Sample records for controls etiological considerations

  1. Differences at brain SPECT between depressed females with and without adult ADHD and healthy controls: etiological considerations

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    Jacobsson Hans


    Full Text Available Abstract Background Comorbidity between Attention Deficit Hyperactivity Disorder (ADHD and mood disorders is common. Alterations of the cerebellum and frontal regions have been reported in neuro-imaging studies of ADHD and major depression. Methods Thirty chronically depressed adult females of whom 16 had scores below, and 14 scores above, cut-offs on the 25-items Wender Utah Retrospective Scale (WURS-25 and the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS were divided into subgroups designated "Depression" and "Depression + ADHD", respectively. Twenty-one of the patients had some audiological symptom, tinnitus and/or hearing impairment. The patients were investigated with other rating scales and 99mTc-HMPAO SPECT. Controls for 99mTc-HMPAO SPECT were 16 healthy females. SPECT was analyzed by both statistical parametric mapping (SPM2 and the computerized brain atlas (CBA. Discriminant analysis was performed on the volumes of interest generated by the CBA, and on the scores from rating scales with the highest group differences. Results The mean score of a depression rating scale (MADRS-S was significantly lower in the "Depression" subgroup compared to in the "Depression + ADHD" subgroup. There was significantly decreased tracer uptake within the bilateral cerebellum at both SPM and CBA in the "Depression + ADHD" subgroup compared to in the controls. No decrease of cerebellar tracer uptake was observed in "Depression". Significantly increased tracer uptake was found at SPM within some bilateral frontal regions (Brodmann areas 8, 9, 10, 32 in the "Depression + ADHD" subgroup compared to in "Depression". An accuracy of 100% was obtained for the discrimination between the patient groups when thalamic uptake was used in the analysis along with scores from Socialization and Impulsivity scales. Conclusion The findings confirm the previous observation of a cerebellar involvement in ADHD. Higher bilateral frontal 99mTc-HMPAO uptake in

  2. Gumboro Disease: Etiology, Epidemiology, Pathology, Diagnosis And Disease Control

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    Sutiastuti Wahyuwardani


    Full Text Available Infectious bursal disease (IBD or known as Gumboro, is a disease that attacks chicken older than 3 weeks, caused by famili Birnaviridae virus. Gumboro in Indonesia was firstly reported in 1983 and until now is commonly found. Very virulent IBD virus causes high morbidity and mortality that can even reach 100%. Clinical symptoms are exhibited as sluggish chicken, dropped wings and cloacal pasting. At gross examination, the bursa was found swollen, with yellowish fluid or hemorrhagic 3 days after infection. The bursa will get atrophy from 7 days post-infection. Meanwhile, the non virulent IBD virus causes subclinical symptoms. Chicken that survived, became stunted or dwarfed. On gross and histopathological findings, the bursa Fabricius has mild lesion and will recover at 14 days post-infection. Diagnosis of IBD can be determined based on pathological observation, supported by immunohistochemical examination and laboratory confirmation of disease by agar gel immunodiffusion, polymerase chain reaction techniques, antigen capture enzyme linked immunosorbent assay and isolation. Detection of antibodies can be made by serum neutralization technique or enzyme linked immunosorbent assay. Prevention can be done by routine vaccination in the field when the maternal antibodies have declined. The review describes the etiology, epidemiology, pathogenesis clinical symptoms, pathological discription and control of the disease to improve the knowledge of poultry farmer or people who are interested in poultry health.

  3. Gene-physical activity interactions in the etiology of obesity: behavioral considerations. (United States)

    Dishman, Rod K


    Understanding how genes, environment, and personal motivation operate to influence physical activity will require (i) inclusion of properly validated measures of putative mediators (e.g., cultural values, efficacy and control beliefs, goals, intentions, enjoyment, and self-management skills) and moderators (e.g., age or maturation, personality, race/ethnicity, fitness, fatness, skill, and competing behaviors) of physical activity, (ii) a search for candidate genes involved with motivational systems of energy expenditure in addition to energy intake pathways, (iii) assessment of specific features physical activity exposure (i.e., type, intensity, timing, and context), (iv) manipulation of physical activity or prospective observation of change in physical activity at multiple times, rather than cross-sectional association and linkage studies, and (v) use of statistical procedures that permit multilevel modeling (i.e., personal and group-level variables) of direct, indirect (i.e., mediated), and moderated (i.e., interactions of mediators with external factors) relations with physical activity within theoretical gene-environment networks.

  4. Obesity: considerations about etiology, metabolism, and the use of experimental models

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    Lancha Junior AH


    Full Text Available Luciana O Pereira-Lancha, Patricia L Campos-Ferraz, Antonio H Lancha JuniorSchool of Physical Education and Sport, University of Sao Paulo, Sao Paulo, BrazilAbstract: Studies have been conducted in order to identify the main factors that contribute to the development of obesity. The role of genetics has also been extensively studied. However, the substantial augmentation of obesity prevalence in the last 20 years cannot be justified only by genetic alterations that, theoretically, would have occurred in such a short time. Thus, the difference in obesity prevalence in various population groups is also related to environmental factors, especially diet and the reduction of physical activity. These aspects, interacting or not with genetic factors, could explain the excess of body fat in large proportions worldwide. This article will focus on positive energy balance, high-fat diet, alteration in appetite control hormones, insulin resistance, amino acids metabolism, and the limitation of the experimental models to address this complex issue.Keywords: obesity, diet, leptin, fat, ghrelin, experimental models

  5. Curtobacterium flaccumfaciens pv. flaccumfaciens: etiology, detection and control strategies

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    Giseli Valentini


    Full Text Available The diseases caused by bacteria present a phytopathological and agricultural problem in various economic crops. The Curtobacterium wilt caused by Curtobacterium fl accumfaciens pv. fl accumfaciens has become a threat to the cultivation of beans (Phaseolus vulgaris L.. The disease statement for the Brazilian territory occurred in 1995 and today the pathogen is distributed in various Brazilian producing regions. Transmission is primarily via contaminated seed, which imposes great diffi culties and limitations on the control of these bacteria. After plant infection, the only way to control it is the eradication of infected plants. The alternatives for the control of this disease are the use of healthy seeds, crop rotation and resistant varieties. The use of resistant varieties is the most effi cient and economical solution for the farmer. The most important research to support the development of bean cultivars resistant to C. fl accumfaciens pv. fl accumfaciens is the identifi cation of sources of genetic resistance and the study of mechanisms of genetic resistance to disease.

  6. Architectural Considerations for Holonic Shop Floor Control

    DEFF Research Database (Denmark)

    Langer, Gilad; Bilberg, Arne


    as flexible. This is a highly de-manding task for the manufacturing control system. The emerging theory regarding Holonic Manufacturing Sys-tems (HMS) introduces an advantageous theoretical foundation for the control system of the manufacturing system of the future. This article presents an overview...... will present a model of both a holonic cell and multi-cell control architecture. The work is based on a theoretical study of new manufac-turing systems theories, practical test, development of a prototype, and two case studies. It is part of a research project which aims at developing a multi-cell control...... architecture based on the Holonic Manufacturing Sys-tem theory....

  7. Cold plasma: Quality control and regulatory considerations (United States)

    In recent years, cold plasma has emerged as a promising antimicrobial treatment for fresh and fresh-cut produce, nuts, spices, seeds, and other foods. Research has demonstrated effective control of human pathogens such as Salmonella, Listeria monocytogenes, Escherichia coli O157:H7, norovirus, and o...

  8. Controller Design Considerations for ACM APFC Systems

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    Alexander Abramovitz


    Full Text Available This paper is concerned with performance of the current shaping network in Average Current Mode (ACM Active Power Factor Correction (APFC systems. Theoretical expressions for the ripple components are derived. Then, ripple interaction and impact on the current loop reference signal are investigated. A modification of the controller network is suggested that results in an improved Total Harmonic Distortion (THD. Design guidelines are suggested. The theoretical predictions were validated by simulation.

  9. Noise control considerations for patient rooms (United States)

    Davenny, Benjamin


    The patient room envelope is a path between outside noise sources and the patient receiver. Within the patient room there are several sources including televisions, clinical monitor alarms, medical pumps, etc. Noise control in patient rooms relies on a combination of the sound transmission loss of the patient room envelope and the level of background sound at the patient's head. Guidelines published by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), American Institute of Architects (AIA), and the U.S. Department of Defense for background noise and sound transmission loss in patient rooms will be discussed. Appropriate levels, spectra, and temporal characteristics of background sound at the patient head location may be helpful in raising the threshold of annoying sounds. Various means of personal hearing protection for patients will be discussed. Sound-pressure levels in patient rooms reported in previous literature will also be discussed.

  10. Randomized Controlled Trial Evaluating a Standardized Strategy for Uveitis Etiologic Diagnosis (ULISSE). (United States)

    de Parisot, Audrey; Kodjikian, Laurent; Errera, Marie-Hélène; Sedira, Neila; Heron, Emmanuel; Pérard, Laurent; Cornut, Pierre-Loïc; Schneider, Christelle; Rivière, Sophie; Ollé, Priscille; Pugnet, Grégory; Cathébras, Pascal; Manoli, Pierre; Bodaghi, Bahram; Saadoun, David; Baillif, Stéphanie; Tieulie, Nathalie; Andre, Marc; Chiambaretta, Frédéric; Bonin, Nicolas; Bielefeld, Philip; Bron, Alain; Mouriaux, Frédéric; Bienvenu, Boris; Vicente, Stéphanie; Bin, Sylvie; Broussolle, Christiane; Decullier, Evelyne; Sève, Pascal


    To prospectively assess the efficiency of a standardized diagnostic approach, compared to an open strategy, for the etiologic diagnosis of uveitis. Noninferiority, prospective, multicenter, clustered randomized controlled trial. Consecutive patients with uveitis, who visited 1 of the participating departments of ophthalmology, were included. In the standardized group, all patients had a minimal evaluation regardless of the type of uveitis (complete blood count, erythrocyte sedimentation rate, C-reactive protein, tuberculin skin test, syphilis serology, and chest radiograph) followed by more complex investigations according to ophthalmologic findings. In the open group, the ophthalmologist could order any type of investigation. Main outcome was the percentage of etiologic diagnoses at 6 months. Nine hundred and three patients with uveitis were included from January 2010 to May 2013 and the per-protocol population comprised 676 patients (open 373; standardized 303). Mean age at diagnosis was 46 years. Anatomic distribution of uveitis was as follows: anterior (60.8% and 72.3%, P = .0017), intermediate (11.7% and 12.3%, P = .8028), posterior (17.8% and 8.2%, P = .0004), and panuveitis (15.3% and 15.2%, P = .9596). An etiologic diagnosis was established in 54.4% of cases in the open group and 49.5% in the standardized group (P = .2029). The difference between both strategies (standardized minus open) was -4.9% (95% CI [-12.5%; 2.6%]). There were more investigations in the open group than in the standardized group (5371 vs 3759, P uveitis, although its noninferiority cannot be proved. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Complex Etiology, Prophylaxis and Hygiene Control in Mycotoxic Nephropathies in Farm Animals and Humans

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    Stoycho D. Stoev


    Full Text Available Various etiological factors contributing to the development of mycotoxic nephropathy in farm animals and humans are reviewed. The possible synergistic effect between ochratoxin A (OTA and other mycotoxins, as penicillic acid (PA and fumonisin B1 (FB1, contributing to this nephropathy is also considered and discussed. The most convenient ways of prophylaxis and various preventive measures against OTA contamination of feeds or foods are reviewed. A reference is made concerning the most successful methods of veterinary hygiene control in the slaughterhouses in order to prevent the entering of OTA in commercial channels with a view to human health. The economic efficacy of these prophylactic procedures is also considered. An evaluation of human exposure to OTA is made.

  12. Chronic leucine supplementation improves glycemic control in etiologically distinct mouse models of obesity and diabetes mellitus

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    Hou Jue


    Full Text Available Abstract Background Leucine may function as a signaling molecule to regulate metabolism. We have previously shown that dietary leucine supplementation significantly improves glucose and energy metabolism in diet-induced obese mice, suggesting that leucine supplementation could potentially be a useful adjuvant therapy for obesity and type 2 diabetes. Since the underlying cause for obesity and type 2 diabetes is multifold, we further investigated metabolic effects of leucine supplementation in obese/diabetes mouse models with different etiologies, and explored the underlying molecular mechanisms. Methods Leucine supplementation was carried out in NONcNZO10/LtJ (RCS10 - a polygenic model predisposed to beta cell failure and type 2 diabetes, and in B6.Cg-Ay/J (Ay - a monogenic model for impaired central melanocortin receptor signaling, obesity, and severe insulin resistance. Mice in the treatment group received the drinking water containing 1.5% leucine for up to 8 months; control mice received the tap water. Body weight, body composition, blood HbA1c levels, and plasma glucose and insulin levels were monitored throughout and/or at the end of the study period. Indirect calorimetry, skeletal muscle gene expression, and adipose tissue inflammation were also assessed in Ay mice. Results Leucine supplementation significantly reduced HbA1c levels throughout the study period in both RCS10 and Ay mice. However, the treatment had no long term effect on body weight or adiposity. The improvement in glycemic control was associated with an increased insulin response to food challenge in RCS10 mice and decreased plasma insulin levels in Ay mice. In leucine-treated Ay mice, energy expenditure was increased by ~10% (p y mice whereas the expression levels of MCP-1 and TNF-alpha and macrophage infiltration in adipose tissue were significantly reduced. Conclusions Chronic leucine supplementation significantly improves glycemic control in multiple mouse models of

  13. Biology, etiology, and control of virus diseases of banana and plantain. (United States)

    Kumar, P Lava; Selvarajan, Ramasamy; Iskra-Caruana, Marie-Line; Chabannes, Matthieu; Hanna, Rachid


    Banana and plantain (Musa spp.), produced in 10.3 million ha in the tropics, are among the world's top 10 food crops. They are vegetatively propagated using suckers or tissue culture plants and grown almost as perennial plantations. These are prone to the accumulation of pests and pathogens, especially viruses which contribute to yield reduction and are also barriers to the international exchange of germplasm. The most economically important viruses of banana and plantain are Banana bunchy top virus (BBTV), a complex of banana streak viruses (BSVs) and Banana bract mosaic virus (BBrMV). BBTV is known to cause the most serious economic losses in the "Old World," contributing to a yield reduction of up to 100% and responsible for a dramatic reduction in cropping area. The BSVs exist as episomal and endogenous forms are known to be worldwide in distribution. In India and the Philippines, BBrMV is known to be economically important but recently the virus was discovered in Colombia and Costa Rica, thus signaling its spread into the "New World." Banana and plantain are also known to be susceptible to five other viruses of minor significance, such as Abaca mosaic virus, Abaca bunchy top virus, Banana mild mosaic virus, Banana virus X, and Cucumber mosaic virus. Studies over the past 100 years have contributed to important knowledge on disease biology, distribution, and spread. Research during the last 25 years have led to a better understanding of the virus-vector-host interactions, virus diversity, disease etiology, and epidemiology. In addition, new diagnostic tools were developed which were used for surveillance and the certification of planting material. Due to a lack of durable host resistance in the Musa spp., phytosanitary measures and the use of virus-free planting material are the major methods of virus control. The state of knowledge on BBTV, BBrMV, and BSVs, and other minor viruses, disease spread, and control are summarized in this review.

  14. CYP19A1 gene polymorphism and colorectal cancer etiology in Saudi population: case–control study

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    Al-Mukaynizi FB


    Full Text Available Fatimah Basil Al-Mukaynizi,1 Mohammed Alanazi,1 Sooad Al-Daihan,1 Narasimha Reddy Parine,1 Majid Almadi,2 Abdulrahman Aljebreen,2 Nahla Azzam,2 Othman Alharbi,2 Maha Arafah,3 Arjumand Warsy4 1Department of Biochemistry, College of Science, 2Department of Internal Medicine, 3Department of Pathology, College of Medicine, 4Central Laboratory, Female Center for Scientific & Medical Colleges, King Saud University, Riyadh, Saudi Arabia Background: Considerable interest is directed toward the enzyme aromatase (CYP19A1 and the development of cancer, due to CYP19A1’s role in estrogen biosynthesis. Several cancers display excessive intra-tumor accumulation of estrogens, and aromatase inhibitors are used for treatment. The CYP19A1 gene exhibits polymorphism and mutations that can alter its expression or aromatase activity and influence estrogen production. We designed this study to investigate the link between CYP19A1 polymorphism and susceptibility to colorectal cancer (CRC development in Saudis. Patients and methods: Blood samples from 100 CRC patients and 100 healthy controls were drawn for DNA extractions. Three polymorphic sites, rs4774585, rs936308, and rs4775936, were genotyped using Taqman genotyping by real-time polymerase chain reaction. Allelic and genotype frequencies were calculated and compared in the two groups. Results: All single nucleotide polymorphisms (SNPs were polymorphic in Saudis, and comparison of allele frequencies showed several differences when compared to other populations. None of the SNPs were associated with the risk of CRC development in Saudis (P>0.05. Some gender and location (colon or rectal differences were observed. Discussion: The results of this study highlighted the genetic heterogeneity existing between populations in the prevalence of different SNPs and their relation to disease state. It showed that, although rs4774585, rs936308, and rs4775936 are involved in CRC development in several populations, their role

  15. Sample size considerations for historical control studies with survival outcomes (United States)

    Zhu, Hong; Zhang, Song; Ahn, Chul


    Historical control trials (HCTs) are frequently conducted to compare an experimental treatment with a control treatment from a previous study, when they are applicable and favored over a randomized clinical trial (RCT) due to feasibility, ethics and cost concerns. Makuch and Simon developed a sample size formula for historical control (HC) studies with binary outcomes, assuming that the observed response rate in the HC group is the true response rate. This method was extended by Dixon and Simon to specify sample size for HC studies comparing survival outcomes. For HC studies with binary and continuous outcomes, many researchers have shown that the popular Makuch and Simon method does not preserve the nominal power and type I error, and suggested alternative approaches. For HC studies with survival outcomes, we reveal through simulation that the conditional power and type I error over all the random realizations of the HC data have highly skewed distributions. Therefore, the sampling variability of the HC data needs to be appropriately accounted for in determining sample size. A flexible sample size formula that controls arbitrary percentiles, instead of means, of the conditional power and type I error, is derived. Although an explicit sample size formula with survival outcomes is not available, the computation is straightforward. Simulations demonstrate that the proposed method preserves the operational characteristics in a more realistic scenario where the true hazard rate of the HC group is unknown. A real data application of an advanced non-small cell lung cancer (NSCLC) clinical trial is presented to illustrate sample size considerations for HC studies in comparison of survival outcomes. PMID:26098200

  16. Etiology of impaired selective motor control: emerging evidence and its implications for research and treatment in cerebral palsy. (United States)

    Cahill-Rowley, Katelyn; Rose, Jessica


    Selective motor control (SMC) impairment involves movement patterns dominated by flexor or extensor synergies that interfere with functional movements in children with cerebral palsy (CP). Emerging evidence on neural correlates of impaired SMC has important implications for etiology and for the treatment for children with CP. Early evidence on the microstructure of brain white matter assessed with diffusion tensor imaging in adult patients after stroke suggests that the rubrospinal tract may compensate for injury to the corticospinal tract. Furthermore, the observed changes on diffusion tensor imaging corresponded to the degree of SMC impairment. The rubrospinal tract may provide imperfect compensation in response to corticospinal tract injury, resulting in diminished SMC. Cortical mapping evidence in stroke patients indicates that loss of SMC is also associated with increased overlap of joint representation in the sensorimotor cortices. The severity of SMC impairment can be assessed with the recently developed Selective Control Assessment of the Lower Extremity, a validated observation-based measure designed for children with spastic CP. Recent advances in neuroimaging and assessment of SMC provide an opportunity to better understand the etiology and impact of impaired SMC, which may ultimately guide strategic treatment for children with CP. © 2013 Mac Keith Press.

  17. Etiologies and manifestations of persistent diarrhea in adults with HIV-1 infection: a case-control study in Lima, Peru. (United States)

    Cárcamo, César; Hooton, Thomas; Wener, Mark H; Weiss, Noel S; Gilman, Robert; Arevalo, Jorge; Carrasco, Juan; Seas, Carlos; Caballero, Martin; Holmes, King K


    OBJECTIVE We sought to determine the etiologies, manifestations, and risk factors for persistent (> or =7 days) diarrhea in human immunodeficiency virus type 1 (HIV-1)-infected persons in Peru. The present study is a case-control study of 147 HIV-1-infected case subjects with persistent diarrhea and 147 HIV-1-infected control subjects without diarrhea. We obtained clinical, demographic, and exposure data, CD4 lymphocyte counts, and stool samples for detection of enteric parasitic and bacterial pathogens and rotavirus. One or more enteric pathogen was identified in 55% of case subjects and 21% of control subjects (odds ratio adjusted for CD4 lymphocyte count, 3.8; 95% confidence interval, 2.2-6.5). The median CD4 lymphocyte count was highest with pathogen-free diarrhea and lowest with Cryptosporidium infection. Cryptosporidium species (the most frequent pathogen), Giardia lamblia, Aeromonas species, Campylobacter species, and rotavirus were all significantly associated with diarrhea. Bacterial pathogens were significantly associated with G. lamblia and rotavirus infection. Of the bacterial pathogens (Aeromonas, Campylobacter, Salmonella, and Vibrio species and enterotoxigenic Escherichia coli), only 24% were susceptible to cotrimoxazole, whereas 90% were susceptible to ciprofloxacin. In no case did the sensitivity or positive predictive value of specific clinical and laboratory findings for curable enteric infections exceed 50%. Several enteric pathogens were associated with diarrhea in HIV-1-infected case subjects in Peru, especially among those who were heterosexual. Clinical findings were poor predictors of detectable microbial etiology. The guidelines for initial management of chronic diarrhea with sulfamethoxazole-trimethoprim in HIV-1-infected persons require revision, at least in settings where prophylaxis with this agent is common.

  18. Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. (United States)

    O'Meara, Wendy P; Mott, Joshua A; Laktabai, Jeremiah; Wamburu, Kabura; Fields, Barry; Armstrong, Janice; Taylor, Steve M; MacIntyre, Charles; Sen, Reeshi; Menya, Diana; Pan, William; Nicholson, Bradly P; Woods, Christopher W; Holland, Thomas L


    In Kenya, more than 10 million episodes of acute febrile illness are treated annually among children under 5 years. Most are clinically managed as malaria without parasitological confirmation. There is an unmet need to describe pathogen-specific etiologies of fever. We enrolled 370 febrile children and 184 healthy controls. We report demographic and clinical characteristics of patients with Plasmodium falciparum, group A streptococcal (GAS) pharyngitis, and respiratory viruses (influenza A and B, respiratory syncytial virus [RSV], parainfluenza [PIV] types 1-3, adenovirus, human metapneumovirus [hMPV]), as well as those with undifferentiated fever. Of febrile children, 79.7% were treated for malaria. However, P. falciparum was detected infrequently in both cases and controls (14/268 [5.2%] versus 3/133 [2.3%], P = 0.165), whereas 41% (117/282) of febrile children had a respiratory viral infection, compared with 24.8% (29/117) of controls (P = 0.002). Only 9/515 (1.7%) children had streptococcal infection. Of febrile children, 22/269 (8.2%) were infected with > 1 pathogen, and 102/275 (37.1%) had fevers of unknown etiology. Respiratory viruses were common in both groups, but only influenza or parainfluenza was more likely to be associated with symptomatic disease (attributable fraction [AF] 67.5% and 59%, respectively). Malaria was overdiagnosed and overtreated. Few children presented to the hospital with GAS pharyngitis. An enhanced understanding of carriage of common pathogens, improved diagnostic capacity, and better-informed clinical algorithms for febrile illness are needed.

  19. What Are the Safety Considerations for Insulin Control for Athletes? (United States)

    McDaniel, Larry W.; Olson, Sara; Gaudet, Laura; Jackson, Allen


    Athletes diagnosed with diabetes may have difficulty with their blood sugar levels fluctuating during intense exercise. Considerations for athletes with insulin concerns may range anywhere from exercise rehabilitation to the use of an automatic insulin pump. The automatic insulin pump is a small battery-operated device about the size of a pager.…

  20. A case-control study of hormonal exposures as etiologic factors for ALS in women: Euro-MOTOR. (United States)

    Rooney, James P K; Visser, Anne E; D'Ovidio, Fabrizio; Vermeulen, Roel; Beghi, Ettore; Chio, Adriano; Veldink, Jan H; Logroscino, Giancarlo; van den Berg, Leonard H; Hardiman, Orla


    To investigate the role of hormonal risk factors for amyotrophic lateral sclerosis (ALS) among women from 3 European countries. ALS cases and matched controls were recruited over 4 years in Ireland, Italy, and the Netherlands. Hormonal exposures, including reproductive history, breastfeeding, contraceptive use, hormonal replacement therapy, and gynecologic surgical history, were recorded with a validated questionnaire. Logistic regression models adjusted for age, education, study site, smoking, alcohol, and physical activity were used to determine the association between female hormones and ALS risk. We included 653 patients and 1,217 controls. Oral contraceptive use was higher among controls (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.51-0.84), and a dose-response effect was apparent. Hormone replacement therapy (HRT) was associated with a reduced risk of ALS only in the Netherlands (OR = 0.57, 95% CI 0.37-0.85). These findings were robust to sensitivity analysis, but there was some heterogeneity across study sites. This large case-control study across 3 different countries has demonstrated an association between exogenous estrogens and progestogens and reduced odds of ALS in women. These results are at variance with previous findings, which may be partly explained by differential regulatory, social, and cultural attitudes toward pregnancy, birth control, and HRT across the countries included. Our results indicate that hormonal factors may be important etiologic factors in ALS; however, a full understanding requires further investigation. © 2017 American Academy of Neurology.

  1. Etiology of diarrhea in young children in Denmark: a case-control study

    DEFF Research Database (Denmark)

    Olesen, B.; Neimann, J.; Bottiger, B.


    -matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were...

  2. Case-control study of ectopic pregnancies in Myanmar: infectious etiological factors. (United States)

    Khin-Nwe-Oo; Wah-Wah-Aung; Moe-Thida; Khin-Thet-Wai; Hta-Hta-Yi; Win-Win-Mya


    We studied the role of infections in ectopic pregnancy and the different methods of detecting Chlamydia trachomatis infection using serology, cervical and tubal PCR assays, by using a hospital-based, case-control study conducted between November 2007 and September 2009. The sample size was 339 with 113 cases and 226 controls. The cases were women admitted for the management of ectopic pregnancy while the controls were women admitted for spontaneous miscarriage. Both cases and controls were tested for syphilis and chlamydial infection by serology. In addition, cervical samples from controls and both cervical and tubal samples from cases were examined for the presence of chlamydia and gonococcal DNA. Sociodemographic data and past histories were collected using set Proforma. Independent variables for multivariate analysis included previous history of spontaneous abortion, ectopic pregnancy, symptoms of sexully transmitted infections (STI), and use of contraception. Women with a previous history of ectopic pregnancy (adjusted OR 28.3; 95% CI 5.8-138.8; p = 0.01) and a past history of having had symptoms of STI (adjusted OR 11.06; 95% CI 5.45-22.44; p = 0.0005) were significantly more likely to have an ectopic pregnancy than those without such a history. Syphilis serology was positive in 13.3% of ectopic pregnancy cases compared to only 3.5% of controls (crude OR 0.24; 95% CI -0.10-0.58; p = 0.001). From cervical swabs, chlamydia DNA was detected significantly more frequently in cases than controls (8.0% vs 2.2%; crude OR 0.261; 95% CI -0.09-0.80, p = 0.012) but gonorrhea DNA detection rates were not significantly different (3.5% vs 0.9%, crude OR 0.24; 95% CI -0.04-1.35; p = 0.1). Chlamydia was positive in cases only as diagnosed tubal samples for PCR in 17 (15.0%), cervical samples for PCR in 9 (8.0%) and IgM ELISA in 6 (5.3%). Among the three STI tested for in this study, C. trachomatis was the most frequently associated with ectopic pregnancy and was more

  3. Spectrum management considerations of adaptive power control in satellite networks (United States)

    Sawitz, P.; Sullivan, T.


    Adaptive power control concepts for the compensation of rain attenuation are considered for uplinks and downlinks. The performance of example power-controlled and fixed-EIRP uplinks is compared in terms of C/Ns and C/Is. Provisional conclusions are drawn with regard to the efficacy of uplink and downlink power control orbit/spectrum utilization efficiency.

  4. Etiological factors in nasopharyngeal carcinoma: a hospital-based, retrospective, case-control, questionnaire study. (United States)

    Shanmugaratnam, K; Tye, C Y; Goh, E H; Chia, K B


    A total of 379 Singapore Chinese patients with NPC were interviewed by use of a questionnaire covering the following items: occupation, level of education, language medium of education, personal and family history of nasal illnesses, types of medicines used, use of Chinese medicines for the nose and throat, use of soya sauce, Chinese tea, cooling drinks and alcohol, cigarette smoking (number and duration), cooking fuels and use of incense (frequency and duration) and of anti-mosquito coils. The same questionnaire was given to two groups of controls: 595 patients with diseases of the ear, nose and throat other than NPC and 1 044 patients with diseases other than cancer or otorhinolaryngeal disease. NPC patients differed significantly from both groups of controls in that they showed stronger associations with personal history of nasal illnesses, family history of nasal illnesses, use of Chinese medicines for the nose and throat and exposure to smoke from anti-mosquito coils.

  5. Fibromialgia: interfaces com as LER/DORT e considerações sobre sua etiologia ocupacional Fibromyalgia: interfaces to RSI and considerations about work etiology

    Directory of Open Access Journals (Sweden)

    Tatiana Teixeira Álvares


    adolescence that became worse after they had suffered an emotionally strong impact. Also, these patients reported cases of similar symptoms of fibromyalgia in their families, on the contrary of the first group. It was conclude that in some patients with fibromyalgia, the overload work is an important etiologic factor, and could be preceded by RSI. In these cases the diagnosis of fibromyalgia could be used as an attempt of disassociate the relation between symptoms and the work, preventing the worker to get social security benefits.

  6. Software Considerations for Subscale Flight Testing of Experimental Control Laws (United States)

    Murch, Austin M.; Cox, David E.; Cunningham, Kevin


    The NASA AirSTAR system has been designed to address the challenges associated with safe and efficient subscale flight testing of research control laws in adverse flight conditions. In this paper, software elements of this system are described, with an emphasis on components which allow for rapid prototyping and deployment of aircraft control laws. Through model-based design and automatic coding a common code-base is used for desktop analysis, piloted simulation and real-time flight control. The flight control system provides the ability to rapidly integrate and test multiple research control laws and to emulate component or sensor failures. Integrated integrity monitoring systems provide aircraft structural load protection, isolate the system from control algorithm failures, and monitor the health of telemetry streams. Finally, issues associated with software configuration management and code modularity are briefly discussed.

  7. Feedback Control Systems Loop Shaping Design with Practical Considerations (United States)

    Kopsakis, George


    This paper describes loop shaping control design in feedback control systems, primarily from a practical stand point that considers design specifications. Classical feedback control design theory, for linear systems where the plant transfer function is known, has been around for a long time. But it s still a challenge of how to translate the theory into practical and methodical design techniques that simultaneously satisfy a variety of performance requirements such as transient response, stability, and disturbance attenuation while taking into account the capabilities of the plant and its actuation system. This paper briefly addresses some relevant theory, first in layman s terms, so that it becomes easily understood and then it embarks into a practical and systematic design approach incorporating loop shaping design coupled with lead-lag control compensation design. The emphasis is in generating simple but rather powerful design techniques that will allow even designers with a layman s knowledge in controls to develop effective feedback control designs.

  8. The Epidemic of Zika Virus-Related Microcephaly in Brazil: Detection, Control, Etiology, and Future Scenarios. (United States)

    Teixeira, Maria G; Costa, Maria da Conceição N; de Oliveira, Wanderson K; Nunes, Marilia Lavocat; Rodrigues, Laura C


    We describe the epidemic of microcephaly in Brazil, its detection and attempts to control it, the suspected causal link with Zika virus infection during pregnancy, and possible scenarios for the future. In October 2015, in Pernambuco, Brazil, an increase in the number of newborns with microcephaly was reported. Mothers of the affected newborns reported rashes during pregnancy and no exposure to other potentially teratogenic agents. Women delivering in October would have been in the first trimester of pregnancy during the peak of a Zika epidemic in March. By the end of 2015, 4180 cases of suspected microcephaly had been reported. Zika spread to other American countries and, in February 2016, the World Health Organization declared the Zika epidemic a public health emergency of international concern. This unprecedented situation underscores the urgent need to establish the evidence of congenital infection risk by gestational week and accrue knowledge. There is an urgent call for a Zika vaccine, better diagnostic tests, effective treatment, and improved mosquito-control methods.

  9. Design and control considerations for industrial and space manipulators (United States)

    Whitney, D. E.; Book, W. J.; Lynch, P. M.


    This paper is a progress report summarizing theoretical and practical results concerning integration of design and control aspects of manipulator arms for industrial or space applications. The relationships between task specifications, gross motions, fine motions, actuator type and location, size and strength of structural members, control servos and strategies, and overall design evaluation are briefly discussed, with some technical examples.

  10. Design and control considerations for industrial and space manipulators (United States)

    Whitney, D. E.; Book, W. J.; Lynch, P. M.


    This paper is a progress report summarizing theoretical and practical results concerning integration of design and control aspects of manipulator arms for industrial or space applications. The relationships between task specifications, gross motions, fine motions, actuator type and location, size and strength of structural members, control servos and strategies, and overall design evaluation are briefly discussed, with some technical examples.

  11. Global Strike 2035: Considerations for Enabling Effective Command and Control (United States)


    organizational networks and databases .49 The second implication for the organizational design stems from the requirement to operate globally. To...Press, 1997. ebook Collection ( EBSCOhost ), EBSCOhost (accessed 26 November 2011). Critchlow, Robert D. “Nuclear Command and Control: Current Programs

  12. Do Different ADHD-Related Etiological Risks Involve Specific Neuropsychological Pathways? An Analysis of Mediation Processes by Inhibitory Control and Delay Aversion (United States)

    Pauli-Pott, Ursula; Dalir, Silke; Mingebach, Tanja; Roller, Alisa; Becker, Katja


    Background: Inhibitory control (IC) has been regarded as a neuropsychological basic deficit and as an endophenotype of attention deficit/hyperactivity disorder (ADHD). Implicated here are mediation processes between etiological factors and ADHD symptoms. We thus analyze whether and to what extent executive IC and delay aversion (DA; i.e.,…

  13. Etiology of temporomandibular disorders. (United States)

    Greene, C S


    This article discusses the subject of causation (etiology) as it has been applied to the field of temporomandibular disorders (TMD). These disorders have been the focus of considerable disagreement about what constitutes proper diagnosis and treatment, and it is clear that the main basis for these controversies has been conflicting views about the etiology of the various disorders. Many earlier theories emphasized dental morphological factors of malocclusion, occlusal dysharmony, and bad mandibular alignment as being primarily responsible for the development of TMD symptoms. Certain versions of these dental/skeletal concepts have long been a part of the belief system of the orthodontic specialty, leading to some special orthodontic protocols for managing TM disorders. Today, it is generally agreed that the etiology of TM disorders includes a multifactorial combination of physical and psychosocial factors, with some of them being either poorly understood or difficult to assess. In most cases, there are no special occlusal or orthodontic factors to be considered, and therefore occlusion-changing procedures are not generally required for successful treatment. This means that contemporary orthodontists must face the same challenge as all their other dental colleagues: to learn about modern concepts of diagnosis and treatment for all types of orofacial pain patients, and then to use currently recommended protocols for pain management and musculoskeletal therapy for those patients who have temporomandibular disorders.

  14. Infection control considerations during construction activities: land excavation and demolition. (United States)

    Cheng, S M; Streifel, A J


    Because current trends in hospital restructuring in North America, amalgamations and mergers, and the aging of health care facilities, the need to restructure physical buildings has become greater. Hospital construction carries with it risks to patients. One key concern is the risk of aspergillosis associated with hospital construction. Infection control practitioners must consider some key factors when addressing land excavation and building demolition, which differ in some ways from construction that occurs within a health care facility. The key factors to consider are project concept, risk assessment of patients, procedures and environment, air quality, routes of entry and egress, soil management, conducting inspections, contingency planning, housekeeping, and lines of cooperation and communication with various stakeholders. Considering these areas will help ensure that health care facility personnel and the workers have exercised diligence in patient care.





    Os motores de indução são as máquinas mais utilizadas nos acionamentos industriais elétricas devido a sua simplicidade, robustez, maior relação torque/corrente, baixa manutenção, etc. Sua aceitação e aplicação em acionamentos com velocidade variável têm sido possível com o desenvolvimento da eletrônica de potência. Atualmente, muitos acionamentos utilizam diversas técnicas para lograr o controle de velocidade por variação da freqüência da rede de al...

  16. Nuclear Instrumentation and Control Cyber Testbed Considerations – Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    Jonathan Gray; Robert Anderson; Julio G. Rodriguez; Cheol-Kwon Lee


    Abstract: Identifying and understanding digital instrumentation and control (I&C) cyber vulnerabilities within nuclear power plants and other nuclear facilities, is critical if nation states desire to operate nuclear facilities safely, reliably, and securely. In order to demonstrate objective evidence that cyber vulnerabilities have been adequately identified and mitigated, a testbed representing a facility’s critical nuclear equipment must be replicated. Idaho National Laboratory (INL) has built and operated similar testbeds for common critical infrastructure I&C for over ten years. This experience developing, operating, and maintaining an I&C testbed in support of research identifying cyber vulnerabilities has led the Korean Atomic Energy Research Institute of the Republic of Korea to solicit the experiences of INL to help mitigate problems early in the design, development, operation, and maintenance of a similar testbed. The following information will discuss I&C testbed lessons learned and the impact of these experiences to KAERI.

  17. Adolescent Drug Abuse: Etiological and Treatment Considerations (United States)

    Amini, Fariboz; And Others


    Issues involved in treating adolescent drug abusers and literature describing abuser personality traits are examined. The Youth Service at Langley Porter Institute and the problems encountered and solutions attempted there are discussed. The importance of residential as opposed to outpatient treatment and honesty in staff-patient relationships is…

  18. Did medieval trade activity and a viral etiology control the spatial extent and seasonal distribution of Black Death mortality? (United States)

    Bossak, Brian H; Welford, Mark R


    Recent research into the world's greatest recorded epidemic, the Medieval Black Death (MBD), has cast doubt on Bubonic Plague as the etiologic agent. Prior research has recently culminated in outstanding advances in our understanding of the spatio-temporal pattern of MBD mortality, and a characterization of the incubation, latent, infectious, and symptomatic periods of the MBD. However, until now, several mysteries remained unexplained, including perhaps the biggest quandary of all: why did the MBD exhibit inverse seasonal peaks in mortality from diseases recorded in modern times, such as seasonal Influenza or the Indian Plague Epidemics of the early 1900 s? Although some have argued that climate changes likely explain the observed differences between modern clinical Bubonic Plague seasonality and MBD mortality accounts, we believe that another factor explains these dissimilarities. Here, we provide a synthetic hypothesis which builds upon previous theories developed in the last ten years or so. Our all-encompassing theory explains the causation, dissemination, and lethality of the MBD. We theorize that the MBD was a human-to-human transmitted virus, originating in East-Central Asia and not Africa (as some recent work has proposed), and that its areal extent during the first great epidemic wave of 1347-1350 was controlled hierarchically by proximity to trade routes. We also propose that the seasonality of medieval trade controlled the warm-weather mortality peaks witnessed during 1347-1350; during the time of greatest market activity, traders, fairgoers, and religious pilgrims served as unintentional vectors of a lethal virus with an incubation period of approximately 32 days, including a largely asymptomatic yet infectious period of roughly three weeks. We include a description of the rigorous research agenda that we have proposed in order to subject our theory to scientific scrutiny and a description of our plans to generate the first publicly available

  19. Anthropometric Considerations in the Modernized Main Control Room: Application to a Virtual Nuclear Power Plant Control Panel

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Chih Wei; Cheng, Tsung Chieh [Institute of Nuclear Energy Research, Taoyuan (China); Lin, Chiuhsiang Joe [Chung-Yuan Christian University, Chung Li (China)


    This study investigates the anthropometric considerations in the main control room (MCR) application to a virtual nuclear power plant (NPP) control panel. Influences of working postures and physical demands on the operational performance are also discussed. Finally, the present research provides a case example to illustrate the influences of anthropometric considerations on the control panel design for MCR operators by applying virtual reality (VR) technology. The MCR design primarily evolved in different countries. The datasets available is usually insufficient or inconsistent for the end users. To solve the upper mentioned problem, this study put emphasis on applying VR technology to anthropometric considerations support control panel design in the modernized MCR. Although the concept of applying VR technology on anthropometric considerations in this paper is related to the MCR in NPPs, it could be easily applied for the purposes of any type of control room in a similar manner.

  20. Cancro bacteriano da videira: etiologia, epidemiologia e medidas de controle Bacterial canker of grapevine: etiology, epidemiology and control strategies

    Directory of Open Access Journals (Sweden)

    Ana Rosa Peixoto Nascimento


    Full Text Available No início de 1998, o cancro bacteriano da videira, causado pela bactéria Xanthomonas campestris pv. viticola, foi detectado pela primeira vez, no Brasil, em parreirais do Submédio São Francisco, onde a doença vem ocasionando prejuízos nas cultivares suscetíveis Red Globe, Itália, Festival, Brasil, Piratininga, Patrícia, Benitaka e Catalunha. Os sintomas, nas folhas, surgem como pontos necróticos (1 a 2mm de diâmetro com ou sem halos amarelados, algumas vezes coalescendo e causando a morte de extensas áreas do limbo foliar. Nas nervuras e pecíolos, nos ramos e ráquis dos frutos, formam-se manchas escuras alongadas que evoluem para fissuras longitudinais de coloração negra conhecidas como cancros. Descoloração vascular é também observada. As bagas são desuniformes em tamanho e cor podendo apresentar lesões necróticas. A disseminação do patógeno ocorre através de material propagativo infectado, material de colheita (contentores, tesouras de poda e raleio, luvas, tratos culturais (desbrota, poda, raleio de bagas, colheita, ventos e chuvas. Apesar da região apresentar um curto período chuvoso, a disseminação da bactéria é mais eficiente durante essa época. Em condições de umidade e temperatura elevadas, o patógeno sobrevive em restos de cultura. Para o controle da doença, recomenda-se o uso de material propagativo sadio, inspeção no campo, poda drástica de órgãos infectados, eliminação de plantas severamente infectadas, condução da época de poda de produção, desinfestação de veículos, de equipamentos e de materiais para poda, utilização de fungicidas protetores cúpricos e tiocarbamatos, e utilização de quebra-ventos para reduzir a disseminação do patógeno.In the begining of 1998, bacterial canker of grapevine, caused by the bacterium Xanthomonas campestris pv. viticola, was detected for the first time in Brazil in vineyards of the “Submédio São Francisco”. Losses in susceptible

  1. Lunar Module ECS (Environmental Control System) - Design Considerations and Failure Modes. Part 1 (United States)

    Interbartolo, Michael


    Design considerations and failure modes for the Lunar Module (LM) Environmental Control System (ECS) are described. An overview of the the oxygen supply and cabin pressurization, atmosphere revitalization, water management and heat transport systems are provided. Design considerations including reliability, flight instrumentation, modularization and the change to the use of batteries instead of fuel cells are discussed. A summary is provided for the LM ECS general testing regime.

  2. Motor/generator and electronic control considerations for energy storage flywheels (United States)

    Nola, F. J.


    A spacecraft electric power supply system is described. Requirements of the system are to accelerate a momentum wheel to a fixed maximum speed when solar energy is available and to maintain a constant voltage on the spacecraft bus under varying loads when solar energy is not available. Candidate motor types, pulse width modulated current control systems, and efficiency considerations are discussed. In addition, the Lunar Roving Vehicle motors are described along with their respective efficiencies.

  3. Active seat suspension for a small vehicle: considerations for control system including observer (United States)

    Katsumata, Hiroyuki; Shiino, Hiroshi; Oshinoya, Yasuo; Ishibashi, Kazuhisa; Ozaki, Koichi; Ogino, Hirohiko


    We have examined the improvement of ride quality and the reduction of riding fatigue brought about by the active control of the seat suspension of small vehicles such as one-seater electric automobiles. A small active seat suspension, which is easy to install, was designed and manufactured for one-seater electric automobiles. For the actuator, a maintenance-free voice coil motor used as a direct drive was adopted. For fundamental considerations, we designed a one-degree-of-freedom model for the active seat suspension system. Then, we designed a disturbance cancellation control system that includes the observer for a two-degree-of-freedom model. In an actual driving test, a test road, in which the concavity and convexity of an actual road surface were simulated using hard rubber, was prepared and the control performance of vertical vibrations of the seat surface during driving was examined. As a result, in comparison with the one-degree-of-freedom control system, it was confirmed that the control performance was improved by the two-degree-of-freedom control system that includes the observer.

  4. Theoretical and baseline considerations for diet and weight control of diabetes among blacks. (United States)

    Kumanyika, S K; Ewart, C K


    This article outlines theoretical considerations for diet and weight control of non-insulin-dependent diabetes mellitus (NIDDM) and identifies factors that may be of particular importance in influencing the success of diet and weight control of NIDDM in the Black population. Long-term adherence to dietary or weight-control regimens requires that the patient evaluate and restructure established eating and physical activity patterns. With the use of the social action theory as a conceptual framework, this complex behavioral change task can be understood as a function of the interplay of various self-regulatory mechanisms. These mechanisms are influenced by the person's capabilities for making changes, his/her physical condition and general health status, the physical and social environmental context, and the person's material and social resources. Many of these factors may differ for Blacks and Whites in a direction that suggests a lesser potential for effective diet and weight-loss therapy among Black NIDDM patients. For example, compared with Whites, Blacks are more likely to have limited incomes, low educational attainment, ambivalence about weight control, multiple health problems, and high-fat high-sodium low-fiber diets or food preferences. However, some evidence suggests that state-of-the-art counseling approaches can be as effective for Blacks as for Whites. The challenge is to adapt the types of approaches suggested by the social action theory for culturally appropriate and cost-effective delivery in Black community health-care settings.

  5. Role of dynamic slow motion video endoscopy in etiological correlation between eustachian dysfunction and chronic otitis media: A case-control study

    Directory of Open Access Journals (Sweden)

    Minal Gupta


    Full Text Available Objective: To assess the role of dynamic slow motion video endoscopy (DSVE for diagnosing eustachian tube (ET dysfunction in the cases of middle ear disorders and to classify eustachian dysfunction into mechanical and functional for the purpose of systematic management of middle ear disorders. Materials and Methods: A prospective, case-control study was carried out on total 84 patients (168 ears of whom 64 patients with ear complaints (total 95 ears having middle ear disease was taken as cases. Remaining 20 patients without any ear and nasal complaints (40 ears and the normal ears among the case group (33 ears were taken as controls (total 73 ears. DSVE was performed in cases and controls to compare the incidence of eustachian dysfunction in the two groups. Tubal movements were classified into four grades depending on: (1 Appearance of tubal mucosa, (2 movements of medial and lateral cartilaginous lamina, (3 lateral excursion and dilatory waves of the lateral pharyngeal wall, (4 whether tubal lumen opened well or not and (5 presence of patulous tubes (concavity in the superior third of tube. Results: On correlating the DSVE findings of ET in both case and control group, 4 times higher incidence of abnormal ET dysfunction was obtained in cases of middle ear disorders as compared to controls (P = 0.001, odds ratio of 4.0852. We found that 29 tubes had mechanical type of dysfunction (Grades 2A and 3A, whereas 30 tubes had functional type of dysfunction (Grades 2B and 3B and patulous. Conclusion: There is a positive etiological correlation between eustachian dysfunction and chronic otitis media by DSVE. It provides valuable information regarding the structural and functional status of the pharyngeal end of the ET and in classifying the type of eustachian dysfunction into mechanical or functional, which has management implications.

  6. Ischemic stroke in young adults: an overview of etiological aspects

    Directory of Open Access Journals (Sweden)

    Fábio Iuji Yamamoto


    Full Text Available Stroke affects mainly people aged over 65 years, and atherosclerosis predominates as the main etiopathogenic factor in ischemic stroke (IS. On the other hand, cardiac embolism and arterial dissection are the most frequent causes of IS in patients aged less than 45 years. However, inappropriate control of traditional vascular risk factors in young people may be causing a significant increase of atherosclerosis-related IS in this population. Furthermore, a variety of etiologies, many of them uncommon, must be investigated. In endemic regions, neurocysticercosis and Chagas' disease deserve consideration. Undetermined cause has been still reported in as many as one third of young stroke patients.

  7. Consideration of Command and Control Performance during Accident Management Process at the Nuclear Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Nisrene M. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kim, Sok Chul [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)


    The accident at the Fukushima Daiichi nuclear power plants shifted the nuclear safety paradigm from risk management to on-site management capability during a severe accident. The kernel of on-site management capability during an accident at a nuclear power plant is situation awareness and agility of command and control. However, little consideration has been given to accident management. After the events of September 11, 2001 and the catastrophic Fukushima nuclear disaster, agility of command and control has emerged as a significant element for effective and efficient accident management, with many studies emphasizing accident management strategies, particularly man-machine interface, which is considered a key role in ensuring nuclear power plant safety during severe accident conditions. This paper proposes a conceptual model for evaluating command and control performance during the accident management process at a nuclear power plant. Communication and information processing while responding to an accident is one of the key issues needed to mitigate the accident. This model will give guidelines for accurate and fast communication response during accident conditions.

  8. Factors controlling inter-catchment variation of mean transit time with consideration of temporal variability (United States)

    Ma, Wenchao; Yamanaka, Tsutomu


    The catchment transit time, a lumped descriptor reflecting both time scale and spatial structure of catchment hydrology can provide useful insights into chemical/nuclear pollution risks within a catchment. Despite its importance, factors controlling spatial variation of mean transit time (MTT) are not yet well understood. In this study, we estimated time-variant MTTs for about ten years (2003-2012) in five mesoscale sub-catchments of the Fuji River catchment, central Japan, to establish the factors controlling their inter-catchment variation with consideration of temporal variability. For this purpose, we employed a lumped hydrological model that was calibrated and validated by hydrometric and isotopic tracer observations. Temporal variation patterns of estimated MTT were similar in all sub-catchments, but with differing amplitudes. Inter-catchment variation of MTT was greater in dry periods than wet periods, suggesting spatial variation of MTT is controlled by water 'stock' rather than by 'flow'. Although the long-term average MTT (LAMTT) in each catchment was correlated with mean slope, coverage of forest (or conversely, other land use types), coverage of sand-shale conglomerate, and groundwater storage, the multiple linear regression revealed that inter-catchment variation of LAMTT is principally controlled by the amount of groundwater storage. This is smaller in mountainous areas covered mostly by forests and greater in plain areas with less forest coverage and smaller slope. This study highlights the topographic control of MTT via groundwater storage, which might be a more important factor in mesoscale catchments, including both mountains and plains, rather than in smaller catchments dominated by mountainous topography.

  9. Etiology and Epidemiology of Diarrhea in Hospitalized Children from Low Income Country: A Matched Case-Control Study in Central African Republic.

    Directory of Open Access Journals (Sweden)

    Sébastien Breurec


    Full Text Available In Sub-Saharan Africa, infectious diarrhea is a major cause of morbidity and mortality. A case-control study was conducted to identify the etiology of diarrhea and to describe its main epidemiologic risk factors among hospitalized children under five years old in Bangui, Central African Republic.All consecutive children under five years old hospitalized for diarrhea in the Pediatric Complex of Bangui for whom a parent's written consent was provided were included. Controls matched by age, sex and neighborhood of residence of each case were included. For both cases and controls, demographic, socio-economic and anthropometric data were recorded. Stool samples were collected to identify enteropathogens at enrollment. Clinical examination data and blood samples were collected only for cases.A total of 333 cases and 333 controls was recruited between December 2011 and November 2013. The mean age of cases was 12.9 months, and 56% were male. The mean delay between the onset of first symptoms and hospital admission was 3.7 days. Blood was detected in 5% of stool samples from cases. Cases were significantly more severely or moderately malnourished than controls. One of the sought-for pathogens was identified in 78% and 40% of cases and controls, respectively. Most attributable cases of hospitalized diarrhea were due to rotavirus, with an attributable fraction of 39%. Four other pathogens were associated with hospitalized diarrhea: Shigella/EIEC, Cryptosporidium parvum/hominis, astrovirus and norovirus with attributable fraction of 9%, 10%, 7% and 7% respectively. Giardia intestinalis was found in more controls than cases, with a protective fraction of 6%.Rotavirus, norovirus, astrovirus, Shigella/EIEC, Cryptosporidium parvum/hominis were found to be positively associated with severe diarrhea: while Giardia intestinalis was found negatively associated. Most attributable episodes of severe diarrhea were associated with rotavirus, highlighting the urgent

  10. Material Control and Accounting Design Considerations for High-Temperature Gas Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Trond Bjornard; John Hockert


    The subject of this report is domestic safeguards and security by design (2SBD) for high-temperature gas reactors, focusing on material control and accountability (MC&A). The motivation for the report is to provide 2SBD support to the Next Generation Nuclear Plant (NGNP) project, which was launched by Congress in 2005. This introductory section will provide some background on the NGNP project and an overview of the 2SBD concept. The remaining chapters focus specifically on design aspects of the candidate high-temperature gas reactors (HTGRs) relevant to MC&A, Nuclear Regulatory Commission (NRC) requirements, and proposed MC&A approaches for the two major HTGR reactor types: pebble bed and prismatic. Of the prismatic type, two candidates are under consideration: (1) GA's GT-MHR (Gas Turbine-Modular Helium Reactor), and (2) the Modular High-Temperature Reactor (M-HTR), a derivative of Areva's Antares reactor. The future of the pebble-bed modular reactor (PBMR) for NGNP is uncertain, as the PBMR consortium partners (Westinghouse, PBMR [Pty] and The Shaw Group) were unable to agree on the path forward for NGNP during 2010. However, during the technology assessment of the conceptual design phase (Phase 1) of the NGNP project, AREVA provided design information and technology assessment of their pebble bed fueled plant design called the HTR-Module concept. AREVA does not intend to pursue this design for NGNP, preferring instead a modular reactor based on the prismatic Antares concept. Since MC&A relevant design information is available for both pebble concepts, the pebble-bed HTGRs considered in this report are: (1) Westinghouse PBMR; and (2) AREVA HTR-Module. The DOE Office of Nuclear Energy (DOE-NE) sponsors the Fuel Cycle Research and Development program (FCR&D), which contains an element specifically focused on the domestic (or state) aspects of SBD. This Material Protection, Control and Accountancy Technology (MPACT) program supports the present work

  11. The Etiology of Giftedness (United States)

    Thompson, Lee Anne; Oehlert, Jeremy


    Many theories of giftedness either explicitly or implicitly acknowledge the role of genetic influences; yet, empirical work has not been able to establish the impact that genes have specifically on gifted behavior. In contrast, a great deal of research has been targeted at understanding the etiology of individual differences in general and…

  12. Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Thomas Bénet

    Full Text Available There are very limited data on children with pneumonia in Mali. The objective was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children <5 years of age in Mali.A prospective hospital-based case-control study was implemented in the Pediatric department of Gabriel Touré University Hospital at Bamako, Mali, between July 2011-December 2012. Cases were children with radiologically-confirmed pneumonia; Controls were hospitalized children without respiratory features, matched for age and period. Respiratory specimens, were collected to identify 19 viruses and 5 bacteria. Whole blood was collected from cases only. Factors associated with pneumonia were assessed by multivariate logistic regression.Overall, 118 cases and 98 controls were analyzed; 44.1% were female, median age was 11 months. Among pneumonia cases, 30.5% were hypoxemic at admission, mortality was 4.2%. Pneumonia cases differed from the controls regarding clinical signs and symptoms but not in terms of past medical history. Multivariate analysis of nasal swab findings disclosed that S. pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6-7.0, human metapneumovirus (aOR = 17.2, 95% CI: 2.0-151.4, respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3-23.3, and influenza A virus (aOR = 10.7, 95% CI: 1.0-112.2 were associated with pneumonia, independently of patient age, gender, period, and other pathogens. Distribution of S. pneumoniae and RSV differed by season with higher rates of S. pneumoniae in January-June and of RSV in July-September. Pneumococcal serotypes 1 and 5 were more frequent in pneumonia cases than in the controls (P = 0.009, and P = 0.04, respectively.In this non-PCV population from Mali, pneumonia in children was mainly attributed to S. pneumoniae, RSV, human metapneumovirus, and influenza A virus. Increased pneumococcal conjugate vaccine coverage in children could significantly reduce the

  13. Etiological study of esophageal squamous cell carcinoma in an endemic region: a population-based case control study in Huaian, China

    Directory of Open Access Journals (Sweden)

    Gao Weimin


    Full Text Available Abstract Background Continuous exposure to various environmental carcinogens and genetic polymorphisms of xenobiotic-metabolizing enzymes (XME are associated with many types of human cancers, including esophageal squamous cell carcinoma (ESCC. Huaian, China, is one of the endemic regions of ESCC, but fewer studies have been done in characterizing the risk factors of ESCC in this area. The aims of this study is to evaluate the etiological roles of demographic parameters, environmental and food-borne carcinogens exposure, and XME polymorphisms in formation of ESCC, and to investigate possible gene-gene and gene-environment interactions associated with ESCC in Huaian, China. Methods A population based case-control study was conducted in 107 ESCC newly diagnosed cases and 107 residency- age-, and sex-matched controls in 5 townships of Huaian. In addition to regular epidemiological and food frequency questionnaire analyses, genetic polymorphisms of phase I enzymes CYP1A1, CYP1B1, CYP2A6, and CYP2E1, and phase II enzymes GSTM1, GSTT1, GSTP1, and microsomal epoxide hydrolase (EPHX were assessed from genomic DNA using PCR based techniques. Results Consuming acrid food, fatty meat, moldy food, salted and pickled vegetables, eating fast, introverted personality, passive smoking, a family history of cancer, esophageal lesion, and infection with Helicobacter pylori were significant risk factors for ESCC (P GSTT1 null genotype was higher in cases (59.4% compared to controls (47.2% with an odds ratio (OR of 1.68 and 95% confidence interval (CI from 0.96 to 2.97 (P = 0.07, especially in males (OR = 2.78; 95% CI = 1.22–6.25; P = 0.01. No associations were found between polymorphisms of CYP1A1, CYP1B1, CYP2A6, CYP2E1, GSTM1, GSTP1, and EPHX and ESCC (P > 0.05. Conclusion Our results demonstrated that dietary and environmental exposures, some demographic parameters and genetic polymorphism of GSTT1 may play important roles in the development of ESCC in Huaian

  14. Etiology of Food Addiction

    Directory of Open Access Journals (Sweden)

    Demet Gulec Oyekcin


    Full Text Available Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some studies still emphasizes the differences between two. The aim of this article was to review clinical and biological aspects of etiological perspectives of food addiction via available clinical, preclinical and genetic studies.

  15. Etiologies of Sarcoidosis. (United States)

    Chen, Edward S; Moller, David R


    Since sarcoidosis was first described more than a century ago, the etiologic determinants causing this disease remain uncertain. Studies suggest that genetic, host immunologic, and environmental factors interact together to cause sarcoidosis. Immunologic characteristics of sarcoidosis include non-caseating granulomas, enhanced local expression of T helper-1 (and often Th17) cytokines and chemokines, dysfunctional regulatory T-cell responses, dysregulated Toll-like receptor signaling, and oligoclonal expansion of CD4+ T cells consistent with chronic antigenic stimulation. Multiple environmental agents have been suggested to cause sarcoidosis. Studies from several groups implicate mycobacterial or propionibacterial organisms in the etiology of sarcoidosis based on tissue analyses and immunologic responses in sarcoidosis patients. Despite these studies, there is no consensus on the nature of a microbial pathogenesis of sarcoidosis. Some groups postulate sarcoidosis is caused by an active viable replicating infection while other groups contend there is no clinical, pathologic, or microbiologic evidence for such a pathogenic mechanism. The authors posit a novel hypothesis that proposes that sarcoidosis is triggered by a hyperimmune Th1 response to pathogenic microbial and tissue antigens associated with the aberrant aggregation of serum amyloid A within granulomas, which promotes progressive chronic granulomatous inflammation in the absence of ongoing infection.


