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Sample records for current clinical gold

  1. Current methods for synthesis of gold nanoparticles.

    Science.gov (United States)

    Herizchi, Roya; Abbasi, Elham; Milani, Morteza; Akbarzadeh, Abolfazl

    2016-01-01

    Metal nanoparticles, such as nanoparticles synthesized using gold, have numerous uncommon chemical and physical properties due to the effects of their quantum size and their large surface area, in comparison with other metal atoms or bulk metal. Gold nanoparticles (GNPs), in particular, are very attractive because of their size and shape-dependent properties. Metal nanoparticles have gathered extensive attention due to their uncommon properties and promising applications in photonics, electronics, biochemical sensing, and imaging. This review covers recent advances in the synthesis of GNPs.

  2. Gold Nanotheranostics: Proof-of-Concept or Clinical Tool?

    Directory of Open Access Journals (Sweden)

    Pedro Pedrosa

    2015-11-01

    Full Text Available Nanoparticles have been making their way in biomedical applications and personalized medicine, allowing for the coupling of diagnostics and therapeutics into a single nanomaterial—nanotheranostics. Gold nanoparticles, in particular, have unique features that make them excellent nanomaterials for theranostics, enabling the integration of targeting, imaging and therapeutics in a single platform, with proven applicability in the management of heterogeneous diseases, such as cancer. In this review, we focus on gold nanoparticle-based theranostics at the lab bench, through pre-clinical and clinical stages. With few products facing clinical trials, much remains to be done to effectively assess the real benefits of nanotheranostics at the clinical level. Hence, we also discuss the efforts currently being made to translate nanotheranostics into the market, as well as their commercial impact.

  3. Current-voltage curves of gold quantum point contacts revisited

    DEFF Research Database (Denmark)

    Hansen, K.; Nielsen, S K.; Brandbyge, Mads;

    2000-01-01

    We present measurements of current-voltage (I-V) curves on gold quantum point contacts (QPCs) with a conductance up to 4 G(0) (G(0) = 2e(2)/h is the conductance quantum) and voltages up to 2 V. The QPCs are formed between the gold tip of a scanning tunneling microscope and a Au(110) surface under...... clean ultra-high-vacuum conditions at room temperature. The I - V curves are found to he almost linear in contrast to previous reports. Tight-binding calculations of I - V curves for one- and two-atom contacts are in excellent agreement with our measurements. On the other hand, clearly nonlinear I - V...

  4. An overview of synthetic strategies and current applications of gold nanorods in cancer treatment

    Science.gov (United States)

    Manish Lakhani, Prit; Vishnu Kiran Rompicharla, Sri; Ghosh, Balaram; Biswas, Swati

    2015-10-01

    Photothermal therapy, also referred to as optical hyperthermia or photothermal ablation, is an emerging strategy for treating solid tumours. Colloidal gold converts the absorbed light into localized heat via a non-radiative mechanism, surface plasmon resonance, which ablates the solid tumours. Several plasmon resonating nanostructures, including gold nanoparticles (AuNPs), gold nanorods (AuNRs), gold nanoshells, gold nanocages, copper sulphide and carbon nanotubes, have shown potential for photo-activated cancer therapy. Generally, spherical AuNPs display absorption maxima between 500-550 nm, making them inefficient due to low tissue penetration. On the other hand, AuNRs absorb light in the near-infrared (NIR) region that penetrates deeper with higher spatial precision, and causes no damage to the surrounding healthy tissues due to the low energy absorption of NIR light by normal tissue. Moreover, the absorption range of light can be fine-tuned to the NIR region by adjusting the aspect ratios of AuNRs. However, large-scale synthesis and stability of this colloidal system still poses challenges for clinical translation. In this review, we discuss various strategies applied up to now for the synthesis of AuNRs. Current trends in the pre-clinical development of multifunctional AuNRs with emphasis on preparation and application strategies in cancer therapy have been delineated.

  5. Enteroclysis: Current clinical value

    Science.gov (United States)

    Maataoui, Adel; Vogl, Thomas J; Jacobi, Volkmar; Khan, M Fawad

    2013-01-01

    AIM: To retrospectively analyze changes in clinical indication, referring medical specialty and detected pathology for small bowel double-contrast examinations. METHODS: Two hundred and forty-one (n = 143 females; n = 98 males; 01.01.1990-31.12.1990) and 384 (n = 225 females; n = 159 males; 01.01.2004-31.12.2010) patients underwent enteroclysis, respectively. All examinations were performed in standardized double-contrast technique. After placement of a nasojejunal probe distal to the ligament of Treitz, radiopaque contrast media followed by X-ray negative distending contrast media were administered. Following this standardized projections in all four abdominal quadrants were acquired. Depending on the detected pathology further documentation was carried out by focused imaging. Examination protocols were reviewed and compared concerning requesting unit, indication and final report. RESULTS: Two hundred and forty-one examinations in 1990 faced an average of 55 examinations per year from 2004-2010. There was an increase of examinations for gastroenterological (33.6% to 64.6%) and pediatric (0.4% to 7.8%) indications while internal (29.0% to 6.0% for inpatients and from 16.6% to 9.1% for outpatients) and surgical (12.4% to 7.3%) referrals significantly decreased. “Follow-up of Crohn’s disease” (33.1%) and “bleeding/tumor search” (15.1%) represented the most frequent clinical indications. A total of 34% (1990) and 53.4% (2004-2010) examinations yielded pathologic findings. In the period 01.01.2004 -31.12.2010 the largest proportion of pathological findings was found in patients with diagnosed Crohn’s disease (73.5%), followed by patients with abdominal pain (67.6% with history of surgery and 52.6% without history of surgery), chronic diarrhea (41.7%), suspected Crohn’s disease (39.5%) and search for gastrointestinal bleeding source/tumor (19.1%). The most common pathologies diagnosed by enteroclysis were “changes in Crohn’s disease” (25.0%) and

  6. Microbial synthesis of gold nanoparticles: current status and future prospects.

    Science.gov (United States)

    Shedbalkar, Utkarsha; Singh, Richa; Wadhwani, Sweety; Gaidhani, Sharvari; Chopade, B A

    2014-07-01

    Gold nanoparticles have been employed in biomedicine since the last decade because of their unique optical, electrical and photothermal properties. Present review discusses the microbial synthesis, properties and biomedical applications of gold nanoparticles. Different microbial synthesis strategies used so far for obtaining better yield and stability have been described. It also includes different methods used for the characterization and analysis of gold nanoparticles, viz. UV-visible spectroscopy, Fourier transform infrared spectroscopy, X ray diffraction spectroscopy, scanning electron microscopy, ransmission electron microscopy, atomic force microscopy, electron dispersive X ray, X ray photoelectron spectroscopy and cyclic voltametry. The different mechanisms involved in microbial synthesis of gold nanoparticles have been discussed. The information related to applications of microbially synthesized gold nanoparticles and patents on microbial synthesis of gold nanoparticles has been summarized.

  7. Origin of current-induced forces in an atomic gold wire: A first-principles study

    DEFF Research Database (Denmark)

    Brandbyge, Mads; Stokbro, Kurt; Taylor, Jeremy Philip;

    2003-01-01

    We address the microscopic origin of the current-induced forces by analyzing results of first principles density functional calculations of atomic gold wires connected to two gold electrodes with different electrochemical potentials. We find that current induced forces are closely related...

  8. Manganese oxides supported on gold nanoparticles: new findings and current controversies for the role of gold.

    Science.gov (United States)

    Najafpour, Mohammad Mahdi; Hosseini, Seyedeh Maedeh; Hołyńska, Małgorzata; Tomo, Tatsuya; Allakhverdiev, Suleyman I

    2015-12-01

    We synthesized manganese oxides supported on gold nanoparticles (diameter gold nanoparticles under hydrothermal conditions. In this green method Mn oxide is deposited on the gold nanoparticles. The compounds were characterized by scanning electron microscopy, energy-dispersive spectrometry, high-resolution transmission electron microscopy, X-ray diffraction, UV-Vis spectroscopy, Fourier transform infrared spectroscopy, and atomic absorption spectroscopy. In the next step, the water-oxidizing activities of these compounds in the presence of cerium(IV) ammonium nitrate as a non-oxo transfer oxidant were studied. The results show that these compounds are good catalysts toward water oxidation with a turnover frequency of 1.0 ± 0.1 (mmol O2/(mol Mn·s)). A comparison with other previously reported Mn oxides and important factors influencing the water-oxidizing activities of Mn oxides is also discussed.

