adelante, Center of expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands Abstract: Generalized joint hypermobility (GJH is highly prevalent among patients diagnosed with chronic pain. When GJH is accompanied by pain in ≥4 joints over a period ≥3 months in the absence of other conditions that cause chronic pain, the hypermobility syndrome (HMS may be diagnosed. In addition, GJH is also a clinical sign that is frequently present in hereditary diseases of the connective tissue, such as the Marfan syndrome, osteogenesis imperfecta, and the Ehlers–Danlos syndrome. However, within the Ehlers–Danlos spectrum, a similar subcategory of patients having similar clinical features as HMS but lacking a specific genetic profile was identified: Ehlers–Danlos syndrome hypermobility type (EDS-HT. Researchers and clinicians have struggled for decades with the highly diverse clinical presentation within the HMS and EDS-HT phenotypes (Challenge 1 and the lack of understanding of the pathological mechanisms that underlie the development of pain and its persistence (Challenge 2. In addition, within the HMS/EDS-HT phenotype, there is a high prevalence of psychosocial factors, which again presents a difficult issue that needs to be addressed (Challenge 3. Despite recent scientific advances, many obstacles for clinical care and research still remain. To gain further insight into the phenotype of HMS/EDS-HT and its mechanisms, clearer descriptions of these populations should be made available. Future research and clinical care should revise and create consensus on the

  7. Insulin Resistance and Chronic Kidney Disease in Patients with Type 1 Diabetes Mellitus

    Science.gov (United States)

    Vladu, Mihaela; Clenciu, Diana; Efrem, Ion Cristian; Amzolini, Anca; Micu, Simona Tudorică; Moţa, Maria

    2017-01-01

    Background and Aims. Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods. The study was conducted over a period of three years (2010–2013) and included patients with DM registered in the Clinical Centre of Diabetes, Nutrition and Metabolic Diseases of Dolj county. The study design was an epidemiological, transversal, noninterventional type. Finally, the study group included 200 subjects with type 1 DM. Insulin resistance (IR) was estimated by eGDR. The subjects with eGDR ≤ 7.5 mg/kg/min were considered with insulin resistance. Results. CKD was found in 44% of the patients. Analyzing statistically the presence of CKD, we found highly significant differences between patients with CKD and those without CKD regarding age and sex of the patients, the duration of diabetes, glycosylated hemoglobin (HbA1c), the estimated glucose disposal rate (eGDR), and the presence of hypertension, dyslipidemia, and hyperuricaemia. In patients with CKD, age and diabetes duration are significantly higher than in those who do not have this complication. CKD is more frequent in males than in females (50.9% men versus 34.5% women, p = 0.022). From the elements of metabolic syndrome, high blood pressure, hyperuricemia, and dyslipidemia are significantly increased in diabetic patients with CKD. eGDR value (expressed as mg·kg−1·min−1) is lower in patients with CKD than in those without CKD (15.92 versus 6.42, p CKD show higher insulin resistance than those without CKD. Conclusions. This study has shown that insulin resistance is associated with an increased risk of CKD, but, due to the cross

  8. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  9. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta block...

  10. Rein tension during canter

    NARCIS (Netherlands)

    Egenvall, Agneta; Eisersiö, Marie; Rhodin, Marie; van Weeren, P.R.; Roepstorff, Lars

    2015-01-01

    Riders generally use reins as a means for communication with the horse. At present, the signalling pattern is poorly understood. The aim of this study was to illustrate and analyse the rein tension patterns in a number of rider/horse combinations across a variety of exercises in the canter gait. Our

  11. Investigating Factors Associated with Depressive Symptoms of Chronic Kidney Diseases in China with Type 2 Diabetes

    Science.gov (United States)

    Wang, Xu; Shen, Biyu; Wang, Xueqin

    2017-01-01

    Aim. To assess the depressive symptoms status of chronic kidney diseases in Nantong, China, with type 2 diabetes and to identify factors associated with depressive symptoms. Methods. In this cross-sectional analytic study, 210 type 2 diabetic patients were recruited from the Second Affiliated Hospital of Nantong University. Depressive symptoms were assessed with the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The quality of life was measured with the RAND 36-Item Health Survey (SF-36). And the independent risk factors of depressive symptoms were assessed by using a stepwise forward model of logistic regression analysis. Results. The mean age of the study subjects was 57.66 years (SD: 11.68). Approximately 21.4% of subjects reported depressive symptoms (n = 45). Forward stepwise logistic regression analysis showed that female gender (P = 0.010), hypertension (P = 0.022), Stage IV (P = 0.003), and Stage V (P hypertension are at a marked increased risk of depressive symptoms. Providing optimal care for the psychological health of this population is vital.

  12. Does parity worsen diabetes-related chronic complications in women with type 1 diabetes?

    Institute of Scientific and Technical Information of China (English)

    Marilia; Brito; Gomes; Carlos; Antonio; Negrato; Ana; Almeida; Antonio; Ponce; de; Leon

    2016-01-01

    AIM: To determine the relationship between parity, glycemic control, cardiovascular risk factors and diabetesrelated chronic complications in women with type 1 diabetes.METHODS: This was a multicenter cross-sectional study conducted between December 2008 and December 2010 in 28 public clinics in 20 cities from the 4 Brazilian geographic regions. Data were obtained from 1532 female patients, 59.2% Caucasians, and aged 25.2 ± 10.6 years. Diabetes duration was of 11.5 ± 8.2 years. Patient’s information was obtained through a questionnaire and a chart review. Parity was stratified in five groups: Group 0(nulliparous), group 1(1 pregnancy), group 2(2 pregnancies), group 3(3 pregnancies), group 4(≥ 4 pregnancies). Test for trend and multivariate random intercept logistic and linear regression models were used to evaluate the effect of parity upon glycemic control, cardiovascular risk factors and diabetes-related complications. RESULTS: Parity was not related with glycemic control and nephropathy. Moreover, the effect of parity upon hypertension, retinopathy and macrovascular disease did not persist after adjustments for demographic and clinical variables in multivariate analysis. For retinopathy, the duration of diabetes and hypertension were the most important independent variables and for macrovascular disease, these variables were age and hypertension. Overweight or obesity was noted in a total of 538 patients(35.1%). A linear association was found between the frequency of overweight or obesity and parity(P = 0.004). Using a random intercept multivariate linear regression model with body mass index(BMI) as dependent variable a borderline effect for parity(P = 0.06) was noted after adjustment for clinical and demographic data. The observed variability of BMI was not attributable to differences between centers.CONCLUSION: Our results suggest that parity has a borderline effect on body mass index but does not have an important effect upon hypertension and micro or

  13. Chronic complications in newly diagnosed patients with Type 2 diabetes mellitus in India

    Directory of Open Access Journals (Sweden)

    Aravind Sosale

    2014-01-01

    Full Text Available Background: Prevalence of diabetes is on an increase in India, currently there is limited nation-wide data regarding the prevalence of chronic complications in diabetic patients at diagnosis. This information will help health-care professionals approach management more aggressively to prevent complications. Objective: To determine the prevalence of chronic complications in newly-diagnosed Type 2 diabetic (T2D patients in India. Design and Methods: This was a cross-sectional survey of T2D patients, diagnosed within 3 months of their first visit to the centers doing the survey. Each patient was screened for diabetic complications, hypertension, dyslipidemia, and body mass index. Family history was recorded. Standard protocols were used to make the diagnosis of retinopathy, neuropathy and nephropathy. Data analysis was carried out using the standard statistical techniques. Results: Of the total 4,600 (males 67%, females 33% newly diagnosed patients with T2D, majority were from the age group 41-50 years (40%. 13.15% of newly detected India T2D had neuropathy 6.1% had retinopathy and 1.06% had nephropathy. Risk factors of macro vascular complication such as hypertension, obesity, and dyslipidemia were observed in 23.3%, 26%, and 27% of patients respectively. Ischemic heart disease was noticed in 6%. Conclusion: High prevalence of micro vascular complications was present at diagnosis along with association of CV cardiovascular risk factors among Indian T2D. In view of this, screening must be instituted for all diabetics for complications at the time of diagnosis itself.

  14. Coulomb string tension, asymptotic string tension, and the gluon chain

    Science.gov (United States)

    Greensite, Jeff; Szczepaniak, Adam P.

    2015-02-01

    We compute, via numerical simulations, the nonperturbative Coulomb potential of pure SU(3) gauge theory in Coulomb gauge. We find that the Coulomb potential scales nicely in accordance with asymptotic freedom, that the Coulomb potential is linear in the infrared, and that the Coulomb string tension is about four times larger than the asymptotic string tension. We explain how it is possible that the asymptotic string tension can be lower than the Coulomb string tension by a factor of four.

  15. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-09-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  16. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-01-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  17. Chronic ethanol ingestion, type 2 diabetes mellitus, and brain-derived neurotrophic factor (BDNF) in rats.

    Science.gov (United States)

    Jung, Kyu-In; Ju, Anes; Lee, Hee-Mi; Lee, Seong-Su; Song, Chan-Hee; Won, Wang-Youn; Jeong, Jae-Seung; Hong, Oak-Kee; Kim, Jae-Hwa; Kim, Dai-Jin

    2011-01-07

    Chronic alcohol consumption contributes to the development of type 2 diabetes mellitus (T2DM) while decreasing the level of brain-derived neurotrophic factor (BDNF). BDNF may be an important regulator of glucose metabolism, so it may be associated with an increased risk for T2DM in alcoholism. We evaluated the association of chronic heavy alcohol exposure, T2DM and BDNF level. Ten week-old type 2 diabetic OLETF rats and non-diabetic LETO rats of similar weight were used. The rats were randomized by weight into four treatment groups: (1) OLETF-Ethanol (O-E, n=13), (2) OLETF-Control (O-C, n=15), (3) LETO-Ethanol (L-E, n=11), and (4) LETO-Control (L-C, n=14). The ethanol groups were fed an isocaloric liquid diet containing ethanol while the control groups were fed with the same diet containing maltose-dextran over a 6-week period using a pair-feeding control model in order to regulate different caloric ingestion. After 6 weeks of feeding, an Intraperitoneal Glucose Tolerance Test (IP-GTT) was performed and BDNF levels were analyzed. Prior to IP-GTT, the mean glucose levels in the O-E, O-C, L-E, and L-C groups were 90.38±12.84, 102.13±5.04, 95.18±6.43, and 102.36±4.43mg/dL, respectively. Thirty minutes after intraperitoneal injection, the mean glucose levels were 262.62±63.77, 229.07±51.30, 163.45±26.63, and 156.64±34.42mg/dL, respectively; the increased amount of the mean glucose level in the O-E group was significantly higher than that in the O-C group (palcohol ingestion may aggravate T2DM and may possibly lower BDNF level.

  18. Influence of food-type on the population growth rate of the rotifier Brachionus calyciflorus in short-chronic assays

    NARCIS (Netherlands)

    Lürling, M.F.L.L.W.; Beekman, W.

    2006-01-01

    The type of food given during short chronic assays with the rotifer Brachionus calyciflorus might be one of the sources of variation in the reproductive rate of the rotifers. Ten green algal species were supplied as monospecific diets to examine variability in rotifer growth rate. In addition, rotif

  19. The effect of chronic heart failure and type 2 diabetes on insulin-stimulated endothelial function is similar and additive

    DEFF Research Database (Denmark)

    Falskov, Britt; Hermann, Thomas Steffen; Rask-Madsen, Christian;

    2011-01-01

    AIM: Chronic heart failure is associated with endothelial dysfunction and insulin resistance. The aim of this investigation was to study insulin-stimulated endothelial function and glucose uptake in skeletal muscles in patients with heart failure in comparison to patients with type 2 diabetes. ME...

  20. Comparison of the Incidence of Anxiety and Depression in Patients With Migraine and Tension Type Headache%偏头痛和紧张型头痛患者中焦虑抑郁的发生情况比较

    Institute of Scientific and Technical Information of China (English)

    王兆春

    2016-01-01

    Objective To compare the clinical characteristics and occurrence of anxiety and depression in patients with migraine and tension type headache.MethodsIn our hospital from January 2012 to June 2016 admitted to the Department of 180 cases of primary headache patients, were divided according to the type of headache in patients for migraine and tension headache group, compared two groups of patients after treatment of headache seizure frequency, duration and degree of headache, determination and evaluation of patients in two groups of anxiety and depression.Results Two groups of patients with anxiety and depression score and incidence rate had no signiifcant difference, migraine and tension type headache anxiety and depression of patients with score and incidence rate and headache attack frequency, there is positive correlation between the duration and degree of headache.Conclusion Migraine and tension type headache patients after treatment of headache attack and anxiety and depression are closely related, clinical can improve the patient's clinical therapeutic effect and prognosis of the occurrence of anxiety and depression of patients with effective control.%目的:比较偏头痛和紧张型头痛患者在临床治疗中焦虑抑郁的临床特点和发生情况。方法选择我院2012年1月~2016年6月内科收治的180例原发性头痛患者,根据患者的头痛类型分为偏头痛组和紧张头痛组,比较两组患者治疗后头痛的发作频率、持续时间及头痛程度,测定评价两组患者的焦虑抑郁情况。结果两组患者的焦虑抑郁评分及发生率不存在显著性差异;偏头痛和紧张型头痛患者焦虑抑郁评分及发生率与头痛的发作频率、持续时间及头痛程度存在正相关关系。结论偏头痛和紧张型头痛患者者治疗后头痛的发作情况与焦虑抑郁发生存在密切关系,临床可通过提高患者的临床治疗效果及预后情况可有效控制患者焦虑抑郁的发生。

  1. Histoenzymatic and Morphometric Analysis of Muscle Fiber Type Transformation during the Postnatal Development of the Chronically Food-Deprived Rat

    OpenAIRE

    2013-01-01

    We analyze the effect of chronic undernourishment on extensor digitorum longus (EDL) muscle maturation in the rat. Cytochrome c oxidase (COX) and alkaline ATPase histoenzymatic techniques were used to determine the relative proportion of different fiber types (oxidative/glycolytic and type I, IIa/IId, or IIb, respectively) and their cross-sectional area in control and undernourished EDL muscles at several postnatal (PN) ages. From PN days 15 to 45, undernourished EDL muscles showed predominan...

  2. Puppy Love, Adolescence, and Chronic Illness: The Importance of Pets for Youth with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Ashby F. Walker PhD

    2015-05-01

    Full Text Available The benefits of animal-companion ties to well-being are consistently documented, yet few studies use patient-centered methodologies to examine how youth living with chronic illnesses rely on domestic pets for support. Youth with type 1 diabetes (T1D aged 12 to 19 years (N=40 completed surveys involving a prompt to take five photos of “what diabetes means to you,” with an accompanying narrative. Content analysis was conducted for photos/narratives and numeric variables analyzed including socio-economic status (SES: measured by total household income and years of parental education and HbA1C. More than half of the youth participants took pictures of coping mechanisms, including pictures of their pets. In fact, pictures of pets outnumbered pictures of people three to one. Pet depictions were captured by youth from all SES levels. Youth with T1D identify pets as an important source of support. More research is needed to understand how pets may offset disease burden for youth with T1D.

  3. Changing glucocorticoid action: 11β-hydroxysteroid dehydrogenase type 1 in acute and chronic inflammation.

    Science.gov (United States)

    Chapman, Karen E; Coutinho, Agnes E; Zhang, Zhenguang; Kipari, Tiina; Savill, John S; Seckl, Jonathan R

    2013-09-01

    Since the discovery of cortisone in the 1940s and its early success in treatment of rheumatoid arthritis, glucocorticoids have remained the mainstay of anti-inflammatory therapies. However, cortisone itself is intrinsically inert. To be effective, it requires conversion to cortisol, the active glucocorticoid, by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Despite the identification of 11β-HSD in liver in 1953 (which we now know to be 11β-HSD1), its physiological role has been little explored until recently. Over the past decade, however, it has become apparent that 11β-HSD1 plays an important role in shaping endogenous glucocorticoid action. Acute inflammation is more severe with 11β-HSD1-deficiency or inhibition, yet in some inflammatory settings such as obesity or diabetes, 11β-HSD1-deficiency/inhibition is beneficial, reducing inflammation. Current evidence suggests both beneficial and detrimental effects may result from 11β-HSD1 inhibition in chronic inflammatory disease. Here we review recent evidence pertaining to the role of 11β-HSD1 in inflammation. This article is part of a Special Issue entitled 'CSR 2013'.

  4. Serum leveis of inflammatory markers in type 2 diabetes patients with chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Priscila Larcher LONGO

    2014-04-01

    Full Text Available Diabetes has been associated with periodontitis, but the mechanisms through which periodontal diseases affect the metabolic control remain unclear. Objective: This study aimed to evaluate serum leveis of inflammatory markers, IL-8, IL-6 and monocyte chemoattractant protein 1 (MCP-1, in type 2 diabetic patients in the presence of chronic periodontitis. Material and Methods: Forty two individuals were enrolled in this study and assigned to one of five groups: diabetes mellitus with inadequate glycemic control and periodontitis (DMI+P, n = 10, diabetes mellitus with adequate glycemic control and periodontitis (DMA+P, n = 10, diabetes mellitus without periodontitis (DM, n = 10, periodontitis without diabetes (P, n=6, and neither diabetes nor periodontitis (H, n = 6. Periodontal clinical examination included visible plaque index (PL, gingival bleeding index (GB, probing depth (PD, attachment level (AL and bleeding on probing (BP. Glycemic control was evaluated by serum concentration of glycated hemoglobin (HbAlc. Inflammatory serum markers IL-8, IL-6 and (MCP-1 were measured by ELISA. Results: DMI+P and DMA+P groups presented higher PD (p=0.025 and AL (p=0.003 values when compared to the P group. There were no significant differences among groups for IL-6, IL-8 and MCP-1 serum levels. Conclusions: Although periodontitis was more severe in diabetic patients, the serum levels of the investigated inflammatory markers did not differ among the groups.

  5. Imaging of human T-lymphotropic virus type I-associated chronic progressive myeloneuropathies

    Energy Technology Data Exchange (ETDEWEB)

    Alcindor, F. (Dept. of Neurology, State Univ. of New York, Health Science Center, Brooklyn, NY (United States)); Valderrama, R. (Dept. of Neurology, State Univ. of New York, Health Science Center, Brooklyn, NY (United States)); Canavaggio, M. (Abbott Labs., North Chicago, IL (United States)); Lee, H. (Abbott Labs., North Chicago, IL (United States)); Katz, A. (Dept. of Neurology, State Univ. of New York, Health Science Center, Brooklyn, NY (United States)); Montesinos, C. (Beth Israel Medical Center, Dept. of Neurology and Clinical Electrophysiology, New York, NY (United States)); Madrid, R.E. (New York State Office of Mental Retardation and Developmental Disabilities, Inst. for Basic Research in Developmental Disabilities, NY (United States)); Merino, R.R. (Beth Israel Medical Center, Dept. of Neurology and Clinical Electrophysiology, New York, NY (United States)); Pipia, P.A. (Dept. of Neurology, State Univ. of New York, Health Science Center, Brooklyn, NY (United States))

    1992-12-01

    We studied magnetic resonance imaging (MRI) of the head and cervical spine and CT of the head in 46 patients (14 men, 32 women) with chronic progressive myeloneuropathy. The findings were correlated with human T-lymphotropic virus type I (HTLV-I) serology, race, country of origin, and age. We found a female predominance of 2:1. Most patients were aged between 30 and 50 years, and most were Caribbean immigrants and black. There were 9 men and 17 women with blood antibody titers to HTLV-I and 7 mem and 15 women with cerebrospinal fluid (CSF) titers. All patients with virus or antibodies in blood or CSF were Caribbean immigrants or black. T2-weighted cranial MRI showed scattered areas of high signal intensity in the cerebral white matter, usually in the periventricular and subcortical areas, but not in the posterior cranial fossa. Cranial CT revealed periventricular low density areas, ventricular enlargement, and atrophy MRI of the cervical spine showed atrophy of the cord. Myelography was normal in all 15 patients examined. No imaging differences were observed between the HTLV-I-positive and -negative patients. These findings, although consistent with demyelination, are not specific. (orig.)

  6. [A case of chronic enteroviral meningitis and hydrocephalus associated with Bruton type agammaglobulinemia].

    Science.gov (United States)

    Ozawa, T; Onodera, O; Iizuka, O; Tanno, Y; Eguchi, I; Soma, Y; Tsuji, S

    1998-02-01

    We report a 10-year-old boy with chronic enteroviral meningitis associated with agammaglobulinemia (CEMA) and hydrocephalus. He was treated with a low-dose intravenous administration (100 mg/kg/4 weeks) of gammaglobulin (gamma-gl) since he was diagnosed as having Bruton type agammaglobulinemia at 1 year of age. At this admission, neurological examination revealed meningeal signs, Babinski sign, frontal signs, urinary incontinence, and mental retardation (IQ = 48) which was considered to be a sequela of the enteroviral encephalitis which had occurred in his first year of life. T 1-weighted MR imaging of the brain following gadolinium administration revealed a marked dilatation of the lateral ventricles and dense enhancement of the meninges. Enterovirus was detected in the cerebrospinal fluid (CSF) using tissue culture. Histological examination of a biopsied leptomeningeal specimen revealed inflammatory thickening, which was a likely cause of the obstruction to the flow of CSF. The hydrocephalus in this patient was treated with external drainage of CSF from the lateral ventricle. The CEMA was brought into remission by means of the intraventricular administration of gamma-gl, at a dose of 125-250 mg/week (total dose: 1.5 g/8 weeks), in addition to the high dose intravenous administration (400 mg/kg/4 weeks) of gamma-gl. Because of the poor prognosis of patients with CEMA, the intraventricular administration of gamma-gl should be initiated immediately following a diagnosis of enteroviral meningitis.

  7. Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis

    Science.gov (United States)

    Mesia, Ruben; Gholami, Fatemeh; Huang, Hong; Clare-Salzler, Michael; Aukhil, Ikramuddin; Wallet, Shannon M; Shaddox, Luciana M

    2016-01-01

    Objective The objective of this case–control study was to quantify the immune responsiveness in individuals with type 2 diabetes (T2D) as compared with patients without diabetes (NT2D) diagnosed with periodontitis. Research Design and Methods Peripheral blood was collected from 20 patients with moderate-to-severe chronic periodontitis (10 T2D, 10 NT2D). Blood samples were stimulated with ultrapure Porphyromonas gingivalis and Escherichia coli lipopolysaccharide (LPS) for 24 hours. 14 cytokines/chemokines were quantified in culture supernatants using multiplex technology. Results T2D individuals demonstrated higher unstimulated levels of interleukin 6 (IL-6), IL-1β, tumor necrosis factor α, interferon γ, IL-10, IL-8, macrophage inflammatory protein 1α (MIP1α), and 1β (MIP1β), and higher stimulated levels of IL-6, IL-8, IL-10, MIP1α and MIP1β, along with lower unstimulated and stimulated levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) when compared with NT2D (pperiodontitis, patients with T2D seem to have an enhanced LPS-induced immune responsiveness than individuals without diabetes, which correlates with periodontal disease severity, concomitant with a less robust GM-CSF response. This data may in part explain the higher predisposition to periodontitis in this population. PMID:27651910

  8. Risks of Metformin in Type 2 Diabetes and Chronic Kidney Disease: Lessons Learned from Taiwanese Data.

    Science.gov (United States)

    Rhee, Connie M; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2017-01-01

    Like other biguanide agents, metformin is an anti-hyperglycemic agent with lower tendency towards hypoglycemia compared to other anti-diabetic drugs. Given its favorable effects on serum lipids, obese body habitus, cardiovascular disease, and mortality, metformin is recommended as the first-line pharmacologic agent for type 2 diabetes in the absence of contraindications. However, as metformin accumulation may lead to type B non-hypoxemic lactic acidosis, especially in the setting of kidney injury, chronic kidney disease, and overdose, regulatory agencies such as the United States Food and Drug Administration (FDA) have maintained certain restrictions regarding its use in kidney dysfunction. Case series have demonstrated a high fatality rate with metformin-associated lactic acidosis (MALA), and the real-life incidence of MALA may be underestimated by observational studies and clinical trials that have excluded patients with moderate-to-advanced kidney dysfunction. A recent study of advanced diabetic kidney disease patients in Taiwan in Lancet Endocrinology and Diabetes has provided unique insight into the potential consequences of unrestricted metformin use, including a 35% higher adjusted mortality risk that was dose-dependent. This timely study, as well as historical data documenting the toxicities of other biguanides, phenformin and buformin, suggest that the recent relaxation of FDA recommendations to expand metformin use in patients with kidney dysfunction (i.e., those with estimated glomerular filtration rates ≥30 instead of our recommended ≥45 ml/min/1.73 m2) may be too liberal. In this article, we will review the history of metformin use; its pharmacology, mechanism of action, and potential toxicities; and policy-level changes in its use over time.

  9. Personality Type Influences Attentional Bias in Individuals with Chronic Back Pain.

    Directory of Open Access Journals (Sweden)

    Zoë C Franklin

    Full Text Available Attentional biases reflect an individual's selective attention to salient stimuli within their environment, for example an experience of back pain. Eysenck suggests that different personality types show different attentional biases to threatening information. This study is the first to test Eysenck's theory within a chronic back pain population by investigating the attentional biases of four different personality types using a back pain specific dot-probe paradigm. Participants were 70 volunteers (45 female recruited from a back rehabilitation program at an NHS Trust. The four groups were selected on their trait anxiety and defensiveness scores: defensive high-anxious; high-anxious; repressor and non-extreme. Participants completed a dot probe task comprising 20 practice trials and 250 experimental trials. The experimental trials contained 100 threat-neutral pairs, 100 positive-neutral pairs and 50 neutral-neutral image pairings. The threat images were taken from the Photograph Series of Daily Activities (PHODA and the neutral and positive images from the International Affective Picture System (IAPS image bank. The results provided partial support for Eysenck's theory; defensive high-anxious individuals showed an attentional bias for threatening information compared to high-anxious individuals who demonstrated no bias. Repressors showed an avoidant bias to threatening images and an attentional bias to positive stimuli relative to neutral images. The clear difference in responses demonstrated by high-anxious individuals who vary in defensiveness highlight the need for separate investigation of these heterogeneous groups and help to explain the cognitive processes of defensive high-anxious individuals within a pain population. The demonstration of an attentional bias in this group to threatening information could explain why defensive high-anxious individuals are more likely to re-present for treatment.

  10. Personality Type Influences Attentional Bias in Individuals with Chronic Back Pain.

    Science.gov (United States)

    Franklin, Zoë C; Holmes, Paul S; Smith, Nickolas C; Fowler, Neil E

    2016-01-01

    Attentional biases reflect an individual's selective attention to salient stimuli within their environment, for example an experience of back pain. Eysenck suggests that different personality types show different attentional biases to threatening information. This study is the first to test Eysenck's theory within a chronic back pain population by investigating the attentional biases of four different personality types using a back pain specific dot-probe paradigm. Participants were 70 volunteers (45 female) recruited from a back rehabilitation program at an NHS Trust. The four groups were selected on their trait anxiety and defensiveness scores: defensive high-anxious; high-anxious; repressor and non-extreme. Participants completed a dot probe task comprising 20 practice trials and 250 experimental trials. The experimental trials contained 100 threat-neutral pairs, 100 positive-neutral pairs and 50 neutral-neutral image pairings. The threat images were taken from the Photograph Series of Daily Activities (PHODA) and the neutral and positive images from the International Affective Picture System (IAPS) image bank. The results provided partial support for Eysenck's theory; defensive high-anxious individuals showed an attentional bias for threatening information compared to high-anxious individuals who demonstrated no bias. Repressors showed an avoidant bias to threatening images and an attentional bias to positive stimuli relative to neutral images. The clear difference in responses demonstrated by high-anxious individuals who vary in defensiveness highlight the need for separate investigation of these heterogeneous groups and help to explain the cognitive processes of defensive high-anxious individuals within a pain population. The demonstration of an attentional bias in this group to threatening information could explain why defensive high-anxious individuals are more likely to re-present for treatment.

  11. Clinical and virological studies on α-interferon treatment of chronic hepatitis type B

    NARCIS (Netherlands)

    H.L.A. Janssen (Harry)

    1993-01-01

    textabstractThe positive results of a-interferon (IFN) therapy have generated an important change in the therapeutic approach of chronic hepatitis B patients. The studies presented in this thesis are directed to the question how the efficacy of a-IFN therapy for chronic hepatitis B could be improved

  12. Normal-tension glaucoma (Low-tension glaucoma

    Directory of Open Access Journals (Sweden)

    Anderson Douglas

    2011-12-01

    Full Text Available Glaucoma is now considered an abnormal physiology in the optic nerve head that interacts with the level of intraocular pressure (IOP, with the degree and rate of damage depending on the IOP and presumably the degree of abnormal physiology. Diagnosis of normal-tension glaucoma (NTG, defined as glaucoma without a clearly abnormal IOP, depends on recognizing symptoms and signs associated with optic nerve vulnerability, in addition to absence of other explanations for disc abnormality and visual field loss. Among the findings are a halo or crescent of absence of retinal pigment epithelium around the disc, bilateral pre-chiasmal visual field defects, splinter hemorrhages at the disc margin, vascular dysregulation (low blood pressure, cold hands and feet, migraine headache with aura, and the like, or a family history of glaucoma. Possibly relevant, is a history of hemodynamic crisis, arterial obstructive disease, or sleep apnea. Neurological evaluation with imaging is needed only for atypical cases or ones that progress unexpectedly. Management follows the same principle of other chronic glaucomas, to lower the IOP by a substantial amount, enough to prevent disabling visual loss. However, many NTG cases are non-progressive. Therefore, it may often be wisein mild cases to determine whether the case is progressive and the rate of progression before deciding on how aggressivene to be with therapy. Efforts at neuroprotection and improvement in blood flow have not yet been shown effective.

  13. Fatigue In Tension Perpendicular to the Grain

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Uhre; Hoffmeyer, Preben;

    2004-01-01

    mechanism and a mechanism connected to damage introduced in the loading sequences. The purpose of the present study is to disentangle the effect of duration of load from the effect of load oscillation in fatigue in tension perpendicular to the grain. Fatigue experiments are made on small specimens...... and on dowel type joints with slotted in steel plates. In series of ten, the small specimens are taken to fatigue failure in uniform tension at square wave shaped load cycles at 0.01 Hz and 0.1 Hz. In arder to test the predictive validity of the result from the small tension specimens, fatigue experiments......Traditionally fatigue resistance is quantified as number of cycles to failure at a given stress level. A previous study by the authors showed that fatigue in compression parallel to the grain is governed partly by duration of load and partly by an effect of loading, i.e. a combination of a creep...

  14. Fatigue in tension perpendicular to the grain

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben;

    1999-01-01

    mechanism and a mechanism connected to damage introduce in the loading sequences. The purpose of the present study is to disentangle the effect of duration of load from the effect of load oscillation in fatigue in tension perpendicular to the grain. Fatigue experiments are made on small specimens...... and on dowel type joints with slotted in steel plates. In series of ten, the small specimens are taken to fatigue failure in uniform tension at square wave shaped load cycles at 0.01 Hz and 0.1 Hz. In order to test the predictive validity of the result from the small tension specimens, fatigue experiments......Traditinally fatigue resistance is quantified as number of cycles to failure at a given stress level. A previous study by the authors showed that fatigue in compression parallel to the grain is governed partly by duration of load and partly by an effect of loading, i.e. a combination of a creep...

  15. COMPARATIVE EVALUATION OF OUTCOME OF TYPE I TYMPANO PLASTY WITH AND WITHOUT CORTICAL MASTOIDECTOMY IN TREATMENT OF INACTIVE MUCOSAL TYPE OF CHRONIC OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Chander

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the result of tympanoplasty type I in inactive mucosal type of chronic suppurative otitis media with and without cortical mastoidectomy. METHODS: This prospective study was carried out in the department of ENT & HNS in a tertiary care hospital of western U.P, where 80 patients with inactive mucosal type of chronic suppurative otitis media (CSOM were included. The period of study was from Aug . 2013 to J uly 2014. The age and sex matched patients were divided into two groups of 40 each. Half of the patients underwent tympanoplasty type I and rest tympanoplasty type I with cortical mastoidectomy. All the patients underwent underlay technique tympanoplasty with temporalis fascia graft. Patients were Followed - up after six weeks, six months and one year. RESULTS: Hearing improvement was comparable in both groups. There was no significant difference in graft uptake between group I and group II cases. CONCLUSION: Cortical Mastoidectomy performed in inactive mucosal type of CSOM shows no statistically significant difference over tympanoplasty type I done without mastoidectomy.

  16. Effects of acute and chronic physical exercise and stress on different types of memory in rats

    Directory of Open Access Journals (Sweden)

    Pâmela Billig Mello

    2008-06-01

    Full Text Available Here we study the effect of acute and chronic physical exercise in a treadmill and of daily stress (because forced exercise involves a degree of stress during 2 or 8 weeks on different types of memory in male Wistar rats. The memory tests employed were: habituation in an open field, object recognition and spatial learning in the Morris water maze. Daily foot-shock stress enhanced habituation learning after 2 but not after 8 weeks; it hindered both short- (STM and long-term memory (LTM of the recognition task at 2 weeks but only STM after 8 weeks and had no effect on spatial learning after either 2 or 8 weeks. Acute but not chronic exercise also enhanced habituation in the open field and hindered STM and LTM in the recognition task. Chronic exercise enhanced one important measure of spatial learning (latency to escape but not others. Our findings indicate that some care must be taken when interpreting effects of forced exercise on brain parameters since at least part of them may be due to the stress inherent to the training procedure.Neste trabalho estudamos os efeitos do exercício forçado diário em esteira rolante e da exposição diária ao estresse (porque o exercício forçado envolve um certo grau de estresse durante 2 ou 8 semanas em diferentes tipos de memória em ratos Wistar machos. Os testes de memória utilizados foram: habituação da exploração em um campo aberto, reconhecimento de objetos, e memória espacial no labirinto aquático de Morris. O estresse diário facilitou a memória de habituação, os animais aprenderam após 2 mas não após 8 semanas; houve prejuízo na memória curta (STM e de longa duração (LTM no teste de reconhecimento em 2 semanas, mas somente de STM após 8 semanas; não houve nenhum efeito na memória espacial após 2 ou 8 semanas. O protocolo do exercício facilitou também a memória de habituação no campo aberto após 2 mas não após 8 semanas; prejudicou STM e LTM na tarefa do reconhecimento

  17. Calcium-dependent expression of transient receptor potential canonical type 3 channels in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Liu, Ying; Krueger, Katharina; Hovsepian, Anahit;

    2011-01-01

    It is unknown whether extracellular calcium may regulate the expression of transient receptor potential canonical type 3 (TRPC3) channels in patients with chronic kidney disease. Using quantitative in-cell Western assay we compared the expression of TRPC3 channel protein in monocytes from 20...... patients with chronic kidney disease and 19 age- and sex-matched healthy control subjects. TRPC3 channels were identified by immunoblotting using specific antibodies and TRPC3 protein was further confirmed by mass spectrometry. We observed a significant increase of TRPC3 channel protein expression...... in patients with chronic kidney disease compared to healthy control subjects (normalized expression, 0.42±0.06 vs. 0.19±0.03; p...

  18. Hepatocellular carcinoma with chronic B-type hepatitis complicated by autoimmune hemolytic anemia: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A 57-year-old man consulted a local hospital because of a persistent slight fever. At the age of 37 years he was diagnosed having B-type hepatitis, but left the liver dysfunction untreated. Twenty years later, he was diagnosed having chronic hepatitis B, hepatocellular carcinoma (HCC) and macrocytic anemia, and referred to our hospital for further investigation. A HCC with a maximum diameter of 5.2 cm was detected in segment 8. Results of blood tests included 1.8 mg/dL serum total bilirubin, 0.9 mg/dL bilirubin, less than 10 mg/dL haptoglobin, 7.9 g/dL hemoglobin, 130 fL MCV, and 14.5% reticulocytes. A bone marrow sample showed erythroid hyperplasia. The direct Coombs test gave a positive result. We diagnosed the anemia as autoimmmune hemolytic anemia (AIHA), for which prednisolone could not be administered due to positivity for HBsAg and HBeAg. After preparation of washed blood cells for later transfusion, the patient underwent systematic resection of segment 8. The cut surface of the resected specimen demonstrated an encapsulated yellow-brownish tumor measuring 52 mm × 40 mmwhich was diagnosed pathologicaly as moderately differentiated HCC. On the 9th postoperative day, the patient's temperature rose to 38℃, and exacerbated hemolysis was observed. The maximum total bilirubin value was 5.8 mg/dL and minimum hemoglobin level was 4.6 g/dL. He tolerated this period without blood transfusion. Currently he is being followed up as an outpatient, and shows no signs of HCC recurrence or symptoms of anemia. AIHA associated with HBV infection has been described in only three previous cases, and the present case is the first in which surgery was performed for accompanying HCC.

  19. Types of dizziness and its relationship with psychological symptoms in patients with chronic dizziness

    Directory of Open Access Journals (Sweden)

    Ahmad Chitsaz

    2016-01-01

    Full Text Available Dizziness could be categorized as one of the most common medical complaints of patients referred to the neurology clinics. The aim of this study was to evaluate the type of dizziness and its relationship with psychological disorders in patients with chronic complaints. 179 patients with a range of 18 to 65 years were studied. Patients were asked to complete the revised questionnaire form that contained 90 questions related to the signs based on severity scale vertigo tool. Subsequently to detect organic or non-organic vertigo, the patients were divided into two groups. Patients were asked to complete the given questionnaire form. For psychiatric disorders screening questions of international standard for testing SCL-90-R were used. Vertigo severity scale was used for the evaluation of dizziness severity. To compare quantitative variables between the two groups independent t-Test was used and p value of ≤0.05 was considered as significant. Of the total population 70.9% were females. 74% of patients have had dizziness due to organic causes and 26% have had dizziness due to non-organic causes. Dimension scores related to somatic complaints, obsessive-compulsive, depression, anxiety, paranoid ideation and global severity index in individuals with non-organic vertigo was significantly higher than other groups. There was a significant direct relationship between the overall score related to intensity of dizziness and all of the questionnaire dimensions'. There was significant correlation between the extent of physical complaints and the fear for morbid (p<0.001. The score of extent related to dizziness/balance in patient with vertigo due to organic causes and score of extent related to autonomic/anxiety in patient with vertigo due to non-organic causes was significantly higher than other groups.

  20. Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease

    Science.gov (United States)

    Yale, J-F; Bakris, G; Cariou, B; Yue, D; David-Neto, E; Xi, L; Figueroa, K; Wajs, E; Usiskin, K; Meininger, G

    2013-01-01

    Aims Canagliflozin is a sodium glucose co-transporter 2 inhibitor in development for treatment of type 2 diabetes mellitus (T2DM). This study evaluated the efficacy and safety of canagliflozin in subjects with T2DM and stage 3 chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR) ≥30 and <50 ml/min/1.73 m2]. Methods In this randomized, double-blind, placebo-controlled, phase 3 trial, subjects (N = 269) received canagliflozin 100 or 300 mg or placebo daily. The primary efficacy endpoint was change from baseline in HbA1c at week 26. Prespecified secondary endpoints were change in fasting plasma glucose (FPG) and proportion of subjects reaching HbA1c <7.0%. Safety was assessed based on adverse event (AE) reports; renal safety parameters (e.g. eGFR, blood urea nitrogen and albumin/creatinine ratio) were also evaluated. Results Both canagliflozin 100 and 300 mg reduced HbA1c from baseline compared with placebo at week 26 (–0.33, –0.44 and –0.03%; p < 0.05). Numerical reductions in FPG and higher proportions of subjects reaching HbA1c < 7.0% were observed with canagliflozin 100 and 300 mg versus placebo (27.3, 32.6 and 17.2%). Overall AE rates were similar for canagliflozin 100 and 300 mg and placebo (78.9, 74.2 and 74.4%). Slightly higher rates of urinary tract infections and AEs related to osmotic diuresis and reduced intravascular volume were observed with canagliflozin 300 mg compared with other groups. Transient changes in renal function parameters that trended towards baseline over 26 weeks were observed with canagliflozin. Conclusion Canagliflozin improved glycaemic control and was generally well tolerated in subjects with T2DM and Stage 3 CKD. PMID:23464594

  1. Pro-A-type natriuretic peptide and pro-adrenomedullin predict progression of chronic kidney disease: the MMKD Study.

    Science.gov (United States)

    Dieplinger, Benjamin; Mueller, Thomas; Kollerits, Barbara; Struck, Joachim; Ritz, Eberhard; von Eckardstein, Arnold; Haltmayer, Meinhard; Kronenberg, Florian

    2009-02-01

    A-type natriuretic peptide (ANP) and adrenomedullin (ADM) are potent hypotensive, diuretic, and natriuretic peptides involved in maintaining cardiovascular and renal homeostasis. We conducted a prospective 7-year study of 177 nondiabetic patients with primary chronic kidney disease to see if ANP and ADM plasma concentrations predict the progression of their disease, using novel sandwich immunoassays covering the midregional epitopes of the stable prohormones (MRproANP and MR-proADM). Progression of chronic kidney disease was defined as doubling of baseline serum creatinine and/or terminal renal failure, which occurred in 65 patients. Analysis of the receiver operating characteristic curve for the prediction of renal endpoints showed similar areas under the curve for the glomerular filtration rate (GFR) (0.838), MR-proANP (0.810), and MRproADM (0.876), respectively, as did the Kaplan-Meier curve analyses of the patients stratified according to the median of the respective markers. In separate multiple Cox-proportional hazard regression analyses, increased plasma concentrations of both peptides were each strongly predictive of the progression of chronic kidney disease after adjustments for age, gender, GFR, proteinuria and amino-terminal pro-B-type natriuretic peptide. Our study suggests that MR-proANP and MR-proADM are useful new markers of progression of primary nondiabetic chronic kidney disease.

  2. THE MICROBIOLOGICAL EFFICACY ESTIMATION OF DIFFERENT TYPES OF CHRONIC PERIODONTITIS’ ANTI-INFLAMMATORY THERAPY

    Directory of Open Access Journals (Sweden)

    O.B. Ryba

    2008-09-01

    Full Text Available The article deals with microbiological status of patients with chronic generalized periodontitis of medium severity. On the basis of clinical and microbiological data the analysis of different methods efficacy of anti-inflammatory therapy was carried out. We studied antimicrobial effect of laser therapy, ozonotherapyandcombinations oflaser- ozonotherapyin comparison with influence ofchlorhexidine 0,2%. Combined laser and ozone influence on periodontium provided high antibacterial effect with increased local nonspecific resistance, and it extended remission term of patients with chronic periodontitis.

  3. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W;

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether T...... Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics....

  4. A CONTROVERSIAL ON THE DIAGNOSIS OF CHRONIC BULLOUS TYPE MUCOCUTANEOUS DISEASE INVOLVING ORAL MUCOSA (A CASE REPORT)

    OpenAIRE

    Isadora Gracia; Harum Sasanti

    2006-01-01

    A case of chronic bullous type mucocutaneous disease involving oral mucosa was reported from a 56 years old man with never healing oral ulcers and wound on the perianal skin for three years. There were also red and black spots on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidasis with differential d...

  5. Three cousins with chronic foot ulcers from late-onset hereditary sensory and autonomic neuropathies type 2 (HSAN2).

    Science.gov (United States)

    Aghaei, Shahin; Pakmanesh, Kambiz

    2006-02-28

    The hereditary sensory and autonomic neuropathies (HSAN) are a group of rare disorders characterized by prominent sensory and autonomic neuropathy without motor involvement. We report three male cousins with chronic foot ulcers, all were affected with late-onset HSAN type 2 (HSAN2). In view of the history of consanguinity and male sex, X-linked recessive transmission was likely in our patients. According to the authors' knowledge this is the first report of HSAN2 from Iran.

  6. Ultrastructural characteristics of novel epithelial cell types identified in human pathologic liver specimens with chronic ductular reaction.