    Directory of Open Access Journals (Sweden)



    Full Text Available In the efforts to investigate the performance of Coanda Jet in enhancing lift of an airfoil, a numerical study is carried out. Tangential jets that take advantage of Coanda effect to closely follow the contours of the body are considered to be simple and particularly effective in that they can entrain a large mass of surrounding air. This can lead to increased circulation in the case of airfoils, or drag reduction (or drag increase if desired in the case of bluff bodies such as an aircraft fuselage. Critical review and analysis is also carried out for the application of Coanda Jet to optimize the aerodynamic performance of wind turbine, using the results of the numerical study and taking advantage of recent efforts to introduce Coanda effect as a novel circulation control technique. For this purpose a simple two-dimensional CFD modeling is utilized to reveal the key elements that could exhibit the desired performance criteria, in particular the lift enhancement and drag reduction, or a combination of both. Three dimensional configurations will be synthesized using certain acceptable assumptions, to compare such results with existing experimental data. Hence in this work the problem is idealized as basic airflow over a two-dimensional airfoil in subsonic flow; by the use of CFD technique, parametric study is carried out to arrive at plausible design considerations and to assess the practicability of Coanda jet in wind turbine design. Parametric study carried out shows the effectiveness of Coanda-jet in producing enhanced lift, which can contribute to increased torque in wind turbine application and increased axial thrust for propeller application. The numerical study also shows that appropriate trailing edge rounding off and tailoring the Coanda-jet thickness and momentum coefficient can produce enhanced lift to drag ratio.ABSTRAK : Dalam usaha untuk mengkaji prestasi Coanda Jet bagi mempertingkatkan daya angkat suatu aerofil, kajian berangka

  17. Resource Considerations during Parallel Scheduling of Large Control Flow Dominated Applications

    DEFF Research Database (Denmark)

    Grode, Jesper Nicolai Riis; Madsen, Jan


    This paper presents a technique to determine the possible parallelism between different control-structures in large hierarchical Control- and Data-Flow Graphs (CDFGs). The technique is based on a hierarchical bottom-up heuristic, which after resolving data- and control-dependencies between control...

  18. [Hepatoblastoma, Etiology, Case Reports]. (United States)

    Puchmajerová, A; Křepelová, A; Indráková, J; Sítková, R; Balaščak, I; Kruseová, J; Švojgr, K; Kodet, R; Kynčl, M; Vícha, A; Macek, M


    Hepatoblastoma is an uncommon malignant neoplasm in general, yet, it is the most common liver malignancy in children with the incidence about one per milion children. This type of liver tumor usually occurs before the age of three years. The etiology of hepatoblastoma remains unknown. However, there are some genetic conditions known to be associated with an increased risk of developing hepatoblastoma such as Beckwith-Wiedemann syndrome, hemihypertrophy, APC-associated polyposis, α-1-antitrypsin defficiency and some metabolic disorders including tyrosinemia, galactosemia and glycogen storage disease type 1. There is a higher risk of hepatoblastoma in children with very low birthweight, children who acquire hepatitis B at an early age and children with congenital biliary atresia.

  19. Lunar Module Environmental Control System Design Considerations and Failure Modes. Part 2 (United States)

    Interbartolo, Michael A.


    This viewgraph presentation seeks to describe the Lunar Module Environmental Control System (ECS) subsystem testing and redesign and seeks to summarize the in-flight failures of the Lunar Module (LM) Environmental Control System (ECS).

  20. Considerations for the implementation and operation of stormwater control measure (SCM) performance monitoring systems (United States)

    Green infrastructure (GI) studies are needed to make informed decisions about whether or not to select GI technologies over traditional urban drainage control methods and to assist in the timing of effective maintenance. Two permeable pavement infiltration stormwater control meas...


    Directory of Open Access Journals (Sweden)

    Lenghel Dorin Radu


    Full Text Available Through the hereby study we set ourselves on an analysis over the internal control and the ways of implementation of it. The final purpose of our research is represented by the characteristics of the internal control system in the context of current accountancy regulations. The accomplishment of such goal has forced us to research the current literature in the area and also the legal regulations over internal control. Of course, the accomplishment of such a research was possible only after a pertinent analysis over the opinions expressed in specialty literature regarding this area. Our research wants to be with a theoretical and applicative character. It is based on analysing the internal control system, the methodology of internal control and the steps of internal control. We express our belief that the implementation of the internal control in a very exact manner comes as an aid to the company management and lead to the accomplishment of managerial objectives and policies. In what it regards the result of our research there can be drawn the following conclusions: from the legal regulations (OMFP nr. 3055/2009, there is no clear conclusion over the procedures and policies of implementation of internal control applicable to an economical entity; also there are not presented in a detailed way the types (forms of internal control, being presented in the legal regulations only a classification of them after the time in which they are exercised (before, during or after the finishing of the operations; also in the legal regulations there is developed a certain way of internal control, represented by the financial and accounting internal control, as if the other forms of internal control do not exist; in what regards the components of internal control, these are presented in another way, but similar to already known models of internal control (Coso and Coco; also in the legal regulations there are presented the general objectives of internal control

  2. Resource Considerations during Parallel Scheduling of Large Control Flow Dominated Applications

    DEFF Research Database (Denmark)

    Grode, Jesper Nicolai Riis; Madsen, Jan


    This paper presents a technique to determine the possible parallelism between different control-structures in large hierarchical Control- and Data-Flow Graphs (CDFGs). The technique is based on a hierarchical bottom-up heuristic, which after resolving data- and control-dependencies between control......-structures, parallelizes selected control-structures , subject to minimizing resource consumption. The purpose of the technique is to be able to predict resource consumption and estimate execution time for large CDFGs. The technique has been tested on several CDFGs with up to 1442 nodes. The results indicate...

  3. Anthropometric considerations for a 4-axis side-arm flight controller (United States)

    Debellis, W. B.


    A data base on multiaxis side-arm flight controls was generated. The rapid advances in fly-by-light technology, automatic stability systems, and onboard computers have combined to create flexible flight control systems which could reduce the workload imposed on the operator by complex new equipment. This side-arm flight controller combines four controls into one unit and should simplify the pilot's task. However, the use of a multiaxis side-arm flight controller without complete cockpit integration may tend to increase the pilot's workload.

  4. The Effect of Part-simulation of Weightlessness on Human Control of Bilateral Teleoperation: Neuromotor Considerations (United States)

    Corker, K.; Bejczy, A. K.


    The effect of weightlessness on the human operator's performance in force reflecting position control of remote manipulators was investigated. A gravity compensation system was developed to simulate the effect of weightlessness on the operator's arm. A universal force reflecting hand controller (FRHC) and task simulation software were employed. Two experiments were performed because of anticipated disturbances in neuromotor control specification on the human operator in an orbital control environment to investigate: (1) the effect of controller stiffness on the attainment of a learned terminal position in the three dimensional controller space, and (2) the effect of controller stiffness and damping on force tracking of the contour of a simulated three dimensional cube using the part simulation of weightless conditions. The results support the extension of neuromotor control models, which postulate a stiffness balance encoding of terminal position, to three dimensional motion of a multilink system, confirm the existence of a disturbance in human manual control performance under gravity compensated conditions, and suggest techniques for compensation of weightlessness induced performance decrement through appropriate specification of hand controller response characteristics. These techniques are based on the human control model.

  5. Optimization of block-floating-point realizations for digital controllers with finite-word-length considerations

    Institute of Scientific and Technical Information of China (English)

    吴俊; 胡协和; 陈生; 褚健


    The closed-loop stability issue of finite-precision realizations was investigated for digital control-lers implemented in block-floating-point format. The controller coefficient perturbation was analyzed resultingfrom using finite word length (FWL) block-floating-point representation scheme. A block-floating-point FWL closed-loop stability measure was derived which considers both the dynamic range and precision. To facilitate the design of optimal finite-precision controller realizations, a computationally tractable block-floating-point FWL closed-loop stability measure was then introduced and the method of computing the value of this measure for a given controller realization was developed. The optimal controller realization is defined as the solution that maximizes the corresponding measure, and a numerical optimization approach was adopted to solve the resulting optimal realization problem. A numerical example was used to illustrate the design procedure and to compare the optimal controller realization with the initial realization.

  6. An Etiological Model of Perfectionism


    Maloney, Gayle K.; Egan, Sarah J.; Kane, Robert T.; Rees, Clare S


    OBJECTIVE: Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. METHOD: The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. RESULTS: Struc...

  7. Recurrent ophthalmoplegia in childhood: diagnostic and etiologic considerations

    Energy Technology Data Exchange (ETDEWEB)

    Oestergaard, J.R.; Moeller, H.U.; Christensen, T.


    The authors present two patients with recurrent painful ophthalmoplegia starting in early childhood. Clinically, both patients fulfilled the criteria for ophthalmologic migraine. In one case, magnetic resonance investigations were performed following the second attack, between the third and fourth and during the fourth attack. The left third cranial nerve was significantly thickened in its course from the brainstem through the prepontine cistern to the cavernous sinus during the attacks and moderately thickened between the attacks. In the second case, magnetic resonance imaging was performed during the 14th attack, when the oculomotor nerve dysfunction was almost permanent, and the imaging demonstrated a swollen oculomotor nerve. Whether these finding are pathognomonic of ophthalmoplegic migraine awaits further reports using magnetic resonance imaging in infants showing recurrent painful ophthalmoplegia of eraly onset. 17 refs.

  8. Optimization of block floating point realizations for digital controllers with finite word length considerations

    Institute of Scientific and Technical Information of China (English)

    吴俊; 胡协和; 陈生; 褚健


    The closed-loop stability issue of finite-precision realizations was investigated for digital controllers implemented in block-floating-point format. The controller coefficient perturbation was analyzed resulting from using finite word length (FWL) block-floating-point representation scheme. A block-floating-point FWL closed-loop stability measure was derived which considers both the dynamic range and precision. To facilitate the design of optimal finite-precision controller realizations, a computationally tractable block-floating-point FWL closed-loop stability measure was then introduced and the method of computing the value of this measure for a given controller realization was developed. The optimal controller realization is defined as the solution that maximizes the corresponding measure, and a numerical optimization approach was adopted to solve the resulting optimal realization problem. A numerical example was used to illustrate the design procedure and to compare the optimal controller realization with the initial realization.

  9. The importance of control considerations for heat exchanger network synthesis: a case study

    Directory of Open Access Journals (Sweden)

    S.G. Oliveira


    Full Text Available Cost optimization in the synthesis decision tree often leads to a reduced degree of freedom which degrades the process’s ability to reject disturbances as a consequence of low controllability. In fact, Heat Exchanger Networks (HENs obtained by traditional synthesis procedures that ignore controllability aspects must be evaluated in this context a posteriori. The aim of this work was to develop a procedure that includes RGA and SVD measures of controllability, which are solely based on steady state information, thereby freeing the synthesis procedure of the cumbersome dynamic analysis. When a structure is defined during a traditional HEN synthesis procedure, a degree of freedom analysis is approached as a simulation problem. Next, an optimization is performed, since new variables are usually added to increase the degree of freedom of the HEN in order to render it controllable. A key point in the proposed procedure is the inference of controllability based on the proposed controllability measures, which also provide a control scheme by pairing controlled and manipulated variables during the process design. A HEN reported in the literature is used to illustrate the proposed procedure. The steady state simulator Aspen Plus and the dynamic simulator Aspen Dynamics (Aspentech, Inc. were employed.

  10. Secondary Control Strategies for Frequency Restoration in Islanded Microgrids with Consideration of Communication Delays

    DEFF Research Database (Denmark)

    Ahumada, Constanza; Cardenas, Roberto; Saez, Doris


    One of the well-known methods to share active and reactive power in microgrids, is droop control. A disadvantage of this method is that in steady state the frequency of the microgrid deviates from the nominal value, and has to be restored using a Secondary Control System (SCS). The signal obtaine...

  11. Design considerations to improve cognitive ergonomic issues of unmanned vehicle interfaces utilizing video game controllers. (United States)

    Oppold, P; Rupp, M; Mouloua, M; Hancock, P A; Martin, J


    Unmanned (UAVs, UCAVs, and UGVs) systems still have major human factors and ergonomic challenges related to the effective design of their control interface systems, crucial to their efficient operation, maintenance, and safety. Unmanned system interfaces with a human centered approach promote intuitive interfaces that are easier to learn, and reduce human errors and other cognitive ergonomic issues with interface design. Automation has shifted workload from physical to cognitive, thus control interfaces for unmanned systems need to reduce mental workload on the operators and facilitate the interaction between vehicle and operator. Two-handed video game controllers provide wide usability within the overall population, prior exposure for new operators, and a variety of interface complexity levels to match the complexity level of the task and reduce cognitive load. This paper categorizes and provides taxonomy for 121 haptic interfaces from the entertainment industry that can be utilized as control interfaces for unmanned systems. Five categories of controllers were based on the complexity of the buttons, control pads, joysticks, and switches on the controller. This allows the selection of the level of complexity needed for a specific task without creating an entirely new design or utilizing an overly complex design.

  12. [Etiology of deafness in children]. (United States)

    Delvaux de Fenffe, J; Deggouj, N; Dutilleux, D; Gersdorff, M


    A retrospective etiological study of 112 files of deaf children is presented. A prenatal etiology is found in 42.8%, a perinatal in 19.6% and a postnatal in 13.4% of the cases. No cause was suspected in 30.3% of the cases. These results emphasise existing literature.

  13. Etiologies of bilateral pleural effusions (United States)

    Puchalski, Jonathan T.; Argento, A. Christine; Murphy, Terrence E.; Araujo, Katy L.B.; Oliva, Isabel B.; Rubinowitz, Ami N.; Pisani, Margaret A.


    Summary Background To evaluate the safety, etiology and outcomes of patients undergoing bilateral thoracentesis. Methods This is a prospective cohort study of 100 consecutive patients who underwent bilateral thoracenteses in an academic medical center from July 2009 through November 2010. Pleural fluid characteristics and etiologies of the effusions were assessed. Mean differences in levels of fluid characteristics between right and left lungs were tested. Associations between fluid characteristics and occurrence of bilateral malignant effusions were evaluated. The rate of pneumothorax and other complications subsequent to bilateral thoracentesis was determined. Results Exudates were more common than transudates, and most effusions had multiple etiologies, with 83% having two or more etiologies. Bilateral malignant effusions occurred in 19 patients, were the most common single etiology of exudative effusions, and were associated with higher levels of protein and LDH in the pleural fluid. Among 200 thoracenteses performed with a bilateral procedure, seven resulted in pneumothoraces, three of which required chest tube drainage and four were ex vacuo. Conclusions More often than not, there are multiple etiologies that contribute to pleural fluid formation, and of the combinations of etiologies observed congestive heart failure was the most frequent contributor. Exudative effusions are more common than transudates when bilateral effusions are present. Malignancy is a common etiology of exudative effusions. This study suggests that the overall complication rate following bilateral thoracentesis is low and the rate of pneumothorax subsequent to bilateral thoracentesis is comparable to unilateral thoracentesis. PMID:23219348

  14. Role of the Health Department in Tuberculosis Prevention and Control-Legal and Public Health Considerations. (United States)

    Jeffries, Carla; Lobue, Phil; Chorba, Terence; Metchock, Beverly; Kashef, Ijaz


    Because tuberculosis is caused by an infectious organism that is spread from person to person through the air, public health measures are essential to control the disease. There are three priority strategies for tuberculosis prevention and control in the United States: (i) identifying and treating persons who have tuberculosis disease; (ii) finding persons exposed to infectious tuberculosis patients, evaluating them for Mycobacterium tuberculosis infection and disease, and providing subsequent treatment, if appropriate; and (iii) testing populations at high risk for latent tuberculosis infection (LTBI) and treating those persons who are infected to prevent progression to disease. These strategies for prevention and control of tuberculosis are discussed in a framework containing the following important topics: historical and epidemiological context of tuberculosis control, organization of public health tuberculosis control programs, legal basis for public health authority, conducting overall planning and development of policy, identifying persons who have clinically active tuberculosis, evaluation of immigrants, managing persons who have or who are suspected of having disease, medical consultation, interjurisdictional referrals, identifying and managing persons infected with Mycobacterium tuberculosis, providing laboratory and diagnostic services, collecting and analyzing data, and providing training and education. This chapter describes the role of the health department in the context of these components. This discussion is primarily applicable to tuberculosis prevention and control programs in the United States.

  15. Adaptive Wide-Area Damping Control Scheme for Smart Grids with Consideration of Signal Time Delay

    Directory of Open Access Journals (Sweden)

    Deyou Yang


    Full Text Available As an important part of the smart grid, a wide-area measurement system (WAMS provides the key technical support for power system monitoring, protection and control. But 20 uncertainties in system parameters and signal transmission time delay could worsen the damping effect and deteriorate the system stability. In the presented study, the subspace system identification technique (SIT is used to firstly derive a low-order linear model of a power system from the measurements. Then, a novel adaptive wide-area damping control scheme for online tuning of the wide-area damping controller (WADC parameters using the residue method is proposed. In order to eliminate the effects of the time delay to the signal transmission, a simple and practical time delay compensation algorithm is proposed to compensate the time delay in each wide-area control signal. Detailed examples, inspired by the IEEE test system under various disturbance scenarios, have been used to verify the effectiveness of the proposed adaptive wide-area damping control scheme.

  16. MPC-Based Path Following Control of an Omnidirectional Mobile Robot with Consideration of Robot Constraints

    Directory of Open Access Journals (Sweden)

    Kiattisin Kanjanawanishkul


    Full Text Available In this paper, the path following problem of an omnidirectional mobile robot (OMR has been studied. Unlike nonholonomic mobile robots, translational and rotational movements of OMRs can be controlled simultaneously and independently. However the constraints of translational and rotational velocities are coupled through the OMR's orientation angle. Therefore, a combination of a virtual-vehicle concept and a model predictive control (MPC strategy is proposed in this work to handle both robot constraints and the path following problem. Our proposed control scheme allows the OMR to follow the reference path successfully and safely, as illustrated in simulation experiments. The forward velocity is close to the desired one and the desired orientation angle is achieved at a given point on the path, while the robot's wheel velocities are maintained within boundaries.

  17. Application of Time Delay Consideration on Bridge Vibration Control Method with Active Tendons

    Directory of Open Access Journals (Sweden)

    Lezin Seba MINSILI


    Full Text Available For many years bridge structures have been designed or constructed as passive structures that rely on their mass and solidity to resist external forces, while being incapable of adapting to the dynamics of an ever-changing environment. When the rigidity assumption is not met in particular for high-rise structures like bridge towers, a proper dynamic model should be established and conclusions made on the differential vibration of the tower when it is investigated out of the bridge system. The present work outlines a vibration control method by tendons on the tower of cable supported structures considering time delay effects, based on the discrete-time Linearization of the Feedback Gain Matrix. The efficiency of this vibration control method first proposed on the design process of a local bridge in Cameroon, is more compatible to the control of civil structures and is of great interest in accordance with simulation results.

  18. Design Considerations for Miniaturized Control Moment Gyroscopes for Rapid Retargeting and Precision Pointing of Small Satellites


    Patankar, Kunal; Fitz-Coy, Norman; Roithmayr, Carlos


    This paper presents the design as well as characterization of a practical control moment gyroscope (CMG) based attitude control system (ACS) for small satellites in the 15-20 kg mass range performing rapid retargeting and precision pointing maneuvers. The paper focuses on the approach taken in the design of miniaturized CMGs while considering the constraints imposed by the use of commercial off-the-shelf (COTS) components as well as the size of the satellite. It is shown that a hybrid mode is...

  19. Theoretical Consideration of The Controllability Indicator of Machine-Tractor Unit Movement

    Directory of Open Access Journals (Sweden)

    Bulgakov Volodymyr


    Full Text Available The paper is focused on the issues of controllability of machine-tractor units based on wheel-type tractors during their non-straight driving on the soil surface, which is positioned at an angle to the horizon. There were obtained analytical expressions for the determination of the actual indicator of control λd, including both the power and the design parameters of the machine-tractor unit, which affect the abovementioned indicator in the longitudinal vertical plane. These expressions are obtained for the tractor driving on both road and also driving during field operation. In addition, the paper discusses the conditions under which there may occur the cross-slip of the tractor steering wheels in the transversal horizontal plane. As a result of this review, there were obtained the analytical expressions for determining the required indicator of the controllability λd of machine-tractor unit in the horizontal plane, excluding the possibility of lateral sliding of the unit by turning its steering wheels at a certain angle. These expressions are obtained for the two modes of the machine-tractor unit: for driving during transport on the road and during the operation in the field. The machine-tractor unit based on the wheel-type tractor with rear mounted 3-mouldboard plough was analytically investigated. By means of computer calculations, there was observed the fact that when moving in non-straight direction on the soil surface, inclined to the horizon at an angle of 12°, the machine-tractor unit is controllable only when the angles of the steering wheel of the given tractor do not exceed 9°. During the working movement (ploughing of the given machine-tractor unit on an inclined field surface, its controllability will be preserved on condition that the angle of the tractor steering wheels does not exceed 11°. According to obtained results, it can be stated that the controllability of the machine-tractor unit is determined by the indicator of

  20. Review of advanced control rooms: Methodological considerations for the use of HFE guidelines

    Energy Technology Data Exchange (ETDEWEB)

    O`Hara, J.M.


    Control rooms for advanced nuclear power plants use advanced human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator`s overall role in the system and the ways in which operators interact with the system. The US Nuclear Regulatory Commission (NRC) reviews HSIs to ensure that they are designed to accepted human factors engineering (HFE) principles. The principal review guidance, however, is more than ten-years old (US NRC, 1981). Accordingly, an Advanced HSI Design Review Guideline (DRG) was developed to provide criteria for these reviews. The DRG contains seven major sections: Information Display, User-System Interaction, Process Control and Input Devices, Alarms, Analysis and Decision Aids, Inter-Personnel Communication, and Workplace Design (see O`Hara & Brown, 1993). The purpose of this paper is to describe the methodology for DRG use.

  1. Design Considerations for Miniaturized Control Moment Gyroscopes for Rapid Retargeting and Precision Pointing of Small Satellites (United States)

    Patankar, Kunal; Fitz-Coy, Norman; Roithmayr, Carlos M.


    This paper presents the design as well as characterization of a practical control moment gyroscope (CMG) based attitude control system (ACS) for small satellites in the 15-20 kilogram mass range performing rapid retargeting and precision pointing maneuvers. The paper focuses on the approach taken in the design of miniaturized CMGs while considering the constraints imposed by the use of commercial off-the-shelf (COTS) components as well as the size of the satellite. It is shown that a hybrid mode is more suitable for COTS based moment exchange actuators; a mode that uses the torque amplification of CMGs for rapid retargeting and direct torque capabilities of the flywheel motors for precision pointing. A simulation is provided to demonstrate on-orbit slew and pointing performance.

  2. Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients

    Directory of Open Access Journals (Sweden)

    Neela K. Patel


    Full Text Available Cardiovascular disease is a leading cause of morbidity and mortality in the United States, and its prevention and treatment remain a priority for the medical community. Ethnic variations account for some differences in the prevalence of hypertension and blood pressure (BP control rates among Hispanics, indicating the need for culturally appropriate management models. Aggressive treatment strategies are key to achieving optimal BP control in high-risk Hispanic patients. Hypertension in this ethnic group continues to be a major health concern. Of note, when provided access to comprehensive care, Hispanics demonstrate similar response rates to treatment as the majority of non-Hispanic whites. This highlights the importance of effective, culturally responsive hypertension management among high-risk Hispanic patients for achieving observable, positive health outcomes.

  3. Production control in the steel industry with energy conservation considerations: a preliminary evaluation. [GASP

    Energy Technology Data Exchange (ETDEWEB)

    Takamoto, H.; Williams, T.J.


    The work here consists mainly of three tasks; the first is to construct the basic production model for the raw-material preparation and the iron-making area which had been ignored in the earlier work, but is vital to the energy problem. The second is to construct the energy utilization and energy generation models over all the steel production units involved in the plant. The third is to develop the hierarchy structure to control the energy management function.

  4. Pragmatic consideration of recent randomized, placebo-controlled clinical trials for treatment of fibromyalgia. (United States)

    Holman, Andrew J


    A flurry of recent randomized, placebo-controlled trials assessing dissimilar pharmacotherapeutic treatment options for fibromyalgia (FM) have been presented in the past few years. This review evaluates these trials in light of recent pathophysiological concepts germane to FM, including mood disorders, autonomic dysregulation, altered sleep stage architecture, and the diagnostic tender point controversy. Studies with gabapentin, pregabalin, duloxetine, milnacipran, sodium oxybate, and pramipexole for treatment of FM are discussed.

  5. Theoretical Considerations on the Organisation of Banking Supervision and Internal Banking Control

    Directory of Open Access Journals (Sweden)

    Loredana CIURLAU


    Full Text Available Prudential supervision of the entities wich make up the banking system from Romania constitute one of the main tasks of the National Bank of Romania which are characterized by a specificity that distinguishes it from its control activities in other areas of social and economic activity. This attribution becomes essential in the activity of the National Bank of Romania as long as the legislature authorizes this institution with an exclusive quality of national authority in this area.

  6. Design and Analysis Considerations for Cluster Randomized Controlled Trials That Have a Small Number of Clusters. (United States)

    Deke, John


    Cluster randomized controlled trials (CRCTs) often require a large number of clusters in order to detect small effects with high probability. However, there are contexts where it may be possible to design a CRCT with a much smaller number of clusters (10 or fewer) and still detect meaningful effects. The objective is to offer recommendations for best practices in design and analysis for small CRCTs. I use simulations to examine alternative design and analysis approaches. Specifically, I examine (1) which analytic approaches control Type I errors at the desired rate, (2) which design and analytic approaches yield the most power, (3) what is the design effect of spurious correlations, and (4) examples of specific scenarios under which impacts of different sizes can be detected with high probability. I find that (1) mixed effects modeling and using Ordinary Least Squares (OLS) on data aggregated to the cluster level both control the Type I error rate, (2) randomization within blocks is always recommended, but how best to account for blocking through covariate adjustment depends on whether the precision gains offset the degrees of freedom loss, (3) power calculations can be accurate when design effects from small sample, spurious correlations are taken into account, and (4) it is very difficult to detect small effects with just four clusters, but with six or more clusters, there are realistic circumstances under which small effects can be detected with high probability. © The Author(s) 2016.

  7. A Consideration on Inertia-Ratio and Vibration Control of Two-Inertia System (United States)

    Takesue, Naoyuki; Furusho, Junji; Iwakoshi, Kunio

    Most Industrial robots are driven through reduction gears such as harmonic drives and RV gears. Since the exibility of the drive system, the vibratory behavior is caused duringthe operation. When the exibility is considered, the drive system of the robot joint can be modeled as a resonant mechanical system called two-inertia system. Two-inertia systems are the vibratory systems that have poles on/near the imaginary axis. Acceleration feedback and torque feedback are known as the vibration control methods of two-inertia systems. In this paper, we consider the two-inertia system with the feedbacks of motor-acceleration, load-acceleration and torsion-torque. It is shown that each feedback works to control the inertia-ratio of two-inertia system. Then, the control performances are compared. Torsion vibration in robot joint, which occurs owingto the accuracy of components and assembly error of gears at a certain speed of rotation, becomes a problem. In order to suppress the torsion vibration, each feedback is applied to the robot arm. As a result, the torsion vibrations are suppressed e ectively.

  8. Energy-efficient control of a screw-drive pipe robot with consideration of actuator's characteristics. (United States)

    Li, Peng; Ma, Shugen; Lyu, Congyi; Jiang, Xin; Liu, Yunhui

    Pipe robots can perform inspection tasks to alleviate the damage caused by the pipe problems. Usually, the pipe robots carry batteries or use a power cable draining power from a vehicle that has many equipments for exploration. Nevertheless, the energy is limited for the whole inspection task and cannot keep the inspection time too long. In this paper, we use the total input energy as the cost function and a more accurate DC motor model to generate an optimal energy-efficient velocity control for a screw-drive pipe robot to make use of the limited energy in field environment. We also propose a velocity selection strategy that includes the actual velocity capacity of the motor, according to the velocity ratio [Formula: see text], to keep the robot working in safe region and decrease the energy dissipation. This selection strategy considers three situations of the velocity ratio [Formula: see text] and has a wide range of application. Simulations are conducted to compare the proposed method with the sinusoidal control and loss minimization control (minimization of copper losses of the motor), and results are discussed in this paper.

  9. [The etiologic diversity of vaginitis]. (United States)

    Bohbot, J-M; Sednaoui, P; Verriere, F; Achhammer, I


    To establish the different etiologies of vaginitis and, especially, assess the distribution of responsible pathogens through a prospective study. One hundred and sixty-nine women aged between 18 and 65 years (average age: 33.7 years old), consulting a physician for symptoms of vaginitis, were examined in 21 centers of gynaecology or infectious diseases. The clinical evaluation was completed by bacteriological sample that was tested for infections (including sexually transmitted infections (STIs)). One hundred and eighteen patients (69.8%) had one or several infectious etiologies distributed as follows: 79 (46.7%) candidiasis (3 of which were caused by non albicans Candida), 37 (21.9%) bacterial vaginitis and 16 (9.5%) bacterial vaginosis. To be noticed that there were 38 cases of mixed etiologies out of the 118 infectious etiologies (32.2%), 3 of them were STIs. Although candidiasis was the most common etiology in this study, it only represented less than 1 out of every two patients. Among the infectious etiologies, 1 out of 3 women presented a bacterial or mixed vaginitis. The etiological diversity of vaginitis leads to consider broad-spectrum treatment as first-line therapy and to prescribe a microbiological analysis in case of failure. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. Training aircraft design considerations based on the successive organization of perception in manual control (United States)

    Heffley, R. K.; Clement, W. F.; Craig, S. J.


    The thesis that pilot skill development in the Navy approach and landing task is very strongly tied to the aircraft closure rate and, therefore, that pilot training for this task should be based on an appropriate progression closure rate is considered. A rational and explicit determination of design point approach speeds as well as other important aerodynamic features for training aircraft is also considered. Two keys are discussed: recognition of the significance of transitioning from a purely compensatory control loop technique to one involving a pursuit crossfeed between throttle and pitch attitude, and addressing the terminal flight path adjustment in terms of range-to-go.

  11. Consideration of three arenas of social control for the treatment and management of sexual offenders. (United States)

    Kirby, S D


    This paper sets out to explore the influences of social control upon the discourse relating to treatment and management of sexual offenders. This discussion takes as its foci three environmental arenas (social, penal/judicial and health care), and examines their influences and culpability within this context. It is not the intention of this article to present, nor does it arrive at, any answers to the perpetual concerns of treatment and management of this offender group, preferring to leave it to the individual reader to draw their own conclusions. It is accepted that there is no gender demarcation amongst sexual offenders, though in this paper, the masculine tense is used.

  12. Etiology of temporomandibular disorder pain. (United States)

    Oral, Koray; Bal Küçük, Burcu; Ebeoğlu, Buğçe; Dinçer, Sibel


    Pain in the masticatory muscles and temporomandibular joint is the main symptom of temporomandibular disorders. The etiology of temporomandibular disorder pain is multifactorial. Several studies have reported that there are predisposing, initiating and aggravating factors contributing to this disorder. Although factors such as trauma, occlusal discrepancies, stress, parafunctions, hypermobility, age, gender, and heredity have been implicated in the maintenance of temporomandibular disorder pain, there are still controversies regarding the actual etiology. This review will summarize the past and current concepts related to the etiology of arthrogenic- and myogenic-originated temporomandibular pain.

  13. Development of controlled release tablet by optimizing HPMC: consideration of theoretical release and RSM. (United States)

    Pani, Nihar R; Nath, Lila K


    The objective of the study was to develop controlled release tablets of nateglinide, a meglitinide derivative anti-diabetic drug, considering theoretical release profile and response surface methodology (RSM). 3(2) factorial design was utilized to optimize concentration of hydroxylpropylmethylcellulose (HPMC) K15M and K100M to obtain the desired responses (drug release at one and six hours). Theoretical release profile of drug for controlled release formulation was calculated and considered as reference for the determination of similarity factor (f2) and desimilarity factor (f1). RSM, f2 and f1 were used to select the optimum formulation. Formulation containing HPMC K15M (5%) and HPMC K100M (15%) was found optimum with desired responses with f2=86.05 and drug release profile followed zero order kinetics. Excipients used were compatible with drug, confirmed initially through DSC and IST study. The optimization of experiments was validated and optimum formulation was passed the stability study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. The 'control' question 'test' (CQT) polygrapher's dilemma: logico-ethical considerations for psychophysiological practitioners and researchers. (United States)

    Furedy, J J


    The so-called 'control' question 'test' (CQT) has been criticized on methodological and ethical grounds by psychophysiologists. The ethical analyses have focussed on the possibility that the CQT's interrogative features may elicit false confessions, but an empirical problem is that the rate of these false confessions is difficult to establish. In this conceptual note, this author raises a logico-ethical problem for the CQT, called the Polygrapher's Dilemma (PD). The two horns of the PD are to damage the innocent examinee classified as deceptive and damage to those examinees' psychological well being who are classified as non-deceptive to the relevant questions and who are not even debriefed concerning their feelings of unease about issues raised by the comparison, so-called 'control' questions. Although there may be arguments about which of the PD's two horns are more serious, there is no doubt that both are, in an absolute sense, ethically negative. Nor is there an ethically justifiable third alternative available. It is also contended that not only practitioners but also researchers (who use the CQT in laboratory, 'mock-crime' situations) are affected by PD. Finally, it is noted that PD exists only for the CQT procedure and not for the more standardized and scientifically based Guilty Knowledge Technique.

  15. The redox control of photorespiration: from biochemical and physiological aspects to biotechnological considerations. (United States)

    Keech, Olivier; Gardeström, Per; Kleczkowski, Leszek A; Rouhier, Nicolas


    Photorespiration is a complex and tightly regulated process occurring in photosynthetic organisms. This process can alter the cellular redox balance, notably via the production and consumption of both reducing and oxidizing equivalents. Under certain circumstances, these equivalents, as well as reactive oxygen or nitrogen species, can become prominent in subcellular compartments involved in the photorespiratory process, eventually promoting oxidative post-translational modifications of proteins. Keeping these changes under tight control should therefore be of primary importance. In order to review the current state of knowledge about the redox control of photorespiration, we primarily performed a careful description of the known and potential redox-regulated or oxidation sensitive photorespiratory proteins, and examined in more details two interesting cases: the glycerate kinase and the glycine cleavage system. When possible, the potential impact and subsequent physiological regulations associated with these changes have been discussed. In a second part, we reviewed the extent to which photorespiration contributes to cellular redox homeostasis considering, in particular, the set of peripheral enzymes associated with the canonical photorespiratory pathway. Finally, some recent biotechnological strategies to circumvent photorespiration for future growth improvements are discussed in the light of these redox regulations. This article is protected by copyright. All rights reserved.

  16. Redox regulation of human sperm function: from the physiological control of sperm capacitation to the etiology of infertility and DNA damage in the germ line. (United States)

    Aitken, Robert J; Curry, Benjamin J


    Defective sperm function is the largest single defined cause of human infertility and one of the major reasons we are witnessing an exponential increase in the uptake of assisted conception therapy in the developed world. A major characteristic of defective human spermatozoa is the presence of large amounts of DNA damage, which is, in turn, associated with reduced fertility, increased rates of miscarriage, and an enhanced risk of disease in the offspring. This DNA damage is largely oxidative and is closely associated with defects in spermiogenesis. To explain the origins of this DNA damage, we postulate that spermiogenesis is disrupted by oxidative stress, leading to the creation of defective gametes with poorly remodeled chromatin that are particularly susceptible to free radical attack. To compound the problem, these defective cells have a tendency to undergo an unusual truncated form of apoptosis associated with high amounts of superoxide generation by the sperm mitochondria. This leads to significant oxidative DNA damage that eventually culminates in the DNA fragmentation we see in infertile patients. In light of the significance of oxidative stress in the etiology of defective sperm function, a variety of antioxidant therapies are now being assessed for their therapeutic potential.

  17. Age-related deficits in voluntary control over saccadic eye movements: consideration of electrical brain stimulation as a therapeutic strategy. (United States)

    Chen, Po Ling; Machado, Liana


    Sudden changes in our visual environment trigger reflexive eye movements, so automatically they often go unnoticed. Consequently, voluntary control over reflexive eye movements entails considerable effort. In relation to frontal-lobe deterioration, adult aging adversely impacts voluntary saccadic eye movement control in particular, which compromises effective performance of daily activities. Here, we review the nature of age-related changes in saccadic control, focusing primarily on the antisaccade task because of its assessment of 2 key age-sensitive control functions: reflexive saccade inhibition and voluntary saccade generation. With an ultimate view toward facilitating development of therapeutic strategies, we systematically review the neuroanatomy underpinning voluntary control over saccadic eye movements and natural mechanisms that kick in to compensate for age-related declines. We then explore the potential of noninvasive electrical brain stimulation to counteract aging deficits. Based on evidence that anodal transcranial direct current stimulation can confer a range of benefits specifically relevant to aging brains, we put forward this neuromodulation technique as a therapeutic strategy for improving voluntary saccadic eye movement control in older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Ethical considerations of randomized control trials with human participants in dentistry. A reflective analysis. (United States)

    Chen, Eric


    A potential conflict is built into the roles of dentists and researchers with regard to ethical principles such as beneficence, nonmaleficence, respect for autonomy, and justice. The practitioner has an obligation to do what is believed to be best for the individual patient: the dentist as researcher has an obligation to use rigorous experimental methods, including randomized control trials (RCTs) to discover what is best for patients generally, including the investigation of experimental modalities. This is the equipoise problem-how can a professional be assured of offering the most beneficial treatment available if only using approaches that have worked in the past? This essay explores the ethical foundations for this challenge and proposes a groundwork for balancing ethical obligations to patients and the needs for scientific and public health advances.

  19. Treatment of impulse control disorders in Parkinson's disease: Practical considerations and future directions. (United States)

    Ramirez-Zamora, Adolfo; Gee, Lucy; Boyd, James; Biller, José


    Impulse control disorders (ICDs) including compulsive gambling, buying, sexual behaviors, and eating occur relatively frequently in Parkinson disease (PD) with at least one ICD identified in 14% of PD patients in a large, multicenter, observational study. ICDs behaviors range widely in severity but can lead to catastrophic consequences, including financial ruin, divorce, loss of employment, and increased health risks. The main risk factor for ICDs in PD is the use of Dopamine agonists (DAs) and discontinuation of the offending agent is considered first line treatment. However, many patients do not tolerate this intervention as consequence of increased motor and psychiatric disability or appearance of DA withdrawal syndrome. In this article, we review current management strategies and emerging new interventions for treatment of ICDs in PD. Pharmacological treatment should be individualized based on patient's unique neuropsychiatric profile, social support, medical comorbidities, tolerability and motor symptoms.


    Directory of Open Access Journals (Sweden)

    Mark Dysinger


    Full Text Available As biomarkers grow in relevance for both the design and support of therapeutics and the clinical trials associated with them, there is an ever increasing need for accurate quantitation of these biochemical entities in biological matrices. While quantifying many biotherapeutics via ligand binding assay platforms can be fairly straightforward, biomarkers present some unique challenges that must be taken into account during assay development, validation and subsequent sample analysis. These challenges can be especially confounded by the relationship between two ligand binding assay tools: The regression curve and quality control samples. Due diligence must be performed to develop an assay that takes into account matrix vs. buffer effects and endogenous biomarker presence. Lack of diligence in these areas can lead to less than reliable results, thus potentially rendering the intended use of the assay moot.

  1. Design Considerations of Polishing Lap for Computer-Controlled Cylindrical Polishing Process (United States)

    Khan, Gufran S.; Gubarev, Mikhail; Speegle, Chet; Ramsey, Brian


    The future X-ray observatory missions, such as International X-ray Observatory, require grazing incidence replicated optics of extremely large collecting area (3 m2) in combination with angular resolution of less than 5 arcsec half-power diameter. The resolution of a mirror shell depends ultimately on the quality of the cylindrical mandrels from which they are being replicated. Mid-spatial-frequency axial figure error is a dominant contributor in the error budget of the mandrel. This paper presents our efforts to develop a deterministic cylindrical polishing process in order to keep the mid-spatial-frequency axial figure errors to a minimum. Simulation studies have been performed to optimize the operational parameters as well as the polishing lap configuration. Furthermore, depending upon the surface error profile, a model for localized polishing based on dwell time approach is developed. Using the inputs from the mathematical model, a mandrel, having conical approximated Wolter-1 geometry, has been polished on a newly developed computer-controlled cylindrical polishing machine. We report our first experimental results and discuss plans for further improvements in the polishing process.

  2. Denitrification in a large river: consideration of geomorphic controls on microbial activity and community structure. (United States)

    Tatariw, Corianne; Chapman, Elise L; Sponseller, Ryan A; Mortazavi, Behzad; Edmonds, Jennifer W


    Ecological theory argues that the controls over ecosystem processes are structured hierarchically, with broader-scale drivers acting as constraints over the interactions and dynamics at nested levels of organization. In river ecosystems, these interactions may arise from broadscale variation in channel form that directly shapes benthic habitat structure and indirectly constrains resource supply and biological activity within individual reaches. To evaluate these interactions, we identified sediment characteristics, water chemistry, and denitrifier community structure as factors influencing benthic denitrification rates in a sixth-order river that flows through two physiographic provinces and the transitional zone between them, each with distinct geomorphological properties. We found that denitrification rates tracked spatial changes in sediment characteristics and varied seasonally with expected trends in stream primary production. Highest rates were observed during the spring and summer seasons in the physiographic province dominated by fine-grained sediments, illustrating how large-scale changes in river structure can constrain the location of denitrification hotspots. In addition, nirS and nirK community structure each responded differently to variation in channel form, possibly due to changes in dissolved oxygen and organic matter supply. This shift in denitrifier community structure coincident with higher rates of N removal via denitrification suggests that microbial community structure may influence biogeochemical processes.

  3. Interface design and human factors considerations for model-based tight glycemic control in critical care. (United States)

    Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey


    Tight glycemic control (TGC) has shown benefits but has been difficult to implement. Model-based methods and computerized protocols offer the opportunity to improve TGC quality and compliance. This research presents an interface design to maximize compliance, minimize real and perceived clinical effort, and minimize error based on simple human factors and end user input. The graphical user interface (GUI) design is presented by construction based on a series of simple, short design criteria based on fundamental human factors engineering and includes the use of user feedback and focus groups comprising nursing staff at Christchurch Hospital. The overall design maximizes ease of use and minimizes (unnecessary) interaction and use. It is coupled to a protocol that allows nurse staff to select measurement intervals and thus self-manage workload. The overall GUI design is presented and requires only one data entry point per intervention cycle. The design and main interface are heavily focused on the nurse end users who are the predominant users, while additional detailed and longitudinal data, which are of interest to doctors guiding overall patient care, are available via tabs. This dichotomy of needs and interests based on the end user's immediate focus and goals shows how interfaces must adapt to offer different information to multiple types of users. The interface is designed to minimize real and perceived clinical effort, and ongoing pilot trials have reported high levels of acceptance. The overall design principles, approach, and testing methods are based on fundamental human factors principles designed to reduce user effort and error and are readily generalizable. © 2012 Diabetes Technology Society.

  4. Multi-layered controllable stiffness beams for morphing: energy, actuation force, and material strain considerations (United States)

    Murray, Gabriel; Gandhi, Farhan


    Morphing aerospace structures could benefit from the ability of structural elements to transition from a stiff load-bearing state to a relatively compliant state that can undergo large deformation at low actuation cost. The present paper focuses on multi-layered beams with controllable flexural stiffness—comprising polymer layers affixed to the surfaces of a base beam and cover layers, in turn, affixed to the surfaces of the polymer layers. Heating the polymer through the glass transition reduces its shear modulus, decouples the cover layers from the base beam and reduces the overall flexural stiffness. Although the stiffness and actuation force required to bend the beam reduce, the energy required to heat the polymer layer must also be considered. Results show that for beams with low slenderness ratios, relatively thick polymer layers, and cover layers whose extensional stiffness is high, the decoupling of the cover layers through softening of the polymer layers can result in flexural stiffness reductions of over 95%. The energy savings are also highest for these configurations, and will increase as the deformation of the beam increases. The decoupling of the cover layers from the base beam through the softening of the polymer reduces the axial strains in the cover layers significantly; otherwise material failure would prevent large deformation. Results show that when the polymer layer is stiff, the cover layers are the dominant contributors to the total energy in the beam, and the energy in the polymer layers is predominantly axial strain energy. When the polymer layers are softened the energy in the cover layers is a small contributor to the total energy which is dominated by energy in the base beam and shear strain energy in the polymer layer.

  5. Changing cluster composition in cluster randomised controlled trials: design and analysis considerations. (United States)

    Corrigan, Neil; Bankart, Michael J G; Gray, Laura J; Smith, Karen L


    There are many methodological challenges in the conduct and analysis of cluster randomised controlled trials, but one that has received little attention is that of post-randomisation changes to cluster composition. To illustrate this, we focus on the issue of cluster merging, considering the impact on the design, analysis and interpretation of trial outcomes. We explored the effects of merging clusters on study power using standard methods of power calculation. We assessed the potential impacts on study findings of both homogeneous cluster merges (involving clusters randomised to the same arm of a trial) and heterogeneous merges (involving clusters randomised to different arms of a trial) by simulation. To determine the impact on bias and precision of treatment effect estimates, we applied standard methods of analysis to different populations under analysis. Cluster merging produced a systematic reduction in study power. This effect depended on the number of merges and was most pronounced when variability in cluster size was at its greatest. Simulations demonstrate that the impact on analysis was minimal when cluster merges were homogeneous, with impact on study power being balanced by a change in observed intracluster correlation coefficient (ICC). We found a decrease in study power when cluster merges were heterogeneous, and the estimate of treatment effect was attenuated. Examples of cluster merges found in previously published reports of cluster randomised trials were typically homogeneous rather than heterogeneous. Simulations demonstrated that trial findings in such cases would be unbiased. However, simulations also showed that any heterogeneous cluster merges would introduce bias that would be hard to quantify, as well as having negative impacts on the precision of estimates obtained. Further methodological development is warranted to better determine how to analyse such trials appropriately. Interim recommendations include avoidance of cluster merges where

  6. CSF glutamate/GABA concentrations in pyridoxine-dependent seizures: etiology of pyridoxine-dependent seizures and the mechanisms of pyridoxine action in seizure control. (United States)

    Goto, T; Matsuo, N; Takahashi, T


    Several lines of evidence suggest that the binding affinity of glutamate decarboxylase (GAD) to the active form of pyridoxine is low in cases of pyridoxine-dependent seizures (PDS) and that a quantitative imbalance between excitatory (i.e. glutamate) and inhibitory (i.e. gamma-aminobutyric acid, GABA) neurotransmitters could cause refractory seizures. However, inconsistent findings with GAD insufficiency have been reported in PDS. We report a case of PDS that is not accompanied by an elevated cerebrospinal fluid (CSF) glutamate concentration. Intravenous pyridoxine phosphate terminated generalized seizures which were otherwise refractory to conventional anti-epileptic medicines. No seizure occurred once oral pyridoxine (13.5 mg/kg per day) was started in combination with phenobarbital sodium (PB, 3.7 mg/kg per day). The electroencephalogram (EEG) normalized approximately 8 months after pyridoxine was started. The patient is gradually acquiring developmental milestones during the 15 months follow-up period. The CSF glutamate and GABA concentrations were determined on three separate occasions: (1) during status epilepticus; (2) during a seizure-free period with administration of pyridoxine and PB; and (3) 6 days after suspension of pyridoxine and PB and immediately before a convulsion. The CSF glutamate level was below the sensitivity of detection (pyridoxine supplementation, were within the normal range. We suggest that (1) PDS is not a discrete disease of single etiology in that insufficient activation of GAD may not account for seizure susceptibility in all cases and (2) mechanism(s) of anti-convulsive effect of pyridoxine, at least in some cases, may be independent of GAD activation.

  7. Neuropsychiatric Symptoms in Patients with the Main Etiological Types of Mild Neurocognitive Disorders: A Hospital-Based Case–Control Study

    Directory of Open Access Journals (Sweden)

    Oleg A. Levada


    Full Text Available BackgroundThe diagnostic construct of mild neurocognitive disorders (MNCDs is substantially congruent with previously proposed criteria for mild cognitive impairment (MCI. MNCD/MCI is associated with neuropsychiatric symptoms (NPS. Previous studies have examined the prevalence of NPS in amnestic and non-amnestic MCI subtypes; however, no studies exist for etiological types of MNCD. We aimed to estimate the prevalence of NPS in patients with MNCD due to Alzheimer’s disease (MNCD-AD and subcortical vascular MNCD (ScVMNCD and to determine whether NPS would expand these MNCD phenotypes.MethodsThe sample comprised 70 patients with MNCD-AD, 70 patients with ScVMNCD, and 55 cognitively normal elderly persons (CNEP. The diagnosis of MNCD-AD was made according to DSM-5 criteria for possible MNCD-AD. ScVMNCD patients fulfilled the DSM-5 criteria of the probable vascular MNCD and the diagnostic criteria for subcortical vascular MCI according to Frisoni et al. (1. The prevalence of NPS was based on the neuropsychiatric inventory. The statistical analyses included parametric and non-parametric tests, multivariate regression, and Spearman’s correlation coefficient.ResultsAbout 69.1% of CNEP, 97.1% of MNCD-AD, and 100% of ScVMNCD patients had one or more NPS. The prevalence of NPS in both MNCD groups was significantly higher than that in CNEP. The most prevalent NPS that had significant differential diagnostic value in separating MNCD-AD from ScVMNCD, as well as MNCD from CNEP, were anxiety (81.43% and irritability (67.14% in MNCD-AD and depression (81.43% in ScVMNCD. In both MNCD groups, we observed significant (p < 0.05 correlations between all distinguishing NPS and the differential cognitive disturbances: the amnestic syndrome in MNCD-AD and executive dysfunction in ScVMNCD.ConclusionNPS occur in the majority of persons with MNCD-AD and ScVMNCD. Anxiety and irritability are the most prevalent NPS in MNCD-AD, as well as depression in ScVMNCD. The

  8. An etiological model of perfectionism.

    Directory of Open Access Journals (Sweden)

    Gayle K Maloney

    Full Text Available OBJECTIVE: Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. METHOD: The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. RESULTS: Structural equation modeling showed a direct relationship between high Parental Expectations and Criticism, and Perfectionism. There was also an indirect relationship between Parental Bonding and Perfectionism that was mediated by core schemas of disconnection and rejection. Finally, it was found that Neuroticism had both an indirect relationship, which was mediated by core schemas, and a direct relationship with perfectionism. CONCLUSIONS: The study provided the first direct test of an etiological model of perfectionism to date. Clinical implications include investigating whether the inclusion of etiological factors in the understanding and treatment of perfectionism is effective.

  9. Chest neoplasms with infectious etiologies. (United States)

    Restrepo, Carlos S; Chen, Melissa M; Martinez-Jimenez, Santiago; Carrillo, Jorge; Restrepo, Catalina


    A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi's sarcoma, Castleman's disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist.

  10. [granulomatous Diseases Of Occupational Etiology].


    Bagatin, Ericson; Pereira, Carlos Alberto de Costa; Afiune,Jorge Barros


    A variety of diseases are encompassed in the didactic denomination of granulomatous diseases of probable occupational etiology. As well as presenting similar clinical aspects, such diseases are characterized by certain common traits: formation of granulomas; systemic and respiratory manifestations; environmental or occupational exposure to organic or inorganic agents; and T lymphocyte involvement in the pathogenesis. Included in this category are hypersensitivity pneumonitis, mycobacteriosis ...

  11. Ictal kissing: occurrence and etiology. (United States)

    Asadi-Pooya, Ali A; Fletman, Elizabeth W


    Ictal kissing is a rare semiological manifestation in patients with epilepsy. We tried to estimate its occurrence and characterize the underlying etiology. We retrospectively reviewed all video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "kiss". We then searched the electronic database PubMed on September 21, 2016 using the following search terms in the English language: "ictal" OR "seizure" OR "epilepsy" AND "kiss" OR "kissing". Relevant original studies were included. During the study period, 5133 patients were investigated in our epilepsy monitoring unit. One patient (0.02%) had one episode of documented ictal kissing. He had drug-resistant right mesial temporal lobe epilepsy. In total, five studies met the criteria for inclusion in the review. These studies described nine patients with drug-resistant focal epilepsy and ictal kissing behavior. Six out of ten patients with ictal kissing had hippocampal sclerosis. We add to the literature on ictal kissing by providing additional information on its frequency and etiology. The most common underlying etiology for ictal kissing is hippocampal sclerosis. However, this semiological ictal phenomenon is not pathognomonic for any etiology or localization.

  12. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie’s disease? Analysis in 279 patients with a control group in Sicily

    Directory of Open Access Journals (Sweden)

    Carlo Pavone


    Full Text Available Objective: To assess the proportion of patients with Peyronie’s Disease (PD and the possible association with its potential risk factors in the general population of the central and western Sicily in our weekly andrological outpatient clinic. Materials and methods: We recruited a sample of 279 consecutive patients consulting our andrological outpatient clinic. Two arms were created: the first one composed by PD patients (men with symptoms suggestive for PD, the second one composed by patients with other andrological diseases (control arm. For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function. In the PD arm we administered validated questionnaires to determine the erectile function status by the International Index of Erectile Function 5 (IIEF-5 and the pain status during erection by the Visual Analogue Scale (VAS. A univariate analysis was conducted using R software. Results: We enrolled 279 consecutive patients. The number of PD patients was 97 (34,7%. The univariate analysis showed a correlation between PD and cigarette smoking (p = 0.0242, blood hypertension (p < 0.001, erectile dysfunction (p < 0.001. No significant association was observed between diabetes and PD (p = 0.358. The median age of PD arm was 60 years and the median age of the control arm was 63,5 years; therefore the median age of PD arm resulted lower than the median age of the control arm (p = 0,031. Conclusions: Peyronie’s disease is more common than we might think; furthermore it can be diagnosed among young patients. According to our results, cigarette smoking and blood hypertension may be considered statically significant risk factors for developing PD. On the contrary diabetes seems not to be a risk factor for PD. According to our results PD should be sought also in young patients. Further studies are necessary to confirm that removing the indicated risk factors may reduce the incidence of PD.

  13. Active placebo control groups of pharmacological interventions were rarely used but merited serious consideration: a methodological overview. (United States)

    Jensen, Jakob Solgaard; Bielefeldt, Andreas Ørsted; Hróbjartsson, Asbjørn


    active placebo control interventions are rarely used in randomized clinical trials, but they constitute a methodological tool which merits serious consideration. We suggest that active placebos are used more often in trials of drugs with noticeable side effects, especially in situations where the expected therapeutic effects are modest and the risk of bias due to unblinding is high. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. HIV treatment as prevention: considerations in the design, conduct, and analysis of cluster randomized controlled trials of combination HIV prevention.

    Directory of Open Access Journals (Sweden)

    Marie-Claude Boily

    Full Text Available The rigorous evaluation of the impact of combination HIV prevention packages at the population level will be critical for the future of HIV prevention. In this review, we discuss important considerations for the design and interpretation of cluster randomized controlled trials (C-RCTs of combination prevention interventions. We focus on three large C-RCTs that will start soon and are designed to test the hypothesis that combination prevention packages, including expanded access to antiretroviral therapy, can substantially reduce HIV incidence. Using a general framework to integrate mathematical modelling analysis into the design, conduct, and analysis of C-RCTs will complement traditional statistical analyses and strengthen the evaluation of the interventions. Importantly, even with combination interventions, it may be challenging to substantially reduce HIV incidence over the 2- to 3-y duration of a C-RCT, unless interventions are scaled up rapidly and key populations are reached. Thus, we propose the innovative use of mathematical modelling to conduct interim analyses, when interim HIV incidence data are not available, to allow the ongoing trials to be modified or adapted to reduce the likelihood of inconclusive outcomes. The preplanned, interactive use of mathematical models during C-RCTs will also provide a valuable opportunity to validate and refine model projections.

  15. Greater sensitivity to novelty in rats is associated with increased motor impulsivity following repeated exposure to a stimulating environment: implications for the etiology of impulse control deficits. (United States)

    Ferland, Jacqueline-Marie N; Zeeb, Fiona D; Yu, Katrina; Kaur, Sukhbir; Taves, Matthew D; Winstanley, Catharine A


    Heightened motor impulsivity and increased novelty-seeking commonly co-occur in psychiatric disorders, including drug addiction. However, the relationship between these two phenomena remains unclear. One-time tests of novelty sensitivity commonly used in preclinical experiments, such as the open-field or novel-object test, fail to capture the fact that novelty-seekers repeatedly experience novel, stimulating situations. The present study therefore investigated whether repeated exposure to a novel, stimulating environment (SE) altered impulsive action. Male Long-Evans rats were trained to perform the five-choice serial reaction time task (5CSRTT) which measures motor impulsivity in the form of premature responding as well as attention and motivation. Animals were then exposed to a novel SE (1 h/day for 16 days) immediately prior to the 5CSRTT. Significant increases in premature responding were observed in a subgroup of reactive animals termed high responders (HR-SE). These rats were not more impulsive at baseline, and levels of impulsivity normalised once exposure to the SE was discontinued. No other aspect of 5CSRTT performance was affected by the SE challenge. We also determined that HR-SE rats were hyperactive in a novel environment. Biochemical analyses revealed changes in gene and protein expression within the dorsal hippocampus of HR-SE rats, including decreases in mRNA encoding the dopamine D1 receptor and brain-derived neurotrophic factor. These results indicate a novel mechanism by which impulsivity and novelty-reactivity interact that may enhance addiction vulnerability synergistically. Furthermore, studying such context-induced impulsivity may provide insight into the process by which environmental load precipitates psychiatric symptoms in impulse control disorders.

  16. Contact vitiligo: etiology and treatment

    Directory of Open Access Journals (Sweden)

    Singh P


    Full Text Available Fifty patients of contact vitiligo were studied. EtiologicaI agents of contact vitiligo were identified by clinical history, distribution of lesions and patch testing with suspected material. All patients were advised to avoid the suspected agent and treated with PUVASOL and topical steroid. Out of 50 patients (Male 8%, Female 92% age 14-60 years., etiological agent of contact vitiligo was found to be sticking bindi alone in 24 (48%, while bindi along with other etiological agents were found to be purse, foot wear, plastic watch strap, lipstick and tooth paste in 14 ( 28% cases. 14 (28% patients also had disseminated lesions of vitiligo along with contact vitiligo. Positive reaction with patch testing was observed in 18 (36% while depigmentation was seen in 4 ( 8% cases. We observed that response of treatment was better in patients with shorter duration of disease while poor response was seen in patients with longer duration of disease.

  17. [Etiological factors of myelodysplastic syndromes]. (United States)

    Nisse, C


    Specific epidemiologic data on myelodysplastic syndromes are rare. Analysis of data is in fact affected by problems of terminology and classification. The link between the exposure to ionizing radiation or alkylating agents and MDS is well established. Etiologic factors of acute leukemia, or new factors such as non ionizing radiation, solvent, ethylene oxide, glycol eters, tobacco smoke, exhaust gases, agricultural work have been hypothesized but should be confirmed by other studies on MDS.


    Turovskiy, Yevgeniy; Noll, Katia Sutyak; Chikindas, Michael L.


    Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV, however due to the complexity of BV and due to lack of a reliable animal model for this condition, its exact etiology remains elusive. In this manuscript we use a historical perspective to critically review the development of major theories on the etiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the etiology of BV is pivotal to formulation of an effective treatment for and prophylaxis of this condition. PMID:21332897

  19. Concepts as elements for consideration of safety-related automatic control; Begriffe als Betrachtungsgrundlagen der sicherheitsgerichteten Automatisierungstechnik

    Energy Technology Data Exchange (ETDEWEB)

    Schrick, D. van [Wuppertal Univ. (Gesamthochschule) (Germany). Fachbereich 14 - Sicherheitstechnik


    After referring to a survey article by L. Litz on the fundamentals of safety-related automatic control published in the at-Volume 2/98, the relevance of a supplementarily detailed discussion of the concepts fault, failure, disturbance, default and concepts associated to them is emphasized. The systematic field-overlapping structuring of the relevant set of concepts for non-desired technical phenomena in technical systems is carried out with symbols for such phenomena and, with respect to the aspects causality, temporality, modality and locality, it is described thereafter. The symbol-based and aspect-dependent structuring of concepts results from considerations of the definitions for the concepts of the relevant set of concepts given in German-language guidelines and standards. The result of the guideline and standard-overlapping structuring of concepts reveals the opportunity for an adaptation of the results of standardization to a field-overlapping use of language by consensus. (orig.) [German] Nach Bezugnahme auf den im at-Schwerpunktheft 2/98 erschienen Uebersichtsartikel von L. Litz zu den Grundlagen der sicherheitsgerichteten Automatisierungstechnik, wird die Bedeutsamkeit einer ergaenzenden ausfuehrlichen Diskussion der Begriffe Fehler, Ausfall, Stoerung, Versagen und der mit ihnen assoziierten Begriffe fuer nichterwuenschte technische Phaenomene in technischen Systemen hervorgehoben. Die systematische fachuebergreifende Ordnung der relevanten Begriffsmenge erfolgt mit Symbolen fuer diese Phaenomene und wird hinsichtlich der Aspekte Kausalitaet, Temporalitaet, Modalitaet und Lokalitaet anschliessend beschrieben. Die symbolgestuetzte und aspektabhaengige Begriffsordnung ergibt sich unter Beruecksichtigung der in den deutschsprachigen Richtlinien und Normen angegebenen Definitionen fuer Begriffe der relevanten Begriffsmenge. Das Ergebnis der richtlinien- und normenuebergreifenden Begriffsordnung offenbart eine Moeglichkeit zur Anpassung der Normungsergebnisse

  20. [Syndroma caudae equinae of rare etiology]. (United States)

    Lukác, I; Sulla, I J


    The results of treatment patients suffering from syndroma caudae equinae (SCE) are not generally satisfactory. The authors decided to evaluate occurrence according to etiology and permanent consequences after treatment in patients that were treated at the Department of Neurosurgery P. J. Safarik University Hospital in Kosice during 12 years (1996-2007). 95 patients from the 101 members file had SCE caused by disc herniation or spinal stenosis. Rare etiology of SCE was found in the six cases: three had traumatic origin, one spinal epidural abscess, one tumor. SCE developed after surgery of intervetebral disc herniation in one patient. Patients underwent control examination or answered by a questionnaire one year from the beginning of SCE or later. Three patients with traumatic SCE had the moderate residual problems. One patient suffered from intermittent pain, perianogenital hypesthesia had two patients, light motor deficit another one. One patient needs to use increased abdominal pressure for urination. Nobody from this subgroup had sexual difficulties or problems with anal spincters' control. The result of treatment patient with SCE caused by spinal epidural abscess was unfavourable. Permanent pain, perianogenital hypesthesia, hard motor deficit and loss of sexual functions persisted. Patient with oncological SCE had deficit in every traced signs. Similar clinical picture was in a patient with postoperative SCE, but residual deficit was moderate.

  1. The etiology of pelvic inflammatory disease. (United States)

    Keith, L; Berger, G S


    The etiology of pelvic inflammatory disease (PID) is speculated upon based on reported incidence and epidemiological studies. In Western society, the incidence of PID (annual) is 1% among women aged 15-34 years and 2% in the high risk group of women aged 15-24 years. The annual incidence in the US is higher, at least 2% among fecund sexually active women aged 13-44 years. The medical consequences of PID are infertility, ectopic pregnancy, and chronic pelvic pain. Causative agents include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and various other aerobic and anaerobic microorganisms; however, the natural genital flora of females is so varied that determining actual causative agents is difficult. some case-control studies have determined risk factors for PID; these include particularly current or prior use of IUD, prior pelvic surgery, sexual activity (including number of partners), race, and prior PID acute infection. PID is not a sexually transmitted disease, but rather is classified as sexually derived. Use of barrier methods and oral contraceptives protects against PID. IUD use greatly increases the risk of PID, probably because of the avenue the device provides for organisms to ascend from the lower to the upper genital tract. The role of males in PID etiology is currently the subject of much discussion. It is theorized that the mechanical action of penis insertion in intercourse helps to move causative agents to the upper genital region; also, semen may carry vaginal flora through the cervical opening into the uterus and tubes. Menstruation and PID are closely associated, perhaps because the cervix dilates during bleedings. Research areas include: determination of role of sexual activity (and number of partners) in PID etiology; evaluation of events of menstruation that are predisposing; evaluation of relationship between bacteriosperma and lower and upper genital infections; relationship of particular contraceptive methods to PID

  2. Intrathoracic neoplasia: Epidemiology and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.


    Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

  3. [Asteatotic dermatitis: etiology and pathogenesis]. (United States)

    Zhou, Li-juan; Lyu, Zhong-fa


    Asteatotic dermatitis (AsD) is a common skin disease characterized by dry skin, itching, erythema, peeling and other skin lesions. It results from the damage in cutaneous barrier related to age, seasonal climate and bathing habits, and presents dysfunction of sebaceous, sweat glands and the increase of transepidermal water loss. The pathogenesis of AsD is not clear. Previous studies mainly focused on the relationship between skin barrier damage and bathing habits, age or gender. Recently, more studies focus on its relationship with other systematic diseases and drugs. This paper reviews etiology and pathogenesis of AsD to provide new ideas for the diagnosis and treatment of AsD.

  4. Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study

    Directory of Open Access Journals (Sweden)

    Grant Adrian M


    Full Text Available Abstract Background Securing and managing finances for multicentre randomised controlled trials is a highly complex activity which is rarely considered in the research literature. This paper describes the process of financial negotiation and the impact of financial considerations in four UK multicentre trials. These trials had met, or were on schedule to meet, recruitment targets agreed with their public-sector funders. The trials were considered within a larger study examining factors which might be associated with trial recruitment (STEPS. Methods In-depth semi-structured telephone interviews were conducted in 2003–04 with 45 individuals with various responsibilities to one of the four trials. Interviewees were recruited through purposive and then snowball sampling. Interview transcripts were analysed with the assistance of the qualitative package Atlas-ti. Results The data suggest that the UK system of dividing funds into research, treatment and NHS support costs brought the trial teams into complicated negotiations with multiple funders. The divisions were somewhat malleable and the funding system was used differently in each trial. The fact that all funders had the potential to influence and shape the trials considered here was an important issue as the perspectives of applicants and funders could diverge. The extent and range of industry involvement in non-industry-led trials was striking. Three broad periods of financial work (foundation, maintenance, and resourcing completion were identified. From development to completion of a trial, the trialists had to be resourceful and flexible, adapting to changing internal and external circumstances. In each period, trialists and collaborators could face changing costs and challenges. Each trial extended the recruitment period; three required funding extensions from MRC or HTA. Conclusion This study highlights complex financial aspects of planning and conducting trials, especially where multiple

  5. Etiological characteristics and treatment of tardive dyskinesia

    Institute of Scientific and Technical Information of China (English)

    Zhe Li; Xueli Sun; Che Zhou


    OBJECTIVE:The pathogenesis of tardive dyskinesia(TD)is complicated and uncertain.Thus,there is not any effective treatment for it.The psychiatrists pay more and more attention to TD,which lasts for a long time and is difficult to treat.DATA SOURCES: A computer-based online search of Medline database was undertaken to jdentify articles about the feature of etiology and the progression of treatment for TD published in English by using the keywords of"TD,etiology.pathogenesis"and"TD,therapy,drug treatment".Meanwhile,Chinese articles about the feature of etiologY and the progression of treatment for TD were searched in Wanfang database and China joumal full-text database,and the keywords were"TD,etiology,pathogenesis"and"TD,therapy,drug Treatment".-in Chinese.STUDY SELECTION:Articles met the following inclusion cdteda were selected in this paper.Inclusion cdteda:①Researches of randomized blind control design,before and after control design and retrospective.②Researches of the feature of etiology and the progression of treatment for TD.Exclusion cdteda:the repetitive researches and individual reports,DATA EXTRACTION:Totally 65 articles related the feature of etiology and the progression of treatment for TD of randomized blind control design,before and after control design and retrospective studies were collected,and 53 of them were accorded with the inclusion criteda.Of the 12 excluded ones,8 were concerning with genetics,4 were repetitive researches.DATA SYNTHESIS:The feature of etiology for TD includes:①Hypothesis of dopamine receptor super-sensitivity:The dopamine recaptor is persistently blocked,so it wi¨result in functional disorder in CNS,and then TD may take place.②Hypothesis of neuronal degeneration:The concentration of aminosucoinic acid and glutamic acid wi¨;ncrease after the antipsychotic used for a Iong time and this wilI result in neuronal degeneration through glutamic acid receptor in the postsynaptic membrane;meanwhile with free radical

  6. [Etiological factors of acute pancreatitis]. (United States)

    Spicák, J


    Acute pancreatitis develops immediately after the causative impulse, while chronic pancreatitis develops after the long-term action of the noxious agent. A typical representative of acute pancreatitis is biliary pancreatitis, chronic pancreatitis develops in alcoholism and has a long latency. As alcoholic pancreatitis is manifested at first as a rule by a potent attack, it is classified in this stage as acute pancreatitis. The most frequent etiological factors in our civilization are thus cholelithiasis and alcoholism (both account for 20-50% in different studies). The assumed pathogenetic principles in acute biliary pancreatitis are the common canal of both efferent ducts above the obturated papilla, duodenopancreatic reflux and intrapancreatic hypertension. A detailed interpretation is however lacking. The pathogenesis of alcoholic pancreatitis is more complicated. Among others some part is played by changes in the calcium concentration and fusion of cellular membranes. Idiopathic pancreatitis occurs in up to 10%, part of the are due to undiagnosed alcoholism and cholelithiasis. Other etiologies are exceptional. Similarly as in cholelithiasis pancreatitis develops also during other pathological processes in the area of the papilla of Vater such as dysfunction of the sphincter of Oddi, ampulloma and juxtapapillary diverticulum, it is however usually mild. The incidence of postoperative pancreatitis is declining. Its lethality is 30% and the diagnosis is difficult. In the pathogenesis changes of the ion concentration are involved, hypoxia and mechanical disorders of the integrity of the gland. Pancreatitis develops in association with other infections--frequently in mumps, rarely in hepatitis, tuberculosis, typhoid and mycoses. Viral pancreatitis is usually mild. In parasitoses pancreatitis develops due to a block of the papilla Vateri. In hyperparathyroidism chronic pancreatitis is more likely to develop, recent data are lacking. As to dyslipoproteinaemias

  7. Etiological diagnosis of pericardial effusion. (United States)

    Levy, Pierre-Yves; Habib, Gilbert; Collart, Fréderic; Lepidi, Hubert; Raoult, Didier


    Detection and treatment of pericarditis remains a challenging problem and the etiology is unknown in 40-85% of cases. As a result, a large proportion of cases are labeled idiopathic pericarditis. The advent of echocardiography, an accurate noninvasive method for the detection of effusion, has clarified the definition from pericarditis to pericardial effusion, which is a standardized and clear entity. A systematic approach to diagnostic testing based on standardized practice guidelines has been proposed. This strategy has led to a decrease in the number of cases classified as idiopathic and to the identification of treatable conditions. Percutaneous pericardiocentesis, guided by fluoroscopy or echocardiography, can now be carried out safely and rapidly and has also allowed the intrapericardial instillation of drugs, representing a new treatment strategy. The inclusion of flexible pericardioscopy, immunohistochemistry and contemporary molecular biology tools has improved the diagnostic value of the biopsy.

  8. Etiological factors of psoas abscesses

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    Mehmet Nuri Bodakçi


    Full Text Available Objective: Psoas abscess (PA is a rare infection disease, which is difficult to diagnose. In the present study, we aimed to evaluate etiological factors and treatment results of patients with PA. Methods: Files of 20 patients who were diagnosed as PA between December 2006 and January 2013, were retrospectively analyzed. Patient’s whose data were entirely reached and diagnosed by Ultrasonography and/or Computed Tomography as an exact PA were included to the study. Results: The mean age of the 20 patients was 48.8 (range 17-82 year, and 6 of them were female and remaining were male. Psoas abscess were on the right side in 12 patients (60%, on the left side in seven patients (35%, and bilateral in one (5%. According to data records four patients had Diabetes Mellitus (20%, two had Hypertension (10%, one had cerebrovascular disease (5%, one had tuberculosis (5%, one had hyperthyroidism (5%, one had mental retardation (5%, and one had paraplegia (5%. Six case (30% were diagnosed as a primary psoas abscess (pPA, sPA and remaining (n=14, %70 were diagnosed as secondary. Percutaneous drainage was performed to 13 patients (65% and exploration was performed to three patients (15% as a treatment modality. Remaining four patients (20% were followed by medical treatment. Conclusion: Psoas abscess is rare and have variable and non-specific clinical characteristic, which may lead to difficulty in diagnosis. In developed and developing countries, it has been reported that the most common causes of sPA are Pott's disease, and Crohn's disease, also it should be taken into account that open surgery and urinary tract stone disease can receive a significant portion of the etiological factors. J Clin Exp Invest 2014; 5 (1: 59-63

  9. The Pathophysiology and Etiology of Vaginismus

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    Cherng-Jye Jeng


    Full Text Available Vaginismus is defined as an involuntary spasm of the pelvic muscles surrounding the outer third of the vagina, especially the perineal muscles and the levator ani muscles. Its severe form usually makes penetration virtually impossible and causes a severe, burning pain, and leads to unconsummated marriage. There appears to be basic agreement that vaginismus is a psychosociologic disorder with phobic elements resulting from actual or imagined negative experiences with penetration attempts. Fear and anxiety concerning penetration is expressed physiologically via the involuntary vaginal muscle spasm that characterizes vaginismus. Since 1547, when vaginismus was first described, thousands of research papers have been published on this female sexual disorder. However, the etiology of vaginismus remains controversial. Women with vaginismus generally experience shame, disgust and dislike toward their genitals. They frequently have or have had other phobias. They are usually overprotected by their fathers and have been “good girls” since childhood. Their sexual partners are usually kind, gentle, considerate and passive “nice guys”. The male partner's lack of aggressiveness actually leads to unconsummation of the marriage. The sexually secure husband can usually overcome mild degrees of vaginismus by persistent but firm penile insertion. For moderate to severe degrees of vaginismus, medical intervention is usually necessary to lead to consummation of the marriage.

  10. Frequency and Etiology of ADHD in New Onset Epilepsy



    The prevalence, complications and etiology of ADHD were determined in 75 children (age 8-18 years) with new/recent onset idiopathic epilepsy nd 62 healthy first-degree cousin controls, in a study at University of Wisconsin School of Medicine and Public Health, Madison, WI; and Rosalind Franklin University of Medicine and Science, North Chicago, IL.

  11. Frequency and Etiology of ADHD in New Onset Epilepsy

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    J Gordon Millichap


    Full Text Available The prevalence, complications and etiology of ADHD were determined in 75 children (age 8-18 years with new/recent onset idiopathic epilepsy nd 62 healthy first-degree cousin controls, in a study at University of Wisconsin School of Medicine and Public Health, Madison, WI; and Rosalind Franklin University of Medicine and Science, North Chicago, IL.

  12. Assessment of Vitamin D status In Patients of Chronic Low Back Pain of Unknown Etiology


    Lodh, Moushumi; Goswami, Binita; Mahajan, Rajni Dawar; Sen, Dipankar; Jajodia, Nirmal; Roy, Abhishek


    Low back pain is very disabling and dispiriting because of the physical impediment it causes and its psychological effects. Innumerable factors have been implicated in its etiology. In spite of improvements in diagnostic modalities, a considerable number of such cases fall in the ambiguous zone of unknown etiology or ‘idiopathic.’Early diagnosis of low back pain will allow effective prevention and treatment to be offered. This study was conducted to assess the contribution of vitamin D levels...

  13. Pyogenic liver abscess: Differences in etiology and treatment in Southeast Asia and Central Europe

    Institute of Scientific and Technical Information of China (English)

    Herwig; Cerwenka


    Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology.In this article,we aim to elaborate these differences and their therapeutic implications.Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA),there ...


    Directory of Open Access Journals (Sweden)

    E. V. Simonova


    Full Text Available Based on the literature data and our personal observations in the article discusses the types of variants of the course of nervous system caused by herpesviruses. In the description of a clinical case demonstrated a classic example of limbic encephalitis infectious etiology. The study involved 36 children with various neurological and infectious diseases: 19 children with the diagnosis - convulsions, 8 children with the diagnosis — epilepsy, 5 children with acute viral encephalitis, 3 children with neuropathies. It was established that in the genesis of diseases such as epilepsy, convulsive syndrome, limbic encephalitis, neuropathy peripheral nerves leading role belongs to of herpes virus infection, in which the dominant role belongs HHV-6 infection. Pathogenetically proved the impact of the virus on the receptor apparatus of glia with the disorder of the functional state of mitochondria of these cells. According to our own observations provided data that result in persistence of HHV-6 variant-in mono or in combination with other herpesviruses growing threat of epilepsy and other neurological disorders. 

  15. Syncope: epidemiology, etiology and prognosis.

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    Rose M F Lisboa Da Silva


    Full Text Available Syncope is a common medical problem, with a frequency between 15% and 39%. In the general population, the annual number episodes are 18.1 to 39.7 per 1000 patients, with similar incidence between genders. The first report of the incidence of syncope is 6.2 per 1000 person-years. However, there is a significant increase in the incidence of syncope after 70 years of age with rate annual 19.5 per thousand individuals after 80 years. It presents a recurrence rate of 35% and 29% of physical injury. Among the causes of syncope, the mediated neural reflex, known as neurocardiogenic or vasovagal syncope, is the most frequent. The others are of cardiac origin, orthostatic hypotension, carotid sinus hypersensitivity, neurological and endocrinological causes and psychiatric disorders. The diagnosis of syncope can be made by clinical method associated with the electrocardiogram in up 50% of patients. Its prognosis is determined by the underlying etiology specifically the presence and severity of cardiac disease. The annual mortality can reach between 18 and 33% if cardiac cause, and between 0 and 12% if the noncardiac cause. Thus, it is imperative to identify its cause and risk stratification for positive impact in reducing morbidity and mortality.


    Farfán F G, Gustavo


    Chronic Diarrhea syndrome is due to several causes. In LatinAmericen countries, infectious and parasitic etiology is frequent. Withinthese infections, the following has been determined: parasitic and enterobacterial agents, overpopulation of bacteria syndrome in the upper small bowel (SOBIA, abbreviation for Síndrome de Sobrepoblación Bacteriana del Intestino Delgado Alto), intestinal TBC, and AIDS. In these processes, the precipitating factor may be unique or multifactor; or there could also exist a tendency towards pathologies for these infections. There has been evidence of SOBIA cases without associated factor in Latin American countries. A study made in Peru shows SOBIA cases in 30 percent of chronic diarrhea.In chronic diarrhea cases, and even more, in those diarrheas of infectiousetiology, a complete study should be made, considering the several factorsthat generate diarrhea in a same one case, such as the mechanisms ofimmunodeficiency, neurological, endocrinemetabolic, and others associated with intestinal infections. This approach will be helpful to make a complete diagnosis and apply timely treatment.

  17. Angioedema: Clinical and Etiological Aspects

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    Kanokvalai Kulthanan


    Full Text Available Angioedema is an abrupt swelling of the skin, mucous membrane, or both including respiratory and gastrointestinal tracts. This study aimed to report an experience of angioedema in a university hospital with respect to etiologies, clinical features, treatment, and outcome. One hundred and five patients were enrolled. About half had angioedema without urticaria. The common sites of involvement were periorbital area and lips. Forty five patients (49% had systemic symptoms. The most common cause of angioedema was allergic angioedema. Nonsteroidal anti-inflammatory drug-induced angioedema and idiopathic angioedema were detected in 20% and 18%, respectively. Among patients with allergic angioedema, 41.7% were caused by food, 39.6% by drugs. Thirty seven patients (39% had recurrent attacks of angioedema. Mean standard deviation (SD number of attacks in patients with recurrent angioedema was 3.9 (2.7 (ranging from 2 to 10 times. Patients who had older age and multiple sites of skin involvement had tendency to have systemic symptoms.

  18. Orthostatic intolerance: emerging genetic and environmental etiologies. (United States)

    Robertson, D; Biaggioni, I; Ertl, A C; Robertson, R M; Diedrich, A; Blakely, R D; Flattem, N; Shannon, J R


    Orthostatic intolerance (OI) is common after space flight and resembles the disabling idiopathic orthostatic intolerance commonly observed in otherwise healthy young individuals. OI can arise from reduced sympathetic nervous system activity and, paradoxically, also from increased sympathetic nervous system activity. Patients with early manifestations of pure autonomic failure demonstrate an etiology based upon reduced sympathetic nervous system activity. Patients with hyperadrenergia demonstrate an etiology based on increased sympathetic nervous activity. For many years, we have recognized that the microgravity environment induces adaptation in the cardiovascular system and its autonomic control mechanisms that lead to the presence of OI on return to gravity. Understanding the nature of OI in astronauts returning from space as well as in the relevant patient population on earth has been a priority of Vanderbilt's Center for Space Physiology and Medicine in recent years. A major purpose of the autonomic experiment in the Neurolab mission was to identify whether the OI experienced by astronauts on return to earth was best explained by a hypoadrenergic or hyperadrenergic state. To address this question, we analyzed sympathetic nervous system activity inflight by 1) measurement of plasma catecholamines; 2) assessment of peroneal microneurographic sympathetic nerve traffic; and 3) assessment of norepinephrine spillover and clearance during infusion of tritiated norepinephrine. These studies documented a slight (five bursts per minute) increase in muscle sympathetic nerve activity, a 200 pg/ml increase in plasma norepinephrine level, and a 350 ng/min increase in norepinephrine clearance. Plasma norepinephrine and norepinephrine spillover and clearance were also raised on recovery day. These data indicate that enhanced sympathetic activation, rather than reduced sympathetic activation, accompanies the orthostatic intolerance following microgravity.

  19. Etiology of severe pneumonia in Ecuadorian children (United States)

    Jonnalagadda, Sivani; Rodríguez, Oswaldo; Estrella, Bertha; Sabin, Lora L.; Sempértegui, Fernando


    Background In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. Methods This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2–59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated. Results Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03). Conclusion These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available. Trial registration NCT 00513929 PMID:28182741

  20. Wind Farm Stabilization by using DFIG with Current Controlled Voltage Source Converters Taking Grid Codes into Consideration (United States)

    Okedu, Kenneth Eloghene; Muyeen, S. M.; Takahashi, Rion; Tamura, Junji

    Recent wind farm grid codes require wind generators to ride through voltage sags, which means that normal power production should be re-initiated once the nominal grid voltage is recovered. However, fixed speed wind turbine generator system using induction generator (IG) has the stability problem similar to the step-out phenomenon of a synchronous generator. On the other hand, doubly fed induction generator (DFIG) can control its real and reactive powers independently while being operated in variable speed mode. This paper proposes a new control strategy using DFIGs for stabilizing a wind farm composed of DFIGs and IGs, without incorporating additional FACTS devices. A new current controlled voltage source converter (CC-VSC) scheme is proposed to control the converters of DFIG and the performance is verified by comparing the results with those of voltage controlled voltage source converter (VC-VSC) scheme. Another salient feature of this study is to reduce the number of proportionate integral (PI) controllers used in the rotor side converter without degrading dynamic and transient performances. Moreover, DC-link protection scheme during grid fault can be omitted in the proposed scheme which reduces overall cost of the system. Extensive simulation analyses by using PSCAD/EMTDC are carried out to clarify the effectiveness of the proposed CC-VSC based control scheme of DFIGs.

  1. On transcending the impasse of respiratory motion correction applications in routine clinical imaging - a consideration of a fully automated data driven motion control framework. (United States)

    Kesner, Adam L; Schleyer, Paul J; Büther, Florian; Walter, Martin A; Schäfers, Klaus P; Koo, Phillip J


    Positron emission tomography (PET) is increasingly used for the detection, characterization, and follow-up of tumors located in the thorax. However, patient respiratory motion presents a unique limitation that hinders the application of high-resolution PET technology for this type of imaging. Efforts to transcend this limitation have been underway for more than a decade, yet PET remains for practical considerations a modality vulnerable to motion-induced image degradation. Respiratory motion control is not employed in routine clinical operations. In this article, we take an opportunity to highlight some of the recent advancements in data-driven motion control strategies and how they may form an underpinning for what we are presenting as a fully automated data-driven motion control framework. This framework represents an alternative direction for future endeavors in motion control and can conceptually connect individual focused studies with a strategy for addressing big picture challenges and goals.

  2. Pyogenic liver abscess: differences in etiology and treatment in Southeast Asia and Central Europe. (United States)

    Cerwenka, Herwig


    Knowledge of etiology and timely treatment of underlying causes, when possible, play an important role in the successful therapy of patients with pyogenic liver abscess (PLA). Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology. In this article, we aim to elaborate these differences and their therapeutic implications. Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA), there are clear differences in the microbiological spectrum, which implies different risk factors and disease courses. Klebsiella pneumoniae (K. pneumoniae) PLA is predominantly seen in Southeast Asia, whereas, in Central Europe, PLA is typically caused by Escherichia coli, Streptococcus or Staphylococcus, and these patients are more likely to be older and to have a biliary abnormality or malignancy. K. pneumoniae patients are more likely to have diabetes mellitus. Control of septic spread is crucial in K. pneumoniae patients, whereas treatment of the underlying diseases is decisive in many Central European PLA patients.

  3. Quality control for the in-clinic veterinary laboratory and pre-analytic considerations for specialized diagnostic testing. (United States)

    Camus, Melinda S


    This review, aimed primarily at general practitioners, focuses on quality assurance/quality control principles for all three phases of clinical pathology testing: preanalytic, analytic, and postanalytic. Specific emphasis is placed on the preanalytic phase of diagnostic modalities for identifying neoplastic cells, specifically flow cytometry, PCR for antigen receptor rearrangement, and immunocytochemistry. Recommendations for establishing an in-clinic quality assurance system are provided.


    Energy Technology Data Exchange (ETDEWEB)

    Branch, Kristi M.; Mitchell, Mark R.; Miller, Mark; Cochrum, Steven


    This paper describes research into the physical fidelity requirements of control room simulators to train U.S. Nuclear Regulatory Commission (NRC) staff for their duties as inspectors and license examiners for next-generation nuclear power plants. The control rooms of these power plants are expected to utilize digital instrumentation and controls to a much greater extent than do current plants. The NRC is assessing training facility needs, particularly for control room simulators, which play a central role in NRC training. Simulator fidelity affects both training effectiveness and cost. Research has shown high simulation fidelity sometimes positively affects transfer to the operational environment but sometimes makes no significant difference or actually impedes learning. The conditions in which these different effects occur are often unclear, especially for regulators (as opposed to operators) about whom research is particularly sparse. This project developed an inventory of the tasks and knowledges, skills, and abilities that NRC regulators need to fulfill job duties and used expert panels to characterize the inventory items by type and level of cognitive/behavioral capability needed, difficulty to perform, importance to safety, frequency of performance, and the importance of simulator training for learning these capabilities. A survey of current NRC staff provides information about the physical fidelity of the simulator on which the student trained to the control room to which the student was assigned and the effect lack of fidelity had on learning and job performance. The study concludes that a high level of physical fidelity is not required for effective training of NRC staff.

  5. DOE handbook: Design considerations

    Energy Technology Data Exchange (ETDEWEB)



    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline.

  6. The complete mitochondrial genome of bighead croaker, Collichthys niveatus (Perciformes, Sciaenidae): structure of control region and phylogenetic considerations. (United States)

    Xu, Tian-Jun; Cheng, Yuan-Zhi; Sun, Yue-Na; Shi, Ge; Wang, Ri-Xin


    Sciaenidae is a diverse, commercially important family. To understand the phylogenetic position of Collichthys niveatus in this family, we present its complete mitochondrial genome sequence. The genome is 16469 bp in length and contains 37 mitochondrial genes (13 protein-coding genes, 2 ribosomal RNA genes and 22 transfer RNA genes) and a control region (CR) as in other bony fishes. Further sequencing for the complete control region was performed on Collichthys lucida. Although the conserved sequence domains such as extend termination associated sequence (ETAS) and conserved sequence block domains (CSB-1, CSB-2 and CSB-3) are recognized in the control region of the two congeneric species, the typical central conserved blocks (CSB-F, CSB-E and CSB-D) could not be detected, while they are found in Miichthys miiuy and Cynoscion acoupa of Sciaenidae and other Percoidei fishes. Phylogenetic analyses do not support the monophyly of Pseudosciaeniae, which is against with the morphological results. C. niveatus is most closely related to Larimichthys polyactis, and Collichthys and Larimichthys may be merged into one genus, based on the current datasets.

  7. Some optimal considerations in attitude control systems. [evaluation of value of relative weighting between time and fuel for relay control law (United States)

    Boland, J. S., III


    The conventional six-engine reaction control jet relay attitude control law with deadband is shown to be a good linear approximation to a weighted time-fuel optimal control law. Techniques for evaluating the value of the relative weighting between time and fuel for a particular relay control law is studied along with techniques to interrelate other parameters for the two control laws. Vehicle attitude control laws employing control moment gyros are then investigated. Steering laws obtained from the expression for the reaction torque of the gyro configuration are compared to a total optimal attitude control law that is derived from optimal linear regulator theory. This total optimal attitude control law has computational disadvantages in the solving of the matrix Riccati equation. Several computational algorithms for solving the matrix Riccati equation are investigated with respect to accuracy, computational storage requirements, and computational speed.

  8. Lymphocytic colitis: A clue to bacterial etiology

    Institute of Scientific and Technical Information of China (English)

    Thanaa EA Helal; Naglaa S Ahmed; Osama Abo El Fotoh


    AIM: To find out the role of bacteria as a possible etiological factor in lymphocytic colitis.METHODS: Twenty patients with histopathological diagnosis of lymphocytic colitis and 10 normal controls were included in this study. Colonoscopic biopsies were obtained from three sites (hepatic and splenic flexures and rectosigmoid region). Each biopsy was divided into two parts. A fresh part was incubated on special cultures for bacterial growth. The other part was used for the preparation of histologic tissue sections that were examined for the presence of bacteria with the help of Giemsa stain.RESULTS: Culture of tissue biopsies revealed bacterial growth in 18 out of 20 patients with lymphocytic colitis mostly Escherichia coli(14/18), which was found in all rectosigmoid specimens (14/14), but only in 8/14 and 6/14 of splenic and hepatic flexure specimens respectively. In two of these cases, E coliwas associated with proteus. Proteus was found only in one case, Klebsiella in two cases, and Staphylococcus aureus in one case. In the control group, only 2 out of 10 controls showed the growth of E coliin their biopsy cultures.Histopathology showed rod-shaped bacilli in the tissue sections of 12 out of 14 cases with positive E coliin their specimen's culture. None of the controls showed these bacteria in histopathological sections.CONCLUSION: This preliminary study reports an association between E coliand lymphocytic colitis, based on histological and culture observations. Serotyping and molecular studies are in process to assess the role of E coliin the pathogenesis of lymphocytic colitis.

  9. Etiological approach to chronic urticaria

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D


    Full Text Available Background: In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching. Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (< 6 weeks duration and chronic (>6 weeks duration. Various clinical investigations may be initiated to diagnosis the cause. Aims: To evaluate the types of chronic urticaria with reference to etiology from history and investigations . Materials and Methods: A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. Results: The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA, IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex was seen in one patient. Cholinergic (4.7% and dermographic (4.7% urticaria were

  10. Etiology of Shock in the Emergency Department

    DEFF Research Database (Denmark)

    Holler, Jon Gitz; Jensen, Helene Kildegaard; Henriksen, Daniel Pilsgaard


    INTRODUCTION: The knowledge of the etiology and associated mortality of undifferentiated shock in the emergency department (ED) is limited. We aimed to describe the etiology based proportions and incidence rates (IR) of shock, as well as the associated mortality in the ED. METHODS: Population......-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. Patients aged ≥18 years living in the ED-catchment area (N = 225,000) with a first time ED presentation with shock (n = 1,646) defined as hypotension (systolic blood pressure ≤100 mmHg)) and ≥1 organ failures...... were included. Discharge diagnoses defined the etiology and were grouped as; distributive septic shock (SS), distributive non-septic shock (NS)), cardiogenic shock (CS), hypovolemic shock (HS), obstructive shock (OS) and other conditions (OC). Outcomes were etiology-based characteristics, annual IR per...

  11. Etiology of Cervicitis and Treatment with Minocycline

    Directory of Open Access Journals (Sweden)

    William R Bowie


    Full Text Available Objective: To evaluate the etiology of cervicitis using the recommended Canadian definition, and to evaluate the efficacy and tolerability of seven days of minocycline treatment, 100 versus 200 mg at bedtime.

  12. New Incremental Actuators based on Electro-active Polymer: Conceptual, Control, and Driver Design Considerations

    DEFF Research Database (Denmark)

    Thummala, Prasanth; Schneider, Henrik; Zhang, Zhe


    incrementalactuator. The DEAP incremental actuator consists of threeindependent DEAP actuators with a unique cylindrical designthat potentially simplifies mass production and scalabilitycompared to existing DEAP actuators. To accomplish theincremental motion, a high voltage (HV) bidirectional DC......-DCconverter, independently charges and discharges each capacitiveDEAP actuator. The topology used for the HV driver is a peakcurrent controlled bidirectional flyback converter. Thescalability of the proposed DEAP incremental actuator isdiscussed, and different scaled designs are provided. Theestimated speeds and forces...... for various scaled incrementalactuator designs are provided. The HV drivers areexperimentally tested with a prototype of the DEAP incrementalactuator. The energy efficiency measurement results of one of theHV driver are presented. The DEAP incremental actuatorprototype achieved bidirectional motion...

  13. RNA Interference (RNAi) as a Potential Tool for Control of Mycotoxin Contamination in Crop Plants: Concepts and Considerations (United States)

    Majumdar, Rajtilak; Rajasekaran, Kanniah; Cary, Jeffrey W.


    Mycotoxin contamination in food and feed crops is a major concern worldwide. Fungal pathogens of the genera Aspergillus. Fusarium, and Penicillium are a major threat to food and feed crops due to production of mycotoxins such as aflatoxins, 4-deoxynivalenol, patulin, and numerous other toxic secondary metabolites that substantially reduce the value of the crop. While host resistance genes are frequently used to introgress disease resistance into elite germplasm, either through traditional breeding or transgenic approaches, such resistance is often compromised by the evolving pathogen over time. RNAi-based host-induced gene silencing of key genes required by the pathogen for optimal growth, virulence and/or toxin production, can serve as an alternative, pre-harvest approach for disease control. RNAi represents a robust and efficient tool that can be used in a highly targeted, tissue specific manner to combat mycotoxigenic fungi infecting crop plants. Successful transgenic RNAi implementation depends on several factors including (1) designing vectors to produce double-stranded RNAs (dsRNAs) that will generate small interfering RNA (siRNA) species for optimal gene silencing and reduced potential for off-target effects; (2) availability of ample target siRNAs at the infection site; (3) efficient uptake of siRNAs by the fungus; (4) siRNA half-life and (5) amplification of the silencing effect. This review provides a critical and comprehensive evaluation of the published literature on the use of RNAi-based approaches to control mycotoxin contamination in crop plants. It also examines experimental strategies used to better understand the mode of action of RNAi with the aim of eliminating mycotoxin contamination, thereby improving food and feed safety.


    Directory of Open Access Journals (Sweden)

    Likhoman A. V.


    Full Text Available Dog poisoning toxicant used at home for rodent control (often based on zinc phosphide is accompanied by the development of anemia . In etiopathogenesis of this type of pathology of the blood we can highlight as important: haemolytic , haemorrhagic and allergic components, but the nature and extent of the changes under there are unequal. This requires the development of a special algorithm of examination and treatment strategies of the animal in accordance with the stages of the development of the disease. Modern conditions dictate the need, along with the actions to carry out urgent medical identification as the main etiological factor and pathogenesis, and the leading pathogenetic factors that pose a threat to the danger of other pathological processes and disease states. First, we evaluate the extent of damage to the liver, kidneys, heart, spleen and blood vessels, which is possible only if the clinic has appropriate methods and equipment. It is undeniable in this regard the importance of evidence-based recommendations for dietary nutrition of the affected animal's behavior after the clinic urgent remedial measures. The article proves high importance of evaluating the effectiveness of the treatment in the clinic

  15. Etiology and immunology of infectious bronchitis virus

    Directory of Open Access Journals (Sweden)

    LF Caron


    Full Text Available Infectious bronchitis virus (IBV of chickens is currently one of the main diseases associated with respiratory syndrome in domestic poultry, as well as with losses related to egg production. The etiological agent is a coronavirus, which presents structural differences in the field, mainly in the S1 spike protein. The immune response against this virus is complicated by the few similarities among serotypes. Environmental and management factors, as well as the high mutation rate of the virus, render it difficult to control the disease and compromise the efficacy of the available vaccines. Bird immune system capacity to respond to challenges depend on the integrity of the mucosae, as an innate compartment, and on the generation of humoral and cell-mediated adaptive responses, and may affect the health status of breeding stocks in the medium run. Vaccination of day-old chicks in the hatchery on aims at eliciting immune responses, particularly cell-mediated responses that are essential when birds are first challenged. Humoral response (IgY and IgA are also important for virus clearance in subsequent challenges. The presence of antibodies against the S1 spike protein in 3- to 4-week-old birds is important both in broilers and for immunological memory in layers and breeders.

  16. Methodological considerations for a randomised controlled trial of podiatry care in rheumatoid arthritis: lessons from an exploratory trial

    Directory of Open Access Journals (Sweden)

    Helliwell Philip S


    Full Text Available Abstract Background Whilst evidence exists to support the use of single treatments such as orthoses and footwear, the effectiveness of podiatry-led care as a complex intervention for patients with rheumatoid arthritis (RA related foot problems is unknown. The aim of this study was to undertake an exploratory randomised controlled parallel arm clinical trial (RheumAFooT to inform the design and implementation of a definitive trial and to understand the potential benefits of this care. Methods Patients with a definite diagnosis of RA, stable drug management 3 months prior to entry, and a current history of foot problems (pain, deformity, stiffness, skin or nail lesions, or footwear problems were recruited from a hospital outpatient rheumatology clinic and randomised to receive 12 months of podiatry treatment or no care. The primary outcome was change in foot health status using the impairment/footwear (LFISIF and activity limitation/participation restriction (LFISAP subscales of the Leeds Foot Impact Scale. Disease Activity Score (DAS, Health Assessment Questionnaire (HAQ score and walking speed (m/s were also recorded. Results Of the 80 patients identified, 64 patients were eligible to participate in the pilot and 34 were recruited. 16 patients were randomised to receive podiatry led foot care and 18 received no care. Against a backdrop of stable disease (DAS and HAQ scores, there was a statistically significant between group difference in the change in foot health status for foot impairment (LFISIF but not activity/participation (LFISAP or function (walking speed over 12 months. In the podiatry arm, 1 patient declined treatment following randomisation (did not want additional hospital visits and 3 self-withdrew (lost to follow-up. Patients received an average of 3 consultations for assessment and treatment comprising routine care for skin and nail lesions (n = 3, foot orthoses (n = 9, footwear referral to the orthotist (n = 5, and ultrasound

  17. System Architectural Considerations on Reliable Guidance, Navigation, and Control (GN and C) for Constellation Program (CxP) Spacecraft (United States)

    Dennehy, Cornelius J.


    This final report summarizes the results of a comparative assessment of the fault tolerance and reliability of different Guidance, Navigation and Control (GN&C) architectural approaches. This study was proactively performed by a combined Massachusetts Institute of Technology (MIT) and Draper Laboratory team as a GN&C "Discipline-Advancing" activity sponsored by the NASA Engineering and Safety Center (NESC). This systematic comparative assessment of GN&C system architectural approaches was undertaken as a fundamental step towards understanding the opportunities for, and limitations of, architecting highly reliable and fault tolerant GN&C systems composed of common avionic components. The primary goal of this study was to obtain architectural 'rules of thumb' that could positively influence future designs in the direction of an optimized (i.e., most reliable and cost-efficient) GN&C system. A secondary goal was to demonstrate the application and the utility of a systematic modeling approach that maps the entire possible architecture solution space.

  18. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje


    Full Text Available Introduction Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended. Case Outline The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. . As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now. Conclusion The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome. .

  19. Sample size considerations in active-control non-inferiority trials with binary data based on the odds ratio. (United States)

    Siqueira, Arminda Lucia; Todd, Susan; Whitehead, Anne


    This paper presents an approximate closed form sample size formula for determining non-inferiority in active-control trials with binary data. We use the odds-ratio as the measure of the relative treatment effect, derive the sample size formula based on the score test and compare it with a second, well-known formula based on the Wald test. Both closed form formulae are compared with simulations based on the likelihood ratio test. Within the range of parameter values investigated, the score test closed form formula is reasonably accurate when non-inferiority margins are based on odds-ratios of about 0.5 or above and when the magnitude of the odds ratio under the alternative hypothesis lies between about 1 and 2.5. The accuracy generally decreases as the odds ratio under the alternative hypothesis moves upwards from 1. As the non-inferiority margin odds ratio decreases from 0.5, the score test closed form formula increasingly overestimates the sample size irrespective of the magnitude of the odds ratio under the alternative hypothesis. The Wald test closed form formula is also reasonably accurate in the cases where the score test closed form formula works well. Outside these scenarios, the Wald test closed form formula can either underestimate or overestimate the sample size, depending on the magnitude of the non-inferiority margin odds ratio and the odds ratio under the alternative hypothesis. Although neither approximation is accurate for all cases, both approaches lead to satisfactory sample size calculation for non-inferiority trials with binary data where the odds ratio is the parameter of interest. © The Author(s) 2014.

  20. The presentation, incidence, etiology, and treatment of surgical site infections after spinal surgery.

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Mohamed, A.S.; Skolasky, R.L.; Laarhoven, C.J.H.M. van; Cohen, D.B.


    STUDY DESIGN: Descriptive, retrospective cohort analysis. OBJECTIVE: To evaluate the presentation, etiology, and treatment of surgical site infections (SSI) after spinal surgery. SUMMARY OF BACKGROUND DATA: SSI after spine surgery is frequently seen. Small case control studies have been published

  1. Prevalence, etiological factors and the treatment of infant exogenous obesity

    Directory of Open Access Journals (Sweden)

    Edio Luiz Petroski


    Full Text Available In the last few years, there has been considerable interest in the effects of excessive weight gain during childhood, due to the fact that the development of fat tissue in this period is a determinant of adult body composition. The objective of this study was to investigate the prevalence of infant obesity, to identify possible etiological factors, and to highlight treatments that have been used to reduce and/or prevent child obesity. Results have shown that obesity has increased more than any other nutritional problem in both developed and developing countries over the last decade. Etiological factors linked to childhood obesity were early weaning, introduction of inadequate nutrition, and physical inactivity. The treatment of childhood obesity requires a multidisciplinary team consisting of a doctor, nutritionist, psychologist, and physical educator. There are also some general recommendations to be followed: a balanced diet for adequate growth and weight control, and controlled physical exercise together with individual and family emotional support. Parental cooperation is important for the best results. Schools also have a fundamental role in teaching children positive attitudes and behavior towards physical activity and nutrition. RESUMO Nos últimos anos, o interesse sobre os efeitos do ganho de peso excessivo na infância tem aumentado consideravelmente, devido ao fato que o desenvolvimento da celularidade adiposa neste período ser determinante nos padrões de composição corporal de um indivíduo adulto. Este trabalho teve como objetivo investigar a prevalência da obesidade infantil, identificar os possíveis fatores etiológicos além de verifi car quais as intervenções que se destacaram nesta última década como forma de diminuir e/ou prevenir a obesidade em crianças. Os resultados encontrados foram que a obesidade é uma das enfermidades nutricionais que mais têm apresentado aumento de sua prevalência, tanto nos pa

  2. Low back pain: considerations for rotary-wing aircrew. (United States)

    Gaydos, Steven John


    Low back pain remains a significant issue among helicopter aircrew. There is a considerable body of scientific literature devoted to the problem, including epidemiologic and experimental studies addressing prevalence, characteristics, primary etiology, and contributing factors. It is endemic and multinational, with a prevalence ranging from 50-92%. Archetypal pain begins with flight or within hours of flight, is mostly targeted in the low back/lumbar region and/or buttocks, is transient, and is commonly described as dull and achy. A minority develop chronic, persistent pain that is variously described with dissimilar characteristics. The pernicious effects of back pain or discomfort while piloting may affect flight performance and safety, including reduced operational effectiveness and lost duty time, occupational attrition, curtailed or cancelled missions, compromised emergency egress, and performance deficits during critical phases of flight. The majority of etiologic studies have focused on the pathophysical posture adopted by pilots for aircraft control and exposure to whole body vibration. With more evidence for the former, it remains likely that both, as well as other factors, may have a contributory and perhaps integrative or concerted role. Corrective and mitigation strategies have addressed lumbar support, seat and cockpit ergonomic redesign, and improved aircrew health. Flight surgeons should be familiar with this prevalent issue and future research must address longitudinal cohort studies with clear definitions, relevant and valid exposure data, dose-response detail, and control for contributing factors and confounders.

  3. Assessment of Vitamin D status In Patients of Chronic Low Back Pain of Unknown Etiology. (United States)

    Lodh, Moushumi; Goswami, Binita; Mahajan, Rajni Dawar; Sen, Dipankar; Jajodia, Nirmal; Roy, Abhishek


    Low back pain is very disabling and dispiriting because of the physical impediment it causes and its psychological effects. Innumerable factors have been implicated in its etiology. In spite of improvements in diagnostic modalities, a considerable number of such cases fall in the ambiguous zone of unknown etiology or 'idiopathic.'Early diagnosis of low back pain will allow effective prevention and treatment to be offered. This study was conducted to assess the contribution of vitamin D levels and other biochemical factors to chronic low back pain in such cases. All patients attending the orthopedics OPD for low back pain in whom a precise anatomical cause could not be localized, were prospectively enrolled in this study. We measured serum levels of glucose, calcium, phosphorus, uric acid, rheumatoid factor, C reactive protein, alkaline phosphatase, total protein, albumin and 25 (OH) D concentrations in 200 cases and 200 control samples. The patients showed significantly lower vitamin D levels compared to controls with p value back pain patients were in the age group of 31-50 years (42 %).The average BMI was 23.27 ± 5.17 kg/sq m, 73 % of total patient population were females and 27 % were known case of type 2 diabetes mellitus. Calcium, alkaline phosphatase, was positively correlated with vitamin D and glucose showed a negative correlation with vitamin D in the patient population. The problem of low back pain provides a challenge to health care providers. The problem in developing countries is compounded by ignorance to report for early treatment and occupational compulsions in rural areas and sedentary lifestyle in urban youth. The authors strongly recommend early frequent screening for vitamin D along with glucose, protein, albumin, calcium, phosphorus, CRP as part of general health checkup for non-specific body pain, especially low back pain.

  4. [Tendinitis in athletes: etiology, diagnosis and treatment]. (United States)

    Gremion, G; Zufferey, P


    Tendinopathy is one of the most common diagnosis in sports. Knowledges about their etiology, the repair process to their diagnosis and their treatment have improved thanks to the development of imaging, especially ultra- sound. The disorder whose etiology could be mechanical or degenerative can cause long- term disability and sometimes the end of the sport carreer. The risk of reccurence is com- mon; this may lead to tendon rupture whose functional effects can be significative. The management should be early: it must respect the deadlines for tendon healing and pro- pose a gradual recovery efforts after elimina tion of the contributing factors involved.

  5. Practical considerations for the implantation of a fuzzy control algorithm in a DSP; Consideraciones practicas para la implantacion de un algoritmo de control difuso en un DSP

    Energy Technology Data Exchange (ETDEWEB)

    Perez C, B.; Benitez R, J.S.; Pacheco S, J.O. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)


    The development of a digital system based on a DSP to implant a Mamdani type algorithm of fuzzy control whose objective is to regulate the neutron power in a nuclear research reactor Type TRIGA Mark III is presented. Its are simultaneously carried out the aggregation des fuzzy stages discreeting the universe of the output variable. The format MPF for the handling of the floating point in the arithmetic operations is used. (Author)

  6. Multifactorial etiology of gastric cancer. (United States)

    Zabaleta, Jovanny


    control, metabolism of essential nutrients, and production of inflammatory mediators, among others, has been described. Interestingly, DNA changes like SNPs or mutations can create CpG sites in sequences where transcription factors normally sit, affecting transcription.In this chapter, we review the literature about the role of SNPs and methylation on H. pylori infection and gastric cancer, with big emphasis to the H. pylori role in the development of the disease due to the strong association between both.

  7. Nutritional considerations in rheumatoid arthritis. (United States)

    Touger-Decker, R


    Rheumatoid arthritis is a chronic, systemic, inflammatory disorder of unknown etiology. The severity of the disease process adversely affects nutritional status. Articular changes, such as small joint deformities and temporomandibular joint syndrome, alter the ability to self-feed. The inflammatory process may increase metabolic rate. Ingestion, digestion, absorption, and excretion may be compromised by secondary manifestations of the disease. Comprehensive nutrition assessment incorporates evaluation of disease and treatment-specific factors, along with the usual assessment parameters. Abnormal values for certain assessment parameters do not necessarily reflect nutritional status. Treatment methods, including medications, may have an impact on nutritional status, assessment tools, and self-feeding. Nutrition management goals focus on identification and implementation of feeding strategies. Evaluation of the ability to feed oneself includes consideration of functional status, secondary manifestations, and medical treatment. Multiple feeding modalities may be required. Oral supplements, tube feedings, and parenteral nutrition may be employed to meet the nutrition needs of the individual with rheumatoid arthritis.

  8. Current Evidence to Justify, and the Methodological Considerations for a Randomised Controlled Trial Testing the Hypothesis that Statins Prevent the Malignant Progression of Barrett's Oesophagus

    Institute of Scientific and Technical Information of China (English)

    David Thurtle; Leo Alexandre; Yoon K Loke; Ed Cheong; Andrew Hart


    Barrett's oesophagus is the predominant risk factor for oesophageal adenocarcinoma, a cancer whose incidence is increasing and which has a poor prognosis. This article reviews the latest experimental and epidemiological evidence justifying the development of a randomised controlled trial investigating the hypothesis that statins prevent the malignant progression of Barrett's oesophagus, and explores the methodological considerations for such a trial. The experimental evidence suggests anti-carcinogenic properties of statins on oesophageal cancer cell lines, based on the inhibition of the mevalonate pathway and the production of pro-apoptotic proteins. The epidemiological evidence reports inverse associations between statin use and the incidence of oesophageal carcinoma in both general population and Barrett's oesophagus cohorts. Such a randomised controlled trial would be a large multi-centre trial, probably investigating simvastatin, given the wide clinical experience with this drug, relatively low side-effect profile and low ifnancial cost. As with any clinical trial, high adherence is important, which could be increased with therapy, patient, doctor and system-focussed interventions. We would suggest there is now sufifcient evidence to justify a full clinical trial that attempts to prevent this aggressive cancer in a high-risk population.

  9. Current Evidence to Justify, and the Methodological Considerations for a Randomised Controlled Trial Testing the Hypothesis that Statins Prevent the Malignant Progression of Barrett's Oesophagus

    Directory of Open Access Journals (Sweden)

    David Thurtle


    Full Text Available Barrett’s oesophagus is the predominant risk factor for oesophageal adenocarcinoma, a cancer whose incidence is increasing and which has a poor prognosis. This article reviews the latest experimental and epidemiological evidence justifying the development of a randomised controlled trial investigating the hypothesis that statins prevent the malignant progression of Barrett’s oesophagus, and explores the methodological considerations for such a trial. The experimental evidence suggests anti-carcinogenic properties of statins on oesophageal cancer cell lines, based on the inhibition of the mevalonate pathway and the production of pro-apoptotic proteins. The epidemiological evidence reports inverse associations between statin use and the incidence of oesophageal carcinoma in both general population and Barrett’s oesophagus cohorts. Such a randomised controlled trial would be a large multi-centre trial, probably investigating simvastatin, given the wide clinical experience with this drug, relatively low side-effect profile and low financial cost. As with any clinical trial, high adherence is important, which could be increased with therapy, patient, doctor and system-focussed interventions. We would suggest there is now sufficient evidence to justify a full clinical trial that attempts to prevent this aggressive cancer in a high-risk population.

  10. Chronic pelvic ischemia: etiology, pathogenesis, clinical presentation and management. (United States)

    Kapoor, H; Gupta, E; Sood, A


    Overactive bladder (OAB) and bladder pain syndrome (BPS) although common, are vaguely defined and difficult to diagnose and manage etiologies of storage-type lower urinary tract symptoms (LUTS). The lack of optimal management options is a direct consequence of deficient understanding of the pathophysiologic mechanisms underlying these conditions. These conditions are especially prevalent in females, and cumulative contemporary epidemiological, clinical and laboratory evidence implicates ischemia as one of the key players in the pathophysiologic foundation of both these disorders. Taken together they make up "the" diagnostic as well as therapeutic black-hole in urologic practice. Much akin to chronic ischemic heart disease, chronic ischemia-reperfusion has been shown to cause degenerative changes at cellular and subcellular level in the bladder mucosa, smooth muscle fibers, and vesical neural and microvascular structures leading to a hypersensitive, hyperactive bladder initially, which with time invariably progresses into a failed, fibrotic and pressurized bladder. Diagnosis and management of these diseases are currently symptom focused and remains a source of much frustration. Consideration of role of ischemia connotates hope and could lead to a paradigm shift in the management of these patients with a completely new therapeutic armamentarium attacking the pathology itself. The aim of the current review is to provide a clinical thought perspective on the etiology/pathophysiology of chronic pelvic ischemia and its role as a precursor to the aforementioned conditions, and shed some light upon the potential management strategies to consider.

  11. Oropharyngeal Dysphagia: neurogenic etiology and manifestation. (United States)

    Sebastian, Swapna; Nair, Prem G; Thomas, Philip; Tyagi, Amit Kumar


    To determine the type, severity and manifestation of dysphagia in patients with neurogenic etiology. Clinical documentation was done on the different etiologies, its manifestation, assessment findings and management strategies taken for patients with neurogenic oropharyngeal dysphagia who were referred for assessment and management of dysphagia over a period of three months in a tertiary care teaching hospital. Flexible endoscopic examination was done in all the patients. The severity of dysphagia in these patients were graded based on Gugging Swallowing Screen (GUSS). A total of 53 patients with neurogenic oropharyngeal dysphagia were evaluated by an otolaryngologist and a speech language pathologist over a period of three months. The grading of severity based on GUSS for these patients were done. There were 30 patients with recurrent laryngeal nerve injury due to various etiologies, one patient with Neurofibroma-vestibular schwanoma who underwent surgical excision, 16 patients with stroke, two patients with traumatic brain injury, two patients with Parkinsonism and two patients with myasthenia gravis. The manifestation of dysphagia was mainly in the form of prolonged masticatory time, oral transit time, and increased number of swallows required for each bolus, cricopharyngeal spasms and aspiration. Among the dysphagia patients with neurogenic etiology, dysphagia is manifested with a gradual onset and is found to have a progressive course in degenerative disorders. Morbidity and mortality may be reduced with early identification and management of neurogenic dysphagia.

  12. CKD of Uncertain Etiology: A Systematic Review. (United States)

    Lunyera, Joseph; Mohottige, Dinushika; Von Isenburg, Megan; Jeuland, Marc; Patel, Uptal D; Stanifer, John W


    Epidemics of CKD of uncertain etiology (CKDu) are emerging around the world. Highlighting common risk factors for CKD of uncertain etiology across various regions and populations may be important for health policy and public health responses. We searched PubMed, Embase, Scopus and Web of Science databases to identify published studies on CKDu. The search was generated in January of 2015; no language or date limits were used. We used a vote-counting method to evaluate exposures across all studies. We identified 1607 articles, of which 26 met inclusion criteria. Eighteen (69%) were conducted in known CKDu-endemic countries: Sri Lanka (38%), Nicaragua (19%), and El Salvador (12%). The other studies were from India, Japan, Australia, Mexico, Sweden, Tunisia, Tanzania, and the United States. Heavy metals, heat stress, and dietary exposures were reported across all geographic regions. In south Asia, family history, agrochemical use, and heavy metal exposures were reported most frequently, whereas altitude and temperature were reported only in studies from Central America. Across all regions, CKDu was most frequently associated with a family history of CKDu, agricultural occupation, men, middle age, snake bite, and heavy metal exposure. Studies examining etiologies of CKDu have reported many exposures that are heterogeneous and vary by region. To identify etiologies of CKDu, designing consistent and comparative multisite studies across high-risk populations may help elucidate the importance of region-specific versus global risk factors. Copyright © 2016 by the American Society of Nephrology.

  13. Incidence, etiology and mortality of cirrhosis

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Schaffalitzky de Muckadell, Ove B; Touborg Lassen, Annmarie


    Knowledge on the prognosis among patients with cirrhosis is mainly based on clinical trials with selected patient groups as well as population-based register studies with suboptimal diagnostic reliability. The aim of the study was to describe incidence, etiology, and mortality of well......-validated cirrhotic cases in a population-based cohort at Funen (population 470,000) between 1996 and 2006....

  14. Etiology and pathogenesis of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Schlösser, Tom P C; Colo, Dino; Castelein, RM


    Despite many years of dedicated research into the etio-pathogenesis, not one single cause for adolescent idiopathic scoliosis has been identified. The purpose of this review is to give a comprehensive overview of the current evidence and main etiological theories. Intrinsic causal mechanisms are fou

  15. The etiology of specific phobias : A review

    NARCIS (Netherlands)

    Merckelbach, H; de Jong, Peter; Muris, P; vandenHout, MA


    The present article summarizes theory and data about symptomatology, epidemiology, and etiology of specific phobias. Additionally, the cognitive mechanisms involved in specific Phobias are briefly discussed By and large, the general pattern behind the development of specific phobias can be summarize

  16. Does carditis have two different etiologies?

    NARCIS (Netherlands)

    Wolf, C; Seldenrijk, CA; Timmer, R; Breumelhof, R; Smout, AJPM


    Carditis has become the subject of much study and discussion, although its etiology is still controversial. We wished to study the prevalence and possible pathogenetic mechanisms of carditis in a well-defined group of patients. In 664 patients biopsies were taken distal to the squamocolumnar junctio

  17. [Hyperemesis gravidarum--etiology and treatment]. (United States)

    Imperato, F; Canova, I; Basili, R; Iuele, T; Mossa, B


    Hyperemesis gravidarum is a common pathology encountered by the obstetrician in 0.1-2% of all pregnancies. The purpose of our review, along with other literature, is to report general outline of the syndrome, with etiology, complications and some guidelines about conventional and newer therapy.

  18. Etiology and pathogenesis of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Schlösser, Tom P C; Colo, Dino; Castelein, RM


    Despite many years of dedicated research into the etio-pathogenesis, not one single cause for adolescent idiopathic scoliosis has been identified. The purpose of this review is to give a comprehensive overview of the current evidence and main etiological theories. Intrinsic causal mechanisms are

  19. Lead - nutritional considerations (United States)

    Lead poisoning - nutritional considerations; Toxic metal - nutritional considerations ... Markowitz M. Lead poisoning. In: Kliegman RM, Behrman RE, Jenson HB, ... Emergency Medicine: Concepts and Clinical Practice . 8th ed. ...

  20. Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach. (United States)

    Moola, Sandeep; Munn, Zachary; Sears, Kim; Sfetcu, Raluca; Currie, Marian; Lisy, Karolina; Tufanaru, Catalin; Qureshi, Rubab; Mattis, Patrick; Mu, Peifan


    present the results, including a narrative, graphical or tabular summary, or meta-analysis. When meta-analysis is not possible, a set of alternative methods for synthesizing research is available. On the basis of the research question and objectives, narrative, tabular and/or visual approaches can be used for data synthesis. There are some special considerations when conducting meta-analysis for questions related to risk and correlation. These include, but are not limited to, causal inference.Systematic review and meta-analysis of studies related to etiology is an emerging methodology in the field of evidence synthesis. These reviews can provide useful information for healthcare professionals and policymakers on the burden of disease. The standardized Joanna Briggs Institute approach offers a rigorous and transparent method to conduct reviews of etiology.

  1. Etiology and pathogenesis of Parkinson disease. (United States)

    Schapira, Anthony H V


    The etiology of Parkinson disease (PD) is multifactorial and is likely to involve different causes in different patients. Several different genes have been identified as causes of familial PD, including alpha-synuclein gene mutations and multiplications, and mutations of parkin, PINK1, DJ1, and LRRK2. The biochemical consequences of these mutations have served to reinforce the relevance of the pathways to pathogenesis previously characterized, for example, mitochondrial dysfunction, oxidative stress, and protein misfolding and aggregation. The recognition that glucocerebrosidase mutations represent a significant risk factor for PD has focused attention on lysosomal function and autophagy as relevant to PD. Several environmental factors have also been shown to influence the risk for PD, although odds ratios remain relatively modest. Specific toxins can cause dopaminergic cell death in man and animals, but they probably have limited relevance to the etiology of PD.