  9. Current clinical approach to achalasia

    Institute of Scientific and Technical Information of China (English)

    Alexander J Eckardt; Volker F Eckardt

    2009-01-01

    Idiopathic achalasia is a rare primary motility disorder of the esophagus.The classical features are incomplete relaxation of a frequently hypertensive lower esophageal sphincter (LES) and a lack of peristalsis in the tubular esophagus.These motor abnormalities lead to dysphagia,stasis,regurgitation,weight loss,or secondary respiratory complications.Although major strides have been made in understanding the pathogenesis of this rare disorder,including a probable autoimmune mediated destruction of inhibitory neurons in response to an unknown insult in genetically susceptible individuals,a definite trigger has not been identified.The diagnosis of achalasia is suggested by clinical features and confirmed by further diagnostic tests,such as esophagogastroduodenoscopy (EGD),manometry or barium swallow.These studies are not only used to exclude pseudoachalasia,but also might help to categorize the disease by severity or clinical subtype.Recent advances in diagnostic methods,including high resolution manometry (HRM),might allow prediction of treatment responses.The primary treatments for achieving long-term symptom relief are surgery and endoscopic methods.Although limited high-quality data exist,it appears that laparoscopic Heller myotomy with partial fundoplication is superior to endoscopic methods in achieving long-term relief of symptoms in the majority of patients.However,the current clinical approach to achalasia will depend not only on patients' characteristics and clinical subtypes of the disease,but also on local expertise and patient preferences.

  10. Estimation of economic consequences of GOLD guidelines adoption in the Italian clinical practice

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2011-03-01

    Full Text Available Background: Chronic Obstructive Pulmonary Disease (COPD affects about 4.5% of the Italian population, representing one of most burdensome public health problems. Literature data report an annual health care expenditure ranging between € 1,300 and € 4,500 per patient, of which drug costs are a limited share. In 1998 the WHO started GOLD program in order to ameliorate COPD patient management. As a part of his program, periodically updated guidelines are produced with the aim of defining an efficient diagnostic-therapeutic pathway managed by a multidisciplinary team and based on the optimization of the use of drugs and diagnostic tests and the reduction of exposure to risk factors.Objective: to estimate the economic consequences of GOLD guidelines adoption in the Italian clinical practice.Methods: a decision analytic model capable of calculating the impact on the National Health Service budget of an ameliorated adherence to GOLD guidelines (GOLD GL strategy, basing on the needed variations in health care strategies on a defined patient cohort treated with the current approach (CURRENT strategy. The simulation runs on a cohort representing Italian COPD patients over 45 years who transit through 5 Markov health states (4 GOLD stages and death, according to patient characteristics (age, gender, FEV1, with a time horizon of 3 years. Stage-specific drug consumption of the CURRENT strategy is based on data of 3,113 patients collected by three Health Local Units involved in a larger clinical audit project. The consumption of other health resources, i.e. medical visits and inpatient care, is estimated based on a multicentre observational Italian study. The GOLD GL strategy includes spirometry-based staging on the totality of the simulated patients, the development of a therapeutic strategy including the redefinition of pharmacological therapy based on guideline recommendations and experts opinion, and variation of other health resources consumption

  11. Gold nanoparticle-mediated photothermal therapy: current status and future perspective.

    Science.gov (United States)

    Hwang, Sekyu; Nam, Jutaek; Jung, Sungwook; Song, Jaejung; Doh, Hyunmi; Kim, Sungjee

    2014-09-01

    Gold nanoparticles (AuNPs) are attractive photothermal agents for cancer therapy because they show efficient local heating upon excitation of surface plasmon oscillations. The strong absorption, efficient heat conversion, high photostability, inherent low toxicity and well-defined surface chemistry of AuNPs contribute to the growing interest in their photothermal therapy (PTT) applications. The facile tunability of gold nanostructures enables engineering of AuNPs for superior near-infrared photothermal efficacy and target selectivity, which guarantee efficient and deep tissue-penetrating PTT with mitigated concerns regarding side effects by nonspecific distributions. This article discusses the current research findings with representative near-infrared-active AuNPs, which include nanoshell, nanorod, nanocage, nanostar, nanopopcorn and nanoparticle assembly systems. AuNPs successfully demonstrate potential for use in PTT, but several hurdles to clinical applications remain, including long-term toxicity and a need for sophisticated control over biodistribution and clearance. Future research directions are discussed, especially regarding the clinical translation of AuNP photosensitizers.

  12. Gold Nanoparticles and Nanocomposites in Clinical Diagnostics Using Electrochemical Methods

    Directory of Open Access Journals (Sweden)

    Pranjal Chandra

    2013-01-01

    Full Text Available Progress and development in clinical diagnostics certainly focus upon the advances in the nanomaterials, particularly gold nanoparticles (AuNPs that offer promise to solve the biocompatible and sensitive detection systems. This paper focuses on the recent application of AuNPs in clinical diagnosis. Various important methods of AuNPs synthesis and their application in clinical detection of various biomolecules using electrochemical detection methods have been described. AuNPs alone and in various composites are also described based on the various biosensors design recently published for the detection of cancer biomarkers, proteins, bacteria, and cancer cells. The effect of AuNPs type and size in clinical detection has also been briefly illustrated.

  13. Current rectification in nickelocenylferrocene sandwiched between two gold electrodes.

    Science.gov (United States)

    Matsuura, Yukihito

    2013-01-07

    I present a theoretical study of the electronic transport properties of nickelocenylferrocene sandwiched between gold electrodes. Compared with the biferrocene system, the nickelocenylferrocene system had high electrical conduction and rectification in the bias range -1 to 1 V. Furthermore, the spin-down states of the nickelocenylferrocene system exhibited perfect spin-filtering properties. From the electronic states of the nickelocenylferrocene, it was found that the rectification was caused by a difference in the bias-dependent behaviors between the Fe 3d and Ni 3d orbitals.

  14. [Use of gold implants as a treatment of pain related to canine hip dysplasia--a review. Part 1: Background and current state of research regarding the effects of implanting gold in tissue].

    Science.gov (United States)

    Deisenroth, A; Nolte, I; Wefstaedt, P

    2013-01-01

    Gold-bead implantation as a method of pain treatment in dogs suffering from osteoarthritic disease is receiving increasing attention in veterinary medicine. For the present article, publications from veterinary books and journals were collected and evaluated, together with related articles in human medicine. After providing an overview of the historical use of gold and gold compounds, the technique of implanting this noble metal is introduced. The reasons for establishing the terms gold acupuncture and gold (bead) implantation are described, considering the question whether and what kind of methodological differences exist behind these terms. Next, previous publications concerning the effects of gold implantation in tissue are summarised. In 2002 it was proven that gold ions are released from the surface of gold implants by a process termed dissolucytosis. Subsequent publications further investigated details about the interaction between gold ions and tissue as well as the distribution pattern of bio-released ions. Gold compounds were previously used for chrysotherapy in human medicine until medication with fewer side effects became established. The anti-inflammatory and immuno-modulatory properties of gold compounds were used to treat rheumatoid arthritis. Current research aims to ascertain whether the anti-inflammatory and immuno-modulating effects of gold compounds are imitated by gold ions released from gold implants at a local level. In conclusion, the present review summarises important findings about the effects of gold implanted in tissue. However, further research is necessary to estimate the limitations and benefits of this auromedication.

  15. Device and methods for "gold standard" registration of clinical 3D and 2D cerebral angiograms

    Science.gov (United States)

    Madan, Hennadii; Likar, Boštjan; Pernuš, Franjo; Å piclin, Žiga

    2015-03-01

    Translation of any novel and existing 3D-2D image registration methods into clinical image-guidance systems is limited due to lack of their objective validation on clinical image datasets. The main reason is that, besides the calibration of the 2D imaging system, a reference or "gold standard" registration is very difficult to obtain on clinical image datasets. In the context of cerebral endovascular image-guided interventions (EIGIs), we present a calibration device in the form of a headband with integrated fiducial markers and, secondly, propose an automated pipeline comprising 3D and 2D image processing, analysis and annotation steps, the result of which is a retrospective calibration of the 2D imaging system and an optimal, i.e., "gold standard" registration of 3D and 2D images. The device and methods were used to create the "gold standard" on 15 datasets of 3D and 2D cerebral angiograms, whereas each dataset was acquired on a patient undergoing EIGI for either aneurysm coiling or embolization of arteriovenous malformation. The use of the device integrated seamlessly in the clinical workflow of EIGI. While the automated pipeline eliminated all manual input or interactive image processing, analysis or annotation. In this way, the time to obtain the "gold standard" was reduced from 30 to less than one minute and the "gold standard" of 3D-2D registration on all 15 datasets of cerebral angiograms was obtained with a sub-0.1 mm accuracy.

  16. Giant streaming currents measured in a gold sputtered glass microchannel array

    Science.gov (United States)

    Mansouri, Abraham; Kostiuk, Larry W.

    2016-02-01

    Pressure-driven-flow of a dilute aqueous solution in a microchannel with charged walls generates streaming currents (ionic current) and streaming potentials across the microchannel. While generation of streaming currents can be performed in network of parallel circular microchannels or unstructured porous media, accurate measurements of such currents remain a challenge. In this study a gigantic amount of streaming current was successfully generated and measured using a glass microchannel array with special gold sputtered coatings on both its ends. Streaming current as high as 0.7 mA was obtained with moderate pressure drop (124 kPa) across the glass microchannel array that consists of approximately 11 250 000 parallel microchannels with radii of 2.5 μm. Higher streaming currents are also possible to generate (scaled to 142 μA/cm2 of frontal area at a flow rate of 12 cm3/s) with potential applications in surface charge characterizations and electrokinetic power generation. In addition, apparent ζ potential of glass microchannel array surface was estimated with the aid of streaming current data and Levine-Olivare theories and an apparent ζ potential of -65 mV (0 M KCl, κa = 8) is reported.