    Science.gov (United States)

    De Vos, R; Desmet, V

    1992-06-01

    Previous immunohistochemical studies on human liver biopsies with chronic ductular reaction revealed the presence of "small cells" with bile-duct type cytokeratin profile in the periportal area. This study identified similar cells by electron microscopy. The authors studied 13 human liver specimens with various liver diseases, but all characterized by chronic ductular reaction. In all specimens, variable numbers of "small cells" with common epithelial characteristics were identified in the periportal area. They could be classified into three types. Type I cells showed an oval cell shape and oval nucleus, early or established formation of junctional complexes with adjacent cells, a full assortment of cytoplasmic organelles, and bundles of tonofilaments. Type II cells showed features of bile-duct cell differentiation, including lateral interdigitations, apical microvilli, basal pinocytotic vacuoles, and basement membrane formation. In contrast, type III cells displayed additional features indicating hepatocellular differentiation, such as a more prominent nucleus, formation of a hemicanaliculus, and glycogen rosettes. It is concluded that these small cells of epithelial nature display variable differentiation characteristics of either bile-duct type cells or hepatocytes. These findings support the existence of bipotential progenitor epithelial cells in human liver. They may have implications for liver regeneration and carcinogenesis.

  7. Baseline characteristics in the Bardoxolone methyl EvAluation in patients with Chronic kidney disease and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Lambers Heerspink, Hiddo J; Chertow, Glenn M; Akizawa, Tadao

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is the most important contributing cause of end-stage renal disease (ESRD) worldwide. Bardoxolone methyl, a nuclear factor-erythroid-2-related factor 2 activator, augments estimated glomerular filtration. The Bardoxolone methyl EvAluation in patients with Chronic k...... kidney disease and type 2 diabetes mellitus: the Occurrence of renal eveNts (BEACON) trial was designed to establish whether bardoxolone methyl slows or prevents progression to ESRD. Herein, we describe baseline characteristics of the BEACON population....

  8. Fragmentation in Biaxial Tension

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, G H; Archbold, G C; Hurricane, O A; Miller, P L

    2006-06-13

    We have carried out an experiment that places a ductile stainless steel in a state of biaxial tension at a high rate of strain. The loading of the ductile metal spherical cap is performed by the detonation of a high explosive layer with a conforming geometry to expand the metal radially outwards. Simulations of the loading and expansion of the metal predict strain rates that compare well with experimental observations. A high percentage of the HE loaded material was recovered through a soft capture process and characterization of the recovered fragments provided high quality data, including uniform strain prior to failure and fragment size. These data were used with a modified fragmentation model to determine a fragmentation energy.

  9. Research on Web Press Tension Control System

    OpenAIRE

    Chen Sheng Jiang; Zhang Chun Feng; Wang Zhong You; Li Qing Lin

    2016-01-01

    Tension control of press is a key and difficult point of the whole machine control. The stand or fall of tension is directly related to the quality of the products. According to the characteristics of the web press tension control, this paper expounds the main factors influencing tension and the purpose of tension control, researches on the tension control principle of web tape, analyzes control rule and control circuit of tension control system, illustrates the advantages of PID control law ...

  10. Surface tension of evaporating nanofluid droplets

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Ruey-Hung [Univ. of Central Florida, Orlando, FL (United States); Phuoc, Tran X. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Martello, Donald [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2011-05-01

    Measurements of nanofluid surface tension were made using the pendant droplet method. Three different types of nanoparticles were used - laponite, silver and Fe2O3 - with de-ionized water (DW) as the base fluid. The reported results focus on the following categories; (1) because some nanoparticles require surfactants to form stable colloids, the individual effects of the surfactant and the particles were investigated; (2) due to evaporation of the pendant droplet, the particle concentration increases, affecting the apparent surface tension; (3) because of the evaporation process, a hysteresis was found where the evaporating droplet can only achieve lower values of surface tension than that of nanofluids at the same prepared concentrations: and (4) the Stefan equation relating the apparent surface tension and heat of evaporation was found to be inapplicable for nanofluids investigated. Comparisons with findings for sessile droplets are also discussed, pointing to additional effects of nanoparticles other than the non-equilibrium evaporation process.

  11. [Impact of physical activity on metabolic control and the development of chronic complications in patients with type 1 diabetes mellitus].

    Science.gov (United States)

    Carral San Laureano, Florentino; Gutiérrez Manzanedo, José Vicente; Ayala Ortega, Carmen; García Calzado, Concepción; Silva Rodríguez, Juan José; Aguilar Diosdado, Manuel

    2010-01-01

    Together with a balanced diet, regular physical activity is one of the pillars of diabetes mellitus (DM) management. Physical activity theoretically provides the same advantages in people with DM as in the general population and also has some beneficial effects in controlling metabolic factors, such as improving blood glucose levels and insulin sensitivity. In this article, we analyze the main clinical studies published to date that evaluate the impact of physical activity on metabolic control or the development of chronic complications in patients with type 1 diabetes mellitus. In conclusion, most of the evaluated studies show that regular physical activity favorably affects metabolic control in DM (or at least does not have adverse effects). However, there is insufficient information about the impact of physical activity on the development and progression of chronic complications.

  12. Research on Web Press Tension Control System

    Directory of Open Access Journals (Sweden)

    Chen Sheng Jiang

    2016-01-01

    Full Text Available Tension control of press is a key and difficult point of the whole machine control. The stand or fall of tension is directly related to the quality of the products. According to the characteristics of the web press tension control, this paper expounds the main factors influencing tension and the purpose of tension control, researches on the tension control principle of web tape, analyzes control rule and control circuit of tension control system, illustrates the advantages of PID control law adopted in the tension control system, and concludes the influencing factors of paper tape tension control system and the corresponding problems needed to solve in the control.

  13. Association of Toll-like receptor 4 (TLR4) with chronic plaque type psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Smith, Rh Ll; Hébert, H L; Massey, J; Bowes, J; Marzo-Ortega, H; Ho, P; McHugh, N J; Worthington, J; Barton, A; Griffiths, C E M; Warren, R B

    2016-04-01

    Family studies have provided overwhelming evidence for an underlying genetic component to psoriasis. Toll-like receptors (TLRs) are key transmembrane proteins in both the innate and adaptive immune responses which are known to be integral processes in psoriasis. Recent functional studies support this notion having suggested a role for TLR4 in the pathogenesis of psoriasis. Furthermore a missense polymorphism in the TLR4 gene has been associated with a number of autoimmune conditions, including Crohn diseases, making TLR4 a viable candidate gene for investigation. The aim of this study was to investigate polymorphisms across the TLR4 region with a high-density single nucleotide polymorphism (SNP) panel in a large cohort of patients with chronic plaque type psoriasis. Twenty SNPs were successfully genotyped using Sequenom iPLEX Gold platform in 2826 UK chronic plaque type psoriasis patients including subgroup data on presence of confirmed psoriatic arthritis (n = 1839) and early-onset psoriasis (n = 1466) was available. Allele frequencies for psoriasis patients were compared against imputed Wellcome Trust Case Control Consortium controls (n = 4861). Significant association was observed between a missense variant rs4986790 of TLR4 (Asp229Gly) and plaque type psoriasis (p = 2 × 10(-4)) which was also notable in those with psoriatic arthritis (p = 2 × 10(-4)) and early-onset psoriasis (p = 8 × 10(-4)). We present data suggestive of an association between a functional variant and an intronic variant of TLR4 and chronic plaque type psoriasis and psoriatic arthritis. However, validation of this association in independent cohorts will be necessary.

  14. Chronic allergic inflammation causes vascular remodeling and pulmonary hypertension in BMPR2 hypomorph and wild-type mice.

    Directory of Open Access Journals (Sweden)

    Elizabeth M Mushaben

    Full Text Available Loss-of-function mutations in the bone morphogenetic protein receptor type 2 (BMPR2 gene have been identified in patients with heritable pulmonary arterial hypertension (PAH; however, disease penetrance is low, suggesting additional factors play a role. Inflammation is associated with PAH and vascular remodeling, but whether allergic inflammation triggers vascular remodeling in individuals with BMPR2 mutations is unknown. Our goal was to determine if chronic allergic inflammation would induce more severe vascular remodeling and PAH in mice with reduced BMPR-II signaling. Groups of Bmpr2 hypomorph and wild-type (WT Balb/c/Byj mice were exposed to house dust mite (HDM allergen, intranasally for 7 or 20 weeks to generate a model of chronic inflammation. HDM exposure induced similar inflammatory cell counts in all groups compared to controls. Muscularization of pulmonary arterioles and arterial wall thickness were increased after 7 weeks HDM, more severe at 20 weeks, but similar in both groups. Right ventricular systolic pressure (RVSP was measured by direct cardiac catheterization to assess PAH. RVSP was similarly increased in both HDM exposed groups after 20 weeks compared to controls, but not after 7 weeks. Airway hyperreactivity (AHR to methacholine was also assessed and interestingly, at 20 weeks, was more severe in HDM exposed Bmpr2 hypomorph mice versus WT. We conclude that chronic allergic inflammation caused PAH and while the severity was mild and similar between WT and Bmpr2 hypomorph mice, AHR was enhanced with reduced BMPR-II signaling. These data suggest that vascular remodeling and PAH resulting from chronic allergic inflammation occurs independently of BMPR-II pathway alterations.

  15. The interaction of disrupted type II neuregulin 1 and chronic adolescent stress on adult anxiety- and fear-related behaviors.

    Science.gov (United States)

    Taylor, S B; Taylor, A R; Koenig, J I

    2013-09-26

    The incidence of anxiety, mood, substance abuse disorders and schizophrenia increases during adolescence. Epidemiological evidence confirms that exposure to stress during sensitive periods of development can create vulnerabilities that put genetically predisposed individuals at increased risk for psychiatric disorders. Neuregulin 1 (NRG1) is a frequently identified schizophrenia susceptibility gene that has also been associated with the psychotic features of bipolar disorder. Previously, we established that Type II NRG1 is expressed in the hypothalamic-pituitary-adrenal (HPA) axis neurocircuitry. We also found, using a line of Nrg1 hypomorphic rats (Nrg1(Tn)), that genetic disruption of Type II NRG1 results in altered HPA axis function and environmental reactivity. The present studies used the Nrg1(Tn) rats to test whether Type II NRG1 gene disruption and chronic stress exposure during adolescence interact to alter adult anxiety- and fear-related behaviors. Male and female Nrg1(Tn) and wild-type rats were exposed to chronic variable stress (CVS) during mid-adolescence and then tested for anxiety-like behavior, cued fear conditioning and basal corticosterone secretion in adulthood. The disruption of Type II NRG1 alone significantly impacts rat anxiety-related behavior by reversing normal sex-related differences and impairs the ability to acquire cued fear conditioning. Sex-specific interactions between genotype and adolescent stress also were identified such that CVS-treated wild-type females exhibited a slight reduction in anxiety-like behavior and basal corticosterone, while CVS-treated Nrg1(Tn) females exhibited a significant increase in cued fear extinction. These studies confirm the importance of Type II NRG1 in anxiety and fear behaviors and point to adolescence as a time when stressful experiences can shape adult behavior and HPA axis function.

  16. Rationale and Trial Design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes : The Occurrence of Renal Events (BEACON)

    NARCIS (Netherlands)

    de Zeeuw, Dick; Akizawa, Tadao; Agarwal, Rajiv; Audhya, Paul; Bakrise, George L.; Chin, Melanie; Krauth, Melissa; Heerspink, Hiddo J. Lambers; Meyer, Colin J.; McMurray, John J.; Parving, Hans-Henrik; Pergola, Pablo E.; Remuzzi, Giuseppe; Toto, Robert D.; Vaziri, Nosratola D.; Wanner, Christoph; Warnock, David G.; Wittes, Janet; Chertow, Glenn M.

    2013-01-01

    Background: Chronic kidney disease (CKD) associated with type 2 diabetes mellitus constitutes a global epidemic complicated by considerable renal and cardiovascular morbidity and mortality, despite the provision of inhibitors of the renin-angiotensin-aldosterone system (RAAS). Bardoxolone methyl, a

  17. Risk Factors for Hepatitis C Virus Infection in Canadian Patients with Chronic Type C Hepatitis

    Directory of Open Access Journals (Sweden)

    GY Minuk

    1995-01-01

    Full Text Available Previous reports from the United States indicate that as many as 40% of patients with chronic hepatitis C virus (HCV have no identifiable risk factor for HCV infection. To determine whether the same is true of Canadian patients with chronic HCV the records of 89 anti-HCV positive patients referred to the authors' tertiary care centre for evaluation of liver disease were reviewed. Each patient had been specifically asked about the following risk factors: previous blood transfusions; intravenous drug abuse; homosexual activity; sexual promiscuity (multiple sexual partners or a history of sexually transmitted diseases; tattoos made with nonsterile techniques; and ear piercing using nonsterile techniques. The results of the study revealed that 76 of 89 patients (85% had at least one risk factor for HCV exposure, 38 (43% had only one risk factor, 19 (21% had two, 12 (14% had three and the remaining three patients (3% had four. The most common risk factor was a history of intravenous drug abuse (30 of 89 patients, 34% followed by sexual promiscuity (28, 32%, previous blood transfusions (21, 24%, tattoos (17, 19%, homosexual contacts (seven, 8% and ear piercing (five, 6%. Contrary to a recent report identifying sexual contact as an independent risk factor for HCV infection, only four cases (5% were found where sexual promiscuity was identified as the only risk factor. In conclusion, these findings indicate that a possible source of HCV infection can be identified in a large majority of Canadians referred to an urban centre with chronic HCV infection.

  18. "Hemicrania episodica"--a new type of headache or a pre-chronic stage of hemicrania continua?

    Science.gov (United States)

    Pareja, J A; Palomo, T; Gorriti, M A; Pareja, J; Espejo, J

    1990-05-01

    For seventeen years, a young man suffered from headaches of one to three days duration occurring once every six or seven days and totally disappearing between episodes. These were strictly unilateral (always on the left side), and were absolutely responsive to indomethacin. They differ clinically from the other two indomethacin-responsive headaches described up to now: Hemicrania Continua (HC) and Chronic Paroxysmal Hemicrania (CPH). He has a sister suffering from HC. Similar to HC, but unlike CPH, topical tyramine in our patient's eyes resulted in anisocoria before, but not after, indomethacin treatment. Our case differs from HC, however, in its time pattern; it could either be a pre-chronic stage of HC or a new type of headache. It seems unlikely that a time pattern that has remained unchanged for 17 years will become continuous, as in HC, in the future, and thus it is possible that our patient represents a case of a new type of headache that we propose to name "Hemicrania Episodica." In any case, it seems probable that this type of headache, although clinically different, may share a common pathogenic basis with HC.

  19. Evenness Control of Rapier Loom Tension by Using Neural Network

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The neural network model (NNM) is used to control the evenness of rapier loom tension and to model the uncertain parameters of drafting process. This model can estimate recursively the tension and incorporate predictive control strategies. After controlling the effect testing, it can be seen that the behavior is excellent following different set point and variations, such as the diameter of the beam of weaver, air stream, density of warp and weft, type of textile, etc. An optimum steady state scheme has been fixed in keeping evenness of tension of loom. This method improves obviously the efficiency and quality of production.

  20. Upregulation of Cannabinoid Type 1 Receptors in Dopamine D2 Receptor Knockout Mice Is Reversed by Chronic Forced Ethanol Consumption

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, P.K.; Wang, G.; Thanos, P.K.; Gopez, V.; Delis, F.; Michaelides, M.; Grand, D.K.; Wang, G.-J.; Kunos, G.; Volkow, N.D.

    2011-01-01

    The anatomical proximity of the cannabinoid type 1 (CNR1/CB1R) and the dopamine D2 receptors (DRD2), their ability to form CB1R-DRD2 heteromers, their opposing roles in locomotion, and their involvement in ethanol's reinforcing and addictive properties prompted us to study the levels and distribution of CB1R after chronic ethanol intake, in the presence and absence of DRD2. We monitored the drinking patterns and locomotor activity of Drd2+/+ and Drd2-/- mice consuming either water or a 20% (v/v) ethanol solution (forced ethanol intake) for 6 months and used the selective CB1 receptor antagonist [{sup 3}H]SR141716A to quantify CB1R levels in different brain regions with in vitro receptor autoradiography. We found that the lack of DRD2 leads to a marked upregulation (approximately 2-fold increase) of CB1R in the cerebral cortex, the caudate-putamen, and the nucleus accumbens, which was reversed by chronic ethanol intake. The results suggest that DRD2-mediated dopaminergic neurotransmission and chronic ethanol intake exert an inhibitory effect on cannabinoid receptor expression in cortical and striatal regions implicated in the reinforcing and addictive properties of ethanol.

  1. Salivary and microbiological parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus: a case-control study

    Directory of Open Access Journals (Sweden)

    José Roberto CORTELLI

    Full Text Available Background: Several studies have investigated the differences in salivary parameters and microbial composition between diabetic and non-diabetic patients, however, specific differences are still not clear mainly due to the effects of confounder. Aim: The aim of this case-control study was to evaluate the salivary and microbial parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus. Material and method: This case-control study included 60 chronic periodontitis subjects, 30 diabetics (case group and 30 non-diabetics (control group, paired according to periodontitis severity, gender and age. Stimulated whole saliva was collected from all volunteers to measure the salivary pH and the salivary flow rate. Bacterial samples were collected with paper points from periodontal sites showing the deepest periodontal pocket depth associated with the highest clinical attachment loss. The frequency of A. actinomycetemcomitans, P. intermedia, P. gingivalis, T. forsythia and C. rectus was evaluated by PCR. Data was statistically analyzed by Student's t, Mann-Whitney and Chi-square (p<0.05. Result: Diabetic subjects showed higher salivary glucose levels and lower stimulated flow rates in comparison to non-diabetic controls. P. gingivalis and T. forsythia were the most frequent pathogens (p<0.05. Bacterial frequency did not differ between case and control groups. Conclusion: Diabetes status influenced salivary glucose levels and flow rate. Within the same severity of chronic periodontitis, diabetic subjects did not show higher frequency of periodontal pathogens in comparison to their paired controls.

  2. A proposal to prevent the "Mephisto sign" side effect of botulinum toxin type A injection in chronic migraine.

    Science.gov (United States)

    Cho, Eunae S; Hwang, Jae Young; Kim, Seong Taek

    2013-11-01

    Botulinum toxin type A (BoNT-A) has been reported as an effective treatment for chronic migraine. When BoNT-A is injected on the frontalis muscle for chronic migraine, an unexpected clinical side effect called the "Mephisto sign" may occur. The aim of this article is to propose a method to eliminate or prevent the Mephisto sign side effect. A 25-year-old female patient visited the hospital and was diagnosed with chronic migraine. A total of 155 U of BoNT-A was injected into 31 sites. 2-weeks later, and the patient developed the Mephisto sign. An additional 2-U dose was administered bilaterally to the lateral-most point of the frontalis muscles, and the eyebrow morphology returned to normal within 2-3 weeks. We propose that the development of the Mephisto sign may be prevented with an additional BoNT-A injection of 2-4 U bilaterally to the lateral most point of the frontalis muscles during the primary injection process.

  3. Impacts of chronic N input on the carbon and nitrogen storage of a postfire Mediterranean-type shrubland

    Science.gov (United States)

    Vourlitis, George L.; Hentz, Cloe S.

    2016-02-01

    Mediterranean-type shrublands are subject to periodic fire and high levels of nitrogen (N) deposition, but little is known how chronic N deposition affects carbon (C) and N storage during succession. We conducted a long-term experiment in Californian chaparral to test the hypothesis that chronic N enrichment would increase postfire C and N accumulation. The experimental layout consisted of a randomized design where four 10 × 10 m plots received 5 g N m-2 annually since 2003 and four 10 × 10 m plots served as controls. Aboveground and belowground C and N pools and fluxes were measured seasonally (every 3 months) for a period of 10 years. Added N rapidly increased soil extractable N pools and decreased soil pH; however, total soil C and N storage were not affected. Added N plots initially had significantly lower C and N storage than control plots, presumably because of nutrient losses from leaching and/or higher belowground C allocation. However, rates of aboveground N and C storage became significantly higher in added N plots after 4-5 years of exposure, thus increasing fuel buildup, which has implications for future fire intensity. This recovering chaparral stand is not yet "N saturated" after 10 years of chronic N input. However, N leaching continues to be higher in added N plots, indicating that postfire chaparral stands in high-N deposition areas can be important sources of N to groundwater/aquatic systems even if productivity is stimulated by N input.

  4. Chronic Daily Headache - A Reappraisal

    Directory of Open Access Journals (Sweden)

    Chakravarty A

    2004-01-01

    Full Text Available Chronic Daily Headache (CDH generally refers to frequent headache occuring more than 15 days/month for over three months. Such headaches may be primary or secondary - the latter referring to headaches related to identifiable intra and extracranial vascular or other pathologies or systemic illnesses. The primary type may be subclassified as short and long lasting ones, depending upon whether the headache spells are more or less than four hours in duration. The present review would deal with the four major types of long lasting primary CDH which include Chronic migraine (CM, Chronic tension type headache (CTTH, New daily persistent headache (NDPH and Hemicrania continua (HC. The first part of the article would focus on the clinical pattern recognising features of these types. The relationship of medication overuse to CM would be critically evaluated. In the second part, the status of CDH in the recently proposed classification of headache disorders by the International Headache Society would be briefly evaluated. In the next section the clinical Profile or CDH in Indian patients would be highlighted based on available published data. Lastly, the pathophysiology of this vexing condition would be discussed specially in relation to CM and postulating on how it may evolve from episodic migraine.

  5. Relationship between chronic complications, hypertension, and health-related quality of life in Portuguese patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sepúlveda E

    2015-10-01

    Full Text Available Eduardo Sepúlveda,1,2 Rui Poínhos,2,3 Miguel Constante,4,5 José Pais-Ribeiro,1,2 Paula Freitas,6–8 Davide Carvalho6–8 1Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal; 2Associação de Prevenção e Apoio à Diabetes, Porto, Portugal; 3Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; 4Institute of Psychiatry, King's College London, London, UK; 5Department of Psychiatry, Hospital Beatriz Ângelo, Loures, Portugal; 6Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal; 7Faculty of Medicine, University of Porto, Porto, Portugal; 8Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal Background: The aim of this study was to assess the relationship between health-related quality of life (HRQoL and the presence or absence of hypertension and diabetes-related chronic complications in type 2 diabetes, and also the association between HRQoL and the number of chronic complications. Methods: One hundred patients with type 2 diabetes were interviewed. HRQoL was evaluated using the age-adjusted Short-Form 36 dimensions (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Results: The mean age of the study population was 62.7±8.7 years; 54.0% were male, and 51.0% were receiving only oral hypoglycemic agents. Chronic complications were related to worse HRQoL in different dimensions: peripheral neuropathy and cardiovascular disease (all, except bodily pain, retinopathy (physical functioning, general health, vitality, and mental health, peripheral arterial disease (physical functioning, role-physical, and general health, and nephropathy (general health and vitality. Hypertension was related to worse general health and vitality. An increased number of chronic complications was associated with worse HRQoL in all dimensions of Short

  6. [Local invasive treatment of chronic pain].

    Science.gov (United States)

    Medvedeva, L A; Zagorul'ko, O I; Gnezdilov, A V

    2014-01-01

    The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels. Therapeutic blockades of the occipital nerve is effective method of treatment of cervicogenic and cluster headache as well as occipital nerve neuralgia. There are clear indications of the efficacy of local injections in primary chronic cephalgia (migraine and headache of tension). The possibility of the abortion of the pain information flow in peripheral nociceptive pathways and, as a consequence, breaking the vicious circle is emphasized. Issues on the efficacy of local injections at trigger points in the treatment of chronic pain are highlighted.

  7. Scaling for interfacial tensions near critical endpoints.

    Science.gov (United States)

    Zinn, Shun-Yong; Fisher, Michael E

    2005-01-01

    Parametric scaling representations are obtained and studied for the asymptotic behavior of interfacial tensions in the full neighborhood of a fluid (or Ising-type) critical endpoint, i.e., as a function both of temperature and of density/order parameter or chemical potential/ordering field. Accurate nonclassical critical exponents and reliable estimates for the universal amplitude ratios are included naturally on the basis of the "extended de Gennes-Fisher" local-functional theory. Serious defects in previous scaling treatments are rectified and complete wetting behavior is represented; however, quantitatively small, but unphysical residual nonanalyticities on the wetting side of the critical isotherm are smoothed out "manually." Comparisons with the limited available observations are presented elsewhere but the theory invites new, searching experiments and simulations, e.g., for the vapor-liquid interfacial tension on the two sides of the critical endpoint isotherm for which an amplitude ratio -3.25+/-0.05 is predicted.

  8. Linearized gravity in flat braneworlds with anisotropic brane tension

    CERN Document Server

    Ito, M

    2002-01-01

    We study the four-dimensional gravitational fluctuation on anisotropic brane tension embedded in braneworlds with vanishing bulk cosmological constant. In this setup, warp factors have two types (A and B) and we point out that the two types correspond to positive and negative tension brane, respectively. We show that volcano potential in the model of type A has singularity and the usual Newton's law is reproduced by the existence of normalizable zero mode. While, in the case of type B, the effective Planck scale is infinite so that there is no normalizable zero mode.

  9. Horizon Thermodynamics and Gravitational Tension

    CERN Document Server

    Widom, A; Srivastava, Y N

    2016-01-01

    We consider the thermodynamics of a horizon surface from the viewpoint of the vacuum tension $\\tau =(c^4/4G )$. Numerically, $\\tau \\approx 3.026\\times 10^{43}$ Newton. In order of magnitude, this is the tension that has been proposed for microscopic string models of gravity. However, after decades of hard work on string theory models of gravity, there is no firm scientific evidence that such models of gravity apply empirically. Our purpose is thereby to discuss the gravitational tension in terms of the conventional Einstein general theory of relativity that apparently does explain much and maybe all of presently known experimental gravity data. The central result is that matter on the horizon surface is bound by the entropy-area law by tension in the closely analogous sense that the Wilson action-area law also describes a surface confinement.

  10. Chronic endocannabinoid system stimulation induces muscle macrophage and lipid accumulation in type 2 diabetic mice independently of metabolic endotoxaemia.

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    Lucie Geurts

    Full Text Available AIMS: Obesity and type 2 diabetes are characterised by low-grade inflammation, metabolic endotoxaemia (i.e., increased plasma lipopolysaccharides [LPS] levels and altered endocannabinoid (eCB-system tone. The aim of this study was to decipher the specific role of eCB-system stimulation or metabolic endotoxaemia in the onset of glucose intolerance, metabolic inflammation and altered lipid metabolism. METHODS: Mice were treated with either a cannabinoid (CB receptor agonist (HU210 or low-dose LPS using subcutaneous mini-pumps for 6 weeks. After 3 weeks of the treatment under control (CT diet, one-half of each group of mice were challenged with a high fat (HF diet for the following 3-week period. RESULTS: Under basal conditions (control diet, chronic CB receptor agonist treatment (i.e., 6 weeks induced glucose intolerance, stimulated metabolic endotoxaemia, and increased macrophage infiltration (CD11c and F4/80 expression in the muscles; this phenomenon was associated with an altered lipid metabolism (increased PGC-1α expression and decreased CPT-1b expression in this tissue. Chronic LPS treatment tended to increase the body weight and fat mass, with minor effects on the other metabolic parameters. Challenging mice with an HF diet following pre-treatment with the CB agonist exacerbated the HF diet-induced glucose intolerance, the muscle macrophage infiltration and the muscle's lipid content without affecting the body weight or the fat mass. CONCLUSION: Chronic CB receptor stimulation under basal conditions induces glucose intolerance, stimulates metabolic inflammation and alters lipid metabolism in the muscles. These effects worsen following the concomitant ingestion of an HF diet. Here, we highlight the central roles played by the eCB system and LPS in the pathophysiology of several hallmarks of obesity and type 2 diabetes.

  11. Chronic disease in child’s life. social and psychological aspects in the context of type i diabetes

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    Lucyna Sochocka

    2011-09-01

    Full Text Available Disease is one of the most undesirable phenomena in life and child’s development. Chronic disease makes very difficult to meet the needs of a child. Chronic failure affects not only the child himself but the child and the whole family. This is often difficult and sometimes even impossible to explain and accept. Lengthiness of type I diabetes often causes the child to stay in hospital where he comes across pain (insulin injections, diagnostic puncture, hospital rigor, impediment in learning.For school-age child is not enough „to be sick”, especially if the disease is associated with sensations such as pain and malaise. In situations like that it is necessary and important to inform the child about the disease. Supply him with basic information of the need for testing, the rules of diet and adverse symptoms such as acidosis, hypoglycemia. Lack of knowledge about the disease exacerbated by stress cause forced isolation of the child. Type I diabetes may be perceived by young people as a disease which limits social contacts. Furthermore may affect sense of otherness in relation to their contemporaries. Peer support is very important. It helps not only in adjusting to the environment but also in overcoming daily duties associated with chronic disease – testing of glucose level, insulin, diet and exercise plan. Treatment of diabetes may not focus solely on achievement of metabolic balance. It also aims at creation of good relationship within therapeutic team (patient, parent, doctor, nurse, laboratory technician, physical therapist, health trainer, psychologist as well as between friends, colleagues and school mates.

  12. Risk of type II diabetes and hypertension associated with chronic insomnia among active component, U.S. Armed Forces, 1998-2013.

    Science.gov (United States)

    Lewis, Paul E; Emasealu, Oseizame V; Rohrbeck, Patricia; Hu, Zheng

    2014-10-01

    Chronic insomnia is a common clinical complaint and its incidence in both U.S. military and civilian populations has increased. Several studies have evaluated the association between chronic insomnia and the development of other chronic diseases. This study estimates the incidence of chronic insomnia. In addition, this report examines the association between both hypertension and type II diabetes and chronic insomnia in active component military members. The Defense Medical Surveillance System was used to identify a cohort of individuals with chronic insomnia between 1998 and 2013 and to match them by age and gender with a cohort without insomnia. During 1998-2013, there were 205,740 incident cases of chronic insomnia among active component service members with an overall rate of 90.3 per 10,000 person-years. Individuals in the chronic insomnia cohort were at higher risk for type II diabetes (adjusted hazard ratio [HR], 2.17 [95% CI, 1.75-2.69]) and hypertension (adjusted HR, 2.00 [95% CI, 1.85-2.16]). Sleep hygiene education along with evaluation and treatment of persistent symptoms are of public health importance in active duty service members.

  13. Chronic β2 adrenergic agonist, but not exercise, improves glucose handling in older type 2 diabetic mice.

    Science.gov (United States)

    Elayan, Hamzeh; Milic, Milos; Sun, Ping; Gharaibeh, Munir; Ziegler, Michael G

    2012-07-01

    Insulin resistant type 2 diabetes mellitus in the obese elderly has become a worldwide epidemic. While exercise can prevent the onset of diabetes in young subjects its role in older diabetic people is less clear. Exercise stimulates the release of the β(2)-agonist epinephrine more in the young. Although epinephrine and β(2)-agonist drugs cause acute insulin resistance, their chronic effect on insulin sensitivity is unclear. We fed C57BL/6 mice a high fat diet to induce diabetes. These overweight animals became very insulin resistant. Exhaustive treadmill exercise 5 days a week for 8 weeks had no effect on their diabetes, nor did the β(2)-blocking drug ICI 118551. In contrast, exercise combined with the β(2)-agonist salbutamol (albuterol) had a beneficial effect on both glucose tolerance and insulin sensitivity after 4 and 8 weeks of exercise. The effect was durable and persisted 5 weeks after exercise and β(2)-agonist had stopped. To test whether β(2)-agonist alone was effective, the animals that had received β(2)-blockade were then given β(2)-agonist. Their response to a glucose challenge improved but their response to insulin was not significantly altered. The β(2)-agonists are commonly used to treat asthma and asthmatics have an increased incidence of obesity and type 2 diabetes. Although β(2)-agonists cause acute hyperglycemia, chronic treatment improves insulin sensitivity, probably by improving muscle glucose uptake.

  14. Induction of type 3 deiodinase activity in inflammatory cells of mice with chronic local inflammation

    NARCIS (Netherlands)

    A. Boelen (Anita); J. Kwakkel (Joan); A. Alkemade (Anneke); R. Renckens (Rosemarijn); E. Kaptein (Ellen); G.G.J.M. Kuiper (George); W.M. Wiersinga (Wilmar); T.J. Visser (Theo)

    2005-01-01

    textabstractDuring illness, changes in thyroid hormone metabolism occur, so-called nonthyroidal illness (NTI). NTI has been characterized by a fall of serum T 3 due to decreased extrathyroidal conversion of T4 into T3 by liver type 1 deiodinase (D1), without an increase in serum TSH. Type 3 deiodina

  15. Relationship Between Type of Hypertension and Renal Arteriolosclerosis in Chronic Glomerular Disease

    Directory of Open Access Journals (Sweden)

    Keiji Kono

    2016-06-01

    Full Text Available Background/Aims: Hypertension (HT is a common complication in patients with chronic kidney disease (CKD. However, the relationship between circadian rhythm disorder of blood pressure (BP and intra-renal damage remains unclear. Methods: Ninety patients with chronic glomerular disease (CGD were included in the present study. On the basis of the clinic BP (CBP and 24 h-ambulatory BP (ABP measurements, the patients were divided into the following groups; normotension (NT, white coat HT (WHT, masked HT (MHT, and sustained HT (SHT. For renal histopathological assessment, we evaluated each biopsy specimen for sclerotic glomeruli (SG, interstitial fibrosis (IF, intimal thickening of intra-lobular arteries (ILA, and arteriolar hyalinosis (AH. Results: The prevalence of NT, WHT, MHT and SHT was 60.0%, 3.3%, 23.3%, and 13.4%, respectively. Compared with circadian BP pattern, all-day HT was most prevalent in the SHT group, whereas nighttime HT was most prevalent in the MHT group. The results of histological analysis showed that the SHT group had more severe SG and IF and the MHT group had more severe IF compared to the NT group. As for renal arteriolosclerosis, the MHT and SHT groups had more severe AH compared with the NT group, whereas ILA was comparable among all four groups. Furthermore, multivariate analysis revealed that ILA was significantly correlated only with age, whereas AH was significantly correlated with age and HT based on ABP, but not HT based on CBP. Conclusions: Our findings suggest that renal AH was severe not only in the SHT group, but also in the MHT group. Careful ABP monitoring should be recommended in patients with CGD.

  16. Association between type 2 diabetes and chronic arsenic exposure in drinking water: A cross sectional study in Bangladesh

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    Islam Md

    2012-06-01

    Full Text Available Abstract Background Chronic exposure to high level of inorganic arsenic in drinking water has been associated with Type 2 Diabetes (T2D. Most research has been ecological in nature and has focused on high levels of arsenic exposure with few studies directly measuring arsenic levels in drinking water as an index of arsenic exposure. The effect of low to moderate levels of arsenic exposure on diabetes risk is largely unknown thus our study is adding further knowledge over previous works. Methods This cross sectional study was conducted in 1004 consenting women and men from 1682 eligible participants yielding a participation rate of 60%. These participants are aged >30 years and were living in Bangladesh and had continuously consumed arsenic-contaminated drinking water for at least 6 months. T2D cases were diagnosed using glucometer following the new diagnostic criteria (Fasting Blood Glucose > 126 mg/dl from the WHO guideline (WHO 2006, or a self-reported physician diagnosis of type 2 diabetes. Association between T2D and chronic arsenic exposure was estimated by multiple logistic regression with adjustment for age, sex, education, Body Mass Index (BMI and family history of T2D. Results A total of 1004 individuals participated in the study. The prevalence of T2D was 9% (95% CI 7-11%. After adjustment for diabetes risk factors, an increased risk of type 2 diabetes was observed for arsenic exposure over 50 μg/L with those in the highest category having almost double the risk of type 2 diabetes (OR=1.9 ; 95% CI 1.1-3.5. For most levels of arsenic exposure, the risk estimates are higher with longer exposure; a dose–response pattern was also observed. Conclusions These findings suggest an association between chronic arsenic exposure through drinking water and T2D. Risks are generally higher with longer duration of arsenic exposure. The risk of T2D is highest among those who were exposed to the highest concentration of arsenic for more than 10 years.

  17. Chronic daily headache and the revised international headache society classification.

    Science.gov (United States)

    Levin, Morris

    2004-02-01

    Chronic daily headache (CDH) is surprisingly common. It is best defined as a primary headache disorder with head pain on most days. There are a number of possible secondary causes of persistent headache, including traumatic, vascular, neoplastic, and infectious processes, all of which must be ruled out when the patient with frequent headache is evaluated. However, most patients with CDH seem to have a primary neurophysiologic disorder. This category of primary CDH does not seem to be a homogeneous disorder, but rather one with important subtypes. Several authors have proposed subdivisions of primary CDH such as chronic migraine, evolved migraine, transformed migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. The International Headache Society (IHS) Classification published in 1988 did not address CDH other than to define a category "chronic tension-type headache." The revised IHS Classification (ICHD II) attempts to characterize CDH more thoroughly with the addition of chronic migraine and new daily persistent headache diagnoses, but this complex issue continues to defy easy categorization. This article provides a review of thinking about the nature of primary CDH and how ICHD II attempts to organize this category for much needed research purposes.

  18. Association of N-Terminal Pro-B-Type Natriuretic Peptide with Left Ventricular Structure and Function in Chronic Kidney Disease (From the Chronic Renal Insufficiency Cohort [CRIC])

    Science.gov (United States)

    Mishra, Rakesh K.; Li, Yongmei; Ricardo, Ana C.; Yang, Wei; Keane, Martin; Cuevas, Magdalena; Christenson, Robert; DeFilippi, Christopher; Chen, Jing; He, Jiang; Kallem, Radhakrishna R.; Raj, Dominic S.; Schelling, Jeffrey R.; Wright, Jackson; Go, Alan S.; Shlipak, Michael G.

    2017-01-01

    We evaluated the cross-sectional associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cardiac structural and functional abnormalities in a cohort of chronic kidney disease (CKD) patients without clinical heart failure (HF), the Chronic Renal Insufficiency Cohort (n=3,232). Associations of NT-proBNP with echocardiographically determined left ventricular (LV) mass and LV systolic and diastolic function were evaluated by multivariable logistic and linear regression models. Reclassification of participants’ predicted risk of LV hypertrophy (LVH), systolic and diastolic dysfunction was performed using a category-free net reclassification improvement (NRI) index that compared a clinical model with and without NT-proBNP. The median (interquartile range) NT-proBNP was 126.6 pg/ml (55.5–303.7). The highest quartile of NT-proBNP was associated with nearly three-fold odds of LVH (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.8–4.0) and LV systolic dysfunction (2.7, 1.7–4.5) and two-fold odds of diastolic dysfunction (2.0, 1.3–2.9) in the fully adjusted models. When evaluated alone as a screening test, NT-proBNP functioned modestly for the detection of LVH (area under the curve, AUC 0.66) and LV systolic dysfunction (AUC 0.62), and poorly for the detection of diastolic dysfunction (AUC 0.51). However, when added to the clinical model, NT-proBNP significantly reclassified participants’ likelihood of having LVH (NRI 0.14, 95% CI 0.13–0.15; p<0.001) and LV systolic dysfunction (0.28, 0.27–0.30; p<0.001), but not diastolic dysfunction (0.10, 0.10–0.11; p=0.07). In conclusion, in this large CKD cohort without HF, NT-proBNP had strong associations with prevalent LVH and LV systolic dysfunction. PMID:23178053

  19. Preferences and experiences of chronically ill and disabled patients regarding shared decision-making: does the type of care to be decided upon matter?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Spreeuwenberg, P.; Rijken, M.

    2011-01-01

    OBJECTIVE: (1) To describe the importance chronically ill and disabled patients attach to involvement in decision-making when various care types are considered, and (2) to analyse the degree to which these patients are involved in shared decision-making (SDM) regarding these care types, and whether

  20. Chronic liraglutide therapy induces an enhanced endogenous glucagon-like peptide-1 secretory response in early type 2 diabetes.

    Science.gov (United States)

    Kramer, Caroline K; Zinman, Bernard; Choi, Haysook; Connelly, Philip W; Retnakaran, Ravi

    2017-02-09

    Sustained exogenous stimulation of a hormone-specific receptor can affect endogenous hormonal regulation. In this context, little is known about the impact of chronic treatment with glucagon-like peptide-1 (GLP-1) agonists on the endogenous GLP-1 response. We therefore evaluated the impact of chronic liraglutide therapy on endogenous GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) response to an oral glucose challenge. A total of 51 people with type 2 diabetes of 2.6 ± 1.9 years' duration were randomized to daily subcutaneous liraglutide or placebo injection and followed for 48 weeks, with an oral glucose tolerance test (OGTT) every 12 weeks. GLP-1 and GIP responses were assessed according to their respective area under the curve (AUC) from measurements taken at 0, 30, 60, 90 and 120 minutes during each OGTT. There were no differences in AUCGIP between the groups. By contrast, although fasting GLP-1 was unaffected, the liraglutide arm had ~2-fold higher AUCGLP-1 at 12 weeks ( P  < .001), 24 weeks ( P  < .001), 36 weeks ( P  = .03) and 48 weeks ( P  = .03), as compared with placebo. Thus, chronic liraglutide therapy induces a previously unrecognized, robust and durable enhancement of the endogenous GLP-1 response, highlighting the need for further study of the long-term effects of incretin mimetics on L-cell physiology.

  1. Decreased expression levels of Nurr1 are associated with chronic inflammation in patients with type 2 diabetes.

    Science.gov (United States)

    Xu, Ying; Huang, Qi; Zhang, Wenfang; Wang, Yaping; Zeng, Qingling; He, Chunyan; Xue, Junli; Chen, Jin; Hu, Xuemei; Xu, Yancheng

    2015-10-01

    Chronic inflammation is associated with insulin resistance, a characteristic of type 2 diabetes (T2D). Nuclear receptor‑related protein 1 (Nurr1) can regulate inflammation, dependent on the nature of individual diseases. However, whether Nurr1 regulates chronic inflammation during the pathogenic process of T2D in humans remains to be fully elucidated. The present study aimed to investigate the potential association between the expression of Nurr1 in peripheral blood mononuclear cells (PBMCs) and inflammation in patients with T2D. The levels of plasma tumor necrosis factor (TNF)α and interleukin (IL)‑6, the relative expression levels of Nurr1, and glycogen synthase kinase (GSK)‑3β phosphorylation in PBMCs from 40 patients with T2D and 40 healthy controls (HC group) were examined, and their potential association with clinical measures were analyzed. The expression levels of Nurr1, induced by high glucose and palmitic acid, were assessed in the PBMCs from the HC group. Compared with the HC group, significantly higher levels of plasma TNFα and IL‑6 were correlated positively with the degree of insulin resistance in the T2D patients. However, significantly lower expression levels of Nurr1 and GSK‑3β phosphorylation in the PBMCs were correlated negatively with the levels of TNFα, IL‑6, fasting insulin and insulin resistance in the T2D patients. Treatment of the PBMCs with high glucose or palmitic acid inhibited the expression of Nurr1 in a dose‑ and time‑dependent manner. Therefore, decreased expression levels of Nurr1 were associated with chronic inflammation and insulin resistance in patients with T2D.

  2. Program evaluation of Sea Mar’s Chronic Care Program for Latino and Caucasian patients with type 2 diabetes: providers and staff perspectives

    Directory of Open Access Journals (Sweden)

    Bond GE

    2012-09-01

    Full Text Available Gail E Bond,1 Laurie Rechholtz,1 Christina Bosa,1 Celine Impert,1,2 Sara Barker21College of Nursing, Seattle University, Seattle WA, USA; 2Sea Mar Community Health Center, Seattle, WA, USAProblem statement: Unprecedented consumption of health care resources in the USA coupled with increasing rates of chronic disease has fueled pursuit of improved models of health care delivery. The Chronic Care Model provides an organizational framework for chronic care management and practice improvement. Sea Mar, a community health care organization in Washington state, implemented the Chronic Care Model, but has not evaluated the outcomes related to provider and staff satisfaction. The specific aim of this project was to evaluate the effectiveness of the Chronic Care Model with the addition of the Chronic Care Coordinator role.Approach: A descriptive method was used, which incorporated quantitative, and qualitative data from providers and clinic staff collected through a Web-based survey consisting of Likert-type questions sent via an electronic link.Results: This evaluation identified the strengths of and barriers to the chronic care model with a focus on provider and staff satisfaction regarding patient care since the addition of the Chronic Care Coordinator role. We found a high appreciation (94% and acceptance of the role; 80% agreed that the Chronic Care Coordinator was well-integrated into clinic operations. Major strengths of the program included more patient education, better follow-up, and improved team communications. Barriers to success included limited provider access, confusion regarding role expectations of the Chronic Care Coordinator, inconsistent communications, and Chronic Care Coordinator turnover.Conclusions/recommendations: Our findings help to validate the importance of community health organizations such as Sea Mar, the utility of the chronic care model, and the potential value for specific roles such as the Chronic Care Coordinator to

  3. Phagocytosis via complement or Fc-gamma receptors is compromised in monocytes from type 2 diabetes patients with chronic hyperglycemia.