  2. Facial dysostoses: Etiology, pathogenesis and management. (United States)

    Trainor, Paul A; Andrews, Brian T


    Approximately 1% of all live births exhibit a minor or major congenital anomaly. Of these approximately one-third display craniofacial abnormalities which are a significant cause of infant mortality and dramatically affect national health care budgets. To date, more than 700 distinct craniofacial syndromes have been described and in this review, we discuss the etiology, pathogenesis and management of facial dysostoses with a particular emphasis on Treacher Collins, Nager and Miller syndromes. As we continue to develop and improve medical and surgical care for the management of individual conditions, it is essential at the same time to better characterize their etiology and pathogenesis. Here we describe recent advances in our understanding of the development of facial dysostosis with a view towards early in utero identification and intervention which could minimize the manifestation of anomalies prior to birth. The ultimate management for any craniofacial anomaly however, would be prevention and we discuss this possibility in relation to facial dysostosis.

  3. Cellulitis: definition, etiology, and clinical features. (United States)

    Gunderson, Craig G


    Cellulitis is a common condition seen by physicians. Over the past decade, skin and soft tissue infections from community-associated methicillin-resistant Staphylococcus aureus have become increasingly common. In this article, the definition, etiology, and clinical features of cellulitis are reviewed, and the importance of differentiating cellulitis from necrotizing soft tissue infections is emphasized. Empiric antimicrobial recommendations are suggested, including the most recent recommendations from the Infectious Disease Society of America.

  4. [Denture stomatitis - definition, etiology, classification and treatment]. (United States)

    Cubera, Katarzyna


    Denture stomatitis pertains to a number of pathological symptoms in the oral cavity caused by wearing acrylic dentures. Etiological factors include: mucosal trauma, fungal infection and accumulation of denture plaque. All of these factors appear to increase the ability of Candida albicans to colonize both the denture and oral mucosal surfaces. Antifungal treatment can eradicate C. albicans contamination and relieve stomatitis symptoms. Early diagnosis of the lesion is essential to assure rational therapy.

  5. Idiopathic scoliosis: etiological concepts and hypotheses



    Scoliosis is diagnosed as idiopathic in 70 % of structural deformities affecting the spine in children and adolescents, probably reflecting our current misunderstanding of this disease. By definition, a structural scoliosis should be the result of some primary disorder. The goal of this article is to give a comprehensive overview of the currently proposed etiological concepts in idiopathic scoliosis regarding genetics, molecular biology, biomechanics, and neurology, with particular emphasis o...

  6. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment


    Enrico Bellato; Eleonora Marini; Filippo Castoldi; Nicola Barbasetti; Lorenzo Mattei; Davide Edoardo Bonasia; Davide Blonna


    Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable ...

  7. Angular cheilitis, part 1: local etiologies. (United States)

    Park, Kelly K; Brodell, Robert T; Helms, Stephen E


    Angular cheilitis (AC) is a common condition characterized by erythema, moist maceration, ulceration, and crusting at the corners of the mouth. This article focuses on the common local factors that act alone and in combination to produce AC. These factors are categorized as irritant, allergic, and infectious causes. Identifying the underlying etiology of AC is a critical step in developing an effective treatment plan for this condition.

  8. Molar Incisor Hypomineralization, Prevalence, and Etiology


    Sulaiman Mohammed Allazzam; Sumer Madani Alaki; Omar Abdel Sadek El Meligy


    Aim. To evaluate the prevalence and possible etiological factors associated with molar incisor hypomineralization (MIH) among a group of children in Jeddah, Saudi Arabia. Methods. A group of 8-12-year-old children were recruited (n = 267) from the Pediatric Dental Clinics at the Faculty of Dentistry, King Abdulaziz University. Children had at least one first permanent molar (FPM), erupted or partially erupted. Demographic information, children's medical history, and pregnancy-related data wer...

  9. Etiology, diagnosis, and clinical management of vulvodynia

    Directory of Open Access Journals (Sweden)

    Sadownik LA


    Full Text Available Leslie A Sadownik University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada Abstract: Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. It may affect girls and women across all age groups and ethnicities. Vulvodynia is a significant burden to society, the health care system, the affected woman, and her intimate partner. The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. An approach to the diagnosis and management of a woman presenting with chronic vulvar pain should address the biological, psychological, and social/interpersonal factors that contribute to her illness. The gynecologist has a key role in excluding other causes for vulvar pain, screening for psychosexual and pelvic floor dysfunction, and collaborating with other health care providers to manage a woman's pain. An important component of treatment is patient education regarding the pathogenesis of the pain and the negative impact of experiencing pain on a woman's overall quality of life. An individualized, holistic, and often multidisciplinary approach is needed to effectively manage the woman's pain and pain-related distress. Keywords: vulvodynia, diagnosis, treatment, etiology, sexual pain disorder, dyspareunia, vestibulodynia, assessment, treatment, multidisciplinary

  10. Controversies in the Etiologies of Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Ali Safdar Khan


    Full Text Available Acute pancreatitis is a potentially life threatening acute inflammatory condition of the pancreas with an annual incidence in the United States estimated to be 40 cases per 100,000 adults [1] which is one of the highest in the world [2]. There is also a rising trend in the incidence of acute pancreatitis in the United States which has been observed over the past several decades [3]. Though most cases are mild with mortality below 1%, there is a subset classified as severe pancreatitis in which the mortality can reach as high as 30% [4]. The direct medical cost of hospitalization for acute pancreatitis is estimated to be $2.2 billion at a mean cost per hospital day of $1,670 [5] which is likely an underestimation. To determine the etiology of the acute pancreatitis is crucial to the management of this potentially fatal condition. Even though a wide variety of etiologies have been proposed, the exact role of the some of these still remains controversial and in some cases ill-defined. A cause is not clinically determined in up to 30% of cases which are labeled idiopathic pancreatitis [6]. This review attempts to re-visit some of the controversies surrounding these etiologies, discuss the current understanding of the mechanisms that underlie them and to identify areas requiring further research.

  11. The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. (United States)

    Türp, J C; Schindler, H


    The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross-sectional survey - the Study of Health in Pomerania (Germany) - associations between 15 occlusion-related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. However, statistical associations do not prove causality. By using Hill's nine criteria of causation, it becomes apparent that the evidence of a causal relationship is weak. Only bruxism, loss of posterior support and unilateral posterior crossbite show some consistency across studies. On the other hand, several reported occlusal features appear to be the consequence of TMDs, not their cause. Above all, however, biological plausibility for an occlusal aetiology is often difficult to establish, because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance-induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non-occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs.

  12. Childhood hydrocephalus – is radiological morphology associated with etiology

    DEFF Research Database (Denmark)

    Foss-Skiftesvik, Jon; Andresen, Morten; Juhler, Marianne


    Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus.......Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus....

  13. Protocol of a Randomized Controlled Trial of Culturally Sensitive Interventions to Improve African Americans' and Non-African Americans' Early, Shared, and Informed Consideration of Live Kidney Transplantation: The talking about Live Kidney Donation (TALK study

    Directory of Open Access Journals (Sweden)

    Senga Mikiko


    Full Text Available Abstract Background Live kidney transplantation (LKT is underutilized, particularly among ethnic/racial minorities. The effectiveness of culturally sensitive educational and behavioral interventions to encourage patients' early, shared (with family and health care providers and informed consideration of LKT and ameliorate disparities in consideration of LKT is unknown. Methods/Design We report the protocol of the Talking About Live Kidney Donation (TALK Study, a two-phase study utilizing qualitative and quantitative research methods to design and test culturally sensitive interventions to improve patients' shared and informed consideration of LKT. Study Phase 1 involved the evidence-based development of culturally sensitive written and audiovisual educational materials as well as a social worker intervention to encourage patients' engagement in shared and informed consideration of LKT. In Study Phase 2, we are currently conducting a randomized controlled trial in which participants with progressing chronic kidney disease receive: 1 usual care by their nephrologists, 2 usual care plus the educational materials, or 3 usual care plus the educational materials and the social worker intervention. The primary outcome of the randomized controlled trial will include patients' self-reported rates of consideration of LKT (including family discussions of LKT, patient-physician discussions of LKT, and identification of an LKT donor. We will also assess differences in rates of consideration of LKT among African Americans and non-African Americans. Discussion The TALK Study rigorously developed and is currently testing the effectiveness of culturally sensitive interventions to improve patients' and families' consideration of LKT. Results from TALK will provide needed evidence on ways to enhance consideration of this optimal treatment for patients with end stage renal disease. Trial Registration number, NCT00932334

  14. Etiology and Management of Hemorrhagic Complications of Portal Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Alejandro Costaguta


    Full Text Available Portal hypertension in children represents a particular diagnostic and management challenge for several reasons: (1 treatment outcomes should be evaluated in relationship with a long-life expectancy, (2 pediatric patients with portal hypertension constitute an heterogeneous population, both in terms of individual characteristics and diversity of liver diseases; making comparison between treatment outcomes very difficult, (3 application of techniques and procedures developed in adult patients ( TIPS face size limitations in small children, and (4 absence of data from well-controlled trials in children forces pediatric specialists to adapt results obtained from adult cohorts suffering from diseases such as HCV and alcoholic cirrhosis. Despite those limitations, substantial progress in the treatment of children with portal hypertension has been achieved in recent years, with better outcomes and survival. Two main factors influence our therapeutic decision: age of the patient and etiology of the liver disease. Therefore, diagnosis and treatment of complications of portal hypertension in children need to be described taking such factors into consideration. This paper summarizes current knowledge and expert opinion.

  15. Urinary tract infections: etiology and antimicrobial susceptibility of uropathogens

    Directory of Open Access Journals (Sweden)

    Mario Laneve


    Full Text Available Background: Urinary tract infections are a serious health problem affecting millions of people each year.They are the second most common type of infection in the body.The objective of study was to determine the etiology and antimicrobial susceptibility patterns of urinary tract infections pathogens isolated in our Patology Clinic laboratory. Materials and Methods: During the period July 2007- July 2008,were analysed 1422 urine samples.The determination of the total microbe load were acquire with an kit of the BIO-DETECTOR while the identification of germs with Apy sistem. Antibiotic susceptibility tests were assaied with the ATB UR strip. Results: About the total of samples analysed, 320 (22% had significant bacteriuria. Escherichia coli was the most common etiologic agent isolated (62%, followed by Klebsiella ssp. (10%, Pseudomonas aeruginosa (5,95% and Proteus mirabilis (5%. Gram-positive bacteria accounted for only 7.32% , with prevalence of Staphylococcus ssp (5,32 and Enterococcus spp (2%. The most effective antibiotics for Gram- were: Imipenem, Amikacin, Ceftazidime and Cefotaxim, while for Gram+ were: Minocyclin,Vancomycin and Oxacillin. Conclusion: Escherichia coli was the microrganism more frequently isolated between Gram negative bacteria with very susceptible to Amoxicillin. Currently, the empirical use of Cotrimoxazole and Amoxicillin is not recommended for Enterobacteriaceae. Urinary tract infections are more common in women than in men. Men are more likely to get a UTI once past the age of 65. Current data on the prevalence of multidrug resistance among urinary tract isolates should be a consideration to change the current empiric treatment of IVU.

  16. Etiological study of microcytic hypochromic anemia

    Directory of Open Access Journals (Sweden)

    S Kafle


    Full Text Available Background: Microcytic hypochromic anemia is a distinct morphologic subtype of anemia with well- de ned etiology and treatment. The objective of this study was to determine the etiology and frequency of microcytic hypochromic anemia. Materials and Methods: This cross-sectional observational study was conducted at Kathmandu Medical College Teaching Hospital. One hundred cases of microcytic hypochromic anemia were included. Relevant clinical history, hemogram, reticulocyte count, iron pro les were documented in a proforma. Bone marrow aspiration and hemoglobin electrophoresis was conducted when required. Data was analysed by Microsoft SPSS 16 windows. Result: Iron de ciency was the commonest etiology (49%. Dysfunctional uterine bleeding (20.8% was the commonest cause of iron de ciency, malignancy (24.3% was the commonest cause of anemia of chronic disease. Mean value of Mean Corpuscular Volume was lowest in hemolytic anemia (71.0 . Mean Red cell Distribution Width was normal (14.0% in hemolytic anemia but was raised in other types. Mean serum iron was reduced in iron de ciency anemia (32.2μg/dl and chronic disease (34.8μg/dl, normal in hemolytic anemia (83μg/dl and raised in sideroblastic anemia (295μg/dl. Mean serum ferritin was reduced in iron de ciency anemia (7.6ng/ml, raised in chronic disease (158.6ng/ml and normal in hemolytic anemia (99.2ng/ml. Serum ferritin was normal in sideroblastic anemia (93ng/ml. Mean Total Iron Binding Capacity was raised in iron de ciency anemia (458μg/dl and normal in other microcytic hypochromic anemias. Conclusion: Diagnosis of microcytic hypochromic anemia requires a standardized approach which includes clinical details, hemogram, peripheral blood smear, reticulocyte count, iron pro le, hemoglobin electrophoresis and bone marrow examination. 

  17. Epidemiology and etiology of denture stomatitis. (United States)

    Gendreau, Linda; Loewy, Zvi G


    Denture stomatitis, a common disorder affecting denture wearers, is characterized as inflammation and erythema of the oral mucosal areas covered by the denture. Despite its commonality, the etiology of denture stomatitis is not completely understood. A search of the literature was conducted in the PubMed electronic database (through November 2009) to identify relevant articles for inclusion in a review updating information on the epidemiology and etiology of denture stomatitis and the potential role of denture materials in this disorder. Epidemiological studies report prevalence of denture stomatitis among denture wearers to range from 15% to over 70%. Studies have been conducted among various population samples, and this appears to influence prevalence rates. In general, where reported, incidence of denture stomatitis is higher among elderly denture users and among women. Etiological factors include poor denture hygiene, continual and nighttime wearing of removable dentures, accumulation of denture plaque, and bacterial and yeast contamination of denture surface. In addition, poor-fitting dentures can increase mucosal trauma. All of these factors appear to increase the ability of Candida albicans to colonize both the denture and oral mucosal surfaces, where it acts as an opportunistic pathogen. Antifungal treatment can eradicate C. albicans contamination and relieve stomatitis symptoms, but unless dentures are decontaminated and their cleanliness maintained, stomatitis will recur when antifungal therapy is discontinued. New developments related to denture materials are focusing on means to reduce development of adherent biofilms. These may have value in reducing bacterial and yeast colonization, and could lead to reductions in denture stomatitis with appropriate denture hygiene.

  18. [Guideline-based diagnosis of dementia etiology]. (United States)

    Hofmann, W


    Dementia encompasses a variety of underlying conditions among which Alzheimer's disease represents the most common cause and in addition, vascular and Parkinson's disease dementia, dementia with Lewy bodies and frontotemporal lobar degeneration. All the current guidelines specify a two-step procedure for the diagnostics of dementia. The first step entails performing a comprehensive description, diagnosis and confirmation of the syndrome. The presented article focuses on the second step: diagnosis of the etiology. This review gives an overview of the current diagnostic approaches including the new proposals of the biomarker in cerebrospinal fluid.

  19. Etiology and Management of Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Narendra Kumar Muthugaduru Shivarudrappa


    Full Text Available Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its management

  20. [Overactive bladder syndrome: etiology, pathogenesis, treatment]. (United States)

    Radchenko, V H


    The article analyzes the causes of hyperactive detrusory contractions, considered etiopathogenesis and treatment of patients with overactive bladder syndrome (OBS). Two groups of patients with overactive bladder syndrome were examined, analyzed etiology, pathogenesis and treatment. A new method for increasing the threshold sensitivity of spinal centers under the OBS by using the local lesions of the mucous membrane of the bladder by electrical coagulation or local microwave hyperthermia of the prostate are proposed. The high efficiency of these methods in dealing with OBS is shown.

  1. [Etiology and pathogenesis of primary hyperparathyroidism. (United States)

    Yamauchi, Mika; Sugimoto, Toshitsugu


    Primary hyperparathyroidism(pHPT)is a frequent endocrine disease in which abnormal calcium(Ca)regulation leads to hypercalcemia. The most frequent cause of pHPT in more than 80% of patients is an adenoma, followed by hyperplasia in about 15%, and cancer in 1~5%. Although most cases of pHPT are sporadic, a few are familial(hereditary), and this is known as familial hyperparathyroidism(FHPT). Gene abnormalities that affect cyclin D1 signaling(CCND1, CDC73, CDKN1B), Wnt/β-catenin signaling(MEN1), and calcium-sensing receptor signaling(CaSR, GNA11, AP2S1)play a role in the etiology and pathogenesis of pHPT. Vitamin D insufficiency/deficiency and CaSR dysfunction also play a role in pHPT severity. Continued elucidation of the etiology and pathogenesis of pHPT may lead to development of new treatments for pHPT as well as further understanding of Ca regulation.

  2. The infectious etiology of Alzheimer's Disease. (United States)

    Sochocka, Marta; Zwolińska, Katarzyna; Leszek, Jerzy


    Inflammation is a part of the first line of defense of the body against invasive pathogens, and plays a crucial role in tissue regeneration and repair. A proper inflammatory response ensures the suitable resolution of inflammation and elimination of harmful stimuli, but when the inflammatory reactions are inappropriate it can lead to damage of the surrounding normal cells. The relationship between infections and Alzheimer's Disease (AD) etiology, especially late-onset AD (LOAD) has been continuously debated over the past three decades. It is suggested that chronic viral, bacterial and fungal infections might be causative factors for the inflammatory pathway for AD. Emerging evidence supports the hypothesis of the role of neurotropic viruses from the Herpesviridae family, especially Human herpesvirus 1 (HHV-1), Cytomegalovirus (CMV), and Human herpesvirus 2 (HHV-2), in AD neuropathology. Recent investigations also indicate the association between Hepatitis C virus (HCV) infection and dementia. Among bacteria special attention is focused on spirochetes family and on periodontal pathogens such as Porphyromonas gingivalis or Treponema denticola that could cause chronic periodontitis and possibly contribute to the clinical onset of AD. This review discusses whether infections could be a causative factor that promotes the progression of AD and summarizes recent investigations associating infectious agents and chronic inflammation with AD. Preventive and therapeutic approaches to AD in the context of an infectious etiology of the disease are also discussed. Copyright© Bentham Science Publishers; For any queries, please email at

  3. [Hormonal factors in etiology of common acne]. (United States)

    Bergler-Czop, Beata; Brzezińska-Wcisło, Ligia


    Common acne is steatorrhoeic chronic disease, to which specific is, among others, the presence of blackheads, papulopustular eruptions, purulent cysts and cicatrices. Such hormonal factors belong to elements inherent in etiology of the affection. Sebaceous glands have cell receptors on their surface for androgens. In etiopathogenesis of common/simple acne, a decisive role is played by a derivative of testosterone, i.e. 5-alpha-dihydrotestosterone (DHT). However, some experts are of opinion that there is no correlation between the increased intensity of common acne and other symptoms of hyperandrogenism. Numerous authors assume, however, that common acne-affected patients may be sometimes subjected to intense reactions caused by sebaceous glands against physiological androgens concentrations. Naturally, estrogens can inhibit release of such androgens. Under physiological conditions, natural progesterone does not conduct to intensification of the seborrhea, but the activity of sebum secretion may be triggered off by its synthetic counterparts. Hormonal etiology can be very distinctly visible in the steroid, androgenic, premenstrual, menopausal acne, as well as in juvenile acne and acne neonatorum. In case of females affected by acne, hormonal therapy should be persistently supported and consulted with dermatologists, endocrinologists and gynecologists. Antiandrogenic preparations are applied, such as: cyproterone acetate concurrently administered with estrogens and, as well as not so frequently with chlormadinone acetate (independently or during estrogenic therapy).

  4. [About etiology and pathogenesis of atherosclerosis]. (United States)

    Vitruk, S K


    On the ground own researches and researches of other authors etiology and pathogenesis of atherosclerosis are proved and refuted existing concept about leading role of disturbance of lipid exchange and atherogenicity of lipoproteins of low and very low density. Established basic etiological factors of damage intima of artery and reason of penetration of lipoproteins in intima after her damage. Is determined that development and progression of atherosclerosis do not depend also from quantitative content of lipoproteins of low density in blood and from normalization of them under influence of drugs. According to our researches atherosclerosis is the polyetiological chronic disease basis of pathogeny which is infringement of blood supply (chronic microcirculatory insufficiency) in arterial wall causing damage of it, and in first place, damage of intima with her most vulnerable microcirculation; inflammation intima hence influence of endogenous and exogenous factors; destruction of antiaggregatic and fibrinolytic properties of intima in places of her damage; formation atherosclerotic plaque with level-by-level imposing of lipoproteins in result of cyclic process of restoration or balance between coagulation and anticoagulation of blood systems.

  5. The developmental etiology of high IQ. (United States)

    Brant, Angela M; Haberstick, Brett C; Corley, Robin P; Wadsworth, Sally J; DeFries, John C; Hewitt, John K


    The genetic and environmental trends in IQ development were assessed in 483 same-sex twin pairs in the Colorado longitudinal twin study using maximum-likelihood model-fitting analysis. The twins were assessed periodically from ages 1 to 16. Results show a decreasing influence of shared environment and an increasing influence of heritability across development, with large and increasing age to age stability of genetic influences. Non-shared environment contributes almost exclusively to age to age change. Similar analyses were conducted designating the top 15% of the sample as having high IQ at each age. The developmental etiology of high IQ did not significantly differ from that found for the continuous measure in this relatively novel analysis. These results demonstrate early stability in etiological influences on IQ and have potential implications for gene-finding efforts, suggesting that samples selected for high IQ can be used to find genetic variation that will be applicable to the full range of the IQ distribution, although conclusive demonstration that the same genes are indeed involved was beyond the scope of this study.

  6. Etiology and Pathogenesis of Idiopathic Achalasia. (United States)

    Pressman, Amanda; Behar, Jose


    This review examines the etiology and pathogenesis of idiopathic achalasia. This disease is clinically characterized by dysphagia of solids and liquids due to the presence of simultaneous or absent esophageal contractions and impaired or absent relaxation of the lower esophageal sphincter. It includes a review of (a) etiology and pathogenesis of this inflammatory process that damage the ganglion cells of the Auerbach plexus that is limited to the esophagus; (b) genetic abnormalities and polymorphisms associated with this disease that may help explain its heterogeneity expressed by the different motility abnormalities of its phenotypes as well as differences in its clinical progression. These different genetic abnormalities may be responsible for the slow progression of types I or II phenotypes; (c) indirect evidence of viruses present in these patients that may initiate its development; (d) the abnormalities of the muscle layer that may be responsible for the dilation of the body of the esophagus that ultimately causes the sigmoid-like esophagus in the very last phase of this disease. This progression to the end-stage phase tends to occur in about 5% of patients. And, (e) the chronic inflammatory abnormalities in the squamous mucosa that may be the cause of the dysplastic and neoplastic changes that may lead to squamous cell carcinoma whose incidence in this disease is increased. These mucosal abnormalities are usually present in patients with markedly dilated body of the esophagus and severe food stasis.

  7. Noncleft Velopharyngeal Insufficiency: Etiology and Need For Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Steven Goudy


    Full Text Available Objective. Velopharyngeal insufficiency (VPI occurs frequently in cleft palate patients. VPI also occurs in patients without cleft palate, but little is known about this patient population and this presents a diagnostic dilemma. Our goal is to review the etiology of noncleft VPI and the surgical treatment involved. Design/Patients. A retrospective review of VPI patients from 1990 to 2005. Demographic, genetic, speech, and surgical data were collected. We compared the need for surgery and outcomes data between noncleft and cleft VPI patients using a Student’s -test. Results. We identified 43 patients with noncleft VPI, of which 24 were females and 19 were males. The average age at presentation of noncleft VPI was 9.6 years (range 4.5–21. The average patient age at the time of study was 13.4 years. The etiology of VPI in these noncleft patients was neurologic dysfunction 44%, syndrome-associated 35%, postadenotonsillectomy 7%, and multiple causes 14%. The need for surgical intervention in the noncleft VPI group was 37% (15/43 compared to the cleft palate controls, which was 27% (12/43. There was not a statistical difference between these two groups (>0.5. Conclusion. Noncleft VPI often occurs in patients who have underlying neurologic disorders or have syndromes. The rate of speech surgery to address VPI is similar to that of cleft palate patients. We propose that newly diagnosed noncleft VPI patients should undergo a thorough neurologic and genetic evaluation prior to surgery.

  8. [Multifactorial etiology of obesity: nutritional and central aspects]. (United States)

    Sengier, A


    World-wide obesity and its effects are public health problems. Research on way of life and eating habits give some indications of etiological factors. Breast feeding and quantity of proteins intake in formulas are factors influencing the risks of obesity later on in life. Research undertaken by Rolland Cachera shows us the importance of the curve of BMI and how the obesity rebound can be predictive of obesity in later years allowing early decisions of weight control. Energy intake and energy expenditure are regulated by the central nervous system. It is a complex mechanism of afferent and efferent systems through the hypothalamus. The inverse effects of ghreline and of leptine on energy balance are more and more studied and cases of precocious obesity are explained by the identification of rare forms of monogenic obesity linked to the metabolism of leptine. The importance of inherited genes has a role and genetic predisposition is a reality. This new approach allows a clinical, etiological and, in the future, probably therapeutic attitude in case of severe precocious obesity.

  9. Etiology and Comprehen-sive Prevention and Con-trol Technology of Cow Mastitis%奶牛乳房炎的病因及综合防治技术

    Institute of Scientific and Technical Information of China (English)

    俞步清; 尹召华; 张宜辉


    Mastitis was one of the most common diseases in cow, including clinical mastitis and subclinical mastitis, which led to severe losses to develop-ment of dairy industry. The aetiological agent, detection ,comprehensive preven-tion and control technology were summa-ried to provide reference for further study on prevention and control of cow mastitis.%乳房炎是奶牛养殖中最常见的疾病之一,可分为临床型乳房炎和隐性乳房炎两种,其发生对奶业发展造成了严重的阻碍。文中从发病原因、检测与综合防治技术等方面对奶牛乳房炎进行了综述,以期为进一步研究奶牛乳房炎防治提供参考。

  10. Etiological factors of Alzheimer disease and recent advances of its treatment advance

    Institute of Scientific and Technical Information of China (English)

    Wen Xia; Enji Han


    OBJECTIVE: To investigate the etiological factors of Alzheimer disease (AD) and the advance in drug treatment.DATA SOURCES: Using the terms "Alzheimer disease, etiology, drug treatment", we searched Medline database for AD treatment-related English literatures which were published between January 1993 and September 2006. Other literatures were obtained by searching concrete magazines and papers by hand.STUDY SELECTION: The data were selected primarily. Epidemiologic study and randomized controlled clinical trials were selected, and those studies with repetitive or similar contents were excluded.DATA EXTRACTION: Totally 1 537 AD and its treatment-related literatures were collected, and 32 of them were involved. Altogether 1 505 non-randomized controlled clinical trials, repetitive studies and reviews were excluded.DATA SYNTHESIS: The restriction of curative effect is a progressive neural degenerative disease. Although the etiological hypothesis of this disease has been introduced, the etiological factors of this disease are still unclear. The current treatments mainly involve: preventing against A β formation and clearing Aβ,application of antioxidant and free radical scavengers, application of anti-inflammatory preparation,application of cholinergic preparation, hormonal therapy, application of metabolic enhancer, application of neurotrophic factor and nerve protectant, gene therapy and so on.CONCLUSION: The etiological factors of AD are still unclear, and symptomatic treatment is much taken in clinical therapy. Therefore, the curative effects of AD are still not very ideal.

  11. Etiological factors associated with temporomandibular joint disorder - study on animal model. (United States)

    Chisnoiu, Andrea Maria; Chisnoiu, Radu; Moldovan, Marioara; Lascu, Liana Maria; Picoş, Alina Monica


    The etiology of temporomandibular disorder (TMD) is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. The main objectives of our study were investigation and analysis of the degree of involvement for several presumptive etiological factors of TMD: biomechanical stress (BS), estrogen hormones (EH) and emotional stress (ES). Six groups (n=10) of mature female Wistar rats were included in the study. Single presumptive etiological factor was applied in three groups (BS, EH and ES groups) and also association of presumptive etiological factors were applied in two groups (BSEH and BSES groups). No etiological factor was applied for the control group. Animals were sacrificed after a 60 days period and histological analysis of the temporomandibular joint (TMJ) tissues was performed. The changes in the mandibular cartilage, articular disc, temporal bone and synovial tissue were observed under optical magnification and quantified. All samples developed changes in the thickness of the condylar cartilage comparing to control group. The reduction was highly statistical significant for the EH, ES and BSES groups (petiological factors in TMD.

  12. Etiology of homosexuality and attitudes toward same-sex parenting: a randomized study. (United States)

    Frias-Navarro, Dolores; Monterde-I-Bort, Hector; Pascual-Soler, Marcos; Badenes-Ribera, Laura


    Attribution theory suggests the hypothesis that heterosexuals' attitudes toward homosexual sexual orientation will be more negative when homosexuality is attributed to controllable causes. Our randomized study analyzed (a) whether beliefs about the genetic or environmental etiology of the homosexual sexual orientation can be immediately modified by reading a text and (b) the causal effect of attributions about the controllability (environmental etiology) or noncontrollability (genetic etiology) of homosexual sexual orientation on the rejection of same-sex parenting and their social rights. The sample was composed of 190 Spanish university students with a mean age of 22.07 years (SD = 8.46). The results show that beliefs about the etiology of the sexual orientation could be modified by means of a written text. Furthermore, participants who believed that sexual orientation had a genetic etiology showed greater support for social rights and less rejection of same-sex parenting. However, the effects were detected only when there was a traditional opposition to the family with same-sex parenting. When the opposition was normative, the effect was not statistically significant. Our results can be useful in planning variables for intervention programs designed to foster tolerance toward and normality of sexual diversity.

  13. Periodontal Considerations for the Child and Adolescent. A Literature Review. (United States)

    Lin, Guo-Hao; Boynton, James R


    The primary etiology of periodontal disease is bacterial plaque and its byproducts in a susceptible host. Although the prevalence of plaque-induced periodontal disease is relatively low for the child and adolescent, destructive periodontal disease may be a manifestation of an underlying systemic disease. In some cases, childhood periodontal destruction may be the first sign of systemic disease, making appropriate recognition and determination of etiology critical in this population. Therefore, this literature review discusses the periodontal considerations for the child and adolescent patient, aiming to offer a guide for differential diagnosis and oral management of periodontal disease in the young population.

  14. Occipital neuralgia: anatomic considerations. (United States)

    Cesmebasi, Alper; Muhleman, Mitchel A; Hulsberg, Paul; Gielecki, Jerzy; Matusz, Petru; Tubbs, R Shane; Loukas, Marios


    Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia.

  15. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

    Directory of Open Access Journals (Sweden)

    Dave TV


    Full Text Available Tarjani Vivek Dave, Faraz Ali Mohammed, Mohammad Javed Ali, Milind N Naik The Institute of Dacryology, L V Prasad Eye Institute, Hyderabad, India Background: The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR. Patients and methods: Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results: Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19 followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16 and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83. The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1 were noted in the external group only. Conclusion: Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. Keywords: failed


    Directory of Open Access Journals (Sweden)



    Full Text Available Oral cancer is the largest group of cancer that categorizes into the head and neck region and worldwide health problem. Exact cause of oral cancer is unknown. Risk factors for cancer could be varied including Iron deficiency anemi a, are alcohol, tobacco, immunologic susceptibility, gene mutations, epithelial cell growth, suppressor proteins and disease of chemotherapy, such as in cases of lymphoma and leukemia. Role of viruses have also been reported in the etiology. Dietary factor s such as high fat and low fiber may play a role in carcinogenesis in some sites. High incidence of alcoholism is relevant because alcohol intake has been related to an increase risk of developing oral cancer. Other signaling factors have also been propose d to have a role. The paper presents a review on oral cancer, its causes & concern.

  17. Etiology of nursing caries: a microbiologic perspective. (United States)

    Berkowitz, R


    A compelling body of scientific evidence supports the concept that nursing caries is an infectious and transmissible disease. This evidence makes a strong case to support the tenet that infants who are colonized by mutans streptococci, and who have feeding habits characterized by frequent and prolonged oral exposure to cariogenic substrates, are likely to have a drastic increase in their oral mutans streptococci populations. Such an increase is associated with a high risk for rampant dental caries. This evidence strongly suggests that the first step in the etiology of nursing caries is primary infection by mutans streptococci; the second step is accumulation of these organisms to pathogenic levels as a consequence of frequent and prolonged oral exposure to cariogenic substrates; and the third step is rapid demineralization and cavitation of enamel resulting in rampant dental caries. This three-step model might provide an important framework for the design of clinical trials targeted at prevention of nursing caries.

  18. [Peptic ulcer disease etiology, diagnosis and treatment]. (United States)

    Bak-Romaniszyn, Leokadia; Wojtuń, Stanisław; Gil, Jerzy; Płaneta-Małecka, Izabela


    Authors in this article present etiology, clinical manifestations, diagnostic procedures and treatment of peptic ulcer disease in children and adults. Increased gastric acid output, Helicobacter pylori, NSAIDs and stress are the basic risk factors in peptic ulcer disease. H. pylori infection is a widely known risk factor in peptic ulcer disease and influences diagnostic and treatment procedures. Primary ulcer disease concerns mainly duodenum and is accompanied by H. pylori infection. Gastroscopy and Helicobacter tests are the only reliable procedures to diagnose peptic ulcer disease. Nowadays the most important aim in peptic ulcer treatment is the H. pylori eradication. Therapy with two antibiotics and a protein pomp inhibitor eradicates the bacteria, treats the ulceration and lowers the number of ulcer recurrence. In non-infected H. pylori ulcers or in a long-term treatment protein pomp inhibitors and H2-inhibitors are effective as well in gastroprotective therapy.

  19. Pulmonary vein stenosis: Etiology, diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Pablo Pazos-López; Cristina García-Rodríguez; Alba Guitián-González; Emilio Paredes-Galán; María ángel; De La Guarda álvarez-Moure; Marta Rodríguez-álvarez; José Antonio Baz-Alonso; Elvis Teijeira-Fernández; Francisco Eugenio Calvo-Iglesias; Andrés í?iguez-Romo


    Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.

  20. Medical considerations for the master athlete. (United States)

    Arlis-Mayor, Stephanie


    As the American population ages, older adults are likely to continue their active lifestyles including participation in high-level competitive sports. Physicians caring for the older athlete will need to guide activity and return-to-play to optimize the athlete's performance, as well as safely support their physical and mental health. Many medical concerns of the older athlete have the same etiology and treatment as those of their younger counterpart However, there are medical considerations of the mature athlete that are unique to this population. It is the purpose of this paper to review some of the medical considerations that may arise in the care of the older athlete. For the purpose of this review, the mature athlete is de!ned as an individual over the age of 40, who participates in sport at a competitive level.

  1. Plantar fasciitis: diagnosis and therapeutic considerations. (United States)

    Roxas, Mario


    Plantar fasciitis is the most common cause of inferior heel pain. The pain and discomfort associated with this condition can have a dramatic impact on physical mobility. The etiology of this condition is not clearly understood and is probably multi-factorial in nature. Weight gain, occupation-related activity, anatomical variations, poor biomechanics, overexertion, and inadequate footwear are contributing factors. Although plantar fasciitis is generally regarded as a self-limited condition, it can take months to years to resolve, presenting a challenge for clinicians. Many treatment options are available that demonstrate variable levels of efficacy. Conservative therapies include rest and avoidance of potentially aggravating activities, stretching and strengthening exercises, orthotics, arch supports, and night splinting. Other considerations include use of anti-inflammatory agents, ultrasonic shockwave therapy, and, in the most extreme cases, surgery. This article reviews plantar fasciitis, presents the most effective treatment options currently available, and proposes nutritional considerations that may be beneficial in the management of this condition.

  2. Lifestyle and Sarcopenia—Etiology, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    Oren Rom


    Full Text Available The term sarcopenia describes the loss of skeletal muscle mass, strength, and function in old age. As the world population continues to grow older, more attention is given to the phenomena of sarcopenia and the search for strategies of prevention and treatment. The progression of sarcopenia is affected by age-related physiological and systemic changes in the body, including alterations in skeletal muscle tissue, hormonal changes, increased inflammatory activities, and oxidative stress. Sarcopenia progression is also affected by lifestyle factors which are far more controllable. These factors include various aspects of nutrition, physical activity, exercise, alcohol intake, and tobacco use. Raising the public awareness regarding the impact of these factors, as causes of sarcopenia and potential strategies of prevention and treatment, is of great importance. In this review we aim to describe various lifestyle factors that affect the etiology, prevention, and treatment of sarcopenia.

  3. Osteoradionecrosis of the mandible: Etiology, prevention, diagnosis and treatment

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    Rayatt Sukh


    Full Text Available The treatment of head and neck cancer remains a challenge. Despite advances in surgical reconstructive techniques, most patients will require adjuvant therapy in the form of radiotherapy or chemo-radiotherapy to improve locoregional control. The short- and long term side effects of radiotherapy can be difficult to treat. In this review the causative effects and pathogenesis of osteoradionecrosis of the mandible will be highlighted. In addition, preventive measures and clinical features of radiotherapy induced damage will be presented. Finally, medical and surgical management of osteoradionecrosis, as well as, reconstructive surgery of the mandible will be discussed. At the end of this paper the reader should have up to date knowledge concerning the etiology, prevention, diagnosis and treatment of patients with osteoradionecrosis of the mandible.

  4. Perspectives on the Etiology of Violence in Later Life

    DEFF Research Database (Denmark)

    Mysyuk, Yuliya; Westendorp, Rudi G. J.; Lindenberg, Jolanda


    This article focuses on the development of a conceptual framework for explaining the etiology of violence in later life by various groups involved in the field of elder abuse. In this study, we explore this through eight focus groups with different professionals involved in the field of elder abuse...... and older persons themselves and in interviews with 35 experts in the field. Our findings show that dependency, vulnerability, power and control, social isolation, stress, and care burden play a central role in their explanations for the occurrence of violence in later life. The role of a history...... of violence in violence in later life is equivocal. The complexity and ambiguity of dependency and vulnerability, the notion of mutual dependency, and diverse attitudes and expectations toward them that arise with the aging process are distinct features of violence in later life that were found....

  5. Oral Lichen Planus: Clinical Features, Etiology, Treatment and Management; A Review of Literature

    Directory of Open Access Journals (Sweden)

    Marzieh Boorghani


    Full Text Available Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many unestablished etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

  6. Enteroviral infection outbreak in the Republic of Belarus: principal characteristics and phylogenetic analysis of etiological agents. (United States)

    Amvrosieva, Tamara V; Paklonskaya, Natallia V; Biazruchka, Aliaksei A; Kazinetz, Olga N; Bohush, Zoya F; Fisenko, Elena G


    For the last decade enterovirus outbreaks were registered in all of six districts of Belarus. Two of them, reported in 1997 (in Gomel) and in 2003 (in Minsk), were the most extensive and involved 461 and 1,351 patients respectively. Virus ECHO 30 was identified as the dominant etiologic agent of the outbreak in 1997 whereas co-circulation of ECHO 30, ECHO 6 and Coxsackievirus B5 took place in 2003. Analysis of clinical manifestations during the Minsk outbreak revealed unusually high rate of severe clinical forms of infection including aseptic meningitis, encephalitis and myocardial disorders. Epidemiologic observation was ordinary for enterovirus epidemics in temperate climates: the peak of the outbreak was recorded during summer-autumn period of 2003, and 0-14 years old children predominated. Data from the case-control study indicated that illness was associated with drinking water from community water system. Also the laboratory examination demonstrated contamination of different water samples with the epidemic virus serotypes and sequence analysis showed high level of genetic similarity between waterborne and clinical isolates. For these reasons the outbreak should be classified as a waterborne one. Phylogenetic reconstruction showed that all Belarusian ECHO 30 isolates belong to the major genotype of ECHO 30 which has been circulating for last 15 years in Europe and North America. Viral agents of 2003 were very similar and substantially differed from isolates of 1997. Comparison of nucleotide sequences of isolates from myocarditis patients revealed their considerable genetic similarity with ECHO 30 isolates from patients with aseptic meningitis and from water. The results of the study draw attention to the importance of virological control of tap and bottled water as a relevant measure aimed at reduction of epidemiological risks.

  7. Erythropoietin Levels in Elderly Patients with Anemia of Unknown Etiology.

    Directory of Open Access Journals (Sweden)

    Zachary Gowanlock

    Full Text Available In many elderly patients with anemia, a specific cause cannot be identified. This study investigates whether erythropoietin levels are inappropriately low in these cases of "anemia of unknown etiology" and whether this trend persists after accounting for confounders.This study includes all anemic patients over 60 years old who had erythropoietin measured between 2005 and 2013 at a single center. Three independent reviewers used defined criteria to assign each patient's anemia to one of ten etiologies: chronic kidney disease, iron deficiency, chronic disease, confirmed myelodysplastic syndrome (MDS, suspected MDS, vitamin B12 deficiency, folate deficiency, anemia of unknown etiology, other etiology, or multifactorial etiology. Iron deficiency anemia served as the comparison group in all analyses. We used linear regression to model the relationship between erythropoietin and the presence of each etiology, sequentially adding terms to the model to account for the hemoglobin concentration, estimated glomerular filtration rate (eGFR and Charlson Comorbidity Index.A total of 570 patients met the inclusion criteria. Linear regression analysis showed that erythropoietin levels in chronic kidney disease, anemia of chronic disease and anemia of unknown etiology were lower by 48%, 46% and 27%, respectively, compared to iron deficiency anemia even after adjusting for hemoglobin, eGFR and comorbidities.We have shown that erythropoietin levels are inappropriately low in anemia of unknown etiology, even after adjusting for confounders. This suggests that decreased erythropoietin production may play a key role in the pathogenesis of anemia of unknown etiology.

  8. The Etiology and Outcome Analysis of Neonatal Burst Suppression EEG

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lian; ZHOU Yanxia; XU Sanqing


    The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was sug-gested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.

  9. Left Atrial Function Is Impaired in Some Patients With Stroke of Undetermined Etiology: Potential Implications for Evaluation and Therapy. (United States)

    Sanchis, Laura; Montserrat, Silvia; Obach, Víctor; Cervera, Álvaro; Chamorro, Ángel; Vidal, Bàrbara; Mas-Stachurska, Aleksandra; Bijnens, Bart; Sitges, Marta


    Stroke etiology remains undetermined in up to 30% of cases. Paroxysmal atrial fibrillation is found in 20% to 28% of patients with stroke initially classified as being of undetermined etiology. The aim of our study was to analyze left atrial function in ischemic stroke patients to identify patterns associated with cardioembolic etiology and to determine whether the patterns identified can be found in individuals initially classified as having a stroke of undetermined etiology. We studied a cohort of in-hospital ischemic stroke patients referred for transthoracic echocardiography. Treating neurologists determined stroke etiology based on the TOAST classification. Left atrial contractile function was assessed using 2-dimensional echocardiography to determine their ejection fraction and speckle tracking to measure left atrial strain rate: a-wave. Left atrial function was compared between stroke etiology subgroups and healthy controls. Ninety-seven patients (aged 67±15 years) with ischemic stroke (16.5% large-artery atherosclerosis, 15.5% small-vessel occlusion, 11.3% cardioembolic, 5.1% other determined etiology, 51.1% undetermined etiology) and 10 healthy volunteers (aged 63±7 years) were included. Left atrial ejection fraction was significantly decreased only in patients with stroke of cardioembolic and undetermined etiology compared with the control group (31.5±17.2%, 40.2±17.1%, and 59.1±8.4%, respectively; P=.004). The left atrial strain rate was significantly lower in patients with stroke caused by cardioembolic or undetermined etiology, or large-artery atherosclerosis compared with controls (-0.86±0.49, -1.31±0.56, -1.5±0.47, -2.37±1.18, respectively; Pundetermined etiology with left atrial function (ejection fraction and strain) similar to that of cardioembolic stroke patients may be misclassified and could potentially benefit from prolonged electrocardiography monitoring. Left atrial function analysis (ejection fraction and strain) might help to

  10. Scoliosis and anaesthetic considerations

    Directory of Open Access Journals (Sweden)

    Anand H Kulkarni


    Full Text Available Scoliosis may be of varied etiology and tends to cause a restrictive ventilatory defect, along with ventilation-perfusion mismatch and hypoxemia. There is also cardiovascular involvement in the form of raised right heart pressures, mitral valve prolapse or congenital heart disease. Thus a careful pre-anaesthetic evaluation and optimization should be done. Intraoperatively temperature and fluid balance, positioning, spinal cord integrity testing and blood conservation techniques are to be kept in mind. Postoperatively, intensive respiratory therapy and pain management are prime concerns.

  11. Contribution to the control of doubly-fed induction generators in wind power plants with particular consideration of asymmetrical grid conditions

    Energy Technology Data Exchange (ETDEWEB)

    Richter, Marlies


    In the study presented here, four different control strategies for the control of the inverter currents of a doubly-fed induction generator (DFIG) system are analysed and evaluated by means of simulation using Matlab/Simulink registered. Special attention is paid to the behaviour of the generator during asymmetrical grid voltage dips. Different control schemes are employed to reduce torque and DC-link voltage oscillations and the resulting additional loads on the system during such dips. The field-oriented control (FOC) scheme is the one usually deployed for the control of DFIGs in wind power plants and is used as the reference system within this study. The inverter currents (of the rotor-side inverter and the grid-side inverter) are regulated by proportional-integral controllers (PI) in a rotating coordinate system in which they are represented by dq-components. These components are direct quantities. A positive-negative-sequence current control (PNC) strategy is used to control the positive-sequence currents and the negative-sequence currents separately in two contra-rotating coordinate systems using PI-controllers. In contrast to the first two control strategies, frequency-selective current controllers (FSC) serve to regulate the currents in a static coordinate system. In this case the currents are represented by {alpha}{beta}-components which are alternating quantities. Combining the FSC and PNC strategies will produce frequencyselective positive-negative-sequence current controllers (FSC(PN)). These control the currents in a static coordinate system. The currents are represented by alternating {alpha}{beta}-components as in frequency-selective control but separate reference values for the negative-sequence currents are provided as in positive-negative-sequence control. Theoretical reasoning suggests and simulations prove that the three proposed alternative control strategies can improve the behaviour of DFIG-systems during slight asymmetries in the grid

  12. Acute pancreatitis: Etiology and common pathogenesis

    Institute of Scientific and Technical Information of China (English)

    Guo-Jun Wang; Chun-Fang Gao; Dong Wei; Cun Wang; Si-Qin Ding


    Acute pancreatitis is an inflammatory disease of the pancreas. The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Many causes of acute pancreatitis have been discovered, but the pathogenetic theories are controversial. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct. The majority of investigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux. Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed. However, little is known about the other acute pancreatitis. We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis. Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure, active trypsin reflux, and subsequent unregulated activation of trypsin within pancreatic acinar cells. Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation. Once the hypothesis is confirmed, traditional therapeutic strategies against acute pancreatitis may be improved. Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.


    Directory of Open Access Journals (Sweden)

    O. E. Iryshkin


    Full Text Available Biliary atresia is an inflammatory fibrosing process, which invades both extrahepatic and intrahepatic bile ducts. There are two forms of biliary atresia: embryonic form, associated with another visceral malformations, and perinatal form, which is an isolated disease. Biliary atresia is a heterogeinc disease which may appear as a result of different etiological factors, the most important of them are genetics, viral infection, vascular factors, toxins and disregulation of immune system. The characteristic morphological features of biliaryatresia are: intracellular and ductular cholestasis, ductular proliferation, giant cell transformation, portal and perilobular oedema and/or fibrosis. As the patalogical process progresses, ductopenia appears, and fibrosis turns to cirrhosis. Embryonic form mophologically manifests with ductal plate malformation is, what is an important diagnostic criterion. Pro- gnosis of biliary atresia depends on form of disease, age of patient and type of surgical operation. Today surgical treatment includes two steps: palliative portoenterostomia, performed in neonatal period and further liver trans- plantation. However liver transplantation is more preferable as first and single-step treatment. 

  14. Understanding and determining the etiology of autism. (United States)

    Currenti, Salvatore A


    Worldwide, the rate of autism has been steadily rising. There are several environmental factors in concert with genetic susceptibilities that are contributing to this rise. Impaired methylation and mutations of mecp2 have been associated with autistic spectrum disorders, and related Rett syndrome. Genetic polymorphisms of cytochrome P450 enzymes have also been linked to autism, specifically CYP27B1 that is essential for proper vitamin D metabolism. Vitamin D is important for neuronal growth and neurodevelopment, and defects in metabolism or deficiency have been implicated in autistic individuals. Other factors that have been considered include: maternally derived antibodies, maternal infection, heavy metal exposure, folic acid supplementation, epigenetics, measles, mumps, rubella vaccination, and even electromagnetic radiation. In each case, the consequences, whether direct or indirect, negatively affect the nervous system, neurodevelopment, and environmental responsive genes. The etiology of autism is a topic of controversial debate, while researchers strive to achieve a common objective. The goal is to identify the cause(s) of autism to understand the complex interplay between environment and gene regulation. There is optimism that specific causes and risk factors will be identified. The results of future investigations will facilitate enhanced screening, prevention, and therapy for "at risk" and autistic patients.

  15. Environmental contaminants as etiologic factors for diabetes. (United States)

    Longnecker, M P; Daniels, J L


    For both type 1 and type 2 diabetes mellitus, the rates have been increasing in the United States and elsewhere; rates vary widely by country, and genetic factors account for less than half of new cases. These observations suggest environmental factors cause both type 1 and type 2 diabetes. Occupational exposures have been associated with increased risk of diabetes. In addition, recent data suggest that toxic substances in the environment, other than infectious agents or exposures that stimulate an immune response, are associated with the occurrence of these diseases. We reviewed the epidemiologic data that addressed whether environmental contaminants might cause type 1 or type 2 diabetes. For type 1 diabetes, higher intake of nitrates, nitrites, and N-nitroso compounds, as well as higher serum levels of polychlorinated biphenyls have been associated with increased risk. Overall, however, the data were limited or inconsistent. With respect to type 2 diabetes, data on arsenic and 2,3,7,8-tetrachlorodibenzo-p-dioxin relative to risk were suggestive of a direct association but were inconclusive. The occupational data suggested that more data on exposure to N-nitroso compounds, arsenic, dioxins, talc, and straight oil machining fluids in relation to diabetes would be useful. Although environmental factors other than contaminants may account for the majority of type 1 and type 2 diabetes, the etiologic role of several contaminants and occupational exposures deserves further study.

  16. Cervicogenic vertigo: etiology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Elham Tavanai


    Full Text Available Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms . In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed. Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar , PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched. Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.

  17. Papilledema: epidemiology, etiology, and clinical management

    Directory of Open Access Journals (Sweden)

    Rigi M


    Full Text Available Mohammed Rigi,1 Sumayya J Almarzouqi,2 Michael L Morgan,2 Andrew G Lee2–4 1Robert Cizik Eye Clinic, University of Texas, 2Department of Ophthalmology, Houston Methodist Hospital, Blanton Eye Institute, 3Baylor College of Medicine, 4Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, UTMB Galveston, UT MD Anderson Cancer Center, Houston, TX, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA Abstract: Papilledema is optic disc swelling due to high intracranial pressure. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydrocephalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracranial hypertension (IIH. Irrespective of the cause, visual loss is the feared morbidity of papilledema, and the main mechanism of optic nerve damage is intraneuronal ischemia secondary to axoplasmic flow stasis. Treatment is directed at correcting the underlying cause. In cases where there is no other identifiable cause for intracranial hypertension (ie, IIH the available options include both medical and surgical modalities. Weight loss and diuretics remain the mainstays for treatment of IIH, and surgery is typically reserved for patients who fail, are intolerant to, or non-compliant with maximum medical therapy. Keywords: papilledema, intracranial hypertension, idiopathic intracranial hypertension, epidemiology, papilledema management, papilledema etiology, acetazolamide, optic nerve sheath fenestration, ventriculoperitoneal shunt, lumboperitoneal shunt, venous sinus stenting

  18. Infantile epileptic syndromes and metabolic etiologies. (United States)

    Vigevano, Federico; Bartuli, Andrea


    Inherited metabolic disorders can cause onset of epilepsy in the first year of life. Epilepsy rarely dominates the clinical presentation, which is more frequently associated with other neurologic symptoms, such as mental retardation, hypotonia and/or dystonia, or vigilance disturbances. The pathogenesis of seizures is multifaceted; inherited metabolic disorder can affect the balance between excitatory and inhibitory chemical mediators, eliminate an energetic substrate at the cerebral level, cause in utero brain malformation, or provoke acute brain lesions. Some clinical disorders that strongly suggest particular metabolic etiologies can be identified. For example, specific clinical signs and findings on electroencephalogram (EEG) are characteristic of pyridoxine-dependent seizures, and inherited metabolic disorders associated with early myoclonic encephalopathy are well defined. In most cases, however, epilepsy secondary to inherited metabolic disorders presents with polymorphic clinical and EEG features that are difficult to classify into precise epileptic syndromes. Common characteristics of these seizures include onset in the first months of life; usually partial, multifocal; simple partial motor semiology; successive appearance of tonic seizures, spasms, and massive myoclonus; and resistance to antiepilepsy drugs. Inherited metabolic disorders must be considered in patients presenting with epilepsy and progressive neurologic worsening.

  19. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Enrico Bellato


    Full Text Available Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable bowel disease, and heat and cold intolerance can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2, milnacipran (NNT 19, and pregabalin (NNT 8.6 are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy.

  20. [Etiology and pathogenesis of inflammatory bowel diseases]. (United States)

    Lukáš, Milan


    Zdenek Mařatka has been the first physician, who had brought a new information for the Czech medical community with topic of inflammatory bowel diseases, which had been systematic studied for him. He had prepared an original theory - two component hypothesis about origin of ulcerative colitis, which had been developed and innovated by him for long time. From the international point of view, Mařatka has had an extraordinary impact and significant contribution for recognition of ulcerative colitis and Crohn´s disease. Despite the fact that the true origin of ulcerative colitis and Crohn´s disease (UC) still remain elusive, basic as well as clinical research bring many new data on etiology and pathogenesis of this inflammatory condition. It seems clear that IBD originate from interaction of several intrinsic and extrinsic factors that contribute individually in a particular patient. Among internal factors the genes play an important role, because its influence on the mucosal immunity system and immunological response. Among the external factors importance are recognized the gut microbiota content, cigarette smoking and psychological stress.

  1. Effect of microorganisms on etiology of hematospermia

    Directory of Open Access Journals (Sweden)

    Musa Saracoglu


    Full Text Available Background: Hematospermia is the presence of blood in the ejaculate. Its etiology is congenital, inflammatory, infectious, obstructive, tumoral, vascular, traumatic, iatrogenic or related to systemic disease. It is a quite irritating and life-quality-disturbing condition for men. It is significant to demonstrate infectious-based hematospermia due to the fact that its treatment is easier than for other reasons. Methods: 30 patients, having spontaneous hematospermia, were taken to our study. The serum total PSA levels of the patients were examined and microbiological examinations such as direct inspection for ejaculate, routine bacteriological and mycetes culture, Gram staining, trichrome staining and Mycoplasma hominis/Ureaplasma urealyticum culture (Mycofast Evolution 3, ELITech, France were performed. Results: Bacteria was isolated in 11 (36% of 30 patients with hematospermia. S.aureus occurred in five patients (45.5%, U.urealyticum in three patients (27.2% and E.coli and K.pneumoniae in one each (9.1%. U.urealyticum and S.aureus occurred together in one patient. No statistical difference of scores of National Institute of Health-Chronic Prostatitis Symptoms Index (CPSI and serum total PSA levels between the patients with and without infection was observed. Conclusions: Hematospermia mostly affects micturition functions of young men and it can be due to infection in one-third of the cases.

  2. Molar incisor hypomineralization, prevalence, and etiology. (United States)

    Allazzam, Sulaiman Mohammed; Alaki, Sumer Madani; El Meligy, Omar Abdel Sadek


    Aim. To evaluate the prevalence and possible etiological factors associated with molar incisor hypomineralization (MIH) among a group of children in Jeddah, Saudi Arabia. Methods. A group of 8-12-year-old children were recruited (n = 267) from the Pediatric Dental Clinics at the Faculty of Dentistry, King Abdulaziz University. Children had at least one first permanent molar (FPM), erupted or partially erupted. Demographic information, children's medical history, and pregnancy-related data were obtained. The crowns of the FPM and permanent incisors were examined for demarcated opacities, posteruptive breakdown (PEB), atypical restorations, and extracted FPMs. Children were considered to have MIH if one or more FPM with or without involvement of incisors met the diagnostic criteria. Results. MIH showed a prevalence of 8.6%. Demarcated opacities were the most common form. Maxillary central incisors were more affected than mandibular (P = 0.01). The condition was more prevalent in children with history of illnesses during the first four years of life including tonsillitis (P = 0.001), adenoiditis (P = 0.001), asthma (P = 0.001), fever (P = 0.014), and antibiotics intake (P = 0.001). Conclusions. The prevalence of MIH is significantly associated with childhood illnesses during the first four years of life including asthma, adenoid infections, tonsillitis, fever, and antibiotics intake.

  3. Molar Incisor Hypomineralization, Prevalence, and Etiology

    Directory of Open Access Journals (Sweden)

    Sulaiman Mohammed Allazzam


    Full Text Available Aim. To evaluate the prevalence and possible etiological factors associated with molar incisor hypomineralization (MIH among a group of children in Jeddah, Saudi Arabia. Methods. A group of 8-12-year-old children were recruited (n=267  from the Pediatric Dental Clinics at the Faculty of Dentistry, King Abdulaziz University. Children had at least one first permanent molar (FPM, erupted or partially erupted. Demographic information, children’s medical history, and pregnancy-related data were obtained. The crowns of the FPM and permanent incisors were examined for demarcated opacities, posteruptive breakdown (PEB, atypical restorations, and extracted FPMs. Children were considered to have MIH if one or more FPM with or without involvement of incisors met the diagnostic criteria. Results. MIH showed a prevalence of 8.6%. Demarcated opacities were the most common form. Maxillary central incisors were more affected than mandibular (P=0.01. The condition was more prevalent in children with history of illnesses during the first four years of life including tonsillitis (P=0.001, adenoiditis (P=0.001, asthma (P=0.001, fever (P=0.014, and antibiotics intake (P=0.001. Conclusions. The prevalence of MIH is significantly associated with childhood illnesses during the first four years of life including asthma, adenoid infections, tonsillitis, fever, and antibiotics intake.

  4. The chronobiology, etiology and pathophysiology of obesity. (United States)

    Garaulet, M; Ordovás, J M; Madrid, J A


    The effect of CD on human health is an emerging issue. Many records link CD with diseases such as cancer, cardiovascular, cognitive impairment and obesity, all of them conducive to premature aging. The amount of sleep has declined by 1.5 h over the past century, accompanied by an important increase in obesity. Shift work, sleep deprivation and exposure to bright light at night increase the prevalence of adiposity. Animal models have shown that mice with Clock gene disruption are prone to developing obesity and MetS. This review summarizes the latest developments with regard to chronobiology and obesity, considering (1) how molecular clocks coordinate metabolism and the specific role of the adipocyte; (2) CD and its causes and pathological consequences; (3) the epidemiological evidence of obesity as a chronobiological illness; and (4) theories of circadian disruption and obesity. Energy intake and expenditure, relevance of sleep, fat intake from a circadian perspective and psychological and genetic aspects of obesity are examined. Finally, ideas about the use of chronobiology in the treatment of obesity are discussed. Such knowledge has the potential to become a valuable tool in the understanding of the relationship between the chronobiology, etiology and pathophysiology of obesity.