  17. Remote ischemic conditioning: Current clinical perspectives.

    Science.gov (United States)

    Le Page, Sophie; Prunier, Fabrice

    2015-08-01

    Remote ischemic conditioning (RIC) constitutes a promising method in which a tissue or organ is exposed to intermittent ischemia/reperfusion periods enabling it to provide protection to a distant target organ. RIC has been tested in various clinical settings through its simple application by means of intermittent inflation of a blood pressure cuff placed on a limb, primarily evaluating its potential abilities to decrease myocardial injury biomarkers. Its use on other organs, such as the kidneys or brain, has recently been a topic of research. To date, no study has yet been powerful enough to reach a conclusion on the potential benefit of RIC on clinical outcomes. The future role of RIC in the clinical arena could be clarified by the large phase III trials currently underway targeting major outcomes as primary endpoints.

  18. Continuous glucose monitoring: current clinical use.

    Science.gov (United States)

    Kim, Hun-Sung; Shin, Jeong-Ah; Chang, Jin-Sun; Cho, Jae-Hyoung; Son, Ho-Young; Yoon, Kun-Ho

    2012-12-01

    Four kinds of subcutaneous continuous glucose monitoring (CGM) machines have been currently introduced in clinical practice. These machines exhibit real-time glucose on the monitor every 5 minutes and have alarms to indicate hypoglycaemia and hyperglycaemia. However, thus far, there is no clear consensus about the clinical indications for CGM in actual clinical practice. CGM should be an ideal and powerful tool for monitoring glucose variability. Glycaemic variability has become a major concern over the years with growing evidence on its detrimental impact with respect to the risk of diabetic complications. Although the HbA1c level is ubiquitously measures in clinical practice, this level does not adequately represent glycaemic variability. Currently available evidence indicates that CGM aids in lowering the HbA1c level without increasing the incidence of severe hypoglycaemic episodes in patients with type 1 diabetes. Thus far, CGM has not been indicated for preventing severe hypoglycaemia or for treating type 2 diabetes because sufficient supporting evidence has not been obtained. Promising results have been obtained for the use of CGM for pregnant women with diabetes and for patients with hospital hyperglycaemia. Predictions regarding the feasibility of the closed-loop system have proven to be optimistic. CGM-integrated communication systems using information technology such as smart phone help controlling blood glucose more easily and effectively.

  19. Immobilization and surface functionalization of gold nanoparticles monitored via streaming current/potential measurements.

    Science.gov (United States)

    Greben, Kyrylo; Li, Pinggui; Mayer, Dirk; Offenhäusser, Andreas; Wördenweber, Roger

    2015-05-14

    A streaming current/potential method is optimized and used for the analysis of the variation of the surface potential upon chemical modifications of a complex interface consisting of different organic molecules and gold nanoparticles (AuNPs). The surfaces of Si/SiO2 substrates modified with 3-aminopropyltriethoxysilane (APTES), AuNPs, and 11-amino-1-undecanethiol (aminothiols) are analyzed via pH and time dependent ζ potential measurements that reveal the stability and modification of the surface and identify crucial parameters for each individual preparation step. For instance, surface activation and especially molecular adsorbate layers tend not to be stable in time, whereas the substrate and the AuNPs provide a stable surface potential as long as impurities are avoided. It is shown that the streaming potential/current technique represents an ideal tool to analyze and monitor the complex surfaces and their modification.

  20. Current topics in clinical FES in Japan.

    Science.gov (United States)

    Handa, Y

    1997-12-01

    This paper reviews recent topics of clinical application of functional electrical stimulation (FES) for the paralyzed extremities in Japan. Transcutaneous and percutaneous FES systems have been clinically used in Japan. Candidates of extremity FES arer mostly stroke and spinal cord injury patients. By using percutaneous FES system, all of the joints of the upper extremity including the shoulder have been controlled for activities of daily living in the hemiplegic patient. Simultaneous FES control of the hand and wrist and the bilateral hands have also been achieved in C5 and C6 quadriplegics, respectively. Hybrid FES systems using percutaneous and surface electrodes, where FES is used in combination with orthoses, have been applied to the paraplegics because they are highly practical for assisting their locomotive activities. Percutaneous FES have been also provided the amyotropic lateral sclerosis patients with standing up motion. A total implant FES system with 16 output channels is currently developing as a next generation FES system.

  1. Current clinical management of brainstem cavernomas.

    Science.gov (United States)

    Bozinov, Oliver; Hatano, Taketo; Sarnthein, Johannes; Burkhardt, Jan-Karl; Bertalanffy, Helmut

    2010-11-26

    Over the last two decades a favourable course for treated or nontreated brainstem cavernomas has become possible with enhanced diagnostic tools and clinical experience, as well as minimally invasive microsurgical improvements. Currently, brainstem cavernoma can be treated microsurgically with excellent results and an acceptable morbidity rate. The preferred surgical route has progressively shifted from a dorsal to a lateral approach, but this remains dependent on the location of the lesion in the brainstem. Surgical evaluation and management of all cases of this rare disease should be performed by experienced teams from the outset.

  2. A plasmon-induced current loop in gold semi-shells

    Energy Technology Data Exchange (ETDEWEB)

    Cortie, Michael; Ford, Mike [Institute for Nanoscale Technology, University of Technology Sydney, PO Box 123, Broadway, NSW 2007 (Australia)

    2007-06-13

    We perform a computational investigation of the optical properties of nanoscale gold 'semi-shells' and show how additional plasmon resonances develop as the shape is successively mutated from 'nanoshell' to 'nano-cup', 'half-shell' and finally to 'nano-cap'. The effects of aspect ratio, surface roughness and cut-off height are explored. Of special interest is a new longitudinal resonance that generates an electric current loop. We predict that this will induce an orthogonal magnetic component that will sum with the magnetic component of incident light at certain orientations. Exploitation of this phenomenon in an ordered array of semi-shells may produce anomalous optical effects due to an altered magnetic permeability.

  3. Current clinical evidence on pioglitazone pharmacogenomics

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    Marina eKawaguchi-Suzuki

    2013-11-01

    Full Text Available Pioglitazone is the most widely used thiazolidinedione and acts as an insulin-sensitizer through activation of the Peroxisome Proliferator-Activated Receptor-γ (PPARγ. Pioglitazone is approved for use in the management of type 2 diabetes mellitus, but its use in other therapeutic areas is increasing due to pleiotropic effects. In this hypothesis article, the current clinical evidence on pioglitazone pharmacogenomics is summarized and related to variability in pioglitazone response. How genetic variation in the human genome affects the pharmacokinetics and pharmacodynamics of pioglitazone was examined. For pharmacodynamic effects, hypoglycemic and anti-atherosclerotic effects, risks of fracture or edema, and the increase in body mass index in response to pioglitazone based on genotype were examined. The genes CYP2C8 and PPARG are the most extensively studied to date and selected polymorphisms contribute to respective variability in pioglitazone pharmacokinetics and pharmacodynamics. We hypothesized that genetic variation in pioglitazone pathway genes contributes meaningfully to the clinically observed variability in drug response. To test the hypothesis that genetic variation in PPARG associates with variability in pioglitazone response, we conducted a meta-analysis to synthesize the currently available data on the PPARG p.Pro12Ala polymorphism. The results showed that PPARG 12Ala carriers had a more favorable change in fasting blood glucose from baseline as compared to patients with the wild-type Pro12Pro genotype (p=0.018. Unfortunately, findings for many other genes lack replication in independent cohorts to confirm association; further studies are needed. Also, the biological functionality of these polymorphisms is unknown. Based on current evidence, we propose that pharmacogenomics may provide an important tool to individualize pioglitazone therapy and better optimize therapy in patients with T2DM or other conditions for which pioglitazone

  4. [Clinical pharmacology of current antiplatelet drugs].

    Science.gov (United States)

    Trenk, D; Nührenberg, T; Stratz, C; Valina, C M; Hochholzer, W

    2014-11-01

    Dual antiplatelet therapy with low-dose acetylsalicylic acid (ASA) and an inhibitor of the P2Y12 adenosine diphosphate (ADP) receptor is the standard treatment for patients presenting with acute coronary syndrome (ACS) or undergoing elective coronary interventions according to the current guidelines published by the European Society of Cardiology (ESC). New generation P2Y12 inhibitors, such as prasugrel and ticagrelor exert stronger and more consistent inhibition of the P2Y12 receptor. In clinical studies enrolling patients with ACS these drugs decreased the incidence of ischemic events compared to the standard therapy with clopidogrel and ASA; however, this beneficial effect was associated with an increase in bleeding events. Alternative therapeutic approaches via addition of drugs with different modes of action showed an overall reduction of ischemic events but also failed to uncouple this beneficial effect from an increased bleeding risk.