    Directory of Open Access Journals (Sweden)

    Blanca I Restrepo

    Full Text Available Type 2 diabetes patients (DM2 have a higher risk of tuberculosis (TB that may be attributed to functional defects in their mononuclear phagocytes given the critical role of these cells in Mycobacterium tuberculosis containment. Our previous findings suggest that monocytes from DM2 have reduced association with serum-opsonized M. tuberculosis. To determine if this alteration is due to defects in phagocytosis via complement or Fc-gamma receptors (FcγRs, in this study we evaluated the uptake of sheep red blood cells coated with IgG or complement, respectively, by monocytes from individuals with and without DM2. We found that chronic hyperglycemia was significantly associated with reduced phagocytosis via either receptor by univariable and multivariable analyses. This defect was independent of host serum opsonins and flow cytometry data indicated this was not attributed to reduced expression of these phagocytic receptors on DM2 monocytes. The positive correlation between both pathways (R = 0.64; p = 0.003 indicate that monocytes from individuals with chronic hyperglycemia have a defect in the two predominant phagocytic pathways of these cells. Given that phagocytosis is linked to activation of effector mechanisms for bacterial killing, it is likely that this defect is one factor contributing to the higher susceptibility of DM2 patients to pathogens like M. tuberculosis.

  4. Identification of a Lactobacillus plantarum strain that ameliorates chronic inflammation and metabolic disorders in obese and type 2 diabetic mice.

    Science.gov (United States)

    Toshimitsu, T; Mochizuki, J; Ikegami, S; Itou, H

    2016-02-01

    In this study, we identified a strain of lactic acid bacteria (LAB) that induces high levels of IL-10 production by immune cells, and evaluated the ability of the strain to suppress chronic inflammation and ameliorate metabolic disorders in in vitro and in vivo models. Among a collection of LAB strains, Lactobacillus plantarum strain OLL2712 (OLL2712) induced the highest levels of IL-10 production in mouse-derived dendritic cells and peritoneal macrophages. The anti-inflammatory effects of this strain were evaluated using a co-culture system comprising RAW 264.7 and 3T3-L1 cells. We also administered heat-killed OLL2712 to obese and type 2 diabetic KKAy mice for 3 wk to evaluate the in vivo effects of the strain. The OLL2712 significantly decreased the production of proinflammatory cytokines in vitro. Likewise, the administration of OLL2712 significantly suppressed proinflammatory cytokine levels in both the visceral adipose tissue and the serum of KKAy mice, and reduced serum triglyceride concentrations. The strain also alleviated oxidative stress and adrenaline levels in the serum of KKAy mice. On the other hand, Lactobacillus gasseri strain MEP222804 (a moderate IL-10 inducer) did not ameliorate the systemic inflammation and hyperlipidemia in KKAy mice. Our results suggest that treatment with strong IL-10-inducing LAB has the potential to ameliorate metabolic disorders by suppressing chronic inflammation in the host animal.

  5. 4-Hydroxy-2-nonenal, an oxidative stress marker in crevicular fluid and serum in type 2 diabetes with chronic periodontitis

    Directory of Open Access Journals (Sweden)

    A R Pradeep

    2013-01-01

    Full Text Available Objective: Chronic periodontitis (CP is a common, chronic inflammatory disease initiated by bacteria, which has an increased prevalence and severity in patients with type 2 diabetes mellitus (t2 DM. A variety of reactive oxygen species are able to cause direct damage to proteins, deoxyribonucleic acid, carbohydrates and lipids. Lipid peroxidation is always combined with the formation of reactive aldehydes like 4-Hydroxy-2-nonenal (HNE. The purpose of this study was to determine the presence of the HNE-His adducts levels in serum and gingival crevicular fluid (GCF in t2 DM among CP subjects and to find an association, if any. Materials and Methods: A total of 40 subjects (20 males and 20 females were selected based on their clinical parameters into three groups: Group 1 (10 healthy, Group 2 (15 subjects, CP without t2 DM, Group 3 (15 subjects, CP with t2 DM. Serum and GCF samples were collected to estimate the levels of the HNE-His adducts by the enzyme linked immunosorbent assay. Results: The mean HNE-His adducts concentration both in serum and GCF was highest for Group 3 followed by Group 2 and least in Group 1. Conclusions: All samples in each group tested positive for HNE-His adducts assay. Serum and GCF HNE-His adducts concentration both in t2 DM with CP and non-diabetic CP subjects were higher than the healthy controls. Further large scale longitudinal studies should be carried out to confirm positive correlations.

  6. Intestinal neuronal dysplasia type B: A still little known diagnosis for organic causes of intestinal chronic constipation

    Institute of Scientific and Technical Information of China (English)

    Pedro Luiz Toledo de Arruda Louren??o; Simone Antunes Terra; Erika Veruska Paiva Ortolan; Maria Aparecida Marchesan Rodrigues

    2016-01-01

    Intestinal neuronal dysplasia type B(IND-B) is a controversial entity among the gastrointestinal neuromuscular disorders. It may occur alone or associated with other neuropathies, such as Hirschsprung’s disease(HD). Chronic constipation is the most common clinical manifestation of patients. IND-B primarily affects young children and mimics HD, but has its own histopathologic features characterized mainly by hyperplasia of the submucosal nerve plexus. Thus, IND-B should be included in the differential diagnoses of organic causes of constipation. In recent years, an increasing number of cases of IND-B in adults have also been described, some presenting severe constipation since childhood and others with the onset of symptoms at adulthood. Despite the intense scientific research in the last decades, there are still knowledge gaps regarding definition, pathogenesis, diagnostic criteria and therapeutic possibilities for IND-B. However, in medical practice, we continue to encounter patients with severe constipation or intestinal obstruction who undergo to diagnostic investigation for HD and their rectal biopsies present hyperganglionosis in the submucosal nerve plexus and other features, consistent with the diagnosis of IND-B. This review critically discusses aspects related to the disease definitions, pathophysiology and genetics, epidemiology distribution, clinical presentation, diagnostic criteria and therapeutic possibilities of this still little-known organic cause of intestinal chronic constipation.

  7. Effect of two contrasting types of physical exercise on chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Kjaer, Michael; Søgaard, Karen

    2008-01-01

    OBJECTIVE: The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type of ...

  8. Prevalence of chronic complications, metabolic control and nutritional intake in type 1 diabetes

    DEFF Research Database (Denmark)

    Toeller, M; Buyken, A E; Heitkamp, G

    1999-01-01

    and proliferative retinopathy were more common. Persons from the eastern European and the German centres consumed undesirably high amounts of cholesterol, total and saturated fat. Overall, improvements in the prevention, detection and management of diabetes complications in persons with type 1 diabetes...

  9. Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia

    NARCIS (Netherlands)

    Bello, Natalie A; Pfeffer, Marc A; Skali, Hicham; McGill, Janet B; Rossert, Jerome; Olson, Kurt A; Weinrauch, Larry; Cooper, Mark E; de Zeeuw, Dick; Rossing, Peter; McMurray, John J V; Solomon, Scott D

    2014-01-01

    OBJECTIVE: Retinopathy is an established microvascular complication of type 2 diabetes mellitus (T2DM), but its independent relationship with macrovascular and other microvascular complications is less well defined across the spectrum of kidney disease in T2DM. We examined the prognostic value of re

  10. Treatment of chronic regional pain syndrome type 1 with palmitoylethanolamide and topical ketamine cream: modulation of nonneuronal cells

    Directory of Open Access Journals (Sweden)

    Keppel Hesselink JM

    2013-03-01

    Full Text Available Jan M Keppel Hesselink,1 David J Kopsky21Institute for Neuropathic Pain, Bosch en Duin, The Netherlands; 2Institute for Neuropathic Pain, Amsterdam, The NetherlandsAbstract: Chronic regional pain syndrome (CRPS can be intractable to treat and patients sometimes suffer for many years. Therefore, new treatment strategies are needed to alleviate symptoms in CRPS patients. This case report describes a patient suffering from intractable CRPS type 1 for 13 years. Due to her swollen painful feet and left knee she is wheelchair-bound. The combination of palmitoylethanolamide and ketamine 10% cream reduced her pain by more than 50% after 1 month of treatment, and a marked reduction in swelling and skin discoloration was noticed. Furthermore, she could walk independently again and she experienced no side effects. Thus, palmitoylethanolamide and topical ketamine could be a combination therapy option for treating CRPS patients.Keywords: palmitoylethanolamide, ketamine, cream, CRPS, endocannabinoid, sudeck, mast cells

  11. The Effectiveness of Mindfulness-Based Stress Reduction on Perceived Pain Intensity and Quality of Life in Patients With Chronic Headache

    OpenAIRE

    Bakhshani, Nour-Mohammad; Amirani, Ahmadreza; Amirifard, Hamed; Shahrakipoor, Mahnaz

    2015-01-01

    The aim of this study was to determine the effectiveness of Mindfulness-Based Stress reduction (MBSR) on perceived pain intensity and quality of life in patients with chronic headache. Thus, forty patients based on the diagnosis of a neurologist and diagnostic criteria of the International Headache Society (IHS) for migraine and chronic tension-type headache were selected and randomly assigned to the intervention group and control group, respectively. The participants completed the Pain and q...

  12. Failure of itraconazole to prevent T-helper type 2 cell immune deviation: Implications for chronic rhinosinusitis

    Science.gov (United States)

    Kennedy, Joshua L.; Steinke, John W.; Liu, Lixia; Negri, Julie; Borish, Larry

    2016-01-01

    Background: T-helper (Th) type 2 cell inflammation is the hallmark of several disease processes, including asthma, atopic dermatitis, and some forms of chronic rhinosinusitis. Itraconazole has been used as both an antifungal and an anti-inflammatory agent, with some success in many of these diseases, in part, by altering Th2 cytokine expression by T cells. It is not known whether this merely reflects inhibition of established Th2-like cells or the inhibition of differentiation of naive T cells into Th2-like cells. Objective: To evaluate the role of itraconazole in the differentiation of naive T cells during activation. Methods: Naive CD45RA+ T cells were isolated from peripheral blood mononuclear cells from healthy volunteers. Th1 and Th2 type cells were differentiated in the presence of varying concentrations of itraconazole. After stimulation with anti-CD3 and anti-CD28 beads, carboxyfluorescein succinimidyl ester dilution was performed to evaluate proliferation and intracellular cytokine staining for interleukin (IL) 4 and interferon (IFN) gamma within proliferating T cells was measured along with enzyme-linked immunosorbent assay for secreted IL-5, IL-13, and IFN gamma. Results: Itraconazole had no effect on proliferation of unbiased, Th1, or Th2 cells. Similarly, there was no effect of itraconazole on either intracellular cytokine staining of IL-4 and IFN gamma or secreted cytokine expression of IFN gamma, IL-5, and IL-13 in any of the cell populations. Conclusion: Itraconazole did not alter the ability of naive T cells to proliferate or secrete cytokines under Th1 or Th2 deviating conditions in vitro. As such, reported inhibition of Th2-like lymphocyte function by itraconazole reflected action on mature effector cells and may have underscored why antifungal treatment failed in many clinical trials of eosinophilic chronic rhinosinusitis.

  13. Cumulative Effects of Hypertension, Dyslipidemia, and Chronic Kidney Disease on Carotid Atherosclerosis in Chinese Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Chuang Yuan

    2014-01-01

    Full Text Available Aims. The aim of this study is to determine the extent of carotid atherosclerosis in Chinese patients with type 2 diabetes in relation to the cumulative atherosclerosis risk factors using ultrasonography. Methods. The presence of hypertension, dyslipidemia, and chronic kidney disease (CKD was documented in 106 Chinese subjects with type 2 diabetes. Subjects with 0, 1, and ≥2 additional atherosclerosis risk factors were assigned into groups 1, 2, and 3, respectively (n=17, 49, and 40, resp.. Using ultrasound, the carotid arteries were assessed for the presence of carotid plaque, plaque score, intima-media thickness (IMT, and carotid arterial stiffness. Results. With the adjustment for age and gender, the presence of plaque and plaque score were significantly higher in groups with more atherosclerosis risk factors (P 60 years old (odds ratio = 2.75; 95% CI: 1.26–6.0 and the presence of hypertension (odds ratio = 2.48; 95% CI: 1.11–5.58, dyslipidemia (odds ratio = 2.41; 95% CI: 1.05–5.51, and CKD (odds ratio = 7.80; 95% CI: 1.46–41.72 could independently predict higher plaque score (P<0.05. Conclusions. Hypertension, dyslipidemia, and CKD in Chinese patients with type 2 diabetes have cumulative effects on the burden of carotid plaque.

  14. Analgesic effects of intra-articular botulinum toxin Type B in a murine model of chronic degenerative knee arthritis pain

    Directory of Open Access Journals (Sweden)

    Stephanie Anderson

    2010-09-01

    Full Text Available Stephanie Anderson1,2, Hollis Krug1,2, Christopher Dorman1, Pari McGarraugh1, Sandra Frizelle1, Maren Mahowald1,21Rheumatology Section, Veteran’s Affairs Medical Center, Minneapolis, Minnesota; 2Division of Rheumatology and Autoimmune Diseases, University of Minnesota Medical School, Minneapolis, Minnesota, USAObjective: To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B in a murine model of chronic degenerative arthritis pain.Methods and materials: Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior and joint tenderness evaluation (evoked pain response. Strength was measured as ability to grasp and cling.Results: Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.Conclusions: This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis

  15. Cosmic Strings with Small Tension

    CERN Document Server

    Halyo, Edi

    2009-01-01

    We describe cosmic F--term strings with exponentially small tension which are D3 branes wrapped on deformed $A_3$ singularities. We show that brane instanton effects which can be calculated after a geometric transition give rise to an exponentially small volume for the node on which the D3 branes wrap leading to a string with small tension. We generalize our description to the case of non--Abelian cosmic strings and argue that these strings are stable against monopole--anti monopole pair creation.

  16. Potential contribution of Type I lung epithelial cells to chronic neonatal lung disease

    Directory of Open Access Journals (Sweden)

    Henry J. Rozycki

    2014-05-01

    Full Text Available The alveolar surface is covered by large flat Type I cells (alveolar epithelial cells 1, AEC1. The normal physiological function of AEC1s involves gas exchange, based on their location in approximation to the capillary endothelium and their thinness, and in ion and water flux, as shown by the presence of solute active transport proteins, water channels, and impermeable tight junctions between cells. With the recent ability to produce relatively pure cultures of AEC1 cells, new functions have been described. These may be relevant to lung injury, repair and the abnormal development that characterizes bronchopulmonary dysplasia. To hypothesize a potential role for AEC1 in the development of lung injury and abnormal repair/development in premature lungs, evidence is presented for their presence in the developing lung, how their source may not be the Type II cell (AEC2 as has been assumed for forty years, and how the cell can be damaged by same type of stressors as those which lead to bronchopulmonary dysplasia (BPD. Recent work shows that the cells are part of the innate immune response, capable of producing pro-inflammatory mediators, which could contribute to the increase in inflammation seen in early bronchopulmonary dysplasia. One of the receptors found exclusively on AEC1 cells in the lung, called RAGE, may also have a role in increased inflammation, and to alveolar simplification. While the current evidence for AEC1 involvement in BPD is circumstantial and limited at present, the accumulating data supports several hypotheses and questions regarding potential differences in the behavior of AEC1 cells from newborn and premature lung compared with the adult lung.

  17. [Mixed type-II cryoglobulinemia associated with a chronic hepatitis C virus infection].

    Science.gov (United States)

    Suárez, A; Vallina, E; Navascués, C A; Rodríguez, M; Otero, L; Sotorrío, N G; San Román, F; Rodrigo, L

    1993-04-01

    We describe the case of a patient with non A-non B post-transfusional cirrhosis and type-II mixed cryoglobulinemia, who showed in relation with said processes several acute symptoms of vasculitis, polyarthritis, pericarditis and autoimmune hemolytic anemia, finally dying due to an advanced hepatocellular insufficiency. In this patient the determination of antibodies against hepatitis C virus (anti-HCV) was positive, that is why we assume a possible relationship between both processes and the first literature references, after the clonation of the hepatitis C virus (HCV) genome, are reviewed.

  18. Effect of two contrasting types of physical exercise on chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, L.L.; Kjær, Michael; Søgaard, Kirsten;

    2008-01-01

    Objective. The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type...... of training is most effective. Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle (leg bicycling) on work-related neck muscle pain. Methods. We conducted a randomized controlled...

  19. Hyperelastic tension of graphene

    Science.gov (United States)

    Saavedra Flores, E. I.; Ajaj, R. M.; Adhikari, S.; Dayyani, I.; Friswell, M. I.; Castro-Triguero, Rafael

    2015-02-01

    In this paper, we investigate the hyperelastic tensile behaviour of single layer graphene sheets (SLGSs). A one-term incompressible Ogden-type hyperelastic model is chosen to describe the mechanical response of C-C bonds. By establishing equality between the Ogden strain-energy and the variation of the Tersoff-Brenner interatomic potential, three different geometries of SLGSs are studied under tensile loading. We compute the Young's modulus, the finite-deformation Poisson's ratio, ultimate strains, total reactions, and the variation of the potential energy per carbon atom for large strains. Numerical simulations are compared with results obtained by molecular mechanics and molecular dynamics simulations, finite elements, continuum mechanics theory, and experiments. Our predictions are validated, revealing the potential predictive capabilities of the present hyperelastic framework for the analysis of graphene in the context of infinitesimal and large deformations. The good agreement found between our calculations and the published data suggests that graphene may be described as a hyperelastic material.

  20. Abolishing the maximum tension principle

    Directory of Open Access Journals (Sweden)

    Mariusz P. Da̧browski

    2015-09-01

    Full Text Available We find the series of example theories for which the relativistic limit of maximum tension Fmax=c4/4G represented by the entropic force can be abolished. Among them the varying constants theories, some generalized entropy models applied both for cosmological and black hole horizons as well as some generalized uncertainty principle models.

  1. AUTOGENIC THERAPY IN TENSION HEADACHE

    OpenAIRE

    Amruthraj, Brunda; Mishra, H.; Kumaraiah, V.

    1987-01-01

    SUMMARY Ten subjects diagnosed as Psychalgia were taken for study. A multiple baseline design was adapted and clients were subjected to 30 sessions of autogenic training. They were assessed using physiological (EMG and thermal change) and behavioural measures (Visual analogue scale and behavioural symptom checklist). Findings revealed autogenic therapy to be effective in reducing tension headache.

  2. Hyperelastic tension of graphene

    Energy Technology Data Exchange (ETDEWEB)

    Saavedra Flores, E. I., E-mail: erick.saavedra@usach.cl [Departamento de Ingeniería en Obras Civiles, Universidad de Santiago de Chile, Av. Ecuador 3659, Santiago (Chile); Ajaj, R. M. [Aeronautics and Astronautics, University of Southampton, Southampton SO171BJ (United Kingdom); Adhikari, S.; Dayyani, I.; Friswell, M. I. [College of Engineering, Swansea University, Singleton Park, Swansea SA2 8PP (United Kingdom); Castro-Triguero, Rafael [Department of Mechanics, University of Cordoba, Campus de Rabanales, Cordoba CP 14071 (Spain)

    2015-02-09

    In this paper, we investigate the hyperelastic tensile behaviour of single layer graphene sheets (SLGSs). A one-term incompressible Ogden-type hyperelastic model is chosen to describe the mechanical response of C-C bonds. By establishing equality between the Ogden strain-energy and the variation of the Tersoff-Brenner interatomic potential, three different geometries of SLGSs are studied under tensile loading. We compute the Young's modulus, the finite-deformation Poisson's ratio, ultimate strains, total reactions, and the variation of the potential energy per carbon atom for large strains. Numerical simulations are compared with results obtained by molecular mechanics and molecular dynamics simulations, finite elements, continuum mechanics theory, and experiments. Our predictions are validated, revealing the potential predictive capabilities of the present hyperelastic framework for the analysis of graphene in the context of infinitesimal and large deformations. The good agreement found between our calculations and the published data suggests that graphene may be described as a hyperelastic material.

  3. Type of dyslipidemia and achievement of the LDL-cholesterol goal in chronic kidney disease patients at the University Hospital

    Directory of Open Access Journals (Sweden)

    Sangsawang T

    2015-11-01

    Full Text Available Tamon Sangsawang, Apiradee SriwijitkamolDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground: Chronic kidney disease (CKD has been defined as a coronary artery disease risk equivalent. Therefore, the current guideline has been recommended for CKD patients to reach and maintain a low-density lipoprotein-cholesterol (LDL-C goal of less than 100 mg/dL. However, the data regarding the achievement of LDL-C goal in these patients is lacking.Objective: This study was conducted to evaluate the types of dyslipidemia affecting patients with CKD stages 3 and 4 and to determine whether these patients achieved LDL-C goal.Methods: We performed a retrospective chart review of patients with CKD stage 3 or 4 and dyslipidemia who were followed-up at Siriraj Hospital between October 2011 and September 2012.Results: In total, 150 patients with CKD stage 3 or 4 and dyslipidemia were recruited. The mean age was 72±10 years, and the body mass index was 25.6±4 kg/m2; 60% had CKD stage 3 with an estimated glomerular filtration rate of 34±12 mL/min/1.73 m2, and 54% had type 2 diabetes. The percentage of patients with hypercholesterolemia was 78%, hypertriglyceridemia 54%, and low high-density lipoprotein-C 36%. Of these, 52% had mixed hyperlipidemia. Statin treatment was prescribed to 87% of the patients, of which only 31.3% achieved the LDL-C goal according to the National Cholesterol Education Program and the European Society of Cardiology/European Atherosclerosis Society recommendations. Patients who did not achieve the LDL-C goal had a higher cholesterol level at diagnosis and higher prevalence of type 2 diabetes and stroke than those who achieved it.Conclusion: Two-thirds of CKD patients with hyperlipidemia had mixed hyperlipidemia. Despite the high frequency of statin treatment, only one-third of patients with CKD achieved the LDL-C goal. Thus, a developmental plan

  4. Effectiveness of the introduction of a Chronic Care Model-based program for type 2 diabetes in Belgium

    Directory of Open Access Journals (Sweden)

    De Maeseneer Jan

    2010-07-01

    Full Text Available Abstract Background During a four-year action research project (2003-2007, a program targeting all type 2 diabetes patients was implemented in a well-defined geographical region in Belgium. The implementation of the program resulted in an increase of the overall Assessment of Chronic Illness Care (ACIC score from 1.45 in 2003 to 5.5 in 2007. The aim of the follow-up study in 2008 was to assess the effect of the implementation of Chronic Care Model (CCM elements on the quality of diabetes care in a country where the efforts to adapt primary care to a more chronic care oriented system are still at a starting point. Methods A quasi-experimental study design involving a control region with comparable geographical and socio-economic characteristics and health care facilities was used to evaluate the effect of the intervention in the region. In collaboration with the InterMutualistic Agency (IMA and the laboratories from both regions a research database was set up. Study cohorts in both regions were defined by using administrative data from the Sickness Funds and selected from the research database. A set of nine quality indicators was defined based on current scientific evidence. Data were analysed by an institution experienced in longitudinal data analysis. Results In total 4,174 type 2 diabetes patients were selected from the research database; 2,425 patients (52.9% women with a mean age of 67.5 from the intervention region and 1,749 patients (55.7% women with a mean age of 67.4 from the control region. At the end of the intervention period, improvements were observed in five of the nine defined quality indicators in the intervention region, three of which (HbA1c assessment, statin therapy, cholesterol target improved significantly more than in the control region. Mean HbA1c improved significantly in the intervention region (7.55 to 7.06%, but this evolution did not differ significantly (p = 0.4207 from the one in the control region (7.44 to 6

  5. Identification of a selective glucocorticoid receptor ligand for the treatment of chronic inflammation in type 2 diabetes mellitus.

    Science.gov (United States)

    Tan, Haifeng; Wang, Wei; Yin, Xiangang; Li, Yao; Yin, Rui

    2014-10-01

    The present study aimed to identify a new selective glucocorticoid receptor (GR) ligand for the treatment of chronic inflammation in type 2 diabetes mellitus. The IN Cell Analyzer 1000 platform was employed to screen for compounds that may promote GR nuclear translocation. A mammalian two-hybrid system and transactivation assay-were used to analyze the selected GR ligands and evaluate their activities for GR transcription and the recruitment of co-activators. A novel selective GR ligand, compound Q40, was identified that was able to promote GR nuclear translocation in a short period of time. It increased the ability of GR to recruit co-activators in a concentration-dependent manner, but had no positive effect on GR transcriptional activity. In conclusion, an increase in the expression levels of gluconeogeneic genes, induced by the transcriptional activation of GR, is the predisposing factor most commonly associated with the side-effects of glucocorticoids. The results suggest that compound Q40 is a ligand of the GR and exerts an agonistic action on the recruitment of co-activators without sugar dysmetabolism-related side-effects. Thus, compound Q40 has the potential to be used as an anti-inflammatory adjuvant therapy with minimal side-effects in patients with type 2 diabetes mellitus.

  6. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Toshitaka Umemura

    2013-07-01

    Full Text Available Background/Aims: In recent years, the relationship between chronic kidney disease (CKD and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods: Seventy-nine type 2 diabetic patients (mean age, 76.0 years were enrolled in the present study. CKD was defined as the presence of albuminuria and/or a low estimated glomerular filtration rate (eGFR 2. SVD was evaluated by the presence and severity of silent brain infarcts (SBIs and white matter lesions (WMLs on brain magnetic resonance imaging. Neuropsychological tests were assessed using four validated cognitive instruments. Results: In multiple linear regression analyses, albuminuria was associated with worse modified Stroop Color Word scores (β = 0.284, p = 0.017 and low eGFR was associated with reduced Digit Symbol Substitution scores (β = -0.224, p = 0.026 after adjustment for age, sex, education years, diabetes duration, hypertension, multiple SBIs, and advanced WMLs. In contrast, there were no significant associations between CKD markers and Mini-Mental State Examination or Word Recall scores. Conclusion: Our findings suggest that albuminuria and low eGFR are associated with frontal lobe dysfunction independently of SVD in elderly type 2 diabetic patients.

  7. Chronic consumption of rebaudioside A, a steviol glycoside, in men and women with type 2 diabetes mellitus.

    Science.gov (United States)

    Maki, K C; Curry, L L; Reeves, M S; Toth, P D; McKenney, J M; Farmer, M V; Schwartz, S L; Lubin, B C; Boileau, A C; Dicklin, M R; Carakostas, M C; Tarka, S M

    2008-07-01

    This trial evaluated the effects of 16 weeks of consumption of 1000mg rebaudioside A (n=60) a steviol glycoside with potential use as a sweetener, compared to placebo (n=62) in men and women (33-75 years of age) with type 2 diabetes mellitus. Mean+/-standard error changes in glycosylated hemoglobin levels did not differ significantly between the rebaudioside A (0.11+/-0.06%) and placebo (0.09+/-0.05%; p=0.355) groups. Changes from baseline for rebaudioside A and placebo, respectively, in fasting glucose (7.5+/-3.7mg/dL and 11.2+/-4.5mg/dL), insulin (1.0+/-0.64microU/mL and 3.3+/-1.5microU/mL), and C-peptide (0.13+/-0.09ng/mL and 0.42+/-0.14ng/mL) did not differ significantly (p>0.05 for all). Assessments of changes in blood pressure, body weight, and fasting lipids indicated no differences by treatment. Rebaudioside A was well-tolerated, and records of hypoglycemic episodes showed no excess vs. placebo. These results suggest that chronic use of 1000mg rebaudioside A does not alter glucose homeostasis or blood pressure in individuals with type 2 diabetes mellitus.

  8. CALCULATION OF TENSION FORCE OF BELT CONVEYOR

    Directory of Open Access Journals (Sweden)

    Ismet Ibishi

    2012-12-01

    Full Text Available In this paper is done the explanation on tension fashion of the belt conveyor which is employed in Kosovo Energy Corporation – KEK, for coal transportation to provide electric power plant. The aim of the paper enables to recognize tension forces not to pass with deformation of belt so that this problem will damage the workingprocess. Work principle is based on initial tension and tension during working process. The fact is known that the tension starts from the carriage on the way to tension mechanization, so forces on the rope passing through pulley there has to dominate the friction coefficient. All this process is related to economy of transportationmechanism.

  9. The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis

    Directory of Open Access Journals (Sweden)

    Reza Hekmat

    2009-03-01

    Full Text Available Background: Identifying the sources of variation in QTc measurementsis important for preventing arrhythmias during and afterhemodialysis. The present study was designed to determine thecorrelation between the type of hemodialysis buffer and thechanges in QTc interval in patients on chronic hemodialysis.Methods: Fifty-nine patients on chronic hemodialysis whoreferred in winter 2007 to hemodialysis centers of Ghaem andHashemi Nejad hospitals, in Mashhad, Iran, were divided intotwo groups according to their last dialysate buffer: acetate orbicarbonate. Electrocardiography, arterial blood gas parameters,serum K+, Na+, ionized calcium, and albumin levels weremeasured prior to and after hemodialysis in all patients.Results: All arterial blood gas parameters and serum electrolytesconcentrations were increased except K+ levels that weresignificantly decreased with hemodialysis. PCO2 and QTc intervalswere slightly increased in all patients, however thisincrease was not statistically significant. We found that thetype of dialysate affected the QTc interval, HCO3, base excess,base excess of extra cellular fluid, and base bufferchanges with no effect on ionized calcium, pH, PCO2, andserum albumin concentration. QTc interval was prolonged byusing bicarbonate and shortened by using acetate dialysatebuffer. We found no correlation between the variations of QTcinterval and serum electrolytes or arterial blood gas parametersin either group.Conclusion: Bicarbonate buffer use in hemodialysis prolongedQTc interval and acetate buffer shortened it. This effectis independent of serum electrolytes and pH changes duringhemodialysis. The effect of bicarbonate buffer is probablydue to more tolerability of ultra filtration, more effectiveedema reduction and augmented body electro-conductivity.

  10. Real-time PCR strategy for the identification of Trypanosoma cruzi discrete typing units directly in chronically infected human blood.

    Science.gov (United States)

    Muñoz-San Martín, Catalina; Apt, Werner; Zulantay, Inés

    2017-04-01

    The protozoan Trypanosoma cruzi is the causative agent of Chagas disease, a major public health problem in Latin America. This parasite has a complex population structure comprised by six or seven major evolutionary lineages (discrete typing units or DTUs) TcI-TcVI and TcBat, some of which have apparently resulted from ancient hybridization events. Because of the existence of significant biological differences between these lineages, strain characterization methods have been essential to study T. cruzi in its different vectors and hosts. However, available methods can be laborious and costly, limited in resolution or sensitivity. In this study, a new genotyping strategy by real-time PCR to identify each of the six DTUs in clinical blood samples have been developed and evaluated. Two nuclear (SL-IR and 18S rDNA) and two mitochondrial genes (COII and ND1) were selected to develop original primers. The method was evaluated with eight genomic DNA of T. cruzi populations belonging to the six DTUs, one genomic DNA of Trypanosoma rangeli, and 53 blood samples from individuals with chronic Chagas disease. The assays had an analytical sensitivity of 1-25fg of DNA per reaction tube depending on the DTU analyzed. The selectivity of trials with 20fg/μL of genomic DNA identified each DTU, excluding non-targets DTUs in every test. The method was able to characterize 67.9% of the chronically infected clinical samples with high detection of TcII followed by TcI. With the proposed original genotyping methodology, each DTU was established with high sensitivity after a single real-time PCR assay. This novel protocol reduces carryover contamination, enables detection of each DTU independently and in the future, the quantification of each DTU in clinical blood samples.

  11. Prevalence and factors affecting occurrence of type 2 diabetes mellitus in Saudi patients with chronic liver disease

    Directory of Open Access Journals (Sweden)

    Singal Ashwani

    2008-01-01

    Full Text Available Background/Aim: Type 2 diabetes mellitus (DM-2 is more common in patients with chronic liver disease (CLD in general and chronic hepatitis C virus (HCV infection in particular. We aimed to determine the prevalence and factors affecting the occurrence of DM-2 in Saudi patients with CLD. Materials and Methods: Retrospective study at the King Fahd Central Hospital (KFCH, Gizan, Saudi Arabia. A total of 277 patients with either cirrhosis (CH or hepatocellular carcinoma (HCC were analyzed for patient demographics, severity of liver disease, HBsAg, and anti-HCV, associated diseases including DM-2, and presence of HCC. The prevalence of DM-2 was also estimated in 400 age- and sex-matched Saudi patients admitted for various nonliver diseases (control group. Chi-square test, univariate analysis, and multivariate regression. Results: Prevalence of DM-2 in patients with CH was higher than in controls (19.2 vs. 9.2%; P = 0.001. Although those with HCC had a higher prevalence, the difference was not significant (10.9 vs. 9.2%; P = 0.5. Seventy-six percent of patients with HCC had associated CH. On multivariate analysis, age and hypertension were more common in diabetics. Although patients with HCV-related disease had a higher prevalence of DM-2 compared to HBV-related disease, the difference was not significant (26.3 vs. 15.7%; P > 0.05. Conclusions: DM-2 occurred more frequently in CLD patients, particularly in cirrhotics. Age and hypertension predicted the occurrence of DM-2. Small sample size of patients with HCV-related CH probably precluded higher prevalence of DM-2 in them.

  12. 可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折%Absorbable thread tension with the needle was merged cross ifxed treat children chronic humerus lateral condyle fracture

    Institute of Scientific and Technical Information of China (English)

    江政晃; 余舒鹏

    2016-01-01

    目的:探讨可吸收线张力带合并克氏针治疗儿童陈旧性肱骨外髁骨折的治疗效果及儿童肱骨外髁骨折治疗的注意事项和经验。方法回顾性研究2014年1月至2016年1月江西中医药大学附属医院收治的18例陈旧性肱骨外髁骨折患儿临床资料,均采用可吸收线张力带合并克氏针交叉固定治疗,术后定期随访患儿骨折愈合情况。结果18例患儿均获得随访。骨折愈合时间4~12周,平均6周。无术后感染、神经损伤、肱骨小头缺血坏死、骨不连等并发症。肘关节活动根据 hardacre的疗效标评估,优16例(88.9%),良2例(11.1%)。结论可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折获得较为满意的治疗效果;肱骨外髁骨折骨折的处理第一要务就是在于早期的诊断,及时正确的治疗,防止陈旧性肱骨外髁骨折的产生,而对于陈旧性肱骨外髁骨折的早期手术治疗却能够使得肘关节的外观和功能得到有效的纠正。%Objective to explore the absorbable thread tension with the needle was merged the curative effect of treating children chronic humerus lateral condyle fracture and children humerus condyle fracture treatment considerations and experience.Methods retrospective study between January 2014 and January 2014 in jiangxi university of traditional Chinese medicine affiliated hospital of 18 cases of pulmonary humerus lateral condyle fracture with clinical data, adopts absorbable thread tension with the needle was merged cross fixed treatment, postoperative follow-up on a regular basis with fracture healing.Results 18 cases were follow-up. Fracture healing time 4 ~ 12 weeks, 6 weeks on average. No postoperative infection, nerve injury, capitellum complications such as ischemic necrosis, bone nonunion. Elbow movement according to the curative effect of hardacre standard evaluation, optimal 16 cases (88.9%), good in 2 cases (11

  13. Cardiac mitochondrial damage and biogenesis in a chronic model of type 1 diabetes.

    Science.gov (United States)

    Shen, Xia; Zheng, Shirong; Thongboonkerd, Visith; Xu, Ming; Pierce, William M; Klein, Jon B; Epstein, Paul N

    2004-11-01

    Diabetic cardiomyopathy is a common complication leading to heightened risk of heart failure and death. In the present report, we performed proteomic analysis on total cardiac proteins from the OVE26 mouse model of type 1 diabetes to identify protein changes that may contribute to diabetic cardiomyopathy. This analysis revealed that a surprising high proportion (12 of 20) of the altered proteins that could be identified by mass spectrometry were of mitochondrial origin. All but one of these proteins were upregulated by diabetes. Quantitative RT-PCR, performed for two of these proteins, indicated that part of the upregulation was attributed to increased messenger RNA levels. Morphological study of diabetic hearts showed significantly increased mitochondrial area and number as well as focal regions with severe damage to mitochondria. Diabetic mitochondria also showed reduced respiratory control ratio (9.63 +/- 0.20 vs. 6.13 +/- 0.41, P factor A and two mitochondrial encoded proteins. Taken together, these results show that mitochondria are a primary target in the diabetic heart, probably due to oxidative stress, and that this damage coincides with and may stimulate mitochondrial biogenesis.

  14. Influence of acupuncturing Feng-fu acupoint on jaw-opening reflex of rats with tension-type headache%针刺风府穴对紧张型头痛大鼠张颌反射的影响

    Institute of Scientific and Technical Information of China (English)

    吴宏赟; 王希友; 王福文; 侯书伟

    2014-01-01

    Objective To explore the influence of acupuncturing Feng-fu acupoint on amplitude and latency of jaw-opening reflex (JOR) of rats with tension-type headache (TTH). Methods The TTH rat model was prepared by injecting ATP into rats' bilateral semispinalis capitis. 40 SPF-Wistar rats weighting 220-260 g, half male and half female, were divided into four groups: blank group, model group, Feng-fu acupoint group and non-acpoint group. Change of pain threshold and sensitivity of muscle and fascia in head and neck was observed by making quantitative analysis on JOR amplitude and latency of TTH model rats. Results No change of JOR's amplitude and latency was caused in blank group with NS injected into semispinalis capitis (P>0.05), JOR's amplitude was decreased in model group with ATP in-jected (P0.05), JOR's amplitude was increased and latency was shortened in Feng-fu acupoint group, JOR's amplitude was increased in non-acupoint group (P 0.05). Compared with model group, JOR's amplitude and latency of Feng-fu acupoint group were increased remarkably (P 0.05). Compared with non-acupoint group, JOR's amplitude of Feng-fu acupoint group was increased observably (P 0.05). Conclusion Acupuncturing Feng-fu acupoint could increase JOR's amplitude and extend its latency, in oth-er words, it can increase pain threshold and decrease sensitivity of muscle and fascia in head and neck.%目的:探索针刺风府穴对紧张型头痛大鼠张颌反射波幅和潜伏期的影响。方法采用大鼠双侧半棘肌注射三磷酸腺苷二钠注射液(ATP)的方法制备紧张型头痛大鼠模型。体重220~260 g的SPF级Wistar大鼠40只,雌雄各半,分为空白组、模型组、风府穴组和假穴组四组,通过定量分析紧张型头痛模型大鼠张颌反射波幅及潜伏期,反映头颈部皮肤肌肉筋膜痛阈及敏感性变化。结果空白组半棘肌注射生理盐水不引起张颌反射波幅及潜伏期变化(P>0.05);模型组半棘肌注射ATP导

  15. Prevalence of Chronic Complications in Korean Patients with Type 2 Diabetes Mellitus Based on the Korean National Diabetes Program

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    Sang Youl Rhee

    2011-10-01

    Full Text Available BackgroundThe Korean National Diabetes Program (KNDP cohort study is performing an ongoing large-scale prospective multicenter investigation to discover the pathogenesis of type 2 diabetes in Korean patients. This study was performed to examine the prevalence of chronic complications in patients with type 2 diabetes among those registered in the KNDP cohort within the past 4 years.MethodsThis study was performed between June 2006 and September 2009 at 13 university hospitals and included 4,265 KNDP cohort participants. Among the participants, the crude prevalence of microvascular and macrovascular diseases of those checked for diabetes-related complications was determined, and the adjusted standard prevalence and standardization of the general population prevalence ratio (SPR was estimated based on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES population demographics.ResultsAmong the KNDP registrants, 43.2% had hypertension, 34.8% had dyslipidemia, 10.8% had macrovascular disease, and 16.7% had microvascular disease. The SPR of the KNDP registrants was significantly higher than that of the KNHANES subjects after adjusting for demographics in the KNHANES 2005 population. However, with the exception of cardiovascular disease in females, the standardized prevalence for the most complicated items in the survey was significantly higher than that in the KNHANES subjects.ConclusionThe prevalence of macrovascular disease and peripheral vascular disease were significantly higher in Korean patients with type 2 diabetes than in the normal population. However, no significant difference was noted in the prevalence of cardiovascular disease in females.

  16. Identification of herpesvirus types 1-8 in oral cavity of children/adolescents with chronic renal failure.

    Science.gov (United States)

    Otero, Renata; Martins, Carla; Ferreira, Dennis; Benati, Fabricio; Santos, Norma; Castro, Gloria

    2011-09-01

    The aim of this investigation was to identify the prevalence of herpesvirus types 1-8 in the oral cavity of subjects with chronic renal failure (CRF) and healthy subjects and compare the two groups, and also correlate the presence of the virus with some characteristics of CRF disease (the type of treatment, drugs administered for CRF and the presence of oral manifestations). The sample was made up of 60 subjects (aged 4-20) divided into the renal group (RG) and healthy group. Anamnesis, intraoral examination and collection of clinical specimens (swab smears) were carried out. The nested-PCR technique was used to identify the viral species. The results showed a higher prevalence of HSV-1 (20%), human herpes virus (HHV)-6B (83%), CMV (13.3%) in RG group than in healthy group (HSV-1: 3.3%; HHV-6B: 20%) (P ≤ 0.05). There was no difference in the prevalence of HHV-7 between the two groups (P > 0.05). HSV-2, EBV, VZV, HHV-6A, and HHV-8 were not identified in either group. The most common symptoms in RG were dry-mouth sensation (60%), changes in taste (33.3%), and uremic odor (26.7%). There was a correlation between HHV-7 and the use of anticoagulants and HHV-6B with dry-mouth sensation (P ≤ 0.05). Based on the results, the prevalence of herpesvirus types (HSV-1, HHV-6B and CMV) were shown to be higher in subjects with CRF as well as in healthy children, but only the HHV-6B and HHV-7 were correlated with some of the disease characteristics. So, more attention should be paid to the oral health of these individuals in order to prevent infection by opportunistic pathogens.

  17. Risk Factors for Eating Disturbances in Young People with Type 1 Diabetes and Chronic Asthma: The Role of Parenting Style and Self-Esteem.

    OpenAIRE

    Hatton, J.

    2014-01-01

    Background Research indicates that eating disturbances are twice as prevalent among adolescents with type 1 diabetes compared to their healthy peers; comparisons with other chronic illness groups are inconclusive. Adolescent self-esteem and parenting factors have been found to be associated with eating disturbances in type 1 diabetes. However, to date the literature is methodologically limited by a lack of comparison group, and has failed to consider the role of parent care and overprotect...

  18. Application of KDIGO classifcation of chronic kidney disease for analyzing the prevalence of kidney disease and other vascular diseases in 1645 type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    李明

    2014-01-01

    Objective To analyze the prevalence,risk factors of kidney disease in type 2 diabetic patients with KDIGO classification of chronic kidney disease,and to study cardiovascular and cerebrovascular diseases and death in these patients,so as to investigate the significance of the KDIGO classification system.Methods One thousand six hundred and forty-five type 2 diabetic patients who were in

  19. Prevalence of chronic complications of type 2 diabetes mellitus in outpatients - a cross-sectional hospital based survey in urban China

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    Wang Weibing

    2010-06-01

    Full Text Available Abstract Background Chronic complications are the major outcome of type 2 diabetes mellitus progress, which reduce the quality of life of patients, incur heavy burdens to the health care system, and increase diabetic mortality. The aims of this study were to describe the prevalence of chronic complications among urban Chinese type 2 diabetic outpatients; and to analyze the associations between chronic complications and patients' demographics, diabetic related clinical characteristics. Methods This cross-sectional hospital-based study was carried out in 4 major Chinese cities: - Shanghai, Chengdu, Beijing and Guangzhou. The survey was conducted from March to July in 2007 among 1,524 type 2 diabetic outpatients. The subjects were interviewed face-to-face by trained interviewers using a questionnaire to capture information on demographics, disease presentations and complications. All the subjects were invited to have a HbA1c test free of charge by the standardized method with Bio-Rad Variant II. Results Of the 1,524 study subjects, 637 (41.8% were male, and the mean age was 63.3 ± 10.2 years. At least one chronic complication was diagnosed in 792 individuals (52.0% of the study subjects; 509 (33.4% presented with macrovascular complications and 528 (34.7% with microvascular complications. The prevalence of cardiovascular and cerebrovascular conditions, neuropathy, nephropathy, ocular lesions and foot disease were 30.1%, 6.8%, 17.8%, 10.7%, 14.8% and 0.8%, respectively. The prevalence of chronic complications varied between cities, and significantly increased with age and duration of diagnosed diabetes. The mean of HbA1c in diabetic patients with chronic complications was 8.2% ± 1.6% and 63.0% of the subjects with type 2 diabetes related complications had a poor glycemic control with the HbA1c > 7.5%. Conclusions Chronic complications are highly prevalent among type 2 diabetic outpatients, the glycemic control of diabetic patients with chronic

  20. Tensions of Corporate Social Responsibility

    DEFF Research Database (Denmark)

    Strand, Robert

    I engaged with the top management team (TMT) and employees of American Cafes Corporation as an action/intervention researcher in the 20 months immediately following the TMT’s decision to formalize the company’s corporate social responsibility (CSR) activities. This led to the establishment...... CSR agenda is considered, which brings with it a multiplicity of substantively rational ends for which the corporation could pursue. I show the CSR bureaucracy can create a space for reflection in which the multiplicity of substantively rational ends can be considered, negotiated, and selected...... for reflection within the corporation. But I also show tensions can arise from the establishment of the CSR bureaucracy itself. This suggests the CSR bureaucracy itself resides in a tension....