    Directory of Open Access Journals (Sweden)

    Maria LULESCU


    Full Text Available The present paper analyses the causes that lead to violent behaviour in sport (from the social, economic, biological and psychological factors to the violent patterns promoted by mass media and it identifies the measures that could be adopted for preventing and fighting against this widespread phenomenon in today’s society. The phenomenon of violence in sport appeared subsequent to the “Sport Revolution”, which occurred in the 19th century, when sport became a mass and democratic phenomenon. Today sport is accessible to all society members for whom it has acquired cultural and economic importance; however, it is generally agreed that sport events are more or less frequently accompanied by violent behaviour on the part of most or some of its supporters. This scientific article enumerates the causes that trigger violent behaviour in society: from the inner ones (tension, fear, lack of success, incapacity to the social, biological, psychological and economic ones (lack of education, illnesses, trauma and poverty. Similarly, the present article analyses the influence of mass media upon human behaviour while taking into consideration two paradigms: there is a former paradigm, according to which mass media strongly influence human behaviour, by inculcating upon people violent reactions; there is a latter paradigm, according to which the influence of mass media on human behaviour is relatively insignificant for it is the individual that controls this influence. In this paper I have also analysed the risk factors that trigger violence and aggressiveness on stadiums, according to the inquiries made by the Ministry of Administration and Domestic Affairs. As solutions for violence prevention and deterrence, I have suggested: - the implementation of the objectives promoted by the Olympic Movement, which may contribute to the formation of a better and more peaceful world through the education of the youth in accordance with the principles and values of

  6. 42 CFR 71.54 - Etiological agents, hosts, and vectors. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Etiological agents, hosts, and vectors. 71.54..., INSPECTION, LICENSING FOREIGN QUARANTINE Importations § 71.54 Etiological agents, hosts, and vectors. (a) A... any arthropod or other animal host or vector of human disease, or any exotic living arthropod or...

  7. 38 CFR 4.17a - Misconduct etiology. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Misconduct etiology. 4... RATING DISABILITIES General Policy in Rating § 4.17a Misconduct etiology. A permanent and total... coexistence of misconduct disability when: (a) A veteran, regardless of employment status, also has...

  8. Early Family Influences in the Etiology of Homosexuality. (United States)

    Neill, Stephanie Anne

    The etiology of homosexuality is probably best explained from a multidimensional framework which takes into account socialization, family background, and individual developmental factors. A research review was conducted to examine the influence of parental characteristics in the etiology of homosexuality. The findings of the review support the…

  9. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian


    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...

  10. 38 CFR 3.380 - Diseases of allergic etiology. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Diseases of allergic... Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial... progress nor as due to the inherent nature of the disease. Seasonal and other acute allergic...

  11. Early Family Influences in the Etiology of Homosexuality. (United States)

    Neill, Stephanie Anne

    The etiology of homosexuality is probably best explained from a multidimensional framework which takes into account socialization, family background, and individual developmental factors. A research review was conducted to examine the influence of parental characteristics in the etiology of homosexuality. The findings of the review support the…

  12. Acculturation, cultural values, and Latino parental beliefs about the etiology of ADHD. (United States)

    Lawton, Kathryn E; Gerdes, Alyson C; Haack, Lauren M; Schneider, Brian


    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders of childhood. Despite the availability of several evidence-based interventions, Latino children are more likely than non-minority children to have an unmet need for services related to ADHD. Given that parental beliefs about the etiology of ADHD likely influence service utilization, research needs to focus on cultural factors that may influence parental beliefs about the etiology of child behavior problems. Thus, the goal of the current study was to investigate the role of acculturation and cultural values of familism, respect, spirituality, and traditional gender roles in explaining parental etiological beliefs about ADHD in a sample of Latino parents. Findings suggest that behavioral acculturation was not significantly correlated with biopsychosocial or sociological/spiritual etiological beliefs; however, the cultural values of familism and traditional gender roles were positively correlated with sociological/spiritual beliefs. Further, exploratory analyses suggested that after controlling for SES, familism and traditional gender roles accounted for 30.5 % of the total variance in sociological/spiritual beliefs about ADHD. Finally, post hoc analyses revealed that cultural values were associated with several individual belief categories within the sociological/spiritual domain, including beliefs about friends, spirituality, and nature disharmony. The current study supports the inclusion of etiological beliefs and cultural factors in research examining help-seeking and access to mental health services among Latino families and suggests that the incorporation of alternative etiological beliefs about child behavior may be an important factor in culturally-appropriate mental health services.

  13. Modern criteria to establish human cancer etiology. (United States)

    Carbone, Michele; Klein, George; Gruber, Jack; Wong, May


    The Cancer Etiology Branch of the National Cancer Institute hosted a workshop, "Validation of a causal relationship: criteria to establish etiology," to determine whether recent technological advances now make it possible to delineate improved or novel criteria for the rapid establishment for cancer causation. The workshop was held in Washington, D.C., December 11-12, 2003, and participants were among the international leaders in the fields of epidemiology, chemistry, biochemistry, microbiology, virology, environmental and chemical carcinogenesis, immunology, pathology, molecular pathology, genetics, oncology, and surgical oncology. There was a general consensus that the rapid identification of human carcinogens and their removal (when possible) or the establishment of specific preventive and therapeutic measures was the most desirable and effective way to have a rapid and positive impact in the fight against cancer. From a clinical perspective, it may be as important to target initiators, cocarcinogens and promoters, if by removing any one of them tumor growth can be prevented. Future studies should focus on interactions among and between different biological, chemical, and physical agents. Analyses of single agents can at times miss their carcinogenic potential when such agents are carcinogenic only in subgroups of individuals because of their genetic background, diet, exposure to other carcinogens, or microbial infection. Epidemiology, molecular pathology (including chemistry, biochemistry, molecular biology, molecular virology, molecular genetics, epigenetics, genomics, proteomics, and other molecular-based approaches), and animal and tissue culture experiments should all be seen as important integrating evidence in the determination of human carcinogenicity. Concerning the respective roles of epidemiology and molecular pathology, it was noted that epidemiology allows the determination of the overall effect of a given carcinogen in the human population (e

  14. Celiac disease - nutritional considerations (United States)

    ... this page: // Celiac disease - nutritional considerations To use the sharing features on this page, please enable JavaScript. Celiac disease is an immune disorder passed down through families. ...

  15. [Lymphocytic duodenosis: etiological study and clinical presentations]. (United States)

    Santolaria, Santos; Dominguez, Manuel; Alcedo, Javier; Abascal, Manuel; García-Prats, M Dolores; Marigil, Miguel; Vera, Jesus; Ferrer, Margarita; Montoro, Miguel


    Lymphocytic duodenosis (LD) is a characteristic lesion in the initial phases of celiac disease (CD) but can be associated with many other entities. The aim of this study was to evaluate the prevalence of distinct causes of LD and possible differences in clinical presentation according to etiology. A retrospective study was performed that included 194 patients diagnosed with LD (more than 25 intraepithelial lymphocytes per 100 epithelial cells). A preestablished strategy to evaluate the cause of the disease was followed that included celiac serology (antitransglutaminase antibodies), HLA-DQ2/DQ8 genotypes, diagnosis of Helicobacter pylori and small intestinal bacterial overgrowth (SIBO). Diagnosis of CD was established on the basis of clinical and histological response to a gluten-free diet in patients with positive serology or compatible findings on HLA-DQ2 (at least one of the alleles) or -DQ8 (both alleles) study. The most frequent cause of LD was CD (39%), followed by SBBO (22%), H.pylori (14%), CD and SIBO (12%), and other causes (13%). Most of the patients (83%) had a compatible HLA-DQ2 or -DQ8 genotype. In these patients, the most frequent diagnosis was CD (46%), while in the absence of HLA-DQ2/DQ8, the most frequent diagnoses were SIBO (44%) and H. pylori (22%). CD was the most frequent diagnosis in patients referred for dyspepsia, diarrhea and anemia, while H. pylori was the most frequent diagnosis in patients with abdominal pain. The most common causes of LD in our environment are CD, followed by SIBO and H. pylori infection. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  16. Etiological aspects of anterior open bite

    Directory of Open Access Journals (Sweden)

    Stojanović Ljiljana


    Full Text Available Introduction. Open bite is a multifactorial phenomenon and no single factor can account for open-bite. Etiology plays an important role in diagnosis. Heredity, unfavorable growth patterns, incorrect jaw postoure, are the characteristics of skeletal open bite. Digit sucking. Depending on where the thumb is placed, a number of different types of dental problems can develop. Malocclusions of the late mixed or permanent dentitions, caused by thumb sucking are not self corrected and orthodontic treatment is necessary for their correction. Lymphatic tissue. In order to produce oral respiration, the mandible is postured inferiorly with the tongue protruded and resting against the oral floor. This postural alteration induces dental and skeletal modifications similar to those caused by thumb sucking. This may cause excessive eruption of the posterior teeth, leading to an increase in the vertical dimension of the face and result in development of anterior open bite. Tongue thrust. Tongue habits cause an anterior open bite or they develop secondarily to thumb sucking. In skeletal open bite the tongue habit acts as a secondary factor which helps to maintain or exacerbate the condition. Many orthodontists have had a discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. Conclusion. Dentoalveolar or habitual open bite is caused by habits, which influence the growth and development of dentoalveolar processes and contribute to occlusal disharmonies. Prior to eruption of adult dentition, open bite related to oral habits is usually not a concern as when the habits stop, because the erupting dentition tends to improve spontaneously. Treatment is usually not necessary until permanent teeth erupt (~6 years old. .

  17. Alar retraction: etiology, treatment, and prevention. (United States)

    Alexander, Ashlin J; Shah, Anil R; Constantinides, Minas S


    The effect of different rhinoplasty maneuvers on alar retraction remains to be elucidated. To determine the etiology and treatment of alar retraction based on a series of specific rhinoplasty maneuvers. Retrospective review of a single surgeon's rhinoplasty digital photo database, examining preoperative alar retraction from January 1, 2002, to December 31, 2005, in 520 patients. Patients with more than 1 mm of alar retraction on preoperative photographs were identified. Postoperative photographs were examined to determine the effect of specific rhinoplasty maneuvers on the position of the alar margin; these maneuvers included cephalic trim, cephalic positioning of the lower lateral cartilage, composite grafts, alar rim grafts, alar batten grafts, and overlay of the lower lateral cartilage. Tertiary care academic health center. Forty-five patients with alar retraction met inclusion criteria, resulting in 63 nasal halves with alar retraction. Intraoperative findings, postoperative results. Forty-seven percent of the patients (n = 21) had prior surgery; 47% also had cephalically positioned lower lateral cartilages. Among patients with less than 4 mm of cartilage width at the outset, 46% of those who received supportive grafts achieved target correction vs only 7% for patients who did not undergo supportive cartilage grafting. In patients who underwent more than 4 mm of cephalic trim, those who received supportive grafts achieved 46% of target correction vs 11% among those who did not. Ninety-five percent of composite grafts, 69% of alar strut grafts, 47% of alar rim grafts, 43% of vertical lobule division, and 12% of alar batten grafts achieved their target correction values. Alar retraction is a highly complex problem. It can be seen de novo and is associated with cephalically positioned lower lateral cartilages. Structurally supportive grafting-including composite grafts, alar strut grafts, alar rim grafts, vertical lobule division, and alar batten grafts

  18. [Definition, etiology, classification and presentation forms]. (United States)

    Mas Garriga, Xavier


    Osteoarthritis is defined as a degenerative process affecting the joints as a result of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of joint cartilage, stimulating the growth of subchondral bone; chronic synovitis is also present. Currently, the joint is considered as a functional unit that includes distinct tissues, mainly cartilage, the synovial membrane, and subchondral bone, all of which are involved in the pathogenesis of the disease. Distinct risk factors for the development of osteoarthritis have been described: general, unmodifiable risk factors (age, sex, and genetic makeup), general, modifiable risk factors (obesity and hormonal factors) and local risk factors (prior joint anomalies and joint overload). Notable among the main factors related to disease progression are joint alignment defects and generalized osteoarthritis. Several classifications of osteoarthritis have been proposed but none is particularly important for the primary care management of the disease. These classifications include etiological (primary or idiopathic forms and secondary forms) and topographical (typical and atypical localizations) classifications, the Kellgren and Lawrence classification (radiological repercussions) and that of the American College of Rheumatology for osteoarthritis of the hand, hip and knee. The prevalence of knee osteoarthritis is 10.2% in Spain and shows a marked discrepancy between clinical and radiological findings. Hand osteoarthritis, with a prevalence of symptomatic involvement of around 6.2%, has several forms of presentation (nodal osteoarthritis, generalized osteoarthritis, rhizarthrosis, and erosive osteoarthritis). Symptomatic osteoarthritis of the hip affects between 3.5% and 5.6% of persons older than 50 years and has different radiological patterns depending on femoral head migration. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  19. The Etiology of Juvenile Idiopathic Arthritis. (United States)

    Rigante, Donato; Bosco, Annalisa; Esposito, Susanna


    Over the years, the commonly used term to describe juvenile idiopathic arthritis (JIA) has changed. By definition, JIA includes all types of arthritis with no apparent cause, lasting more than 6 weeks, in patients aged less than 16 years at onset. JIA pathogenesis is still poorly understood: the interaction between environmental factors and multiple genes has been proposed as the most relevant working mechanism to the development of JIA. The concept that various microbes that colonize or infect not only the mucosal surfaces, like the oral cavity, but also the airways and gut might trigger autoimmune processes, resulting in chronic arthritides, and JIA was first drafted at the outset of last century. JIA development might be initiated and sustained by the exposure to environmental factors, including infectious agents which affect people at a young age, depending on the underlying genetic predisposition to synovial inflammation. Many data from patients with JIA suggest a scenario in which different external antigens incite multiple antigen-specific pathways, cytotoxic T cell responses, activation of classical complement cascade, and production of proinflammatory cytokines. In this review, emphasis is paid not only to the potential role of parvovirus B19 and Epstein-Barr virus in primis but also to the general involvement of different bacteria as Salmonella spp., Shigella spp., Campylobacter spp., Mycoplasma pneumoniae, Chlamydophila pneumoniae, Bartonella henselae, and Streptococcus pyogenes for the development of immune-mediated arthritides during childhood. No unequivocal evidence favoring or refuting these associations has been clearly proved, and today, the strict definition of JIA etiology remains unknown. The infection can represent a random event in a susceptible individual, or it can be a necessary factor in JIA development, always in combination with a peculiar genetic background. Further studies are needed in order to address the unsolved questions

  20. Force Display and Bi-Lateral Master-Slave Control with an Internal Model under the Consideration of Human Cross-Over Model (United States)

    Kawahata, Nagakatsu; Nishizawa, Masanori; Itoh, Youichirou; Yoshida, Hiroaki

    Human behavior for controlling machines is quite adaptive but restrictive in gain, phase, frequency bandwidth and so on. It is often assumed by a cross-over model especially for compensatory tracking task. Force display system is increasingly important in robotics, remote manipulations, machine handling and etc. The control system design for force display and/or bi-lateral master-slave manipulator is not so easy because of gain limits, mechanical vibration, human-induced oscillation and others. Proposed is a control system design for force display and/or bi-lateral master-slave manipulator based on model-following control under the concept of human crossover model in compensatory tracking. Experimental results are also shown for an actual force display device designed by the proposed method.

  1. Etiologic factors of gastric cardiac adenocarcinoma among men in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Chen; Deng-Chyang Wu; Jia-Ming Lin; Ming-Tsang Wu; Fung-Chang Sung


    AIM: To elucidate etiologic associations between Helicobacter pylori ( H pylori), lifestyle, environmental factors and gastric cardiac adenocarcinoma (GCA) among men.METHODS: A hospital-based case-control study was conducted in Taiwan from 2000 to 2009.All cases were newly confirmed as primary GCA.Five controls were selected matching with age, sex, and admission date to each case.Participants were informed of potential risk factors with a structured questionnaire by trained interviewers during hospitalization and provided a blood sample for the determination of H pylori infection.Odds ratio (OR) and 95% confidence interval (95% CI) were used to evaluate risk, and a multivariate conditional logistic regression model was performed.RESULTS: All participants recruited for this study were men, consisting of 41 cases and 205 controls.Results of the univariate analysis showed that significant factors associated with the etiology of GCA included H pylori (OR = 2.69, 95% CI = 1.30-5.53), cigarette smoking (OR = 2.28, 95% CI = 1.05-4.96), working or exercising after meals (OR = 3.26, 95% CI = 1.31-8.11), salted food (OR = 2.51, 95%CI = 1.08-6.11), fresh vegetables (OR = 0.28, 95% CI = 0.09-0.80), fruits (OR = 0.19, 95% CI = 0.04-0.89), and rice as principal food (OR = 0.53, 95% CI = 0.30-0.85).Multivariate conditional logistic regression models indicated that a significantly elevated risk of contracting GCA was associated with working or exercising after meals (OR = 3.18, 95% CI = 1.23-9.36) and H pylori infection (OR = 2.93, 95% CI = 1.42-6.01).In contrast, the consumption of fresh vegetables (OR = 0.22, 95% CI = 0.06-0.83), fruits (OR = 0.28, 95% CI = 0.09-0.79) and rice as principal food (OR = 0.48, 95% CI = 0.24-0.93) remained as significant beneficial factor associated with GCA.CONCLUSION: Working or exercising after meals and H pylori infection increase the risk of GCA, but higher intakes of rice, fresh vegetables and fruits reduce the risk.

  2. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships. (United States)

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E


    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions.

  3. Porcine epidemic diarrhea virus infection: Etiology, epidemiology, pathogenesis and immunoprophylaxis. (United States)

    Jung, Kwonil; Saif, Linda J


    Porcine epidemic diarrhea virus (PEDV), a member of the genera Alphacoronavirus in the family Coronaviridae, causes acute diarrhea/vomiting, dehydration and high mortality in seronegative neonatal piglets. For the last three decades, PEDV infection has resulted in significant economic losses in the European and Asian pig industries, but in 2013-2014 the disease was also reported in the US, Canada and Mexico. The PED epidemic in the US, from April 2013 to the present, has led to the loss of more than 10% of the US pig population. The disappearance and re-emergence of epidemic PED indicates that the virus is able to escape from current vaccination protocols, biosecurity and control systems. Endemic PED is a significant problem, which is exacerbated by the emergence (or potential importation) of multiple PEDV variants. Epidemic PEDV strains spread rapidly and cause a high number of pig deaths. These strains are highly enteropathogenic and acutely infect villous epithelial cells of the entire small and large intestines although the jejunum and ileum are the primary sites. PEDV infections cause acute, severe atrophic enteritis accompanied by viremia that leads to profound diarrhea and vomiting, followed by extensive dehydration, which is the major cause of death in nursing piglets. A comprehensive understanding of the pathogenic characteristics of epidemic or endemic PEDV strains is needed to prevent and control the disease in affected regions and to develop an effective vaccine. This review focuses on the etiology, epidemiology, disease mechanisms and pathogenesis as well as immunoprophylaxis against PEDV infection.

  4. Etiology and Epidemiological Conditions Promoting Fusarium Root Rot in Sweetpotato. (United States)

    Scruggs, A C; Quesada-Ocampo, L M


    Sweetpotato production in the United States is limited by several postharvest diseases, and one of the most common is Fusarium root rot. Although Fusarium solani is believed to be the primary causal agent of disease, numerous other Fusarium spp. have been reported to infect sweetpotato. However, the diversity of Fusarium spp. infecting sweetpotato in North Carolina is unknown. In addition, the lack of labeled and effective fungicides for control of Fusarium root rot in sweetpotato creates the need for integrated strategies to control disease. Nonetheless, epidemiological factors that promote Fusarium root rot in sweetpotato remain unexplored. A survey of Fusarium spp. infecting sweetpotato in North Carolina identified six species contributing to disease, with F. solani as the primary causal agent. The effects of storage temperature (13, 18, 23, 29, and 35°C), relative humidity (80, 90, and 100%), and initial inoculum level (3-, 5-, and 7-mm-diameter mycelia plug) were examined for progression of Fusarium root rot caused by F. solani and F. proliferatum on 'Covington' sweetpotato. Fusarium root rot was significantly reduced (P Fusarium spp. revealed the production of fumonisin B1 by F. proliferatum when infecting sweetpotato. This study is a step toward characterizing the etiology and epidemiology of Fusarium root rot in sweetpotato, which allows for improved disease management recommendations to limit postharvest losses to this disease.

  5. Etiology-specific differences in motor function after hemispherectomy. (United States)

    van der Kolk, Nicolien M; Boshuisen, Kim; van Empelen, Ron; Koudijs, Suzanne M; Staudt, Martin; van Rijen, Peter C; van Nieuwenhuizen, Onno; Braun, Kees P J


    Prediction of functional motor outcome after hemispherectomy is difficult due to the heterogeneity of motor outcomes observed. We hypothesize that this might be related to differences in plasticity during the onset of the underlying epileptogenic disorder or lesion and try to identify predictors of motor outcome after hemispherectomy. Thirty-five children with different etiologies (developmental, stable acquired or progressive) underwent functional hemispherectomy and motor function assessment before hemispherectomy and 24 months after hemispherectomy. Preoperatively, children with developmental etiologies performed better in terms of distal arm strength and hand function, but not on gross motor function tests. Postoperatively, the three etiology groups performed equally poor in muscle strength and hand function, but gross motor function improved in those with acquired and progressive etiologies. Loss of voluntary hand function and distal arm strength after surgery was associated with etiology, intact insular cortex and intact structural integrity of the ipsilesional corticospinal tract on presurgical MRI scans. In conclusion, postoperative motor function can be predicted more precisely based on etiology and on preoperative MRI. Children with developmental etiology more often lose distal arm strength and hand function and show less improvement in gross motor function, compared to those with acquired pathology.

  6. Febrile Seizures: Etiology, Prevalence, and Geographical Variation

    Directory of Open Access Journals (Sweden)



    Full Text Available How to Cite This Article: Delpisheh A, Veisani Y, Sayehmiri K, Fayyazi A. Febrile Seizures: Etiology, Prevalence, and Geographical Variation. Iran J Child Neurol. 2014 Summer; 8(3:30-37. AbstractObjectiveFebrile seizures (FSs are the most common neurological disorder observed in the pediatric age group. The present study provides information about epidemiological and clinical characteristics as well as risk factors associated with FS among Iranian children.Materials & MethodsOn the computerized literature valid databases, the FS prevalence and 95% confidence intervals were calculated using a random effects model. A metaregression analysis was introduced to explore heterogeneity between studies. Data manipulation and statistical analyses were performed using Stata10.ResultsThe important viral or bacterial infection causes of FSs were; recent upper respiratory infection 42.3% (95% CI: 37.2%–47.4%, gastroenteritis21.5% (95% CI: 13.6%–29.4%, and otitis media infections15.2% (95% CI: 9.8%- 20.7% respectively. The pooled prevalence rate of FS among other childhood convulsions was 47.9% (95% CI: 38.8–59.9%. The meta–regression analysis showed that the sample size does not significantly affect heterogeneity for the factor ‘prevalence FS’.ConclusionsAlmost half of all childhood convulsions among Iranian children are associated with Febrile seizure. ReferencesFelipe L, Siqueira M. febrile seizures: update on diagnosis and management. Siqueira LFM. 2010;56 (4:489–92.Oka E, Ishida S, Ohtsuka Y, Ohtahara S. Neuroepidemiological Study of Childhood Epilepsy by Application of International Classification of Epilepsies and Epileptic Syndromes (ILAE, 1989. Epilepsia. 1995;36 (7:658–61.Shi X, Lin Z, Ye X, Hu Y, Zheng F, Hu H. An epidemiological survey of febrile convulsions among pupils in the Wenzhou region. Zhongguo Dang Dai Er Ke Za Zhi. 2012 Feb;14 (2:128–30.Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child

  7. Etiology and Early Marker Studies (EEMS) | Division of Cancer Prevention (United States)

    The Etiology and Early Marker Studies (EEMS) is a component of the PLCO Trial. By collecting biologic materials and risk factor information from trial participants before the diagnosis of disease, PLCO EEMS adds substantial value to the trial, providing a resource for cancer research, focused, in particular, on cancer etiology and early markers. Etiologic studies investigate the environmental, biochemical and genetic risk factors for cancer. Early detection studies aim to develop reproducible, diagnostics-ready biomarkers of early disease. | Risk factor data and biospecimens collected before the diagnosis of disease from participants in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

  8. Modern views on the epidemiology, etiology and pathogenesis of gynecomastia

    Directory of Open Access Journals (Sweden)

    Yu. N. Yashina


    Full Text Available The review deals with one of the pressing andrological issues – gynecomastia, its etiology and pathogenesis. Based on the current epidemiological and experimental data, most common etiological factors of gynecomastia were investigated. A multiple-valued role of various causes of gynecomastia in several age-groups was revealed. Literature data show that gynecomastia may be a manifestation of various diseases: endocrine, genetic, systematic. As well as that, gynecomastia may occur in patients with oncological diseases. However, gynecomastia can be an iatrogenic complication. Currently, we continue to make insights to the problem of gynecomastia in order to be able to classify its etiological factors and determine its basic pathogenesis pathways.

  9. Coma Etiologies And Its One-Month Outcome Sina Hospital (Year 2000

    Directory of Open Access Journals (Sweden)

    Togha M


    Full Text Available Defining the patient outcome and decision making about allocation of our limited fund and technology for comatose patients depends on our knowledge about frequency and outcome of various coma etiologies. We determined the various coma causes frequency and one-month outcome of non traumatic coma. . In addition the co existence of the primary neurologic signs with the one-month outcome of non traumatic coma was defined."nMethods and Materials: Our study is based on 130 comatose patients in a one-year study in Sina Hospital that consisted of 80 non traumatic and 50 traumatic patients."nResults: 74% of the cases were men and 26% were women. The most common etiology of coma was trauma (38.5%. The other common etiologies were cerebro¬vascular diseases (25.4%, cancer (10% and hypoxia-ischemia (8.5%. The most common cause of coma in men was trauma (46.9% while the vascular diseases were the most common etiology of coma in women (41.2%.In under 40 year patients trauma was the cause of coma in 57.5% of cases in respect to 28% in above 40 cases. On the other hand, vascular diseases and malignancies were the etiology of coma in 15% of under 40 year patients and 46.5% of above 40 year patients. Among traumatic etiologies of coma, subdural hematoma was the most frequent (40%. In our research none of patients who did not have one of pupillary, oculocephalic or motor reflexes in the 3rd and 7th day of the onset of coma had acceptable outcome after one month. With consideration of pupillary, corneal, oculocephalic and motor reflexes in combination, loss of at least two of them in the 3rd and 7th day accompanied with no acceptable outcome. On the other hand the presence of three or more reflexes in the 3rd and 7th day of coma was a good prognostic factor, with 80% and 88.9% chance of acceptable recovery respectively."nConclusion: According of the study, the best time for prediction of outcome in a comatose patient, is the third or seventh the day after the onset

  10. Etiology and neuropsychology of comorbidity between RD and ADHD: the case for multiple-deficit models. (United States)

    Willcutt, Erik G; Betjemann, Rebecca S; McGrath, Lauren M; Chhabildas, Nomita A; Olson, Richard K; DeFries, John C; Pennington, Bruce F


    Attention-deficit/hyperactivity disorder (ADHD) and reading disability (RD) are complex childhood disorders that frequently co-occur, but the etiology of this comorbidity remains unknown. Participants were 457 twin pairs from the Colorado Learning Disabilities Research Center (CLDRC) twin study, an ongoing study of the etiology of RD, ADHD, and related disorders. Phenotypic analyses compared groups with and without RD and ADHD on composite measures of six cognitive domains. Twin analyses were then used to test the etiology of the relations between the disorders and any cognitive weaknesses. Phenotypic analyses supported the hypothesis that both RD and ADHD arise from multiple cognitive deficits rather than a single primary cognitive deficit. RD was associated independently with weaknesses on measures of phoneme awareness, verbal reasoning, and working memory, whereas ADHD was independently associated with a heritable weakness in inhibitory control. RD and ADHD share a common cognitive deficit in processing speed, and twin analyses indicated that this shared weakness is primarily due to common genetic influences that increase susceptibility to both disorders. Individual differences in processing speed are influenced by genes that also increase risk for RD, ADHD, and their comorbidity. These results suggest that processing speed measures may be useful for future molecular genetic studies of the etiology of comorbidity between RD and ADHD. Copyright © 2010 Elsevier Srl. All rights reserved.

  11. Key considerations for the experimental training and evaluation of cancer odour detection dogs: lessons learnt from a double-blind, controlled trial of prostate cancer detection


    Elliker, Kevin R; Sommerville, Barbara A; Donald M. Broom; Neal, David E.; Armstrong, Sarah; Williams, Hywel C


    Background Cancer detection using sniffer dogs is a potential technology for clinical use and research. Our study sought to determine whether dogs could be trained to discriminate the odour of urine from men with prostate cancer from controls, using rigorous testing procedures and well-defined samples from a major research hospital. Methods We attempted to train ten dogs by initially rewarding them for finding and indicating individual prostate cancer urine samples (Stage 1). If dogs were suc...

  12. Design and Methodological Considerations of the Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida. (United States)

    Routh, Jonathan C; Cheng, Earl Y; Austin, J Christopher; Baum, Michelle A; Gargollo, Patricio C; Grady, Richard W; Herron, Adrienne R; Kim, Steven S; King, Shelly J; Koh, Chester J; Paramsothy, Pangaja; Raman, Lisa; Schechter, Michael S; Smith, Kathryn A; Tanaka, Stacy T; Thibadeau, Judy K; Walker, William O; Wallis, M Chad; Wiener, John S; Joseph, David B


    Care of children with spina bifida has significantly advanced in the last half century, resulting in gains in longevity and quality of life for affected children and caregivers. Bladder dysfunction is the norm in patients with spina bifida and may result in infection, renal scarring and chronic kidney disease. However, the optimal urological management for spina bifida related bladder dysfunction is unknown. In 2012 the Centers for Disease Control and Prevention convened a working group composed of pediatric urologists, nephrologists, epidemiologists, methodologists, community advocates and Centers for Disease Control and Prevention personnel to develop a protocol to optimize urological care of children with spina bifida from the newborn period through age 5 years. An iterative quality improvement protocol was selected. In this model participating institutions agree to prospectively treat all newborns with spina bifida using a single consensus based protocol. During the 5-year study period outcomes will be routinely assessed and the protocol adjusted as needed to optimize patient and process outcomes. Primary study outcomes include urinary tract infections, renal scarring, renal function and bladder characteristics. The protocol specifies the timing and use of testing (eg ultrasonography, urodynamics) and interventions (eg intermittent catheterization, prophylactic antibiotics, antimuscarinic medications). Starting in 2014 the Centers for Disease Control and Prevention began funding 9 study sites to implement and evaluate the protocol. The Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida began accruing patients in 2015. Assessment in the first 5 years will focus on urinary tract infections, renal function, renal scarring and clinical process improvements. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Impacted canines: Etiology, diagnosis, and orthodontic management

    Directory of Open Access Journals (Sweden)

    Ranjit Manne


    Full Text Available Impaction of maxillary and mandibular canines is a frequently encountered clinical problem, the treatment of which usually requires an interdisciplinary approach. Surgical exposure of the impacted tooth and the complex orthodontic mechanisms that are applied to align the tooth into the arch may lead to varying amounts of damage to the supporting structures of the tooth, not to mention the long treatment duration and the financial burden to the patient. Hence, it seems worthwhile to focus on the means of early diagnosis and interception of this clinical situation. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.

  14. 应急照明消防强启控制在施工中应注意的问题%Considerations about Fire Force Start Control for Emergency Lighting during Construction

    Institute of Scientific and Technical Information of China (English)

    王岑元; 刘安强


    针对工程建设项目中.应急照明的消防强启控制原理及其接线存在的一些问题进行探讨,并指出建筑电气施工中容易出错的地方和应注意的问题。%The fire force start control principles of emergency lighting during construction as well as some wiring issues are discussed, and error - prone points and considerations during construction of building electricity are presented.

  15. Phenomenological aspects of quasi-stationary controlled and uncontrolled three-dimensional flow separations. [in relation to aircraft design considerations and swept wings (United States)

    Peake, D. J.


    Quasi-steady three dimensional separated flows about bodies of large fineness ratio operating at large angles of incidence or yaw are discussed. The general character of the three dimensional attached boundary layer, the concept of limiting streamlines, and the physics of three dimensional separation and reattachment are among the factors considered. Specific examples are given. The advantages of swept, sharp edges that generate controlled (or fixed) three dimensional flow separations on a vehicle, due to the qualitatively unchanging flow field developed throughout the range of flight conditions, are emphasized.

  16. Etiology of acute scrotal pain in children and adolescent patients ...

    African Journals Online (AJOL)

    Etiology of acute scrotal pain in children and adolescent patients ... with skin redness and swelling. This is .... Age distribution among patients with different diagnoses. ..... clinical outcomes using color doppler testicular ultrasound for testicular.

  17. Perceptions among primary caregivers about the etiology of delirium ...

    African Journals Online (AJOL)

    understanding or beliefs of the cause of delirium and also their level of ... current study, which investigated the caregivers' perception about the causality of .... instruments to assess the etiological models and should focus on the implications of ...

  18. Etiology and treatment of occlusal pathosis and associated facial pain. (United States)

    Okeson, J P


    The treatment of occlusal pathosis and associated facial pain is a difficult and complex problem. The interaction of two etiologic factors, occlusal interferences and psychologic stress, results in parafunctional activity. The most important prerequisite to selection of a treatment method is an understanding of the etiology of the problem. What dentistry needs is a mechanism by which the major etiologic factor of parafunctional activity can be identified for each patient. Treatment can then be directed toward the reduction or elimination of that factor. When treatment is directed toward the major cause of the problem, the likelihood of success will increase greatly. Continued research on this problem will yield new insights and means for the accurate determination of the etiology of parafunctional activity for each patient.

  19. Childhood Urinary Tract Infection in Abakaliki: Etiological Organisms ...

    African Journals Online (AJOL)


    Keywords: Etiological organisms, Antibiotic sensitivity, Children, Urinary tract infection. Access this article ... to preserve renal function of the growing kidney. Delay in .... in children with severe protein energy malnutrition who were screened for.

  20. Chemical-to-mechanical energy conversion in biomacromolecular machines: a plasmon and optimum control theory for directional work. 1. General considerations. (United States)

    Starikov, Evgeni B; Panas, Itai; Nordén, Bengt


    To rationalize coherence and mechanochemical aspects of proteins acting as molecular machines, a plasmon concept for dealing with protein nonequilibrium dynamics is introduced and tested with respect to thermodynamic consistency. A stochastic optimum-control theory for protein conformational diffusion is developed and the corresponding stochastic Newton's second law derived for optimum-controlled conformational diffusion in proteins. The plasmon concept is shown to be consistent with this theory, in that optical plasmons can pump entropy out of (or into) the protein, decreasing (or increasing) its conformational diffusion and, at the same time, help decrease intra- and intermolecular friction, as well as (potentially) break the symmetry of the latter. Instead, acoustic plasmons may break the spatial symmetry of a protein's "potential of mean force", thus converting it into an effective Brownian ratchet potential by applying quasistatic deformational corrections to the former. These concepts seem to be of rather general applicability and might also be useful when studying, for example, intercalation of cationic dyes into DNA duplexes, positively charged oligopeptide transduction through cell membranes, or even DNA translocation through nanopores.

  1. Etiología del colesteatoma ótico Etiology of otic cholesteatoma

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa


    Full Text Available El colesteatoma es una estructura quística caracterizada por la presencia de epitelio escamoso productor de queratina, que sustituye o recubre la mucosa normal en la hendidura del oído medio y ápex petroso, y puede ser causa de hipoacusia irreversible, destrucción ósea y graves complicaciones por su crecimiento expansivo. Clásicamente se describen los colesteatomas en congénitos y adquiridos. La etiología de su formación es multifactorial y continúa siendo poco claro y controversial. Se reportan diferentes teorías que han tratado de explicar el colesteatoma congénito, la transición de un bolsillo de retracción hasta la aparición del colesteatoma adquirido primario, y otras en la génesis del colesteatoma adquirido secundario. Se describe la presencia de algunas citoquinas dentro del colesteatoma que inducen la hiperproliferación e invasión incoordinada de los queratinocitos de la piel del conducto auditivo externo y la pars fláccida, más agresiva en el colesteatoma adquirido pediátrico, y que desempeñan un papel fundamental en la proliferación y en la apoptosis del queratinocito. En cultivo in vitro de una muestra de tejido colesteatomatoso, se ha identificado recientemente que el TNF-a estimula la producción de la IL-8. Se considera de interés ofrecer esta revisión sobre la etiología del colesteatoma, que aún se mantiene en el campo de la investigación y continúa siendo un reto para los otocirujanos por su alta incidencia de recidivas y posibles complicaciones.Cholesteatoma is a cystic structure characterized by presence of squamous epithelium producing keratin substituting or recovering the normal mucosa in the groove of middle ear and petrous apex and may to be caused by irreversible hypoacusia, bone destruction and severe complications due to its expansive growth. Typically the cholesteatomas are described as congenital and acquired. The etiology of its formation is multifactor and still remains a subject not

  2. Etiological study on isolated esophageal atresia

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    Szendrey, T.; Danyi, G.; Czeizel, A.


    A study group of 160 index patients with isolated esophageal atresia, a control group of 160 matched healthy controls, and the first-degree relatives of patients and controls were examined; epidemiological, family planning, teratological, and genetic data were obtained by personal interview in the study and control groups. One half of the index patients were male. Intrauterine growth retardation, a higher proportion of mothers under 19 or over 30 years of age, and less skilled professions of the parents were found in the study group. There were more extramarital conceptions, more pregnancies in spite of the use of contraceptive pills, and more delayed conceptions in index patients mothers. The teratogens studied did not have an obvious pathological effect here. The sib occurrence of isolated esophageal atresia was 0.43%, which did not correspond well to the expected figure of 1.34% based on the polygenic model.

  3. Participation of some campylobacter species in the etiology of enterocolitis

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    Otašević Marica M.


    Full Text Available Background. In recent decades, medical community has increasingly been calling attention to the importance of Campylobacter as an disease-causing agent in humans. Nowdays, Campylobacter jejuni (C. jejuni is known as the most frequent bacterial cause of diarrhea worldwide. Epidemiological differences of the infections caused by Campylobacter, present in the developed and the developing countries, are attributed to the differences of the types of virulence. Due to the specificity, and the demanding features of Campylobacter, as well as poorly equipped microbiological laboratories, campylobacteriosis is insufficiently studied in our country. This investigation aimed to determine the participation of some Campylobacter species in the etiology of diarrheal diseases in our population. Methods. The four-years continuous monitoring of Campylobacter presence was performed in the faeces of 12 605 patients with enterocolitis. The control group included 5 774 examinees of healthy children and youth. Faeces samples were cultivated on Skirrow's selective medium, and further incubated according to effective methodology for Campylobacter. Identification of strains was based on morphological, cultural and physiologic features of strains (oxidase test, catalase test, susceptibility to nalidixic acid, and hypurate hydrolysis. As a statistical method, for data processing, c2 test and Fisher’s exact test were used. Results. Campylobacter was proven in 3.86% of enterocolitis patients, and in 0.71% of healthy population. Out of 518 Campylobacter isolates, 86.48% belonged to enterocolitis outpatients, and 13,51% to inpatients. Predominant symptoms of the disease were diarrhea (81.83%, increased temperature (34.71%, vomiting (19.77%, and stomach pain (15.17%. The diseased were predominantly infants in the first year of life. Out of 300 Campylobacter isolates, 75% were identified as Campylobacer jejuni, 23% as Campylobacter coli (C. coli, and 2% as Campylobacter lari

  4. Uncovering the etiology of conversion disorder: insights from functional neuroimaging (United States)

    Ejareh dar, Maryam; Kanaan, Richard AA


    Conversion disorder (CD) is a syndrome of neurological symptoms arising without organic cause, arguably in response to emotional stress, but the exact neural substrates of these symptoms and the underlying mechanisms remain poorly understood with the hunt for a biological basis afoot for centuries. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from CDs in both motor and nonmotor domains. This review summarizes recent functional neuroimaging studies including functional magnetic resonance imaging (fMRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET) to see whether they bring us closer to understanding the etiology of CD. Convergent functional neuroimaging findings suggest alterations in brain circuits that could point to different mechanisms for manifesting functional neurological symptoms, in contrast with feigning or healthy controls. Abnormalities in emotion processing and in emotion-motor processing suggest a diathesis, while differential reactions to certain stressors implicate a specific response to trauma. No comprehensive theory emerges from these clues, and all results remain preliminary, but functional neuroimaging has at least given grounds for hope that a model for CD may soon be found. PMID:26834476

  5. Microscopic colitis: A review of etiology, treatment and refractory disease


    Park, Tina; Cave, David; Marshall, Christopher


    Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Ex...

  6. Lepra: various etiologies from miasma to bacteriology and genetics. (United States)

    Grzybowski, Andrzej; Sak, Jarosław; Suchodolska, Elżbieta; Virmond, Marcos


    Leprosy is a chronic infectious disease caused by a close relative of Mycobacterium tuberculosis: Mycobacterium leprae. There have been various beliefs in its etiology with two main concepts emerging: anticontagion and contagion. From ancient times through the early Middle Ages, the miasmatic theory of leprosy was the main anticontagion view. The development of histopathologic and cytologic studies in the second half of the 19th century provided a starting point to explain the etiology of leprosy bacteriologically.

  7. Etiologies of septic shock in a pediatric emergency department population. (United States)

    Gaines, Nakia N; Patel, Binita; Williams, Eric A; Cruz, Andrea T


    Knowledge of pediatric sepsis etiologies is needed to optimize empiric therapy. A retrospective cross-sectional review of 428 children with clinically diagnosed sepsis found that 13% had lobar pneumonia, 12% bacteremia and 10% viral infections. No etiologies were found in 76%. Empiric antibiotic coverage of vancomycin/piperacillin-tazobactam/gentamicin for immunocompromised children and vancomycin/nafcillin/cefotaxime for previously healthy children would have covered all bacteremic children.

  8. Etiology and pathogenesis of pectus excavatum in children

    Directory of Open Access Journals (Sweden)

    I. O. Kulik


    Full Text Available Funnel chest is the most common chest deformity characterized by the depression of sternum and rib cartilages. In spite of the centuries-old history of pectus excavatum investigation, plenty of publications on etiology and pathogenesis and many theories on this theme no one of them is generally accepted. This article is to summarize the modern views on the etiology and pathogenesis of funnel chest.

  9. Re-emerging conceptual integration: commentary on Berkowitz's "on the consideration of automatic as well as controlled psychological processes in aggression". (United States)

    Pahlavan, Farzaneh


    In recent decades, researchers in various areas of psychology have challenged the claims of a single mode of information processing, and developed dual-process models of social behaviors. Although these theories differ on a number of dimensions, they all share the basic assumption that two different modes of information processing operate in making decision and copying behavior. In essence, the common distinction in these perspectives is between controlled vs. automatic, conscious vs. unconscious, and affective vs. cognitive modes of processing. The purpose of Berkowitz's article is to go beyond the notion of automatic processes in order to use classic notions of conditioning and displacement to explain aggressive behavior. I assert that an explanatory framework for psychology of aggression must be anchored not only in the new but also classic theoretical paradigms. However, progress in psychology does not rest solely on the accumulation of theoretical insights. It demands a large body of empirical facts, with attention to incongruities, discordances, and conceptual clarifications.

  10. Quality control considerations for size exclusion chromatography with online ICP-MS: a powerful tool for evaluating the size dependence of metal-organic matter complexation (United States)

    McKenzie, Erica R.; Young, Thomas M.


    Size exclusion chromatography (SEC), which separates molecules based on molecular volume, can be coupled with online inductively coupled plasma mass spectrometry (ICP-MS) to explore size-dependent metal-natural organic matter (NOM) complexation. To make effective use of this analytical dual detector system, the operator should be mindful of quality control measures. Al, Cr, Fe, Se, and Sn all exhibited columnless attenuation, which indicated unintended interactions with system components. Based on signal-to-noise ratio and peak reproducibility between duplicate analyses of environmental samples, consistent peak time and height were observed for Mg, Cl, Mn, Cu, Br, and Pb. Al, V, Fe, Co, Ni, Zn, Se, Cd, Sn, and Sb were less consistent overall, but produced consistent measurements in select samples. Ultrafiltering and centrifuging produced similar peak distributions, but glass fiber filtration produced more high molecular weight peaks. Storage in glass also produced more high molecular weight peaks than did plastic bottles. PMID:23416600


    Directory of Open Access Journals (Sweden)

    Natalia Mashcenko


    Full Text Available Biological activity of the iridoid glycosides extract from Linaria genistifolia (L. Mill. has been investigated, namely its influence on the resistance of the winter wheat Odesschi 51 plant to the caused by the Fusarium oxysporum and Helminthosporium avenae pathogenic fungi root rot. Our results indicate that summary iridoid glycosides from this plant, containing four major known compounds: 5-O-allosylantirrinoside, antirrinoside, linarioside and 6-β-hidroxiantirride, can be successfully employed in biological control of the afore-mentioned wheat pathogens: it stimulates wheat grains germination and embryonic root growth in conditions of fungal infection. 1H and 13C NMR characteristics of 5-O-allosylantirrinoside in Py-d5 are for the first time presented. Structures of two conformers of 5-O-allosylantirrinoside in D2O and Py-d5 solutions are proposed, based on the experimental NMR evidence and molecular modelling studies.

  12. Frequency-Weighting Filter Selection for H2 Control of Microgravity Isolation Systems: A Consideration of the "Implicit Frequency Weighting" Problem (United States)

    Hampton, R. David; Whorton, Mark S.


    Many space-science experiments need an active isolation system to provide them with the requisite microgravity environment. The isolation system planned for use with the International Space Station (ISS) have been appropriately modeled using relative position, relative velocity, and acceleration states. In theory, frequency-weighting design filters can be applied to them state-space models, In order to develop optimal H2 or mixed-norm controllers with desired stability and performance characteristics. In practice. however, since there Is a kinematic relationship among the various states. any frequency weighting applied to one state will implicitly weight other states. These implicit frequency-weighting effects must be considered, for intelligent frequency-weighting filter assignment. This paper suggests a rational approach to the assignment of frequency-weighting design filters, in the presence of the kinematic coupling among states that exists in the microgravity vibration isolation problem.

  13. An overview of plant volatile metabolomics, sample treatment and reporting considerations with emphasis on mechanical damage and biological control of weeds. (United States)

    Beck, John J; Smith, Lincoln; Baig, Nausheena


    The technology for the collection and analysis of plant-emitted volatiles for understanding chemical cues of plant-plant, plant-insect or plant-microbe interactions has increased over the years. Consequently, the in situ collection, analysis and identification of volatiles are considered integral to elucidation of complex plant communications. Due to the complexity and range of emissions the conditions for consistent emission of volatiles are difficult to standardise. To discuss: evaluation of emitted volatile metabolites as a means of screening potential target- and non-target weeds/plants for insect biological control agents; plant volatile metabolomics to analyse resultant data; importance of considering volatiles from damaged plants; and use of a database for reporting experimental conditions and results. Recent literature relating to plant volatiles and plant volatile metabolomics are summarised to provide a basic understanding of how metabolomics can be applied to the study of plant volatiles. An overview of plant secondary metabolites, plant volatile metabolomics, analysis of plant volatile metabolomics data and the subsequent input into a database, the roles of plant volatiles, volatile emission as a function of treatment, and the application of plant volatile metabolomics to biological control of invasive weeds. It is recommended that in addition to a non-damaged treatment, plants be damaged prior to collecting volatiles to provide the greatest diversity of odours. For the model system provided, optimal volatile emission occurred when the leaf was punctured with a needle. Results stored in a database should include basic environmental conditions or treatments. Copyright © 2013 John Wiley & Sons, Ltd.

  14. Esthetic considerations in interdental papilla: remediation and regeneration. (United States)

    Sharma, Anita Angela; Park, Jae Hyun


    This article reviews the etiology and treatment of open gingival embrasures or black triangles. An open gingival embrasure or black triangle occurs as a result of a deficiency of papilla beneath the contact point. The treatment of open embrasures may require restorative, orthodontic and periodontal considerations depending on the underlying etiology. The authors reviewed a total of 42 articles including review of literature, radiographic, cross-sectional, and retrospective studies in Ovid search engine using the terms "open gingival embrasure,"interdental papilla," and "black triangle." The studies provided information regarding etiology, diagnosis, and treatment of open embrasures. There are several risk factors leading to the development of open gingival embrasures. These factors include aging, periodontal disease, loss of height of the alveolar bone relative to the interproximal contact, length of embrasure area, root angulations, interproximal contact position, and triangular-shaped crowns. Treatment of open embrasures requires an interdisciplinary approach of orthodontic, periodontic, and restorative treatment. CLINICAL SIGNIFICANCE Open gingival embrasures are complex esthetic and functional problems. An interdisciplinary team approach with the general dentist, orthodontist, and periodontist is critical. Management of open embrasures requires careful evaluation of the underlying etiology.

  15. Considerations on FEM modeling in analyzing buckling and plastic collapse of a detection control; Boto panel no zakutsu sosei hokai kaiseki ni okeru FEM model ka ni kansuru kosatsu

    Energy Technology Data Exchange (ETDEWEB)

    Yao, T.; Fujikubo, M.; Yanagihara, D.; Irisawa, M. [Hiroshima University, Hiroshima (Japan). Faculty of Engineering


    Buckling and plastic collapse of upper decks and bottom outer plates of a hull results directly in longitudinal bending collapse of the hull. Therefore, discussions were given on analysis for pressure destruction strength of a detection control panel which assumes an upper deck and a bottom outer plate. Pressure destruction behavior of the panting panel is a complex phenomenon accompanying non-linearity and geometrical non-linearity of the materials. Its whole phenomenon may be analyzed by using the finite element method (FEM) as a principle, but the analysis is not efficient. Therefore, considerations were given in relation to modeling when using the FEM. The considerations were given on a panel attached with flat steel panting members with respect to the modeling scope which considers the buckling mode according to the aspect ratio of the panel partitioned by the deflection control members. If the local buckling mode of the panel is an even number wave mode in the longitudinal direction, a triple span model is required. A modeling scope for a case of being subjected to water pressure and in-plane compression was considered on a panel attached with angle-type steel members having non-symmetric cross section. In this case, a triple bay model is more preferable to reproduce the behavior under water pressure loading. 1 ref., 6 figs.

  16. Preliminary considerations concerning actinide solubilities

    Energy Technology Data Exchange (ETDEWEB)

    Newton, T.W.; Bayhurst, B.P.; Daniels, W.R.; Erdal, B.R.; Ogard, A.E.


    Work at the Los Alamos Scientific Laboratory on the fundamental solution chemistry of the actinides has thus far been confined to preliminary considerations of the problems involved in developing an understanding of the precipitation and dissolution behavior of actinide compounds under environmental conditions. Attempts have been made to calculate solubility as a function of Eh and pH using the appropriate thermodynamic data; results have been presented in terms of contour maps showing lines of constant solubility as a function of Eh and pH. Possible methods of control of the redox potential of rock-groundwater systems by the use of Eh buffers (redox couples) is presented.


    Directory of Open Access Journals (Sweden)

    Nunes Neto Nei Freitas Freitas


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    ABSTRACT. In this paper, we argue for a taxonomy of approaches to function based on different epistemological perspectives assumed with regard to the treatment of this central concept in the life sciences. We distinguish between etiological and organizational perspectives on function, analyzing two distinct theories related to each perspective: Wright’s selectionist etiological approach and Godfrey-Smith’s modern history theory of functions, in the case of the etiological perspective; and Cummins’ functional analysis and Collier’s interactivist approach to function, among organizational accounts. We explain differences and similarities between these theories and the broader perspectives on function, arguing for a particular way of understanding the consensus without unity in debates about function. While explaining the accounts of function, we also deal with the relationship between this concept and other important biological concepts, such as adaptation, selection, complexity, and autonomy. We also advance an argument for the limits and prospects of the explanatory role of function in evolution. By arguing that changes in functionality are always grounded on changes in systems’ organization, we show that function can never explain the origins of traits. Nevertheless, it can explain the spread of traits in populations, but only when we are dealing with functionally novel traits. Finally, we stress that organizational accounts of function are needed to understand how new functions appear by means of changes in systems

  18. The School Psychologist's Primer on Early Onset Schizophrenia: A Review of Research Regarding Epidemiology, Etiology, Assessment, and Treatment (United States)

    Hernandez, Rafael J. C.; Rime, W. Jeremy; Jimerson, Shane R.


    The purpose of this article is to provide school psychologists and other educational professionals with important information regarding the epidemiology, etiology, assessment, and treatment of early onset schizophrenia (EOS). The central aim herein is to bring science to practice by succinctly highlighting key considerations for school…

  19. Percutaneous vertebroplasty: technical considerations

    Institute of Scientific and Technical Information of China (English)

    Gao-jun TENG; Shi-cheng HE


    Percutaneous vertebroplasty (PVP) is a relative new interventional technique, which is widely used in treatment of vertebral collapse caused by vertebral neoplasms and osteoporotic compression fractures. The general technical considerations of PVP techniques are discussed based on authors' experience obtained over 400 patients in the past years in this article, including preparation of PMMA, instrument of PVP, guidance and puncture approaches, and technique of the procedure, etc. The conclusion is that PVP is a safe procedure if the physicians handle it properly.

  20. Implant treatment planning considerations. (United States)

    Kao, Richard T


    As dental implants become a more accepted treatment modality, there is a need for all parties involved with implant dentistry to be familiar with various treatment planning issues. Though the success can be highly rewarding, failure to forecast treatment planning issues can result in an increase of surgical needs, surgical cost, and even case failure. In this issue, the focus is on implant treatment planning considerations.

  1. Five-year experience of quality control for a 3D LSO-based whole-body PET scanner: results and considerations. (United States)

    Matheoud, R; Goertzen, A L; Vigna, L; Ducharme, J; Sacchetti, G; Brambilla, M


    PET scanners require routine monitoring and quality control (QC) to ensure proper scanner performance. QC helps to ensure that PET equipment performs as specified by the manufacturer and that there have not been significant changes in the system response since acceptance. In this work we describe the maintenance history and we report on the results obtained from the PET system QC testing program over 5 years at two centers, both utilizing a Siemens Biograph 16 HiRez PET/CT system. QC testing programs were based on international standards and included the manufacturer's daily QC, monthly uniformity and sensitivity, quarterly cross-calibration and annual resolution and image quality. For the Winnipeg and Novara sites, two and one PET detector blocks have been replaced, respectively. Neither system has had other significant PET system related hardware replacements. The manufacturer's suggested daily QC was sensitive to detecting problems in the function of PET detector elements. The same test was not sensitive for detecting long term drifts in the systems: the Novara system observed a significant deterioration over five years of testing in the sensitivity which exhibited a decrease of 16% as compared to its initial value measured at system installation. The measure of the energy spectrum, showed that the 511 keV photopeak had shifted to a position of 468 keV. This shift was corrected by having service personnel perform a complete system calibration and detector block setup. We recommend including tests of system energy response and of sensitivity as part of a QC program since they can provide useful information on the actual performance of the scanner. A modification of the daily QC test by the manufacturer is suggested to monitor the long term stability of the system. Image quality and spatial resolution tests have proven to be of limited value for monitoring the system over time.

  2. Stochastic Optimal Preview Control of Active Vehicle Suspension with Time-delay Consideration%考虑控制时滞的车辆主动悬架随机预瞄控制

    Institute of Scientific and Technical Information of China (English)

    宋刚; 许长城


    Stochastic preview control with time-delay consideration was investigated for an active vehicle suspension system with look-ahead sensor.The road roughness height was modeled as a filtered white noise stochastic process and the rate of change in the road profile at some distances in front of the vehicle was measured by the look-ahead sensor.The suspension system was optimized by minimizing the performance index containing the mean-square values of body acceleration,suspension rattle space,tire deflection and control force.Only partial state variables were assumed able to be measured and the measurement noises were taken into consideration.Design of the preview compensator that may be called stochastic optimal,output feedback,preview regulator problem with time-delay consideration was reduced to the classical linear quadratic Gaussian (LQG) control problem,by converting the state equations and the performance index into discrete forms and augmenting the state and output vectors.Simulation results demonstrated that time delay should be considered in the stochastic preview control of an active suspension system,especially when large time delay exited.If the suspension system with time delay was controlled by the optimal controller designed with no consideration of time delay,instability in responses might occur and the control effects possibly got worse with preview time increase.%采用随机预瞄控制策略对存在控制时滞的车辆主动悬架系统进行了研究.路面不平度被看作过滤白噪声随机过程,通过安装在车辆前部的预瞄传感器来量测车轮前方一定距离的路面变化信息.在控制器设计中,采用包含车身加速度、悬架动行程、轮胎动位移和控制力加权的连续形式性能指标,假定只有部分状态变量可以量测,而且量测噪声不能忽略.通过将连续形式的状态方程和性能指标进行离散化,并对状态向量和量测向量进行增维,这种考虑控制时滞的基于

  3. Opiate addiction in Republic of Srpska: Characteristics and etiology

    Directory of Open Access Journals (Sweden)

    Niškanović Jelena


    Full Text Available Opiate addiction is a significant social and health problem with a negative impact on individuals' health and their social environment. The aim of this paper is to analyze the characteristics of opiate addicts in order to determine the social and contextual factors underlying the development of addiction. All health care facilities and therapeutic communities which provide care and help addicts are required to fill in the Form of treated addicts. The analysis included people who sought treatment during the period from 25th November 2010 to 21st May 2013 in health care facilities and associations for substance abuse treatment in the Republic of Srpska. The majority of treated addicts belong to opiate addiction (N= 241: 91%. Opiate addicts are mostly males (88.8%, while 11.2% of treated opiate addicts are female. The highest percentage of opiate addicts live in urban areas (86.7%, have secondary education (73.4%, 63.3% are unemployed, while 70.5% live with primary family. Predominant etiologic factor for the development of addiction is peer or partner pressure (29%, pathology of the family as family breakdown or alcoholism (19.3%, while on the third place is low self control (16.8%. For 19.1% of opiate addicts, delinquent behavior started before taking any drugs. The presented data confirms the importance of social environment, like low family control and presence of family pathology. The mentioned factors in combination with negative peer pressure can lead to risky behavior and potential addiction.

  4. Pouchitis – What’s new in etiology and management

    Directory of Open Access Journals (Sweden)

    R John Nicholls


    Full Text Available Pouchitis requires a clear clinicopathological definition. There are many conflicting data concerning etiology. It is linked to an initial diagnosis of ulcerative colitis by clinical association and occurrence of extra-alimentary manifestations, histologically and by macrophage types and inflammatory mediators. Evidence for a bacteriological cause comes from response to metronidazole, increased counts of intramucosal bacteria in pouchitis and the possible association of hypochlorhydria. Most studies have, however, shown no specific bacterial pathogen or luminal bacterial count differences in pouches with or without pouchitis. Abnormal fecal bile salt concentrations have been reported. Stasis and evacuation efficiency of the pouch are not associated with pouchitis in most studies. Reduced mucosal bloodflow may be associated perhaps leading to increased permeability to toxins causing activation of interleukin-1, platelet-activating factor (PAF and tumour necrosis factor (TNF. PAF may be increased in pouchitis. Pouchitis may respond to allopurinol. Volatile short chain fatty acids (VSFA may be reduced in ileal reservoirs compared with straight ileoanal segments and in pouchitis. The response of pouchitis to administered VSFA is, however, variable. Glutamine administration may help. There is evidence that intraepithelial T lymphocytes are reduced. Crypt cell turnover is higher in colitic than in polypotic pouches. Mucosal morphological changes of villous atrophy and inflammation occur early after relapsing polychondritis and may predict future susceptibility to pouchitis. Early mucosal biopsy appears to have prognostic value. Metronidazole and antibiotics (amoxicillin/potassium clavulanate, ciprofloxacin may be effective although in a controlled trial of the former there was little advantage over placebo. The results of treatment using VSFA, glutamine, allopurinol sucralfate and anti-inflammatory agents, including aminosalicylic acid (5-ASA and

  5. Etiology and sequelae of root resorption. (United States)

    Vlaskalic, V; Boyd, R L; Baumrind, S


    This article reviews the current status of investigation into apical root resorption within the context of orthodontic treatment. Treatment and patient factors that have traditionally been investigated are discussed, along with the results of current research in this area. The need for rethinking traditional research strategies in the quest for identifying both control and causative mechanisms is explored. Finally, proposals for key areas of future interest are highlighted.

  6. Human Factors Considerations in System Design (United States)

    Mitchell, C. M. (Editor); Vanbalen, P. M. (Editor); Moe, K. L. (Editor)


    Human factors considerations in systems design was examined. Human factors in automated command and control, in the efficiency of the human computer interface and system effectiveness are outlined. The following topics are discussed: human factors aspects of control room design; design of interactive systems; human computer dialogue, interaction tasks and techniques; guidelines on ergonomic aspects of control rooms and highly automated environments; system engineering for control by humans; conceptual models of information processing; information display and interaction in real time environments.