  5. Gold deposits in metamorphic belts: Overview of current understanding, outstanding problems, future research, and exploration significance

    Science.gov (United States)

    Groves, D.I.; Goldfarb, R.J.; Robert, F.; Hart, C.J.R.

    2003-01-01

    Metamorphic belts are complex regions where accretion or collision has added to, or thickened, continental crust. Gold-rich deposits can be formed at all stages of orogen evolution, so that evolving metamorphic belts contain diverse gold deposit types that may be juxtaposed or overprint each other. This partly explains the high level of controversy on the origin of some deposit types, particularly those formed or overprinted/remobilized during the major compressional orogeny that shaped the final geometry of the hosting metamorphic belts. These include gold-dominated orogenic and intrusion-related deposits, but also particularly controversial gold deposits with atypical metal associations. There are a number of outstanding problems for all types of gold deposits in metamorphc belts. These include the following: (1) definitive classifications, (2) unequivocal recognition of fluid and metal sources, (3) understanding of fluid migration and focusing at all scales, (4) resolution of the precise role of granitoid magmatism, (5) precise gold-depositional mechanisms, particularly those producing high gold grades, and (6) understanding of the release of CO2-rich fluids from subducting slabs and subcreted oceanic crust and granitoid magmas at different crustal levels. Research needs to be better coordinated and more integrated, such that detailed fluid-inclusion, trace-element, and isotopic studies of both gold deposits and potential source rocks, using cutting-edge technology, are embedded in a firm geological framework at terrane to deposit scales. Ultimately, four-dimensional models need to be developed, involving high-quality, three-dimensional geological data combined with integrated chemical and fluid-flow modeling, to understand the total history of the hydrothermal systems involved. Such research, particularly that which can predict superior targets visible in data sets available to exploration companies before discovery, has obvious spin-offs for global- to deposit

  6. Comparative evaluation of an ambulatory EEG platform vs. clinical gold standard.

    Science.gov (United States)

    Jackson, Gregory; Radhu, Natasha; Sun, Yinming; Tallevi, Kevin; Ritvo, Paul; Daskalakis, Zafiris J; Grundlehner, Bernard; Penders, Julien; Cafazzo, Joseph A

    2013-01-01

    Electroencephalography (EEG) testing in clinical labs makes use of large amplifiers and complex software for data acquisition. While there are new ambulatory electroencephalogram (EEG) systems, few have been directly compared to a gold standard system. Here, an ultra-low power wireless EEG system designed by Imec is tested against the gold standard Neuroscan SynAmps2 EEG system, recording simultaneously from the same laboratory cap prepared with electrode gel. The data was analyzed using correlation analysis for both time domain and frequency domain data. The analysis indicated a high Pearson's correlation coefficient (mean=0.957, median=0.985) with high confidence (mean P=0.002) for 10-second sets of data transformed to the frequency domain. The time domain results had acceptable Pearson's coefficient (mean=0.580, median =0.706) with high confidence (mean P=0.008).

  7. Electrodeposition of Gold to Conformally Fill High Aspect Ratio Nanometric Silicon Grating Trenches: A Comparison of Pulsed and Direct Current Protocols

    OpenAIRE

    Znati, Sami A.; Chedid, Nicholas; Miao, Houxun; Chen,Lei; Bennett, Eric E.; Wen, Han

    2015-01-01

    Filling high-aspect-ratio trenches with gold is a frequent requirement in the fabrication of x-ray optics as well as micro-electronic components and other fabrication processes. Conformal electrodeposition of gold in sub-micron-width silicon trenches with an aspect ratio greater than 35 over a grating area of several square centimeters is challenging and has not been described in the literature previously. A comparison of pulsed plating and constant current plating led to a gold electroplatin...

  8. Clinical utility of eslicarbazepine: current evidence

    Directory of Open Access Journals (Sweden)

    Zaccara G

    2015-02-01

    Full Text Available Gaetano Zaccara,1 Fabio Giovannelli,1,2 Massimo Cincotta,1 Alessia Carelli,3 Alberto Verrotti31Department of Medicine, Unit of Neurology, Florence Health Authority, Florence, Italy; 2Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 3Department of Pediatrics, University of Perugia, Perugia, ItalyAbstract: Eslicarbazepine acetate (ESL is a new antiepileptic drug whose mechanism of action is blockade of the voltage-gated sodium channel (VGSC. However, in respect to carbamazepine and oxcarbazepine, the active ESL metabolite (eslicarbazepine affects slow inactivation of VGSC and has a similar affinity for the inactivated state and a lower affinity for the resting state of the channel. This new antiepileptic drug has been recently approved in Europe (trade name Zebinix and in the United States (trade name Stedesa for adjunctive treatment in adult subjects with partial-onset seizures, with or without secondary generalization. Following oral administration, ESL is rapidly and extensively metabolized by hepatic esterases to eslicarbazepine. This active metabolite has a linear pharmacokinetic profile, a low binding to plasma proteins (<40%, and a half-life of 20–24 hours and is mainly excreted by kidneys in an unchanged form or as glucuronide conjugates. ESL is administered once a day and has a low potential for drug–drug interactions. Efficacy and safety of this drug in patients with focal seizures have been assessed in four randomized clinical trials, and responder rates (percentage of patients with a ≥50% improvement of their seizures ranged between 17% and 43%. Adverse events were usually mild to moderate, and the most common were dizziness, somnolence, diplopia, abnormal coordination, blurred vision, vertigo, headache, fatigue, nausea, and vomiting. ESL may be considered an interesting alternative to current antiepileptic drugs for the treatment of drug-resistant focal

  9. Electron transport in dodecylamine capped gold nanocluster films using current sensing atomic force microscope (C-AFM).

    Science.gov (United States)

    Chaudhary, Minakshi; Dey, Shirshendu; Date, Kalyani; Iyyer, S B; Dharmadhikaril, C V

    2009-09-01

    Electron transport across cataphoretically deposited dodecylamine capped gold nanocluster rough films on Si(111) substrate is investigated using current sensing atomic force microscopy. Contact mode images depict uniform deposition of agglomerates of gold nanoparticles. The current images display strong correlation with topographic images. The I-V measurement on a single agglomerate of approximately = 250 nm size at different forces exhibits force dependent threshold voltage. The electron transport from tip to sample is found to be ohmic in contrast to that from sample to tip which, exhibits Fowler-Nordheim behavior up to 35 nN force. At higher forces, the I-V behavior could be attributed to other electron transfer processes such as Schottky/Poole-Frenkel or trapping/detrapping, although no exact mechanism could be identified. The results are discussed in the light of models based on Coulomb blockaded collective charge transport in nanoparticle arrays duly accounting for the potential role of the capping layer.

  10. Gold nanoparticles in theranostic oncology: current state-of-the-art

    NARCIS (Netherlands)

    Akhter, S.; Ahmad, M.Z.; Ahmad, F.J.; Storm, G.; Kok, R.J.

    2012-01-01

    INTRODUCTION: In recent years, extensive multidisciplinary investigations have been carried out in the area of cancer nanotechnology. Gold nanoparticles (GNPs) have emerged as promising carrier for delivery of various pay-loads into their target. In view of their unique physicochemical and optical

  11. Clinical characteristics and current treatment of glaucoma.

    Science.gov (United States)

    Cohen, Laura P; Pasquale, Louis R

    2014-06-02

    Glaucoma is a neurodegenerative disorder in which degenerating retinal ganglion cells (RGC) produce significant visual disability. Clinically, glaucoma refers to an array of conditions associated with variably elevated intraocular pressure (IOP) that contributes to RGC loss via mechanical stress, vascular abnormalities, and other mechanisms, such as immune phenomena. The clinical diagnosis of glaucoma requires assessment of the ocular anterior segment with slit lamp biomicroscopy, which allows the clinician to recognize signs of conditions that can produce elevated IOP. After measurement of IOP, a specialized prismatic lens called a gonioscope is used to determine whether the angle is physically open or closed. The structural manifestation of RGC loss is optic nerve head atrophy and excavation of the neuroretinal rim tissue. Treatment is guided by addressing secondary causes for elevated IOP (such as inflammation, infection, and ischemia) whenever possible. Subsequently, a variety of medical, laser, and surgical options are used to achieve a target IOP.

  12. Current clinical research in orthodontics: a perspective.

    Science.gov (United States)

    Baumrind, Sheldon

    2006-10-01

    This essay explores briefly the approach of the Craniofacial Research Instrumentation Laboratory to the systematic and rigorous investigation of the usual outcome of orthodontic treatment in the practices of experienced clinicians. CRIL's goal is to produce a shareable electronic database of reliable, valid, and representative data on clinical practice as an aid in the production of an improved environment for truly evidence-based orthodontic treatment.