  1. Detection of mixed populations of wild-type and YMDD hepatitis B variants by pyrosequencing in acutely and chronically infected patients

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    Mello Francisco C A

    2012-07-01

    Full Text Available Abstract Background Lamivudine (LAM is associated with the highest known rate of resistance mutations among nucleotide analogs used to treat chronic hepatitis B virus (HBV infection. Despite this, LAM continues in widespread use, especially in combination therapies. The primary LAM resistance mutation (rtM204V/I occurs in the YMDD motif of HBV polymerase. The aim of this study was to characterize Brazilian HBV isolates from acute and chronic cases by direct sequencing, and to identify HBV quasispecies in the YMDD motif using a pyrosequencing method capable of detecting single-nucleotide polymorphisms. HBV DNA from serum samples of 20 individuals with acute HBV infection and 44 with chronic infection undergoing antiviral therapies containing LAM were analyzed by direct sequencing and pyrosequencing methods. Results Phylogenic analyses of direct-sequenced isolates showed the expected genotypes (A, D and F for the Brazilian population in both acute and chronic infections. However, within genotype A isolates, subgenotype A2 was more frequently detected in acute cases than in chronic cases (P = 0.012. As expected, none of the individuals with acute hepatitis B had LAM-resistant isolates as a dominant virus population, whether detected by direct sequencing or pyrosequencing. However, pyrosequencing analyses showed that 45% of isolates (9/20 had minor subpopulations (4-17% of LAM-resistant isolates. Among chronic patients undergoing LAM treatment, YMDD mutants were frequently found as a dominant virus population. In cases where wild-type virus was the dominant population, subpopulations of YMDD variants were usually found, demonstrating the complexity of HBV quasispecies. Conclusions YMDD variants were frequently detected as a minor population in acute HBV infection. The occurrence of pre-existing variants may lead to a high frequency of resistant mutants during antiviral therapy in the chronic phase. In chronic infection, detection of YMDD

  2. Robust Tensioned Kevlar Suspension Design

    Science.gov (United States)

    Young, Joseph B.; Naylor, Bret J.; Holmes, Warren A.

    2012-01-01

    One common but challenging problem in cryogenic engineering is to produce a mount that has excellent thermal isolation but is also rigid. Such mounts can be achieved by suspending the load from a network of fibers or strings held in tension. Kevlar fibers are often used for this purpose owing to their high strength and low thermal conductivity. A suite of compact design elements has been developed to improve the reliability of suspension systems made of Kevlar.

  3. Type 1 diabetes stigma in China: a call to end the devaluation of individuals living with a manageable chronic disease.

    Science.gov (United States)

    Jaacks, Lindsay M; Liu, Wei; Ji, Linong; Mayer-Davis, Elizabeth J

    2015-02-01

    Stigma is a significant barrier to improving care for individuals with type 1 diabetes mellitus (T1DM). This commentary describes this phenomenon in China, where stigma has led to labeling and devaluing of individuals with T1DM. Difficulties finding a spouse and regulations restricting admission to universities and government employment have forced many individuals to hide their diabetes. The shame, fear, and guilt stemming from stigma may preclude the use of insulin pumps; multiple daily injections, which require pre-meal insulin dosing at school or the workplace; participation in research studies; and general health-seeking behaviors. A multifaceted, multilevel approach is urgently needed and should involve improving public awareness and understanding of T1DM; adoption by health care providers of holistic rather than biomedical approaches to disease management; patient counseling on positive coping skills; and expansion of the scope of research to consider the psychosocial realities of diabetes care in China. Recent media attention in the form of a nationally broadcasted documentary on T1DM is an important step in the right direction. We believe that coordinated action by multiple stakeholders can lead to meaningful improvements in treatment, ultimately leading to better physical and emotional health outcomes for individuals living with this manageable chronic disease.

  4. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child

    Science.gov (United States)

    Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    ABSTRACT% Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219. PMID:25709306

  5. Chronic Endotoxemia in Subjects with Type-1 Diabetes Is Seen Much before the Onset of Microvascular Complications.

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    Vivekanandhan Aravindhan

    Full Text Available Lipopolysaccharide (LPS/Endotoxin is hypothesized to play an important role in chronic inflammation associated with Type-1 diabetes (T1DM and its complications. Endotoxin core antibodies (EndoCAb, LPS binding protein (LBP and soluble CD14 (sCD14 act as modulators of LPS induced activation of innate immune system in vivo. For the present study we estimated the levels of LPS and its translocation markers in T1DM subjects with and without microvascular complications (MVC and correlate them with clinical parameters of T1DM and serum inflammatory cytokine levels (TNF-α, IL-6, IL-1β and GM-CSF.A total of 197 subjects (64 normal glucose tolerance (NGT subjects, 97 T1DM subjects without MVC and 36 with MVC were included in this study and the levels of serum LPS, its translocation markers and cytokines measured by immunoassays.Compared to NGT, T1DM subjects (both with and without MVC had significantly higher levels of LPS, reduced levels of LBP and EndoCAb along with significant increase in the levels of IL-1β, IL-6, TNF-α and GM-CSF (p<0.05. No significant change was seen in the levels of these biomarkers between T1DM subjects with and without MVC.Decreased levels of EndoCAb and LBP suggest sustained endotoxin activity in T1DM subjects even before the onset of microvascular complications.

  6. Use of dipeptidyl peptidase-4 inhibitors for the treatment of patients with type 2 diabetes mellitus and chronic kidney disease.

    Science.gov (United States)

    Mikhail, Nasser

    2012-07-01

    Choices of antidiabetic agents for patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) are limited. Available data suggest that the use of dipeptidyl peptidase-4 (DPP-4) inhibitors may be safe in patients at various stages of renal insufficiency. However, except for linagliptin, dosage adjustment is necessary. The efficacy of DPP-4 inhibitors in patients with renal insufficiency is generally similar to that of the general population with T2DM, with reductions in mean glycated hemoglobin (HbA(1c)) levels of 0.7% to 1.0% compared with baseline, and 0.4% to 0.7% compared with placebo. The frequency of moderate hypoglycemia is 21% to 80% higher with DPP-4 inhibitors compared with placebo, but the frequency of severe hypoglycemia is similar to that with placebo. The use of DPP-4 inhibitors in patients with renal insufficiency is associated with a slight weight loss of pioglitazone. They can also be used as add-on therapy to glipizide and/or pioglitazone in patients with HbA(1c) levels < 9%, but studies are needed to evaluate these combinations in patients with renal insufficiency. Long-term and large-scale clinical trials are underway to better determine the safety and efficacy of DPP-4 inhibitors in patients with T2DM with and without CKD.

  7. A CONTROVERSIAL ON THE DIAGNOSIS OF CHRONIC BULLOUS TYPE MUCOCUTANEOUS DISEASE INVOLVING ORAL MUCOSA (A CASE REPORT

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    Isadora Gracia

    2006-04-01

    Full Text Available A case of chronic bullous type mucocutaneous disease involving oral mucosa was reported from a 56 years old man with never healing oral ulcers and wound on the perianal skin for three years. There were also red and black spots on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidasis with differential diagnosis pemphigus vegetates and acuminarum condiloma. However the histopathologic examination did not support these diagnosis. After several histopathologic examinations, the latest perianal skin diagnosis was lichen planus with differential diagnosis granulomatous vasculitis, bowenoid papulosis and pyodema gangrenosum. Other skin diagnosis was erythema multiforme. Oral diagnosis was mucous membrane pemphigoid with differential diagnosis lichen planus, Behçet's syndrome and erythema multiforme. Oral histopathologic examinations showed a sub-epithelial blister, which supported mucous membrane pemphigoid. A lip balm, prednisone 5 mg oral rinse and multivitamins were given but oral improvement started after blood sugar level was controlled. Conclusion: It is not yet known whether skin and oral mucous lesions are from the same disease or not.

  8. Heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B: Quantification by dynamic CTA

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Tim F. [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: tim.weber@med.uni-heidelberg.de; Ganten, Maria-Katharina [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: m.ganten@dkfz.de; Boeckler, Dittmar [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: dittmar.boeckler@med.uni-heidelberg.de; Geisbuesch, Philipp [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: philipp.geisbuesch@med.uni-heidelberg.de; Kauczor, Hans-Ulrich [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: hu.kauczor@med.uni-heidelberg.de; Tengg-Kobligk, Hendrik von [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: h.vontengg@dkfz.de

    2009-12-15

    Purpose: The purpose of this study was to characterize the heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B (CADB). Materials and methods: Electrocardiogram-gated computed tomography angiography was performed during inspiratory breath-hold in 11 patients with CADB: Collimation 16 mm x 1 mm, pitch 0.2, slice thickness 1 mm, reconstruction increment 0.8 mm. Multiplanar reformations were taken for 20 equidistant time instances through both ascending (AAo) and descending aorta (true lumen, DAoT; false lumen, DAoF) and the vertex of the aortic arch (VA). In-plane vessel displacement was determined by region of interest analysis. Results: Mean displacement was 5.2 {+-} 1.7 mm (AAo), 1.6 {+-} 1.0 mm (VA), 0.9 {+-} 0.4 mm (DAoT), and 1.1 {+-} 0.4 mm (DAoF). This indicated a significant reduction of displacement from AAo to VA and DAoT (p < 0.05). The direction of displacement was anterior for AAo and cranial for VA. Conclusion: In CADB, the thoracic aorta undergoes a heartbeat-related displacement that exhibits an unbalanced distribution of magnitude and direction along the thoracic vessel course. Since consecutive traction forces on the aortic wall have to be assumed, these observations may have implications on pathogenesis of and treatment strategies for CADB.

  9. Comparison of the number of gingival blood vessels between type 2 diabetes mellitus and chronic periodontitis patients: An immunohistological study

    Science.gov (United States)

    Penmetsa, Gautami Subhadra; Baddam, Satyanarayana; Manyam, Ravikanth; Dwarakanath, Chinni Doraswamy

    2015-01-01

    Background: The relationship between diabetes and periodontitis has been studied for more than 50 years and is generally agreed that the periodontal disease is more prevalent in diabetic patients compared to nondiabetics. Vascular changes like increased thickness of basement membrane in small vessels has been reported in diabetic patients, but the quantity of blood vessels in gingiva of diabetic patients has not been discussed much. The aim of this study was to compare the number of blood vessels in gingiva between chronic periodontitis (CP) patients, CP with diabetes (type 2), and normal healthy gingiva. Materials and Methods: The study included 75 patients, divided into three groups of 25 patients each-Group I with healthy periodontium (HP), Group II with CP, and Group III with CP with diabetes mellitus (CPDM). Gingival biopsies were obtained from the subjects undergoing crown lengthening procedure for Group I, and in patients with CP and in CPDM biopsies were collected from teeth undergoing extraction. Sections were prepared for immune histochemical staining with CD34. Results: Difference was observed in the average number of blood vessels when compared between HP, CP, and CPDM groups. Statistical significant difference was observed when the HP and CP groups and HP and CPDM groups were compared. Conclusion: The results of the study indicated that the number of blood vessels in gingival connective tissue is significantly higher in CP and CPDM patients. PMID:26015666

  10. Comparison of the number of gingival blood vessels between type 2 diabetes mellitus and chronic periodontitis patients: An immunohistological study

    Directory of Open Access Journals (Sweden)

    Gautami Subhadra Penmetsa

    2015-01-01

    Full Text Available Background: The relationship between diabetes and periodontitis has been studied for more than 50 years and is generally agreed that the periodontal disease is more prevalent in diabetic patients compared to nondiabetics. Vascular changes like increased thickness of basement membrane in small vessels has been reported in diabetic patients, but the quantity of blood vessels in gingiva of diabetic patients has not been discussed much. The aim of this study was to compare the number of blood vessels in gingiva between chronic periodontitis (CP patients, CP with diabetes (type 2, and normal healthy gingiva. Materials and Methods: The study included 75 patients, divided into three groups of 25 patients each-Group I with healthy periodontium (HP, Group II with CP, and Group III with CP with diabetes mellitus (CPDM.Gingival biopsies were obtained from the subjects undergoing crown lengthening procedure for Group I, and in patients with CP and in CPDM biopsies were collected from teeth undergoing extraction. Sections were prepared for immune histochemical staining with CD34. Results: Difference was observed in the average number of blood vessels when compared between HP, CP, and CPDM groups. Statistical significant difference was observed when the HP and CP groups and HP and CPDM groups were compared. Conclusion: The results of the study indicated that the number of blood vessels in gingival connective tissue is significantly higher in CP and CPDM patients.

  11. Demography, types, outcome and relationship of surgically treated intracranial suppuration complicating chronic suppurative otitis media and bacterial rhinosinusitis

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    Olufemi Emmanuel Idowu

    2014-01-01

    Full Text Available Introduction: Surgically treated intracranial suppurations (ICS are uncommon, life-threatening neurosurgical emergencies. They can result from complication of chronic suppurative otitis media (CSOM and bacterial rhinosinusitis (BRS. The objective of this study was to know the frequency of BRS and CSOM and relate it to its rare complication of surgically treated ICS while also describing the demography, type and outcome of ICS that resulted from BRS and CSOM. Materials and Methods: All patients that presented to the Otorhinolaryngological department and Neurosurgical unit of the same institution with clinical and radiological features of CSOM, BRS, and ICS were prospectively studied over a 5-year period. Patients were followed up for a minimum of 3 months. Results: Two thousand, two hundred and seventy-nine patients presented during the 5-year study period. Of all these patients, 1511 had CSOM (66.3% and 768 (33.7% presented with features of BRS. Eleven (0.73% had ICS complicating their CSOM while 8 (1.04% cases of surgically treated ICS followed BRS. Bacterial rhinosinusitis was not more likely to lead to ICS (P = 0.4348. The Odds ratio (OR of a child ≤ 18 years of age with CSOM developing ICS was 5.24 (95% Confidence interval 1.13-24.34; P = 0.0345, while it was 7.60 (95% Confidence interval 1.52-37.97; P = 0.0134 for children with BRS. Conclusions: The most common type of ICS complicating CSOM and BRS was brain abscess and subdural empyema, respectively. Children are more prone to develop surgical ICS following CSOM and BRS. The proportion of males that had ICS was higher in both CSOM and BRS patients. Optimal outcome is achieved in patients that presented with GCS of 13 and above.

  12. Pharmacokinetics, Pharmacodynamics and Clinical Use of SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease.

    Science.gov (United States)

    Scheen, André J

    2015-07-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus. SGLT2 cotransporters are responsible for reabsorption of 90 % of the glucose filtered by the kidney. The glucuretic effect resulting from SGLT2 inhibition contributes to reduce hyperglycaemia and also assists weight loss and blood pressure reduction. Several SGLT2 inhibitors are already available in many countries (dapagliflozin, canagliflozin, empagliflozin) and in Japan (ipragliflozin, tofogliflozin). These SGLT2 inhibitors share similar pharmacokinetic characteristics with a rapid oral absorption, a long elimination half-life allowing once-daily administration, an extensive hepatic metabolism mainly via glucuronidation to inactive metabolites and a low renal elimination as a parent drug. Pharmacokinetic parameters are slightly altered in the case of chronic kidney disease (CKD). While no dose adjustment is required in the case of mild CKD, SGLT2 inhibitors may not be used or only at a lower daily dose in patients with moderate CKD. Furthermore, the pharmacodynamic response to SGLT2 inhibitors as assessed by urinary glucose excretion declines with increasing severity of renal impairment as assessed by a reduction in the estimated glomerular filtration rate. Nevertheless, the glucose-lowering efficacy and safety of SGLT2 inhibitors are almost comparable in patients with mild CKD as in patients with normal kidney function. In patients with moderate CKD, the efficacy tends to be dampened and safety concerns may occur. In patients with severe CKD, the use of SGLT2 inhibitors is contraindicated. Thus, prescribing information should be consulted regarding dosage adjustments or restrictions in the case of renal dysfunction for each SGLT2 inhibitor. The clinical impact of SGLT2 inhibitors on renal function and their potential to influence the course of diabetic nephropathy deserve attention because of preliminary favourable results

  13. Experimental Study on a Single Layer Two-Way Grid Shell with Tension Members

    Institute of Scientific and Technical Information of China (English)

    Zhonghao Zhang; Masumi Fujimoto; Atsuo Takino; Katsuhiko Imai

    2015-01-01

    Single layer two⁃way grid shell with in⁃plane and out⁃of⁃plane tension members is a new type of single⁃layer latticed shell roofs. Compared with traditional single⁃layer latticed shells, this new type has a unique mesh form and excellent rigidity. In order to further understand the buckling behaviors of single layer two⁃way grid cylindrical shell roof with tension members, the buckling experiments have been undertaken to investigate the effect of tension members, in either out⁃of⁃plane or in⁃plane placement. A single layer two⁃way grid cylindrical shell roof with out⁃of⁃plane tension members has been tested under symmetric and asymmetric loading. The tension member placement, the introducing initial axial force to tension members and the load patterns are considered to investigate the buckling behavior. Experimental results indicate that four long out⁃of⁃plane tension members work well under symmetrical loading, but only two long out⁃of⁃plane tension members work under asymmetrical loading. It can be concluded that the PC bar members used as tension members for this study are useful in the construction of a single layer two⁃way grid cylindrical shell roof with structural members intersecting at small angles.

  14. A human type 5 adenovirus-based Trypanosoma cruzi therapeutic vaccine re-programs immune response and reverses chronic cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Isabela Resende Pereira

    2015-01-01

    Full Text Available Chagas disease (CD, caused by the protozoan Trypanosoma cruzi, is a prototypical neglected tropical disease. Specific immunity promotes acute phase survival. Nevertheless, one-third of CD patients develop chronic chagasic cardiomyopathy (CCC associated with parasite persistence and immunological unbalance. Currently, the therapeutic management of patients only mitigates CCC symptoms. Therefore, a vaccine arises as an alternative to stimulate protective immunity and thereby prevent, delay progression and even reverse CCC. We examined this hypothesis by vaccinating mice with replication-defective human Type 5 recombinant adenoviruses (rAd carrying sequences of amastigote surface protein-2 (rAdASP2 and trans-sialidase (rAdTS T. cruzi antigens. For prophylactic vaccination, naïve C57BL/6 mice were immunized with rAdASP2+rAdTS (rAdVax using a homologous prime/boost protocol before challenge with the Colombian strain. For therapeutic vaccination, rAdVax administration was initiated at 120 days post-infection (dpi, when mice were afflicted by CCC. Mice were analyzed for electrical abnormalities, immune response and cardiac parasitism and tissue damage. Prophylactic immunization with rAdVax induced antibodies and H-2Kb-restricted cytotoxic and interferon (IFNγ-producing CD8+ T-cells, reduced acute heart parasitism and electrical abnormalities in the chronic phase. Therapeutic vaccination increased survival and reduced electrical abnormalities after the prime (analysis at 160 dpi and the boost (analysis at 180 and 230 dpi. Post-therapy mice exhibited less heart injury and electrical abnormalities compared with pre-therapy mice. rAdVax therapeutic vaccination preserved specific IFNγ-mediated immunity but reduced the response to polyclonal stimuli (anti-CD3 plus anti-CD28, CD107a+ CD8+ T-cell frequency and plasma nitric oxide (NO levels. Moreover, therapeutic rAdVax reshaped immunity in the heart tissue as reduced the number of perforin+ cells

  15. Psychiatric disorders and muscle tenderness in episodic and chronic migraine.

    Science.gov (United States)

    Mongini, Franco; Deregibus, Andrea; Rota, Eugenia

    2005-09-01

    This review first reports on the data concerning the relationship between migraine and personality traits and psychiatric disorders. The relationship between migraine and tenderness of the pericranial and cervical muscles is then discussed. In one study, a psychologic assessment was performed in 56 women with migraine, and the Minnesota Multiphase Personality Inventory (MMPI) and State Trait Anxiety Inventory were administered at baseline (T0) and after 6-7 years (T2). Frequency, severity and duration of migraine were recorded at T0, after treatment (T1) and at T2, and their relationship to the prevalence of depression, MMPI and State Trait Anxiety Inventory data were examined. Pain parameters improved in all patients in T0-1, but were higher at T2 in patients with depression at T0. The patients whose migraine improved at T2 had significantly lower MMPI and State Trait Anxiety Inventory scores at T0 and T2. Moreover, the prevalence of depression of the patients whose migraine improved at T2 was 37.5% at T0 and decreased to 12.5% at T2. The authors subsequently studied the function of the frontal lobe in 23 female patients previously treated for chronic migraine and 23 controls by applying three neuropsychologic tests (gambling task, tower of hanoi-3 and object alternation test). The patient group performed significantly worse on the tower of hanoi-3 and the object alternation test. In order to assess the extent to which muscle tenderness may relate to psychiatric disorders in patients with migraine and tension-type headache, diagnosed according International Headache Society criteria [2004], a psychologic assessment was performed and palpation tenderness scores calculated for the pericranial and cervical muscles in 459 patients. In total, 125 patients had frequent episodic migraine, 97 had chronic migraine, 82 had frequent episodic tension-type headache and chronic tension-type headache was present in 83. In a further 72 patients, both episodic migraine and

  16. Aspen Tension Wood Fibers Contain β-(1---> 4)-Galactans and Acidic Arabinogalactans Retained by Cellulose Microfibrils in Gelatinous Walls.

    Science.gov (United States)

    Gorshkova, Tatyana; Mokshina, Natalia; Chernova, Tatyana; Ibragimova, Nadezhda; Salnikov, Vadim; Mikshina, Polina; Tryfona, Theodora; Banasiak, Alicja; Immerzeel, Peter; Dupree, Paul; Mellerowicz, Ewa J

    2015-11-01

    Contractile cell walls are found in various plant organs and tissues such as tendrils, contractile roots, and tension wood. The tension-generating mechanism is not known but is thought to involve special cell wall architecture. We previously postulated that tension could result from the entrapment of certain matrix polymers within cellulose microfibrils. As reported here, this hypothesis was corroborated by sequential extraction and analysis of cell wall polymers that are retained by cellulose microfibrils in tension wood and normal wood of hybrid aspen (Populus tremula × Populus tremuloides). β-(1→4)-Galactan and type II arabinogalactan were the main large matrix polymers retained by cellulose microfibrils that were specifically found in tension wood. Xyloglucan was detected mostly in oligomeric form in the alkali-labile fraction and was enriched in tension wood. β-(1→4)-Galactan and rhamnogalacturonan I backbone epitopes were localized in the gelatinous cell wall layer. Type II arabinogalactans retained by cellulose microfibrils had a higher content of (methyl)glucuronic acid and galactose in tension wood than in normal wood. Thus, β-(1→4)-galactan and a specialized form of type II arabinogalactan are trapped by cellulose microfibrils specifically in tension wood and, thus, are the main candidate polymers for the generation of tensional stresses by the entrapment mechanism. We also found high β-galactosidase activity accompanying tension wood differentiation and propose a testable hypothesis that such activity might regulate galactan entrapment and, thus, mechanical properties of cell walls in tension wood.

  17. Sleep disorders and chronic craniofacial pain: Characteristics and management possibilities.

    Science.gov (United States)

    Almoznino, Galit; Benoliel, Rafael; Sharav, Yair; Haviv, Yaron

    2017-06-01

    Chronic craniofacial pain involves the head, face and oral cavity and is associated with significant morbidity and high levels of health care utilization. A bidirectional relationship is suggested in the literature for poor sleep and pain, and craniofacial pain and sleep are reciprocally related. We review this relationship and discuss management options. Part I reviews the relationship between pain and sleep disorders in the context of four diagnostic categories of chronic craniofacial pain: 1) primary headaches: migraines, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs) and hypnic headache, 2) secondary headaches: sleep apnea headache, 3) temporomandibular joint disorders (TMD) and 4) painful cranial neuropathies: trigeminal neuralgia, post-herpetic trigeminal neuropathy, painful post-traumatic trigeminal neuropathy (PTTN) and burning mouth syndrome (BMS). Part II discusses the management of patients with chronic craniofacial pain and sleep disorders addressing the factors that modulate the pain experience as well as sleep disorders and including both non-pharmacological and pharmacological modalities.

  18. 郑徐客运专线 CRTSⅢ型先张无砟轨道板创新技术及生产工艺%Innovative Technology and Manufacturing Technique of CRTS Ⅲ Type Pre-Tensioning Ballastless Track Slab for Zhengzhou-Xuzhou Passenger Dedicated Line

    Institute of Scientific and Technical Information of China (English)

    王红亮

    2015-01-01

    文章通过CRTSⅢ型先张板与CRTSⅢ型后张板设计技术和制造技术的对比,介绍了CRTSⅢ型先张无砟轨道板创新技术,即(1)以双向先张工艺为前提的结构设计能使预应力钢筋与混凝土形成很强的握裹力,提高了轨道板的整体耐久性,避免了预应力钢筋断裂窜出的可能;(2)锚穴尺寸减小,增加了其周围混凝土的厚度,可有效控制锚穴处混凝土浅薄性微裂纹,减小了锚穴开裂的可能性;(3)实现了双向先张工艺制板的规模化生产,以矩阵坑单元生产模式取代后张板的单台座模式,每坑可生产2×4块板,实现了整体张拉及放张,有利于流水线生产,辅之以自动张拉设备,张拉精度及效率均得到提高;(4)由于结构中钢筋布置优化,使得钢筋用量大幅减少,节约了成本。基于郑徐客运专线的制板实践,介绍了有别于后张板的先张轨道板制造工艺流程及工装设备,并对有显著区别的张拉、蒸汽养护及放张工序的操作要点进行了介绍。%This paper introduces the innovative technology and manufacturing technique of CRTS Ⅲ type pre-tensioning ballastless track slab by contrasting with which of CRTSⅢtype post-tensioning ballastless track slab (1) The structure design on the premise of two-direction pre-tensioning technology can bring the prestressed reinforcement and the concrete into being strong bond stress which enhances the whole durability of the track slab and avoids the fracture and springing of the prestressed reinforcement. ( 1 ) Thickness of the concrete surrounding the anchor hole is increased with the de-crease of the anchor hole size which can effectively control the superficial micro cracks in concrete surrounding the an-chor hole and reduce the possibility of anchor hole cracking. (3) large-scale production of the slabs manufactured by two-direction pre-tensioning method is realized, with single pedestal model for

  19. Loss of the TGFβ-activating integrin αvβ8 on dendritic cells protects mice from chronic intestinal parasitic infection via control of type 2 immunity.

    Directory of Open Access Journals (Sweden)

    John J Worthington

    Full Text Available Chronic intestinal parasite infection is a major global health problem, but mechanisms that promote chronicity are poorly understood. Here we describe a novel cellular and molecular pathway involved in the development of chronic intestinal parasite infection. We show that, early during development of chronic infection with the murine intestinal parasite Trichuris muris, TGFβ signalling in CD4+ T-cells is induced and that antibody-mediated inhibition of TGFβ function results in protection from infection. Mechanistically, we find that enhanced TGFβ signalling in CD4+ T-cells during infection involves expression of the TGFβ-activating integrin αvβ8 by dendritic cells (DCs, which we have previously shown is highly expressed by a subset of DCs in the intestine. Importantly, mice lacking integrin αvβ8 on DCs were completely resistant to chronic infection with T. muris, indicating an important functional role for integrin αvβ8-mediated TGFβ activation in promoting chronic infection. Protection from infection was dependent on CD4+ T-cells, but appeared independent of Foxp3+ Tregs. Instead, mice lacking integrin αvβ8 expression on DCs displayed an early increase in production of the protective type 2 cytokine IL-13 by CD4+ T-cells, and inhibition of this increase by crossing mice to IL-4 knockout mice restored parasite infection. Our results therefore provide novel insights into how type 2 immunity is controlled in the intestine, and may help contribute to development of new therapies aimed at promoting expulsion of gut helminths.

  20. Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic techniques and considerations regarding their application.

    Science.gov (United States)

    Coppieters, Michel W; Butler, David S

    2008-06-01

    Despite the high prevalence of carpal tunnel syndrome and cubital tunnel syndrome, the quality of clinical practice guidelines is poor and non-invasive treatment modalities are often poorly documented. The aim of this cadaveric biomechanical study was to measure longitudinal excursion and strain in the median and ulnar nerve at the wrist and proximal to the elbow during different types of nerve gliding exercises. The results confirmed the clinical assumption that 'sliding techniques' result in a substantially larger excursion of the nerve than 'tensioning techniques' (e.g., median nerve at the wrist: 12.6 versus 6.1mm, ulnar nerve at the elbow: 8.3 versus 3.8mm), and that this larger excursion is associated with a much smaller change in strain (e.g., median nerve at the wrist: 0.8% (sliding) versus 6.8% (tensioning)). The findings demonstrate that different types of nerve gliding exercises have largely different mechanical effects on the peripheral nervous system. Hence different types of techniques should not be regarded as part of a homogenous group of exercises as they may influence neuropathological processes differently. The findings of this study and a discussion of possible beneficial effects of nerve gliding exercises on neuropathological processes may assist the clinician in selecting more appropriate nerve gliding exercises in the conservative and post-operative management of common neuropathies.

  1. Genetic polymorphism of ACE and the angiotensin II type1 receptor genes in children with chronic kidney disease

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    Elshamaa Manal F

    2011-08-01

    Full Text Available Abstract Aim and Methods We investigated the association between polymorphisms of the angiotensin converting enzyme-1 (ACE-1 and angiotensin II type one receptor (AT1RA1166C genes and the causation of renal disease in 76 advanced chronic kidney disease (CKD pediatric patients undergoing maintenance hemodialysis (MHD or conservative treatment (CT. Serum ACE activity and creatine kinase-MB fraction (CK-MB were measured in all groups. Left ventricular mass index (LVMI was calculated according to echocardiographic measurements. Seventy healthy controls were also genotyped. Results The differences of D allele and DI genotype of ACE were found significant between MHD group and the controls (p = 0.0001. ACE-activity and LVMI were higher in MHD, while CK-MB was higher in CT patients than in all other groups. The combined genotype DD v/s ID+II comparison validated that DD genotype was a high risk genotype for hypertension .~89% of the DD CKD patients were found hypertensive in comparison to ~ 61% of patients of non DD genotype(p = 0.02. The MHD group showed an increased frequency of the C allele and CC genotype of the AT1RA1166C polymorphism (P = 0.0001. On multiple linear regression analysis, C-allele was independently associated with hypertension (P = 0.04. Conclusion ACE DD and AT1R A/C genotypes implicated possible roles in the hypertensive state and in renal damage among children with ESRD. This result might be useful in planning therapeutic strategies for individual patients.

  2. Botulinum toxin type A for cephalic cutaneous allodynia in chronic migraine: a randomized, double-blinded, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Luciano Hollanda

    2014-12-01

    Full Text Available Cephalic allodynia (CA can be observed in 50-70% of patients with chronic migraine (CM. The aim of this trial was to assess the efficacy of botulinum toxin type A (Botx-A in the treatment of CA associated with CM. In this placebo-controlled trial, patients were randomized either into Botx-A or 0.9% saline injections and efficacy measures were assessed every 4 weeks for 3 months. Efficacy endpoints were number of migraine episodes associated with CA, changes from baseline in visual analogical scale scores for pain (VAS and frequency of common analgesics use for migraine. A total of 38 subjects were randomized to saline (n=18 or Botx-A (n=20. There were no significant differences in baseline between active intervention or placebo groups regarding mean age, number of headache episodes [mean 12.1 (9.22 and 17.00 (9.69 respectively; P=0.12], pain severity as measured by the VAS or frequency of analgesic use for headache episodes. Efficacy analysis showed that Botx-A injections led to an important decrease from baseline in the mean migraine episodes associated with CA after 12 weeks (5.20 versus 11.17; P=0.01. Also, VAS scores and frequency of analgesics use for headache were significantly reduced in the Botx-A group. This study suggests that Botx-A injections are superior to saline in the treatment of CA associated with CM, with mild self limited side effects.

  3. Prevalence of antinuclear and anti-liver-kidney-microsome type-1 antibodies in patients with chronic hepatitis C in China

    Institute of Scientific and Technical Information of China (English)

    BAI Li; FENG Zhen-ru; LU Hai-ying; LI Wen-gang; YU Min; XU Xiao-yuan

    2009-01-01

    Background Hepatitis C virus (HCV) infection may induce autoimmune response and autoantibodies can be detected in chronic hepatitis C (CHC) patients. However, the reported positive rate of autoantibodies in CHC patients in China varies considerably. In this study, we investigated the prevalence of antinuclear antibodies (ANA) and anti-liver-kidney-microsome type 1 autoantibodies (anti-LKM-1) in a large cohort of CHC patients, and analyzed the factors related to the presence of the autoantibodies. Methods A total of 360 CHC patients were enrolled in this study. Serum ANA and anti-LKM-1 were detected by indirect immunofluorescence and enzyme-linked immunosorbent assay, respectively. Clinical analysis was performed to disclose the related factors to autoantibody production. Results The prevalence of ANA and anti-LKM-1 in CHC patients was 12.5% (45/360) and 2.5% (9/360), respectively. Women had a higher prevalence than men (18.9% vs 11.4%, P=0.046). Patients with positive autoantibodies had lower HCV RNA levels (1.2x107 copies/L vs 7.2x107 copies/L, P <0.05). Positive ANA was associated with higher serum globulin (P<0.05). Stratified analysis showed that there were no significant differences in age, HCV genotype, disease course, clinical stage, prevalence of cirrhosis and interferon therapy between autoantibody-positive and-negative subgroups. Conclusion Autoantibodies can be induced in the course of CHC, and some CHC patients can even develop autoimmune hepatitis.

  4. Serum uric acid and its association with hypertension, early nephropathy and chronic kidney disease in type 2 diabetic patients

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    Mohamed Fouad

    Full Text Available Abstract Introduction: Early detection diabetic nephropathy (DN is important. Whether serum uric acid (SUA has a role in the development of DN is not known. Objective: To study the relationship between SUA and hypertension, early nephropathy and progression of chronic kidney disease (CKD in type 2 diabetes mellitus (T2DM. Methods: The total number of the study was 986 participants, according to presence and duration of diabetes were classified into three groups. Group I; including 250 healthy participants. Group II; including 352 with onset of diabetes 5 years. All participants were submitted to complete clinical examination, anthropometric measurements, laboratory investigations, including glycosylated hemoglobin (HbA1C, as well triglycerides to high-density lipoprotein ratios (TG/HDL-C, SUA, urinary albumin/creatinine ratio (ACR and estimated glomerular filtration rate (eGFR. Results: SUA, BP, HbA1c, TG/HDL-C ratio, and ACR levels were significantly higher in group III than group I, II and in II than I. eGFR significantly lower in group III than group I, II and in II than I (p 6.1 mg/dl, > 6.2 mg/dl and > 6.5 mg/dl had a greater sensitivity and specificity for identifying hypertension, early nephropathy and decline eGFR respectively. Conclusion: Even high normal SUA level, was associated with the risk of hypertension, early nephropathy and decline of eGFR. Moreover SUA level may identify the onset of hypertension, early nephropathy and progression of CKD in T2DM.

  5. Axelrod's Model with Surface Tension

    CERN Document Server

    Pace, Bruno

    2012-01-01

    In this work we propose a subtle change in Axelrod's model for the dissemination of culture. The mechanism consists of excluding non-interacting neighbours from the set of neighbours out of which an agent is drawn for potential cultural interactions. Although the alteration proposed does not alter topologically the configuration space, it yields significant qualitative changes, specifically the emergence of surface tension, driving the system in some cases to metastable states. The transient behaviour is considerably richer, and cultural regions have become stable leading to the formation of different spatio-temporal structures. A new metastable "glassy" phase emerges between the globalised phase and the polarised, multicultural phase.

  6. Influence of Type 2 Diabetes on Prevalence of Key Periodontal Pathogens, Salivary Matrix Metalloproteinases, and Bone Remodeling Markers in Sudanese Adults with and without Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Hasaan Gassim Mohamed

    2016-01-01

    Full Text Available This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP, 29 with chronic periodontitis (CP, and 20 with type 2 diabetes (DM. Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA. The CP group had the highest prevalence of P. gingivalis (81.5%, followed by the DM + CP (59.3% and DM (55.0% groups (P>0.05. Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG.

  7. Effects of Acute Exercise and Chronic Exercise on the Liver Leptin-AMPK-ACC Signaling Pathway in Rats with Type 2 Diabetes

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    Xuejie Yi

    2013-01-01

    Full Text Available Aim. To investigate the effects of acute and chronic exercise on glucose and lipid metabolism in liver of rats with type 2 diabetes caused by a high fat diet and low dose streptozotocin (STZ. Methods. Animals were classified into control (CON, diabetes (DC, diabetic chronic exercise (DCE, and diabetic acute exercise (DAE groups. Results. Compared to CON, the leptin levels in serum and liver and ACC phosphorylation were significantly higher in DC, but the levels of liver leptin receptor, AMPKα1/2, AMPKα1, and ACC proteins expression and phosphorylation were significantly lower in DC. In addition, the levels of liver glycogen reduced significantly, and the levels of TG and FFA increased significantly in DC compared to CON. Compared to DC, the levels of liver AMPKα1/2, AMPKα2, AMPKα1, and ACC phosphorylation significantly increased in DCE and DAE. However, significant increase of the level of liver leptin receptor and glycogen as well as significant decrease of the level of TG and FFA were observed only in DEC. Conclusion. Our study demonstrated that both acute and chronic exercise indirectly activated the leptin-AMPK-ACC signaling pathway and increased insulin sensitivity in the liver of type 2 diabetic rats. However, only chronic and long-term exercise improved glucose and lipid metabolism of the liver.

  8. Field Evaluation of the System Identification Approach for Tension Estimation of External Tendons

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    Myung-Hyun Noh

    2015-01-01

    Full Text Available Various types of external tendons are considered to verify the applicability of tension estimation method based on the finite element model with system identification technique. The proposed method is applied to estimate the tension of benchmark numerical example, model structure, and field structure. The numerical and experimental results show that the existing methods such as taut string theory and linear regression method show large error in the estimated tension when the condition of external tendon is different with the basic assumption used during the derivation of relationship between tension and natural frequency. However, the proposed method gives reasonable results for all of the considered external tendons in this study. Furthermore, the proposed method can evaluate the accuracy of estimated tension indirectly by comparing the measured and calculated natural frequencies. Therefore, the proposed method can be effectively used for field application of various types of external tendons.

  9. [Chronic hepatitis].

    Science.gov (United States)

    Figueroa Barrios, R

    1995-01-01

    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results.

  10. Chronic granulomatous disease

    Science.gov (United States)

    CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... In chronic granulomatous disease (CGD), immune system cells called phagocytes are unable to kill some types of bacteria and ...

  11. The use of oral recombinant feline interferon omega in two cats with type II diabetes mellitus and concurrent feline chronic gingivostomatitis syndrome

    OpenAIRE

    Leal, Rodolfo O; Gil, Solange; Brito, Maria T. V.; McGahie, David; Niza, Maria M. R. E.; Tavares, Luís

    2013-01-01

    Articles in International Journals Feline Chronic Gingivostomatitis Syndrome (FCGS) is a common disease in clinical practice. Among the therapeutic options available, long-acting corticosteroids are frequently used due to their anti-inflammatory and immunosuppressive properties. Although they may improve the clinical symptoms, they can lead to a progressive form of the disease that becomes refractory to treatment. Furthermore, their direct relationship with type II diabetes mel...

  12. Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes.

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    Hasaan G Mohamed

    Full Text Available The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1, 24 with T2DM (G2, 30 with chronic periodontitis (G3 and 44 without T2DM or periodontitis (G4. The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman's correlation co-efficient: -0.240, P < 0.01 and positively with GIP and visfatin (Spearman's correlation co-efficient: 0.255 and 0.241, respectively, P < 0.01. The results demonstrate that chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.

  13. Impact of Chronic Periodontitis on Levels of Glucoregulatory Biomarkers in Gingival Crevicular Fluid of Adults with and without Type 2 Diabetes.

    Science.gov (United States)

    Mohamed, Hasaan G; Idris, Shaza B; Mustafa, Manal; Ahmed, Mutaz F; Åstrøm, Anne N; Mustafa, Kamal; Ibrahim, Salah O

    2015-01-01

    The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF) is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM) presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1), 24 with T2DM (G2), 30 with chronic periodontitis (G3) and 44 without T2DM or periodontitis (G4). The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman's correlation co-efficient: -0.240, P chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.

  14. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  15. On Surface Tension for Compact Stars

    Indian Academy of Sciences (India)

    R. Sharma; S. D. Maharaj

    2007-06-01

    In an earlier analysis it was demonstrated that general relativity gives higher values of surface tension in strange stars with quark matter than neutron stars. We generate the modified Tolman–Oppenheimer–Volkoff equation to incorporate anisotropic matter and use this to show that pressure anisotropy provides for a wide range of behaviour in the surface tension than is the case with isotropic pressures. In particular, it is possible that anisotropy drastically decreases the value of the surface tension.

  16. Surface tension profiles in vertical soap films

    CERN Document Server

    Adami, N

    2013-01-01

    Surface tension profiles in vertical soap films are experimentally investigated. Measurements are performed introducing deformable elastic objets in the films. The shape adopted by those objects set in the film can be related to the surface tension value at a given vertical position by numerical solving of adapted elasticity equations. We show that the observed dependency of the surface tension versus the vertical position in the soap film can be reproduced by simple modeling taking into account film thickness measurements.

  17. Treating Chronic Myeloid Leukemia by Phase

    Science.gov (United States)

    ... Myeloid Leukemia (CML) Treating Chronic Myeloid Leukemia Treating Chronic Myeloid Leukemia by Phase Treatment options for people ... a stem cell donor with matching tissue type. Chronic phase The standard treatment for chronic phase CML ...

  18. HILBERTIAN APPROACH FOR UNIVARIATE SPLINE WITH TENSION

    Institute of Scientific and Technical Information of China (English)

    A.Bouhamidi

    2001-01-01

    In this work,a new approach is proposed for constructing splines with tension.The basic idea is in the use of distributions theory,which allows us to define suitable Hilbert spaces in which the tension spline minimizes some energy functional.Classical orthogonal conditions and characterizations of the spline in terms of a fundamental solution of a differential operator are provided.An explicit representation of the tension spline is given.The tension spline can be computed by solving a linear system.Some numerical examples are given to illustrate this approach.

  19. Surface Tension Calculation of Undercooled Alloys

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Based on the Butler equation and extrapolated thermodynamic data of undercooled alloys from those of liquid stable alloys, a method for surface tension calculation of undercooled alloys is proposed. The surface tensions of liquid stable and undercooled Ni-Cu (xNi=0.42) and Ni-Fe (xNi=0.3 and 0.7) alloys are calculated using STCBE (Surface Tension Calculation based on Butler Equation) program. The agreement between calculated values and experimental data is good enough, and the temperature dependence of the surface tension can be reasonable down to 150-200 K under the liquid temperature of the alloys.

  20. Transcutaneous oxygen tension in imminent foot gangrene

    DEFF Research Database (Denmark)

    Tønnesen, K H

    1978-01-01

    with moderate obstruction, the oxygen tension reached zero at a toe systolic blood pressure of 5--10 mmHg (tilt toe up) and reached arterial oxygen tension at about 50 to 70 mmHg (tilt toe down). In legs withsevere arterial obstruction and ischaemic rest pain, oxygen tension rose from zero not before systolic......Transcutaneous oxygen tension at 44 degree C and maximal isotope clearance (90m Tc-pretechnetate + histramine) just proximal to the 1st toe and systolic toe blood pressure (strain gauge) were studied on a tilt table in patients with various degrees of obstructive arteriosclerotic disease. In legs...