  7. Etiological profile of epilepsia partialis continua among adults in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Vikrant Shrivastava


    Full Text Available Background: Epilepsia partialis continua (EPC, is a subtype of status epilepticus, have a varied spectrum of etiology and the out-come depends on the etiology. Aims and Objectives: The present study is aimed to analyze the clinical characteristics and outcome. Materials and Methods: This is a prospective analysis of 17 patients admitted to our center between August 2010 and April 2012. EPC was defined as regular or irregular clonic muscular twitches affecting a limited part of the body, occurring for a minimum of 1 h, and recurring at intervals of no more than 10 s. The data collected included etiology, radiological findings, electroencephalogram (EEG abnormalities, associated comorbid conditions, and outcome. Results: The mean age at presentation was 44.26 ± 13.77 years and the mean duration was 2.7 ± 1.5 days. There were ten patients with diabetic non-ketotic hyperosmolar state and one patient each of oligodendroglioma, varicella zoster vasculitis, central nervous demyelination, ischemic stroke, post traumatic seizure, arteriovenous malformation, and in one patient no cause could be established. Imaging showed abnormality only in five patients and EEG was abnormal in four patients. The EPC was controlled by one antiepileptic drug (AED in eight patients, with two AEDs in seven patients and two patients required three AEDs. Conclusion: EPC is a rare type of focal motor status epilepticus. Treatment of the underlying cause in addition to controlling EPC is essential to achieve the good outcomes.

  8. Genetic associations between delusional disorder and paranoid schizophrenia: A novel etiologic approach. (United States)

    Debnath, Monojit; Das, Sujit K; Bera, Nirmal K; Nayak, Chitta R; Chaudhuri, Tapas K


    Genetic associations between delusional disorder and paranoid schizophrenia are not well understood, although involvement of biological factors has been suspected. We investigated the incidence of human leukocyte antigen (HLA) class I alleles in patients with delusional disorder and paranoid schizophrenia, first, to explore a possible immunogenetic etiology of these paranoid disorders and, second, to determine whether they share similar etiologic mechanisms. We employed a nested case-control study design. Psychiatric reference data were available for 38,500 patients attending a hospital-based psychiatric outpatient department between 1998 and 2005. We enrolled 100 patients with delusional disorder and 50 patients with paranoid schizophrenia as the subject cases, using DSM-IV criteria. We considered equivalent numbers of healthy volunteers matched for age and ethnic background as control subjects. All subjects came from an India-born Bengali population. We applied the polymerase chain reaction-based molecular typing method to all patients and healthy subjects. The HLA-A*03 gene is significantly associated with delusional disorder as well as with paranoid schizophrenia. This HLA gene alone or in linkage disequilibrium with other HLA genes or other closely linked non-HLA genes may influence susceptibility to delusional disorder and paranoid schizophrenia. The study reveals important associations between HLA genes and paranoid disorders. Delusional disorder and paranoid schizophrenia may share similar etiologic mechanisms. This preliminary observation may help our understanding of the genetic basis of these paranoid disorders.

  9. Feminist Framework Plus: Knitting Feminist Theories of Rape Etiology Into a Comprehensive Model. (United States)

    McPhail, Beverly A


    The radical-liberal feminist perspective on rape posits that the assault is motivated by power and control rather than sexual gratification and is a violent rather than a sexual act. However, rape is a complex act. Relying on only one early strand of feminist thought to explain the etiology of rape limits feminists' understanding of rape and the practice based upon the theory. The history of the adoption of the "power, not sex" theory is presented and the model critiqued. A more integrated model is developed and presented, the Feminist Framework Plus, which knits together five feminist theories into a comprehensive model that better explains the depth and breadth of the etiology of rape. Empirical evidence that supports each theory is detailed as well as the implications of the model on service provision, education, and advocacy. © The Author(s) 2015.

  10. PERCH in Perspective: What Can It Teach Us About Pneumonia Etiology in Children? (United States)

    Klugman, Keith P; Rodgers, Gail L


    The pneumonia team at the Bill & Melinda Gates Foundation congratulates the Pneumonia Etiology Research for Child Health (PERCH) study on delivering on their grant to collect high-quality data from thousands of children with World Health Organization-defined severe and very severe pneumonia and from controls in 9 diverse sites in 7 low- and middle-income countries. This supplement sets the foundation to understanding this complex study by providing an in-depth description of the study methodology, including discussion of key aspects such as antibiotic pretreatment, chest radiograph interpretation, utility of induced sputum in children, measurement of pathogen density, and use of C-reactive protein, and how these affect pneumonia etiology. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  11. Cultural Considerations in Translation

    Institute of Scientific and Technical Information of China (English)



    Language is the expression of human communication through which knowledge, belief, and behavior can be experi-enced, explained, and shared. It influences the way the speakers perceive the world. But as it has been long taken for granted, translation deals only with language. Cultural perspective, however, has never been brought into discussion. This paper first analyses the definitions of translation and culture, and then discusses why we should take culture into consideration and in the end, two translating strategies:domestication and foreignization are introduced.

  12. Cultural Considerations in Translation

    Institute of Scientific and Technical Information of China (English)



    Language is the expression of human communication through which knowledge, belief, and behavior can be experi- enced, explained, and shared. It influences the way the speakers perceive the world. But as it has been long taken for granted, translation deals only with language. Cultural perspective, however, has never been brought into discussion. This paper first analyses the definitions of translation and culture, and then discusses why we should take culture into consideration and in the end, two translating strategies: domestication and foreignization are introduced.

  13. Hirsutism in Kashmir: An etiological study

    Directory of Open Access Journals (Sweden)

    Ahmad Qazi


    Full Text Available Background: Hirsutism refers to the presence of terminal hairs at the body sites under androgenic control. Various factors, including genetic makeup and hormonal status, influence the rate and pattern of hair growth at these sites. Purpose: To study the pattern of hirsutism in Kashmir . Materials and Methods: Thirty five consecutive patients of hirsutism were included in the study. After detailed history taking, physical examination and relevant investigations, scoring of hirsutism was done using the Ferriman Gallwey (FG scoring system. Findings: The FG score ranged from 10-34. Twenty patients had associated menstrual abnormalities. Polycystic ovarian syndrome (PCOS was diagnosed in four patients, hypothyroidism in two and congenital adrenal hyperplasia (CAH in one. The rest of the patients had idiopathic hirsutism. Conclusion: Idiopathic hirsutism was the most common category, whilst PCOS, hypothyroidism and CAH were also seen.

  14. Einstein's cosmological considerations

    CERN Document Server

    Janzen, Daryl


    The objective of this paper is not simply to present an historical overview of Einstein's cosmological considerations, but to discuss the central role they played in shaping the paradigm of relativistic cosmology. This, we'll show, was a result of both his actions and, perhaps more importantly, his inactions. Accordingly, discussion won't simply be restricted to Einstein's considerations, as we'll analyse relevant contributions to the relativistic expansion paradigm during the approximately twenty years following Slipher's first redshift measurements in 1912. Our aim is to shed some light on why we think some of the things we do, with the idea that a better understanding of the reasoning that fundamentally influenced the common idea of our expanding universe might help to resolve some of the significant problems that modern cosmology now faces; and we eventually use this knowledge to probe the foundations of the standard model. Much of the information we present, including many of the historical details, we e...

  15. The developmental etiology and pathogenesis of Hirschsprung disease. (United States)

    Butler Tjaden, Naomi E; Trainor, Paul A


    The enteric nervous system is the part of the autonomic nervous system that directly controls the gastrointestinal tract. Derived from a multipotent, migratory cell population called the neural crest, a complete enteric nervous system is necessary for proper gut function. Disorders that arise as a consequence of defective neural crest cell development are termed neurocristopathies. One such disorder is Hirschsprung disease (HSCR), also known as congenital megacolon or intestinal aganglionosis. HSCR occurs in 1/5000 live births and typically presents with the inability to pass meconium, along with abdominal distension and discomfort that usually requires surgical resection of the aganglionic bowel. This disorder is characterized by a congenital absence of neurons in a portion of the intestinal tract, usually the distal colon, because of a disruption of normal neural crest cell migration, proliferation, differentiation, survival, and/or apoptosis. The inheritance of HSCR disease is complex, often non-Mendelian, and characterized by variable penetrance. Extensive research has identified a number of key genes that regulate neural crest cell development in the pathogenesis of HSCR including RET, GDNF, GFRα1, NRTN, EDNRB, ET3, ZFHX1B, PHOX2b, SOX10, and SHH. However, mutations in these genes account for only ∼50% of the known cases of HSCR. Thus, other genetic mutations and combinations of genetic mutations and modifiers likely contribute to the etiology and pathogenesis of HSCR. The aims of this review are to summarize the HSCR phenotype, diagnosis, and treatment options; to discuss the major genetic causes and the mechanisms by which they disrupt normal enteric neural crest cell development; and to explore new pathways that may contribute to HSCR pathogenesis.

  16. How We Predict the Etiology of Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Miguel Pérez-Mateo


    Full Text Available Acute pancreatitis (AP is a frequent disease which represents 0.15-1.5% of all diagnoses in the emergency room. Although its prevalence varies in different countries and even in different areas of a given country, it is likely that its real prevalence ranges from 200-300 cases per million inhabitants a year [1, 2, 3]. The list of etiologic factors related to its development is shown in Table 1. However, a biliary origin is by far the most frequent cause, followed by an alcoholic origin. Together these etiologies are responsible for 80% of all episodes of AP [4]. In a published series, each one of the remaining possible etiologic causes affected a reduced number of patients with AP.

  17. Etiology of Sarcoidosis: Does Infection Play a Role? (United States)

    Saidha, Shiv; Sotirchos, Elias S.; Eckstein, Christopher


    Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology, which is known to affect multiple organ systems including the lungs, heart, skin, central nervous system, and eyes, among others. For this reason, sarcoidosis represents a systemic medical disorder that is clinically relevant to multiple medical sub-specialties. Despite extensive research, the etiology of sarcoidosis has yet to be elucidated, although most evidence supports that the pathogenetic mechanism of sarcoidosis is an aberrant immune response, driven by an unidentified antigen (or antigens) in genetically susceptible individuals. Multiple candidate etiologic agents, including microbial organisms and environmental agents, have been investigated, but study results are inconclusive. In this review, we describe the known histologic and immunologic features of sarcoidosis and discuss the evidence supporting a role for infectious processes in the pathogenesis of sarcoidosis. PMID:22461752

  18. Pharmacogenomics considerations in the control of hypertension. (United States)

    Lupoli, Sara; Salvi, Erika; Barcella, Matteo; Barlassina, Cristina


    The response to antihypertensive therapy is very heterogeneous and the need by the physicians to account for it has driven much interest in pharmacogenomics of antihypertensive drugs. The Human Genome Project and the initiatives in genomics that followed, generated a huge number of genetic data that furnished the tools to explore the genotype-phenotype association in candidate genes and at genome-wide level. In spite of the efforts and the great number of publications, pharmacogenomics of antihypertensive drugs is far from being used in clinical practice. In this review, we analyze the main findings available in PubMed from 2010 to 2015, in relation to the major classes of antihypertensive drugs. We also describe a new Phase II drug that targets two specific hypertension predisposing mechanisms.

  19. Etiology and portal vein thrombosis in Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    Oguz Uskudar; Meral Akdogan; Nurgul Sasmaz; Sevinc Yilmaz; Muharrem Tola; Burhan Sahin


    AIM: To research the etiology, portal vein thrombosis and other features of Budd-Chiari syndrome (BCS)patients prospectively.METHODS: A total of 75 patients (40 female, 35 male) who were diagnosed between January 2002 and July 2004 as having BCS were studied prospectively.Findings from on physical examination, ultrasonography,duplex ultrasonography and venography were analyzed.Hemogram and blood chemistry were studied at the time of diagnosis and on each hospital visit. Bone marrow examination and immune phenotyping were performed by a hematologist when necessary. Protein C, S, antithrombin Ⅲ, activated protein C resistance,and anticardiolipin antibodies, antinuclear antibodies,and anti ds-DNA were studied twice. The presence of ascite, esophageal varices, and portal thrombosis were evaluated at admission and on every visit.RESULTS: At least one etiological factor was determined in 54 (72%) of the patients. The etiology could not be defined in 21 (28%) patients. One etiological factor was found in 39, 2 factors in 14 and 3 factors in 1 patient.The most common cause was the web (16%), the second was Hydatid disease (11%), the third was Behcet's disease (9%). Portal vein thrombosis was present in 11 patients and at least one etiology was identified in 9 of them (82%).CONCLUSION: Behcet's disease and hydatid disease are more prominent etiological factors in Turkey than in other countries. Patients with web have an excellent response to treatment without signs of portal vein thrombosis while patients having thrombofilic factors more than one are prone to develop portal vein thrombosis with worse clinical outcome.

  20. Quemaduras y etiología medicolegal Burns and medicolegal etiology

    Directory of Open Access Journals (Sweden)

    Héctor Barreiro Ramos


    Full Text Available Las muertes por quemaduras plantean a la instrucción policial y al médico legista diversos problemas, entre los que se encuentran, determinar su causa medicolegal, es decir, si se trata de un homicidio, suicidio o accidente, pero para tan trascendental afirmación solo contamos con las versiones de testigo del hecho, sin contar con los elementos científicos que nos orienten, como pudiera ser algún indicador somático o de otro tipo. En tal caso nos preguntamos si existen variables que nos orienten en la causa medicolegal de la muerte. El propósito, por tanto, del trabajo consiste en evaluar un grupo de variables como posibles indicadores de la causa medicolegal de las muertes por llamas. El universo de trabajo fueron 135 fallecidos atendidos en el Centro Provincial de Medicina Legal de La Habana en el decenio 1994-2003, y la muestra la formaron 75 de ellos. Los resultados señalan que el 62 % de los fallecidos fueron suicidios, el 32 % accidentes y el 5 % homicidios, con un predominio del sexo femenino. El suicidio tiene una media de 70 años, para el accidente es 45, y para el homicidio 58. El lugar del hecho más frecuente fue la casa. El agente causal más encontrado fue en primer lugar el alcohol y en segundo el queroseno; en el suicidio el alcohol fue el más empleado, mientras que en el accidente, por el contrario, el más causal fue el queroseno. En el homicidio solo se empleó el alcohol. Se concluye que no existe un solo indicador que nos pueda confirmar la etiología medicolegal de estas muertes, pero el conjunto de ellos sí nos puede señalar con bastante certeza la causa probable.Deaths caused by burns pose diverse problems to the police instruction and to the legist physician. One of these problems is to determine its medicolegal cause, that is, wether it is a homicide, suicide or accident, but for such a trascendental affirmation we only have the versions of the witness, without the scientific elements that may orientate us

  1. Uso de terapias alternativas en la cicatrización de úlceras de etiología venosa: La cromoterapia Colour therapy in venous ulcers healing: chromoteraphy


    Sandra Alexandre Lozano; Neus Arola Serra; Mercè Jovè Jové; Joan Blanco Blanco


    La úlcera de etiología venosa es la más prevalente de las úlceras de extremidad inferior. Entre el 75 y el 80% de las úlceras de la extremidad inferior son de esta etiología. De acuerdo con las evidencias disponibles, el tratamiento de las úlceras de etiología venosa tiene como base dos grandes pilares: el manejo de la úlcera como una herida crónica y el control de la hipertensión venosa crónica (HTV), su causa primordial, mediante sistemas de alta compresión decreciente y mantenida. De todos...

  2. A survey of etiologic hypotheses among testicular cancer researchers

    DEFF Research Database (Denmark)

    Stang, A; Trabert, B; Rusner, C


    the plausibility of the suggested etiologic hypotheses on a scale of 1 (very implausible) to 10 (very plausible). This report describes the methodology of the survey, the score distributions by individual hypotheses, hypothesis group, and the participants' major research fields, and discuss the hypotheses......Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops...

  3. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

    Directory of Open Access Journals (Sweden)

    F. eLucieer


    Full Text Available Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1 imbalance and/or oscillopsia during locomotion, and 2 summated slow phase velocity of nystagmus of less than 20 degrees per second during bithermal caloric tests.Results:The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50% versus 11%, p<0.001. Among all patients, 23.4% were known with autoimmune disorders in their medical history. All 4 clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH and slowly progressive BVH with ataxia were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients.Conclusion:BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and auto-immunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is

  4. Chromosomal anomalies in the etiology of anorectal malformations: a review. (United States)

    Marcelis, Carlo; de Blaauw, Ivo; Brunner, Han


    Anorectal malformation (ARM) is a severe congenital anomaly that can occur either isolated or in association with other congenital abnormalities. It has a heterogeneous etiology with contribution of both genetic and environmental factors, although the etiological factors remain largely unknown. Several chromosomal abnormalities have been described in patients with an ARM. These chromosomal abnormalities could point to specific genes involved in the development of the anorectal canal and associated structures. This paper reviews the chromosomal abnormalities described in ARM and may act as a starting point to identify chromosomal regions containing putative anorectal development genes. Copyright © 2011 Wiley Periodicals, Inc.

  5. Commercial considerations in tissue engineering. (United States)

    Mansbridge, Jonathan


    Tissue engineering is a field with immense promise. Using the example of an early tissue-engineered skin implant, Dermagraft, factors involved in the successful commercial development of devices of this type are explored. Tissue engineering has to strike a balance between tissue culture, which is a resource-intensive activity, and business considerations that are concerned with minimizing cost and maximizing customer convenience. Bioreactor design takes place in a highly regulated environment, so factors to be incorporated into the concept include not only tissue culture considerations but also matters related to asepsis, scaleup, automation and ease of use by the final customer. Dermagraft is an allogeneic tissue. Stasis preservation, in this case cryopreservation, is essential in allogeneic tissue engineering, allowing sterility testing, inventory control and, in the case of Dermagraft, a cellular stress that may be important for hormesis following implantation. Although the use of allogeneic cells provides advantages in manufacturing under suitable conditions, it raises the spectre of immunological rejection. Such rejection has not been experienced with Dermagraft. Possible reasons for this and the vision of further application of allogeneic tissues are important considerations in future tissue-engineered cellular devices. This review illustrates approaches that indicate some of the criteria that may provide a basis for further developments. Marketing is a further requirement for success, which entails understanding of the mechanism of action of the procedure, and is illustrated for Dermagraft. The success of a tissue-engineered product is dependent on many interacting operations, some discussed here, each of which must be performed simultaneously and well.

  6. Paediatric pharmacokinetics: key considerations (United States)

    Batchelor, Hannah Katharine; Marriott, John Francis


    A number of anatomical and physiological factors determine the pharmacokinetic profile of a drug. Differences in physiology in paediatric populations compared with adults can influence the concentration of drug within the plasma or tissue. Healthcare professionals need to be aware of anatomical and physiological changes that affect pharmacokinetic profiles of drugs to understand consequences of dose adjustments in infants and children. Pharmacokinetic clinical trials in children are complicated owing to the limitations on blood sample volumes and perception of pain in children resulting from blood sampling. There are alternative sampling techniques that can minimize the invasive nature of such trials. Population based models can also limit the sampling required from each individual by increasing the overall sample size to generate robust pharmacokinetic data. This review details key considerations in the design and development of paediatric pharmacokinetic clinical trials. PMID:25855821

  7. Lesiones medulares no traumáticas: etiología, demografía y clínica Nontraumatic spinal cord injury: etiology, demography and clinics

    Directory of Open Access Journals (Sweden)

    Asencio Quintana-Gonzales


    Full Text Available Se realizó un estudio retrospectivo y descriptivo en 210 pacientes hospitalizados con lesión medular del Instituto Nacional de Rehabilitación (INR, Callao-Perú (2000-2006 para conocer la etiología, características clínicas y socio-demográficas de los pacientes con lesiones medulares no traumáticas (LMNT. Se encontró una prevalencia de 27 % para LMNT siendo la edad promedio al inicio de la lesión 32,0 años; siendo varones el 50,5 %, y el 41,9 % tuvieron educación secundaría, el nivel de pobreza alcanzó el 90,5 %. Predominó la etiología infecciosa (viral y bacteriana en 37,6 %, con un 11,9 % de infección por HTLVI. No obstante ser el INR un centro de referencia, nuestros resultados son preliminares, siendo necesario realizar mayores estudios para proponer estrategias de prevención y control, dado el alto costo del tratamiento integral de rehabilitación en estos pacientes.We performed a retrospective and descriptive cross-sectional; study in 210 hospitalized patients with spinal cord injury at the National Institute of Rehabilitation (INR, Callao, Peru from 2000-2006. The goal was to describe etiology, and clinical and socio-demographic characteristics of non traumatic spinal cord injuries (LMNT. We found a prevalence of 27 % for LMNT, average age at onset of 32.0 years, male gender 50.5 %, and secondary education completed in 41.9 %, poverty 90.5 %. The infectious etiology (viral and bacterial was predominant in 37.6 %, with 11.9 infected with HTLVI. Although the INR is a reference center, the findings can’t be generalized because it isn’t a representative sample of the Peruvian population, further studies are necessary to propose strategies for prevention and control, considering the high cost of integral rehabilitation treatment in these patients.

  8. Hepatic Hypertransaminasaemia of unknown Etiology Aclinico-pathological study

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    El Sayed El-Meghawry El Sayed*, Hany Abu Zeid*, Salah Mohamed


    Full Text Available Hepatic aminotransferases are sensitive indicators of liver cell injury. In some patients with persistent elevation of such enzymes; routine clinical, laboratory and serological data cannot establish the underlying causes. This study was designed to evaluate such patients both clinically and pathologically as a trial to reach the underlying etiology. Thirty patients with hepatic hypertransaminasaemia of unknown cause (18 females & 12 males, aged 18-50 years (mean age 37.7 4.6 years, together with ten controls (5 males & 5 females [matched in age and body mass index with patients]; were included in this study. Both patients and controls were subjected to full history taking, clinical examination, estimation of blood glucose and lipid profile, liver function tests, serum iron & ferrtin estimation, hepatitis viral markers (HBs Ag HCV-Ab, anti Epstien Barr (EBV and cytomegalovirus (CMV antibodies, abdominal ultrasonography (U/Sand needle liver biopsy (done only for 15 patients who approved undergoing it. The study revealed that 18 patients had non alcoholic fatty liver disease NAFLD (bright liver on U/S, eleven patients out of them underwent liver biopsy that showed simple hepatic steatosis in four of them and non alcoholic steatohepatitis (NASH in the other seven patients. Most of the eighteen patients with NAFLD were obese, diabetic and hypertensive. Four patients had positive serology for autoimmune hepatitis and two patients had positive serology for cytomegalovirus infection. All patients had normally ranged serum iron & ferritin. The remaining six patients had normal hepatic U/S and negative serology for different hepatic viruses; four of them underwent liver biopsy that revealed simple hepatic steatosis in two of them and non alcoholic steatohepatitis (NASH in the other two patients. Conclusion & recommendation: Non alcoholic fatty liver disease (NAFLD was found to be the commonest cause of unexplained hepatic hypertransamina-saemia. However

  9. Role of psychosocial factors in the etiology of bruxism

    NARCIS (Netherlands)

    Manfredini, D.; Lobbezoo, F.


    AIMS: To summarize literature data about the role of psychosocial factors in the etiology of bruxism. METHODS: A systematic search in the National Library of Medicine's PubMed Database was performed to identify all peer-reviewed papers in the English literature dealing with the bruxism-psychosocial

  10. Etiology, prevalence, and treatment of dry eye disease

    Directory of Open Access Journals (Sweden)

    Johnny L Gayton


    Full Text Available Johnny L GaytonEyesight Associates, Warner Robins, GA, USAPurpose: This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify peer-reviewed articles related to dry eye published prior to September 2008. The terms “dry eye” and “women” were searched in combination with one or more of the following words or phrases: prevalence, postmenopausal, etiology, risk factors, therapy, medications, surgery, tear film, and quality of life. Articles were selected based on their direct applicability to the subject matter. A manual search was also conducted based on citations in the published literature.Results: Epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan. Risk factors include advanced age, female sex, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications.Conclusion: The last decade has brought about a better understanding of the etiology of dry eye disease. New therapies that can alleviate the signs and symptoms of dry eye disease and, consequently, improve the quality of life of dry eye patients are available in the market.Keywords: dry eye disease, etiology, prevalence, postmenopausal women

  11. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of

  12. [Ischemic colitis after renal transplantation:etiology and pathogenesis]. (United States)

    Alperovich, G; Idiarte, L; Besasso, O; Avagnina, A


    Ischemic colitis is a well-recognized complication occurring in renal transplant recipients. It has often been associated with cytomegalovirus (CMV) vasculitis. However, the diagnosis of this pathology in the absence of CMV suggests that other etiological factors might be involved. Drugs inducing mesenteric vasoconstriction, such as non-steroidal anti-inflamatory drugs (NSAIDs) and cyclosporine could be related to this entity.

  13. Rheumatoid arthritis: an immune disease in search of an etiology. (United States)

    Weiss, D L


    The current knowledge of the immunologic and etiologic factors which play a role in rheumatoid arthritis is reviewed and extrapolated to the systemic effects of rheumatoid disease. The disease process is viewed as the incidental result of an atypical immuno-inflammatory mechanism initiated by an unidentified antigenic stimulus.

  14. The Etiology of Suicide: Perceptions of Prevention Center Directors. (United States)

    Rogers, James R.; Subich, Linda Mezydlo


    Results of random sampling of suicide prevention center directors suggests that etiological models of suicidal behavior emphasizing environmental stress and/or prepotent vulnerability are most commonly held perceptions of causes of suicide. Category that included both stress and predisposition models was advocated by 37.5 percent of respondents…

  15. Etiology and clinical management of adult meningitis in Indonesia

    NARCIS (Netherlands)

    Rizal Ganiem, A.


    This thesis consists of 8 chapters and addresses the etiology, diagnosis, outcome and treatment of adult meningitis in Indonesia. The studies were conducted in Hasan Sadikin Hospital, Bandung, the referral hospital for West Java province, Indonesia between December 2006 and August 2012. In a cohor

  16. A Study of the Etiology of Referred Otalgia

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Taziki


    Conclusion:  In view of the fact that a significant proportion of the patients who complained of otalgia had no pathologies in the ear, thorough physical examination in adjacent structures especially teeth should be performed and malignancies should be considered as a possible etiology of otalgia.

  17. A Review of Etiological Formulations and Possible Treatments of Enuresis. (United States)

    Odebunmi, Akin

    This literature review discusses enuresis from various etiological formulations: pyschoanalytic and psychodynamic; medical and physiological; and behavioral. Both historical and current perspectives on a definition of enuresis are offered. Treatment methodologies are reviewed. An emphasis is placed on the ruling out of medical causes before any…

  18. Ketosis in dairy cows: etiologic factors, monitoring, treatment

    NARCIS (Netherlands)

    van der Drift, S.G.A.


    Ketosis is a metabolic disorder that mainly occurs during the negative energy balance in early-lactation dairy cows. It is characterized by elevated concentrations of ketone bodies in blood (hyperketonemia), urine, and milk. The thesis of Saskia van der Drift covers investigations on etiologic facto

  19. Infectious uveitis. New developments in etiology and pathogenesis

    NARCIS (Netherlands)

    de Visser, L.


    Uveitis is an inflammation of the inner-eye and is initiated by various infectious and noninfectious causes. In a large portion of patients the etiology is unknown and might be associated with until now undiagnosed infections.The identification of infectious uveitis is of crucial importance since it

  20. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.


    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  1. Evaluation of etiological factors in patients with chronic urticaria. (United States)

    Colgecen, Emine; Ozyurt, Kemal; Gul, Ali Irfan; Utas, Serap


    In the last few decades, increasing understanding of the pathomechanisms involved in chronic urticaria has highlighted the heterogeneity of different subtypes, and chronic urticaria is now classified as chronic spontaneous urticaria and inducible urticaria. Although many factors are thought to be involved in chronic urticaria, the etiology is yet to be clarified. The purpose of this study was to investigate etiological factors in patients with chronic urticaria. Five hundred patients with chronic urticaria, 351 women and 149 men, were studied for etiological factors. The autologous serum skin test was performed on 197 patients. Provocation testing for physical urticaria was performed on 354 patients. Patients with acute urticaria were excluded from the study. We determined at least one focus of infection that might be involved in the etiology of the disease in 18.8% of cases. Patients with infections were treated, and symptoms resolved after treatment in six cases (5.3%). Autologous serum skin tests were positive in 125 patients (63.5%). Provocation tests for physical urticaria were positive in 131 (37%) patients with urticaria. We suggest that physical stimuli and autoantibodies play an important role in the etiopathogenesis of urticaria.

  2. Protocol for a Controlled Experiment to Identify the Causal Role of Acute Alcohol Consumption in Condomless Sex among HIV-Positive MSM: Study Procedures, Ethical Considerations, and Implications for HIV Prevention (United States)

    Shuper, Paul A.; Joharchi, Narges; Rehm, Jürgen


    Although alcohol consumption is frequently perceived as a driver of condomless sex and subsequent HIV acquisition, the causal nature of this relationship remains unclear, and little is known about alcohol’s direct versus indirect impact on the sexual risk dynamics of those who are HIV-positive. To address this gap, we present the protocol for an in-progress NIAAA-funded controlled experiment, wherein a sample of HIV-positive men-who-have-sex-with-men (MSM) undergoes an alcohol consumption manipulation (alcohol/placebo/control) and sexual arousal induction (sexually aroused/non-aroused), and then reports intentions to engage in condom-protected and condomless sexual acts with hypothetical sexual partners differing in HIV serostatus (HIV+/HIV−/HIV status unknown), condom use preference (use/don’t use/not stated), and physical attractiveness (attractive/unattractive). Study outcomes will identify alcohol’s impact on HIV-positive MSM’s condomless sex intentions in the context of experimentally-manipulated factors as well as risk-relevant personality traits and alcohol-related expectancies. Detailed experimental procedures, ethical considerations, and potential implications for HIV prevention are discussed. PMID:26163147

  3. Attention-Deficit/Hyperactivity Disorder and Risk of Substance Use Disorder: Developmental Considerations, Potential Pathways, and Opportunities for Research (United States)

    Molina, Brooke S.G.; Pelham, William E.


    Many opportunities to explain ADHD-related risk of substance use/disorder (SUD) remain available for study. We detail these opportunities by considering characteristics of children with ADHD and factors affecting their outcomes side-by-side with overlapping variables in the developmental literature on SUD etiology. Although serious conduct problems are a known contributor to ADHD-related risk of SUD, few studies have considered their emergence developmentally and in relation to other candidate mediators and moderators that could also explain risk and be intervention targets. Common ADHD-related impairments, such as school difficulties, are in need of research. Heterogeneous social impairments have the potential for predisposing, and buffering, influences. Research on neurocognitive domains should move beyond standard executive function batteries to measure deficits in the interface between cognitive control, reward, and motivation. Ultimately, maximizing prediction will depend, as it has in the SUD literature, on simultaneous consideration of multiple risk factors. PMID:24437435

  4. Etiologic Ischemic Stroke Phenotypes in the NINDS Stroke Genetics Network (United States)

    Ay, Hakan; Arsava, Ethem Murat; Andsberg, Gunnar; Benner, Thomas; Brown, Robert D.; Chapman, Sherita N.; Cole, John W.; Delavaran, Hossein; Dichgans, Martin; Engström, Gunnar; Giralt-Steinhauer, Eva; Grewal, Raji P.; Gwinn, Katrina; Jern, Christina; Jimenez-Conde, Jordi; Jood, Katarina; Katsnelson, Michael; Kissela, Brett; Kittner, Steven J.; Kleindorfer, Dawn O.; Labovitz, Daniel L.; Lanfranconi, Silvia; Lee, Jin-Moo; Lehm, Manuel; Lemmens, Robin; Levi, Chris; Li, Linxin; Lindgren, Arne; Markus, Hugh S.; McArdle, Patrick F.; Melander, Olle; Norrving, Bo; Peddareddygari, Leema Reddy; Pedersén, Annie; Pera, Joanna; Rannikmäe, Kristiina; Rexrode, Kathryn M.; Rhodes, David; Rich, Stephen S.; Roquer, Jaume; Rosand, Jonathan; Rothwell, Peter M.; Rundek, Tatjana; Sacco, Ralph L.; Schmidt, Reinhold; Schürks, Markus; Seiler, Stephan; Sharma, Pankaj; Slowik, Agnieszka; Sudlow, Cathie; Thijs, Vincent; Woodfield, Rebecca; Worrall, Bradford B.; Meschia, James F.


    Background and Purpose NINDS Stroke Genetics Network (SiGN) is an international consortium of ischemic stroke studies that aims to generate high quality phenotype data to identify the genetic basis of etiologic stroke subtypes. This analysis characterizes the etiopathogenetic basis of ischemic stroke and reliability of stroke classification in the consortium. Methods Fifty-two trained and certified adjudicators determined both phenotypic (abnormal test findings categorized in major etiologic groups without weighting towards the most likely cause) and causative ischemic stroke subtypes in 16,954 subjects with imaging-confirmed ischemic stroke from 12 US studies and 11 studies from 8 European countries using the web-based Causative Classification of Stroke System. Classification reliability was assessed with blinded re-adjudication of 1509 randomly selected cases. Results The distribution of etiologic categories varied by study, age, sex, and race (pstroke etiology (phenotypic subtype) were classified into the same final causative category with high confidence. There was good agreement for both causative (kappa 0.72, 95%CI:0.69-0.75) and phenotypic classifications (kappa 0.73, 95%CI:0.70-0.75). Conclusions This study demonstrates that etiologic subtypes can be determined with good reliability in studies that include investigators with different expertise and background, institutions with different stroke evaluation protocols and geographic location, and patient populations with different epidemiological characteristics. The discordance between phenotypic and causative stroke subtypes highlights the fact that the presence of an abnormality in a stroke patient does not necessarily mean that it is the cause of stroke. PMID:25378430

  5. Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents. (United States)

    Tagwerker Gloor, Friederike; Walitza, Susanne


    Tic disorders (TD), including chronic/persistent TD (CTD) and Tourette syndrome, have been described and studied for many years. Within the last two decades, intensified study efforts led to more specific assumptions about genesis and influences of both hereditary and environmental factors. TD in children and adolescents are very often accompanied by attention-deficit/hyperactivity disorders and obsessive-compulsive disorders (OCD) as comorbid disorders. Comorbidities are aggravating factors concerning prognosis and treatment opportunities. Therefore, etiological considerations and treatment strategies have to take associated psychiatric disorders into account. Treatment approaches are symptom targeted and include behavioral treatments and/or medication and show positive outcomes concerning tic symptomatology, global functioning, and associated psychopathology. This review presents an update of the research, definitions, and classification according to ICD-10 and DSM-5 and summarizes the diagnostic procedures and most effective clinical strategies.

  6. Revisiting Postoperative Vision Loss following Non-Ocular Surgery: A Short Review of Etiology and Legal Considerations

    Directory of Open Access Journals (Sweden)

    Ehud Mendel


    Full Text Available Postoperative vision loss (POVL following non-ocular surgery is a serious complication where the causes are not fully understood. Studies have identified several causes of POVL as well as risk factors and prevention strategies. POVL research is made difficult by the fact that cases are often subject to malpractice claims, resulting in a lack of public access to case reports. This literature review was conducted in order to identify legal issues as a major barrier to studying POVL and address how this affects current knowledge. Informed consent provides an opportunity to overcome legal challenges by reducing malpractice litigation through educating the patient on this outcome. Providing pertinent information regarding POVL during the informed consent process has potential to reduce malpractice claims and increase available clinical information.

  7. Different Types of Fantastic Etiology in Hafez Poetry

    Directory of Open Access Journals (Sweden)

    Ghodrat Ghasemipour


    Full Text Available  Abstract Fantastic etiology in Persian poetry has such a high status that we can say that this figure of speech is one of the most interested figures between classic Persian poets. This figure is frequently used by Hafez in his poetries so that after equivocalness it is the second rhetorical figure in his poetries. The definition of fantastic etiology is that causality in poetry is based on similarity and it must be aesthetical and satisfactory, not scientific and discursive. By Fantastic etiology poets create imaginative connection between two phenomena; in the other hand, this figure rationally proves the possibility of the impossible and thus presents the lies disguised as truth. The poet’s goal in fantastic etiology is not to invent the cause, but rather to make the conventional descriptions sound unusual. For example, in the line “Because the cloud weeps without reason, tulips and roses laugh at it,” it is the groundless tears of the cloud which cause mockery on the part of the tulips and roses. In this example, two conventional expressions- “the cloud’s tears” (describing the spring rain and “the flowers’ laughter” (describing their blossoming - are connected by a causal relationship which does not exist in reality.   In classical Persian poetry Hafez, along with equivocalness, utilized of fantastic etiology in the best form . His uses of this literary device, like another figures of speech in his poetry, is very natural and unassuming. Understanding, interpreting and aesthetical purpose of some Hafez poetries is based on fantastic etiology.   Companionship, concomitancy and admixture of poetical figures are factors that must be discussed in stylistic analysis of poetry. Literary figures occasionally uses alone in poetry and some when uses together. Though fantastic etiology in rhetoric or figure of thought is an independent figure, but this devise occasionally uses with another

  8. Cancer: Some genetic considerations

    African Journals Online (AJOL)

    Mohammad Saad Zaghloul Salem


    Sep 22, 2014 ... quite reasonable, as cancer is primarily a genetic alteration, lack of .... induced by malignant transformation impart to the cell new ... involved in this mysterious biological behavior of cells. ... the preservation of the evolutionary ability of the zygote ... by genomic regulatory mechanisms controlled by master.

  9. Microbiology--Safety Considerations. (United States)

    Hoffmann, Sheryl K.

    This paper discusses the risk assessment associated with microbiology instruction based on grade level, general control measures, appropriate activities for middle school and high school students, the preparation and sterilization of equipment, and safe handling techniques. Appended are instructions and figures on making wire loops and the…

  10. Regulatory considerations for biosimilars

    Directory of Open Access Journals (Sweden)

    Ranjani Nellore


    Full Text Available Currently there is considerable interest in the legislative debate around generic biological drugs or "biosimilars" in the EU and US due to the large, lucrative market that it offers to the industry. While some countries have issued a few regulatory guidelines as well as product specific requirements, there is no general consensus as to a single, simple mechanism similar to the bioequivalence determination that leads to approval of generic small molecules all over the world. The inherent complex nature of the molecules, along with complicated manufacturing and analytical techniques to characterize them make it difficult to rely on a single human pharmacokinetic study for assurance of safety and efficacy. In general, the concept of comparability has been used for evaluation of the currently approved "similar" biological where a step by step assessment on the quality, preclinical and clinical aspects is made. In India, the focus is primarily on the availability and affordability of life-saving drugs. In this context every product needs to be evaluated on its own merit irrespective of the innovator brand. The formation of the National Biotechnology Regulatory Authority may provide a step in the right direction for regulation of these complex molecules. However, in order to have an efficient machinery for initial approval and ongoing oversight with a country-specific focus, cooperation with international authorities for granting approvals and continuous risk-benefit review is essential. Several steps are still needed for India to be perceived as a country that leads the world in providing quality biological products.

  11. [Long-term effects of osteopathic treatment of chronic prostatitis with chronic pelvic pain syndrome: a 5-year follow-up of a randomized controlled trial and considerations on the pathophysiological context]. (United States)

    Marx, S; Cimniak, U; Rütz, M; Resch, K L


    The etiology of chronic prostatitis chronic pelvic pain syndrome (CP/CPPS) is still unclear. As no pathological findings exist the diagnosis of CP/CPPS is essentially a diagnosis by exclusion and functional disorders, so-called somatoform disorders play a more important role. Osteopathy treats functional disorders of the musculoskeletal system including all associated internal organs but little attention has so far been paid to this treatment method. Therefore, the 5-year follow-up period was intended to show that this is a sustainable form of therapy using exclusively manual and gentle techniques and simple treatment procedures resulting in manageable costs. The aim of this study was to investigate whether sustainability of osteopathic treatment could be demonstrated even after 5 years. This was a randomized controlled study initially involving 5 treatment sessions, a follow-up without treatment after 6 weeks and further follow-up after 1.5 and 5 years. Of the 20 patients 19 in the test group participated in the 5-year follow-up. The control group were not asked because it would have been unacceptable to expect the patients to refrain from having treatment for as long as 5 years. The men were aged between 29 and 70 years. The patients were asked to complete the international prostate symptom score (IPSS), the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) and the quality of life (QOL) questionnaires once again and in particular to state whether they had received osteopathic treatment specifically for the prostate problem and how often they had been treated. The follow-up assessment of the symptoms of chronic prostatitis (NIH-CPSI) showed that they had further improved after 1.5 years (intragroup difference -1.8 points, 95 % confidence interval CI=-3.8 to 0.3) and also after 5 years (intragroup difference -1.3 points 95 % CI=-3.4 to 0.8). The urinary tract symptoms (IPSS) showed a statistically significant improvement (intergroup

  12. Chronic kidney disease of uncertain etiology in Sri Lanka: Are leptospirosis and Hantaviral infection likely causes? (United States)

    Gamage, Chandika Damesh; Sarathkumara, Yomani Dilukshi


    Chronic kidney disease of uncertain etiology (CKDu) has been a severe burden and a public health crisis in Sri Lanka over the past two decades. Many studies have established hypotheses to identify potential risk factors although causative agents, risk factors and etiology of this disease are still uncertain. Several studies have postulated that fungal and bacterial nephrotoxins are a possible etiological factor; however, the precise link between hypothesized risk factors and the pathogenesis of chronic kidney disease has yet to be proven in prior studies. Leptospirosis and Hantavirus infections are important zoonotic diseases that are naturally maintained and transmitted via infected rodent populations and which present similar clinical and epidemiological features. Both infections are known to be a cause of acute kidney damage that can proceed into chronic renal failure. Several studies have reported presence of both infections in Sri Lanka. Therefore, we hypothesized that pathogenic Leptospira or Hantavirus are possible causative agents of acute kidney damage which eventually progresses to chronic kidney disease in Sri Lanka. The proposed hypothesis will be evaluated by means of an observational study design. Past infection will be assessed by a cross-sectional study to detect the presence of IgG antibodies with further confirmatory testing among chronic kidney disease patients and individuals from the community in selected endemic areas compared to low prevalence areas. Identification of possible risk factors for these infections will be followed by a case-control study and causality will be further determined with a cohort study. If the current hypothesis is true, affected communities will be subjected for medical interventions related to the disease for patient management while considering supportive therapies. Furthermore and possibly enhance their preventive and control measures to improve vector control to decrease the risk of infection. Copyright © 2016

  13. Conditioning theory: a model for the etiology of public speaking anxiety? (United States)

    Hofmann, S G; Ehlers, A; Roth, W T


    To study the etiology of public speaking anxiety (speech phobia), 30 Ss with the fear of public speaking, and 24 controls without this fear were asked about past public speaking experiences, their beliefs about the main reason for their phobia, and their concerns in the feared situation. All speech phobics met the DSM-III-R criteria for social phobia. Results showed that traumatic external events, vicarious and informational learning--the causes for phobia that fit in best with Rachman's conditioning theory--were notably uncommon among these phobics, who attributed their fear most often to panic attacks. Yet it was not clear whether panic attacks were causes or consequences of phobia.

  14. Lactate Elevation During and After Major Cardiac Surgery in Adults: A Review of Etiology, Prognostic Value, and Management. (United States)

    Andersen, Lars W


    Elevated lactate is a common occurrence after cardiac surgery. This review summarizes the literature on the complex etiology of lactate elevation during and after cardiac surgery, including considerations of oxygen delivery, oxygen utilization, increased metabolism, lactate clearance, medications and fluids, and postoperative complications. Second, the association between lactate and a variety of outcomes are described, and the prognostic role of lactate is critically assessed. Despite the fact that elevated lactate is strongly associated with many important outcomes, including postoperative complications, length of stay, and mortality, little is known about the optimal management of postoperative patients with lactate elevations. This review ends with an assessment of the limited literature on this subject.

  15. A control-oriented lithium-ion battery pack model for plug-in hybrid electric vehicle cycle-life studies and system design with consideration of health management (United States)

    Cordoba-Arenas, Andrea; Onori, Simona; Rizzoni, Giorgio


    A crucial step towards the large-scale introduction of plug-in hybrid electric vehicles (PHEVs) in the market is to reduce the cost of its battery systems. Currently, battery cycle- and calendar-life represents one of the greatest uncertainties in the total life-cycle cost of battery systems. The field of battery aging modeling and prognosis has seen progress with respect to model-based and data-driven approaches to describe the aging of battery cells. However, in real world applications cells are interconnected and aging propagates. The propagation of aging from one cell to others exhibits itself in a reduced battery system life. This paper proposes a control-oriented battery pack model that describes the propagation of aging and its effect on the life span of battery systems. The modeling approach is such that it is able to predict pack aging, thermal, and electrical dynamics under actual PHEV operation, and includes consideration of random variability of the cells, electrical topology and thermal management. The modeling approach is based on the interaction between dynamic system models of the electrical and thermal dynamics, and dynamic models of cell aging. The system-level state-of-health (SOH) is assessed based on knowledge of individual cells SOH, pack electrical topology and voltage equalization approach.

  16. [Ventricular tachyarrhythmias. A retrospective analysis of etiology, demography and treatment

    DEFF Research Database (Denmark)

    Christensen, A.H.; Henningsen, K.; Svendsen, Jesper Hastrup


    to ventricular tachyarrhythmias. MATERIALS AND METHODS: We conducted a retrospective review of 993 patients discharged from Rigshospitalet over 6 years and 5 months with the diagnostic codes ventricular tachycardia, ventricular fibrillation or premature ventricular contractions. RESULTS: The population had...... an average age of 59 years (ranging 15-95 years) with a majority of males (76%). Among the patients with known etiology ischemic heart disease (60%), dilated cardiomyopathy (6%) and arrhythmogenic right ventricular cardiomyopathy (6%) were the most frequent. A substantial number of the patients (15%) had...... unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted...

  17. Controversies about a common etiology for eating and mood disorders

    Directory of Open Access Journals (Sweden)

    Clara eRossetti


    Full Text Available Obesity and depression represent a growing health concern worldwide. For many years, basic science and medicine have considered obesity as a metabolic illness, while depression was classified a psychiatric disorder. Despite accumulating evidence suggesting that obesity and depression may share commonalities though, the causal link between eating and mood disorders remains to be fully understood. This etiology is highly complex, consisting of multiple environmental and genetic risk factors that interact with each other. In this review, we sought to summarize the preclinical and clinical evidence supporting a common etiology for eating and mood disorders, with a particular emphasis on signaling pathways involved in the maintenance of energy balance and mood stability, among which orexigenic and anorexigenic neuropeptides, metabolic factors, stress responsive hormones, cytokines and neurotrophic factors.

  18. The etiology of primary femoroacetabular impingement: genetics or acquired deformity? (United States)

    Packer, Jonathan D; Safran, Marc R


    The etiology of primary femoroacetabular impingement (FAI) remains controversial. Both genetic and acquired causes have been postulated and studied. While recent studies suggest that genetic factors may have a role in the development of FAI, there is no conclusive evidence that FAI is transmitted genetically. Currently, the most popular theory for the development of cam-type deformities is that a repetitive injury to the proximal femoral physis occurs during a critical period of development. There is a correlation between a high volume of impact activities during adolescence and the development of cam-type deformities. Multiple studies have found a high prevalence of FAI in elite football, ice hockey, basketball and soccer players. In this article, we review the current literature relating to the etiology of primary FAI.

  19. The etiology of primary femoroacetabular impingement: genetics or acquired deformity? (United States)

    Packer, Jonathan D.; Safran, Marc R.


    The etiology of primary femoroacetabular impingement (FAI) remains controversial. Both genetic and acquired causes have been postulated and studied. While recent studies suggest that genetic factors may have a role in the development of FAI, there is no conclusive evidence that FAI is transmitted genetically. Currently, the most popular theory for the development of cam-type deformities is that a repetitive injury to the proximal femoral physis occurs during a critical period of development. There is a correlation between a high volume of impact activities during adolescence and the development of cam-type deformities. Multiple studies have found a high prevalence of FAI in elite football, ice hockey, basketball and soccer players. In this article, we review the current literature relating to the etiology of primary FAI. PMID:27011846

  20. Migraine: etiology, risk, triggering, aggravating factors and clinical manifestations

    Directory of Open Access Journals (Sweden)

    Natalia Lindemann Carezzato


    Full Text Available This study aimed to identify the etiology and clinical manifestations of migraine. An integrative literature review was performed guided by the question: What is the evidence available in the literature about the etiology, signs and symptoms of migraine? The article search was conducted in the electronic databases PubMed and LILACS, considering publications in the period from 2006 to 2010. The selected articles were categorized and evaluated according to the level of evidence. One found 1,677 articles and 26 were selected for full reading. Most studies (84.6% consisted of a non-experimental design and were classified as evidence level IV. Although the clinical manifestations found in this study confirm the data available in the literature, it is noticed that migraine does not have well-established causes

  1. [Etiological diagnosis of hirsutism and implications for the treatment]. (United States)

    Spritzer, Poli Mara


    Hirsutism may be defined as the presence of terminal hair in the women, with a male pattern of distribution. The clinical presentation is variable, from isolated hirsutism to the presence of other signs of hyperandrogenism, menstrual irregularities and/or infertility. Hirsutism is related to serum androgens and to the cutaneous sensitivity to these hormones. The most prevalent causes of hirsutism are polycystic ovary syndrome and isolated hirsutism, in the presence of ovulatory cycles. Non-classical congenital adrenal hyperplasia (21-hydroxylase deficiency) and drug-induced hirsutism are less frequent causes. Androgen-secreting neoplasms and Cushing syndrome are rare etiologies related to hirsutism. Diagnostic evaluation should address on identifying the etiology and potential risk for associated comorbidities. The aims of the treatment are: to suppress androgen overproduction, if present; to block androgen action on hair follicles; to identify and treat patients at risk for metabolic disturbances or reproductive neoplasias.

  2. Prevalence and possible etiology of dental enamel hypoplasia. (United States)

    El-Najjar, M Y; DeSanti, M V; Ozebek, L


    Two hundred black and white adult human skeletons and 200 living black and white children from the greater Cleveland area were examined for evidence of enamel hypoplasia. Enamel hypoplasia, present in varying expressings (pits, lines and grooves), was found to be more prevalent in both skeletal samples, than in the living groups. In the majority of cases, sex differences between white and black males and females through time and space are highly significant for all tooth catagories. Regardless of the mechanisms behind it, prevalence of enamel hypoplasia for both white and black group has significantly declined through time. No evidence suggesting specific etiologies responsible for enamel hypoplasia can be found. In the majority of previously published reports, the etiology is still idiopathic. The reduction in the prevalence of enamel hypoplasia in the groups examined through time may be related to improved nutritional conditions and the elimination or decline of childhood diseases that have been implicated in this condition.

  3. Epigenetic: A new approach to etiology of infertility

    Directory of Open Access Journals (Sweden)

    Silvia W. Lestari


    Full Text Available Infertility is a complex disease which could be caused by male and female factors. The etiology from both factors needs further study. There are some approaches to understanding the etiology of infertility, one of them is epigenetic. Epigenetic modifications consist of DNA methylation, histone modifications, and chromatin remodelling. Male and female germinal cells undergo epigenetic modifications dynamically during differentiation into matured sperm and oocyte cells. In a male, the alteration of DNA methylation in spermatogenesis will cause oligo/asthenozoospermia. In addition, the histone methylation, acetylation, or other histone modification may lead sperm lose its ability to fertilize oocyte. Similarly, in a female, the alteration of DNA methylation and histone modification affects oogenesis, created aneuploidy in fertilized oocytes and resulted in embryonic death in the uterus. Alteration of these epigenetic modification patterns will cause infertility, both in male and female.


    Directory of Open Access Journals (Sweden)

    A.B. Sugak


    Full Text Available Pericarditis is relatively widespread inflammatory disease of pericardium. Symptoms of this disease was described already in the beginning of XIXth century, but it's clinical diagnostics in patient's lifetime is difficult up to now. Majority of acute pericardites have favorable clinical course, but some of them have complications (cardiac tamponade and constrictive pericarditis, which are potentially lethal. Development of non-invasive radiation methods of heart visualization technologies improved diagnostics of pericarditis in last years. Besides, achievements of immunology, virology and microbiology allowed widening of data of etiology and pathogenesis of pericardial diseases. Present lecture gives modern data of etiology, classification, clinical signs, diagnostics and treatment of pericarditis. The description of separate specific types of pericardites is given.Key words: children, pericarditis.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:77-84

  5. [Sarcoidosis: etiology, pathogenesis, epidemiology, risk factors, clinical presentation]. (United States)

    Éksarenko, O V; Kharlap, S I; Safonova, T N


    Sarcoidosis is a chronic idiopathic multisystem granulomatous inflammatory disease of unknown etiology. Prevalence of this condition is approximately 3-5: 100 000 with the highest incidence at the age of 25-40 years old and no gender predomination. Early morbidity, disability and severe prognosis worsen patient's condition and make them socially limited. In some cases ocular involvement and vision loss aggravate general condition of the patients. Ocular involvement in sarcoidosis occurs in 10-75% patients. At the same time some data confirm the fact that in 7% of patients ocular damage is the presenting sign making them come to an ophthalmologist whereas orbital involvement may present in systemic disease only. Unclear etiology and clinical similarity with other conditions cause difficulties in early diagnosis and monitoring of patients with sarcoidosis.

  6. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review (United States)

    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria


    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Results: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. Conclusions: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications. PMID:26756016

  7. Anger in psychological disorders: Prevalence, presentation, etiology and prognostic implications. (United States)

    Fernandez, Ephrem; Johnson, Sheri L


    Anger is present as a key criterion in five diagnoses within DSM-5: Intermittent Explosive Disorder, Oppositional Defiant Disorder, Disruptive Mood Dysregulation Disorder, Borderline Personality Disorder and Bipolar Disorder. This review amasses scientific literature demonstrating that within each of these disorders, anger is a central clinical feature that is highly prevalent and predictive of important outcomes. For each disorder, we also discuss the phenomenology and etiology of anger. Although models of anger have been quite distinct across these disorders, few empirical studies have truly tested whether anger stems from different etiological factors across these different conditions. We end with a discussion of transdiagnostic research that draws from cognitive psychology, affective science, and the neuroscience of anger, and that also fits with integrative approaches to treatment.

  8. Energetic etiologies of acute pancreatitis: A report of five cases

    Institute of Scientific and Technical Information of China (English)

    Artem; Shmelev; Alain; Abdo; Sarina; Sachdev; Urvi; Shah; Gopal; C; Kowdley; Steven; C; Cunningham


    There are several common causes of acute pancreatitis, principally excessive alcohol intake and gallstones, and there are many rare causes. However, cases of pancreatitis still occur in the absence of any recognizable factors, and these cases of idiopathic pancreatitis suggest the presence of unrecognized etiologies. Five cases of acute pancreatitis in four patients came to attention due to a strong temporal association with exposure to nerve stimulators and energy drinks. Given that these cases of pancreatitis were otherwise unexplained, and given that these exposures were not clearly known to be associated with pancreatitis, we performed a search for precedent cases and for mechanistic bases. No clear precedent cases were found in Pub Med and only scant, weak precedent cases were found in public-health databases. However, there was a coherent body of intriguing literature in support of a mechanistic basis for these exposures playing a role in the etiology of pancreatitis.

  9. Etiological and clinical analysis on 220 children with cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Zhi-hong TANG


    Full Text Available Etiological and clinical analyses of 220 children with cerebrovascular diseases were retrospectively analyzed. One hundred and forty-nine cases (67.73% were male, and 71 cases (32.27% were female. There were 186 cases (84.55% of patients to be found with clear causes, most of which were arteriovenous malformation (80/220, 36.36%, traumatic brain injury (38/220, 17.27%, intracranial infection (15/220, 6.82% , intracranial aneurysm (13/220, 5.91% , delayed vitamin K deficiency (12/220, 5.45% , congenital heart disease (9/220, 4.09% and cavernous malformation (7/220, 3.18%. The etiological and clinical features of children cerebrovascular diseases are distinct, and timely diagnosis and treatment will help to improve patients' prognosis. doi: 10.3969/j.issn.1672-6731.2014.03.017

  10. Etiology and Outcome of Chronic Kidney Disease in Iranian Children

    Directory of Open Access Journals (Sweden)

    Neamatollah Ataei


    Full Text Available Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD, the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 –2014. Children (186 boys, 186 girls with Stage 3 to 5 CKDs, defined as a glomerular filtration rate below 60 ml/min per 1.73 m2body surface area, were identified. Results Etiology was congenital anomalies of the kidney and urinary tract in 125 (33.60%, cystic/ hereditary/ congenital diseases in 91 (24.46%, glomerulopathy in 73(19.62%, and cause unknown in 71 (19.09% patients. Forty-eight (13.22% were on conservative treatment, 174(47.93% had end-stage renal disease (ESRD with chronic hemodialysis, 24 (6.61% were on continuous ambulatory peritoneal dialysis. Sixty-eight (18.74% underwent on renal transplant which was successful in 52 (14.33% patients but was associated with abnormal renal function in 16(4.41% children. Finally, 49 (13.50% patients died. Conclusion A large number of children developed CKD secondary to congenital anomalies of the kidney and urinary tract. Planning for screening, early detection and instituting timely treatment of preventable causes could lead to a lower incidence of CKD in this group of children.


    Directory of Open Access Journals (Sweden)



    Full Text Available Yeasts have to be considered as an etiological factor of autism. Urine testing by professor W. Shaw’s method is being done in all major laboratories in the USA. Tests for proving the existence of unidentified diseases with a fault in metabolism, lack of vitamins and the existence of abnormal metabolites cateholamine, dopamine, and serotonine can be done. The existence of 62 substances can be tested for time being, and according to that, adequate treatment can be undertaken.

  12. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review


    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria


    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Result...

  13. Prognostic value of EEG in different etiological types of coma. (United States)

    Khaburzania, M; Beridze, M


    Study aimed at evaluation of prognostic value of standard EEG in different etiology of coma and the influence of etiological factor on the EEG patterns and coma outcome. Totally 175 coma patients were investigated. Patients were evaluated by Glasgow Coma Scale (GCS), clinically and by 16 channel electroencephalography. Auditory evoked potentials studied by EEG -regime for evoked potentials in patients with vegetative state (VS). Patients divided in 8 groups according to coma etiology. All patients were studied for photoreaction, brainstem reflexes, localization of sound and pain, length of coma state and outcome. Brain injury visualized by conventional CT. Outcome defined as death, VS, recovery with disability and without disability. Disability was rated by Disability Rating Scale (DRS). Recovered patients assessed by Mini Mental State Examination (MMSE) scale. Statistics performed by SPSS-11.0. From 175 coma patients 55 patients died, 23 patients found in VS, 97 patients recovered with and without disability. In all etiological groups of coma the background EEG patterns were established. Correspondence analysis of all investigated factors revealed that sound localization had the significant association with EEG delta and theta rhythms and with recovery from coma state (Chi-sqr. =31.10493; p= 0.000001). Among 23 VS patients 9 patients had the signs of MCS and showed the long latency waves (p300) after binaural stimulation. The high amplitude theta frequencies in frontal and temporal lobes significantly correlated with prolongation of latency of cognitive evoked potentials (r=+0.47; pcoma outcome only in hemorrhagic and traumatic coma (chi-sqr.=12.95; pcoma outcome. Low amplitude decreased power delta and theta frequencies correlated with SND in survived coma patients (r=+0.21; pcoma patients with a high probability to recover as well as those patients, who are at high risk of SND in case of recovery from coma state.

  14. Epidemiological and etiological aspects of burning mouth syndrome. (United States)

    Coculescu, E C; Tovaru, S; Coculescu, B I


    Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in clinically healthy oral mucosa. Incidence BMS diagnosed in the Department of Oral Medicine - Oral Pathology Dental Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy Bucharest is 16,23%. The etiology of BMS remains far less known. This article makes an overview of the latest theories about possible etiopathogenic factors involved in the occurrence of BMS.

  15. Prevalence, etiology, diagnosis, treatment and complications of supernumerary teeth


    Ata-Ali Mahmud, Fadi; Ata-Ali Mahmud, Francisco Javier; Peñarrocha Oltra, David; Peñarrocha Diago, Miguel


    The aim of this article was to review the literature on supernumerary teeth, analyzing their prevalence, etiology, diagnosis, treatment and possible complications. An electronic search was made in the Pubmed-Medline database up to January 2014 using the key search terms “multiple supernumerary teeth” (n=279), “prevalence supernumerary teeth” (n=361), and “supernumerary teeth” (n=2412). In addition to the articles initially identified, others were included in the review proceeding from a manua...