  13. Colorimetric assessment of BCR-ABL1 transcripts in clinical samples via gold nanoprobes.

    Science.gov (United States)

    Vinhas, Raquel; Correia, Cláudia; Ribeiro, Patricia; Lourenço, Alexandra; Botelho de Sousa, Aida; Fernandes, Alexandra R; Baptista, Pedro V

    2016-07-01

    Gold nanoparticles functionalized with thiolated oligonucleotides (Au-nanoprobes) have been used in a range of applications for the detection of bioanalytes of interest, from ions to proteins and DNA targets. These detection strategies are based on the unique optical properties of gold nanoparticles, in particular, the intense color that is subject to modulation by modification of the medium dieletric. Au-nanoprobes have been applied for the detection and characterization of specific DNA sequences of interest, namely pathogens and disease biomarkers. Nevertheless, despite its relevance, only a few reports exist on the detection of RNA targets. Among these strategies, the colorimetric detection of DNA has been proven to work for several different targets in controlled samples but demonstration in real clinical bioanalysis has been elusive. Here, we used a colorimetric method based on Au-nanoprobes for the direct detection of the e14a2 BCR-ABL fusion transcript in myeloid leukemia patient samples without the need for retro-transcription. Au-nanoprobes directly assessed total RNA from 38 clinical samples, and results were validated against reverse transcription-nested polymerase chain reaction (RT-nested PCR) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The colorimetric Au-nanoprobe assay is a simple yet reliable strategy to scrutinize myeloid leukemia patients at diagnosis and evaluate progression, with obvious advantages in terms of time and cost, particularly in low- to medium-income countries where molecular screening is not routinely feasible. Graphical abstract Gold nanoprobe for colorimetric detection of BCR-ABL1 fusion transcripts originating from the Philadelphia chromosome.

  14. [Schizophrenic disorders: current etiologic and clinical knowledge].

    Science.gov (United States)

    Olié, Jean-Pierre; Krebs, Marie-Odile; Lôo, Henri

    2005-05-01

    Brain anomalies associated with schizophrenic disorders may be of a cognitive, neurophysiological or neurological nature [the latter being relatively minor and nonspecific]. Brain imaging has revealed early anomalies such as cortical-subcortical atrophy and abnormal gyration. These anomalies can also be present in relatives free of schizophrenic symptoms. This raises the question of what determines the transition from vulnerability to clinical onset. There is now evidence that schizophrenic disorders are true brain diseases. This is based on neuropathological studies, brain imaging and clinical findings such as "soft" neurological signs (pyramidal and extrapyramidal symptoms, coordination difficulties, etc.). Cognitive dysfunctions such as attention and memory disorders and abnormal verbal fluency have also been described. Oculomotor pursuit and auditive evoked potentials have identified specific neurophysiological disorders such as N300 and P50 wave modifications. Schizophrenic disorders can also be associated with neuronal abnormalities, notably affecting factors involved in synaptic transmission and plasticity. For example, BDNF protein deficit is linked to certain late-onset forms of schizophrenia. Genetic studies are no longer focusing on a possible disease genotype but rather on phenotypic characteristics determined by simpler genotypes (P50 wave modulation, COMT and BDNF genes). The ultimate objective is to identify high-risk subjects, in order to shorten the treatment delay and thereby improve long-term outcome. The benefit of primary prophylaxis remains to be determined, however.

  15. Occlusion on oral implants: current clinical guidelines.

    Science.gov (United States)

    Koyano, K; Esaki, D

    2015-02-01

    Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future.

  16. Nanoscale radiation transport and clinical beam modeling for gold nanoparticle dose enhanced radiotherapy (GNPT) using X-rays.

    Science.gov (United States)

    Zygmanski, Piotr; Sajo, Erno

    2016-01-01

    We review radiation transport and clinical beam modelling for gold nanoparticle dose-enhanced radiotherapy using X-rays. We focus on the nanoscale radiation transport and its relation to macroscopic dosimetry for monoenergetic and clinical beams. Among other aspects, we discuss Monte Carlo and deterministic methods and their applications to predicting dose enhancement using various metrics.

  17. Vaginitis: current microbiologic and clinical concepts.

    Science.gov (United States)

    Hill, L V; Embil, J A

    1986-01-01

    Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed. PMID:3510698

  18. Terazosin, doxazosin, and prazosin: current clinical experience.

    Science.gov (United States)

    Akduman, B; Crawford, E D

    2001-12-01

    Lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction are common in aging men. Nearly 25% of men >40 years of age have LUTS. Medical therapy with alpha-blockade is the most common method of medical therapy for benign prostatic obstruction. Multiple methods of minimally invasive surgical therapies have been introduced in the last decade. These methods include balloon dilatation, temporary and permanent urethral stents, various laser techniques, microwave thermotherapy, transurethral needle ablation, electrovaporization, and high-intensity focused ultrasound. alpha-Receptor blockers to reduce the sympathetic tone of the prostate are considered as first-line therapy to relieve the symptoms of benign prostatic hyperplasia. Selective alpha(1)-receptor blockers relax prostatic smooth muscle, relieve bladder outlet obstruction, and enhance urine flow with fewer side effects. In addition, it was determined that treating patients with alpha-blockers increases prostatic apoptosis. Pharmacokinetic activity, mode of action, clinical efficacy, and side effects of the selective alpha(1)-receptor blockers terazosin, doxazosin, and prazosin are reviewed.

  19. Current clinical evidence on topiramate pharmacokinetics

    Directory of Open Access Journals (Sweden)

    Jakovljević Mihajlo

    2009-01-01

    Full Text Available Topiramate is biochemically classified as a fructopyranose sulphamate. Discovered as early as 1979, during middle 1980's it was approved in many countries for the treatment of epilepsies and migraine prevention. More recently, in the experimental stage, possible new indications have been disclosed: treatment of obesity, bipolar disorder, also cessation of smoking, neuropathic pain, cerebral pseudotumour, bulimia, periventricular leucomalatia in preterm infants and alcohol addiction. Most epileptologists consider it to be the first choice antiepileptic drug in severe pharmacoresistant epilepsies. A substantial corpus of evidence in paediatric population has been accumulated that confirms its efficiency in the treatment of generalised tonic-clonic seizures, Lenox-Gestaut syndrome, partial, absence and combined seizures. Having a unique monosaccharide chemical structure among other anticonvulsant drugs, characterizes it with special pharmacokinetic features. This substance exhibits a low interindividual variability in plasma levels and hence it features predictable pharmacokinetics. A steady state plasma concentration of topiramate increases linearly with higher dosages. Serum protein binding is approximately 15%, and biologic half-life in healthy volunteers is considered to range from 20 to 30 hours. Mean expected distribution volume rates from 0.55-0.8 l/kg, and accordingly, the drug shows a low and saturable binding capacity toward erythrocytes. It has not been present at the market for a sufficiently long time that would enable us to speak about a significant accumulation of data on its metabolism based on post-registration 4th stage clinical trials. For this purpose, we have done a literature review in order to summarise so far reported experience on topiramate pharmacokinetics in patients and healthy adults. Deeper understanding of its pharmacokinetic profile could enable a better technological design of the produced drug and the choice of

  20. Evaluation of image quality and radiation dose using gold nanoparticles and other clinical contrast agents in dual-energy Computed Tomography (CT): CT abdomen phantom

    Science.gov (United States)

    Zukhi, J.; Yusob, D.; Tajuddin, A. A.; Vuanghao, L.; Zainon, R.

    2017-05-01

    The aim of this study was to evaluate the image quality and radiation dose using commercial gold nanoparticles and clinical contrast agents in dual-energy Computed Tomography (CT). Five polymethyl methacrylate (PMMA) tubes were used in this study, where four tubes were filled with different contrast agents (barium, iodine, gadolinium, and gold nanoparticles). The fifth tube was filled with water. Two optically stimulated luminescence dosimeters (OSLD) were placed in each tube to measure the radiation dose. The tubes were placed in a fabricated adult abdominal phantom of 32 cm in diameter using PMMA. The phantom was scanned using a DECT at low energy (80 kV) and high energy (140 kV) with different pitches (0.6 mm and 1.0 mm) and different slice thickness (3.0 mm and 5.0 mm). The tube current was applied automatically using automatic exposure control (AEC) and tube current modulation recommended by the manufacturer (CARE Dose 4D, Siemens, Germany). The contrast-to-noise ratio (CNR) of each contrast agent was analyzed using Weasis software. Gold nanoparticles has highest atomic number (Z = 79) than barium (Z = 56), iodine (Z = 53) and gadolinium (Z = 64). The CNR value of each contrast agent increases when the slice thickness increases. The radiation dose obtained from this study decreases when the pitch increases. The optimal imaging parameters for gold nanoparticles and other clinical contrast agents is obtained at pitch value of 1.0 mm and slice thickness of 5.0 mm. Low noise and low radiation dose obtained at these imaging parameters. The optimal imaging parameters obtained in this study can be applied in multiple contrast agents imaging.

  1. Current state and prospects of the phytosynthesized colloidal gold nanoparticles and their applications in cancer theranostics.