  1. Chronic administration of phosphodiesterase type 5 inhibitor suppresses renal production of endothelin-1 in dogs with congestive heart failure.

    Science.gov (United States)

    Yamamoto, Takashi; Wada, Atsuyuki; Ohnishi, Masato; Tsutamoto, Takayoshi; Fujii, Masanori; Matsumoto, Takehiro; Takayama, Tomoyuki; Wang, Xinwen; Kurokawa, Kiyoshi; Kinoshita, Masahiko

    2002-08-01

    Endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) play important roles in the regulation of body fluid balance in congestive heart failure (CHF). Renal production of ET-1 increases in CHF and it is a significant independent predictor of sodium excretion. ANP inhibits the ET system through cGMP, a second messenger of ANP. However, in severe CHF, plasma cGMP levels reached a plateau despite the activation of ANP secretion. Thus, ANP does not seem to sufficiently oppose exaggerated ET-1 actions in severe CHF, partially due to the accelerated degradation of cGMP, through phosphodiesterase type 5 (PDE5). We examined the chronic effects of a PDE5 inhibitor, T-1032 (1 mg/kg per day, n=5), on renal function and renal production of ET-1 in dogs with CHF induced by rapid ventricular pacing (270 beats/min). Vehicle dogs were given a placebo (n=5) and normal dogs (n=5) served as normal controls without pacing. In this experimentally produced CHF, plasma levels of ET-1, ANP and cGMP were elevated and renal production of cGMP was increased compared with the normal group, associated with increases in renal expression of preproET-1 mRNA and the number of ET-1-positive cells in glomeruli. In the T-1032 group, systemic and renal production of cGMP were further increased compared with the vehicle group despite no significant difference in plasma ANP levels between the two groups. Subsequently, the agent significantly improved urine flow rate, sodium excretion rate and glomerular filtration rate (GFR) associated with reductions in renal expression of preproET-1 mRNA and the number of ET-1-positive cells compared with the vehicle group. Moreover, there was a significant negative correlation between the number of ET-1-positive cells and GFR (r=-0.802 and Prenal ANP and ET-1 through the cGMP pathway, subsequently preventing renal dysfunction during the progression of CHF.

  2. Effects of maturation, artery size, and chronic hypoxia on 5-HT receptor type in ovine cranial arteries.

    Science.gov (United States)

    Teng, G Q; Williams, J; Zhang, L; Purdy, R; Pearce, W J

    1998-09-01

    To test the hypothesis that variations in cerebrovascular reactivity to 5-HT among arteries of different size or type, during maturation, or during acclimatization to high altitude involve differences in serotonergic receptor subtype, we determined relative agonist potency orders and antagonist affinities in common carotid (Com), main branch middle cerebral (Main), and second branch middle cerebral (2BR) arteries from term fetal lambs and nonpregnant adult sheep acclimatized at sea level or at an altitude of 3,820 m for approximately 110 days. In normoxic adult Com segments, agonist potency order was 5-hydroxytryptamine (5-HT) > 5-carboxamidotryptamine (5-CT) >/= 8-hydroxy-2(di-n-propylamino)tetraline (8-OH-DPAT); sumatriptan (Suma) produced no contractile response; and antagonist dissociation constant (pKb) values were 9.4 and 9.5 for ketanserin against 5-HT and 5-CT, 7.5 for GR-127935 against 5-HT, and 7.2 for SB-206553 against 5-HT. In normoxic adult Main segments, agonist potency order was 5-HT > 5-CT >/= Suma >/= DPAT, and pKb values were 9.1 and 9.2 for ketanserin against 5-HT and 5-CT and 7.4 and 8.5 for GR-127935 against 5-HT and Suma, respectively. In the 2BR segments from normoxic adults, agonist potency order was 5-CT > 5-HT > Suma > DPAT and pKb values were 7.4 and 7.2 for ketanserin against 5-HT and 5-CT and 10.0 and 8.7 for GR-127935 against 5-HT and Suma, respectively. Compared with normoxic adults, none of these values were significantly different in hypoxic adults and in fetuses only the pKb values for ketanserin against 5-HT in the 2BR segments (8.8) were greater. From these results we propose that the ratio of 5-HT2 to 5-HT1 receptors is greatest in the Com and decreases progressively to its smallest values in 2BR or smaller segments. Because this gradient appears stable and relatively resistant to the effects of maturation and chronic hypoxia, changes in reactivity associated with these perturbations may involve alterations in receptor density

  3. Plasma Pro-C3 (N-terminal type III collagen propeptide) predicts fibrosis progression in patients with chronic hepatitis C

    DEFF Research Database (Denmark)

    Nielsen, Mette J.; Veidal, Sanne S.; Karsdal, Morten A.

    2015-01-01

    BACKGROUND & AIMS: Fibrogenesis results in release of certain extracellular matrix protein fragments into the circulation. We evaluated the diagnostic and prognostic performance of two novel serological markers, the precisely cleaved N-terminal propeptide of type III collagen (Pro-C3) and a peptide...... of helical collagen type III degradation (C3M), in chronic hepatitis C (CHC) patients. METHOD: Pro-C3 and C3M were measured by ELISA in plasma from CHC patients (n = 194) from a prior phase II antifibrotic trial (NCT00244751). Plasma samples and paired liver biopsies were obtained at baseline and after 1...

  4. The Plastic Tension Field Method

    DEFF Research Database (Denmark)

    Hansen, Thomas

    2005-01-01

    . The emphasis is attached to the presentation of a design method based on the diagonal tension field theory. Also, how to determine the load-carrying capacity of a given steel plate girder with transverse web stiffeners, is briefly presented. The load-carrying capacity may be predicted by applying both...... method. The method is based on the theory of plasticity and is analogous to the so-called diagonal compression field method developed for reinforced concrete beams with transverse stirrups, which is adopted in the common European concrete code (Eurocode 2). Many other theories have been developed......, but the method presented differs from these theories by incorporating the strength of the transverse stiffeners and by the assumption that the tensile bands may pass the transverse stiffeners, which often is observed in tests. Other methods have only dealt with a single web field between two stiffeners...

  5. [Tension pneumomediastinum and tension pneumothorax following tracheal perforation during cardiopulmonary resuscitation].

    Science.gov (United States)

    Buschmann, C T; Tsokos, M; Kurz, S D; Kleber, C

    2015-07-01

    Tension pneumothorax can occur at any time during cardiopulmonary resuscitation (CPR) with external cardiac massage and invasive ventilation either from primary or iatrogenic rib fractures with concomitant pleural or parenchymal injury. Airway injury can also cause tension pneumothorax during CPR. This article presents the case of a 41-year-old woman who suffered cardiopulmonary arrest after undergoing elective mandibular surgery. During CPR the upper airway could not be secured by orotracheal intubation due to massive craniofacial soft tissue swelling. A surgical airway was established with obviously unrecognized iatrogenic tracheal perforation and subsequent development of tension pneumomediastinum and tension pneumothorax during ventilation. Neither the tension pneumomediastinum nor the tension pneumothorax were decompressed and accordingly resuscitation efforts remained unsuccessful. This case illustrates the need for a structured approach to resuscitate patients with ventilation problems regarding decompression of tension pneumomediastinum and/or tension pneumothorax during CPR.

  6. Aldosterone breakthrough caused by chronic blockage of angiotensin II type 1 receptors in human adrenocortical cells: possible involvement of bone morphogenetic protein-6 actions.

    Science.gov (United States)

    Otani, Hiroyuki; Otsuka, Fumio; Inagaki, Kenichi; Suzuki, Jiro; Miyoshi, Tomoko; Kano, Yoshihiro; Goto, Junko; Ogura, Toshio; Makino, Hirofumi

    2008-06-01

    Circulating aldosterone concentrations occasionally increase after initial suppression with angiotensin II (Ang II) converting enzyme inhibitors or Ang II type 1 receptor blockers (ARBs), a phenomenon referred to as aldosterone breakthrough. However, the underlying mechanism causing the aldosterone breakthrough remains unknown. Here we investigated whether aldosterone breakthrough occurs in human adrenocortical H295R cells in vitro. We recently reported that bone morphogenetic protein (BMP)-6, which is expressed in adrenocortical cells, enhances Ang II- but not potassium-induced aldosterone production in human adrenocortical cells. Accordingly, we examined the roles of BMP-6 in aldosterone breakthrough induced by long-term treatment with ARB. Ang II stimulated aldosterone production by adrenocortical cells. This Ang II stimulation was blocked by an ARB, candesartan. Interestingly, the candesartan effects on Ang II-induced aldosterone synthesis and CYP11B2 expression were attenuated in a course of candesartan treatment for 15 d. The impairment of candesartan effects on Ang II-induced aldosterone production was also observed in Ang II- or candesartan-pretreated cells. Levels of Ang II type 1 receptor mRNA were not changed by chronic candesartan treatment. However, BMP-6 enhancement of Ang II-induced ERK1/2 signaling was resistant to candesartan. The BMP-6-induced Smad1, -5, and -8 phosphorylation, and BRE-Luc activity was augmented in the presence of Ang II and candesartan in the chronic phase. Chronic Ang II exposure decreased cellular expression levels of BMP-6 and its receptors activin receptor-like kinase-2 and activin type II receptor mRNAs. Cotreatment with candesartan reversed the inhibitory effects of Ang II on the expression levels of these mRNAs. The breakthrough phenomenon was attenuated by neutralization of endogenous BMP-6 and activin receptor-like kinase-2. Collectively, these data suggest that changes in BMP-6 availability and response may be involved

  7. KCa3.1 channel downregulation and impaired EDH-type relaxation in pulmonary arteries from chronic hypoxic rats

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Kudryavtseva, Olga; Dalsgaard, Thomas

    2013-01-01

    hypoxia-induced pulmonary hypertension in rats. For functional studies, pulmonary arteries were mounted in microvascular myographs for isometric tension recordings. The K(Ca) channel expression was evaluated by immunoblotting and quantitative PCR. Although ACh induced similar relaxations, the ACh......Calcium-activated potassium channels of small (K(Ca)2, SK) and intermediate (K(Ca)3.1, IK) conductance are involved in endothelium-dependent relaxation of pulmonary arteries. We hypothesized that the function and expression of K(Ca)2 and K(Ca)3.1 increase as a compensatory mechanism to counteract......-induced relaxations were abolished by the combined inhibition of nitric oxide synthase (by L-nitro-arginine, L-NOARG), cyclo-oxygenase (by indomethacin) and soluble guanylate cyclase (by ODQ) in pulmonary arteries from hypoxic rats, whereas 20 ± 6% (n = 8) maximal relaxation in response to ACh persisted in arteries...

  8. 疝环充填式无张力性疝修补术治疗腹股沟复发性斜疝的临床研究%Clinical research of groin recurrent inclined hernia treatment with hernia ring filling type without tension hernia neoplasty

    Institute of Scientific and Technical Information of China (English)

    孔卓明

    2012-01-01

      目的观察探讨疝环充填式无张力性疝修补术在腹股沟复发性斜疝治疗中的临床效果,总结其临床价值.方法选取笔者所在医院2008年3月~2012年3月收治的腹股沟疝患者212例,其中有64例为腹股沟复发性斜疝,随机分为观察组和对照组,各32例,观察组使用疝环充填式无张力性疝修补术治疗,对照组使用常规手术治疗,观察对比两组临床治疗效果.结果观察组总有效率为90.6%;对照组总有效率为53.1%;两组的治疗效果比较差异有统计学意义(P<0.05).结论使用疝环充填式无张力性疝修补术治疗腹股沟复发性斜疝其效果快,创伤小,治疗效果好,并发症低,后遗症低,值得临床推广使用.%  Objective Observing the clinical effect of groin recurrent inclined hernia treatment with hernia ring filling type without tension hernia neoplasty,and summarize clinical value. Methods From March 2008 to March 2012,Selected groin hernia patients 212 cases,64 cases of recurrent groin hernia inclined,212 cases were randomly divided into trial group and control group,each 32 cases,the observation group use hernia ring filling type without tension sex hernia repair of treatment, the control group with conventional surgery, and the observation group compared to two clinical treatment effect. Results The observation group the total effective rate was 90.6%; Control group total effectiveness is 53.1%. Two groups of the treatment effect were significant difference(P <0.05). Conclusion The effect of using hernia ring filling type without tension groin hernia repair of surgical treatment of recurrent inclined hernia is fast, small wound, good, low complications, low sequela,and worth clinical promotion.

  9. Analysis of efficacy of two types of local anesthetic in tension-free inguinal hernia repair%腹股沟疝无张力修补术中局麻药物选择的效果分析

    Institute of Scientific and Technical Information of China (English)

    周涛; 麻涛; 田文; 李晨; 菅雁兵; 肖西平; 周彬; 彭喆

    2014-01-01

    Objective To investigate the advantages of combined application of lidocaine and ropivacaine in local anesthesia of tension-free inguinal hernia repair.Methods From January 2012 to December 2013, 172 patients with inguinal hernia were randomly divided into 2 groups:88 patients in lidocaine+ropivacaine group (test group) and 84 patients in lidocaine group (control group) , all of whom received tension-free repair . Clinical data were analyzed retrospectively by using SPSS 17.0 software.The operation time, analgesic duration, time to ambulation, hospital stay were compared by using the t test , while postoperative use of analgesic and anesthesia satisfaction of patients were compared by using χ2 test.P <0.05 was considered statistically significant.Results Operation time of the test group was (41 ±8) minutes, which was not significantly shorter than that of the control group [(43 ±7) minutes (t=1.742, P=0.083)].The analgesic duration of the test group was (7.4 ±1.6) hours, which was longer than that of [(4.8 ±1.8) hours] the control group, (t=10.023, P<0.001).There were 18 patients using painkillers in the test group 24 hours after operation, significantly less than 31 patients in the control group (χ2 =5.709, P=0.017).The mean time to ambulation of the test group was (4.6 ±0.8) hours, which was significantly shorter than that of the control group[(6.7 ±1.4) hours (t=12.147, P<0.001)].The mean discharge time of the test group was (2.7 ±0.4) days, which was significantly shorter than that of the control group [(3.6 ±0.5) days (t=13.065, P<0.001)].74 patients were satisfied with the aesthetic effect in the test group, in contrast to 57 patients in the control group of (χ2 =6.238, P=0.013). Conclusion Local anesthesia of ropivacaine combined with lidocaine in tension-free inguinal hernia repair is an effective and safe method with simple operation and minimal invasion , by which patients could gain less pain, faster recovery, and less complications and costs

  10. Predictors of fatal and nonfatal cardiovascular events in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia

    DEFF Research Database (Denmark)

    McMurray, John J V; Uno, Hajime; Jarolim, Petr

    2011-01-01

    This study aims to examine predictors of cardiovascular mortality and morbidity in patients with chronic kidney disease (CKD). Individuals with the triad of diabetes, CKD, and anemia represent a significant proportion of patients with cardiovascular disease and are at particularly high risk...

  11. [Incurable keratitis and chronic palmoplantar hyperkeratosis with hypertyrosinemia. Cure using a tyrosine-restricted diet. Type II tyrosinemia].

    Science.gov (United States)

    Hervé, F; Moreno, J L; Ogier, H; Saudubray, J M; De Prost, Y; Duffier, J L; Charpentier, C; Lemonnier, F; Frézal, J

    1986-01-01

    One should henceforth systematically search for hypertyrosinemia which, too often, goes unrecognized for years, in patients presenting chronic keratitis associated with palmar and plantar hyperkeratosis. As a matter of fact, this highly crippling disease may be cured with an appropriate diet and the diagnosis, once suspected, is easily confirmed by simple investigations.

  12. The association of pioglitazone and urinary tract disease in type 2 diabetic Taiwanese: bladder cancer and chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Mei-Yueh Lee

    Full Text Available OBJECTIVE: Although studies have shown an association between pioglitazone and bladder cancer, the associated factors have not been identified. The aim of this study was to investigate the factors that may link pioglitazone to bladder cancer. MATERIALS AND METHODS: In total, 34,970 study subjects were identified from the National Health Insurance Research Database in 2003 with follow-up from 2005 to 2009. The demographic characteristics of patients who had used and had never used pioglitazone, including age, sex, diabetes duration, urinary tract disease, nephropathy, bladder cancer, and cumulative dose and duration of pioglitazone therapy, were analyzed using the χ2 test. Cox proportional hazard regression models were used to determine the independent effects of pioglitazone on bladder cancer and newly developed chronic kidney disease. RESULTS: Among 3,497 ever users and 31,473 never users of pioglitazone, the respective incident cases of bladder cancer were 12 (0.4% and 72 (0.2%, and for newly developed chronic kidney disease 245 (8.1% and 663 (2.3%, respectively. Ever use of pioglitazone [1.59(1.32-1.91], cumulative dose of pioglitazone 10,500 mg [1.34 (1.04-1.73], and duration of therapy 12 months [1.39 (1.09-1.76] were associated with the development of chronic kidney disease. CONCLUSIONS: There was no association of pioglitazone use with bladder cancer development, however, there was an association with an increased risk of newly developed chronic kidney disease.

  13. [The moderator role of family type in the relationship between functional disability and quality of life in patients with chronic low back pain].

    Science.gov (United States)

    Ferreira, Maria Salomé Martins; Pereira, Maria da Graça

    2016-01-01

    Chronic low back pain is a disease that interferes with quality of life and the patient's functional capability. This study aimed to identify the moderating effect of the "Type of Family" in the relationship between functional disability and quality of life in patients with chronic low back pain. Two hundred and three patients with low back pain for longer than 3 months participated in the study. The instruments used were: Medical Outcome Study (MOS 20); Roland Morris Disability Questionnaire (RMDO; Family Adaptability and Cohesion Evaluation Scales (FACES II). Regression analyses were performed in order to test the moderating effect of the type of family. The results showed that patients with lower levels of disability presented better quality of life in the intermediate and balanced families, and this relationship was even stronger in balanced families. According to the results, intervention programs in chronic low back pain, besides the patient, should include the family particularly in balanced families since they are the ones that feel the impact of the disease on their quality of life the most.

  14. Dropwise Condensation of Low Surface Tension Fluids on Omniphobic Surfaces

    Science.gov (United States)

    Rykaczewski, Konrad; Paxson, Adam T.; Staymates, Matthew; Walker, Marlon L.; Sun, Xiaoda; Anand, Sushant; Srinivasan, Siddarth; McKinley, Gareth H.; Chinn, Jeff; Scott, John Henry J.; Varanasi, Kripa K.

    2014-03-01

    Compared to the significant body of work devoted to surface engineering for promoting dropwise condensation heat transfer of steam, much less attention has been dedicated to fluids with lower interfacial tension. A vast array of low-surface tension fluids such as hydrocarbons, cryogens, and fluorinated refrigerants are used in a number of industrial applications, and the development of passive means for increasing their condensation heat transfer coefficients has potential for significant efficiency enhancements. Here we investigate condensation behavior of a variety of liquids with surface tensions in the range of 12 to 28 mN/m on three types of omniphobic surfaces: smooth oleophobic, re-entrant superomniphobic, and lubricant-impregnated surfaces. We demonstrate that although smooth oleophobic and lubricant-impregnated surfaces can promote dropwise condensation of the majority of these fluids, re-entrant omniphobic surfaces became flooded and reverted to filmwise condensation. We also demonstrate that on the lubricant-impregnated surfaces, the choice of lubricant and underlying surface texture play a crucial role in stabilizing the lubricant and reducing pinning of the condensate. With properly engineered surfaces to promote dropwise condensation of low-surface tension fluids, we demonstrate a four to eight-fold improvement in the heat transfer coefficient.

  15. Tension and robustness in multitasking cellular networks.

    Directory of Open Access Journals (Sweden)

    Jeffrey V Wong

    Full Text Available Cellular networks multitask by exhibiting distinct, context-dependent dynamics. However, network states (parameters that generate a particular dynamic are often sub-optimal for others, defining a source of "tension" between them. Though multitasking is pervasive, it is not clear where tension arises, what consequences it has, and how it is resolved. We developed a generic computational framework to examine the source and consequences of tension between pairs of dynamics exhibited by the well-studied RB-E2F switch regulating cell cycle entry. We found that tension arose from task-dependent shifts in parameters associated with network modules. Although parameter sets common to distinct dynamics did exist, tension reduced both their accessibility and resilience to perturbation, indicating a trade-off between "one-size-fits-all" solutions and robustness. With high tension, robustness can be preserved by dynamic shifting of modules, enabling the network to toggle between tasks, and by increasing network complexity, in this case by gene duplication. We propose that tension is a general constraint on the architecture and operation of multitasking biological networks. To this end, our work provides a framework to quantify the extent of tension between any network dynamics and how it affects network robustness. Such analysis would suggest new ways to interfere with network elements to elucidate the design principles of cellular networks.

  16. Traumatic tension pneumocephalus: Two case reports

    Directory of Open Access Journals (Sweden)

    Abubaker Al-Aieb

    2017-01-01

    Conclusions: These are two rare cases with posttraumatic tension pneumocephalus treated conservatively with a favorable outcome. Early diagnosis of tension pneumocephalus is a crucial step to facilitate early recovery; however, the associated injuries need attention as they could influence the hospital course.

  17. Functional influence of botulinum neurotoxin type A treatment (Xeomin® of multifocal upper and lower limb spasticity on chronic hemiparetic gait

    Directory of Open Access Journals (Sweden)

    Maurizio Falso

    2012-05-01

    Full Text Available This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

  18. [Multiple gastro-intestinal stromal tumors (GIST) in a patient with type I neurofibromatosis revealed by chronic bleeding: pre-operative radiological diagnosis].

    Science.gov (United States)

    Guillaud, Olivier; Dumortier, Jérôme; Bringuier, Pierre-Paul; Saurin, Jean-Christophe; Poncet, Gilles; Boulez, Jean; Henry, Luc; Chayvialle, Jean-Alain; Scoazec, Jean-Yves

    2006-02-01

    Recent studies have pointed out a high incidence of GIST, usually multiple and of small intestinal location, in patients with type I neurofibromatosis. We here report an additional case, revealed by chronic gastro-intestinal bleeding and diagnosed at pre-operative imaging studies. A 56-year-old patient, with known type I neurofibromatosis, was referred to our department for the exploration of chronic gastro-intestinal bleeding during anti-aggregant therapy. Endoscopical examination was negative. Enteroscanner showed the presence of four tumor lesions, 3 in the jejunum and 1 in the ileum. Segmental surgical resections were performed. At histological examination, 2 of among the 3 jejunal lesions were diagnosed as typical GIST, of low risk of malignancy, CD117+, CD34+, whereas the last jejunal and ileal lesions were identified as fibroid tumors. Mutations of c-kit gene and of the gene coding for PDGF-Ralpha were not detected. Post-operative recovery was uneventful; no recurrent bleeding was observed. Our case report underlines the potential role of enteroscanner in the management of patients with type I neurofibromatosis with possible digestive complications. It also emphasizes the importance of an accurate diagnosis of the digestive tumors associated with type I neurofibromatosis: GISTs are frequent in this setting and must not be misdiagnosed as neurofibromas.

  19. FORMULAS OF TENSION OF CONTINUOUS ROLLING PROCESS

    Institute of Scientific and Technical Information of China (English)

    J.Z. Zhang; X.P. Zhang

    2007-01-01

    The development of computer controlled continuous rolling process calls for a mathematicalexpression that can express the inequality condition of "constant flow". Tension is the link of thecontinuous rolling process. From the condition of dynamic equilibrium, a differential equation oftension is given out. On the basis of the physical rules established from the industrial practice andexperimental studies, the law of volume constancy, the linear relation of forward slip and tension,the state equation of continuous rolling, the formula of dynamic tension, and the formula of statictension have been obtained. These formulae reflect the functional relations between tensions,thickness, roll velocity, and time in the continuous rolling process. It is implied that the continuousrolling process is a gradually steady, controllable, and measurable dynamic system. An assumptionof predicting the thickness of a steel plate using these tension formulae is also put forward.

  20. Magnetic Tension of Sunspot Fine Structures

    CERN Document Server

    Venkatakrishnan, P

    2010-01-01

    The equilibrium structure of sunspots depends critically on its magnetic topology and is dominated by magnetic forces. Tension force is one component of the Lorentz force which balances the gradient of magnetic pressure in force-free configurations. We employ the tension term of the Lorentz force to clarify the structure of sunspot features like penumbral filaments, umbral light bridges and outer penumbral fine structures. We compute vertical component of tension term of Lorentz force over two active regions namely NOAA AR 10933 and NOAA AR 10930 observed on 05 January 2007 and 12 December 2006 respectively. The former is a simple while latter is a complex active region with highly sheared polarity inversion line (PIL). The vector magnetograms used are obtained from Hinode(SOT/SP). We find an inhomogeneous distribution of tension with both positive and negative signs in various features of the sunspots. The existence of positive tension at locations of lower field strength and higher inclination is compatible...

  1. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience"

    Directory of Open Access Journals (Sweden)

    Van Royen Paul

    2009-08-01

    Full Text Available Abstract Background Most research publications on Chronic Care Model (CCM implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Belgian healthcare setting, a setting where the organisational framework for chronic care is mainly hospital-centered. Methods Process evaluation of an action research project (2003–2007 guided by the CCM in a well-defined geographical area with 76,826 inhabitants and an estimated number of 2,300 type 2 diabetes patients. In consultation with the region a program for type 2 diabetes patients was developed. The degree of implementation of the CCM in the region was assessed using the Assessment of Chronic Illness Care survey (ACIC. A multimethod approach was used to evaluate the implementation process. The resulting data were triangulated in order to identify the main facilitators and barriers encountered during the implementation process. Results The overall ACIC score improved from 1.45 (limited support at the start of the study to 5.5 (basic support at the end of the study. The establishment of a local steering group and the appointment of a program manager were crucial steps in strengthening primary care. The willingness of a group of well-trained and motivated care providers to invest in quality improvement was an important facilitator. Important barriers were the complexity of the intervention, the lack of quality data, inadequate information technology support, the lack of commitment procedures and the uncertainty about sustainable funding. Conclusion Guided by the CCM, this study highlights the opportunities and the bottlenecks for adapting chronic care

  2. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  3. [Biomarkers of iron metabolism and inflammation in patients with chronic heart failure and various types of left ventricular dysfunction].

    Science.gov (United States)

    Kazymyrko, V K; Kutovyĭ, V V; Ivanyts'ka, L M; Dubkova, A G; Silant'ieva, T S

    2013-09-01

    Study the level of some of the indicators of iron metabolism and inflammatory markers in patients with chronic heart failure due to hypertension and coronary heart disease. The results of the study in systolic and diastolic dysfunction of the left ventricle, the varying degrees of severity of heart failure. The level of the studied parameters determined by the severity of heart failure and does not depend on the nature of left ventricular dysfunction.

  4. Uniaxial tension of drying sieves

    Directory of Open Access Journals (Sweden)

    Bojić Nada V.

    2013-01-01

    Full Text Available Although the literature contains numerous studies that have been developed to describe the nonlinear behavior of drying sieves' operation, there are no papers in this which report deeper investigation of the drying sieve behavior when exposed to tension and thermo stabilization. The aim of this paper is to provide insight into the elastoplastic behavior of the thermo stabilized and not stabilized sieves subjected to the tensile force. Within this work both theoretical and experimental investigations were performed. The sieves were joined by using a spiral. In separate experiments tests of wire base and weft of the weave mesh were performed, both for thermo stabilized and not thermo stabilized sieves, sieves joining and the sieve thermo stabilization itself. It was established that the thermo stabilization of sieves provides for stability of sieves' dimensions and that open thermo stabilized drying sieve exhibits better mechanical properties and exploitation characteristics then the sieves joining. [Projekat Ministarstva nauke Republike Srbije, br. ON174004: Micromechanics criteria of damage and fracture and br. TR 32036: Development of software for solving the coupled multi-physical problems

  5. Lipid metabolism and levels of proinflammatory cytokines in patients with type 2 diabetes with diabetic nephropathy depending on the stage of chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Y V Khasanova

    2012-06-01

    Full Text Available Aim: to study the role and relationship of lipid metabolism and levels of proinflammatory cytokines in patients with type 2 diabetes mellitus (DM2 with diabetic nephropathy (DN, depending on the stage of chronic kidney disease (CKD. Materials and Methods: a total of 240 patients with type 2 diabetes in the early stages of DN and CKD were studied. Results: in patients with type 2 diabetes development of DN was associated with an increased level of proinflammatory cytokines and lipid abnormalities (hypertriglyceridemia. We found a negative correlation between the level of triglycerides (TG and glomerular filtration rate (GFR (r = -0,43 and a direct correlation between the level of IL-6 and TG (r = 0,48. Conclusions: increased levels of proinflammatory cytokines and triglycerides increase the risk of development and progression of DN and CKD.

  6. Optimazation of antibiotic therapy in patients with chronic pyelonephritis combined with pancreatic diabetes of the 2 type by evaluation of the expression of plasmid resistance genes

    Directory of Open Access Journals (Sweden)

    Ольга Игоревна Чуб

    2015-07-01

    Full Text Available The resistance caused by the transfer of resistance genes among the uropathogenes with a help of plasmids in the treatment of chronic pyelonephritis (CP combined with pancreatic diabetes (PD of the 2 type increased last years. The aim of research was an optimization of methods of differentiated prescription of antibiotic therapy (ABT for patients with CP and contaminant PD of the 2 type depending on expression of plasmid-induced genic mechanisms of antibiotic resistance.Methods. There were examined 105 patients with chronic pyelonephritis, 73 of them – against the background of PD of the 2 type. The sensitivity of isolated cultures to antibiotics was carried out by the disco-diffuse method of Bauer-Kirbi on the medium of Hinton-Muller using commercial discs. The study of plasmid-induced mechanisms of resistance was carried out by the method of polymerase chain reaction (PCR.Results. Detectability of plasmid-induced mechanisms in patients with CP and PD of the 2 type is 31,5 %. Β-lactamase of extended spectrum (βLES – were the most diffuse detected genes. The highest inhibitory activity against the strains with plasmid genes was shown by meropenem, fosfomicyn, nitroxolinum, 4th generation of cephalosporins and the 3th generation of fluoroquinolones. According to received results it was elaborated an algorithm of differentiated prescription of ABT for patients with CP and PD of the 2 type depending on expression of plasmid-induced resistance genes.Conclusions. There was studied the prevalence of plasmid-induced resistance mechanisms and elaborated the methods for increase an efficiency of empirical ABT for patients with CP and contaminant PD of the 2 type

  7. Neurofeedback therapy in patients with acute and chronic pain syndromes--literature review and own experience.

    Science.gov (United States)

    Kubik, Alicja; Biedroń, Agnieszka

    2013-01-01

    Pain management is based mainly on pharmacotherapy which has many limitations. Non-pharmacological techniques, like neurofeedback (EEG-biofeedback) are alternative methods of pain treatment. Data from literature confirm high efficacy of neurofeedback in pain syndromes treatment, chronic and acute as well. Neurofeedback plays an important role in management of post stroke, post traumatic headaches and in primary headaches like tension type headaches or migraine. Literature review and own experience indicate importance of number and frequency of performed neurofeedback trainings on treatment effectiveness. Satisfactory results have already been observed after 30 trainings however usually 40-60 training have to be performed. Effectiveness of such therapy in pain syndromes is usually good or less often acceptable (50% reduction of headaches). Children with tension type headaches (differently than adults) need reminder therapy every 6-12 months, otherwise recurrence of headaches is observed. Based on our own experience neurofeedback therapy seems to play role in neuropathic pain and cancer pain management.

  8. Impairments and activity limitations in subjects with chronic upper-limb complex regional pain syndrome type I.

    NARCIS (Netherlands)

    F.C. Schasfoort (Fabiënne); J.B.J. Bussmann (Hans); H.J. Stam (Henk)

    2004-01-01

    textabstractOBJECTIVE: To determine the degree of impairments and activity limitations and their interrelationship in complex regional pain syndrome type I (CRPS type I). DESIGN: Cross-sectional study interrelating impairments and objectively measured activity limitations. SETTING: Ambulatory and

  9. Effect of periodontal therapy on type 2 diabetes mellitus patients with chronic periodontitis with the evaluation of HbA1c

    Directory of Open Access Journals (Sweden)

    Manvi Chandra Agarwal

    2016-01-01

    Full Text Available Context: In the recent years, a two-way correlation has been postulated between periodontitis and systemic conditions. One such condition is diabetes mellitus (DM. Several studies have demonstrated a close relationship between DM and chronic periodontitis. Aims: To assess the effect of periodontal therapy and scaling and root planing (SRP on the metabolic control in type 2 DM patients with chronic periodontitis based on the estimation of glycated hemoglobin (HbA1c. Settings and Design: A prospective, comparative, clinical study was performed on 50 patients suffering from type 2 DM with moderate, generalized chronic periodontitis. The study period was 6 months. Type 2 moderately controlled diabetic patients with glycated hemoglobin values within the range of 6-8% were selected. Patients with major diabetic complications, history of any antibiotic intake or periodontal treatment within the last 4 months, and smoking habits were excluded. Materials and Methods: The parameters recorded were gingival index (GI, plaque index (PI, sulcus bleeding index (SBI, probing pocket depth (PPD, clinical attachment level (CAL, and glycated hemoglobin. The recordings were done at baseline and 6 months after scaling and root planing procedures. HbA1c was measured by NycoCard Reader. Statistical Analysis Used: Karl-Pearson coefficient test, Z-test, and paired t-test. Results: Reductions in all the clinical parameters were observed and were found to be statistically significant (P < 0.005. Conclusions: Scaling and root planing resulted in a statistically significant reduction in the clinical parameters and HbA1c. So, periodontal treatment should be included in the management of diabetic patients.

  10. Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial.

    Science.gov (United States)

    Castro Dos Santos, Nídia Cristina; Andere, Naira Maria Rebelatto Bechara; Araujo, Cássia Fernandes; de Marco, Andrea Carvalho; Dos Santos, Lúcio Murilo; Jardini, Maria Aparecida Neves; Santamaria, Mauro Pedrine

    2016-11-01

    Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.

  11. Experimental and calculated liquid-liquid interfacial tension in demixing metal alloys

    Institute of Scientific and Technical Information of China (English)

    Walter Hoyer; Ivan Kaban

    2006-01-01

    Liquid-liquid interfacial tension in binary and ternary Al-based monotectic systems has been determined experimentally with a tensiometric method in a wide temperature interval. The temperature dependence of the interfacial tension is well described by a power law function of the type σαβ~ (1 - T/Tc)δ with the critical exponent δ = 1.3 and a critical tem perature TC. Theoretical models describing the liquid-liquid interface in monotectic alloys and their applicability for calculation of the interfacial tension and its temperature dependence in binary systems are considered.

  12. Roseires Dam Heightening Project in Sudan Works of Pre-tensioned Pre-stressed Concrete Beams

    Institute of Scientific and Technical Information of China (English)

    黄志敏

    2014-01-01

    Works of pre-tensioned and pre-stressed concrete beams at dam crest of Roseires Dam Heightening Project located on Nile Riv-er in the Country of Sudan was in a big quantity, complexity and tight completion time. For pre-tensioning operation, frame type pedestal was built. Strict work method statement and applicable work procedure were also developed to assure high work quality and timely completion. All these have become precious experience in the field of pre-tensioning and pre-stressing beams.

  13. Computer-aided design of tension structures

    OpenAIRE

    Ong, C.F.

    1992-01-01

    This thesis consists of three parts. Part I (chapters 1-4) gives a review and description of the basis for the numerical modelling of tension structures. The discussion in Part I leads to the conclusion of a need for an interactive design procedure for tension structures which is the subject under consideration in Part II (chapters 5-7). In the design of tension structures, an area which requires special attention is the dynamic response often initiated by the action of a natural wind. In Par...

  14. Surface tension profiles in vertical soap films

    Science.gov (United States)

    Adami, N.; Caps, H.

    2015-01-01

    Surface tension profiles in vertical soap films are experimentally investigated. Measurements are performed by introducing deformable elastic objets in the films. The shape adopted by those objects once set in the film is related to the surface tension value at a given vertical position by numerically solving the adapted elasticity equations. We show that the observed dependency of the surface tension versus the vertical position is predicted by simple modeling that takes into account the mechanical equilibrium of the films coupled to previous thickness measurements.

  15. The surface tension of liquid gallium

    Science.gov (United States)

    Hardy, S. C.

    1985-01-01

    The surface tension of liquid gallium has been measured using the sessile drop technique in an Auger spectrometer. The experimental method is described. The surface tension in mJ/sq m is found to decrease linearly with increasing temperature and may be represented as 708-0.66(T-29.8), where T is the temperature in centigrade. This result is of interest because gallium has been suggested as a model fluid for Marangoni flow experiments. In addition, the surface tension is of technological significance in the processing of compound semiconductors involving gallium.

  16. A cross-sectional study on occurrence of type 2 diabetes among patients admitted with chronic liver diseases in a medical college in Kolkata

    Directory of Open Access Journals (Sweden)

    Shuvankar Mukherjee

    2013-01-01

    Full Text Available Objectives: To study the magnitude of the problem of type 2 diabetes mellitus and impaired glucose intolerance among the patients with various types of chronic liver diseases and to find out the association of diabetes mellitus and impaired glucose tolerance with the demographic and clinical characteristics of the patients. Materials and Methods: This observational study, which was cross-sectional in design, was undertaken in the Department of General Medicine at a medical College in Kolkata during October 2010 to July 2011. Altogether 161 patients diagnosed with chronic liver disease (CLD were admitted in the General Medicine ward during the study period, out of which 9 patients got themselves discharged against medical advice. From the remaining 152 patients, a total of 136 patients aged 20 years and above were selected for the study according to the inclusion criteria. A detailed history was taken, and a thorough clinical examination was done followed by further investigations, all of which were recorded in a pre-designed, structured proforma. Results : Among the study subjects, 58.1% had impaired glucose tolerance (IGT, while 14.0% had overt diabetes mellitus. IGT and diabetes were significantly higher among the CLD patients aged 45 years or more (P < 0.05. However, similar association was not observed with regard to sex of the patients. No association was found between the occurrence of IGT and/or overt diabetes with either severity (as per Child-Pugh score or with the duration of CLD. More than half of the study subjects having alcoholic liver disease or chronic hepatitis B or C or autoimmune hepatitis and one third of those having Wilson's disease had IGT, while one third of those with either chronic hepatitis C or Wilson's disease and one fourth of those having autoimmune hepatitis had overt diabetes. Twenty-one percent of those with chronic hepatitis B also found to have overt diabetes, which was least in those with alcoholic liver

  17. Acceptance and commitment therapy in youth with neurofibromatosis type 1 (NF1) and chronic pain and their parents: A pilot study of feasibility and preliminary efficacy.

    Science.gov (United States)

    Martin, Staci; Wolters, Pamela L; Toledo-Tamula, Mary Anne; Schmitt, Shawn Nelson; Baldwin, Andrea; Starosta, Amy; Gillespie, Andrea; Widemann, Brigitte

    2016-06-01

    Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder affecting about 1 in 3,500 individuals. Chronic pain is commonly reported among individuals with NF1 and plexiform neurofibroma tumors (PNs). Acceptance and Commitment Therapy (ACT), an empirically supported method for addressing chronic pain, helps individuals re-focus on valued relationships and activities. This pilot study investigated the feasibility and preliminary efficacy of a brief ACT workshop in the NF1 population. Eligible participants included adolescents and young adults (AYA; 12-21 years) with NF1 and chronic pain that interfered with daily functioning and their parents. Patients and parents completed baseline measures of pain interference, pain intensity, functional disability, pain acceptance, depression, and anxiety. Then, AYA and parents participated separately in a 2-day small-group ACT workshop. A telephone booster session occurred 1 month post-intervention. Three-month post-treatment measures were completed by mail. Ten adolescents (4 males; M age = 16.9 years) and seven parents provided baseline and 3-month data. Mean satisfaction with the study was moderate to high (3.9 for patients and 4.6 for parents on a 1-5 scales). Patients and parents reported significant declines in patients' pain interference at 3 months post-treatment. Patient-reported pain intensity significantly declined from baseline to 3 months. Parents reported marginally greater acceptance of their child's pain. No changes emerged in functional ability or mood. Preliminary findings suggest that a brief ACT group intervention is feasible and may help AYA with NF1 and PNs cope with their chronic pain, although larger randomized studies are needed to confirm treatment efficacy. © 2016 Wiley Periodicals, Inc.

  18. Neural Plasticity in Common Forms of Chronic Headaches

    Science.gov (United States)

    Lai, Tzu-Hsien; Protsenko, Ekaterina; Cheng, Yu-Chen; Loggia, Marco L.; Coppola, Gianluca; Chen, Wei-Ta

    2015-01-01

    Headaches are universal experiences and among the most common disorders. While headache may be physiological in the acute setting, it can become a pathological and persistent condition. The mechanisms underlying the transition from episodic to chronic pain have been the subject of intense study. Using physiological and imaging methods, researchers have identified a number of different forms of neural plasticity associated with migraine and other headaches, including peripheral and central sensitization, and alterations in the endogenous mechanisms of pain modulation. While these changes have been proposed to contribute to headache and pain chronification, some findings are likely the results of repetitive noxious stimulation, such as atrophy of brain areas involved in pain perception and modulation. In this review, we provide a narrative overview of recent advances on the neuroimaging, electrophysiological and genetic aspects of neural plasticity associated with the most common forms of chronic headaches, including migraine, cluster headache, tension-type headache, and medication overuse headache. PMID:26366304

  19. Neural Plasticity in Common Forms of Chronic Headaches

    Directory of Open Access Journals (Sweden)

    Tzu-Hsien Lai

    2015-01-01

    Full Text Available Headaches are universal experiences and among the most common disorders. While headache may be physiological in the acute setting, it can become a pathological and persistent condition. The mechanisms underlying the transition from episodic to chronic pain have been the subject of intense study. Using physiological and imaging methods, researchers have identified a number of different forms of neural plasticity associated with migraine and other headaches, including peripheral and central sensitization, and alterations in the endogenous mechanisms of pain modulation. While these changes have been proposed to contribute to headache and pain chronification, some findings are likely the results of repetitive noxious stimulation, such as atrophy of brain areas involved in pain perception and modulation. In this review, we provide a narrative overview of recent advances on the neuroimaging, electrophysiological and genetic aspects of neural plasticity associated with the most common forms of chronic headaches, including migraine, cluster headache, tension-type headache, and medication overuse headache.

  20. Functional proteins involved in regulation of intracellular Ca(2+) for drug development: chronic nicotine treatment upregulates L-type high voltage-gated calcium channels.

    Science.gov (United States)

    Katsura, Masashi; Ohkuma, Seitaro

    2005-03-01

    Neurochemical mechanisms underlying drug dependence and withdrawal syndrome remain unclear. In this review, we discuss how chronic nicotine exposure to neurons affects expression of diazepam binding inhibitor (DBI), an endogenous anxiogenic neuropeptide supposed to be a common substance participating drug dependence, and function of L-type high voltage-gated Ca(2+) channels (HVCCs). We also discuss the functional interaction between DBI and L-type HVCCs in nicotine dependence. Both DBI levels and [(45)Ca(2+)] influx significantly increased in the brain from mice treated with nicotine for long term, which was further enhanced after abrupt cessation of nicotine and was abolished by nicotinic acetylcholine receptor (nAChR) antagonists. Similar responses of DBI expression and L-type HVCC function were observed in cerebral cortical neurons after sustained exposure to nicotine. In addition, increased DBI expression was inhibited by antagonists of nAChR and L-type HVCCs. Sustained exposure of neurons to nicotine significantly enhanced expression of alpha(1) and alpha(2)/delta(1) subunits for L-type HVCCs and caused an increase in the B(max) value of [(3)H]verapamil binding to the particulate fractions. Therefore, it is concluded that the alterations in DBI expression is mediated via increased influx of Ca(2+) through upregulated L-type HVCCs and these neurochemical changes have a close relationship with development of nicotine dependence and/or its withdrawal syndrome.