  16. Fever of undetermined etiology after cleaning of steam turbine condensers. (United States)

    Deubner, D C; Gilliam, D K


    Two outbreaks of a febrile syndrome marked by chills, headaches, myalgia, nausea, and malaise occurred in workers who had cleaned the steam condensers of electric power turbines. Mean incubation period was 38 hours. Twenty-two of twenty-three exposed men became ill. Clinical and environmental investigation failed to reveal the etiology of the outbreaks. The circumstances and clinical syndrome have points of similarity to fever following inhalation of metal fumes and low-grade, stained cotton dust, and to Pontiac fever.

  17. Etiology of congenital hypothyroidism in Isfahan: Does it different?

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour


    Conclusion: Seven years of our experiences in CH screening program indicated that the etiology of CH in Isfahan, with a higher rate of CH, with a predominance of thyroid dyshormonogenesis is different from most of the studies world-wide and similar to other reports from Iran. The findings of the current study provide us baseline information for determination of CH pathogenesis in this region.

  18. Prevalence and etiology of anemias in the adult Turkish population


    MEMİŞOĞULLARI, Ramazan; YILDIRIM, Hayriye AK; UÇGUN, Taner; ERKAN, Melih Engin; GÜNEŞ, Cemalettin; ERBAŞ, Mesut; GÜNGÖR, Adem; YANIK, Mehmet Emin


    Anemia is common in the general population and one of the most frequently observed nutritional deficiency diseases in the world today. The aim of this study was to investigate the prevalence and etiology of anemias in a large cohort representing the Turkish nation. Materials and methods: The study population comprised 2187 subjects. Serum iron, iron binding capacity, ferritin, vitamin B12, and folic acid analyses were conducted with autoanalyzers using commercial kits. Results: A total of ...

  19. Etiology, prevalence, and treatment of dry eye disease


    Gayton, Johnny L


    Johnny L GaytonEyesight Associates, Warner Robins, GA, USAPurpose: This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women.Method: A systematic literature search utilizing MEDLINE was conducted to identify peer-reviewed articles related to dry eye published prior to September 2008. The terms “dry eye” and “women” were searched in combination with one or more of the follo...

  20. [Proliferative vitreoretinopathy: modern view on etiology and pathogenesis]. (United States)

    Artem'eva, O V; Samoĭlov, A N; Zhernakov, S V


    Studies on etiology and pathogenesis of proliferative vitreoretinopathy are necessitated by the absence of a unified theory, which would provide a clear understanding of causes and mechanisms of the disease. The results of recent investigations allow to consider proliferative vitreoretinopathy as an uncontrollable plastic process caused by certain changes in the retina aimed at survival of its cells under oxidative stress. This approach enables preclinical indication of the process and development of new therapies.

  1. UTIs in small animal patients: part 1: etiology and pathogenesis. (United States)

    Smee, Nicole; Loyd, Kimberly; Grauer, Greg


    Understanding how urinary tract infections (UTIs) can occur and how to classify them can help the practitioner to make a plan for treatment. This review summarizes the etiology, pathogenesis, and host defense mechanisms associated with bacterial UTIs in dogs and cats. UTIs in Small Animal Patients: Part 2: Diagnosis, Treatment, and Complications will appear in the March/April 2013 issue of the Journal of the American Animal Hospital Association.

  2. [Celiacia and hypolactasia in adults: etiology, pathogenesis, diagnostics and treatment]. (United States)

    Tsimmerman, Ia S


    A review of current data on the most widespread clinical forms of intestinal enzymopathies is presented with emphasis on celiacia and hypolactasia in adult patients. An alternative definition of these diseases is proposed, their prevalence in different countries and ethnic groups is discussed. Their etiology, pathogenesis, and clinical variants in different age groups are analysed. The clinical classification of celiacia, informative value of different diagnostic methods, their specificity and sensitivity, potential for dietetic and medicamental therapy are considered.

  3. A survey of etiologic hypotheses among testicular cancer researchers. (United States)

    Stang, A; Trabert, B; Rusner, C; Poole, C; Almstrup, K; Rajpert-De Meyts, E; McGlynn, K A


    Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops and corresponding authors of PubMed-indexed articles identified by the search term 'testicular cancer' and published within 10 years (in total 2750 recipients) were invited to respond to an e-mail-based survey. Participants of the 8th Copenhagen Testis Cancer Workshop in May 2014 were subsequently asked to rate the plausibility of the suggested etiologic hypotheses on a scale of 1 (very implausible) to 10 (very plausible). This report describes the methodology of the survey, the score distributions by individual hypotheses, hypothesis group, and the participants' major research fields, and discuss the hypotheses that scored as most plausible. We also present plans for improving the survey that may be repeated at a next international meeting of experts in testicular cancer. Overall 52 of 99 (53%) registered participants of the 8th Copenhagen Testis Cancer Workshop submitted the plausibility rating form. Fourteen of 27 hypotheses were related to exposures during pregnancy. Hypotheses with the highest mean plausibility ratings were either related to pre-natal exposures or exposures that might have an effect during pregnancy and in post-natal life. The results of the survey may be helpful for triggering more specific etiologic hypotheses that include factors related to endocrine disruption, DNA damage, inflammation, and nutrition during pregnancy. The survey results may stimulate a multidisciplinary discussion about new etiologic hypotheses of testicular cancer.

  4. Etiological features of cirrhosis inpatients in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    SONG Guang-jun; FENG Bo; RAO Hui-ying; WEI Lai


    Background The etiological spectrum of cirrhosis has changed over the years,but our knowledge of it is limited.The present study aimed to investigate the etiological features of cirrhosis inpatients and their variation in the past 18 years in Beijing.Methods A retrospective analysis was performed on all patients with cirrhosis diagnosed for the first time in Peking University People's Hospital from January 1,1993,to October 25,2010.Data were analyzed using SPSS 20.0.Results A total of 2119 cirrhosis inpatients were included in this study:1412 (66.6%) male and 707 (33.4%) female.Chronic hepatitis B accounted for 58.7%; chronic hepatitis C for 7.6%; chronic hepatitis B and hepatitis C virus co-infection for 0.8% (16 cases); alcoholic liver disease for 9.4% (200 cases); and autoimmune diseases for 9.4% (199 cases).In the past 18 years,the percentage of chronic hepatitis B has decreased from 75.2% to 48.7%; alcoholic liver disease has increased from 5.1% to 10.6%; and autoimmune disease has increased from 2.2% to 12.9%.The percentages of chronic hepatitis B and alcoholic liver disease were higher among men,whereas the percentages of chronic hepatitis C,autoimmune diseases and cryptogenic cirrhosis were higher among women.Conclusions Chronic hepatitis B was still the most common etiology of cirrhosis in China,but the percentage has been decreasing.The percentages of alcoholic liver disease and autoimmune diseases have been increasing.The etiological spectrum of cirrhosis inpatients differed significantly according to sex.

  5. Severe acute pancreatitis in the elderly: Etiology and clinical characteristics

    Institute of Scientific and Technical Information of China (English)

    Ming-Jun Xin; Hong Chen; Bin Luo; Jia-Bang Sun


    AIM: To investigate the etiology and clinical characteristics of severe acute pancreatitis (SAP) in elderly patients (≥60 years of age).METHODS: We reviewed retrospectively all the SAP cases treated in Xuanwu Hospital in Beijing between 2000 and 2007.RESULTS: In 169 patients with SAP, 94 were elderly and 16 died.Biliary and idiopathic etiologies were the first two causes that accounted for over 90% of SAP in the elderly.Biliary, hyperlipemic and alcoholic etiologies were the first three causes in the young.The proportion of comorbidity of cholelithiasis, biliary infection, hypertension and coronary heart disease in the aged was significantly higher than that in their young partners.The scores of APACHE Ⅱ and Ranson were also significantly higher in the elderly except the CT score.Organ failures were more common in the elderly, but the local pancreatic complications were not different between the two groups.Mortality of the aged was correlated with the severity of SAP, multiple co-morbidity and incidence of multiple organ dysfunction syndrome (NODS).NODS was the main cause of death.CONCLUSION: The etiology of SAP in the elderly is quite different from that in the young.Biliary and unknown factors are main causes in the aged.The elderly are subject to major organ failures but there is no difference in the occurrence of local pancreatic complications between the elderly and the young.It is crucial to monitor and improve the functions of major organs so as to prevent MODS in the aged with SAP.

  6. Etiology, prevalence, and treatment of dry eye disease. (United States)

    Gayton, Johnny L


    This review article examines the prevalence, etiology, and current therapies of dry eye disease, with special focus on postmenopausal women. A systematic literature search utilizing MEDLINE was conducted to identify peer-reviewed articles related to dry eye published prior to September 2008. The terms "dry eye" and "women" were searched in combination with one or more of the following words or phrases: prevalence, postmenopausal, etiology, risk factors, therapy, medications, surgery, tear film, and quality of life. Articles were selected based on their direct applicability to the subject matter. A manual search was also conducted based on citations in the published literature. Epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan. Risk factors include advanced age, female sex, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications. The last decade has brought about a better understanding of the etiology of dry eye disease. New therapies that can alleviate the signs and symptoms of dry eye disease and, consequently, improve the quality of life of dry eye patients are available in the market.

  7. [The concept, the symptoms and the etiological factors of codependency]. (United States)

    Knapek, Eva; Kuritárné Szabó, Ildikó


    The concept of codependency stems from the field of chemical dependency. Initially, codependent individuals meant women who dominated their partners and took care of them, while women actually were dependent upon their husbands. Nowadays, it has been recognized that men can become codependent as well, and its presence is not limited only to the relationship. This paper reviews the various interpretations of codependency and the empirical researches on the etiological factors of codependency. The explanatory models of codependency can be placed on a continuum of severity: psychopathology on the level of personality disorder, behavioural addiction, or excessive feminine behaviour. The etiology is mutifactorical: biological, psychological and social elements are also listed among etiology factors. The individual variability of the predisposition to care, failure of prefrontal cortex to inhibit empathic responses, a multitude of aversive experiences in a dysfunctional family (e.g. parental conflicts, emotional abuse, neglect and parentification), changes in the perception of women's role, and the emergence of substance abuse in the family could play a role in the development of codependency. Codependency is often unrecognized. Codependent individuals visit the health care system with stress-related or depressive symptoms which can mask the underlying causes, thus, it is possible that they will only receive symptomatic treatment. Through its trans-generational nature, codependency endangers children growing up in the family.

  8. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

    Directory of Open Access Journals (Sweden)

    Kazim Duman


    Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232

  9. Bronchiolitis: adopting a unifying definition and a comprehensive etiological classification. (United States)

    Papiris, Spyros A; Malagari, Katerina; Manali, Effrosyni D; Kolilekas, Likurgos; Triantafillidou, Christina; Baou, Katerina; Rontogianni, Dimitra; Bouros, Demosthenes; Kagouridis, Konstantinos


    Bronchiolitis is an inflammatory and potentially fibrosing condition affecting mainly the intralobular conducting and transitional small airways. Secondary bronchiolitis participates in disease process of the airways and/or the surrounding lobular structures in the setting of several already defined clinical entities, mostly of known etiology, and occurs commonly. Primary or idiopathic bronchiolitis dominates and characterizes distinct clinical entities, all of unknown etiology, and occurs rarely. Secondary bronchiolitis regards infections, hypersensitivity disorders, the whole spectrum of smoking-related disorders, toxic fumes and gas inhalation, chronic aspiration, particle inhalation, drug-induced bronchiolar toxicities, sarcoidosis and neoplasms. Idiopathic or primary bronchiolitis defines clinicopathologic entities sufficiently different to be designated as separate disease entities and include cryptogenic constrictive bronchiolitis, diffuse panbronchiolitis, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, neuroendocrine hyperplasia in infants, bronchiolitis obliterans syndrome in lung and allogeneic hematopoietic cell transplantation, connective tissue disorders, inflammatory bowel disease and bronchiolitis obliterans organizing pneumonia. Most of the above are pathological descriptions used as clinical diagnosis. Acute bronchiolitis, though potentially life threatening, usually regresses. Any etiology chronic bronchiolitis contributes to morbidity and/or mortality if it persists and/or progresses to diffuse airway narrowing and distortion or complete obliteration. Bronchiolitis in specific settings leads to bronchiolectasis, resulting in bronchiectasis.

  10. Etiology and pathogenesis of late-onset Alzheimer's disease. (United States)

    Balin, Brian J; Hudson, Alan P


    Alzheimer's disease (AD) is a neurodegenerative condition that occurs in two forms, an early-onset form that is genetically determined and a far more common late-onset form that is not. In both cases, the disease results in severe cognitive dysfunction, among other problems, and the late-onset form of the disease is now considered to be the most common cause of dementia among the elderly. While a good deal of research has been focused on elucidating the etiology of the late-onset form for more than two decades, results to date have been modest and have not yet engendered useful therapeutic strategies for cure of the disease. In this review, we discuss the prevalent ideas that have governed this research for several years, and we challenge these ideas with alternative findings suggesting a multifactorial etiology. We review promising newer ideas that may prove effective as therapeutic interventions for late-onset AD, as well as providing reliable means of earlier and more specific diagnosis of the disease process. In the discussions included here, we reference relevant clinical and basic science literature underlying research into disease etiology and pathogenesis, and we highlight current reviews on the various topics addressed.

  11. Semicircular canal, saccular and utricular function in patients with bilateral vestibulopathy: analysis based on etiology (United States)

    Bremova, Tatiana; Kremmyda, Olympia; Strupp, Michael


    The diagnosis of bilateral vestibulopathy (BV) is typically established based on bilateral semicircular canal dysfunction. The degree to which both otolith organs—the saccule and utricle—are also impaired in BV is not wellestablished, particularly with respect to the etiology and severity of BV. The aim of this study was to evaluate semicircular canal, saccular and utricular function in patients with BV due to aminoglycoside ototoxicity and bilateral Menière’s disease, and with different severities of BV. Caloric and head impulse testing were used as measures of canal function. Cervical vestibular-evoked myogenic potentials (cVEMP) and ocular VEMPs (oVEMP) were used as measures of saccular and utricular function, respectively. We enrolled 34 patients with BV and 55 controls in a prospective case–control study. Patients with BV were less likely to have saccular (61 %) or utricular (64 %) dysfunction relative to canal dysfunction (100 %). Utricular function differed significantly between patients by etiologic group: the poorest function was found in patients with BV due to aminoglycoside toxicity, and the best function in Menière’s disease patients. Canal and saccular function did not vary according to etiology. Further, utricular but not saccular function was significantly correlated with canal function. Saccular and utricular function had the strongest association with Dizziness Handicap Inventory scores relative to canal function. These data suggest that when a patient with BV is identified in a clinical context, oVEMP testing is the most sensitive test in distinguishing between aminoglycoside toxicity and bilateral Menière’s disease. Both cVEMP and oVEMP testing may be considered to evaluate the functional impact on the patient. PMID:23104126

  12. User interface design considerations

    DEFF Research Database (Denmark)

    Andersen, Simon Engedal; Jakobsen, Arne; Rasmussen, Bjarne D.


    When designing a user interface for a simulation model there are several important issues to consider: Who is the target user group, and which a priori information can be expected. What questions do the users want answers to and what questions are answered using a specific model?When developing...... the user interface of EESCoolTools these issues led to a series of simulation tools each with a specific purpose and a carefully selected set of input and output variables. To allow a more wide range of questions to be answered by the same model, the user can change between different sets of input...... and output variables. This feature requires special attention when designing the user interface and a special approach for controlling the user selection of input and output variables are developed. To obtain a consistent system description the different input variables are grouped corresponding...

  13. Etiology of convulsions in neonatal and infantile period. (United States)

    Kurokawa, T; Yokata, K; Takashima, S; Nambu, Y; Hanai, T


    1) Etiology of convulsions starting prior to two years of age was discussed in 418 cases. Neonatal seizures before 30 days old appeared in 86 cases (53 boys and 33 girls). Three hundred and thirty-two patients (172 boys and 160 girls) had convulsions in infancy. Twelve patients (9 boys and 3 girls) suffered from convulsions both in neonatal and infantile period. 2)Etiology of convulsions was prenatal in 67 cases (16%), natal in 49 cases (12%), postnatal in 158 cases (38%) and unknown in 144 cases (34%). Prenatal factors consisted of cerebral malformation (23 cases, 6%), associated physical minor anomaly such as cataracta or finger abomaly (11 cases, 3%), abnormal pernatal history (8 cases, 2%), congenital heart disease 3) cases, 1%), tuberose scleorsis (7 cases, 2%) and positive family history (13 cases, 3%). Postnatal causes included hypocalcemia or hypoglycemia (7 cases, 2%), brain tumors (3 cases, 1%), breath-holding spells (21 cases, 5%), febrile convulsion (44 cases, 11%), bathing (3 cases, 1%), afebrile colds (3 cases, 1%), purulent meningitis (17 cases, 4%), DPT immunization (10 cases 2%), vaccination (7 cases, 2%) and acute hemiplegia (10 cases, 2%). The group of unknown etiology were as fns (38 cases, 9%), epilepsy associated with interictal signs (23 cases, 6%), benign infantile convulsions (57 cases, 14%), neonatal convulsion of unknown etiology (12 cases, 3%) and miscellaneous categories (4%). 3) Pregnancy was abnormal in 53% of cases with cerebral malformation. Asphyxia at birth was noted in 43% of patients with tuberose sclerosis and in 35% of congenital cerebral abomaly. 4) Pneumoencephalographic examinations revealed midline anomaly in 50% of cerebral malformation. It was abnormal in all cases with tuberose sclerosis, head injury and epilepsy with interseizure neurological signs. 5) There were no correlations between the seizure pattern and the etiology in neonatal convulsion. In infancy, focal-unilateral convulsions and infantile spasms were

  14. Efeito de fungicidas no controle in vitro de Colletotrichum gloeosporioides, agente etiológico da antracnose do mamoeiro (Carica papaya l. Effects of fungicides on the in vitro control of Colletotrichum gloeosporioides, the anthracnosis etiologic agent of the Papaya tree (Carica papaya L.

    Directory of Open Access Journals (Sweden)

    Giltembergue Macedo Tavares


    Full Text Available Com o objetivo de avaliar a eficiência de alguns fungicidas sobre Colletotrichum gloeosporioides, agente etiológico da antracnose do mamoeiro (Carica papaya L., testes in vitro foram conduzidos no Laboratório de Epidemiologia/UFLA. Para tanto, utilizou-se o método de incorporação do fungicida ao meio de cultura BDA para avaliação da inibição do crescimento micelial e lâmina escavada contendo água com fungicida para germinação de conídios. Os fungicidas testados foram: azoxystrobin, chlorotalonil, hipoclorito de sódio, imazalil, oxicloreto de cobre, prochloraz, propiconazol, tebuconazol, thiabendazol e tiofanato metílico, nas concentrações de 0, 1, 10, 100, 500 e 1.000 ppm para avaliar a inibição do crescimento do micélio e 0, 1, 10, 50 e 100 ppm para testar inibição da germinação de conídios. Os fungicidas azoxystrobin, chlorotalonil, imazalil, prochloraz, propiconazol e tebuconazol apresentaram alta eficiência na inibição do crescimento micelial. Os fungicidas dos grupos dos benzimidazóis (thiabendazol e tiofanato metílico mostraram baixa eficiência e ineficiência, respectivamente, no controle do patógeno, demonstrando uma tolerância do isolado em estudo a estes produtos. O hipoclorito de sódio também apresentou baixa eficiência no controle do crescimento micelial do fungo. Quanto à inibição da germinação dos conídios, os fungicidas que demonstraram maior eficiência em baixas concentrações foram: chlorotalonil e hipoclorito de sódio.The efficiency of fungicides on Colletotrichum gloeosporioides was evaluated in vitro in the Laboratory of Epidemiology and Diseases Management of the Department of Phytopathology /UFLA. The fungicides were applied either in BDA medium or in glass slide chambers, the latter to assess the effects on conidial germination. The fungicides tested were: azoxystrobin, chlorothalonil, sodium hypochloride, imazalil, copper oxychloride, prochloraz, propiconazol, tebuconazol

  15. Compressor station layout considerations

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, Rainer; Ohanian, Sebouh; Lubomirsky, Matt [Solar Turbines Incorporated, San Diego, CA (United States)


    This paper discusses issues that influence the decision on the arrangement of compressors and the type of equipment in gas pipeline compressor stations. Different concepts such as multiple small units versus single large units are considered, both regarding their impact on the individual station and the overall pipeline. The necessity of standby units is discussed. Various concepts for drivers (gas turbine, gas motor and electric motor) and compressors (centrifugal and reciprocating) are analyzed. The importance of considering all possible operating conditions is stressed. With the wide range of possible operating conditions for the pipeline in mind, the discussion is brought into the general context of operational flexibility, availability, reliability, installation issues, remote control, and operability of gas turbine driven centrifugal compressors compared to other solutions such as electric motor driven compressors or gas engine driven reciprocating compressors. The impact of different concepts on emissions and fuel cost is discussed. Among the assumptions in this paper are the performance characteristics of the compressor. This paper outlines how these performance characteristics influence the conclusions. (author)

  16. Practical considerations on frenectomy (United States)

    Moldoveanu, Lucia; Badea, Florin Ciprian; Odor, Alin A.


    Besides surgically classical frenectomy, modern dentistry currently allows its approach by dental laser. Materials and Method: We proposed clinical observation of the results obtained by frenectomy with/without frenoplasty made by laser Er,Cr:YSGG 2780 nm. Results: The patients reported no pain, bleeding, swelling or major discomfort during the postoperative control of the following day. In terms of psycho-emotional reactions, both patients well behave well, the calm being given by no pain, bleeding, suture or edema. Discussions: The accuracy of this method, as well as the use of additional means of healing, allow satisfactory results both for patient and physician. Working parameters depend on the type of laser that is used, in our case Biolase Waterlase MD Turbo, regularly used in Toldimed Clinic in Constanta. Conclusions: Our study reveals that the possibilities regarding the surgical modeling of the lower lip frenulum are higher due to laser than the classical surgical approach. Moreover, a major role in the prevention of relapse by inappropriate healing is represented by the approach of frenectomy accompanied by frenuloplasty.

  17. Nutrition in Pediatric Inflammatory Bowel Disease: From Etiology to Treatment. A Systematic Review (United States)

    Penagini, Francesca; Dilillo, Dario; Borsani, Barbara; Cococcioni, Lucia; Galli, Erica; Bedogni, Giorgio; Zuin, Giovanna; Zuccotti, Gian Vincenzo


    Nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of disease. With regards to etiology, there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset. As for disease treatment, exclusive enteral nutrition (EEN) is an extensively studied, well established, and valid approach to the remission of pediatric Crohn’s disease (CD). Apart from EEN, several new nutritional approaches are emerging and have proved to be successful (specific carbohydrate diet and CD exclusion diet) but the available evidence is not strong enough to recommend this kind of intervention in clinical practice and new large experimental controlled studies are needed, especially in the pediatric population. Moreover, efforts are being made to identify foods with anti-inflammatory properties such as curcumin and long-chain polyunsaturated fatty acids n-3, which can possibly be effective in maintenance of disease. The present systematic review aims at reviewing the scientific literature on all aspects of nutrition in pediatric IBD, including the most recent advances on nutritional therapy. PMID:27258308

  18. Advanced LBB methodology and considerations

    Energy Technology Data Exchange (ETDEWEB)

    Olson, R.; Rahman, S.; Scott, P. [Battelle, Columbus, OH (United States)] [and others


    LBB applications have existed in many industries and more recently have been applied in the nuclear industry under limited circumstances. Research over the past 10 years has evolved the technology so that more advanced consideration of LBB can now be given. Some of the advanced considerations for nuclear plants subjected to seismic loading evaluations are summarized in this paper.

  19. Ethical Considerations in Technology Transfer. (United States)

    Froehlich, Thomas J.


    Examines ethical considerations involved in the transfer of appropriate information technology to less developed countries. Approaches to technology are considered; two philosophical frameworks for studying ethical considerations are discussed, i.e., the Kantian approach and the utilitarian perspective by John Stuart Mill; and integration of the…

  20. Ethical Considerations in Technology Transfer. (United States)

    Froehlich, Thomas J.


    Examines ethical considerations involved in the transfer of appropriate information technology to less developed countries. Approaches to technology are considered; two philosophical frameworks for studying ethical considerations are discussed, i.e., the Kantian approach and the utilitarian perspective by John Stuart Mill; and integration of the…

  1. Revealed preference with limited consideration

    NARCIS (Netherlands)

    Demuynck, T.; Seel, C.


    We derive revealed preference tests for models where individuals use consideration sets to simplify their consumption problem. Our basic test provides necessary and sufficient conditions for consistency of observed choices with the existence of consideration set restrictions. The same conditions can

  2. Protocol of a Randomized Controlled Trial of Culturally Sensitive Interventions to Improve African Americans' and Non-African Americans' Early, Shared, and Informed Consideration of Live Kidney Transplantation: The talking about Live Kidney Donation (TALK) study



    Abstract Background Live kidney transplantation (LKT) is underutilized, particularly among ethnic/racial minorities. The effectiveness of culturally sensitive educational and behavioral interventions to encourage patients' early, shared (with family and health care providers) and informed consideration of LKT and ameliorate disparities in consideration of LKT is unknown. Methods/Design We report the protocol of the Talking About Live Kidney Donation (TALK) Study, a two-phase study utilizing q...

  3. Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

    Directory of Open Access Journals (Sweden)

    Şar V


    Full Text Available Vedat Şar,1 Martin J Dorahy,2 Christa Krüger3 1Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey; 2Department of Psychology, University of Canterbury, Christchurch, New Zealand; 3Department of Psychiatry, University of Pretoria, Pretoria, South Africa Abstract: Dissociative identity disorder (DID is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such

  4. Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective (United States)

    Şar, Vedat; Dorahy, Martin J; Krüger, Christa


    Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such, DID may be seen as an exemplary disease model of the biopsychosocial paradigm in psychiatry. PMID:28496375

  5. Chronic kidney disease of unknown etiology and the effect of multiple-ion interactions. (United States)

    Dharma-Wardana, M W C


    High incidence of chronic kidney disease of unknown etiology (CKDU) prevalent in many countries (e.g., Sri Lanka, equatorial America) is reviewed in the context of recent experimental work and using our understanding of the hydration of ions and proteins. Qualitative considerations based on Hofmeister-type action of these ions, as well as quantitative electrochemical models for the Gibbs free energy change for ionpair formation, are used to explain why (1) fluoride and water hardness due to magnesium ions (but not due to calcium ions) and similarly (2) cadmium ions in the presence of suitable pairing ions can be expected to be more nephrotoxic, while arsenite in the presence of fluoride and hardness may be expected to be less nephrotoxic. No synergy of arsenic with calcium hardness is found. The analysis is applied to a variety of ionic species that may be found in typical water sources to predict their likely combined electrochemical action. These results clarify the origins of chronic kidney disease that has reached epidemic proportions in the North Central Province of Sri Lanka as being most likely due to the joint presence of fluoride and magnesium ions in drinking water. The conclusion is further strengthened by a study of the dietary load of Cd and other toxins in the affected regions and in the healthy regions where the dietary toxin loads and lifestyles are similar, and found to be safe especially when the mitigating effects of micronutrient ionic forms of Zn, Se, as well as corrections for bioavailability are taken into account. The resulting etiological picture is consistent with the views of most workers in the field who have suspected that fluoride and other ions found in the hard water stagnant in shallow household wells were the major causative factors of the disease. Similar incidence of CKDu found in other hot tropical climates is likely to have similar origins.

  6. Etiology of growth hormone deficiency in children and adolescents

    Directory of Open Access Journals (Sweden)

    Mitrović Katarina


    Full Text Available Introduction. Growth hormone deficiency (GHD can be isolated or associated with deficiency of other pituitary gland hormones. According to age at diagnosis, causes of GHD are divided into congenital or acquired, and according to etiology into recognized and unknown. Objective. We analyzed etiology and prevalence of GHD, demographic data at birth, age, body height (BH and bone age at diagnosis as well as the frequency of other pituitary hormone deficiencies. Methods. The study involved 164 patients (109 male. The main criterion for the diagnosis of GHD was inadequate response of GH after two stimulation tests. The patients were classified into three groups: idiopathic, congenital and acquired GHD. Results. Idiopathic GHD was confirmed in 57.9% of patients, congenital in 11.6% and acquired in 30.5%. The mean age at diagnosis of GHD was 10.1±4.5 years. The patients with congenital GHD had most severe growth retardation (-3.4±1.4 SDS, while the patients with idiopathic GHD showed most prominent bone delay (-3.6±2.3 SDS. The prevalence of multiple pituitary hormone deficiency was 56.1%, in the group with congenital GHD 73.7%, acquired GHD 54.0% and idiopathic GHD 53.7%. The frequency of thyrotropin deficiency ranged from 88.2-100%, of adrenocorticotrophin 57.1-68.8% and of gonadotrophins deficiency 57.1- 63.0%, while deficiency of antidiuretic hormone was 2.0-25.0%. Conclusion. Although regular BH measurements enable early recognition of growth retardation, patients’ mean age and degree of growth retardation indicate that GHD is still diagnosed relatively late. A high incidence of other pituitary hormone deficiencies requires a detailed investigation of the etiology of disorders and evaluation of all pituitary functions in each child with confirmed GHD.

  7. Etiology of Short Stature in East Azerbaijan, Iran

    Directory of Open Access Journals (Sweden)

    Alireza Nikzad


    Full Text Available Objective: Short stature is a common problem encountered by pediatricians and is the most common cause for referral to pediatric endocrinologists. Although most children referred with short stature are normal and classified as normal variants of stature (constitutional growth delay and familial short stature, it may sometimes be the only obvious manifestation of an endocrine or systemic disease. The objective of this study was to assess the characteristics of patients referred to pediatric endocrinology clinic because of short stature and determination of the etiology.Methods: Three hundred-seventy nine children and adolescents were studied which referred with short stature to pediatric endocrinology clinic. After complete clinical and paraclinical evaluation and appropriate treatment (if needed, patients were followed for at least six months.Findings: From 379 studied patients with a mean age of 9.7±3.7 years, 192 (50.7% were girls and 187 (49.3% boys (P=0.066; short stature in 132 (34.8% of patients was not approved. Normal variants of Short stature (familial and constitutional constituted 53.3% of etiology in short patients. In 11.5% of short patients, no obvious etiology was found, and 9.8% were born with intra uterine growth retardation. Other causes were growth hormone deficiency, hypothyroidism, skeletal dysphasia, Turner syndrome, and malnutrition.Conclusion: A great number of children and adolescents referred with short stature to pediatric endocrinology clinics are not really short. Greater than half of short patients are normal variants of Short stature.

  8. Etiology and Outcome of Non-Traumatic Coma in Children Admitted to Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Fariba Khodapanahandeh


    Full Text Available Objective: Non-traumatic coma is a relatively common condition in children that may cause considerable mortality and morbidity. The purpose of this study was to determine clinical presentation, etiology and outcome of non-traumatic coma in children.Methods: In a retrospective cross sectional study over a period of 5 years, files of 150 children aged between 1 month and 14 years admitted with non-traumatic coma to pediatric intensive care unit of Rasool Akram hospital were reviewed. Historical, presenting symptoms, clinical and laboratory data were collected. Etiology of coma was determined on the basis of clinical history and relevant investigations. The outcome was recorded as died or neurological condition at discharge as normal, mild or sever disability. Chi-square test was used to test the differences in categorical variables.Findings: There were 63 (42% boys and 87 (58% girls. The mean±SD age of patients was 2.7±2.35 years. Systemic presentations including nausea, vomiting, fever, lethargy and poor feeding were more prominent in children under 2 years. Etiology of coma in 49 patients (32.7% was infectious (meningitis, encephalitis, respiratory and systemic. Other causes were status epilepticus 44 (29.4%, metabolic (diabetic ketoacidosis, inborn errors of metabolism 11 (7.3%, intoxications 10 (6.7%, accidental (drowning, electrical shock, suffocation 9 (6%, shunt dysfunction (secondary to congenital brain malformations 7 (4.6%, others (acute disseminated encephalomyelitis, vasculitis, hypertensive encephalopathy 11 (7.3%, unknown 9 (6%. Infection occurred significantly (P=0.002 in children under 2 years of age, whereas accidents and intoxications were more prominent (P=0.004 in those between 2 and 6 years. Overall 25 children (16.6% died. Of those survived 16 became severely disabled. Accidents and infections had higher mortality compared to other groups (P<0.001 and P=0.02 respectively.Conclusion: Our results showed that infection was the

  9. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol


    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  10. Halitosis: an overview of epidemiology, etiology and clinical management. (United States)

    Rösing, Cassiano Kuchenbecker; Loesche, Walter


    Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

  11. Halitosis: an overview of epidemiology, etiology and clinical management

    Directory of Open Access Journals (Sweden)

    Cassiano Kuchenbecker Rösing


    Full Text Available Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

  12. Etiology of the obstructive pattern in hepatobiliary imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, K.S.; Marrangoni, A.G.; Turbiner, E.


    The records of all patients undergoing hepatobiliary imaging with technetion radioisotopes at our hospital from January 1980 to March 1983 were reviewed and 29 scans met the criteria for a pattern consistent with complete biliary tract obstruction. Biliary tract obstruction (due to choledocholithiasis, primary or secondary carcinoma involving the common bile duct, and pancreatitis) was documented in 24 of these patients. However, the remaining five patients had a patent common bile duct, and the etiologic factor was intrahepatic cholestasis secondary to sepsis in four and peritonitis in one. A classification of altered biliary dynamics in hepatobiliary imaging, which is based on the classification of jaundice, is proposed.

  13. Feline degenerative joint disease: studies of prevalence, etiology and diagnosis


    Freire González, Milagros


    La tesis detallada en este documento está dividida en cuatro secciones que corresponden con artículos publicados en diferentes revistas de difusión veterinaria. En conjunto estos estudios tienen como objetivo general profundizar en el mejor conocimiento de la patología articular en gatos domésticos, en concreto, avanzar en los conocimientos acerca de la prevalencia, etiología y diagnóstico de esta enfermedad. El primer estudio incluido en esta tesis se diseñó para determinar la prevalencia de...

  14. Epithelioid Hemangioendothelioma of the Liver: Etiology, Natural History and Treatment

    Institute of Scientific and Technical Information of China (English)

    Weirong Chen; Maogen Chen; Gaoyang Cai; Ziqun Liao


    @@ Introduction Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor, which also has been called histiocytoid haemangioma. This low-grade malignant tumor was first described as a distinctive entity in 1982 by Weiss and Enzinger[1]. Histopathologically, EHE is charac-terized by round or spindle-shaped endothelial cells with cytoplasmic vacuolation[2]. The tumor may occur in numerous organs, includingliver, lung, parotid grand, skin, pleura, thyroid, spleen, cardiac valve,radial artery, oral cavity and parapharyngeal space[2-11]. Many cases have been reported, but its etiology and natural history remain un-clear.

  15. Chronic meningitis in systemic lupus erythematosus: An unusual etiology

    Directory of Open Access Journals (Sweden)

    Anu Gupta


    Full Text Available Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus (SLE. Apart from immunological causes and drugs, the aseptic meningitis group can include some unidentified viral infections that cannot be detected by routine microbiological testing. It is imperative to do complete cerebrospinal fluid (CSF workup before implicating the symptoms to disease activity or drugs, as untreated infections cause significant mortality in SLE. We present a case of young female with SLE who presented with chronic meningitis of an uncommon etiology.

  16. Towards an Etiologic Diagnosis: Assessing the Patient with Hearing Loss (United States)

    Lin, Jerry; Oghalai, John S.


    This article reviews the clinical approach taken towards identification of the cause of hearing loss in children. A brief overview of the universal newborn hearing screening program is presented. Discussion is then focused on clinical elements of the diagnostic process with emphasis on the importance of the history, physical examination, and audiologic testing. The utility and appropriateness of additional diagnostic testing is considered, particularly with regards to the incorporation of diagnostic radiologic imaging and genetic testing. In the course of these discussions, the genetic and non- genetic causes of pediatric hearing loss are reviewed. Finally, the implications of a definitive identification of hearing loss etiology are considered. PMID:21358182

  17. Oral cancer: Etiology and risk factors: A review

    Directory of Open Access Journals (Sweden)

    Malay Kumar


    Full Text Available Oral cancer is the sixth most common malignancy in the world. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits of betel quid chewing, smoking, and alcohol consumption. Despite recent advances in cancer diagnoses and therapies, the 5.year survival rate of oral cancer patients has remained at a dismal 50% in the last few decades. This paper is an overview of the various etiological agents and risk factors implicated in the development of oral cancer.

  18. Renal infarct: a rare disease due to a rare etiology (United States)

    Akshintala, Divya; Bansal, Saurabh K.; Emani, Vamsi Krishna; Yadav, Manajyoti


    Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan. PMID:26091657

  19. Renal infarct: a rare disease due to a rare etiology

    Directory of Open Access Journals (Sweden)

    Divya Akshintala


    Full Text Available Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan.

  20. [Recent advances in dry eye: etiology, pathogenesis and management]. (United States)

    Qin, Yi; Pan, Zhi-qiang


    Dry eye is one of the most common and multifactorial disease of the ocular surface that results in ocular discomfort, blurred vision, reduced quality of life, and decreased productivity. Recent advances in our knowledge of the causation of dry eye open opportunities for improving diagnosis , and disease management and for developing new, more effective therapies to manage this widely prevalent and debilitating disease state. In light of the above knowledge, the present article reviews the newer theories and reports on etiology , pathogenesis and management of dry eye.

  1. Legg-Calve-Perthes disease: etiology, pathogenesis, and biology. (United States)

    Kim, Harry K W


    Legg-Calve-Perthes disease is a complex pediatric hip disorder with many uncertainties. Various theories on its etiology have been proposed but none have been validated conclusively. Through experimental studies, however, some insight into the pathogenesis of a femoral head deformity after ischemic necrosis has been gained. These studies reveal that mechanical and biological factors contribute to the development of the femoral head deformity. Better understanding of the pathobiology of Legg-Calve-Perthes disease will lead to the development of more effective treatments, which are able to specifically target the pathogenic processes.

  2. Etiología en parálisis cerebral.


    Campos,Patricia; Bancalari, Ernesto; Castañeda, Carlos


    Objetivo: Determinar las causas mas frecuentes de parálisis cerebral (PC). Material y métodos: Estudio descriptivo realizado en Hospital Nacional Cayetano Heredia y el Hogar Clínica San Juan de Dios (Lima-Perú), entre noviembre 1990 y mayo de 1992. Se revisaron las historias clínicas de 102 pacientes con diagnósticos de PC y se revisó las etiologías. Resultados: En relación a edad gestacional hubieron 15 casos de prematuros (14.7%), 67(65%) a término y un postmaduro, en 19 no se tuvo la edad ...

  3. Etiology of bacterial vaginosis and polymicrobial biofilm formation. (United States)

    Jung, Hyun-Sul; Ehlers, Marthie M; Lombaard, Hennie; Redelinghuys, Mathys J; Kock, Marleen M


    Microorganisms in nature rarely exist in a planktonic form, but in the form of biofilms. Biofilms have been identified as the cause of many chronic and persistent infections and have been implicated in the etiology of bacterial vaginosis (BV). Bacterial vaginosis is the most common form of vaginal infection in women of reproductive age. Similar to other biofilm infections, BV biofilms protect the BV-related bacteria against antibiotics and cause recurrent BV. In this review, an overview of BV-related bacteria, conceptual models and the stages involved in the polymicrobial BV biofilm formation will be discussed.

  4. Moyamoya disease:epidemiology,etiology,diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Zheng Huang; Jizong Zhao


    Moyamoya disease as an uncommon cerebrovascular disease has been known for more than 40 years.It is characterized by progressive stenosis of internal carotid artery and its main branches.There is compensatory development of col-lateral vessels,which are termed moyamoya vessels.Ischemic and hemorrhagic stroke can occur in both pediatric and adult patients.Surgical revascularization can improve cerebral hemodynamics and prevent further stroke.In this review,we discuss the epidemiology,etiology,clinical features and surgical treatment of moyamoya disease.

  5. The etiology of autoimmune diseases: the case of myasthenia gravis. (United States)

    Bach, Jean-François


    Autoimmune diseases comprise a wide variety of disorders, from those that are acute and spontaneously regressive to chronic diseases. Their occurrence is the sign of a loss of tolerance to self-antigens. With few exceptions, the etiology of autoimmune diseases has not been clearly established. In all cases, it is complex, involving genetic, epigenetic, and environmental factors. In this article I will attempt to analyze the various factors that have a triggering or protecting role, with particular reference to myasthenia gravis. © 2012 New York Academy of Sciences.

  6. Roles of radiation dose and chemotherapy in the etiology of stomach cancer as a second malignancy

    DEFF Research Database (Denmark)

    van den Belt-Dusebout, Alexandra W; Aleman, Berthe M P; Besseling, Gijs


    PURPOSE: To evaluate the roles of radiation dose, chemotherapy, and other factors in the etiology of stomach cancer in long-term survivors of testicular cancer or Hodgkin lymphoma. METHODS AND MATERIALS: We conducted a cohort study in 5,142 survivors of testicular cancer or Hodgkin lymphoma treated...... in the Netherlands between 1965 and 1995. In a nested case-control study, detailed information on treatment, smoking, gastrointestinal diseases, and family history was collected for 42 patients with stomach cancer and 126 matched controls. For each subject, the mean radiation dose to the stomach was estimated....... Relative risks (RRs) of stomach cancer and the radiation-related excess relative risk (ERR) per gray were calculated by conditional logistic regression analysis. RESULTS: The risk of stomach cancer was 3.4-fold increased compared with the general population. The risk increased with increasing mean stomach...

  7. Vejle Diabetes Biobank - a resource for studies of the etiologies of diabetes and its comorbidities

    DEFF Research Database (Denmark)

    Petersen, Eva Rabing Brix; Nielsen, Aneta Aleksandra; Christensen, Henry;


    as numerous original and pertinent bioclinical hypotheses related to human disease etiology and prognosis. The objective of the present study was to present the baseline data, design, and methods used for the establishment of the Vejle Diabetes Biobank. Further aims included assessment of the prevalence...... of diabetes and quality of diabetes treatment in a specified Danish region. METHODS: The Vejle Diabetes Biobank was established from 2007 to 2010 as a regional Biobank containing blood, DNA, and urine samples from patients with diabetes and a gender- and age-matched control population aged 25-75 years...... individuals and 3,320 patients with diabetes were included. Type 2 diabetes (T2D) patients had a higher body mass index (30 kg/m(2)) than type 1 diabetes (T1D) patients (25 and 26 kg/m(2) in women and men, respectively) and control subjects (25 and 27 kg/m(2) in women and men, respectively). Fasting levels...

  8. Materials considerations in accelerator targets (United States)

    Peacock, H. B.; Iyer, N. C.; Louthan, M. R.


    Future nuclear materials production and/or the burn-up of long lived radioisotopes may be accomplished through the capture of spallation produced neutrons in accelerators. Aluminum clad-lead and/or lead alloys has been proposed as a spallation target. Aluminum was the cladding choice because of the low neutron absorption cross section, fast radioactivity decay, high thermal conductivity, and excellent fabricability. Metallic lead and lead oxide powders were considered for the target core with the fabrication options being casting or powder metallurgy (PM). Scoping tests to evaluate gravity casting, squeeze casting, and casting and swaging processes showed that, based on fabricability and heat transfer considerations, squeeze casting was the preferred option for manufacture of targets with initial core cladding contact. Thousands of aluminum clad aluminum-lithium alloy core targets and control rods for tritium production have been fabricated by coextrusion processes and successfully irradiated in the SRS reactors. Tritium retention in, and release from, the coextruded product was modeled from experimental and operational data. The model assumed that tritium atoms, formed by the 6Li(n,a)3He reaction, were produced in solid solution in the Al-Li alloy. Because of the low solubility of hydrogen isotopes in aluminum alloys, the irradiated Al-Li rapidly became supersaturated in tritium. Newly produced tritium atoms were trapped by lithium atoms to form a lithium tritide. The effective tritium pressure required for trap or tritide stability was the equilibrium decomposition pressure of tritium over a lithium tritide-aluminum mixture. The temperature dependence of tritium release was determined by the permeability of the cladding to tritium and the local equilibrium at the trap sites. The model can be used to calculate tritium release from aluminum clad, aluminum-lithium alloy targets during postulated accelerator operational and accident conditions. This paper describes

  9. Etiological Analysis of Neurodevelopmental Disabilities: Single-Center Eight-Year Clinical Experience in South China

    Directory of Open Access Journals (Sweden)

    Li Guo


    Full Text Available Etiology determination of neurodevelopmental disabilities (NDDs currently remains a worldwide common challenge on child health. We herein reported the etiology distribution feature in a cohort of 285 Chinese patients with NDDs. Although concrete NDD etiologies in 48.4% of the total patients could not be identified, genetic diseases (with the proportion of 35.8% in the total cases including inborn errors of metabolism (IEM and congenital dysmorphic diseases, constituted the commonest etiology category for NDDs in this study. The two key experimental technologies in pediatric metabolomics, gas chromatography-mass spectrometry (GC-MS, and tandem mass spectrometry (MS-MS, proved to be substantially helpful for the exploration of the NDD etiologies in this clinical investigation. The findings in this paper provided latest epidemiologic information on the etiology distribution of NDDs in Chinese, and the syndromic NDDs caused by citrin deficiency and the novel chromosomal karyotype, respectively, further expanded the etiology spectrum of NDDs.

  10. Management of maxillary midline diastema with emphasis on etiology. (United States)

    Gkantidis, Nikolaos; Kolokitha, Olga-Elpis; Topouzelis, Nikolaos


    The importance of the presence of a maxillary midline diastema resides in its position and the concern it causes to patients. This specific diastema has been attributed to genetic and environmental factors, even though it is often a normal feature of growth, especially in primary and mixed dentition. The need for treatment is mainly attributed to esthetic and psychological reasons, rather than functional ones. Although it is often the case, treatment plans should not be selected empirically but rather should be based on adequate scientific documentation. Possible therapeutic approaches include orthodontics, restorative dentistry, surgery and various combinations of the above. The ideal treatment should seek to manage not only the diastema in question but also the cause behind it. Irrespective of the treatment alternative selected, permanent retention of stable results should be considered as a treatment objective. The aim of this paper is to underscore the main etiological factors for the presence of a maxillary midline diastema and to illustrate the clinical and laboratory examinations required to recognize these factors. Furthermore, alternative treatment options are discussed depending on the etiology of the problem.

  11. Microbial Etiology of Pneumonia: Epidemiology, Diagnosis and Resistance Patterns (United States)

    Cilloniz, Catia; Martin-Loeches, Ignacio; Garcia-Vidal, Carolina; San Jose, Alicia; Torres, Antoni


    Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity. Despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures, pneumonia remains the main cause of death from infectious disease in the world. An important reason for the increased global mortality is the impact of pneumonia on chronic diseases, along with the increasing age of the population and the virulence factors of the causative microorganism. The increasing number of multidrug-resistant bacteria, difficult-to-treat microorganisms, and the emergence of new pathogens are a major problem for clinicians when deciding antimicrobial therapy. A key factor for managing and effectively guiding appropriate antimicrobial therapy is an understanding of the role of the different causative microorganisms in the etiology of pneumonia, since it has been shown that the adequacy of initial antimicrobial therapy is a key factor for prognosis in pneumonia. Furthermore, broad-spectrum antibiotic therapies are sometimes given until microbiological results are available and de-escalation cannot be performed quickly. This review provides an overview of microbial etiology, resistance patterns, epidemiology and microbial diagnosis of pneumonia. PMID:27999274

  12. Microbial Etiology of Pneumonia: Epidemiology, Diagnosis and Resistance Patterns

    Directory of Open Access Journals (Sweden)

    Catia Cilloniz


    Full Text Available Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity. Despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures, pneumonia remains the main cause of death from infectious disease in the world. An important reason for the increased global mortality is the impact of pneumonia on chronic diseases, along with the increasing age of the population and the virulence factors of the causative microorganism. The increasing number of multidrug-resistant bacteria, difficult-to-treat microorganisms, and the emergence of new pathogens are a major problem for clinicians when deciding antimicrobial therapy. A key factor for managing and effectively guiding appropriate antimicrobial therapy is an understanding of the role of the different causative microorganisms in the etiology of pneumonia, since it has been shown that the adequacy of initial antimicrobial therapy is a key factor for prognosis in pneumonia. Furthermore, broad-spectrum antibiotic therapies are sometimes given until microbiological results are available and de-escalation cannot be performed quickly. This review provides an overview of microbial etiology, resistance patterns, epidemiology and microbial diagnosis of pneumonia.

  13. Microscopic colitis: A review of etiology, treatment and refractory disease. (United States)

    Park, Tina; Cave, David; Marshall, Christopher


    Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Exposure to medications, such as non-steroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors, is suspected to play a role in microscopic colitis, although their direct causal relationship has not been proven. Multiple medications, including corticosteroids, anti-diarrheals, cholestyramine, bismuth, 5-aminosalicylates, and immunomodulators, have been used to treat microscopic colitis with variable response rates. Budesonide is effective in inducing and maintaining clinical remission but relapse rate is as high as 82% when budesonide is discontinued. There is limited data on management of steroid-dependent microscopic colitis or refractory microscopic colitis. Immunomodulators seem to have low response rate 0%-56% for patients with refractory microscopic colitis. Response rate 66%-100% was observed for use of anti-tumor necrosis factor (TNF) therapy for refractory microscopic colitis. Anti-TNF and diverting ileostomy may be an option in severe or refractory microscopic colitis.

  14. Microbial Etiology of Pneumonia: Epidemiology, Diagnosis and Resistance Patterns. (United States)

    Cilloniz, Catia; Martin-Loeches, Ignacio; Garcia-Vidal, Carolina; San Jose, Alicia; Torres, Antoni


    Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity. Despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures, pneumonia remains the main cause of death from infectious disease in the world. An important reason for the increased global mortality is the impact of pneumonia on chronic diseases, along with the increasing age of the population and the virulence factors of the causative microorganism. The increasing number of multidrug-resistant bacteria, difficult-to-treat microorganisms, and the emergence of new pathogens are a major problem for clinicians when deciding antimicrobial therapy. A key factor for managing and effectively guiding appropriate antimicrobial therapy is an understanding of the role of the different causative microorganisms in the etiology of pneumonia, since it has been shown that the adequacy of initial antimicrobial therapy is a key factor for prognosis in pneumonia. Furthermore, broad-spectrum antibiotic therapies are sometimes given until microbiological results are available and de-escalation cannot be performed quickly. This review provides an overview of microbial etiology, resistance patterns, epidemiology and microbial diagnosis of pneumonia.

  15. Etiological Profile of Plasmacytosis on Bone Marrow Aspirates

    Directory of Open Access Journals (Sweden)

    Monika Gupta


    Full Text Available Objective: In recent years, during routine examination of bone marrow aspirates, an increased plasma cell per­centage has been noted in a good number of cases which included both neoplastic and non-neoplastic diseases. An attempt has been made to observe the spectra of condi­tions with plasmacytosis in bone marrow. Methods: The present study was conducted in the de­partment of pathology over a period of one year. A total of 114 bone marrow aspirates that showed increased plas­ma cells (>3.5% constitute the study material. A detailed relevant clinical examination followed by complete blood count, peripheral smear examination and bone marrow aspiration was done in all cases. Results: There was slight female predominance with male to female ratio of 1:1.1. The majority of patients were in 4th decade. The plasma cell concentration ranged from 5% to 36%. As far as the etiology is concerned, 96 cases (84.2% were non-neoplastic and 18 cases (15.7% had neoplastic etiology. Conclusion: Bone marrow plasmacytosis can present as diagnostic dilemma and some time can be challenging to differentiate reactive from neoplastic condition as there is an overlap both in counts and morphology. Each case with plasmacytosis especially in the overlap range requires complete clinical evaluation, individualized investigations and more specific tests like immunoelectrophoresis and bone marrow biopsy with immunohistochemistry to arrive at a final diagnosis for patient management.

  16. Fluoroquinolone-induced tendinopathy: etiology and preventive measures. (United States)

    Kaleagasioglu, Ferda; Olcay, Ercan


    Tendinopathy is a serious health problem and its etiology is not fully elucidated. Among intrinsic and extrinsic predisposing factors of tendinopathy, the impact of therapeutic agents, especially fluoroquinolone (FQ) group antibiotics, is recently being recognized. FQs are potent bactericidal agents widely used in various infectious diseases, including community acquired pneumonia and bronchitis, chronic osteomyelitis, traveler's diarrhea, typhoid fever, shigellosis, chronic bacterial prostatitis, uncomplicated cervical and urethral gonorrhea and prophylaxis of anthrax. FQs have an acceptable tolerability range. However, many lines of evidence for developing tendinitis and tendon rupture during FQ use have resulted in the addition of a warning in patient information leaflets. FQ-induced tendinopathy presents a challenge for the clinician because healing response is poor due to low metabolic rate in mature tendon tissue and tendinopathy is more likely to develop in patients who are already at high risk, such as elderly, solid organ transplant recipients and concomitant corticosteroid users. FQs become photo-activated under exposure to ultraviolet light, and this process results in formation and accumulation of intracellular reactive oxygen species (ROS). The subsequent FQ-related oxidative stress disturbs mitochondrial functions, leading to apoptosis. ROS overproduction also has direct cytotoxic effects on extracellular matrix components. Understanding the mechanisms of the FQ-associated tendinopathy may enable designing safer therapeutic strategies, hence optimization of clinical response. In this review, we evaluate multi-factorial etiology of the FQ-induced tendinopathy and discuss proposed preventive measures such as antioxidant use and protection from natural sunlight and artificial ultraviolet exposure.

  17. The Sea Lamprey as an Etiological Model for Biliary Atresia

    Directory of Open Access Journals (Sweden)

    Yu-Wen Chung-Davidson


    Full Text Available Biliary atresia (BA is a progressive, inflammatory, and fibrosclerosing cholangiopathy in infants that results in obstruction of both extrahepatic and intrahepatic bile ducts. It is the most common cause for pediatric liver transplantation. In contrast, the sea lamprey undergoes developmental BA with transient cholestasis and fibrosis during metamorphosis, but emerges as a fecund adult with steatohepatitis and fibrosis in the liver. In this paper, we present new histological evidence and compare the sea lamprey to existing animal models to highlight the advantages and possible limitations of using the sea lamprey to study the etiology and compensatory mechanisms of BA and other liver diseases. Understanding the signaling factors and genetic networks underlying lamprey BA can provide insights into BA etiology and possible targets to prevent biliary degeneration and to clear fibrosis. In addition, information from lamprey BA can be used to develop adjunct treatments for patients awaiting or receiving surgical treatments. Furthermore, the cholestatic adult lamprey has unique adaptive mechanisms that can be used to explore potential treatments for cholestasis and nonalcoholic steatohepatitis (NASH.

  18. Infectious encephalitis: Management without etiological diagnosis 48hours after onset. (United States)

    Fillatre, P; Crabol, Y; Morand, P; Piroth, L; Honnorat, J; Stahl, J P; Lecuit, M


    The etiological diagnosis of infectious encephalitis is often not established 48hours after onset. We aimed to review existing literature data before providing management guidelines. We performed a literature search on PubMed using filters such as "since 01/01/2000", "human", "adults", "English or French", and "clinical trial/review/guidelines". We also used the Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis". With Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis", we retrieved 223 and 258 articles, respectively. With search terms "encephalitis and corticosteroid", we identified 38 articles, and with "encephalitis and doxycycline" without the above-mentioned filters we identified 85 articles. A total of 210 articles were included in the analysis. Etiological investigations must focus on recent travels, animal exposures, age, immunodeficiency, neurological damage characteristics, and potential extra-neurological signs. The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Traumatic dental injuries: etiology, prevalence and possible outcomes. (United States)

    Zaleckiene, Vaida; Peciuliene, Vytaute; Brukiene, Vilma; Drukteinis, Saulius


    . The aim was to overview the etiology, prevalence and possible outcomes of dental trauma. An electronic search of Medline (PubMed), Cochrane, SSCI (Social Citation Index), SCI (Science Citation Index) databases from 1995 to the present, using the following search words: tooth injuries, tooth trauma, traumatized teeth, dental trauma, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, prevention, pulp necrosis, inflammatory resorption, ankylosis, cervical resorption, was performed. During last decade traumatic dental injuries were recognized as public dental health problem worldwide. Prevalence of traumatic dental injuries varies between countries. According to the existing data they are more prevalent in permanent than in primary dentition. All treatment procedures in case of dental trauma are directed to minimize undesired consequences despite that treatment of traumatic dental injuries in the young patient is often complicated and can continue during the rest of his/her life. The changing lifestyle and requirements of modern society lead to an emergence of new patterns of dental trauma. A regular update of knowledge in dental traumatology is required.

  20. Etiology of epilepsy a prospective study of 210 cases

    Directory of Open Access Journals (Sweden)

    Walter Oleschko Arruda


    Full Text Available The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male, aged 14-82 years (34.2±13.3. Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5% were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%, the EEG in 68 (45.5%, and CT-scan in 93 (44.3%. According to the International Classification of Epileptic Seizures (1981, 101 (48.1% have generalized seizures, 66 (31.4% partial seizures secondarily generalized, 25 (11.8% simple partial and complex partial seizures, and 14 (6.6% generalized and partial seizures. Four patients (2.0% could not be classified. In 125 (59.5% patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1% of cases, followed by cerebrovascular disease 8 (3.8%, perinatal damage 5 (2.4%, familial epilepsy 4 (1.9%, head injury 4 (1.9%, infective 1 (0.5%, and miscelanea 6 (2.8%.

  1. Etiology, pathophysiology and conservative management of degenerative joint disease

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica


    Full Text Available Etiology of degenerative joint diseases Etiology of degenerative joint diseases is still not clearly understood and there is no specific management for this group of diseases. Various pathological conditions cause damage of the articular cartilage and lead to clinically and radiographically recognized impairment. Biomechanical, metabolic, genetic factors inflammation and other risk factors contribute to development of osteoarthrosis. Pathophysiology of degenerative joint diseases Osteoarthrosis is characterized by progressive erosion of articular cartilage and bone overgrowth at the joint margins. Cartilage integrity requires balance between synthesis and degradation of matrix components. Chondrocytes react to various mechanical and chemical stresses in order to stabilize and restore the tissue. Failures in stabilizing and restoring the tissue lead to cartilage degeneration that may be irreversibile. For better understanding of conservative management of degenerative joint diseases it is important to know the impact of pathophysiology mechanisms on development of degenerative joint diseases. There is great variability in the rate of progression of erosive processes in articular cartilage in clinical radiographic signs and course of the disease. This is in relation with many factors, as well as with management and response to therapy. Treatment of degenerative joint diseases Treatment should vary depending on the severity of disease and patient's expectations and level of activity. Besides analgesic and anti-inflammatory drugs, conventional and not conventional treatment and techniques can be used for management of osteoarthrosis. Physical therapy and exercises are very important for maintaining muscle strength, joint stability and mobility, but should be closely monitored for optimal efficacy.

  2. Infertility in Mazandaran province - north of Iran: an etiological study (United States)

    Karimpour Malekshah, Abbasali; Esmailnejad Moghaddam, Amir; Moslemizadeh, Narges; Peivandi, Sepideh; Barzegarnejad, Ayyub; Musanejad, Nadali; Jursarayee, Gholamali


    Background: The prevalence and etiology of infertility are not similar in different parts of the world. There are only few reports of this topic in Iran. Objective: This study was conducted to determine the clinical patterns and major causes of infertility in Mazandaran province in north of Iran. Materials and Methods: The medical records of 3734 consecutive couples attending two infertility clinics in Mazandaran province, from 2003 to 2008, were reviewed. The couples had not had a viable birth after at least 1 year of unprotected intercourse and were fully investigated. Results: Of the entire samples, 78.7% had primary infertility and 21.3% had secondary infertility. The mean duration of infertility in couples was 5.7±4 years. The etiology of infertility in couples revealed; male factor in 38.9%, female factor in 34.7%, combined factors in 14.6% and undetermined cause in 11.8%. Conclusion: In this study, delayed attendance of infertile couples to the infertility clinic was found. Therefore, there is a need to revise public health program on infertility to focus on the education and prevention of infertility and its risk factors. PMID:25356077

  3. Etiological model of disordered eating behaviors in Brazilian adolescent girls. (United States)

    Fortes, Leonardo de Sousa; Filgueiras, Juliana Fernandes; Oliveira, Fernanda da Costa; Almeida, Sebastião Sousa; Ferreira, Maria Elisa Caputo


    The objective was to construct an etiological model of disordered eating behaviors in Brazilian adolescent girls. A total of 1,358 adolescent girls from four cities participated. The study used psychometric scales to assess disordered eating behaviors, body dissatisfaction, media pressure, self-esteem, mood, depressive symptoms, and perfectionism. Weight, height, and skinfolds were measured to calculate body mass index (BMI) and percent body fat (%F). Structural equation modeling explained 76% of variance in disordered eating behaviors (F(9, 1,351) = 74.50; p = 0.001). The findings indicate that body dissatisfaction mediated the relationship between media pressures, self-esteem, mood, BMI, %F, and disordered eating behaviors (F(9, 1,351) = 59.89; p = 0.001). Although depressive symptoms were not related to body dissatisfaction, the model indicated a direct relationship with disordered eating behaviors (F(2, 1,356) = 23.98; p = 0.001). In conclusion, only perfectionism failed to fit the etiological model of disordered eating behaviors in Brazilian adolescent girls.