    Science.gov (United States)

    Ovais, Muhammad; Raza, Abida; Naz, Shagufta; Islam, Nazar Ul; Khalil, Ali Talha; Ali, Shaukat; Khan, Muhammad Adeeb; Shinwari, Zabta Khan

    2017-05-01

    The design, development, and biomedical applications of phytochemical-based green synthesis of biocompatible colloidal gold nanoparticles (AuNPs) are becoming an emerging field due to several advantages (safer, eco-friendly, simple, fast, energy efficient, low-cost, and less toxic) over conventional chemical synthetic procedures. Biosynthesized colloidal gold nanoparticles are remarkably attractive in several biomedical applications including cancer theranostics due to small size, unusual physico-chemical properties, facile surface modification, high biocompatibility, and numerous other advantages. Of late, several researchers have investigated the biosynthesis and prospective applications (diagnostics, imaging, drug delivery, and cancer therapeutics) of AuNPs in health care and medicine. However, not a single review article is available in the literature that demonstrates the anti-cancer potential of biosynthesized colloidal AuNPs with detailed mechanistic study. In the present review article, we for the first time discuss the biointerface of colloidal AuNPs, plants, and cancer mainly (i) comprehensive mechanistic aspects of phytochemical-based synthesis of AuNPs; (ii) proposed anti-cancer mechanisms along with biomedical applications in diagnostics, imaging, and drug delivery; and (iii) key challenges for biogenic AuNPs as future cancer nanomedicine.

  2. Current-voltage characteristics of single-molecule diarylethene junctions measured with adjustable gold electrodes in solution.

    Science.gov (United States)

    Briechle, Bernd M; Kim, Youngsang; Ehrenreich, Philipp; Erbe, Artur; Sysoiev, Dmytro; Huhn, Thomas; Groth, Ulrich; Scheer, Elke

    2012-01-01

    We report on an experimental analysis of the charge transport through sulfur-free photochromic molecular junctions. The conductance of individual molecules contacted with gold electrodes and the current-voltage characteristics of these junctions are measured in a mechanically controlled break-junction system at room temperature and in liquid environment. We compare the transport properties of a series of molecules, labeled TSC, MN, and 4Py, with the same switching core but varying side-arms and end-groups designed for providing the mechanical and electrical contact to the gold electrodes. We perform a detailed analysis of the transport properties of TSC in its open and closed states. We find rather broad distributions of conductance values in both states. The analysis, based on the assumption that the current is carried by a single dominating molecular orbital, reveals distinct differences between both states. We discuss the appearance of diode-like behavior for the particular species 4Py that features end-groups, which preferentially couple to the metal electrode by physisorption. We show that the energetic position of the molecular orbital varies as a function of the transmission. Finally, we show for the species MN that the use of two cyano end-groups on each side considerably enhances the coupling strength compared to the typical behavior of a single cyano group.

  3. Electric Current-induced Failure of 200-nm-thick Gold Interconnects

    Institute of Scientific and Technical Information of China (English)

    Bin ZHANG; Qingyuan YU; Jun TAN; Guangping ZHANG

    2008-01-01

    200-nm-thick Au interconnects on a quartz substrate were tested in-situ inside a dual-beam microscope by applying direct current,alternating current and alternating current with a small direct current component.The failure behavior of the Au interconnects under three kinds of electric currents were characterized in-situ by scanning electron microscopy.It is found that the formation of voids and subsequent growth perpendicular to the interconnect direction is the fatal failure mode for all the Au interconnects under three kinds of electric currents.The failure mechanism of the ultrathin metal lines induced by the electric currents was analyzed.

  4. Clinical use of placebo treatments may undermine the trust of patients: a response to Gold and Lichtenberg.

    Science.gov (United States)

    Louhiala, Pekka; Hemilä, Harri; Puustinen, Raimo

    2014-11-01

    There is an obvious need for a critical discussion of the concepts 'placebo' and 'placebo effect'. In a recent paper on the use of placebos in clinical medicine, Gold and Lichtenberg note the conceptual difficulties but use the terminology in a confused way throughout their paper. In our response, we demonstrate these problems with a few examples from their paper.

  5. The role of relativity in the optical response of gold within the time-dependent current-density-functional theory.

    Science.gov (United States)

    Romaniello, P; de Boeij, P L

    2005-04-22

    We included relativistic effects in the formulation of the time-dependent current-density-functional theory for the calculation of linear response properties of metals [P. Romaniello and P. L. de Boeij, Phys. Rev. B (to be published)]. We treat the dominant scalar-relativistic effects using the zeroth-order regular approximation in the ground-state density-functional theory calculations, as well as in the time-dependent response calculations. The results for the dielectric function of gold calculated in the spectral range of 0-10 eV are compared with experimental data reported in literature and recent ellipsometric measurements. As well known, relativistic effects strongly influence the color of gold. We find that the onset of interband transitions is shifted from around 3.5 eV, obtained in a nonrelativistic calculation, to around 1.9 eV when relativity is included. With the inclusion of the scalar-relativistic effects there is an overall improvement of both real and imaginary parts of the dielectric function over the nonrelativistic ones. Nevertheless some important features in the absorption spectrum are not well reproduced, but can be explained in terms of spin-orbit coupling effects. The remaining deviations are attributed to the underestimation of the interband gap (5d-6sp band gap) in the local-density approximation and to the use of the adiabatic local-density approximation in the response calculation.

  6. Modeling the dark current histogram induced by gold contamination in complementary-metal-oxide-semiconductor image sensors

    Science.gov (United States)

    Domengie, F.; Morin, P.; Bauza, D.

    2015-07-01

    We propose a model for dark current induced by metallic contamination in a CMOS image sensor. Based on Shockley-Read-Hall kinetics, the expression of dark current proposed accounts for the electric field enhanced emission factor due to the Poole-Frenkel barrier lowering and phonon-assisted tunneling mechanisms. To that aim, we considered the distribution of the electric field magnitude and metal atoms in the depth of the pixel. Poisson statistics were used to estimate the random distribution of metal atoms in each pixel for a given contamination dose. Then, we performed a Monte-Carlo-based simulation for each pixel to set the number of metal atoms the pixel contained and the enhancement factor each atom underwent, and obtained a histogram of the number of pixels versus dark current for the full sensor. Excellent agreement with the dark current histogram measured on an ion-implanted gold-contaminated imager has been achieved, in particular, for the description of the distribution tails due to the pixel regions in which the contaminant atoms undergo a large electric field. The agreement remains very good when increasing the temperature by 15 °C. We demonstrated that the amplification of the dark current generated for the typical electric fields encountered in the CMOS image sensors, which depends on the nature of the metal contaminant, may become very large at high electric field. The electron and hole emissions and the resulting enhancement factor are described as a function of the trap characteristics, electric field, and temperature.

  7. Clinical Education In psychiatric mental health nursing: Overcoming current challenges.

    Science.gov (United States)

    Choi, Heeseung; Hwang, Boyoung; Kim, Sungjae; Ko, Heesung; Kim, Sumi; Kim, Chanhee

    2016-04-01

    In response to current challenges in psychiatric mental health nursing education, nursing schools have implemented new strategies in teaching undergraduate nursing students. The objectives of the study were to evaluate learning outcomes of a mental health nursing clinical practicum and to explore students' perceptions of the clinical practicum. This was a mixed-method study. Sixty-three undergraduate nursing students, who were undertaking their first mental health clinical practicum, completed a set of structured questionnaires and answered open-ended questions about the clinical practicum. Answers to open-ended questions were analyzed qualitatively, and learning outcomes (i.e., empathy, mental illness prejudice, simulation-related efficacy, and satisfaction) were measured at three time points: pre-clinical, post-simulation, and post-clinical. Students reported improvement in empathy and simulation-related self-efficacy after the clinical practicum, but no change was found in mental illness prejudice. Students' expectations for and evaluation of the clinical practicum are summarized. The observed improvement in learning outcomes of the clinical practicum may be attributed to the unique contribution of each component of the clinical practicum and the synergic effect of these diverse components. To manage emerging challenges in clinical settings and nursing education, it is critical to develop systematic and comprehensive mental health nursing clinical practicums for undergraduate nursing students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. The clinical utility of the GOLD classification of COPD disease severity in pulmonary rehabilitation

    NARCIS (Netherlands)

    Huijsmans, Rosalie J.; de Haan, Arnold; ten Hacken, Nick N. H. T.; Straver, Renata V. M.; van't Hu, Alex J.

    2008-01-01

    The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has introduced a four-stage classification of chronic obstructive pulmonary disease (COPD) severity. The present study investigated the discriminatory capacity of the GOLD classification for health status outcomes in patients with COP

  9. Clinical pharmacology in Russia-historical development and current state.

    Science.gov (United States)

    Zagorodnikova Goryachkina, Ksenia; Burbello, Aleksandra; Sychev, Dmitry; Frolov, Maxim; Kukes, Vladimir; Petrov, Vladimir

    2015-02-01

    Clinical pharmacology in Russia has long history and is currently active, but rather unrecognized internationally. It is governmentally approved as a teaching/scientific specialty since 1983 and as a medical specialty since 1997. Courses of clinical pharmacology are included in the undergraduate curricula in the 5th and/or 6th year of education at all medical schools in the Russian Federation. Postgraduate education includes initial specialization in internal medicine with further residency in clinical pharmacology. Governmental legislation recommends that every healthcare institution has either a department or a single position of clinical pharmacologist. Major routine duties include information about and monitoring of medication use, consultations in difficult clinical situations, pharmacogenetic counseling, therapeutic drug monitoring, pharmacovigilance, and participation in drug and therapeutics (formulary) committees. There are official experts in clinical pharmacology in Russia responsible for coordinating relevant legislative issues. The chief expert clinical pharmacologist represents the discipline directly at the Ministry of Health. Research in clinical pharmacology in Russia is extensive and variable, but only some of it is published internationally. Russia is a participant of international societies of clinical pharmacology and therapeutics and collaboration is actively ongoing. There are still certain problems related to the development of the discipline in Russia-some healthcare institutions do not see the need for clinical pharmacology. However, the number of clinical pharmacologists in Russia is increasing as well as their role in physicians' education, national healthcare, and research.