  1. Dipeptidyl peptidase 4 inhibition may facilitate healing of chronic foot ulcers in patients with type 2 diabetes.

    Science.gov (United States)

    Marfella, Raffaele; Sasso, Ferdinando Carlo; Rizzo, Maria Rosaria; Paolisso, Pasquale; Barbieri, Michelangela; Padovano, Vincenzo; Carbonara, Ornella; Gualdiero, Pasquale; Petronella, Pasquale; Ferraraccio, Franca; Petrella, Antonello; Canonico, Raffaele; Campitiello, Ferdinando; Della Corte, Angela; Paolisso, Giuseppe; Canonico, Silvestro

    2012-01-01

    The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19-35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  2. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Raffaele Marfella

    2012-01-01

    Full Text Available The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  3. Chronic daily headache in the elderly.

    Science.gov (United States)

    Özge, Aynur

    2013-12-01

    Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the "aging world" continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body.

  4. The Utility of a Syndemic Framework in Understanding Chronic Disease Management Among HIV-Infected and Type 2 Diabetic Men Who Have Sex with Men.

    Science.gov (United States)

    Byg, Blaire; Bazzi, Angela Robertson; Funk, Danielle; James, Bonface; Potter, Jennifer

    2016-12-01

    Syndemic theory posits that epidemics of multiple physical and psychosocial problems co-occur among disadvantaged groups due to adverse social conditions. Although sexual minority populations are often stigmatized and vulnerable to multiple health problems, the syndemic perspective has been underutilized in understanding chronic disease. To assess the potential utility of this perspective in understanding the management of co-occurring HIV and Type 2 diabetes, we used linear regression to examine glycemic control (A1c) among men who have sex with men (MSM) with both HIV and Type 2 diabetes (n = 88). Bivariable linear regression explored potential syndemic correlates of inadequate glycemic control. Compared to those with adequate glycemic control (A1c ≤ 7.5 %), more men with inadequate glycemic control (A1c > 7.5 %) had hypertension (70 vs. 46 %, p = 0.034), high triglycerides (93 vs. 61 %, p = 0.002), depression (67 vs. 39 %, p = 0.018), current substance abuse (15 vs. 2 %, p = 0.014), and detectable levels of HIV (i.e., viral load ≥75 copies per ml blood; 30 vs. 10 %, p = 0.019). In multivariable regression controlling for age, the factors that were independently associated with higher A1c were high triglycerides, substance use, and detectable HIV viral load, suggesting that chronic disease management among MSM is complex and challenging for patients and providers. Findings also suggest that syndemic theory can be a clarifying lens for understanding chronic disease management among sexual minority stigmatized populations. Interventions targeting single conditions may be inadequate when multiple conditions co-occur; thus, research using a syndemic framework may be helpful in identifying intervention strategies that target multiple co-occurring conditions.

  5. Transcutaneous Determination of Arterial Oxygen Tension

    Science.gov (United States)

    Fenner, A.; And Others

    1975-01-01

    Evaluated were two techniques (the conventional method and the new transcutaneous method) of measuring arterial oxygen tension in 20 severely ill preterm and term infants and in 70 healthy infants. (Author/CL)

  6. The Dynamic Surface Tension of Water.

    Science.gov (United States)

    Hauner, Ines M; Deblais, Antoine; Beattie, James K; Kellay, Hamid; Bonn, Daniel

    2017-03-23

    The surface tension of water is an important parameter for many biological or industrial processes, and roughly a factor of 3 higher than that of nonpolar liquids such as oils, which is usually attributed to hydrogen bonding and dipolar interactions. Here we show by studying the formation of water drops that the surface tension of a freshly created water surface is even higher (∼90 mN m(-1)) than under equilibrium conditions (∼72 mN m(-1)) with a relaxation process occurring on a long time scale (∼1 ms). Dynamic adsorption effects of protons or hydroxides may be at the origin of this dynamic surface tension. However, changing the pH does not significantly change the dynamic surface tension. It also seems unlikely that hydrogen bonding or dipole orientation effects play any role at the relatively long time scale probed in the experiments.

  7. Psychology--tensions between objectivity and subjectivity.

    Science.gov (United States)

    Klempe, Sven Hroar

    2012-09-01

    The self is often defined in terms of its presentational appearances. This may easily end up in a denial of the internal aspects of the self, which is very often related to a tendency to avoid the tension between the internal and the external, but also between subjectivity and objectivity. In this paper this ambition is regarded in a historical perspective, in which Fichte and Hegel both represent attempts at abolishing the tension, whereas Kant and Kierkegaard represent the opposite. History shows that an eradication of the tension between subjectivity and objectivity implies a deterioration of psychology as well. Thus the conclusion is that psychology is primarily to be defined in terms of the tension between subjectivity and objectivity, which requires an accurate understanding and the inclusion of both of them.

  8. Proximal scalloped custom-made Relay® stent graft in chronic type B dissection: endovascular repair in a drug abuser patient

    Science.gov (United States)

    Szeberin, Zoltán; Nemes, Balázs; Csobay-Novák, Csaba; Mihály, Zsuzsa; Entz, László

    2016-01-01

    The best solution for enlarging chronic type B aortic dissection is not known. Hybrid surgical and endovascular procedures offer a reliable solution in such circumstances, but technically complex stent-graft designs are sometimes needed when the treatment segment of the aorta presents anatomical challenges. We report a case of a proximally scalloped custom-made stent-graft implantation following left subclavian artery transposition in a formerly cocaine-abuser patient. The one-month follow-up computed tomography angiography showed a proximal endoleak (type Ia) which was successfully solved by coil embolization. Proximally scalloped stent grafts offer a reliable solution in complex aortic dissections involving the supra-aortic branches. PMID:28250982

  9. Snailase Preparation of Ginsenoside M1 from Protopanaxadiol-Type Ginsenoside and Their Protective Effects Against CCl4-Induced Chronic Hepatotoxicity in Mice

    Directory of Open Access Journals (Sweden)

    Li Chen

    2011-12-01

    Full Text Available To investigate the protective effects of protopanaxadiol-type ginsenoside (PDG and its metabolite ginsenoside M1 (G-M1 on carbon tetrachloride (CCl4-induced chronic liver injury in ICR mice, we carried out conversion of protopanaxadiol-type ginsenosides to ginsenoside M1 using snailase. The optimum time for the conversion was 24 h at a constant pH of 4.5 and an optimum temperature of 50 °C. The transformation products were identified by high-performance liquid chromatography and electrospray ion-mass spectrometry. Subsequently, most of PDG was decomposed and converted into G-M1 by 24 h post-reaction. During the study on hepatoprotective in a mice model of chronic liver injury, PDG or G-M1 supplement significantly ameliorated the CCl4-induced liver lesions, lowered the serum levels of select hepatic enzyme markers (alanine aminotransferase, ALT, and aspartate aminotransferase, AST and malondialdehyde and increased the activity of superoxide dismutase in liver. Histopathology of the liver tissues showed that PDG and G-M1 attenuated the hepatocellular necrosis and led to reduction of inflammatory cell infiltration. Therefore, the results of this study show that PDG and G-M1 can be proposed to protect the liver against CCl4-induced oxidative injury in mice, and the hepatoprotective effect might be attributed to amelioration of oxidative stress.

  10. Tension Hydrothorax Related to Disseminated Endometriosis

    Directory of Open Access Journals (Sweden)

    AnnaKate Deal, MD

    2016-01-01

    Full Text Available We present the case of a 34-year-old woman presenting to the emergency department (ED with dyspnea, cough, and fever. She was found to have a tension hydrothorax and was treated with ultrasound-guided thoracentesis in the ED. Subsequent inpatient evaluation showed the patient had disseminated endometriosis. Tension hydrothorax has not been previously described in the literature as a complication of this disease.

  11. The Tensions of In Situ Visualization.

    Science.gov (United States)

    Moreland, Kenneth

    2016-01-01

    In situ visualization is the coupling of visualization software with a simulation or other data producer to process the data "in memory" before the data are offloaded to a storage system. Although in situ visualization provides superior analysis, it has implementation tradeoffs resulting from conflicts with some traditional expected requirements. Numerous conflicting requirements create tensions that lead to difficult implementation tradeoffs. This article takes a look at the most prevailing tensions of in situ visualization.

  12. Type D personality and depressive symptoms are independent predictors of impaired health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W;

    2008-01-01

    To examine whether Type D personality exerts a stable, independent effect on health status in CHF over time, adjusted for depressive symptoms.......To examine whether Type D personality exerts a stable, independent effect on health status in CHF over time, adjusted for depressive symptoms....

  13. OUTCOME OF TYPE I TYMPANOPLASTY IN TUBOTYMPANIC CHRONIC SUPPURATIVE OTITIS MEDIA IN RELATION TO SITE AND SIZE OF TYMPANIC MEMBRANE PERFORATION

    Directory of Open Access Journals (Sweden)

    Nitin V

    2015-11-01

    Full Text Available AIM: To find out the relation between hearing loss with site and size of perforation and assessment of improvement in hearing and graft uptake following type I tympanoplasty in dry Tubotympanic Chronic Suppurative Otitis Media. Study Design-Non-Randomized Experimental Study. MATERIAL AND METHOD: This study was done in ENT OPD at Tertiary Health Care Institute of Central India. It was conducted from November 2012 to October 2014 on 46 patients having dry Tubotympanic Chronic Suppurative Otitis Media. Type 1 Tympanoplasty was done in all patients using temporalis fascia graft. All patients were followed up for 12 weeks postoperatively and evaluated for graft uptake and hearing improvement with respect to size and site of perforation. Results were analyzed statistically. RESULTS: Complete graft uptake was seen in 86.46% patients. Graft uptake was more in small perforations than larger ones (p value=0.0008. Graft failure was more in subtotal perforation and perforations involving all four quadrants. Average Pure Tone hearing loss was more in Subtotal perforation (45.5dB and perforations occupying all four quadrants (41.27%. Hearing loss was more in Posteroinferior quadrant perforations as compared to Anteroinferior quadrant perforations and so also the hearing improvement after type I tympanoplasty. CONCLUSION: There was a relationship between size and site of perforation with hearing impairment in tubotympanic type of CSOM. Posterior quadrant perforations were having more hearing loss and greater hearing improvement after surgery as compared to those with anterior quadrant perforation. Rate of graft uptake was directly proportional to size of perforation.

  14. Monte Carlo study of the frame, fluctuation and internal tensions of fluctuating membranes with fixed area

    Science.gov (United States)

    Shiba, Hayato; Noguchi, Hiroshi; Fournier, Jean-Baptiste

    Three types of surface tensions can be defined for lipid membranes: the internal tension, $\\sigma$, conjugated to the real membrane area in the Hamiltonian, the mechanical frame tension, $\\tau$, conjugated to the projected area, and the "fluctuation tension", $r$, obtained from the fluctuation spectrum of the membrane height. We investigate these surface tensions by means of a Monge gauge lattice Monte Carlo simulation involving the exact, nonlinear, Helfrich Hamiltonian and a measure correction for excess entropy of the Monge gauge. Our results for the relation between $\\sigma$ and $\\tau$ agrees well with the theoretical prediction of [J.-B. Fournier and C. Barbetta, Phys. Rev. Lett., 2008, 100, 078103] based on a Gaussian approximation. This provides a valuable knowledge of~$\\tau$ in the standard Gaussian models where the tension is controlled by $\\sigma$. However, contrary to the conjecture in the above paper, we find that $r$ exhibits no significant difference from $\\tau$ over more than five decades of tension. Our results appear to be valid in the thermodynamic limit and are robust to changing the ensemble in which the membrane area is controlled.

  15. Tension-oriented cell divisions limit anisotropic tissue tension in epithelial spreading during zebrafish epiboly.

    Science.gov (United States)

    Campinho, Pedro; Behrndt, Martin; Ranft, Jonas; Risler, Thomas; Minc, Nicolas; Heisenberg, Carl-Philipp

    2013-12-01

    Epithelial spreading is a common and fundamental aspect of various developmental and disease-related processes such as epithelial closure and wound healing. A key challenge for epithelial tissues undergoing spreading is to increase their surface area without disrupting epithelial integrity. Here we show that orienting cell divisions by tension constitutes an efficient mechanism by which the enveloping cell layer (EVL) releases anisotropic tension while undergoing spreading during zebrafish epiboly. The control of EVL cell-division orientation by tension involves cell elongation and requires myosin II activity to align the mitotic spindle with the main tension axis. We also found that in the absence of tension-oriented cell divisions and in the presence of increased tissue tension, EVL cells undergo ectopic fusions, suggesting that the reduction of tension anisotropy by oriented cell divisions is required to prevent EVL cells from fusing. We conclude that cell-division orientation by tension constitutes a key mechanism for limiting tension anisotropy and thus promoting tissue spreading during EVL epiboly.

  16. A survival case of painless chronic type A aortic dissection with a history of stroke and anticoagulant use.

    Science.gov (United States)

    Tugcu, Aylin; Yildirimturk, Ozlem; Demiroglu, I C Cemsid; Aytekin, Saide

    2010-10-01

    We report the case of a patient with completely painless chronic aortic dissection, who presented to another hospital with a left hemiparesia 3 months ago and received anticoagulation therapy with a diagnosis of ischemic stroke. Most of her symptoms had resolved when she presented to our outpatient clinic except for numbness of her left hand and dysphasia. Physical examination found a diastolic murmur at the left sternal border and a bruit over the right carotid artery. Transthoracic echocardiography and carotid sonography demonstrated aortic dissection with extension into the internal right carotid artery and severe aortic regurgitation. Surgery was performed successfully and the patient was discharged. This case emphasizes that the diagnosis of a completely painless aortic dissection with only neurologic symptoms at presentation can be extremely difficult and should always be considered as a cause of ischemic stroke to avoid catastrophic antithrombolytic or anticoagulation therapy.

  17. Effect of acute and chronic eccentric exercise on FOXO1 mRNA expression as fiber type transition factor in rat skeletal muscles.

    Science.gov (United States)

    Azad, Milad; Khaledi, Neda; Hedayati, Mehdi

    2016-06-15

    Skeletal muscle is a highly elastic tissue which can respond to various functional demands by altering fiber-type composition. Exercise affects muscle fiber phenotype. One of the transcription factors that induce fiber-type transition is forkhead box O1 (FOXO1). Since eccentric contraction considered an essential part of exercise, so we are interested to see the effects of eccentric exercise (acute/chronic) on FOXO1 as an important factor of fiber-type transition in rat skeletal muscles. Twenty-four Sprague-Dawley rats (190-235g) were divided to 3 groups of 8 rats: 1) chronic eccentric exercise (CEE), 2) acute eccentric exercise (AEE), and 3) control (C). The exercise groups underwent downhill running protocol. CEE was running on treadmill in 3 days of week for 9 weeks, that slope and duration gradually managed from -4° to -16° and 15 to 90 min, respectively. AEE group was running with 16 m/min on -16° slope for 3 consecutive days that included 18 sets of 5 min with rest interval of 2 min in between. Soleus and super vastus lateralis (SVL) muscles mRNA were analyzed by real-time RT-PCR. SVL FOXO1 mRNA levels increased by 3.92-fold in the AEE and decreased 0.56-fold in the CEE group and were not significant in soleus muscle. In soleus muscle, myosin heavy chain (MHC) IIa, IIx, and IIb decreased in the AEE group and MHC IIa and IIx decreased in the CEE group. In SVL muscle, MHC I, IIa, and IIx increased in the AEE group and MHC IIa and IIX increased in the CEE group. In summary, both acute and chronic eccentric exercise could lead to change in FOXO1 mRNA only in fast SVL muscle of rat and so could induce fiber-type transition in both muscles regardless of changes in expression of FOXO1. So, oxidative stress can play important role in change of FOXO1.

  18. Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Mohammed F Shamji

    2016-01-01

    Conclusion: Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions.

  19. Large deflection analysis of a tension-foil bearing

    Science.gov (United States)

    Elrod, David A.

    1996-01-01

    The rolling element bearings (REB's) which support many turbomachinery rotors offer high load capacity, low power requirements, and durability. Two disadvantages of REB's are as follows: rolling or sliding contact within the bearing has life-limiting consequences; and REB's provide essentially no damping. The REB's in the Space Shuttle Main Engine (SSME) turbopumps must sustain high static and dynamic loads, at high speeds, with a cryogenic fluid as lubricant and coolant. The pump end ball bearings limit the life of the SSME high pressure oxygen turbopump (HPOTP). Compliant foil bearing (CFB) manufacturers have proposed replacing turbopump REB's with CFB's. CFB's work well in aircraft air cycle machines, auxiliary power units, and refrigeration compressors. In a CFB, the rotor only contacts the foil support structure during start up and shut down. CFB damping is higher than REB damping. However, the load capacity of the CFB is low, compared to a REB. Furthermore, little stiffness and damping data exist for the CFB. A rotordynamic analysis for turbomachinery critical speeds and stability requires the input of bearing stiffness and damping coefficients. The two basic types of CFB are the tension-dominated bearing and the bending-dominated bearing. Many investigators have analyzed and measured characteristics of tension-dominated foil bearings, which are applied principally in magnetic tape recording. The bending-dominated CFB is used more in rotating machinery. Recently, a new tension-foil bearing configuration has been proposed for turbomachinery applications.

  20. Oxygen tension affects lubricin expression in chondrocytes.

    Science.gov (United States)

    Hatta, Taku; Kishimoto, Koshi N; Okuno, Hiroshi; Itoi, Eiji

    2014-10-01

    We assessed the effects of oxygen tension on lubricin expression in bovine chondrocytes and cartilage explants and a role for hypoxia-inducible transcription factor (HIF)-1α in regulating lubricin expression was investigated using a murine chondroprogenitor cell line, ATDC5, and bovine chondrocytes isolated from superficial and middle/deep zones of femoral cartilage. ATDC5 cells and bovine chondrocytes were cultured in micromass under different oxygen tensions (21%, 5%, and 1%). ATDC5 cells and middle/deep zone chondrocytes that initially had low lubricin expression levels were also cultured with or without transforming growth factor (TGF)-β1. Quantitative reverse transcription (RT)-PCR was used to determine lubricin and chondrogenic marker gene mRNA levels and immunohistochemistry was used to assess lubricin protein expression. Explant cartilage plugs cultured under different oxygen tensions were also subjected to immunohistological analysis for lubricin. HIF-1α gene silencing was achieved by electroporatic transfer into ATDC5 cells. A low oxygen tension reduced lubricin gene expression levels in bovine superficial chondrocytes, TGF-β1-treated middle/deep zone chondrocytes, and TGF-β1-treated ATDC5 cells. Lubricin expression in explant cartilage was also suppressed under hypoxia. HIF-1α gene silencing in ATDC5 cells attenuated the lubricin expression response to the oxygen tension. These results corroborate with previous studies that the oxygen tension regulates lubricin gene expression and suggest that HIF-1α plays an important role in this regulation. The normal distribution of lubricin in articular cartilage may be due to the hypoxic oxygen environment of cartilage as it is an avascular tissue. An oxygen tension gradient may be a key factor for engineering cartilage tissue with a layered morphology.

  1. Emergency percutaneous needle decompression for tension pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Körner Markus

    2011-05-01

    Full Text Available Abstract Background Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and sometimes to capacity constraints of medical staff and equipment in the clinic. Methods This is a retrospective analysis of cases of pneumoperitoneum and tension pneumoperitoneum due to iatrogenic bowel perforation. All patients admitted to our surgical department between January 2005 and October 2010 were included. Tension pneumoperitoneum was diagnosed in those patients presenting signs of hemodynamic and ventilatory compromise in addition to abdominal distension. Results Between January 2005 and October 2010 eleven patients with iatrogenic bowel perforation were admitted to our surgical department. The mean time between perforation and admission was 36 ± 14 hrs (range 30 min - 130 hrs, between ER admission and begin of the operation 3 hrs and 15 min ± 47 min (range 60 min - 9 hrs. Three out of eleven patients had clinical signs of tension pneumoperitoneum. In those patients emergency percutaneous needle decompression was performed with a 16G venous catheter. This improved significantly the patients' condition (stabilization of vital signs, reducing jugular vein congestion, bridging the time to the start of the operation. Conclusions Hemodynamical and respiratory compromise in addition to abdominal distension shortly after endoscopy are strongly suggestive of tension pneumoperitoneum due to iatrogenic bowel perforation. This is a rare but life threatening condition and it can be managed in a preclinical and clinical setting with emergency percutaneous needle decompression like tension pneumothorax. Emergency percutaneous decompression is no

  2. Chronic psychosocial stress induces reversible mitochondrial damage and corticotropin-releasing factor receptor type-1 upregulation in the rat intestine and IBS-like gut dysfunction.

    Science.gov (United States)

    Vicario, María; Alonso, Carmen; Guilarte, Mar; Serra, Jordi; Martínez, Cristina; González-Castro, Ana M; Lobo, Beatriz; Antolín, María; Andreu, Antoni L; García-Arumí, Elena; Casellas, Montserrat; Saperas, Esteban; Malagelada, Juan Ramón; Azpiroz, Fernando; Santos, Javier

    2012-01-01

    The association between psychological and environmental stress with functional gastrointestinal disorders, especially irritable bowel syndrome (IBS), is well established. However, the underlying pathogenic mechanisms remain unknown. We aimed to probe chronic psychosocial stress as a primary inducer of intestinal dysfunction and investigate corticotropin-releasing factor (CRF) signaling and mitochondrial damage as key contributors to the stress-mediated effects. Wistar-Kyoto rats were submitted to crowding stress (CS; 8 rats/cage) or sham-crowding stress (SC; 2 rats/cage) for up to 15 consecutive days. Hypothalamic-pituitary-adrenal (HPA) axis activity was evaluated. Intestinal tissues were obtained 1h, 1, 7, or 30 days after stress exposure, to assess neutrophil infiltration, epithelial ion transport, mitochondrial function, and CRF receptors expression. Colonic response to CRF (10 μg/kg i.p.) and hyperalgesia were evaluated after ending stress exposure. Chronic psychosocial stress activated HPA axis and induced reversible intestinal mucosal inflammation. Epithelial permeability and conductance were increased in CS rats, effect that lasted for up to 7 days after stress cessation. Visceral hypersensitivity persisted for up to 30 days post stress. Abnormal colonic response to exogenous CRF lasted for up to 7 days after stress. Mitochondrial activity was disturbed throughout the intestine, although mitochondrial response to CRF was preserved. Colonic expression of CRF receptor type-1 was increased in CS rats, and negatively correlated with body weight gain. In conclusion, chronic psychosocial stress triggers reversible inflammation, persistent epithelial dysfunction, and colonic hyperalgesia. These findings support crowding stress as a suitable animal model to unravel the complex pathophysiology underlying to common human intestinal stress-related disorders, such as IBS.

  3. Rosuvastatin attenuates mucus secretion in a murine model of chronic asthma by inhibiting the gamma-aminobutyric acid type A receptor

    Institute of Scientific and Technical Information of China (English)

    ZHU Tao; ZHANG Wei; WANG Dao-xin; HUANG Ni-wen; BO Hong; DENG Wang; DENG Jia

    2012-01-01

    Background Asthma is a chronic inflammatory disease characterized by reversible bronchial constriction,pulmonary inflammation and airway remodeling.Current standard therapies for asthma provide symptomatic control,but fail to target the underlying disease pathology.Furthermore,no therapeutic agent is effective in preventing airway remodeling.A substantial amount of evidence suggests that statins have anti-inflammatory properties and immunomodulatory activity.In this study,we investigated the effect of rosuvastatin on airway inflammation and its inhibitory mechanism in mucus hypersecretion in a murine model of chronic asthma.Methods BALB/c mice were sensitized and challenged by ovalbumin to induce asthma.The recruitment of inflammatory cells into bronchoalveolar lavage fluid (BALF) and the lung tissues were measured by Diff-Quik staining and hematoxylin and eosin (H&E) staining.ELISA was used for measuring the levels of IL-4,IL-5,IL-13 and TNF-α in BALF.Periodic acid-Schiff (PAS) staining was used for mucus secretion.Gamma-aminobutyric acid type A receptor (GABAAR)32 expression was measured by means of immunohistochemistry,reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Results Rosuvastatin reduced the number of total inflammatory cells,lymphocytes,macrophages,neutrophils,and eosinophils recruited into BALF,the levels of IL-4,IL-5,IL-13 and TNF-α in BALF,along with the histological mucus index (HMI) and GABAAR β2 expression.Changes occurred in a dose-dependent manner.Conclusions Based on its ability to reduce the inflammatory response and mucus hypersecretion by regulating GABAAR activity in a murine model of chronic asthma,rosuvastatin may be a useful therapeutic agent for treatment of asthma.

  4. Exploratory experimental investigations on post-tensioned structural glass beams

    DEFF Research Database (Denmark)

    Louter, C.; Nielsen, Jens Henrik; Belis, J.

    2013-01-01

    This paper discusses two projects on post-tensioned glass beams, performed at EPFL and DTU, respectively. In these projects small scale glass beams (length of 1.5m and 1m) are post-tensioned by means of steel threaded rods tensioned at the beam ends. The purpose of post-tensioning glass beams...

  5. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study

    Directory of Open Access Journals (Sweden)

    Young Mark A

    2007-05-01

    Full Text Available Abstract Background Chronic plantar heel pain (CPHP is one of the most common musculoskeletal disorders of the foot, yet its aetiology is poorly understood. The purpose of this study was to examine the association between CPHP and a number of commonly hypothesised causative factors. Methods Eighty participants with CPHP (33 males, 47 females, mean age 52.3 years, S.D. 11.7 were matched by age (± 2 years and sex to 80 control participants (33 males, 47 females, mean age 51.9 years, S.D. 11.8. The two groups were then compared on body mass index (BMI, foot posture as measured by the Foot Posture Index (FPI, ankle dorsiflexion range of motion (ROM as measured by the Dorsiflexion Lunge Test, occupational lower limb stress using the Occupational Rating Scale and calf endurance using the Standing Heel Rise Test. Results Univariate analysis demonstrated that the CPHP group had significantly greater BMI (29.8 ± 5.4 kg/m2 vs. 27.5 ± 4.9 kg/m2; P P P 2 (OR 2.9, 95% CI 1.4 – 6.1, P P Conclusion Obesity and pronated foot posture are associated with CPHP and may be risk factors for the development of the condition. Decreased ankle dorsiflexion, calf endurance and occupational lower limb stress may not play a role in CPHP.

  6. Association of Helicobacter pylori infection with chronic atrophic gastritis: Meta-analyses according to type of disease definition.

    Science.gov (United States)

    Weck, Melanie N; Brenner, Hermann

    2008-08-15

    Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG). A large variety of definitions of CAG have been used in epidemiologic studies in the past. The aim of this work was to systematically review and summarize estimates of the association between H. pylori infection and CAG according to the various definitions of CAG. Articles on the association between H. pylori infection and CAG published until July 2007 were identified. Separate meta-analyses were carried out for studies defining CAG based on gastroscopy with biopsy, serum pepsinogen I (PG I) only, the pepsinogen I/pepsinogen II ratio (PG I/PG II ratio) only, or a combination of PG I and the PG I/PG II ratio. Numbers of identified studies and summary odds ratios (OR) (95% confidence intervals) were as follows: gastroscopy with biopsy: n = 34, OR = 6.4 (4.0-10.1); PG I only: n = 13, OR = 0.9 (0.7-1.2); PG I/PG II ratio: n = 8, OR = 7.2 (3.1-16.8); combination of PG I and the PG I/PG II ratio: n = 20, OR = 5.7 (4.4-7.5). Studies with CAG definitions based on gastroscopy with biopsy or the PG I/PG II ratio (alone or in combination with PG I) yield similarly strong associations of H. pylori with CAG. The association is missed entirely in studies where CAG is defined by PG I only.

  7. Different types of errors in saccadic task are sensitive to either time of day or chronic sleep restriction.

    Science.gov (United States)

    Wachowicz, Barbara; Beldzik, Ewa; Domagalik, Aleksandra; Fafrowicz, Magdalena; Gawlowska, Magda; Janik, Justyna; Lewandowska, Koryna; Oginska, Halszka; Marek, Tadeusz

    2015-01-01

    Circadian rhythms and restricted sleep length affect cognitive functions and, consequently, the performance of day to day activities. To date, no more than a few studies have explored the consequences of these factors on oculomotor behaviour. We have implemented a spatial cuing paradigm in an eye tracking experiment conducted four times of the day after one week of rested wakefulness and after one week of chronic partial sleep restriction. Our aim was to verify whether these conditions affect the number of a variety of saccadic task errors. Interestingly, we found that failures in response selection, i.e. premature responses and direction errors, were prone to time of day variations, whereas failures in response execution, i.e. omissions and commissions, were considerably affected by sleep deprivation. The former can be linked to the cue facilitation mechanism, while the latter to wake state instability and the diminished ability of top-down inhibition. Together, these results may be interpreted in terms of distinctive sensitivity of orienting and alerting systems to fatigue. Saccadic eye movements proved to be a novel and effective measure with which to study the susceptibility of attentional systems to time factors, thus, this approach is recommended for future research.

  8. Type 1 Autoimmune Pancreatitis Can Transform into Chronic Pancreatitis: A Long-Term Follow-Up Study of 73 Japanese Patients

    Directory of Open Access Journals (Sweden)

    Masahiro Maruyama

    2013-01-01

    Full Text Available Some patients with autoimmune pancreatitis (AIP form pancreatic stones suggestive of transformation into chronic pancreatitis (CP. The present study examined the underlying risk factors and mechanism of AIP progression to confirmed CP. We compared the clinical and laboratory parameters of subjects who progressed to confirmed CP with those of the subjucts who did not in a cohort of 73 type 1 AIP patients. A total of 16 (22% AIP patients progressed to CP. Univariate analysis revealed that relapse was significantly more frequent in the progression group, and multivariate analysis indicated that pancreatic head swelling (OR 12.7, P=0.023 and nonnarrowing of the main pancreatic duct in the pancreatic body (OR 12.6, P=0.001 were significant independent risk factors for progression to CP. Kaplan-Meier testing showed that the progression rate to CP was approximately 10% at 3 years and 30% at 10 years in total AIP patients and 30% at 3 years and 60% at 10 years in subjects with both risk factors. AIP with pancreatic head swelling and a history of relapse may cause pancreatic juice stagnation and nonnarrowing of the main pancreatic duct in the pancreatic body, which can progress to advanced stage chronic pancreatitis.

  9. Simple Cystatin C Formula for Estimation of Glomerular Filtration Rate in Overweight Patients with Diabetes Mellitus Type 2 and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Sebastjan Bevc

    2012-01-01

    Full Text Available In clinical practice the glomerular filtration rate (GFR is estimated from serum creatinine-based equations like the Cockcroft-Gault formula (C&G and Modification of Diet in Renal Disease formula (MDRD. Recently, serum cystatin C-based equations, the newer creatinine formula (The Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI, and equation that use both serum creatinine and cystatin C (CKD-EPI creatinine & cystatin formula were proposed as new GFR markers. Present study compares serum creatinine-based equations, combined (including both serum creatinine and cystatin C equation, and serum simple cystatin C formula (100/serum cystatin C against 51CrEDTA clearance in 113 adult overweight Caucasians with diabetes mellitus type 2 (DM2 and chronic kidney disease (CKD. The results of present study demonstrated that the simple cystatin C formula could be a useful tool for the evaluation of renal function in overweight patients with DM2 and impaired kidney function in daily clinical practice in hospital and especially in outpatients. Despite the advantages of the simple cystatin C formula, cystatin C-based equations cannot completely replace the “gold standard” for estimation of the GFR in a population of DM2 patients with CKD, but may contribute to a more accurate selection of patients requiring such invasive and costly procedures.

  10. National observatory on the therapeutic management in ambulatory care patients aged 65 and over, with type 2 diabetes, chronic pain or atrial fibrillation.

    Science.gov (United States)

    Becquemont, Laurent; Benattar-Zibi, Linda; Bertin, Philippe; Berrut, Gilles; Corruble, Emmanuelle; Danchin, Nicolas; Delespierre, Tiba; Derumeaux, Geneviève; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Céline

    2013-01-01

    The primary objective of the S.AGES cohort is to describe the real-life therapeutic care of elderly patients. Patients and methods. This is a prospective observational cohort study of 3 700 non-institutionalized patients over the age of 65 years with either type 2 diabetes mellitus (T2DM), chronic pain or atrial fibrillation (AF) recruited by French general practitioners (GPs). Follow-up is planned for 3 years. Baseline characteristics. In the chronic pain sub-cohort, 33% of patients are treated with only grade 1 analgesics, 29% with grade 2 analgesics and 3% with grade 3 analgesics, and 22% have no pain treatment. In the T2DM sub-cohort, 61% of patients have well-controlled diabetes (Hb1c<7%) and 18% are treated with insulin. In the AF sub-cohort, 65% of patients have a CHADS2 score greater than 2, 77% are treated with oral anticoagulants, 17% with platelet inhibitors, 40% with antiarrhythmic drugs and 56% with rate slowing medications. Conclusion. The S.AGES cohort presents a unique opportunity to clarify the real-life therapeutic management of ambulatory elderly subjects and will help to identify the factors associated with the occurrence of major clinical events.

  11. Angiotensin II type 1a receptors in subfornical organ contribute towards chronic intermittent hypoxia-associated sustained increase in mean arterial pressure.

    Science.gov (United States)

    Saxena, Ashwini; Little, Joel T; Nedungadi, T Prashant; Cunningham, J Thomas

    2015-03-01

    Sleep apnea is associated with hypertension. The mechanisms contributing to a sustained increase in mean arterial pressure (MAP) even during normoxic awake-state remain unknown. Rats exposed to chronic intermittent hypoxia for 7 days, a model of the hypoxemia associated with sleep apnea, exhibit sustained increases in MAP even during the normoxic dark phase. Activation of the renin-angiotensin system (RAS) has been implicated in chronic intermittent hypoxia (CIH) hypertension. Since the subfornical organ (SFO) serves as a primary target for the central actions of circulating ANG II, we tested the effects of ANG II type 1a receptor (AT1aR) knockdown in the SFO on the sustained increase in MAP in this CIH model. Adeno-associated virus carrying green fluorescent protein (GFP) and small-hairpin RNA against either AT1aR or a scrambled control sequence (SCM) was stereotaxically injected in the SFO of rats. After recovery, MAP, heart rate, respiratory rate, and activity were continuously recorded using radiotelemetry. In the normoxic groups, the recorded variables did not deviate from the baseline values. Both CIH groups exhibited significant increases in MAP during CIH exposures (P SCM-injected group exhibited a sustained increase in MAP (P SCM-CIH group. Our data indicate that AT1aRs in the SFO are critical for the sustained elevation in MAP and increased FosB/ΔFosB expression in forebrain autonomic nuclei associated with CIH.

  12. Tension Distribution in a Tendon-Driven Robotic Finger

    Science.gov (United States)

    Abdallah, Muhammad E. (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor)

    2013-01-01

    A method is provided for distributing tension among tendons of a tendon-driven finger in a robotic system, wherein the finger characterized by n degrees of freedom and n+1 tendons. The method includes determining a maximum functional tension and a minimum functional tension of each tendon of the finger, and then using a controller to distribute tension among the tendons, such that each tendon is assigned a tension value less than the maximum functional tension and greater than or equal to the minimum functional tension. The method satisfies the minimum functional tension while minimizing the internal tension in the robotic system, and satisfies the maximum functional tension without introducing a coupled disturbance to the joint torques. A robotic system includes a robot having at least one tendon-driven finger characterized by n degrees of freedom and n+1 tendons, and a controller having an algorithm for controlling the tendons as set forth above.

  13. INTERFACIAL DEBONDING OF COATED-FIBER-REINFORCED COMPOSITES UNDER TENSION-TENSION CYCLIC LOADING

    Institute of Scientific and Technical Information of China (English)

    Shi Zhifei; Zhou Limin

    2000-01-01

    A new degradation function of the friction coefficient is used. Based on the double shear-lag model and Paris formula, the interfacial damage of coated fiber-reinforced composites under tension-tension cyclic loading is studied. The effects of strength and thickness of the coating materials on the debond stress, debond rate as well as debond length are simulated.

  14. A special type of endovascular stent repair with complicated thoracic aneurysm and chronic type B dissection aligned in tandem: double perfusion in true and false distal aorta lumen

    Institute of Scientific and Technical Information of China (English)

    GAN Hui-li; ZHANG Jian-qun

    2008-01-01

    @@ Aortic dissection and aortic aneurysm are two of the most common catastrophic events involving the aorta. Thoracic endovascular aortic repair is now considered as a promising alternative to open surgical graft replacement, The aim of endovascular repair of a thoracic aneurysm is to exclude, and thus depressurize, the aneurismal wall and the aim of the endovascular repair of type B aortic dissection is to obliterate all of the false lumen through thrombosis after sealing the primary entry tears, thus to ensure the true lumen perfusion.

  15. Type D personality predicts chronic anxiety following percutaneous coronary intervention in the drug-eluting stent era

    DEFF Research Database (Denmark)

    Spindler, Helle; Pedersen, Susanne S.; Serruys, Patrick W.

    2007-01-01

    factors. Limitations: All psychological measures are based on self-report, and there is no information on cardiac rehabilitation or use of pharmacotherapy, however our sample represents patients seen in daily clinical practice.  Conclusions: These findings suggest that Type D personality is a risk factor...

  16. TNF-α type 2 receptor mediates renal inflammatory response to chronic angiotensin II administration with high salt intake in mice.

    Science.gov (United States)

    Singh, Purnima; Bahrami, Laleh; Castillo, Alexander; Majid, Dewan S A

    2013-04-01

    Tumor necrosis factor-alpha (TNF-α) has been implicated in salt-sensitive hypertension and renal injury (RI) induced by angiotensin II (ANG II). To determine the receptor type of TNF-α involved in this mechanism, we evaluated the responses to chronic ANG II infusion (25 ng/min by implanted minipump) given with high-salt diet (HS; 4% NaCl) for 2 wk in gene knockout mice for TNF-α receptor type 1 (TNFR1KO; n = 6) and type 2 (TNFR2KO; n = 6) and compared the responses with those in wild-type (WT; C57BL/6; n = 6) mice. Blood pressure in these mice was measured by implanted radiotelemetry as well as by tail-cuff plethysmography. RI responses were assessed by measuring macrophage cell infiltration (CD68(+) immunohistochemistry), glomerulosclerosis (PAS staining), and interstitial fibrosis (Gomori's trichrome staining) in renal tissues at the end of the treatment period. The increase in mean arterial pressure induced by ANG II + HS treatment was not different in these three groups of mice (TNFR1KO, 114 ± 1 to 161 ± 7 mmHg; TNFR2KO, 113 ± 1 to 161 ± 3 mmHg; WT, 110 ± 3 to 154 ± 3 mmHg). ANG II + HS-induced RI changes were similar in TNFR1KO mice but significantly less in TNFR2KO mice (macrophage infiltration, 0.02 ± 0.01 vs. 1.65 ± 0.45 cells/mm(2); glomerulosclerosis, 26.3 ± 2.6 vs. 35.7 ± 2.2% area; and interstitial fibrosis, 5.2 ± 0.6 vs. 8.1 ± 1.1% area) compared with the RI changes in WT mice. The results suggest that a direct activation of TNF-α receptors may not be required in inducing hypertensive response to chronic ANG II administration with HS intake, but the induction of inflammatory responses leading to renal injury are mainly mediated by TNF-α receptor type 2.

  17. Chronic wasting disease and atypical forms of bovine spongiform encephalopathy and scrapie are not transmissible to mice expressing wild-type levels of human prion protein.

    Science.gov (United States)

    Wilson, Rona; Plinston, Chris; Hunter, Nora; Casalone, Cristina; Corona, Cristiano; Tagliavini, Fabrizio; Suardi, Silvia; Ruggerone, Margherita; Moda, Fabio; Graziano, Silvia; Sbriccoli, Marco; Cardone, Franco; Pocchiari, Maurizio; Ingrosso, Loredana; Baron, Thierry; Richt, Juergen; Andreoletti, Olivier; Simmons, Marion; Lockey, Richard; Manson, Jean C; Barron, Rona M

    2012-07-01

    The association between bovine spongiform encephalopathy (BSE) and variant Creutzfeldt-Jakob disease (vCJD) has demonstrated that cattle transmissible spongiform encephalopathies (TSEs) can pose a risk to human health and raises the possibility that other ruminant TSEs may be transmissible to humans. In recent years, several novel TSEs in sheep, cattle and deer have been described and the risk posed to humans by these agents is currently unknown. In this study, we inoculated two forms of atypical BSE (BASE and H-type BSE), a chronic wasting disease (CWD) isolate and seven isolates of atypical scrapie into gene-targeted transgenic (Tg) mice expressing the human prion protein (PrP). Upon challenge with these ruminant TSEs, gene-targeted Tg mice expressing human PrP did not show any signs of disease pathology. These data strongly suggest the presence of a substantial transmission barrier between these recently identified ruminant TSEs and humans.

  18. [ASSESSING THE IMPACT OF CARDIAC DYSSYNCHRONY ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC HEART FAILURE IN COMBINATION WITH TYPE 2 DIABETES MELLITUS].

    Science.gov (United States)

    Vlasenko, M A; Rodionova, Iu V; Lopin, D O

    2014-01-01

    In the article considers the influence of type 2 diabetes mellitus (T2DM) and cardiac dyssyn- chrony (DYS) on health-related quality of life (HRQoL) in patients with chronic heart failure (CHF) by means of Minnesota Living with Heart Failure Questionnaire (MLHFQ). It was found a negative impact of T2DM both on the overall assessment; and on the physical and emotional components of the HRQoL.in patients with CHE DYS also has a negative effect on HRQoL both in patients with isolated CHF and patients with CHF and concomitant T2DM, but its influence is mediated mainly by physical component. There were a number of factors that contribute to the DYS development in patients of studied groups identified, including the poor state of carbohydrate and lipid metabolism compensation, activation of systemic inflammation. It is expedient to study HRQoL to optimize therapeutic strategies in these patients.

  19. Electroconvulsive stimulations prevent chronic stress-induced increases in L-type calcium channel mRNAs in the hippocampus and basolateral amygdala

    DEFF Research Database (Denmark)

    Maigaard, Katrine; Pedersen, Ida Hageman; Jørgensen, Anders;

    2012-01-01

    Although affective disorders have high prevalence, morbidity and mortality, we do not fully understand disease etiopathology, nor have we determined the exact mechanisms by which treatment works. Recent research indicates that intracellular calcium ion dysfunction might be involved. Here we use...... the chronic restraint stress model of affective disorder (6 h restraint per day for 21 days) in combination with electroconvulsive stimulations to examine the effects of stress and an effective antidepressive treatment modality on L-type voltage gated calcium channel subunit mRNA expression patterns......, while stress only upregulated Ca(v)1.3 channel expression significantly in the dentate gyrus. ECS effects on Ca(v)1.2 channel expression were generally specific to stressed animals. Our findings are consistent with and extent previous studies on the involvement of intracellular calcium ion dysfunction...

  20. Elastic properties and mechanical tension of graphene

    Science.gov (United States)

    Ramírez, R.; Herrero, C. P.

    2017-01-01

    Room-temperature simulations of graphene have been performed as a function of the mechanical tension of the layer. Finite-size effects are accurately reproduced by an acoustic dispersion law for the out-of-plane vibrations that, in the long-wave limit, behaves as ρ ω2=σ k2+κ k4 . The fluctuation tension σ is finite (˜0.1 N/m) even when the external mechanical tension vanishes. Transverse vibrations imply a duplicity in the definition of the elastic constants of the layer, as observables related to the real area of the surface may differ from those related to the in-plane projected area. This duplicity explains the variability of experimental data on the Young modulus of graphene based on electron spectroscopy, interferometric profilometry, and indentation experiments.

  1. Statistical Mechanics of Multilayer Sorption: Surface Tension.

    Science.gov (United States)

    Wexler, Anthony S; Dutcher, Cari S

    2013-05-16

    Mathematical models of surface tension as a function of solute concentration are needed for predicting the behavior of surface processes relevant to the environment, biology, and industry. Current aqueous surface tension-activity models capture either solutions of electrolytes or those of nonelectrolytes, but a single equation has not yet been found that represents both over the full range of compositions. In prior work, we developed an accurate model of the activity-concentration relationship in solutions over the full range of compositions by extending the BET (Brunauer, Emmett, Teller) and GAB (Guggenheim, Anderson, de Boer) isotherms to multiple monolayers of solvent molecules sorbed to solutes. Here, we employ similar statistical mechanical tools to develop a simple equation for the surface tension-activity relationship that differs remarkably from prior formulations in that it (1) works equally well for nonelectrolyte and electrolyte solutes and (2) is accurate over the full range of concentrations from pure solvent to pure solute.