  4. Kleine-Levin syndrome: Etiology, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Ramdurg Santosh


    Full Text Available Kleine-Levin syndrome (KLS is a rare sleep disorder mainly affecting teenage boys in which the main features are intermittent hypersomnolence, behavioral and cognitive disturbances, hyperphagia, and in some cases hypersexuality. Each episode is of brief duration varying from a week to 1-2 months and affected people are entirely asymptomatic between episodes. No definite cause has been identified, and no effective treatments are available even though illness is having well-defined clinical features. Multiple relapses occur every few weeks or months, and the condition may last for a decade or more before spontaneous resolution. In this study, PubMed was searched and appropriate articles were reviewed to highlight etiology, clinical features, and management of KLS. On the basis of this knowledge, practical information is offered to help clinicians about how to investigate a case of KLS, and what are the possible treatment modalities available currently for the treatment during an episode and interepisodic period for prophylaxis. Comprehensive research into the etiology, pathophysiology, investigation, and treatments are required to aid the development of disease-specific targeted therapies.

  5. Etiology and prognosis of non-convulsive status epilepticus. (United States)

    Kang, Bong Su; Jhang, Yunsook; Kim, Young-Soo; Moon, Jangsup; Shin, Jung-Won; Moon, Hye Jin; Lee, Soon-Tae; Jung, Keun-Hwa; Chu, Kon; Park, Kyung-Il; Lee, Sang Kun


    Although non-convulsive status epilepticus (NCSE) is an important type of epilepsy, it is not often recognized. In order to analyze the clinical characteristics and outcome in patients with NCSE, we examined the medical records of patients with NCSE admitted to the Seoul National University Hospital between June 2005 and October 2008. The clinical details and electroencephalography records of 34 adult NCSE patients (aged over 16 years) were collected. Their mean age was 47 years (standard deviation 20 years, range, 16-87 years), and 20 were female. Twenty-seven patients (79.4%) showed decreased awareness with acute onset, and seven (20.6%) were obtunded or comatose. Ten patients (29.4%) had a history of epilepsy, and four (11.8%) had a history of stroke. NCSE was etiologically attributed to acute medical or neurological problems in 25 patients (73.5%), was cryptogenic in three (8.8%), and was secondary to underlying epilepsy in six (17.7%). Acute symptomatic etiology was associated with poor recovery (p=0.048), with all unresponsive patients in this acute symptomatic group. Eight (23.5%) of the 34 NCSE patients did not recover or died, whereas nine (26.5%) recovered. Our study shows that the presence of acute symptoms or central nervous system infection is associated with poor outcome, suggesting that a high level of vigilance is required to identify and prevent complications.

  6. Scleroderma: nomenclature, etiology, pathogenesis, prognosis, and treatments: facts and controversies. (United States)

    Fett, Nicole


    Scleroderma refers to a heterogeneous group of autoimmune fibrosing disorders. The nomenclature of scleroderma has changed dramatically in recent years, with morphea (localized scleroderma), limited cutaneous systemic sclerosis, diffuse cutaneous systemic sclerosis, and systemic sclerosis sine scleroderma encompassing the currently accepted disease subtypes. Major advances have been made in the molecular studies of morphea and systemic sclerosis; however, their etiologies and pathogenesis remain incompletely understood. Although morphea and systemic sclerosis demonstrate activation of similar inflammatory and fibrotic pathways, important differences in signaling pathways and gene signatures indicate they are likely biologically distinct processes. Morphea can cause significant morbidity but does not affect mortality, whereas systemic sclerosis has the highest disease-specific mortality of all autoimmune connective tissue diseases. Treatment recommendations for morphea and systemic sclerosis are based on limited data and largely expert opinions. Current collaborative efforts in morphea and systemic sclerosis research will hopefully lead to better understanding of the etiology and pathogenesis of these rare and varied diseases and improved treatment options.

  7. [Etiologic factors in temporomandibular joint disorders and pain]. (United States)

    De Laat, A


    Parallel to the construction of better classifications and the identification of subgroups of temporomandibular disorders, an important development has taken place in research concerning its etiology. The etiological factors implied in muscle problems refer to more generalised disorders as myofascial pain syndrome and fibromyalgia. The role of occlusal and articular factors has been brought down to realistic proportions, indicating a minor contribution. Similarly, doubt has arisen concerning the existence of a vicious cycle of pain/spasm/pain. With regard to internal derangements, emphasis has been put on the high prevalence in an otherwise normal population and the fluctuating character of the symptom. Also here, developments point towards constitutional and systemic factors, more than local influences. Trauma, however, seems to play an increasing role. The development of osteoarthrosis has been studied more in depth revealing local processes of inflammation, neurogenic inflammation and the existence of specific markers which might be important in the future. The relationship between disc derangement and the development of osteoarthrosis remains unclear.

  8. An Etiologic Profile of Anemia in 405 Geriatric Patients

    Directory of Open Access Journals (Sweden)

    Tabea Geisel


    Full Text Available Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients. Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine in addition to medical history and demographics. Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1% in a mild form. Anemia was primarily due to iron deficiency (65%, frequently due to underlying chronic infection (62.1%, or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role. Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.

  9. Romantic Relationship Satisfaction Moderates the Etiology of Adult Personality. (United States)

    South, Susan C; Krueger, Robert F; Elkins, Irene J; Iacono, William G; McGue, Matt


    The heritability of major normative domains of personality is well-established, with approximately half the proportion of variance attributed to genetic differences. In the current study, we examine the possibility of gene × environment interaction (G×E) for adult personality using the environmental context of intimate romantic relationship functioning. Personality and relationship satisfaction are significantly correlated phenotypically, but to date no research has examined how the genetic and environmental components of variance for personality differ as a function of romantic relationship satisfaction. Given the importance of personality for myriad outcomes from work productivity to psychopathology, it is vital to identify variables present in adulthood that may affect the etiology of personality. In the current study, quantitative models of G×E were used to determine whether the genetic and environmental influences on personality differ as a function of relationship satisfaction. We drew from a sample of now-adult twins followed longitudinally from adolescence through age 29. All participants completed the Multidimensional Personality Questionnaire (MPQ) and an abbreviated version of the Dyadic Adjustment Scale. Biometric moderation was found for eight of the eleven MPQ scales examined: well-being, social potency, negative emotionality, alienation, aggression, constraint, traditionalism, and absorption. The pattern of findings differed, suggesting that the ways in which relationship quality moderates the etiology of personality may depend on the personality trait.

  10. Clinical and etiological associations in chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Yu. V. Zhitkova


    Full Text Available Objective: to study the clinical features of chronic cerebral ischemia (CCI in relation to the leading etiological factor.Patients and methods. Examinations were made in 515 non-stroke CCI patients: 306 men and 209 women aged 58 to 75 years with hypertension and no obvious atherosclerosis of head and neck vessels (n=197; with obvious atherosclerosis of head and neck vessels and no hypertension (n=157; with obvious atherosclerosis of head and neck vessels and hypertension (n=161. In all cases, the investigators performed standard neurological examination and evaluated cognitive, affective symptoms with a set of neuropsychological scales and equilibrium and gait abnormalities with the Tinetti scale.Results and discussion. The development of extrapyramidal syndrome was more related to hypertension or its concurrence with the atherosclerotic process. The patients with atherosclerosis and no hypertension showed a more distinct differentiation of clinical syndromes, which was associated with stenosis in the specific vascular bed; this was probably due to decreased local perfusion. A relationship was established between hypertension and the development of severe cognitive impairments (CIs that had predominantly a dysregulation neuropsychological profile. In the patients with atherosclerosis and no hypertension, emotional disorders were more common than CI and the latter resembled Alzheimer’s disease. A differentiated prophylactic and therapeutic strategy accounting for the leading etiological factor will be able to prevent or significantly reduce functional limitations in patients with CCI.

  11. Etiological Distinction of Working Memory Components in Relation to Mathematics (United States)

    Lukowski, Sarah L.; Soden, Brooke; Hart, Sara A.; Thompson, Lee A.; Kovas, Yulia; Petrill, Stephen A.


    Working memory has been consistently associated with mathematics achievement, although the etiology of these relations remains poorly understood. The present study examined the genetic and environmental underpinnings of math story problem solving, timed calculation, and untimed calculation alongside working memory components in 12-year-old monozygotic (n = 105) and same-sex dizygotic (n = 143) twin pairs. Results indicated significant phenotypic correlation between each working memory component and all mathematics outcomes (r = 0.18 – 0.33). Additive genetic influences shared between the visuo-spatial sketchpad and mathematics achievement was significant, accounting for roughly 89% of the observed correlation. In addition, genetic covariance was found between the phonological loop and math story problem solving. In contrast, despite there being a significant observed relationship between phonological loop and timed and untimed calculation, there was no significant genetic or environmental covariance between the phonological loop and timed or untimed calculation skills. Further analyses indicated that genetic overlap between the visuo-spatial sketchpad and math story problem solving and math fluency was distinct from general genetic factors, whereas g, phonological loop, and mathematics shared generalist genes. Thus, although each working memory component was related to mathematics, the etiology of their relationships may be distinct. PMID:25477699

  12. Nontraumatic spontaneous rupture of the kidney : etiology and CT findings

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    Heo, Tae Haeng; Jeon, Hae Jeong; Shin, Hyun Joon [Konkuk Univ. College of Medicine, chungju (Korea, Republic of); Kim, Bo Hyun [Seongkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Cho, Kyoung Sik [Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Kim, Young Hwa [Soonchunhyang Univ. College of Medicine, Asan (Korea, Republic of); Kim, Seung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Park, Churl Min [Korea Univ. College of Medicine, Seoul (Korea, Republic of)


    To evaluate the usefulness of CT scanning in determining the etiology of spontaneous rupture of the kidney We retrospectively analyzed the CT findings of spontaneous rupture of the kidney in eleven patients, Four were male and seven were female, and they were aged between 20 and 71 (mean, 46.6) years. Both pre- and post-contrast enhanced CT scanning was performed in all patients. Spontaneous renal rupture was induced in seven cases by neoplasms (three angiomyolipomas, three renal cell carcinomas, and one metastatic choriocarcinoma), in three cases by infection or inflammation (acute and chronic pyelonephritis, and renal abscess), and in one, by renal cyst. Common CT findings of rupture of the kidney were the accumulation of high density fluid in the perirenal and anterior pararenal space, and inhomogeneous irregular low density of renal parenchyma and the rupture site. Angiomyolipoma showed fat and an angiomatous component in the lesion, while acute and chronic pyelonephrities revealed thinning of the renal parenchyma and an irregular renal outline. Renal cell carcinoma showed a dense soft tissue mass in the parenchyma. Well-defined, round low-density lesions were noted in the case of renal cyst and renal abscess. CT is very useful in diagnosing and determining the etiology of non-traumatic spontaneous rupture of the kidney and plays an important role in the evaluation of emergency cases.

  13. Effect of etiology of mouth breathing on craniofacial morphology

    Directory of Open Access Journals (Sweden)

    Mohammadreza Majidi


    Full Text Available Introduction: Nasal septal deviation and hypertrophy of the adenoids and palatine tonsils are two common causes of nasopharyngeal obstruction and consequently mouth breathing in children. It is accepted that chronic mouth breathing influences craniofacial growth and development. The aim of this study was to evaluate the differences of craniofacial morphology in children with two different etiological factors of mouth breathing. Materials and Methods: Study design: cross sectional. The research was conducted between 2005-2007 on 47 predominantly mouth breathing patients aged 6-10 years. After otorhinolaryngologic examination, patients were divided into two groups based on the etiology of nasopharyngeal obstruction: group 1, with Adenoid hypertrophy and group 2 with nasal septal deviation. Lateral cephalometric radiographs were obtained to assess craniofacial development. Data gained were statistically evaluated by Mann-Whitney and T-student tests. Results: With respect to the inclination of the mandibular and palatal planes, anteroposterior relationship of maxilla and mandible to the cranial base, and indexes of facial height proportions, no significant differences were observed between two groups of children with mouth breathing. Only the gonial and craniocervical angle measurements were significantly larger in children with adenoid hypertrophy (P

  14. The bacterial etiology of conjunctivitis in early infancy. Eye Prophylaxis Study Group. (United States)

    Krohn, M A; Hillier, S L; Bell, T A; Kronmal, R A; Grayston, J T


    The authors conducted this study to determine the etiologic agents of conjunctivitis in early infancy. From 1985 to 1990, 630 infants enrolled in a randomized, controlled, double-masked study of eye prophylaxis were observed for 60 days after delivery for signs of conjunctivitis. The following isolates were categorized as pathogens: Haemophilus influenzae, Streptococcus pneumoniae, Neisseria cinerea, Klebsiella pneumoniae, and Chlamydia trachomatis. Using conditional logistic regression for analysis of 97 infant pairs, the authors identified isolates categorized as pathogens almost exclusively among cases (odds ratio (OR) = 18.0, 95% confidence interval (CI) 2.3-128). Among the microorganisms which have not usually been regarded as pathogens in the etiology of infant conjunctivitis, Streptococcus mitis was the only microorganism associated with an increased risk of conjunctivitis (OR = 5.3, 95% CI 1.8-15.0). The findings concerning the species of bacteria most often associated with conjunctivitis, as well as the finding that method of delivery is unimportant, suggest that bacteria were transmitted to the infants' eyes after birth and not from the birth canal.

  15. Advances in the microbial etiology and pathogenesis of early childhood caries. (United States)

    Hajishengallis, E; Parsaei, Y; Klein, M I; Koo, H


    Early childhood caries (ECC) is one of the most prevalent infectious diseases affecting children worldwide. ECC is an aggressive form of dental caries, which, left untreated, can result in rapid and extensive cavitation in teeth (rampant caries) that is painful and costly to treat. Furthermore, it affects mostly children from impoverished backgrounds, and so constitutes a major challenge in public health. The disease is a prime example of the consequences arising from complex, dynamic interactions between microorganisms, host, and diet, leading to the establishment of highly pathogenic (cariogenic) biofilms. To date, there are no effective methods to identify those at risk of developing ECC or to control the disease in affected children. Recent advances in deep-sequencing technologies, novel imaging methods, and (meta)proteomics-metabolomics approaches provide an unparalleled potential to reveal new insights to illuminate our current understanding about the etiology and pathogenesis of the disease. In this concise review, we provide a broader perspective about the etiology and pathogenesis of ECC based on previous and current knowledge on biofilm matrix, microbial diversity, and host-microbe interactions, which could have direct implications for developing new approaches for improved risk assessment and prevention of this devastating and costly childhood health condition. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Etiology matters - Genomic DNA Methylation Patterns in Three Rat Models of Acquired Epilepsy. (United States)

    Dębski, Konrad J; Pitkanen, Asla; Puhakka, Noora; Bot, Anna M; Khurana, Ishant; Harikrishnan, K N; Ziemann, Mark; Kaspi, Antony; El-Osta, Assam; Lukasiuk, Katarzyna; Kobow, Katja


    This study tested the hypothesis that acquired epileptogenesis is accompanied by DNA methylation changes independent of etiology. We investigated DNA methylation and gene expression in the hippocampal CA3/dentate gyrus fields at 3 months following epileptogenic injury in three experimental models of epilepsy: focal amygdala stimulation, systemic pilocarpine injection, or lateral fluid-percussion induced traumatic brain injury (TBI) in rats. In the models studies, DNA methylation and gene expression profiles distinguished controls from injured animals. We observed consistent increased methylation in gene bodies and hypomethylation at non-genic regions. We did not find a common methylation signature in all three different models and few regions common to any two models. Our data provide evidence that genome-wide alteration of DNA methylation signatures is a general pathomechanism associated with epileptogenesis and epilepsy in experimental animal models, but the broad pathophysiological differences between models (i.e. pilocarpine, amygdala stimulation, and post-TBI) are reflected in distinct etiology-dependent DNA methylation patterns.

  17. Etiology matters – Genomic DNA Methylation Patterns in Three Rat Models of Acquired Epilepsy (United States)

    Dębski, Konrad J.; Pitkanen, Asla; Puhakka, Noora; Bot, Anna M.; Khurana, Ishant; Harikrishnan, KN; Ziemann, Mark; Kaspi, Antony; El-Osta, Assam; Lukasiuk, Katarzyna; Kobow, Katja


    This study tested the hypothesis that acquired epileptogenesis is accompanied by DNA methylation changes independent of etiology. We investigated DNA methylation and gene expression in the hippocampal CA3/dentate gyrus fields at 3 months following epileptogenic injury in three experimental models of epilepsy: focal amygdala stimulation, systemic pilocarpine injection, or lateral fluid-percussion induced traumatic brain injury (TBI) in rats. In the models studies, DNA methylation and gene expression profiles distinguished controls from injured animals. We observed consistent increased methylation in gene bodies and hypomethylation at non-genic regions. We did not find a common methylation signature in all three different models and few regions common to any two models. Our data provide evidence that genome-wide alteration of DNA methylation signatures is a general pathomechanism associated with epileptogenesis and epilepsy in experimental animal models, but the broad pathophysiological differences between models (i.e. pilocarpine, amygdala stimulation, and post-TBI) are reflected in distinct etiology-dependent DNA methylation patterns. PMID:27157830

  18. Alcohol dependence--classificatory considerations. (United States)

    Lesch, O M; Ades, J; Badawy, A; Pelc, I; Sasz, H


    The term alcoholism or alcohol dependence has acquired a broad range of meanings. The Plinius Maior Society herewith presents new classificatory considerations and suggests additional recording of special dimensions according to the individual hypothesis and design of a study.

  19. Special Considerations for Multiple Limb Amputation. (United States)

    Pasquina, Paul F; Miller, Matthew; Carvalho, A J; Corcoran, Michael; Vandersea, James; Johnson, Elizabeth; Chen, Yin-Ting


    It has been estimated that more than 1.6 million individuals in the United States have undergone at least one amputation. The literature abounds with research of the classifications of such injuries, their etiologies, epidemiologies, treatment regimens, average age of onset (average age of amputation), and much more. The subpopulation that is often overlooked in these evaluations, however, is comprised of individuals who have suffered multiple limb loss. The challenges faced by those with single-limb loss are amplified for those with multiple limb loss. Pain, lifestyle adjustment, and quality of life return are just a few key areas of concern in this population. Along with amputations resulting from trauma, many individuals with multiple amputations have endured them as a result of dysvascular disease. Over recent years, amputations as a result of dysvascular disease have risen to comprise more than 80 % of new amputations occurring in the United States every year. This compares to just 54 % of total current prevalence. Those with diabetes comorbid with dysvascular disease make up 74 % of those with dysvascular amputations, and these individuals with diabetes comorbid with dysvascular disease have a 55 % chance of enduring an amputation of their contralateral limb within 2-3 years of their initial amputation. With the well-documented aging of the nation's population and the similarly skyrocketing prevalence of dysvascular disease and diabetes, it can be expected that the number of individuals with multiple limb loss will continue to increase in the United States. This article outlines the recommended measures of care for this particular subpopulation, including pain management, behavioral health considerations, strategies for rehabilitation for various levels and variations of multiple limb loss, and the assistive technology and adaptive equipment that might be available for these individuals to best enable them to continue healthy, fulfilling lives following

  20. Adenite equina: sua etiologia, diagnóstico e controle Strangles: etiology, diagnosis and control

    Directory of Open Access Journals (Sweden)

    Carina Martins de Moraes


    Full Text Available A adenite equina, também conhecida como garrotilho, é uma enfermidade bacteriana contagiosa, causada por Streptococcus equi, subsp. equi, bactéria β hemolítica do grupo C de Lancefield, que afeta o trato respiratório anterior de equinos de todas as idades, com maior prevalência entre um e cinco anos de idade. Caracteriza-se por produzir secreção mucopurulenta das vias aéreas anteriores e linfadenite dos gânglios retrofaríngeos e submandibulares com formação de abscessos. Fatores de virulência de S. equi, subsp. equi, incluem cápsula de ácido hialurônico, hialuronidase, estreptolisina O, estreptoquinase, receptores para Fc de IgG, peptidoglicano e proteína M. Dentre esses fatores, a proteína M tem especial importância por ser de membrana com propriedades antifagocitárias e de aderência. A doença tem baixa letalidade e alta morbidade e seus prejuízos econômicos devem-se à perda de performance e custo do tratamento. O diagnóstico clínico e o tratamento não apresentam dificuldades, mas a profilaxia é prejudicada pela baixa eficiência das vacinas disponíveis, com índices de proteção de 50%. O garrotilho pode ocorrer em todas as épocas do ano, mas o frio e a umidade facilitam a sobrevivência do agente e sua disseminação, portanto animais que vivem nos estados mais frios e úmidos do país são mais vulneráveis à infecção. Novas vacinas utilizando antígenos purificados ou de subunidades estão sendo desenvolvidas com a finalidade de incrementar sua potência e evitar efeitos indesejáveis. A comprovação de diferenças de antigenicidade, entre estirpes, alerta sobre a importância da seleção apropriada das cepas vacinais.Strangles is a contagious disease of the respiratory tract of horses produced by Streptococcus equi subsp. equi, a Lancefield's group C β haemolytic bacterium. It produces a mucopurulent secretion of the anterior airways, as well as lymphadenitis and abscesses. The bacteria synthesizes several pathogenicity factors such a hyaluronic acid capsule, hyaluronidase, streptolisin O, streptokinase, IgG Fc receptors, peptidoglican and protein M. Among these factors, protein M deserves special importance due to its antifagocitic and adherence properties. The disease has high morbidity and low lethality, and produces economic losses due to low performance and treatment. Clinical diagnosis and treatment are done easily, but prophylaxis is hampered by the low potency of vaccines, that protect around 50 % of vaccinated animals. Strangles may occur during all the year, but cold and humid weather favors the survival of streptococci, making animals that live in regions with those characteristics more prone to infection. New vaccines using purified or subunit antigens have been developed aiming to increase their potency and to avoid undesirable side effects. The demonstration that bacteria strains show differences in their antigenicity, called attention on the selection of appropriate strains to use as antigens.

  1. 40 CFR 144.4 - Considerations under Federal law. (United States)


    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Considerations under Federal law. 144... (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM General Provisions § 144.4 Considerations under Federal law. The following is a list of Federal laws that may apply to the issuance of permits under these...

  2. Ball python nidovirus: a candidate etiologic agent for severe respiratory disease in Python regius. (United States)

    Stenglein, Mark D; Jacobson, Elliott R; Wozniak, Edward J; Wellehan, James F X; Kincaid, Anne; Gordon, Marcus; Porter, Brian F; Baumgartner, Wes; Stahl, Scott; Kelley, Karen; Towner, Jonathan S; DeRisi, Joseph L


    A severe, sometimes fatal respiratory disease has been observed in captive ball pythons (Python regius) since the late 1990s. In order to better understand this disease and its etiology, we collected case and control samples and performed pathological and diagnostic analyses. Electron micrographs revealed filamentous virus-like particles in lung epithelial cells of sick animals. Diagnostic testing for known pathogens did not identify an etiologic agent, so unbiased metagenomic sequencing was performed. Abundant nidovirus-like sequences were identified in cases and were used to assemble the genome of a previously unknown virus in the order Nidovirales. The nidoviruses, which were not previously known to infect nonavian reptiles, are a diverse order that includes important human and veterinary pathogens. The presence of the viral RNA was confirmed in all diseased animals (n = 8) but was not detected in healthy pythons or other snakes (n = 57). Viral RNA levels were generally highest in the lung and other respiratory tract tissues. The 33.5-kb viral genome is the largest RNA genome yet described and shares canonical characteristics with other nidovirus genomes, although several features distinguish this from related viruses. This virus, which we named ball python nidovirus (BPNV), will likely establish a new genus in Torovirinae subfamily. The identification of a novel nidovirus in reptiles contributes to our understanding of the biology and evolution of related viruses, and its association with lung disease in pythons is a promising step toward elucidating an etiology for this long-standing veterinary disease. Ball pythons are popular pets because of their diverse coloration, generally nonaggressive behavior, and relatively small size. Since the 1990s, veterinarians have been aware of an infectious respiratory disease of unknown cause in ball pythons that can be fatal. We used unbiased shotgun sequencing to discover a novel virus in the order Nidovirales that was

  3. Operative considerations for rectovaginal fistulas

    Institute of Scientific and Technical Information of China (English)

    Kevin; R; Kniery; Eric; K; Johnson; Scott; R; Steele


    To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas.

  4. Sepsis in AIDS patients: clinical, etiological and inflammatory characteristics

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    João Manoel Silva


    Full Text Available Introduction: Intensive care mortality of HIV-positive patients has progressively decreased. However, critically ill HIV-positive patients with sepsis present a worse prognosis. To better understand this condition, we propose a study comparing clinical, etiological and inflammatory data, and the hospital course of HIV-positive and HIV-negative patients with severe sepsis or septic shock. Methods: A prospective observational study enrolling patients with severe sepsis or septic shock associated or not with HIV infection, and admitted to intensive care unit (ICU. Clinical, microbiological and inflammatory parameters were assessed, including C-reactive protein (CRP, procalcitonin (PCT, interleukin-6, interleukin-10 and TNF-α. Outcome measures were in-hospital and six-month mortality. Results: The study included 58 patients with severe sepsis/septic shock admitted to ICU, 36 HIV-positive and 22 HIV-negative. All HIV-positive patients met the criteria for AIDS (CDC/2008. The main foci of infection in HIV-positive patients were pulmonary and abdominal (p=0.001. Fungi and mycobacteria were identified in 44.4% and 16.7% of HIV-positive patients, respectively. In contrast, the main etiologies for sepsis in HIV-negative patients were Gram-negative bacilli (36.4% and Gram-positive cocci (36.4% (p=0.001. CRP and PCT admission concentrations were lower in HIV-positive patients (130 vs. 168 mg/dL p=0.005, and 1.19 vs. 4.06 ng/mL p=0.04, respectively, with a progressive decrease in surviving patients. Initial IL-10 concentrations were higher in HIV-positive patients (4.4 pg/mL vs. 1.0 pg/mL, p=0.005, with moderate accuracy for predicting death (area under receiver-operating characteristic curve =0.74. In-hospital and six-month mortality were higher in HIV-positive patients (55.6 vs. 27.3% p=0.03, and 58.3 vs. 27.3% p=0.02, respectively. Conclusions: The course of sepsis was more severe in HIV-positive patients, with distinct clinical, etiological and

  5. Clinical Etiologies of Fever of Unknown Origin in 500 Cases. (United States)

    Jun-Cai, T U; Ping, Zhou; Xiao-Juan, L I; Ying, Sun; Hui-Yuan, S I; Chun-Wei, Wang; Shou-Lei, Han; Fei-Yun, Zhu


    To investigate the distribution and change of the causes of fever of unknown origin(FUO). The clinical data of 500 inpatients with FUO in our center between December 2003 and June 2014 were retrospectively analyzed. The diagnostic methods,etiologies,and their possible relationship with age,sex,fever duration,and period. Of these 500 FUO patients,452(90.4%)were confirmed to be with fever caused by conditions including infectious diseases [(n=231,46.2%;e.g.tuberculosis(32.9%,76/231)],connective tissue diseases(CTD)(n=99,19.8%),neoplasms(n=58,11.6%),miscellaneous causes(n=64,12.8%). The causes were not identified in 48 cases(9.6%).The proportion of CTD in female patients was significantly higher than that in male patients(26.3% vs. 14.5%,P=0.025),whereas the proportion of neoplasms in male patients was significantly higher than that in female patients(14.5% vs. 8.0%,P=0.001). Infectious diseases was the most common cause in all age groups,CTD ranked the second in the 21-39-year group and 40-59-year group,and neoplasm was the second most coomon cause in the over 60 year group. Thus,the distribution of FUO etiologies significantly differed in different age groups(χ(2)=43.10,P=0.000). The duration of fever in patients with neoplasms [60(28,90)d] was longer than that in patients with infectious diseases [28(21,42)d,Z=-4.168,P=0.000] or CTD [30(21,60)d,Z=-2.406,P=0.016)]. Compared with the level in 2003-2008,the proportion of CTD significantly increased in 2009-2014(13.7% vs. 23.8%,χ(2)=8.598,P=0.003),along with the dicrease of the proportions of infectious diseases,neoplasms and miscellaneous diseases were decreased(all P>0.05). Infectious diseases(in particular,tuberculosis)remains the major cause of FUO. CTD and neoplasms also play important roles in the development of FUO. The distributions of the FUO etiologies have certain differences in terms of age,sex,duration of fever,and period.

  6. Modern views on etiology and pathogenesis of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    А.V. Kutsak


    Full Text Available Aim. To analyze the specialized scientific literature for data generalization concerning current views on etiology and pathogenesis of Parkinson's disease (PD. PD is a chronic progressive CNS disease, mainly associated with degeneration of brain’s dopamine-producing neurons, motor and non-motor violations and resulting in persistent disability. Although the PD is the most studied disease among all parkinsonism disorders, there is no consensus on its nature until now. The basis of PD pathomorphology and neurological degeneration is a violation of a-synuclein protein with Lewy’s bodies accumulation in the cells. The formation of pathological a-synuclein is connected with features of genotype, environmental agents and internal processes in the body. The review presents the current data about etiological and pathogenic mechanisms of PD development. Special attention is paid to the role of genetics, the influence of exogenous agents and the basic factors in the pathogenesis of the disease. Conclusions. A number of questions of PD etiology and pathogenesis are not quite certain for today. Pathogenetic mechanism of degeneration in PD is heterogeneous: mitochondrial dysfunction, oxidative stress, of proteolytic functions violations (ubiquitin-proteasome system. The reasons which start the degenerative process are varied, and can be both external and internal, as well as their interaction also is possible, which determines the probability of PD development. Sporadic forms of PD pathogenesis are noticeably different from disease with hereditary predisposition. Verification of risk factors if genes predisposing to the disease development are present has a key role for the complex preventive measures formation in patients with a predisposition to the disease. Despite the fact that genetics has the primary importance in the process initiation for persons with a family history, varied clinical scenario of PD with the presence of identical genetic

  7. Etiology of stillbirth at term: a 10-year cohort study. (United States)

    Walsh, Colin A; Vallerie, Amy M; Baxi, Laxmi V


    To examine etiological factors contributing to cases of intrauterine fetal demise in term pregnancies over a 10-year period. This was a retrospective cohort analysis of 29 908 term (37(+0) to 41(+6) weeks gestation) infants delivering in a single tertiary-referral university institution over the 10-year period from 1996 to 2005. Cases of stillbirth were identified from a computerized hospital database, and pathological, clinical, and biochemical data were reviewed for all cases. Trends were analyzed using the Cusick test for trend. Categorical data were analyzed using the Fisher's exact test, with the 5% level considered significant. The incidence of intrauterine fetal demise at term was 1.8 per 1000 at-risk pregnancies. There was no significant downward trend in the rate of term stillbirth between 1996 and 2005 (p = 0.0808). Stillbirths were unexplained in 51% of cases, although in many cases a possible etiological factor was identified but not necessarily proven. There was a significant downward trend in the incidence of unexplained term stillbirths at our institution over the 10-year study period (p = 0.0105). Placental/cord factors accounted for 25% of term stillbirths and did not decrease significantly over the study period (p = 0.0953). Almost 50% of term stillbirths occurred in women who registered late or had no antenatal care. However, suboptimal antenatal care was not predictive of differences in either acceptance of perinatal postmortem or successful identification of stillbirth etiology. The incidence of stillbirth at term is 2 per 1000 term pregnancies and has not changed significantly in the past 10 years. Almost 50% of term stillbirths occurred in women with suboptimal antenatal care. More than half of cases are unexplained, often resulting from an incomplete diagnostic work-up. Despite this, there has been a significant downward trend in the rates of unexplained stillbirth at term. It is imperative that a complete diagnostic work-up is performed in

  8. [Current views on etiology, pathophysiology and clinical manifestations of acromegaly]. (United States)

    Krysiak, Robert; Okopień, Bogusław; Marek, Bogdan


    Acromegaly is a relatively rare disease caused by excess secretion of growth hormone, usually from a pituitary somatotrope adenoma. Most of the tumors causing acromegaly are sporadic but in some cases the disease results from the presence of an inherited endocrine syndrome including type 1 multiple endocrine neoplasia, McCune-Albright syndrome and Carney complex. Because of the slow evolution of signs and symptoms, acromegaly can be a diagnostic challenge. The disease is characterised by significantly increased morbidity and mortality, both of which are secondary to the involvement of multiple organ systems. This prompts the need for the rapid and accurate recognition and management of this disorder. Acromegaly is diagnosed on the basis of clinical picture, hormonal assays and radiologic imaging of the pituitary gland. This article reviews the etiology, histopathological picture, clinical features and current diagnostic strategies in acromegaly and prognosis in this disorder.

  9. Supernumerary ring chromosome: an etiology for Pallister-Killian syndrome? (United States)

    Lloveras, E; Canellas, A; Cirigliano, V; Català, V; Cerdan, C; Plaja, A


    Characterization of marker chromosomes before the introduction of array CGH (aCGH) assays was only based on their banding patterns (G, C, and NOR staining) and fluorescent in situ hybridization techniques. The use of aCGH greatly improves the identification of marker chromosomes in some cases. We describe an atypical case of Pallister-Killian syndrome (PKS) detected at prenatal diagnosis with a very unusual cytogenetic presentation: a supernumerary ring chromosome including two copies of 12p. A similar anomaly described in a postnatal patient suggests ring chromosome as a possible cause of PKS. Extra ring chromosomes might be a more common etiology for PKS than previously thought, given the difficulty in their characterization before the advent of aCGH.

  10. Etiology, pathophysiology and classifications of the diabetic Charcot foot

    Directory of Open Access Journals (Sweden)

    Nikolaos Papanas


    Full Text Available In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, increasing the risk of foot ulceration. The most common anatomical classification describes five patterns, according to the localization of bone and joint pathology. This review article aims to provide a brief overview of the diabetic Charcot foot in terms of etiology, pathophysiology, and classification.

  11. Etiology, pathophysiology and classifications of the diabetic Charcot foot. (United States)

    Papanas, Nikolaos; Maltezos, Efstratios


    In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, increasing the risk of foot ulceration. The most common anatomical classification describes five patterns, according to the localization of bone and joint pathology. This review article aims to provide a brief overview of the diabetic Charcot foot in terms of etiology, pathophysiology, and classification.

  12. Prevalence and etiology of nosocomial diarrhoea in children hospital. (United States)

    Alrifai, S B; Alsaadi, A; Mahmood, Y A; Ali, A A; Al-Kaisi, L A


    A cross-sectional hospital-based study was carried out at Tikrit teaching hospital, Iraq, from October 2004 to September 2005, to identify the prevalence and etiology of nosocomial infectious diarrhoea among children under 5 years of age. Of 259 children admitted to the paediatric ward for reasons other than diarrhoea and hospitalized for more than 3 days, clinical and laboratory analysis of stool samples showed nosocomial diarrhoea in 84 children (32.4%). The most common causative agents were enteropathogenic Escherichia coli (25.9%), Clostridium difficile (21.0%) and rotavirus (18.5%). Single infectious agents caused 63.1% of the cases, while mixed infections were detected in 16.7%; in 20.2% of children the cause remained unknown.

  13. Budd-Chiari syndrome: Etiology, pathogenesis and diagnosis (United States)

    Aydinli, Musa; Bayraktar, Yusuf


    Budd-Chiari syndrome is a congestive hepatopathy caused by blockage of hepatic veins. This syndrome occurs in 1/100 000 in the general population. Hypercoagulable state could be identified in 75% of the patients; more than one etiologic factor may play a role in 25% of the patients. Primary myeloproliferative diseases are the leading cause of the disease. Two of the hepatic veins must be blocked for clinically evident disease. Liver congestion and hypoxic damage of hepatocytes eventually result in predominantly centrilobular fibrosis. Doppler ultrasonography of the liver should be the initial diagnostic procedure. Hepatic venography is the reference procedure if required. Additionally liver biopsy may be helpful for differential diagnosis. The prognosis of the chronic form is acceptable compared to other chronic liver diseases. PMID:17569137

  14. Budd-Chiari syndrome: Etiology, pathogenesis and diagnosis

    Institute of Scientific and Technical Information of China (English)

    Musa Aydinli; Yusuf Bayraktar


    Budd-Chiari syndrome is a congestive hepatopathy caused by blockage of hepatic veins. This syndrome occurs in 1/100000 in the general population. Hypercoagulable state could be identified in 75% of the patients; more than one etiologic factor may play a role in 25% of the patients. Primary myeloproliferative diseases are the leading cause of the disease. Two of the hepatic veins must be blocked for clinically evident disease. Liver congestion and hypoxic damage of hepatocytes eventually result in predominantly centrilobular fibrosis. Doppler ultrasonography of the liver should be the initial diagnostic procedure. Hepatic venography is the reference procedure if required. Additionally liver biopsy may be helpful for differential diagnosis. The prognosis of the chronic form is acceptable compared to other chronic liver diseases.

  15. Oral Anaerobic Bacteria in the Etiology of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Mesut Öğrendik


    Full Text Available Ankylosing spondylitis (AS is associated with periodontitis. Anti– Porphyromonas gingivalis and anti– Prevotella intermedia antibody titers were higher in patients with spondyloarthritis than in healthy people. Sulfasalazine is an effective antibiotic treatment for AS. Moxifloxacin and rifamycin were also found to be significantly effective. The etiology hypothesis suggests that oral anaerobic bacteria such as Porphyromonas spp and Prevotella spp contribute to the disease. These bacteria have been identified in AS, and we will discuss their pathogenic properties with respect to our knowledge of the disease. Periodontal pathogens are likely to be responsible for the development of AS in genetically susceptible individuals. This finding should guide the development of more comprehensive and efficacious treatment strategies for AS.

  16. Issues in etiology and diagnosis making of chyluria

    Directory of Open Access Journals (Sweden)

    D Dalela


    Full Text Available Chyluria, the passage of intestinal lymph in urine is common in the rural and economically weaker population of our country. Etiologically it has been classified as parasitic and nonparasitic (rare. By far the most important and most common cause effect relationship of chyluria is with Wuchereria bancrofti. The issues in diagnosis making of chyluria include: confirmation of chyluria, localization of site of leakage in urinary tract, identifying the cause of chyluria and assessing as to how bad is the disease? A number of biochemical and radiological diagnostic tests are available for the same. Since this is ′a disease of the poor′, there is a need to modify the approach of diagnostic evaluation and therapeutic protocols in order to curtail the overall cost of treatment.

  17. Portal hypertension due to portal venous thrombosis: Etiology, clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    Ozgur Harmanci; Yusuf Bayraktar


    The thrombophilia in adult life has major implications in the hepatic vessels. The resulting portal vein thrombosis has various outcomes and complications. Esophageal varices, portal gastropathy, ascites, severe hypersplenism and liver failure needing liver transplantation are known well. The newly formed collateral venous circulation showing itself as pseudocholangicarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of portal vein thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we present and discuss the portal vein thrombosis, etiology and the resulting clinical pictures. There are controversial issues in nomenclature,management (including anticoagulation problems), follow up strategies and liver transplantation. In the light of the current knowledge, we discuss some controversial issues in literature and present our experience and our proposals about this group of patients.

  18. Etiology and Diagnosis of Major Depression - A Novel Quantitative Approach

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.


    Background: Classical psychiatric opinions are relative uncertain and treatment results are not impressive when dealing with major depression. Depression is related to the endocrine system, but despite much effort a good quantitative measure for characterizing depression has not yet emerged...... we compare the O-index with opinions reach by classical psychiatric diagnostic procedure (sensitivity 83%, specificity 59%, likelihood ratio positive 2.0, and likelihood ratio negative 0.29). The O-index nicely refines the etiology of depression: Combined with clinical data for 29 subjects earlier...... reported three categories emerge (p = 4.4 × 10-13): hypocortisolemic depressed, non-depressed, and hypercotisolemic depressed. The O-index also reveals why it has been difficult to obtain good markers earlier. It explains that healthy subjects may have an elevated (suppressed) level of cortisol or ACTH...

  19. Etiology of cicatricial alopecias: a basic science point of view. (United States)

    McElwee, Kevin J


    This article presents a short summary of our current knowledge of cicatricial alopecia disease pathogenesis and the hypothetical disease mechanisms that may be involved in scarring alopecia development. Several forms of scarring alopecia likely involve targeted cytotoxic action against hair follicle cells mediated by a folliculocentric inflammation. However, the specific nature of the inflammatory interference in hair follicle growth is open to question. A popular hypothesis of lymphocyte-mediated scarring alopecia development involves autoimmune targeting of hair follicle-specific self-antigens, although there is no direct evidence in support of such a view. Alternative hypotheses focus on defects in sebaceous gland function, destruction of hair follicle stem cells, and interference in the communication between hair follicle mesenchyme and epithelium. Many questions arise from these hypotheses, and addressing them with a systematic research approach may enable significant advances in understanding cicatricial alopecia etiology.

  20. Carotenemia in mentally retarded children I. Incidence and etiology (United States)

    Patel, H.; Dunn, H. G.; Tischler, B.; McBurney, A. Karaa


    The incidence and etiology of carotenemia in mentally retarded children were examined. Fasting serum carotenoid and vitamin A levels were measured in 77 profoundly mentally retarded children aged 3 to 19 years who were receiving a standard diet containing 2000 IU of carotene (expressed in terms of vitamin A activity) and supplemented by 2000 IU of vitamin A daily. Seventeen of the 77 patients had serum carotenoid levels of more than 300 μg./ml. The particulate size of food had a significant inverse relationship to serum carotenoid levels and was an important factor in determining carotenemia. The serum vitamin A level was also higher in children on homogenized diet than in those on pureed feeds, while the lowest level was noted among patients on a chopped diet. Besides particulate size of food, other factors may also be operative in determining carotenemia. PMID:4707231

  1. MicroRNA-33 in atherosclerosis etiology and pathophysiology. (United States)

    Chen, Wu-Jun; Zhang, Min; Zhao, Guo-Jun; Fu, Yuchang; Zhang, Da-Wei; Zhu, Hai-Bo; Tang, Chao-Ke


    MicroRNAs are a group of endogenous, small non-coding RNA molecules that can induce translation repression of target genes within metazoan cells by specific base pairing with the mRNA of target genes. Recently, microRNA-33 has been discovered as a key regulator in the initiation and progression of atherosclerosis. This review highlights the impact of microRNA-33-mediated regulation in the major cardiometabolic risk factors of atherosclerosis including lipid metabolism (HDL biogenesis and cholesterol homeostasis, fatty acid, phospholipid and triglyceride, bile acids metabolism), inflammatory response, insulin signaling and glucose/energy homeostasis, cell cycle progression and proliferation, and myeloid cell differentiation. Understanding the etiology and pathophysiology of microRNA-33 in atherosclerosis may provide basic knowledge for the development of novel therapeutic targets for ameliorating atherosclerosis and cardiovascular disease.

  2. Epidemiology and etiology of ovarian cancer: a review

    Energy Technology Data Exchange (ETDEWEB)

    Heintz, A.P.; Hacker, N.F.; Lagasse, L.D.


    Ovarian cancer is the most frequent cause of death from gynecologic malignancies in the western world. Much effort has been put into attempts to correlate differences in incidence rates with environmental, endocrinologic, and genetic factors. A review of the literature reveals that there is currently no evidence to incriminate any single etiologic factor for this group of tumors. There is growing evidence of familial predisposition in a small group of patients and of a relationship with reproductive history. If current knowledge of the epidemiology of ovarian cancer is to be translated into disease prevention, more attention should be paid to women at risk because of their family history, and more awareness should be made of the protective effect of oral contraceptives. 79 references.

  3. Giant scrotal elephantiasis of inflammatory etiology: a case report

    Directory of Open Access Journals (Sweden)

    Denzinger Stefan


    Full Text Available Abstract Background Scrotal lymphedema is rare outside endemic filariasis regions in Africa and Asia. It is of variable origin in the western world. Case presentation We present a case of a 40-year-old European man with massive elephantiasis of the scrotum attributed to chronic inflammation of the lower urinary tract caused by urinary outlet obstruction and diabetes mellitus. The patient underwent subtotal scrotectomy saving penis, testes and spermatic cords and followed by scrotal reconstruction with adequate cosmetic and functional outcome. Conclusion In this report we discuss a rare case of scrotal elephantiasis in an European patient, reflect on the etiology and the diagnostic and therapeutic approaches. Surgery can be successful even in giant scrotal elephantiasis.

  4. A critique of the literature on etiology of eating disorders. (United States)

    Rikani, Azadeh A; Choudhry, Zia; Choudhry, Adnan M; Ikram, Huma; Asghar, Muhammad W; Kajal, Dilkash; Waheed, Abdul; Mobassarah, Nusrat J


    The development of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and atypical eating disorders that affect many young women and even men in the productive period of their lives is complex and varied. While numbers of presumed risk factors contributing to the development of eating disorders are increasing, previous evidence for biological, psychological, developmental, and sociocultural effects on the development of eating disorders have not been conclusive. Despite the fact that a huge body of research has carefully examined the possible risk factors associated with the eating disorders, they have failed not only to uncover the exact etiology of eating disorders, but also to understand the interaction between different causes of eating disorders. This failure may be due complexities of eating disorders, limitations of the studies or combination of two factors. In this review, some risk factors including biological, psychological, developmental, and sociocultural are discussed.

  5. Achalasia: A Review of Etiology, Pathophysiology, and Treatment

    Directory of Open Access Journals (Sweden)

    Nor Hedayanti


    Full Text Available Achalasia was a condition marked by peristaltic movement absent in lower esophageal sphincter and segment that hypertonic result in imperfect relaxation during food ingestion. Achalasia incidence did not differ between men and women, account for 1 in 100.000 people every year with prevalence of 10 in 100.000 people, unrelated specifically with ethnic, and has its highest incidence on 30-60 age group. Based on its etiology, it was divided into primary and secondary Achalasia, while based on its motility, it was into hypermotil, hypomotil, and amotil Achalasia. Until present, several therapeutic modalities were available to treat Achalasia, among them was pharmacology therapy, botulinum toxin injection via endoscopy, pneumatic dilatation, Heller myotomy surgery, and Per Oral Endoscopy Myotomy (POEM.

  6. [Neuropediatrics: epidemiological features and etiologies at the Dakar neurology service]. (United States)

    Ndiaye, M; Sene-Diouf, F; Diop, A G; Ndao, A K; Ndiaye, M M; Ndiaye, I P


    Child neurology is a relatively young speciality of neurosciences which is at the frontier of Neurology and Paediatrics. Its development has been impulsed by the diagnosis techniques such as Neurobiology, Genetics, Neuroimaging and pedo-psychology. We conducted a retrospective survey among the in-patients from January 1980 to December 1997 in the service of Neurology of the University Hospital. Have been included children ranged from 0 to 15 years old without any racial, sexual or origin distinctive. In Neurology Department, children of 0 to 15 years old represent 10.06% of the in-patients received from 1980 to 1997. The mortality rate was 9.23%. The diseases are dominated by epilepsy and infantile encephalopathies with 31.02%, infectious diseases with 19.36% represented by tuberculosis, other bacterial, viral and parasitical etiologies, tumors with 10.36%, vascular pathology and degenerative disorders.

  7. Thyroid Storm in Postoperative Delirium Etiology: Case Report

    Directory of Open Access Journals (Sweden)

    Nermin Kelebek Girgin


    Full Text Available Delirium is an acute organic brain syndrome of different physical and pathophysiological etiologies characterized by a disturbance in consciousness with accompanying change in cognition. Delirium causes prolonged length of stay in hospital and intensive care unit, also increased morbidity and mortality. Thyroid storm is a severe, life-threatening type of thyrotoxicosis and is one of a few endocrine disorders that cause delirium. It is mostly occured suddenly after acute infection, surgical stress or trauma. This condition occurs due to excess production of thyroid hormone and 20-50% mortality rate depends on early diagnosis and treatment. In this study it was aimed to present the diagnosis and treatment of a previously unknown hyperthyroid patient who underwent suspension laryngoscopy under general anesthesia and was post-operatively admitted to the intensive care unit because of pulmonary edema and proceeded to develop severe delirium caused by hyrotoxicosis.

  8. An approach to the etiology of metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Angélica M Muñoz


    Full Text Available Increased prevalence of obesity in the world, especially accumulation of abnormal amounts of visceral fat predisposes to insulina resistance, which is the central role of metabolic syndrome (MS. Obesity can deregulate the intracellular signaling of insulina due to the production of inflammatory substances, chemo attractant proteins, adipokines and molecules that trigger hormonal mediator potentials for destabilization of signal transduction, leading to metabolic disorders such as hyperglycemia, hypertension, and dyslipidemia. The complexity of the MS and of the genetic mechanisms involved in its etiology derives from the combination of variants on genes involved and environmental factors that predispose it. The purpose of this paper is to review the effects of obesity in molecular and biochemical responses that trigger insulin resistance and its relation to some candidate genes and the ancestral component of the population.

  9. Ulnar drift in rheumatoid arthritis: a review of biomechanical etiology. (United States)

    Morco, Stephanie; Bowden, Anton


    The objective of this article is to summarize current understanding of biomechanical factors that cause ulnar drift in the hands of patients with rheumatoid arthritis. This was done through literature review of published articles on the mechanical etiology of ulnar drift. There are several theories regarding the cause of ulnar drift, however conclusive evidence is still lacking. Current mechanical factors that are postulated to play a role include: failure of the collateral ligaments, intra-articular pressure changes, degenerative changes in the carpal and metacarpal anatomy, muscle hypoxia induced changes in wrist tension, and exacerbating activities of daily living. Although current theories regarding ulnar drift almost universally include an at least partially mechanical rationale, the causes may be multifactorial. Significantly more research is needed to elucidate the relative importance of mechanical factors leading to significant ulnar drift concurrent with advanced rheumatoid arthritis.

  10. Renal cell carcinoma: Review of etiology, pathophysiology and risk factors. (United States)

    Petejova, Nadezda; Martinek, Arnost


    The global incidence of renal cell cancer is increasing annually and the causes are multifactorial. Early diagnosis and successful urological procedures with partial or total nephrectomy can be life-saving. However, only up to 10% of RCC patients present with characteristic clinical symptoms. Over 60% are detected incidentally in routine ultrasound examination. The question of screening and preventive measures greatly depends on the cause of the tumor development. For the latter reason, this review focuses on etiology, pathophysiology and risk factors for renal neoplasm. A literature search using the databases Medscape, Pubmed, UpToDate and EBSCO from 1945 to 2015. Genetic predisposition/hereditary disorders, obesity, smoking, various nephrotoxic industrial chemicals, drugs and natural/manmade radioactivity all contribute and enviromental risks are a serious concern in terms of prevention and the need to screen populations at risk. Apropos treatment, current oncological research is directed to blocking cancer cell division and inhibiting angiogenesis based on a knowledge of molecular pathways.

  11. Two cases of nephrotic syndrome with different etiologies

    Directory of Open Access Journals (Sweden)

    Sanjay K Mandal


    Full Text Available There are various causes of secondary nephrotic syndrome. Finding an underlying etiology in a case of nephrotic syndrome or subnephrotic range proteinuria can markedly alter the therapeutic options and disease course. We describe two cases of secondary nephrotic syndrome. The first case was a 22-year-old male with pulmonary tuberculosis with nephrotic syndrome secondary to renal amyloidosis, whereas the second case was a 17-year-old male with chronic hepatitis B-associated nephrotic syndrome. It is important, especially in developing countries, to be aware that tuberculosis and infections like hepatitis B, C, etc. continue to be part of the differential diagnosis of secondary nephrotic syndrome in adolescents and young adults.

  12. Halitosis: Current concepts on etiology, diagnosis and management (United States)

    Kapoor, Uditi; Sharma, Gaurav; Juneja, Manish; Nagpal, Archna


    Halitosis or oral malodor is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment. A patient with halitosis is most likely to contact primary care practitioner for the diagnosis and management. With proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach for each patient seeking assistance. It is significant to highlight the necessity of an interdisciplinary method for the treatment of halitosis to prevent misdiagnosis or unnecessary treatment. The literature on halitosis, especially with randomized clinical trials, is scarce and additional studies are required. This article succinctly focuses on the development of a systematic flow of events to come to the best management of the halitosis from the primary care practitioner's point of view. PMID:27095913

  13. Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention. (United States)

    Tomasetti, Cristian; Li, Lu; Vogelstein, Bert


    Cancers are caused by mutations that may be inherited, induced by environmental factors, or result from DNA replication errors (R). We studied the relationship between the number of normal stem cell divisions and the risk of 17 cancer types in 69 countries throughout the world. The data revealed a strong correlation (median = 0.80) between cancer incidence and normal stem cell divisions in all countries, regardless of their environment. The major role of R mutations in cancer etiology was supported by an independent approach, based solely on cancer genome sequencing and epidemiological data, which suggested that R mutations are responsible for two-thirds of the mutations in human cancers. All of these results are consistent with epidemiological estimates of the fraction of cancers that can be prevented by changes in the environment. Moreover, they accentuate the importance of early detection and intervention to reduce deaths from the many cancers arising from unavoidable R mutations.

  14. [The etiology and pathogenesis of sporadic inclusion body myositis]. (United States)

    Murata, Ken-Ya; Ito, Hidefumi


    Sporadic inclusion body myositis (sIBM) is the most common acquired muscle disease in older individuals. Muscle weakness and atrophy in the quadriceps, wrist flexor, and finger flexors are the typical clinical findings in sIBM. The etiology and pathogenesis of sIBM are still poorly understood; however, genetic factors, aging, and environmental factors might possibly play a role. The pathological characteristics of sIBM include two unique features: inflammatory changes in muscle fibers, and cytoplasmic and intranuclear inclusions containing several Alzheimer-type proteins. Based on these pathological findings, there is a continuing debate on whether sIBM is primarily a T cell-mediated inflammatory myositis or a myodegenerative disorder characterized by abnormal protein aggregation, presence of inclusions bodies, and secondary inflammation. Unfortunately, sIBM is also generally refractory to immune therapy.

  15. [Ulcer disease: challenging problems of etiology, pathogenesis, differential treatment]. (United States)

    Tsimmerman, Ia S


    This review summarizes the data of Russian and foreign authors as well as the results of original studies on etiology pathogenesis, and differential treatment of ulcer disease (UD). The author's original concepts of UD pathogenesis and relations between man and Helicobacter pylori are discussed. The pathogenetic role of disturbances in the system of gastroduodental self-regulatory function and psychosomatic mechanisms as well as immune deficiency and impaired antioxidatve protection is considered. Peculiarities and results of UD eradication therapy intended to eliminate H. pylori infection are described. The importance of the choice of the UD treatment strategy on an individual basis is emphasized as opposed to the use of universal standards and therapeutic modalities influencing only local pathogenic factors, such as acidopeptic ones and H. pylori infection.

  16. Osteonecrosis of the femoral head: Etiology, imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Malizos, Konstantinos N. [Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St., 41222 Larissa (Greece)]. E-mail:; Karantanas, Apostolos H. [Department of Radiology, University of Crete, Heraklion (Greece); Varitimidis, Sokratis E. [Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St., 41222 Larissa (Greece); Dailiana, Zoe H. [Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St., 41222 Larissa (Greece); Bargiotas, Konstantinos [Department of Orthopaedic Surgery, University of Thessalia, 22 Papakiriazi St., 41222 Larissa (Greece); Maris, Thomas [Department of Medical Physics, University of Crete, Heraklion (Greece)


    Osteonecrosis of the femoral head is a disabling clinical entity affecting young adults that usually leads to destruction of the hip joint. A high index of suspicion is necessary for the diagnosis due to the insidious onset of the bone infarcts and the lack of specific clinical signs at the early stages. Many etiology-associated factors have been identified reducing thus the number of idiopathic cases. A number of joint salvaging treatment options are available if early diagnosis can be achieved. MR imaging has been proved to be a highly accurate method both for early diagnosis and for staging of the disease. Replacement of the hip joint is the last resort for pain relief and function, although non-desirable because of the young age of the affected population.

  17. Canine trypanosomiasis: etiology of infection and implications for public health

    Directory of Open Access Journals (Sweden)

    LJ Eloy


    Full Text Available Canine trypanosomiasis, caused by protozoans of the genus Trypanosoma, is divided into two primary types: the American form (Chagas disease, due to Trypanosoma cruzi infection, and the African form (sleeping sickness or surra, provoked by Trypanosomaevansi. This disease was originally enzootic and affected only wild animals, including mammals and birds, which served as reservoirs. Later, it spread to domestic animals such as horses, cattle and dogs. The disease became a zoonosis when contact between rural inhabitants and natural Trypanosoma foci occurred, due to ecological imbalances and increasing migration. Dogs are significantly involved in this context, because they are the main domestic animals and participate in the transmission and maintenance cycles of these parasites. This article reports etiological, epidemiological and public health aspects of canine trypanosomiasis, and the most important peculiarities of this zoonosis in dogs.

  18. On the Etiology of Molar-Incisor Hypomineralization. (United States)

    Vieira, Alexandre R; Kup, Elaine

    Molar-incisor hypomineralization (MIH) is a condition that is defined based on its peculiar clinical presentation. Reports on the etiology of the condition and possible risk factors are inconclusive and the original suggestion that MIH is an idiopathic condition is often cited. Our group was the first to suggest MIH has a genetic component that involves genetic variation in genes expressed during dental enamel formation. In this report, we provide a rationale to explain the preferential affection of molars and incisors. We suggest that MIH is a genetic condition based on its prevalence, which varies depending on the geographic location, and the evidence that on occasion second primary molars, permanent canines, and premolars can show signs of hypomineralization of enamel when molars and incisors are affected.


    Directory of Open Access Journals (Sweden)

    I. V. Semenova


    Full Text Available The review analyzes the current understanding of the mechanisms of formation of liver fibrosis in chronic diffuse liver diseases. The urgency and importance of the clinical evaluation of the degree of fibrosis, are shown methods of early diagnosis of liver fibrosis and its progression are offered. The modern principles of treatment of chronic hepatitis of various etiologies based on numerous clinical and experimental studies described in domestic and foreign literature are presented. Detailed description of the main directions of comprehensive treatment program with the main characteristic of causal agents and pathogenetic therapy, the aim of which is to correct the universal units of liver fibrogenesis is shown. Reversibility of liver fibrosis at an effective antiviral therapy for patients with chronic viral hepatitis is convincinglu presented. At present time Further study of clinical and immunological aspects of fibrogenesis in chronic diffuse liver diseases for the improvement of anti-fibrotic therapy remains relevant.

  20. Depression in Parkinson's disease: health risks, etiology, and treatment options. (United States)

    Frisina, Pasquale G; Borod, Joan C; Foldi, Nancy S; Tenenbaum, Harriet R


    Depression is found in about 30%-40% of all patients with Parkinson's disease (PD), but only a small percentage (about 20%) receive treatment. As a consequence, many PD patients suffer with reduced health-related quality of life. To address quality of life in depressed PD patients, we reviewed the literature on the health correlates of depression in PD (eg, cognitive function), etiology of depression in PD, and treatment options (ie, antidepressants, electroconvulsive therapy, and psychotherapy). The current review is unique in its focus on psychosocial aspects, as well as neuropathological factors, of depression in PD. Overall, we conclude that neurochemical (eg, serotonin) and psychosocial factors (eg, coping style, self-esteem, and social support) contribute to the affective disturbances found in this neuropsychiatric population. Therefore, we recommend that a multidisciplinary (eg, pharmacotherapeutic, psychoeducational, and/or psychotherapeutic) approach to treatment be taken with depressed PD patients.