  10. Are Randomized Controlled Trials the (G)old Standard? From Clinical Intelligence to Prescriptive Analytics.

    Science.gov (United States)

    Van Poucke, Sven; Thomeer, Michiel; Heath, John; Vukicevic, Milan

    2016-07-06

    Despite the accelerating pace of scientific discovery, the current clinical research enterprise does not sufficiently address pressing clinical questions. Given the constraints on clinical trials, for a majority of clinical questions, the only relevant data available to aid in decision making are based on observation and experience. Our purpose here is 3-fold. First, we describe the classic context of medical research guided by Poppers' scientific epistemology of "falsificationism." Second, we discuss challenges and shortcomings of randomized controlled trials and present the potential of observational studies based on big data. Third, we cover several obstacles related to the use of observational (retrospective) data in clinical studies. We conclude that randomized controlled trials are not at risk for extinction, but innovations in statistics, machine learning, and big data analytics may generate a completely new ecosystem for exploration and validation.

  11. Modeling the dark current histogram induced by gold contamination in complementary-metal-oxide-semiconductor image sensors

    Energy Technology Data Exchange (ETDEWEB)

    Domengie, F., E-mail: florian.domengie@st.com; Morin, P. [STMicroelectronics Crolles 2 (SAS), 850 Rue Jean Monnet, 38926 Crolles Cedex (France); Bauza, D. [CNRS, IMEP-LAHC - Grenoble INP, Minatec: 3, rue Parvis Louis Néel, CS 50257, 38016 Grenoble Cedex 1 (France)

    2015-07-14

    We propose a model for dark current induced by metallic contamination in a CMOS image sensor. Based on Shockley-Read-Hall kinetics, the expression of dark current proposed accounts for the electric field enhanced emission factor due to the Poole-Frenkel barrier lowering and phonon-assisted tunneling mechanisms. To that aim, we considered the distribution of the electric field magnitude and metal atoms in the depth of the pixel. Poisson statistics were used to estimate the random distribution of metal atoms in each pixel for a given contamination dose. Then, we performed a Monte-Carlo-based simulation for each pixel to set the number of metal atoms the pixel contained and the enhancement factor each atom underwent, and obtained a histogram of the number of pixels versus dark current for the full sensor. Excellent agreement with the dark current histogram measured on an ion-implanted gold-contaminated imager has been achieved, in particular, for the description of the distribution tails due to the pixel regions in which the contaminant atoms undergo a large electric field. The agreement remains very good when increasing the temperature by 15 °C. We demonstrated that the amplification of the dark current generated for the typical electric fields encountered in the CMOS image sensors, which depends on the nature of the metal contaminant, may become very large at high electric field. The electron and hole emissions and the resulting enhancement factor are described as a function of the trap characteristics, electric field, and temperature.

  12. NUCLEAR CARDIOLOGY, CURRENT APPLICATIONS IN CLINICAL-PRACTICE

    NARCIS (Netherlands)

    NIEMEYER, MG; VANDERWALL, EE; KUIJPER, AFM; CLEOPHAS, AT; PAUWELS, EKJ

    1995-01-01

    The clinical applications of nuclear cardiology have rapidly expanded since the introduction of suitable imaging cameras and readily applicable isotopes. The currently available methods can provide useful data on estimates of ventricular function and detection of myocardial ischemia for adequate pat

  13. Feasibility of Energy Dispersive X-Ray Fluorescence Determination of Gold in Soft Tissue for Clinical Applications.

    Science.gov (United States)

    Magaña, Isidro B; Adhikari, Pratik; Smalley, Megan C; Eklund, Sven; O'Neal, D Patrick

    2013-06-21

    The feasibility of using EDXRF for a rapid quantitative analysis of gold in tumor tissue has been investigated. The protocol described here demonstrates that sample biopsies can be analyzed in as little as 8 hours, with minimal sample preparation. Samples were prepared by drying a 35 μL aliquot of tissue dissolved in KOH in a standard EDXRF cup on a Prolene® support, producing a thin sample. Calibration curves of XRF peak intensity (CPS/mA) to the gold concentration (0-50 PPM) were prepared for liver, tumor, and a mix of tissue types. A linear regression demonstrated an R(2) correlation of 0.93. Analysis of experimental samples showed that gold accumulation in tumors (5.8-41.3 PPM) was in agreement with previous studies, where samples were processed using INAA or ICP-MS. This report provides guidance for elemental analysis of gold in tissue in a shorter time span, showing potential for its use in a clinical setting.

  14. Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification

    DEFF Research Database (Denmark)

    Lange, Peter; Marott, Jacob Louis; Vestbo, Jørgen

    2012-01-01

    The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations.......The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations....

  15. Self-Assembled Core-Satellite Gold Nanoparticle Networks for Ultrasensitive Detection of Chiral Molecules by Recognition Tunneling Current.

    Science.gov (United States)

    Zhang, Yuanchao; Liu, Jingquan; Li, Da; Dai, Xing; Yan, Fuhua; Conlan, Xavier A; Zhou, Ruhong; Barrow, Colin J; He, Jin; Wang, Xin; Yang, Wenrong

    2016-05-24

    Chirality sensing is a very challenging task. Here, we report a method for ultrasensitive detection of chiral molecule l/d-carnitine based on changes in the recognition tunneling current across self-assembled core-satellite gold nanoparticle (GNP) networks. The recognition tunneling technique has been demonstrated to work at the single molecule level where the binding between the reader molecules and the analytes in a nanojunction. This process was observed to generate a unique and sensitive change in tunneling current, which can be used to identify the analytes of interest. The molecular recognition mechanism between amino acid l-cysteine and l/d-carnitine has been studied with the aid of SERS. The different binding strength between homo- or heterochiral pairs can be effectively probed by the copper ion replacement fracture. The device resistance was measured before and after the sequential exposures to l/d-carnitine and copper ions. The normalized resistance change was found to be extremely sensitive to the chirality of carnitine molecule. The results suggested that a GNP networks device optimized for recognition tunneling was successfully built and that such a device can be used for ultrasensitive detection of chiral molecules.

  16. Mineralized Collagen: Rationale, Current Status, and Clinical Applications

    Directory of Open Access Journals (Sweden)

    Zhi-Ye Qiu

    2015-07-01

    Full Text Available This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.

  17. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  18. A novel lateral flow assay based on GoldMag nanoparticles and its clinical applications for genotyping of MTHFR C677T polymorphisms

    Science.gov (United States)

    Hui, Wenli; Zhang, Sinong; Zhang, Chao; Wan, Yinsheng; Zhu, Juanli; Zhao, Gang; Wu, Songdi; Xi, Dujuan; Zhang, Qinlu; Li, Ningning; Cui, Yali

    2016-02-01

    Current techniques for single nucleotide polymorphism (SNP) detection require tedious experimental procedures and expensive and sophisticated instruments. In this study, a visual genotyping method has been successfully established via combining ARMS-PCR with gold magnetic nanoparticle (GoldMag)-based lateral flow assay (LFA) and applied to the genotyping of methylenetetrahydrofolate reductase (MTHFR) C677T. C677T substitution of the gene MTHFR leads to an increased risk of diseases. The genotyping result is easily achievable by visual observation within 5 minutes after loading of the PCR products onto the LFA device. The system is able to accurately assess a broad detection range of initial starting genomic DNA amounts from 5 ng to 1200 ng per test sample. The limit of detection reaches 5 ng. Furthermore, our PCR-LFA system was applied to clinical trials for screening 1721 individuals for the C677T genotypes. The concordance rate of the genotyping results detected by PCR-LFA was up to 99.6% when compared with the sequencing results. Collectively, our PCR-LFA has been proven to be rapid, accurate, sensitive, and inexpensive. This new method is highly applicable for C677T SNP screening in laboratories and clinical practices. More promisingly, it could also be extended to the detection of SNPs of other genes.