  2. Cosmological Spacetimes from Negative Tension Brane Backgrounds

    CERN Document Server

    Burgess, C P; Rey, S J; Tasinato, G

    2002-01-01

    We put forward a viable nonsingular cosmology emerging out of negative-tension branes. The cosmology is based on a general class of solutions in Einstein-dilaton-Maxwell theory, presented in {\\tt hep-th/0106120}. We argue that solutions with hyperbolic or planar symmetry describe gravitational interactions due to a pair of negative-tension $q$-branes. These spacetimes are static near each brane, but become time-dependent and expanding at late times -- in some cases asymptotically approaching flat space. We interpret this expansion as being the spacetime's response to the branes presence. The time-dependent regions provide explicit realizations of cosmological spacetimes having past horizons without naked past singularities, and the past horizons are reminiscent of the S-brane solutions. We prove that the singularities in the static regions are repulsive to timelike geodesics, extract a cosmological `bounce' interpretation, compute the explicit charge and tension of the branes, analyse the classical stability ...

  3. Tension Stiffened and Tendon Actuated Manipulator

    Science.gov (United States)

    Doggett, William R. (Inventor); Dorsey, John T. (Inventor); Ganoe, George G. (Inventor); King, Bruce D. (Inventor); Jones, Thomas C. (Inventor); Mercer, Charles D. (Inventor); Corbin, Cole K. (Inventor)

    2015-01-01

    A tension stiffened and tendon actuated manipulator is provided performing robotic-like movements when acquiring a payload. The manipulator design can be adapted for use in-space, lunar or other planetary installations as it is readily configurable for acquiring and precisely manipulating a payload in both a zero-g environment and in an environment with a gravity field. The manipulator includes a plurality of link arms, a hinge connecting adjacent link arms together to allow the adjacent link arms to rotate relative to each other and a cable actuation and tensioning system provided between adjacent link arms. The cable actuation and tensioning system includes a spreader arm and a plurality of driven and non-driven elements attached to the link arms and the spreader arm. At least one cable is routed around the driven and non-driven elements for actuating the hinge.

  4. Combined chronic blockade of hyper-active L-type calcium channels and NMDA receptors ameliorates HIV-1 associated hyper-excitability of mPFC pyramidal neurons.

    Science.gov (United States)

    Khodr, Christina E; Chen, Lihua; Dave, Sonya; Al-Harthi, Lena; Hu, Xiu-Ti

    2016-10-01

    Human Immunodeficiency Virus type 1 (HIV-1) infection induces neurological and neuropsychological deficits, which are associated with dysregulation of the medial prefrontal cortex (mPFC) and other vulnerable brain regions. We evaluated the impact of HIV infection in the mPFC and the therapeutic potential of targeting over-active voltage-gated L-type Ca(2+) channels (L-channel) and NMDA receptors (NMDAR), as modeled in HIV-1 transgenic (Tg) rats. Whole-cell patch-clamp recording was used to assess the membrane properties and voltage-sensitive Ca(2+) potentials (Ca(2+) influx) in mPFC pyramidal neurons. Neurons from HIV-1 Tg rats displayed reduced rheobase, spike amplitude and inwardly-rectifying K(+) influx, increased numbers of action potentials, and a trend of aberrant firing compared to those from non-Tg control rats. Neuronal hyper-excitation was associated with abnormally-enhanced Ca(2+) influx (independent of NMDAR), which was eliminated by acute L-channel blockade. Combined chronic blockade of over-active L-channels and NMDARs with open-channel blockers abolished HIV effects on spiking, aberrant firing and Ca(2+) potential half-amplitude duration, though not the reduced inward rectification. In contrast, individual chronic blockade of over-active L-channels or NMDARs did not alleviate HIV-induced mPFC hyper-excitability. These studies demonstrate that HIV alters mPFC neuronal activity by dysregulating membrane excitability and Ca(2+) influx through the L-channels. This renders these neurons more susceptible and vulnerable to excitatory stimuli, and could contribute to HIV-associated neuropathogenesis. Combined targeting of over-active L-channels/NMDARs alleviates HIV-induced dysfunction of mPFC pyramidal neurons, emphasizing a potential novel therapeutic strategy that may effectively decrease HIV-induced Ca(2+) dysregulation in the mPFC.

  5. Reversion to subgroup J avian leukosis virus viremia in seroconverted adult meat-type chickens exposed to chronic stress by adrenocorticotrophin treatment.

    Science.gov (United States)

    Pandiri, A R; Gimeno, I M; Mays, J K; Reed, W M; Fadly, A M

    2012-09-01

    Chickens infected with subgroup J avian leukosis virus (ALV J) early in posthatch life develop viremia followed by a neutralizing antibody (Nab) response that may or may not be able to clear the viremia. Occasionally, chickens that do clear viremia by developing an efficient Nab response revert to viremia, and the factors responsible for this reversion are not clear. In this study, it was hypothesized that stress can cause seroconverted viremia-free chickens to revert to viremia. Adult (52-wk-old) male commercial meat-type chickens that were exposed to ALV J at hatch and had since cleared viremia and remained viremia-free for up to 40 wk, when subjected to chronic stress (for 14 days) induced by porcine adrenocorticotrophin (ACTH), reverted to viremia and cloacal shedding (2/6 [33%]). However, chickens that were contact-exposed to ALV J at 32 wk of age and had seroconverted failed to revert to viremia when subjected to similar chronic stress. Stress did not increase the susceptibility of adult meat-type chickens to ALV J infection by contact exposure. The lack of statistical significance due to the small sample size is a limitation of this study. However, in general, the results suggest that treatment of chickens with ACTH can cause reversion of viremia and cloacal shedding in ALV J-seroconverted adult male chickens that had been exposed to the virus at hatch, but not in chickens that were contact-exposed at 32 wk of age. The results warrant further studies with greater sample size to examine the role of stress in ALV J epidemiology.

  6. Obinutuzumab (GA101) for the treatment of chronic lymphocytic leukemia and other B-cell non-hodgkin's lymphomas: a glycoengineered type II CD20 antibody.

    Science.gov (United States)

    Goede, Valentin; Klein, Christian; Stilgenbauer, Stephan

    2015-01-01

    Obinutuzumab (GA101) is a humanized, monoclonal type II CD20 antibody modified by glycoengineering. The glycoengineered Fc portion enhances the binding affinity to the FcγRIII receptor on immune effector cells, resulting in increased antibody-dependent cellular cytotoxicity and phagocytosis. In addition, the type II antibody binding characteristics of obinutuzumab to CD20 lead to an efficient induction of direct non-apoptotic cell death. Preclinical data demonstrated more efficient B-cell depletion in whole blood and superior antitumor activity in xenograft models of obinutuzumab as compared to the type I CD20 antibody rituximab. In previously untreated patients with chronic lymphocytic leukemia (CLL) and comorbidities, obinutuzumab plus chlorambucil increased response rates and prolonged progression-free survival compared with rituximab plus chlorambucil. Obinutuzumab had an acceptable and manageable safety profile, with infusion-related reactions during the first infusion as the most common adverse event. Further phase I/II clinical trials have also shown promising activity in other CD20-positive B-cell non-Hodgkin's lymphomas (NHL). Therefore, several clinical studies are planned or ongoing to investigate obinutuzumab with different combination partners in both untreated and relapsed/refractory patients with different B-cell NHL entities, which in addition to CLL include diffuse large B-cell lymphoma and follicular lymphoma. © 2015 S. Karger GmbH, Freiburg.

  7. Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes

    Science.gov (United States)

    MIRANDA, Tamires Szeremeske; FERES, Magda; RETAMAL-VALDÉS, Belén; PEREZ-CHAPARRO, Paula Juliana; MACIEL, Suellen Silva; DUARTE, Poliana Mendes

    2017-01-01

    Abstract Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP). Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1cTannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05). Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP. PMID:28198980

  8. Oxygen Tension Regulates the Expression of Angiogenesis Factor by Macrophages

    Science.gov (United States)

    Knighton, David R.; Hunt, Thomas K.; Scheuenstuhl, Heinz; Halliday, Betty J.; Werb, Zena; Banda, Michael J.

    1983-09-01

    When cultured in a hypoxic environment similar to that found in the center of a wound, macrophages secreted active angiogenesis factor into the medium. Under conditions similar to those of well-oxygenated tissue, macrophages did not secrete active angiogenesis factor. Macrophages that secreted the factor at hypoxic conditions stopped secreting it when returned to room air. Thus the control of angiogenesis in wound healing may be the result of macrophages responding to tissue oxygen tension without the necessity of interacting with other cell types or biochemical signals.

  9. Oxygen tension regulates the expression angiogenesis factor by macrophages

    Energy Technology Data Exchange (ETDEWEB)

    Knighton, D.R.; Hunt, T.K.; Scheuenstuhl, H.; Halliday, B.J.; Werb, Z.; Banda, M.J.

    1983-09-23

    When cultured in a hypoxic environment similar to that found in the center of a wound, macrophages secreted active angiogenesis factor into the medium. Under conditions similar to those of well-oxygenated tissue, macrophages did not secrete active angiogenesis factor. Macrophages that secreted the factor at hyposic conditions stopped secreting it when returned to room air. Thus the control of angiogenesis in wound healing may be the result of macrophages responding to tissue oxygen tension without the necessity of interacting with other cell types or biochemical signals.

  10. Oxygen tension regulated the expression of angiogenesis factor by macrophages

    Energy Technology Data Exchange (ETDEWEB)

    Knighton, D.R.; Hunt, T.K.; Scheuenstuhl, H.; Halliday, B.J.; Werb, Z.; Banda, M.J.

    1983-09-23

    When cultured in a hypoxic environment similar to that found in the center of a wound, macrophages secreted active angiogenesis factor into the medium. Under conditions similar to those of well-oxygenated tissue, macrophages did not secrete active angiogenesis factor. Macrophages that secreted the factor at hypoxic conditions stopped secreting it when returned to room air. Thus the control of angiogenesis in wound healing may be the result of macrophages responding to tissue oxygen tension without the necessity of interacting with other cell types or biochemical signals.

  11. Scoring system based on electrocardiogram features to predict the type of heart failure in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Hendry Purnasidha Bagaswoto

    2016-12-01

    Full Text Available ABSTRACT Heart failure is divided into heart failure with reduced ejection fraction (HFrEF and heart failure with preserved ejection fraction (HFpEF. Additional studies are required to distinguish between these two types of HF. A previous study showed that HFrEF is less likely when ECG findings are normal. This study aims to create a scoring system based on ECG findings that will predict the type of HF. We performed a cross-sectional study analyzing ECG and echocardiographic data from 110 subjects. HFrEF was defined as an ejection fraction ≤40%. Fifty people were diagnosed with HFpEF and 60 people suffered from HFrEF. Multiple logistic regression analysis revealed certain ECG variables that were independent predictors of HFrEF i.e., LAH, QRS duration >100 ms, RBBB, ST-T segment changes and prolongation of the QT interval. Based on ROC curve analysis, we obtained a score for HFpEF of -1 to +3, while HFrEF had a score of +4 to +6 with 76% sensitivity, 96% specificity, 95% positive predictive value, an 80% negative predictive value and an accuracy of 86%. The scoring system derived from this study, including the presence or absence of LAH, QRS duration >100 ms, RBBB, ST-T segment changes and prolongation of the QT interval can be used to predict the type of HF with satisfactory sensitivity and specificity

  12. Doubling of serum creatinine and the risk of cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes mellitus: a cohort study

    Directory of Open Access Journals (Sweden)

    Schneider C

    2016-06-01

    Full Text Available Cornelia Schneider,1,2 Blai Coll,3 Susan S Jick,4 Christoph R Meier1,2,4 1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; 3Renal Development, AbbVie, North Chicago, IL, USA; 4Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, MA, USA Background: Doubling of serum creatinine is often used as a marker for worsening kidney function in nephrology trials. Most people with chronic kidney disease die of other causes before reaching end-stage renal disease. We were interested in the association between doubling of serum creatinine and the risk of a first-time diagnosis of angina pectoris, congestive heart failure (CHF, myocardial infarction (MI, stroke, or transient ischemic attack in patients with chronic kidney disease and with diagnosed type 2 diabetes mellitus. Methods: We identified all adult patients registered in the “Clinical Practice Research Datalink” between 2002 and 2011 with incident chronic kidney disease and type 2 diabetes mellitus and did a cohort study with a Cox proportional hazard analysis. Results: We identified in total 27,811 patients, 693 developed angina pectoris, 1,069 CHF, 508 MI, 970 stroke, and 578 transient ischemic attacks. Patients whose serum creatinine doubled during follow-up had increased risks of CHF (hazard ratio [HR] 2.98, 95% confidence interval [CI] 2.27–3.89, MI (HR 2.53, 95% CI 1.62–3.96, and stroke (HR 1.93, 95% CI 1.38–2.69, as compared with patients whose serum creatinine did not double. The relative risks of angina pectoris (HR 1.18, 95% CI 0.66–2.10 or a transient ischemic attack (HR 1.32, 95% CI 0.78–2.22 were similar in both groups. Conclusion: Diabetic patients with a doubling of serum creatinine were at an increased risk of CHF, MI, or stroke, compared with diabetic

  13. P/Q-type and T-type calcium channels, but not type 3 transient receptor potential cation channels, are involved in inhibition of dendritic growth after chronic metabotropic glutamate receptor type 1 and protein kinase C activation in cerebellar Purkinje cells.

    Science.gov (United States)

    Gugger, Olivia S; Hartmann, Jana; Birnbaumer, Lutz; Kapfhammer, Josef P

    2012-01-01

    The development of a neuronal dendritic tree is modulated both by signals from afferent fibers and by an intrinsic program. We have previously shown that chronic activation of either type 1 metabotropic glutamate receptors (mGluR1s) or protein kinase C (PKC) in organotypic cerebellar slice cultures of mice and rats severely inhibits the growth and development of the Purkinje cell dendritic tree. The signaling events linking receptor activation to the regulation of dendritic growth remain largely unknown. We have studied whether channels allowing the entry of Ca(2+) into Purkinje cells, in particular the type 3 transient receptor potential cation channels (TRPC3s), P/Q-type Ca(2+) channels, and T-type Ca(2+) channels, might be involved in signaling after mGluR1 or PKC stimulation. We show that the inhibition of dendritic growth seen after mGluR1 or PKC stimulation is partially rescued by pharmacological blockade of P/Q-type and T-type Ca(2+) channels, indicating that activation of these channels mediating Ca(2+) influx contributes to the inhibition of dendritic growth. In contrast, the absence of Ca(2+) -permeable TRPC3s in TRPC3-deficient mice or pharmacological blockade had no effect on mGluR1-mediated and PKC-mediated inhibition of Purkinje cell dendritic growth. Similarly, blockade of Ca(2+) influx through glutamate receptor δ2 or R-type Ca(2+) channels or inhibition of release from intracellular stores did not influence mGluR1-mediated and PKC-mediated inhibition of Purkinje cell dendritic growth. These findings suggest that both T-type and P/Q-type Ca(2+) channels, but not TRPC3 or other Ca(2+) -permeable channels, are involved in mGluR1 and PKC signaling leading to the inhibition of dendritic growth in cerebellar Purkinje cells.

  14. Polarization-correlation diagnostics and differentiation of cholelithiasis in patients with chronic cholecystitis combined with diabetes mellitus type 2

    Science.gov (United States)

    Marchuk, Yu F.; Fediv, O. I.; Ivashchuk, I. O.; Andriychuk, D. R.

    2012-01-01

    The principles of optical modeling of human bile polycrystalline structure are described. The main types of polycrystalline structures are detailed. It has been proposed and founded the scenarios of formation of bile microscopic images polarization structure in coherent radiation. The results of investigating the interrelation between statistical moments of the 1st-4th order are presented that characterize the coordinate distributions of intensity of laser images of bile smears of cholelithiasis patients in combination with other pathologies. The diagnostic criteria of the cholelithiasis nascency and its severity degree differentiation are determined.

  15. Alcohol and HCV Chronic Infection Are Risk Cofactors of Type 2 Diabetes Mellitus for Hepatocellular Carcinoma in Italy

    Directory of Open Access Journals (Sweden)

    Massimiliano Balbi

    2010-03-01

    Full Text Available Type 2 diabetes mellitus (DM2 has been associated with hepatocellular carcinoma (HCC development. To study this relationship, we enrolled 465 HCC patients compared with 618 Cirrhotic cases and 490 Controls. The prevalence of DM2 is significantly higher in HCC patients with an Odds Ratio of 3.12 versus Controls. In HCC cases with alcohol abuse, the frequency of DM2 is the highest. In our HCC patients, when HCV infection is associated with alcohol abuse, the liver cancer develops earlier. In addition, multivariate analysis shows that alcohol consumption is an independent risk factor for HCC more relevant than HCV infection.

  16. A progressive reduce tension method to fabricate Bradbury-Nielsen gates with uniform tension

    CERN Document Server

    Kai, Ni; Zhou, Yu

    2015-01-01

    Bradbury-Nielsen gates (BNG) which consist of two interleaved and electrically isolated sets of wires can be used to modulate the beams of charged particles, particularly ion beams in mass spectrometry and ion mobility spectrometry. The wires of BNG with uniform tension is critical to make sure the BNG work reliable and robust. In our previous work, we have analyzed the problem of wires tension non-uniform that exists in the traditional sequentially winding methods when the metal wire's elastic modulus is much larger than insulations substrate's and developed a template-based transfer method to solve this problem. In this study, we proposed a progressive reduce tension method which does not need template to fabricate BNG with uniform tension. First input the initial parameters to calculate the final progressive reduce tension sequence (FA(i)) through program; then sequentially adjust the weight set according to FA(i) to construct a BNG with uniform tension wires through a home-built device. Wires tension non-...

  17. Linking chronic infection and autoimmune diseases: Mycobacterium avium subspecies paratuberculosis, SLC11A1 polymorphisms and type-1 diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Daniela Paccagnini

    Full Text Available BACKGROUND: The etiology of type 1 diabetes mellitus (T1DM is still unknown; numerous studies are performed to unravel the environmental factors involved in triggering the disease. SLC11A1 is a membrane transporter that is expressed in late endosomes of antigen presenting cells involved in the immunopathogenic events leading to T1DM. Mycobacterium avium subsp. paratuberculosis (MAP has been reported to be a possible trigger in the development of T1DM. METHODOLOGY/PRINCIPAL FINDINGS: Fifty nine T1DM patients and 79 healthy controls were genotyped for 9 polymorphisms of SLC11A1 gene, and screened for the presence of MAP by PCR. Differences in genotype frequency were evaluated for both T1DM patients and controls. We found a polymorphism in the SLC11A1 gene (274C/T associated to type 1 diabetic patients and not to controls. The presence of MAP DNA was also significantly associated with T1DM patients and not with controls. CONCLUSIONS/SIGNIFICANCE: The 274C/T SCL11A1 polymorphism was found to be associated with T1DM as well as the presence of MAP DNA in blood. Since MAP persists within macrophages and it is also processed by dendritic cells, further studies are necessary to evaluate if mutant forms of SLC11A1 alter the processing or presentation of MAP antigens triggering thereby an autoimmune response in T1DM patients.

  18. Comparing contact angle measurements and surface tension assessments of solid surfaces.

    Science.gov (United States)

    Cwikel, Dory; Zhao, Qi; Liu, Chen; Su, Xueju; Marmur, Abraham

    2010-10-05

    Four types of contact angles (receding, most stable, advancing, and "static") were measured by two independent laboratories for a large number of solid surfaces, spanning a large range of surface tensions. It is shown that the most stable contact angle, which is theoretically required for calculating the Young contact angle, is a practical, useful tool for wettability characterization of solid surfaces. In addition, it is shown that the experimentally measured most stable contact angle may not always be approximated by an average angle calculated from the advancing and receding contact angles. The "static" CA is shown in many cases to be very different from the most stable one. The measured contact angles were used for calculating the surface tensions of the solid samples by five methods. Meaningful differences exist among the surface tensions calculated using four previously known methods (Owens-Wendt, Wu, acid-base, and equation of state). A recently developed, Gibbsian-based correlation between interfacial tensions and individual surface tensions was used to calculate the surface tensions of the solid surfaces from the most stable contact angle of water. This calculation yielded in most cases higher values than calculated with the other four methods. On the basis of some low surface energy samples, the higher values appear to be justified.

  19. Comparative study on the nonlinear properties of bilayer graphene and silicene under tension

    Science.gov (United States)

    Xu, Peng; Yu, Zhongyuan; Yang, Chuanghua; Lu, Pengfei; Liu, Yumin; Ye, Han; Gao, Tao

    2014-11-01

    Atomic structures and nonlinear properties of single layer graphene (SLG), bilayer graphene (BLG), single layer silicene (SLS), and bilayer silicene (BLS) under equiaxial tension and uniaxial tensions along armchair and zigzag directions have been investigated comparatively using first-principles calculations. First, we have calculated the dependences of atomic structures (bond length, interlayer distance, and buckling height) of BLG and BLS on strain under three types of tensions. There exists the weak Van der Waals interaction between two layers of BLG and the interlayer distance is not variable with strain for three types of tensions. However, the interlayer of BLS is the covalent bond interaction, and the distance decreases with the increasing strain for three types of tensions. The continuum description of elastic response is formulated by expanding the elastic strain energy density in a Taylor series in strain truncated after the third-order term. The in-plane second- and third-order elastic constants of BLG and BLS have been obtained by fitting to the strain energy density versus Lagrangian strain relationships. The results show the in-plane stiffnesses of BLG and BLS become slightly larger than those of their single layer counterparts. In spite of the interlayer Si-Si covalent bond between two layers of BLS, its stiffness is still much less than BLG and SLG. Poisson's ratios of BLG and BLS basically maintain unchanged compared to their single layer counterparts.

  20. Protein tyrosine nitration in chronic intramuscular parasitism: immunohistochemical evaluation of relationships between nitration, and fiber type-specific responses to infection

    Directory of Open Access Journals (Sweden)

    Ted H. Elsasser

    2011-05-01

    Full Text Available The present study was conducted to determine whether preferential muscle catabolism [psoas major (PM > rectus femoris (RF] observed during the chronic intramuscular stage of Sarcocystis cruzi infection could be associated with the pathological consequences of increased protein tyrosine nitration in fibers characteristically more metabolically active due to higher mitochondrial density. Holstein calves were assigned to control (C, or S. cruzi-infected (I groups, n=5/group. Calves were euthanized on day 63 of infection. Samples of RF and PM were prepared for metabolic fiber typing (MFT: slow oxidative, SO – Type I; fast oxidative glycolytic, FOG - Type IIa; fast glycolytic, FG – Type IIb, fiber area, and immunohistochemical localization of fast myosin heavy chain 2a and 2b, nitrotyrosine (NT, and mitochondrial Complex V ATP-synthase. MFT analysis documented that PM contained twice the number of SO fibers compared to RF (32 v 16%, P<0.002. SO and FOG fibers (Both higher in mitochondrial density than FG fibers in both PM and RF were significantly smaller in area in I calves with mean FG areas not different between C and I. Muscle NT content (Western blot of myofibrillar protein fraction increased with infection; NT was immunohistochemically localized into three distinct patterns in fibers: i sparse fiber staining, ii dense punctuate intrafiber staining, and iii pericystic staining. By image analysis, the greatest punctuate intrafiber pixel density of NT was associated with SO fibers from I calves with the NT colocalizing with mitochondrial Complex V – F1F0 ATP synthase. More fibers were positive for the colocalization in PM than RF (P<0.04. The data are consistent with the concept that fibers rich in mitochondria possessing more inherent oxidative energy capacity generate more nitrated proteins than glycolytic fibers and as such are more affected by the proinflammatory response to infections like Sarcocystosis.

  1. Muscles and their role in episodic tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, L; Ashina, S; Moore, A;

    2016-01-01

    . Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non-pharmacological therapies include electromyographic biofeedback, physiotherapy and muscle relaxation therapy. Future studies should aim to identify the triggers...

  2. Treating tension-type headache -- an expert opinion

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Jensen, Rigmor

    2011-01-01

    -behavioral therapy and relaxation training are most likely to be effective. Physical therapy and acupuncture may be valuable options for patients with frequent TTH. Simple analgesics and nonsteroidal anti-inflammatory drugs are recommended for treatment of episodic TTH. Combination analgesics containing caffeine...

  3. Drug and Nondrug Treatment in Tension-type Headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    . Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH...

  4. Review: Drug and nondrug treatment in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    . Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH...

  5. Pain perception studies in tension-type headache

    DEFF Research Database (Denmark)

    Bezov, David; Ashina, Sait; Jensen, Rigmor;

    2011-01-01

    of pathophysiology of TTH as well as to review the research of pathophysiology of TTH. Pain perception studies such as measurement of muscle tenderness, pain detection thresholds, pain tolerance thresholds, pain response to suprathreshold stimulation, temporal summation and diffuse noxious inhibitory control (DNIC...

  6. Acute calcific prevertebral tendonitis mimicking tension-type headache.

    Science.gov (United States)

    Wakabayashi, Yukihiro; Hori, Yuzo; Kondoh, Yayoi; Asano, Tomoshige; Yamada, Akira; Yamashita, Masanori; Nagatomi, Hirofumi

    2012-01-01

    A 74-year-old woman was admitted to our hospital due to severe nuchal pain and occipitalgia. Neurological examination found neck stiffness but no throat pain or dysphagia. Blood examination showed slight elevation of white blood cell count, but C-reactive protein level was normal. Cerebrospinal fluid examination found no abnormalities. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated no abnormalities in the brain. Cervical CT showed a small calcification in front of the C1 body. Cervical T(2)-weighted MR imaging showed a high intensity area in front of the upper cervical vertebral body from C1 to C4, suggesting inflammation of the longus colli muscles. We diagnosed acute calcific prevertebral tendonitis. She was administered nonsteroidal anti-inflammatory drugs. Her symptoms gradually improved and she was discharged without neurological deficit 8 days after admission. It is important to be aware of the possibility of this rare disease in a patient with severe occipitalgia but no sign of intracerebral lesion.

  7. Review: Drug and nondrug treatment in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    . Combination analgesics, triptans, muscle relaxants and opioids should not be used, and it is crucial to avoid frequent and excessive use of simple analgesics to prevent the development of medication-overuse headache. The tricyclic antidepressant amitriptyline is drug of first choice for the prophylactic...

  8. Drug and Nondrug Treatment in Tension-type Headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars

    2009-01-01

    . Psychological treatments with scientific evidence for efficacy include relaxation training, EMG biofeedback and cognitive-behavioural therapy. Physical therapy and acupuncture are widely used, but the scientific evidence for efficacy is sparse. Simple analgesics are the mainstays for treatment of episodic TTH...... efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient....

  9. Normal tension glaucoma and Alzheimer disease

    DEFF Research Database (Denmark)

    Bach-Holm, Daniella; Kessing, Svend Vedel; Mogensen, Ulla

    2012-01-01

    PURPOSE: To investigate whether normal tension glaucoma (NTG) is associated with increased risk of developing dementia/Alzheimer disease (AD). METHODS: A total of 69 patients with NTG were identified in the case note files in the Glaucoma Clinic, University Hospital of Copenhagen (Rigshospitalet...

  10. Tension and relaxation in the individual.

    Science.gov (United States)

    Newbury, C R

    1979-06-01

    Increasing materialism in society is resulting in more wide spread nervous tension in all age groups. While some degree of nervous tension is necessary in everyday living, its adverse effects require that we must learn to bring it under control. Total tension is shown to have two components: a controllable element arising from factors in the environment and the inbuilt uncontrollable residue which is basic in the individual temperament. The effects of excessive or uncontrolled stress can be classified as 1) emotional reactions such as neurotic behaviour (anxiety hypochondria, hysteria, phobia, depression obsessions and compulsions) or psychotic behaviour and 2) psychosomatic reactions (nervous asthma, headache, insomnia, heart attack). Nervous energy can be wastefully expended by such factors as loss of temper, wrong attitudes to work, job frustration and marital strains. Relaxation is the only positive way to control undesirable nervous tension and its techniques require to be learned. A number of techniques (progressive relaxation, differential relaxation, hypnosis, the use of biofeedback, Yoga and Transcendental Meditation) are described and their application to dental practice is discussed.

  11. Tension in Chemistry and Its Contents.

    Science.gov (United States)

    Hoffmann, Roald

    2015-01-01

    This article makes a case for a positive role of tension in the creative process in chemistry. I begin with an argument that there is an inherent tension in what makes molecules interesting--their positioning along various polar axes. One of these, the age-old differentiation between useful (to society and for personal profit) commercialization and pure understanding of molecules and their reactions is characteristic. The question of whether there are any bad molecules then leads me to ethical concerns in chemistry, and a particular working out of these in interactions of chemists in the Middle East. An analysis is made of the special tensions involved in publishing, especially in citation ethics; chemists publish a lot, so this is situation ethics worked out on a daily basis. I then find in the literature of psychology good evidence for the positive value of moderate stress in stimulating creativity. It is obvious that too much tension leads to distress, and there are some institutional aspects of chemistry that do not come out well here. But all in all, the dynamic middle is alive, and it leads to good new science.

  12. Dynamic Surface Tensions of Fluorous Surfactant Solutions

    Institute of Scientific and Technical Information of China (English)

    高艳安; 侯万国; 王仲妮; 李干佐; 韩布兴; 张高勇; 吕锋锋

    2005-01-01

    Dynamic surface properties of aqueous solutions of cationic fluorous surfactant CF3CF2CF20(CF(CF3)CF2O)2CF(CF3)CONH(CHE)3N+(C2H5)2CH3I- (abbrev. FC-4 ) were reported. The critical micelle concentration (cmc)(3.6×10-5 mol/L) and equilibdum surface tensions γeq were measured by Krtlss K12 tension apparatus. Dynamic surface tension γ(t) was measured in the range of 15 ms to 200 s using the MBP tensiometer. The surface excess Γ,as a function of concentration, was obtained from equilibrium tensiometry using the Gibbs equation. Data from these experiments were combined to analyze the γ(t) decays according to the asymptotic Ward and Tordai equation.The results show that at the initial adsorption stage, the dynamic surface tension data were all consistent with this diffusion-controlled mechanism, and at the end of the adsorption process, there were some evidences for an adsorption barrier, suggesting a mixed diffusion-controlled adsorption mechanism. Using measured quantities, the barrier strength was estimated as between 25 and 35 kJ/mol at 25℃. The surface pressure plays an important role in contributing to the barrier.

  13. Worldsheet electromagnetism and the superstring tension

    Energy Technology Data Exchange (ETDEWEB)

    Townsend, P.K. (DAMTP, Univ. Cambridge (United Kingdom))

    1992-03-05

    A superstring action, invariant under the symmetries corresponding to a free differential N=1 superalgebra, is constructed. Its worldsheet fields include an electromagnetic gauge potential. Its equations of motion are those of the Green-Schwarz superstring but with the string tension given by the circulation of the worldsheet electric field around the string. (orig.).

  14. Tension Tests On Bored Piles In Sand

    DEFF Research Database (Denmark)

    Krabbenhøft, Sven; Clausen, Johan; Damkilde, Lars

    2006-01-01

    The lengths of the bored piles varied from 2 m to 6 m and all were of a diameter of 140 mm. The piles were tested to failure in tension and the load-displacement relations were recorded. The investigation has shown pronounced differences between the load bearing capacities obtained by different...

  15. Lower blood glucose and variability are associated with earlier recovery from renal injury caused by episodic urinary tract infection in advanced type 2 diabetic chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Ping-Fang Chiu

    Full Text Available In our previous study, type 2 diabetic chronic kidney disease (CKD patients with glomerular filtration rates of 9 days, Group B groups. The differences in the continuous and categorical variables of the two groups were assessed separately. The mean glucose levels and their variability (using the standard deviation and the coefficient of standard deviation were compared at the fasting, midday pre-meal, evening pre-meal, and evening post-meal time points during hospitalization. We have organized the manuscript in a manner compliant with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology statement.Acute kidney injury occurred within the two groups (p = 0.007 and p = 0.001, respectively. The early-morning blood glucose levels (149.7±44.0 mg/dL and average blood glucose levels (185.6±52.0 mg/dL were better in Group A (p = 0.01, p = 0.02. Group A patients also had lower glucose variability than Group B at the different time points (p<0.05. Group A also had earlier renal recovery. More relevant pathogens were identified from blood in Group B (p = 0.038.Early-morning fasting and mean blood glucose levels and their variability can be good indicators of severe infection and predictors of renal outcome in type 2 diabetic patients with CKD and UTI.

  16. Occipital peripheral nerve stimulation in the management of chronic intractable occipital neuralgia in a patient with neurofibromatosis type 1: a case report

    Directory of Open Access Journals (Sweden)

    Calvillo Octavio

    2011-05-01

    Full Text Available Abstract Introduction Occipital peripheral nerve stimulation is an interventional pain management therapy that provides beneficial results in the treatment of refractory chronic occipital neuralgia. Herein we present a first-of-its-kind case study of a patient with neurofibromatosis type 1 and bilateral occipital neuralgia treated with occipital peripheral nerve stimulation. Case presentation A 42-year-old Caucasian woman presented with bilateral occipital neuralgia refractory to various conventional treatments, and she was referred for possible treatment with occipital peripheral nerve stimulation. She was found to be a suitable candidate for the procedure, and she underwent implantation of two octapolar stimulating leads and a rechargeable, programmable, implantable generator. The intensity, severity, and frequency of her symptoms resolved by more than 80%, but an infection developed at the implantation site two months after the procedure that required explantation and reimplantation of new stimulating leads three months later. To date she continues to experience symptom resolution of more than 60%. Conclusion These results demonstrate the significance of peripheral nerve stimulation in the management of refractory occipital neuralgias in patients with neurofibromatosis type 1 and the possible role of neurofibromata in the development of occipital neuralgia in these patients.

  17. Psychometric properties of the Iranian version of resources and support for chronic illness self-management scale in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Elham Shakibazadeh

    2012-01-01

    Full Text Available Background: This article is a report of psychometric testing of the Farsi version of Resources and Support for Chronic Illness Self-management (RSSM scale. Methods: In this cross-sectional study, a convenience sample of 160 patients with type 2 diabetes, registered with the Charity Foundation for Special Diseases′ team-focused diabetes clinic, were recruited (response rate=83.7%; n=134. Participants older than 18 years who had active medical files in the system completed the questionnaire. Content validity was established using translation and back-translation procedures, pilot testing of the instrument, and getting views of the expert panel. Construct validity was determined using explanatory factor analysis. Internal consistency was ascertained using Cronbach′s alpha. The stability was confirmed using intra-class correlation coefficients. Results: Using exploratory factor analysis, a five-factor model emerged, which explained 75.24% of the total variance. Internal consistency reliability was sufficient (α=0.70; range=0.66 - 0.87. The intra-class correlation coefficient was 0.74 - 0.81 for individual items. Conclusion: The RSSM-Farsi seems to be a valid and reliable instrument to measure outcomes of diabetes self-management education programs in Farsi. The RSSM-Farsi version scale could be a useful, comprehensive, and culturally sensitive scale for assessing resources and support for self-management between type 2 diabetic patients.

  18. The Effect of Non-surgical Periodontal Therapy on Hemoglobin A1c Levels in Persons with Type 2 Diabetes and Chronic Periodontitis: A Randomized Clinical Trial

    Science.gov (United States)

    Engebretson, Steven P.; Hyman, Leslie G.; Michalowicz, Bryan S.; Schoenfeld, Elinor R.; Gelato, Marie C.; Hou, Wei; Seaquist, Elizabeth R.; Reddy, Michael S.; Lewis, Cora E.; Oates, Thomas W.; Tripathy, Devjit; Katancik, James A.; Orlander, Philip R.; Paquette, David W.; Hanson, Naomi Q.; Tsai, Michael Y.

    2014-01-01

    Importance Chronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control. Objective To determine if non-surgical periodontal treatment reduces hemoglobin A1c (HbA1c) in persons with type 2 diabetes (DM) and moderate to advanced chronic periodontitis. Design, Setting and Participants The Diabetes and Periodontal Therapy Trial (DPTT) is a 6-month, single-masked, randomized, multi-center clinical trial. Participants had DM, were taking stable doses of medications, had HbA1c ≥7% and <9%, and untreated periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with five academic medical centers. Intervention The treatment group (n=257) received scaling and root planing plus chlorhexidine oral rinse at baseline, and supportive periodontal therapy at three and six months. The control group (n=257) received no treatment for six months. Main Outcome Measure Difference in HbA1c change from baseline between groups at six months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose, and the Homeostasis Model Assessment (HOMA2). Results Enrollment was stopped early due to futility. At 6 months, the periodontal therapy group increased HbA1c 0.17% (1.0) (mean (SD)) compared to 0.11% (1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference = -0.05%; 95% Confidence Interval (CI): -0.23%, 0.12%; p=0.55). Probing depth, clinical attachment loss, bleeding on probing and gingival index measures improved in the treatment group compared to the control group at six months with adjusted between-group differences of 0.33mm (95% CI: 0.26, 0.39), 0

  19. Multi-omic integrated networks connect DNA methylation and miRNA with skeletal muscle plasticity to chronic exercise in Type 2 diabetic obesity

    Science.gov (United States)

    Page, Rachel A.; Sukala, William R.; Giri, Mamta; Ghimbovschi, Svetlana D.; Hayat, Irum; Cheema, Birinder S.; Lys, Isabelle; Leikis, Murray; Sheard, Phillip W.; Wakefield, St. John; Breier, Bernhard; Hathout, Yetrib; Brown, Kristy; Marathi, Ramya; Orkunoglu-Suer, Funda E.; Devaney, Joseph M.; Leiken, Benjamin; Many, Gina; Krebs, Jeremy; Hopkins, Will G.; Hoffman, Eric P.

    2014-01-01

    Epigenomic regulation of the transcriptome by DNA methylation and posttranscriptional gene silencing by miRNAs are potential environmental modulators of skeletal muscle plasticity to chronic exercise in healthy and diseased populations. We utilized transcriptome networks to connect exercise-induced differential methylation and miRNA with functional skeletal muscle plasticity. Biopsies of the vastus lateralis were collected from middle-aged Polynesian men and women with morbid obesity (44 kg/m2 ± 10) and Type 2 diabetes before and following 16 wk of resistance (n = 9) or endurance training (n = 8). Longitudinal transcriptome, methylome, and microRNA (miRNA) responses were obtained via microarray, filtered by novel effect-size based false discovery rate probe selection preceding bioinformatic interrogation. Metabolic and microvascular transcriptome topology dominated the network landscape following endurance exercise. Lipid and glucose metabolism modules were connected to: microRNA (miR)-29a; promoter region hypomethylation of nuclear receptor factor (NRF1) and fatty acid transporter (SLC27A4), and hypermethylation of fatty acid synthase, and to exon hypomethylation of 6-phosphofructo-2-kinase and Ser/Thr protein kinase. Directional change in the endurance networks was validated by lower intramyocellular lipid, increased capillarity, GLUT4, hexokinase, and mitochondrial enzyme activity and proteome. Resistance training also lowered lipid and increased enzyme activity and caused GLUT4 promoter hypomethylation; however, training was inconsequential to GLUT4, capillarity, and metabolic transcriptome. miR-195 connected to negative regulation of vascular development. To conclude, integrated molecular network modelling revealed differential DNA methylation and miRNA expression changes occur in skeletal muscle in response to chronic exercise training that are most pronounced with endurance training and topographically associated with functional metabolic and microvascular

  20. Prevalence of Cognitive Impairment in Recently Diagnosed Type 2 Diabetes Patients: Are Chronic Inflammatory Diseases Responsible for Cognitive Decline?

    Science.gov (United States)

    Lavielle, Pilar; Talavera, Juan O.; Reynoso, Nancy; González, Marissa; Gómez-Díaz, Rita A.; Cruz, Miguel; Vázquez, Felipe; Wacher, Niels H.

    2015-01-01

    Objective To estimate the prevalence of cognitive impairment (CI) among patients recently diagnosed with type 2 diabetes (RDD) and to identify any relationships between CI and RDD comorbidities. Methods: One thousand seven hundred twelve patients with RDD participated in a cross-sectional study. The patients’ sociodemographic and clinical data were registered. Results The sample population had an average age of 51 ± 11 years, and 63.26% of the patients were female. CI was diagnosed in 38 patients (2.2%) and was more common among both females (2.8% vs. 1.3%, p = 0.063) and the elderly (0% at an age ≤ 30 years vs. 10.4% at an age > 70 years, p = 0.0001). Rheumatoid arthritis (present in 15.8% vs. absent in 2.1%) and asthma (13% vs. 2.1%) correlated significantly with CI based on the results of our logistic regression analysis. Conclusion Age, female gender, rheumatoid arthritis and asthma are risk factors for CI in the setting of RDD. PMID:26517541

  1. EFFECT OF CHRONIC ACE INHIBITION ON GLUCOSE TOLERANCE AND INSULIN SENSITIVITY IN HYPERTENSIVE TYPE 2 DIABETIC PATIENTS

    Institute of Scientific and Technical Information of China (English)

    尹卫东; G.Seghieri; C.Boni,G,Sanna; R.Anichinl; G.Bartolomei; E.Ferrannini

    1994-01-01

    We studied 14 moderately overweight Type 2 diabetic patients with essential hypertension in stable metabolic control after a run-in period,and again after 3 months of antihypertensive treatment with the angiotensin-convert-ing enzyme(ACE)inhibitor captopril.Glucose tolerance was tested with a 75g oral glucose load (OGTT) and in-sulin sensitivity was measured by the insulin suppression test (IST)while dietary and drug treatment of the hyper-glycemia was maintained constant.In the whole group,mean blood pressure (MBP) fell progressively over 3 months from a baseline value of 123±3mmHg(1 mmHg=0.133kpa)to a final value of 115±2mmHg(P<0.005).After treatment,fasting plasma glucose,insulin,free fatty acid (FFA),potassium,and glycosylated hemoglobin concentrations were unchanged from baseling.There were no significant differences in glucose toler-ance and insulin sensitivity between pre-and post-trearment values.Neither endogenous (oral glucose)nor exoge-nous(IST)insulin caused any change in plasma potassium concentration. This resistance to the hypokalemic action of insulin was not affected by captopril.

  2. Chronic inhibition of 11 β -hydroxysteroid dehydrogenase type 1 activity decreases hypertension, insulin resistance, and hypertriglyceridemia in metabolic syndrome.

    Science.gov (United States)

    Schnackenberg, Christine G; Costell, Melissa H; Krosky, Daniel J; Cui, Jianqi; Wu, Charlene W; Hong, Victor S; Harpel, Mark R; Willette, Robert N; Yue, Tian-Li

    2013-01-01

    Metabolic syndrome is a constellation of risk factors including hypertension, dyslipidemia, insulin resistance, and obesity that promote the development of cardiovascular disease. Metabolic syndrome has been associated with changes in the secretion or metabolism of glucocorticoids, which have important functions in adipose, liver, kidney, and vasculature. Tissue concentrations of the active glucocorticoid cortisol are controlled by the conversion of cortisone to cortisol by 11 β -hydroxysteroid dehydrogenase type 1 (11 β -HSD1). Because of the various cardiovascular and metabolic activities of glucocorticoids, we tested the hypothesis that 11 β -HSD1 is a common mechanism in the hypertension, dyslipidemia, and insulin resistance in metabolic syndrome. In obese and lean SHR/NDmcr-cp (SHR-cp), cardiovascular, metabolic, and renal functions were measured before and during four weeks of administration of vehicle or compound 11 (10 mg/kg/d), a selective inhibitor of 11 β -HSD1. Compound 11 significantly decreased 11 β -HSD1 activity in adipose tissue and liver of SHR-cp. In obese SHR-cp, compound 11 significantly decreased mean arterial pressure, glucose intolerance, insulin resistance, hypertriglyceridemia, and plasma renin activity with no effect on heart rate, body weight gain, or microalbuminuria. These results suggest that 11 β -HSD1 activity in liver and adipose tissue is a common mediator of hypertension, hypertriglyceridemia, glucose intolerance, and insulin resistance in metabolic syndrome.

  3. Chronic Inhibition of 11β-Hydroxysteroid Dehydrogenase Type 1 Activity Decreases Hypertension, Insulin Resistance, and Hypertriglyceridemia in Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Christine G. Schnackenberg

    2013-01-01

    Full Text Available Metabolic syndrome is a constellation of risk factors including hypertension, dyslipidemia, insulin resistance, and obesity that promote the development of cardiovascular disease. Metabolic syndrome has been associated with changes in the secretion or metabolism of glucocorticoids, which have important functions in adipose, liver, kidney, and vasculature. Tissue concentrations of the active glucocorticoid cortisol are controlled by the conversion of cortisone to cortisol by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1. Because of the various cardiovascular and metabolic activities of glucocorticoids, we tested the hypothesis that 11β-HSD1 is a common mechanism in the hypertension, dyslipidemia, and insulin resistance in metabolic syndrome. In obese and lean SHR/NDmcr-cp (SHR-cp, cardiovascular, metabolic, and renal functions were measured before and during four weeks of administration of vehicle or compound 11 (10 mg/kg/d, a selective inhibitor of 11β-HSD1. Compound 11 significantly decreased 11β-HSD1 activity in adipose tissue and liver of SHR-cp. In obese SHR-cp, compound 11 significantly decreased mean arterial pressure, glucose intolerance, insulin resistance, hypertriglyceridemia, and plasma renin activity with no effect on heart rate, body weight gain, or microalbuminuria. These results suggest that 11β-HSD1 activity in liver and adipose tissue is a common mediator of hypertension, hypertriglyceridemia, glucose intolerance, and insulin resistance in metabolic syndrome.

  4. Noradrenaline-induced changes in intracellular Ca(2+) and tension in mesenteric arteries from diabetic rats.

    Science.gov (United States)

    Chow, W L; Zhang, L; MacLeod, K M

    2001-09-01

    1. The purpose of this investigation was to determine whether enhanced contractile responses to noradrenaline (NA) of mesenteric arteries from rats with chronic streptozotocin-induced diabetes are associated with increases in mean cytosolic [Ca(2+)]i. 2. [Ca(2+)]i was measured with fura 2-AM, and was monitored simultaneously with tension in perfused endothelium-denuded mesenteric arterial rings from 12 - 14 week diabetic rats and age- and gender-matched control rats. 3. Basal [Ca(2+)]i (expressed as R(n), the normalized fura 2 ratio) was not significantly different in arteries from control and diabetic rats. Similarly, no differences between control and diabetic arteries in the tension or [Ca(2+)]i responses to 80 mM KCl in the presence of phentolamine were detected. 4. The rate of tension development, peak tension and integrated tension in response to 30 microM NA were all significantly greater in diabetic than control arteries. However, this was not associated with enhancement of the corresponding [Ca(2+)]i responses in the diabetic arteries. 5. Peak contractile responses to perfusion with both 0.3 and 3 microM NA, but peak [Ca(2+)]i only in response to 0.3 microM NA, were significantly greater in diabetic than control arteries. 6. NA (30 microM) produced a greater increase in both peak tension and [Ca(2+)]i in diabetic than control arteries perfused with Ca(2+)-free solution containing 1 mM EGTA. Neither the rate nor the magnitude of NA-induced Ca(2+) influx appeared to be altered in the diabetic arteries. 7. The enhanced sustained contractile response of diabetic arteries to NA appears to be dissociated from increases in [Ca(2+)]i, and may be due to other factors, such as an increase in the Ca(2+) sensitivity of the contractile proteins.

  5. Measurements of oxygen tension in native and transplanted rat pancreatic islets.

    Science.gov (United States)

    Carlsson, P O; Liss, P; Andersson, A; Jansson, L

    1998-07-01

    This study was performed to measure the oxygen tension before and after revascularization of pancreatic islets transplanted beneath the renal capsule and to investigate to what extent this was affected by acute and chronic hyperglycemia. In addition, the oxygen tension in islets within the pancreas was determined. PO2 was measured with a modified Clark electrode (tip 2-6 microm o.d.). Within native pancreatic islets, the mean PO2 was higher (31-37 mmHg) than within the exocrine pancreas (20-23 mmHg). The mean oxygen tension in the transplanted islets the day after implantation was half of that recorded in native islets (14-19 mmHg) and did not differ between normoglycemic and diabetic recipients. At 1 month after transplantation, when revascularization had occurred, the mean PO2 in the islet grafts was 9-15 mmHgf in normoglycemic animals but was lower (6-8 mmHg) in diabetic animals, whereas the blood perfusion of the transplants, as measured with laser-Doppler flowmetry (probe diameter 0.45 mm), was similar in both groups. The mean oxygen tension in the superficial renal cortex surrounding the implanted islets was similar in all groups and remained stable at 13-21 mmHg. Intravenous administration of D-glucose (1 g/kg) did not affect the oxygen tension in any of the investigated tissues. We conclude that the mean PO2 in islets implanted under the renal capsule is markedly lower than in native islets, not only in the immediate posttransplantation period but also 1 month after implantation, i.e., when revascularization has occurred. Furthermore, persistent hyperglycemia in the recipient leads to a further decrease in graft oxygen tension. To what extent this may contribute to islet graft failure is at present unknown.

  6. The difference in correlation between insulin resistance index and chronic inflammation in type 2 diabetes with and without metabolic syndrome

    Science.gov (United States)

    Pourfarzam, Morteza; Zadhoush, Fouzieh; Sadeghi, Masoumeh

    2016-01-01

    Background: Insulin resistance (IR) is associated with low-grade systemic inflammation. It plays an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in patients with metabolic syndrome (MetS). It is unclear whether diabetic patients with MetS confer elevated CVD risk and outcomes beyond the impact of individual's components of MetS. The aim of this study is to highlight the central role of IR, inflammation, triglyceride/high-density lipoprotein- cholesterol (TG/HDL-C) ratio, and atherogenic index of plasma (AIP) in T2DM with MetS. Materials and Methods: This cross-sectional study comprised 130 men distributed into three groups, namely Controls: 40 nondiabetic healthy volunteers; Group I: 40 T2DM patients without MetS, and Group II: 50 T2DM patients with MetS. Fasting blood samples were collected for the measurement of blood lipid profile, glucose, insulin, hemoglobin A1c, and high-sensitivity C-reactive protein (hs-CRP). TG/HDL-C ratio, AIP, and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Results: Significant positive association was observed between HOMA-IR and hs-CRP only in Group II and between HOMA-IR and TG/HDL-C ratio in all subjects. Significant differences were seen in waist and hip circumferences, waist/hip ratio, body mass index, systolic blood pressure, fasting blood glucose, TGs, HDL-C, insulin, hs-CRP, HOMA-IR, TG/HDL ratio, and AIP between Controls and Group I with Group II. Conclusions: In T2DM with MetS, coexistence of elevated atherogenic indices, systemic inflammation, and association between HOMA-IR and TG/HDL-C ratio were seen. These factors are considered having important role in elevated CVD risk beyond MetS components in these patients. PMID:27713874

  7. The use of oral recombinant feline interferon omega in two cats with type II diabetes mellitus and concurrent feline chronic gingivostomatitis syndrome.

    Science.gov (United States)

    Leal, Rodolfo O; Gil, Solange; Brito, Maria Tv; McGahie, David; Niza, Maria Mre; Tavares, Luís

    2013-10-23

    Feline Chronic Gingivostomatitis Syndrome (FCGS) is a common disease in clinical practice. Among the therapeutic options available, long-acting corticosteroids are frequently used due to their anti-inflammatory and immunosuppressive properties. Although they may improve the clinical symptoms, they can lead to a progressive form of the disease that becomes refractory to treatment. Furthermore, their direct relationship with type II diabetes mellitus (DM) is well known. Consequently, these drugs are controversial and not recommended for routine management of FCGS. Recombinant feline interferon-omega (rFeIFN-ω) is an immunomodulatory compound. Recently, its daily oral administration has been shown to be successful in treating refractory cases of FCGS. This case study describes two clinical cases of type II DM complicated by FCGS. Both animals were calicivirus positive and they had been previously treated with long-acting corticosteroids, which may have been the major cause of DM. The two cats were treated with glargine insulin (Lantus, starting dose 1 IU/cat twice daily (BID)), achieving remission 10 and 18 weeks later respectively. Considering the difficulty with control of FCGS in these animals, an oral daily dose of rFeIFN-ω was started as an alternative to long-acting corticosteroids. In both cats oral clinical signs gradually improved and 60 days after the start of therapy the owners reported a significant relief of pain during mastication. According to the authors' knowledge, this is the first case report that describes the successful use of rFeIFN-ω in the management of FCGS in type II diabetic cats, in which long-acting corticosteroids are contraindicated.

  8. Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Tamires Szeremeske MIRANDA

    Full Text Available Abstract Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM and generalized chronic periodontitis (ChP. Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c into one of the following groups: HbA1c<8% (n=28 or HbA1c≥8% (n=28. Three subgingival biofilm samples from sites with probing depth (PD<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05. Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05. Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05. Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.

  9. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... Chronic myelogenous leukemia is grouped into phases: Chronic Accelerated Blast crisis The chronic phase can last for ...

  10. Parametric Instability Analysis of Deepwater Top-Tensioned Risers Considering Variable Tension Along the Length

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jie; TANG Yougang

    2015-01-01

    Parametric instability of a riser is caused by fluctuation of its tension in time due to the heave motion of floating plat-form. Many studies have tackled the problem of parametric instability of a riser with constant tension. However, tension in the riser actually varies linearly from the top to the bottom due to the effect of gravity. This paper presents the parametric instability analysis of deepwater top-tensioned risers (TTR) considering the linearly varying tension along the length. Firstly, the governing equation of transverse motion of TTR under parametric excitation is established. This equation is reduced to a system of ordinary differential equations by using the Galerkin method. Then the parametric instability of TTR for three calculation models are investigated by ap-plying the Floquet theory. The results show that the natural frequencies of TTR with variable tension are evidently reduced, the pa-rametric instability zones are significantly increased and the maximum allowable amplitude of platform heave is much smaller under the same damping; The nodes and antinodes of mode shape are no longer uniformly distributed along the axial direction and the am-plitude also changes with depth, which leads to coupling between the modes. The combination resonance phenomenon occurs as a result of mode coupling, which causes more serious damage.

  11. Distribution in law of the dialectical type of TCM of chronic hepatopathy%慢性肝病中医证候规律分布特征

    Institute of Scientific and Technical Information of China (English)

    侯岩; 崔丽萍; 张明香; 颜迎春

    2012-01-01

    Objective To investigate the law of dialectical type of TCM of chronic hepatopathy and predicting treatment results. Methods A retrospective survey was made on 1025 cases of chronic hepatitis and liver cirrhosis from September 2008 to January 2011. Results From high to low frequency order of Chinese medicinal symptom is burnout>irascibility>anxiety>loss of vitality> dry mouth> fatigue> sighing. From high to low frequency order of dialectical typing of TCM is liver-stagnation and spleen-deficiency>liver qi stagnation>damp -heat in the liver and the gall>obstruction of collaterals by blood stasis incoordination between liver and stomach>Yang deficiency of spleen and kidney, insufficiency of liver and kidney>Qi and Damp Stagnation. Conclusion liver-stagnation and spleen-deficiency runs through the disease course, dysfunction of Qi, deficiency of healthy Qi are the key points of disease development course.%目的 探讨慢性肝病的中医症候及中医证型分布特点与疾病预后的关系.方法 对2008年9月至2011年1月各种慢性肝炎、肝硬化患者1025例进行回顾性调查.结果 慢性肝病患者中出现症候频率较高的依次为倦怠、急躁易怒、烦躁、神疲、口干、困重、太息.证型分布依次为肝郁脾虚>肝气郁结>肝胆湿热>血瘀阻络>肝胃不和>脾肾阳虚>肝肾不足>气滞湿阻>寒湿.结论肝郁脾虚贯穿于慢性肝病的整个病程中,气机的不畅、正气的不足是肝病进展的关键.

  12. Intrathecal long-term gene expression by self-complementary adeno-associated virus type 1 suitable for chronic pain studies in rats

    Directory of Open Access Journals (Sweden)

    Janssen William GM

    2006-01-01

    Full Text Available Abstract Background Intrathecal (IT gene transfer is an attractive approach for targeting spinal mechanisms of nociception but the duration of gene expression achieved by reported methods is short (up to two weeks impairing their utility in the chronic pain setting. The overall goal of this study was to develop IT gene transfer yielding true long-term transgene expression defined as ≥ 3 mo following a single vector administration. We defined "IT" administration as atraumatic injection into the lumbar cerebrospinal fluid (CSF modeling a lumbar puncture. Our studies focused on recombinant adeno-associated virus (rAAV, one of the most promising vector types for clinical use. Results Conventional single stranded rAAV2 vectors performed poorly after IT delivery in rats. Pseudotyping of rAAV with capsids of serotypes 1, 3, and 5 was tested alone or in combination with a modification of the inverted terminal repeat. The former alters vector tropism and the latter allows packaging of self-complementary rAAV (sc-rAAV vectors. Combining both types of modification led to the identification of sc-rAAV2/l as a vector that performed superiorly in the IT space. IT delivery of 3 × 10e9 sc-rAAV2/l particles per animal led to stable expression of enhanced green fluorescent protein (EGFP for ≥ 3 mo detectable by Western blotting, quantitative PCR, and in a blinded study by confocal microscopy. Expression was strongest in the cauda equina and the lower sections of the spinal cord and only minimal in the forebrain. Microscopic examination of the SC fixed in situ with intact nerve roots and meninges revealed strong EGFP fluorescence in the nerve roots. Conclusion sc-rAAVl mediates stable IT transgene expression for ≥ 3 mo. Our findings support the underlying hypothesis that IT target cells for gene transfer lack the machinery for efficient conversion of the single-stranded rAAV genome into double-stranded DNA and favor uptake of serotype 1 vectors over 2

  13. Association analysis of ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 gene polymorphisms with chronic renal insufficiency among Asian Indians with type-2 diabetes

    Directory of Open Access Journals (Sweden)

    Gupta Arvind

    2010-03-01

    Full Text Available Abstract Background To determine association of nine single nucleotide polymorphisms (SNPs in ADP ribosyltransferase-1 (ADPRT1, aldo-keto reductase family 1 member B1 (AKR1B1, receptor for advanced glycation end-products (RAGE, glutamine:fructose-6-phosphate amidotransferase-2 (GFPT2, and plasminogen activator inhibitor-1 (PAI-1 genes with chronic renal insufficiency (CRI among Asian Indians with type 2 diabetes; and to identify epistatic interactionss between genes from the present study and those from renin-angiotensin-aldosterone system (RAAS, and chemokine-cytokine, dopaminergic and oxidative stress pathways (previously investigated using the same sample set. Methods Type 2 diabetes subjects with CRI (serum creatinine ≥3.0 mg/dl constituted the cases (n = 196, and ethnicity and age matched individuals with diabetes for a duration of ≥ 10 years, normal renal functions and normoalbuminuria recruited as controls (n = 225. Allelic and genotypic constitution of 10 polymorphisms (SNPs from five genes namely- ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 with diabetic CRI was investigated. The genetic associations were evaluated by computation of odds ratio and 95% confidence interval. Multiple logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study epistatic interactions between SNPs in different genes. Results Single nucleotide polymorphisms -429 T>C in RAGE and rs7725 C>T SNP in 3' UTR in GFPT2 gene showed a trend towards association with diabetic CRI. Investigation using miRBase statistical tool revealed that rs7725 in GFPT2 was a perfect target for predicted miRNA (hsa miR-378 suggesting the presence of the variant 'T' allele may result in an upregulation of GFPT2 contributing to diabetic renal complication. Epistatic interaction between SNPs in transforming growth factor TGF-β1 (investigated using the same sample set and reported elsewhere and GFPT2 genotype was observed. Conclusions

  14. Simulation Analysis of Standard Metal Specimen Tension Experiment by Fem

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>Some standard metal rod-shaped, plate-shaped or pipe-shaped specimens usually are used to be tensioned to acquire the material properties such as tensional ductility, contractibility ratio on breaking section,

  15. 颈部肌肉痛点按摩对紧张性头痛的疗效及对颅周肌肉肌电的影响%Massage on the trigger points of neck muscles for tension-type headache

    Institute of Scientific and Technical Information of China (English)

    李信明; 李定明; 魏安宁

    2010-01-01

    Seventy two patients with tension type headache (TTH) were divided randomly into two groups: massage group was treated with massage on the trigger points of neck muscles, and control group was treated with drugs.The frequency, duration, severity of TTH, use of painkiller and electromyography of pericranial muscle (temporalis muscle and masseter muscle ) were recorded before and after treatment.The frequency, duration and severity of TTH, the frequency of painkiller use, and amplitude and frequency on electromyography of pericranial muscles in massage groups after treatment were reduced significantly (P <0.05 ) .In summary, massage on the trigger points in neck muscles has significant therapeutic effects for TTH.%为观察颈部肌肉痛点按摩治疗紧张性头痛的临床疗效及对颅周肌肉肌电的影响,选取72例紧张性头痛患者,随机分为按摩组(接受颈部肌肉痛点按摩)和对照组(接受口服药物治疗).观察治疗前后头痛发作频率、持续时间、疼痛程度、使用止痛药物情况及颅周肌肉肌电的变化.按摩组治疗后头痛发作频率、持续时间、疼痛程度均较治疗前明显下降,使用止痛药物减少,肌电频率和波幅明显降低(P<0.05).说明颈部肌肉痛点按摩治疗紧张性头痛有较好的疗效.

  16. Clinical effect analysis of tension-free hernia repair in treatment of chronic obstructive emphysema combined with inguinal hernia%无张力修补术治疗慢性阻塞性肺气肿合并腹股沟疝的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    张伟军

    2014-01-01

    目的:了解对成人疝气患者选择无张力疝修补术治疗方案的临床效果。方法随机抽取我院2013年4月至2014年5月间收治的腹股沟疝合并其他疾病的患者100例随机分为观察组和对照组各50例,研究组患者使用无张力疝修补术进行治疗,观察组患者使用传统疝修补术进行治疗,对比2组患者临床治疗效果。结果观察组患者在手术时间住院时间、医疗花费以及术后并发症事件发生概率等各项指标相对于对照组均有显著优越性(P <0.05);使用无张力疝修补术对腹股沟疝合并糖尿病、高血压、前列腺增生等疾病治疗的临床有效率显著高于对照组,其差异显著(P <0.05),具有统计学意义。结论对成人疝气患者应用无张力疝修补术治疗方案,其临床治疗效果可得到有效保障,提高合并症的临床治疗效果,极大程度降低患者的生理和心理负担,值得临床推广。%Objective to understand the clinical results of tension-free hernia repair treatment in adult patients with hernia. Methods 100 cases of adult patients with tension-free hernia with complication of other diseases admitted in our hospital from april 2013 to May 2014 were randomly divided into observation group and control group, with 50 cases in each group. Patients in observation group were treated with tension-free hernia repair operation, while patients in control group received traditional hernia repair treatment. the clinical outcomes of patients in two groups were compared.Results in the observation group, the operative time, length of hospital stay, medical costs and probability of postoperative complications occurring were all better than that in control group (P <0.05). also, the clinical effective rate of tension-free hernia repair treatment in patients with complication of diabetes, hypertension and benign prostatic hyperplasia in the observation group were higher than that in the

  17. Surface and interfacial tension measurement, theory, and applications

    CERN Document Server

    Hartland, Stanley

    2004-01-01

    This edited volume offers complete coverage of the latest theoretical, experimental, and computer-based data as summarized by leading international researchers. It promotes full understanding of the physical phenomena and mechanisms at work in surface and interfacial tensions and gradients, their direct impact on interface shape and movement, and their significance to numerous applications. Assessing methods for the accurate measurement of surface tension, interfacial tension, and contact angles, Surface and Interfacial Tension presents modern simulations of complex interfacial motions, such a

  18. Thermal Analysis of Bending Under Tension Test

    DEFF Research Database (Denmark)

    Ceron, Ermanno; Martins, Paulo A.F.; Bay, Niels

    2014-01-01

    The tribological conditions in deep drawing can be simulated in the Bending Under Tension test to evaluate the performance of new lubricants, tool materials, etc. Deep drawing production with automatic handling runs normally at high rate. This implies considerable heating of the tools, which...... sometimes can cause lubricant film breakdown and galling. In order to replicate the production conditions in bending under tension testing it is thus important to control the tool/workpiece interface temperature. This can be done by pre-heating the tool, but it is essential that the interface temperature...... during testing is similar to the one in the production tool. A universal sheet tribo-tester has been developed, which can run multiple tests automatically from coil. This allows emulating the temperature increase as in production. The present work performs finite element analysis of the evolution...

  19. Separation anxiety: Stress, tension and cytokinesis

    Energy Technology Data Exchange (ETDEWEB)

    Mohan, Krithika [Department of Electrical and Computer Engineering, The Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218 (United States); Iglesias, Pablo A., E-mail: pi@jhu.edu [Department of Electrical and Computer Engineering, The Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218 (United States); Robinson, Douglas N., E-mail: dnr@jhmi.edu [Department of Cell Biology, Johns Hopkins University School of Medicine, 725 N. Wolfe Street, Baltimore, MD 21205 (United States)

    2012-07-15

    Cytokinesis, the physical separation of a mother cell into two daughter cells, progresses through a series of well-defined changes in morphology. These changes involve distinct biochemical and mechanical processes. Here, we review the mechanical features of cells during cytokinesis, discussing both the material properties as well as sources of stresses, both active and passive, which lead to the observed changes in morphology. We also describe a mechanosensory feedback control system that regulates protein localization and shape progression during cytokinesis. -- Highlights: Black-Right-Pointing-Pointer Cytokinesis progresses through three distinct mechanical phases. Black-Right-Pointing-Pointer Cortical tension initially resists deformation of mother cell. Black-Right-Pointing-Pointer Late in cytokinesis, cortical tension provides stress, enabling furrow ingression. Black-Right-Pointing-Pointer A mechanosensory feedback control system regulates cytokinesis.

  20. Modelling Tension Stiffening in Reinforced Concrete Structures

    DEFF Research Database (Denmark)

    Christiansen, Morten Bo; Nielsen, Mogens Peter

    1997-01-01

    flexure.In the first model, the yield zone model, it is assumed that the mean crack distance is a descending function of the reinforcement stress in a crack. Furthermore it is assumed that in certain zones between the cracks the concrete is carrying its full effective tensile strength, i.e. the concrete...... with deformations in reinforced concrete disks subjected to pure shear.A physical model for the shear stress-shear strain behaviour of disks, including tension stiffening, is proposed.In the disk model it is assumed that the tensile principal stress in the concrete decreases linearly from the initiation of cracking...... until a certain load level. At any load level the model can predict the shear strains of the disk and the inclination of the crack system. When regarding tension stiffening this latter parameter will be a function of the load level.The model is compared with experimental data, and in the light...

  1. Tensions of Teaching Media Literacy in Teacher Education

    Science.gov (United States)

    Ngomba-Westbrook, Nalova Elaine

    2013-01-01

    This study investigates the tensions a teacher educator faces in facilitating a media literacy teacher education course at the university level. Teaching tensions are conceptualized as a three-tier framework. At the first level, tensions may arise in the selection and application of pedagogies associated with critical and new/21st century…

  2. Bending Under Tension Test with Direct Friction Measurement

    DEFF Research Database (Denmark)

    Andreasen, Jan Lasson; Olsson, David Dam; Chodnikiewicz, K.

    2004-01-01

    A special BUT-transducer has been developed in which friction around the tool radius can be directly measured when drawing a plane sheet strip around a cylindrical tool-pin under constant back tension. The front tension, back tension and torque on the tool-pin are all measured directly, thus enab...

  3. 2-rational Cubic Spline Involving Tension Parameters

    Indian Academy of Sciences (India)

    M Shrivastava; J Joseph

    2000-08-01

    In the present paper, 1-piecewise rational cubic spline function involving tension parameters is considered which produces a monotonic interpolant to a given monotonic data set. It is observed that under certain conditions the interpolant preserves the convexity property of the data set. The existence and uniqueness of a 2-rational cubic spline interpolant are established. The error analysis of the spline interpolant is also given.

  4. A microprocessor based portable bolt tension monitor

    Science.gov (United States)

    Perey, D. F.

    1991-01-01

    A bolt tension monitor (BTM) which uses ultrasonics and a pulsed phase locked loop circuit to measure load-induced acoustic phase shifts which are independent of friction is described. The BTM makes it possible to measure the load in a bolt that was tightened at some time in the past. This capability to recertify a load after-the-fact will help to insure the integrity of a bolted joint.

  5. Delayed-type hypersensitivity responses to HIV Gag p24 relate to clinical outcome after peptide-based therapeutic immunization for chronic HIV infection.

    Science.gov (United States)

    Kran, Anne-Marte B; Sommerfelt, Maja A; Baksaas, Ingebjørg; Sørensen, Birger; Kvale, Dag

    2012-03-01

    Therapeutic immunization in chronic HIV infection aims to induce durable, HIV-specific immune responses capable of controlling disease progression, but immunological correlates of clinical efficacy are poorly defined. We have previously immunized 38 patients with a mixture of four short Gag p24-like conserved peptides (Vacc-4x) targeting skin dendritic cells. Antiretroviral treatment (ART) was initially stopped after completed immunizations and resumed post-protocol during regular clinical follow-up according to current guidelines. Four years after enrolment, Vacc-4x-specific cellular responses were evaluated in vivo by delayed-type hypersensitivity (DTH) skin test, and in vitro by a T-cell proliferation assay. Kaplan-Meier product-limit estimates were used to analyse time until ART was resumed. Peptide-specific cellular immune responses induced by Vacc-4x had persisted 4 years after the last immunization in terms of unchanged DTH independent of ART and detectable proliferative T-cell responses which correlated to the native peptides (R = 0.73, p = 0.01). Circulating bifunctional (IFN-γ and IL-10) Vacc-4x-specific T-cell clones were detected in 43% of patients. Subjects with the strongest post-immunization DTH responses appeared to start ART later compared with DTH low responders (p = 0.07). These data suggest that DTH responses should be further evaluated as a new and convenient tool for predicting clinical efficacy in trials testing therapeutic immunizations.

  6. SERUM CONCENTRATIONS OF HYALURONIC ACID, PROCOLLAGEN TYPE Ⅲ NH2-TERMINAL PEPTIDE, AND LAMININ IN PATIENTS WITH CHRONIC CONGESTIVE HEART FAILURE

    Institute of Scientific and Technical Information of China (English)

    Gang Li; Qing-bo Yan; Liang-ming Wei

    2006-01-01

    Objective To explore the role of serum fibrotic indices including hyaluronic acid (HA), procollagen type ⅢNH2-terminal peptide (PCⅢP), and laminin (LN) in assessing the severity of myocardial fibrosis in chronic congestive heart failure (CHF).Methods Serum levels of HA, PCⅢP, and LN in 39 patients with CHF [ 14 with New York Heart Association (NYHA) functional class Ⅱ, 21 with class Ⅲ, 4 with class Ⅳ] and in 46 patients with NYHA functional class Ⅰ were assessed by radioimmunoassay.Results The serum concentrations of HA, PCⅢP, and LN were 359.75 ± 84. 59 μg/L, 77.88±24. 67μg/L,86.73±23.90 μg/L in CHF group, and 211.60±54. 80μg/L, 64.82±23.99 μg/L, 82.26±23.98μg/L in NYHA functional class Ⅰ group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class Ⅰ group (P<0.05 ). However, no difference was found in the levels of PCⅢP and LN between CHF group and NYHA functional class Ⅰ group. The serum HA concentration was negatively correlated with left ventricular ejection fraction (r=-0.71, P<0.05 ).Conclusion Serum HA level may act as an indicator for myocardial fibrosis.

  7. [Autopsy case of a patient with Charcot-Marie-Tooth disease type 1A and suspected chronic inflammatory demyelinating polyradiculoneuropathy, which was later diagnosed as amyotrophic lateral sclerosis].

    Science.gov (United States)

    Higuchi, Yujiro; Sakiyama, Yusuke; Nishihira, Yasushi; Endo, Kazuhiro; Suwazono, Shugo; Suehara, Masahito

    2012-01-01

    We report an autopsy case of a 74-year-old man with late onset Charcot-Marie-Tooth disease type 1A (CMT1A) diagnosed by genetic screening, later associated with amyotrophic lateral sclerosis (ALS). At the age of 70 years, the patient was admitted to our hospital because of progressive weakness and dysesthesia in the right upper limb. In the early stages of the illness, he was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and transient improvement was achieved with intravenous immunoglobulin. However, the symptoms progressively worsened and became refractory. Gene analysis revealed PMP22 gene duplication, which confirmed CMT1A. On sural nerve biopsy, severe demyelinating neuropathy and abundant onion-bulb formations with endoneurial infiltration of inflammatory cells were observed. Thereafter, pseudo-bulbar palsy and respiratory muscle weakness developed insidiously and progressed rapidly along with muscle weakness in the limbs and trunk. The patient died about four years after the onset of this disease. Postmortem examination showed moderate neuronal cell loss, Bunina bodies, and TDP-43-positive inclusions in the anterior horn cells. The spinal cord revealed axonal loss and extensive macrophage permeation in the corticospinal tracts. On the basis of these findings, the final neuropathological diagnosis was ALS. This is the first report of an autopsy case of CMT1A complicated with ALS. We here discuss the significant clinical and neuropathological findings of this case.

  8. Tension-induced binding of semiflexible biopolymers

    CERN Document Server

    Benetatos, Panayotis; Zippelius, Annette

    2014-01-01

    We investigate theoretically the effect of polymer tension on the collective behavior of reversibly binding cross-links. For this purpose, we employ a model of two weakly bending wormlike chains aligned in parallel by a tensile force, with a sequence of inter-chain binding sites regularly spaced along the contours. Reversible cross-links attach and detach at the sites with an affinity controlled by a chemical potential. In a mean-field approach, we calculate the free energy of the system and find the emergence of a free-energy barrier which controls the reversible (un)binding. The tension affects the conformational entropy of the chains which competes with the binding energy of the cross-links. This competition gives rise to a sudden increase in the fraction of bound sites as the tension increases. We show that this transition is related to the cross-over between weak and strong localization of a directed polymer in a pinning potential. The cross-over to the strongly bound state can be interpreted as a mechan...

  9. Cross-Border Higher Education: Global and Local Tensions within Competition and Economic Development

    Science.gov (United States)

    Owens, Taya L.; Lane, Jason E.

    2014-01-01

    In this chapter, the authors explore various types of cross-border higher education, considering equity and quality issues within these developments. With a particular focus on international branch campuses, the authors discuss the ways in which global competition for knowledge and economic development interact with tensions at the local level.

  10. The behavior of high-strength unidirectional composites under tension with superposed hydrostatic pressure

    NARCIS (Netherlands)

    Zinoviev, P.A.; Tsvetkov, S.V.; Kulish, G.G.; Berg, van den R.W.; Schepdael, van L.J.M.M.

    2001-01-01

    Three types of high-strength unidirectional composite materials were studied under longitudinal tension with superposed high hydrostatic pressure. Reinforcing fibers were T1000G carbon, S2 glass and Zylon PBO fibers; the Ciba 5052 epoxy resin was used as matrix. The composites were tested under exte

  11. Pharmacokinetics in patients with chronic liver disease and hepatic safety of incretin-based therapies for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Scheen, André J

    2014-09-01

    Patients with type 2 diabetes mellitus have an increased risk of chronic liver disease (CLD) such as non-alcoholic fatty liver disease and steatohepatitis, and about one-third of cirrhotic patients have diabetes. However, the use of several antidiabetic agents, such as metformin and sulphonylureas, may be a concern in case of hepatic impairment (HI). New glucose-lowering agents targeting the incretin system are increasingly used for the management of type 2 diabetes. Incretin-based therapies comprise oral inhibitors of dipeptidyl peptidase-4 (DPP-4) (gliptins) or injectable glucagon-like peptide-1 (GLP-1) receptor agonists. This narrative review summarises the available data regarding the use of both incretin-based therapies in patients with HI. In contrast to old glucose-lowering agents, they were evaluated in specifically designed acute pharmacokinetic studies in patients with various degrees of HI and their hepatic safety was carefully analysed in large clinical trials. Only mild changes in pharmacokinetic characteristics of DPP-4 inhibitors were observed in patients with different degrees of HI, presumably without major clinical relevance. GLP-1 receptor agonists have a renal excretion rather than liver metabolism. Specific pharmacokinetic data in patients with HI are only available for liraglutide. No significant changes in liver enzymes were reported with DPP-4 inhibitors or GLP-1 receptor agonists, alone or in combination with various other glucose-lowering agents, in clinical trials up to 2 years in length. On the contrary, preliminary data suggested that incretin-based therapies may be beneficial in patients with CLD, more particularly in the presence of non-alcoholic fatty liver disease. Nevertheless, caution should be recommended, especially in patients with advanced cirrhosis, because of a lack of clinical experience with incretin-based therapies in these vulnerable patients.

  12. Netazepide, a gastrin receptor antagonist, normalises tumour biomarkers and causes regression of type 1 gastric neuroendocrine tumours in a nonrandomised trial of patients with chronic atrophic gastritis.

    Directory of Open Access Journals (Sweden)

    Andrew R Moore

    Full Text Available INTRODUCTION: Autoimmune chronic atrophic gastritis (CAG causes hypochlorhydria and hypergastrinaemia, which can lead to enterochromaffin-like (ECL cell hyperplasia and gastric neuroendocrine tumours (type 1 gastric NETs. Most behave indolently, but some larger tumours metastasise. Antrectomy, which removes the source of the hypergastrinaemia, usually causes tumour regression. Non-clinical and healthy-subject studies have shown that netazepide (YF476 is a potent, highly selective and orally-active gastrin/CCK-2 receptor antagonist. Also, it is effective in animal models of ECL-cell tumours induced by hypergastrinaemia. AIM: To assess the effect of netazepide on tumour biomarkers, number and size in patients with type I gastric NETs. METHODS: We studied 8 patients with multiple tumours and raised circulating gastrin and chromogranin A (CgA concentrations in an open trial of oral netazepide for 12 weeks, with follow-up 12 weeks later. At 0, 6, 12 and 24 weeks, we carried out gastroscopy, counted and measured tumours, and took biopsies to assess abundances of several ECL-cell constituents. At 0, 3, 6, 9, 12 and 24 weeks, we measured circulating gastrin and CgA and assessed safety and tolerability. RESULTS: Netazepide was safe and well tolerated. Abundances of CgA (p<0.05, histidine decarboxylase (p<0.05 and matrix metalloproteinase-7(p<0.10 were reduced at 6 and 12 weeks, but were raised again at follow-up. Likewise, plasma CgA was reduced at 3 weeks (p<0.01, remained so until 12 weeks, but was raised again at follow-up. Tumours were fewer and the size of the largest one was smaller (p<0.05 at 12 weeks, and remained so at follow-up. Serum gastrin was unaffected. CONCLUSION: The reduction in abundances, plasma CgA, and tumour number and size by netazepide show that type 1 NETs are gastrin-dependent tumours. Failure of netazepide to increase serum gastrin further is consistent with achlorhydria. Netazepide is a potential new treatment for type 1 NETs

  13. Analysis of Pre-tension Level upon Biaxial Behaviour of Fused Systems

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    Donata Zubauskiene

    2015-06-01

    Full Text Available The results of fused multilayer systems pre-tension level upon biaxial loading are presented in this research work. The values of initial pre-tension of fused multilayer systems in longitudinal and transverse directions were: 0.0 %, 0.4 %, 0.8 %, 1.2 %, 1.7 % and 2.1 %. The results of the investigations have shown that deformational characteristics (F, N and Hmax, mm in longitudinal and transverse directions differ with the increase of pre-tension level. Thus, seam allowances can be defined more accurately in more deformable direction at the stage of product development. Cotton fabric (100 % of plain weave was used as base material for fused systems. Biaxial tension testing was performed with three types of interlinings: woven, nonwoven and knitted, which differed not only in surface density, but in the density of adhesive layer, which was 52 and 76 dots/cm2, as well. The samples of fused systems were punched from the side of the main cotton fabric in order to maintain the same friction force between the punch and the specimen. Obtained results have shown that different number of force peaks, i.e. breakings is characteristic for different fused systems. For initial pre-tension from 0.0 % to 2.1 % the first breaking always appears in longitudinal direction irrespectfully to longitudinal or transverse pre-tension direction. It means that at low levels of pre-tension, e.g. 2.1 % it is possible to control the height of punching deformation, but not to change the location of critical stresses.DOI: http://dx.doi.org/10.5755/j01.ms.21.2.5788

  14. LICHENSTEIN TENSION FREE MESH HERNIOPLASTY: A PROSPECTIVE STUDY

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    Rakesh K

    2014-12-01

    Full Text Available : INTRODUCTION: Mesh inguinal hernioplasty is one of the most commonly performed surgery by general surgeons. One of the significant problems following hernia repair is recurrence. Prosthetic materials like polypropylene mesh has been used for inguinal hernia repair and has many advantages like low recurrence rates, less postoperative pain, decreased hospital stay and fewer complications. MATERIALS AND METHODS: In this prospective study, 432 open Lichenstein tension-free inguinal mesh hernioplasty was performed between June 2004 and May 2014. Various parameters regarding postoperative complications were studied. RESULTS: In 432 cases, inguinal hernia was indirect in 59.03% of cases (255 cases, direct in 36.57% (158 cases and of the pantaloon (mixed type in 4.39% (18 cases. Mean age of patients was 50.8 years (range 19–92. The median follow-up period was 2.1 years (range 1 month–5 years. Seroma and hematoma formation requiring drainage was observed in 9 and 11 patients, respectively, while transient testicular swelling occurred in 28 patients. We have not observed acute infection or abscess formation related to the presence of the foreign body (mesh. There was one recurrence of the hernia. Residual neuralgia was observed in 3 patients. CONCLUSION: Lichtenstein Tension-free mesh hernioplasty has many advantages of being simple, effective, low recurrence rate, early return to daily activities and good patient compliance and satisfaction. This technique is preferable for hernia repair in our setting.

  15. Integral equation for the interfacial tension of liquid metal in contact with ionic melt

    CERN Document Server

    Kobelev, O A; Kobelev, Oleg A.; Kobelev, Alexandr V.

    2004-01-01

    The closed integral equations for the interfacial tension as a function of external polarization at the liquid metal - ionic melt interface are derived. The version of Popel'-Pavlov isotherm is applied to the analysis of electrocapillary curves (ecc), i.e. the dependences of interfacial tension on electrode potential. The interaction between adsorbed particles is taken into account within 'two exchange parameters' approximation. The type of the distribution of electric potential in the double electric layer (del) is assumed to be like 'in series connected capacitors'. The methods of solution are proposed for the analysis of the experimental ecc's.

  16. The Value of Friction, Tension, and Disparity in Global Collaboration (Invited)

    Science.gov (United States)

    Parsons, M. A.

    2013-12-01

    Misunderstandings; conflicting goals; competition for limited funds; differing worldviews, agendas, ideals... These types of 'friction' are inevitable in national and global collaboration. And while friction can create tension and conflict, it is not inherently bad. It is at these points of interaction and tension where we can sometimes gain the most insight. Common understanding comes not only through agreed universal principles but also through multiple lines of evidence that wind through disparate views and describe a greater story. Collaboration is not straightforward in an environment of friction, tension, and disparity. Collaborators do not necessarily have common goals. Dynamic, coalition-style politics emerge. How can we align these disparities to achieve standards and common knowledge while still valuing and understanding differing perspectives? Achieving the understanding that comes through both unity and disparity is a central goal of the Research Data Alliance. RDA is emerging as a "neutral place" or "social gateway" where frictions can be identified, addressed, and understood but not necessarily removed.

  17. Malfunction of a Heimlich flutter valve causing tension pneumothorax: case report of a rare complication

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    Braunstein Volker A

    2010-06-01

    Full Text Available Abstract Background Thoracic injuries play an important role in major trauma patients due to their high incidence and critical relevance. A serious consequence of thoracic trauma is pneumothorax, a condition that quickly can become life-threatening and requires immediate treatment. Decompression is the state of the art for treating tension pneumothorax. There are many different methods of decompression using different techniques, devices, valves and drainage systems. Referring to our case report we would like to discuss the utilization of these devices. Case presentation We report of a patient suffering from tension pneumothorax despite insertion of a chest drain at the accident scene. The decompression was by tube thoracostomy which was connected to a Heimlich flutter valve. During air transportation the patient suffered from cardiorespiratory arrest with asystole and was admitted to the trauma room undergoing manual chest compressions. The initial chest film showed a persisting tension pneumothorax, despite the chest tube that had been correctly placed and connected properly to the Heimlich valve. We assume that the Heimlich valve leaves did not open up and thus tension pneumothorax was not released. Conclusion We would like to raise awareness to the fact that if a Heimlich flutter valve is applied in the pre-hospital setting it should be used with caution. Failure in this type of valve may lead to recurrent tension pneumothorax.

  18. Tension between SNeIa and BAO: current status and future forecasts

    Energy Technology Data Exchange (ETDEWEB)

    Escamilla-Rivera, Celia [Astrophysics, University of Oxford, DWD, Kebble Road, Oxford, OX1 3RH (United Kingdom); Lazkoz, Ruth; Salzano, Vincenzo; Sendra, Irene, E-mail: celia_escamilla@ehu.es, E-mail: ruth.lazkoz@ehu.es, E-mail: vincenzo.salzano@ehu.es, E-mail: irene.sendra@ehu.es [Fisika Teorikoaren eta Zientziaren Historia Saila, Zientzia eta Teknologia Fakultatea, Euskal Herriko Unibertsitatea, 644 Posta Kutxatila, 48080 Bilbao (Spain)

    2011-09-01

    Using real and synthetic Type Ia SNe (SNeIa) and baryon acoustic oscillations (BAO) data representing current observations forecasts, this paper investigates the tension between those probes in the dark energy equation of state (EoS) reconstruction considering the well known CPL model and Wang's low correlation reformulation. In particular, here we present simulations of BAO data from both the the radial and transverse directions. We also explore the influence of priors on Ω{sub m} and Ω{sub b} on the tension issue, by considering 1σ deviations in either one or both of them. Our results indicate that for some priors there is no tension between a single dataset (either SNeIa or BAO) and their combination (SNeIa+BAO). Our criterion to discern the existence of tension (σ-distance) is also useful to establish which is the dataset with most constraining power; in this respect SNeIa and BAO data switch roles when current and future data are considered, as forecasts predict and spectacular quality improvement on BAO data. We also find that the results on the tension are blind to the way the CPL model is addressed: there is a perfect match between the original formulation and that by the correlation optimized proposed in Wang (2008), but the errors on the parameters are much narrower in all cases of our exhaustive exploration, thus serving the purpose of stressing the convenience of this reparametrization.

  19. STUDY REGARDING YARN TENSION DURING KNITTING ON CIRCULAR MACHINE WITH SMALL DIAMETER

    Directory of Open Access Journals (Sweden)

    VLAD Dorin

    2015-05-01

    Full Text Available If yarn tension is controlled properly during knitting, it gives an improved and uniform fabric appearance. The main objective of knitters is to feed yarn to the knitting point at a low and uniform tension. To ensure that the stress do not affect yarn properties, literature recommends that the yarn tension shall be so adjusted that it fits in the field elastic. The value of the yarn stress influences not only quality of knitted product, but also the value of the knitting machine production, by the frequency rupture of yarns. This is influenced directly by the yarn stress and yarn quality. The value of this tension is influenced by a complex of factors, such as: technological diagram of the routing of the yarn from coils up to the knitting area, the structure and characteristics of the raw materials, the typo of knitting, type supply, etc. In the present article, using practical method, we test some ecological yarns used to make sock, like cotton, organic cotton, bambooviscose, Tencel, according to 6 different fabric geometry: single jersey, plated single jersey, ribb 4:2, plated ribb 4:2, purl, plated purl. Was enregistered and discussed the values of yarn tension.

  20. Static and dynamic testing of a damaged post tensioned concrete beam

    Directory of Open Access Journals (Sweden)

    Limongelli M.P.

    2015-01-01

    Full Text Available In this paper are reported the results of an experimental campaign carried out on a post tensioned concrete beam with the aim of investigating the possibility to detect early warning signs of deterioration basing on static and/or dynamic tests. The beam was tested in several configurations aimed to reproduce several different phases of the ‘life’ of the beam: the original undamaged state, increasing loss of tension in the post tensioning cables, a strengthening intervention carried out by means of a second tension cable, formation of further cracks on the strengthened beam. Responses of the beam were measured by an extensive set of instruments consisting of accelerometers, inclinometers, displacement transducers, strain gauges and optical fibres. The paper discusses the tests program and the dynamic characterization of the beam in the different damage scenarios. The modal properties of the beam in the different phases were recovered basing on the responses recorded on the beam during sine-sweep and impact hammer tests. The variation of the first modal frequency was studied to investigate the sensitivity of this parameter to both the cracking of the concrete section and the tension in the cables and also to compare results given by different types of experimental tests.