  19. The current state of clinical interpretation of sequence variants.

    Science.gov (United States)

    Hoskinson, Derick C; Dubuc, Adrian M; Mason-Suares, Heather

    2017-01-31

    Accurate and consistent variant classification is required for Precision Medicine. But clinical variant classification remains in its infancy. While recent guidelines put forth jointly by the American College of Medical Genetics and Genomics (ACMG) and Association of Molecular Pathology (AMP) for the classification of Mendelian variants has advanced the field, the degree of subjectivity allowed by these guidelines can still lead to inconsistent classification across clinical molecular genetic laboratories. In addition, there are currently no such guidelines for somatic cancer variants, only published institutional practices. Additional variant classification guidelines, including disease- or gene-specific criteria, along with inter-laboratory data sharing is critical for accurate and consistent variant interpretation.

  20. Nausea: current knowledge of mechanisms, measurement and clinical impact.

    Science.gov (United States)

    Kenward, Hannah; Pelligand, Ludovic; Savary-Bataille, Karine; Elliott, Jonathan

    2015-01-01

    Nausea is a subjective sensation, which often acts as a signal that emesis is imminent. It is a widespread problem that occurs as a clinical sign of disease or as an adverse effect of a drug therapy or surgical procedure. The mechanisms of nausea are complex and the neural pathways are currently poorly understood. This review summarises the current knowledge of nausea mechanisms, the available animal models for nausea research and the anti-nausea properties of commercially available anti-emetic drugs. The review also presents subjective assessment and scoring of nausea. A better understanding of the underlying mechanisms of nausea might reveal potential clinically useful biomarkers for objective measurement of nausea in species of veterinary interest.

  1. Animal models of frailty: current applications in clinical research.

    Science.gov (United States)

    Kane, Alice E; Hilmer, Sarah N; Mach, John; Mitchell, Sarah J; de Cabo, Rafael; Howlett, Susan E

    2016-01-01

    The ethical, logistical, and biological complications of working with an older population of people inherently limits clinical studies of frailty. The recent development of animal models of frailty, and tools for assessing frailty in animal models provides an invaluable opportunity for frailty research. This review summarizes currently published animal models of frailty including the interleukin-10 knock-out mouse, the mouse frailty phenotype assessment tool, and the mouse clinical frailty index. It discusses both current and potential roles of these models in research into mechanisms of frailty, interventions to prevent/delay frailty, and the effect of frailty on outcomes. Finally, this review discusses some of the challenges and opportunities of translating research findings from animals to humans.

  2. Current status of clinical laser applications in periodontal therapy.

    Science.gov (United States)

    Aoki, Akira; Mizutani, Koji; Takasaki, Aristeo Atsushi; Sasaki, Katia Miyuki; Nagai, Shigeyuki; Schwarz, Frank; Yoshida, Itaru; Eguro, Toru; Zeredo, Jorge Luis; Izumi, Yuichi

    2008-01-01

    Periodontal disease is a chronic inflammatory disorder caused by bacterial infection. Laser treatment demonstrates specific characteristics that may be valuable in managing periodontal disease. In addition, lasers reduce stress and uncomfortable conditions for patients during and after treatment compared to other conventional tools. This article reviews the literature to describe the current clinical applications of lasers for gingival tissue management-including esthetic treatment, non-surgical and surgical periodontal pocket therapy, osseous surgery, and implant therapy.

  3. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    OpenAIRE

    Yoshihiro Abiko; Hirofumi Matsuoka; Itsuo Chiba; Akira Toyofuku

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) A...

  4. The clinical application of clopidogrel in current coronary artery surgery

    Institute of Scientific and Technical Information of China (English)

    Yangyang Zhang; Kejiang Cao

    2008-01-01

    The article presents an overview of the current clinical application of clopidogrel in coronary artery surgery. The viewpoint is that clopidogrel can reduce preoperative and postoperative ischemic events of coronary artery bypass grafting(CABG). With the development of standardized medication and the corresponding preventive technique, it will be of great value to reduce hemorrhage complications and obtain the maximum benefit from clopidogrel' s anti-platelet properties.

  5. Treatment of sepsis: current status of clinical immunotherapy.

    LENUS (Irish Health Repository)

    O'Callaghan, A

    2012-02-03

    While antibiotics address the root cause of sepsis--that of pathogen infection--they fail to provide an adequate cure for the condition. Currently, 30% to 50% of septic patients die, and this figure is likely to increase in line with the proliferation of multi-drug resistant bacteria. With an increased understanding of the immune response, it has been proposed that modulation of this defence mechanism offers the best hope of cure. Many entry-points in the immune system have been identified and targeted therapies have been developed,but why are these not in routine clinical practice? This review examines the latest evidence for the use of immuno-modulating drugs, obtained from human clinical trials. We discuss cytokine-based therapies, steroids and anti-coagulants. Finally, consideration is given as to why successful therapies in the laboratory, and in vivo models, do not automatically translate into clinical benefit

  6. Pathology and sensitivity of current clinical criteria in corticobasal syndrome.

    Science.gov (United States)

    Ouchi, Haruka; Toyoshima, Yasuko; Tada, Mari; Oyake, Mutsuo; Aida, Izumi; Tomita, Itsuro; Satoh, Akira; Tsujihata, Mitsuhiro; Takahashi, Hitoshi; Nishizawa, Masatoyo; Shimohata, Takayoshi

    2014-02-01

    The aim of this study was to investigate corticobasal syndrome with respect to underlying pathologies, the ability of current clinical criteria to detect early stages of disease, and symptoms and signs predicting background pathologies. We retrospectively analyzed the clinicopathological findings from patients with corticobasal syndrome. We also analyzed whether those findings fulfilled the diagnostic criteria for corticobasal degeneration (CBD). Finally, we investigated characteristic clinical features that are specific to each background pathology. Of 10 consecutive autopsied patients who had corticobasal syndrome (mean age ± standard deviation, 67.9 ± 9.3 years; male:female ratio, 6:4), three had corticobasal degeneration pathology, three had progressive supranuclear palsy, three had Alzheimer's disease, and one had atypical four-repeat tauopathy. Nine patients fulfilled Mayo criteria, and all 10 patients fulfilled modified Cambridge criteria at the later stage, but only two patients fulfilled either clinical criteria within 2 years of disease onset. Five patients fulfilled the clinical criteria for possible CBD (p-CBD), and one patient fulfilled the clinical research criteria for probable sporadic CBD (cr-CBD) at the later stage. Only two patients fulfilled the criteria for either p-CBD or cr-CBD within 2 years of disease onset. Although we could not find any predictive characteristic clinical features that were specific to CBD pathology, only patients with progressive supranuclear palsy developed apraxia of eyelid opening and cerebellar ataxia. Myoclonus and memory impairment, especially if they appear at an early stage of the disease, may predict Alzheimer's disease pathology. Sensitivity of the available clinical criteria for corticobasal syndrome was poor within 2 years of disease onset.

  7. Clinical utility of ivabradine in cardiovascular disease management: current status

    Directory of Open Access Journals (Sweden)

    Rosano GMC

    2014-08-01

    Full Text Available Giuseppe MC Rosano,1,2 Cristiana Vitale,1,2 Ilaria Spoletini,1 Maurizio Volterrani11Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy; 2Cardiovascular and Cell Sciences Research Institute, St George's University of London, London, UK Abstract: Ivabradine is a selective antagonist of the funny channels with anti-anginal and anti-ischemic properties, approved for the treatment of coronary artery disease (CAD and heart failure (HF. It provides pure heart rate reduction, reducing the diastolic depolarization slope, without altering hemodynamic parameters. This review summarizes the current knowledge on the efficacy of ivabradine in patients with cardiovascular diseases, with a particular focus on its role in the clinical management of patients with CAD and HF. There is consistent evidence that ivabradine is effective in reducing angina pectoris symptoms and myocardial ischemia. At approved doses ivabradine is safe, improves exercise tolerance, and reduces heart rate. Available data from clinical trials support its use in the management of patients with stable CAD and chronic HF. Recent studies have cast doubt on the safety of non-approved high doses of ivabradine for the treatment of patients with CAD and without clinical HF, but have shown no concerns on the doses approved for clinical use. Keywords: ivabradine, coronary artery disease, heart failure, angina pectoris, exercise performance

  8. [Current views on etiology, pathophysiology and clinical manifestations of acromegaly].

    Science.gov (United States)

    Krysiak, Robert; Okopień, Bogusław; Marek, Bogdan

    2012-02-01

    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. [Asperger syndrome: evolution of the concept and current clinical data].

    Science.gov (United States)

    Aussilloux, C; Baghdadli, A

    2008-05-01

    Although Asperger syndrome is described by international classifications as a category of pervasive developmental disorder (PDD), its validity as a specific entity distinct from autistic disorders remains controversial. The syndrome, first described by Hans Asperger, could not be distinguished from high functioning autism (onset, symptoms, outcome...). However, international classifications propose a distinction between the two syndromes based on a delayed onset, the absence of speech delay, the presence of motor disorders and a better outcome in Asperger syndrome. This categorical differentiation is not confirmed by current studies and in the absence of biological markers, no clinical, neuropsychological or epidemiological criteria makes it possible to distinguish high functioning autism from Asperger syndrome. From a clinical perspective, it is nevertheless of interest to isolate Asperger syndrome from other autistic disorders to propose specific assessment and therapy.

  10. Efficacy and Safety of Saffron Supplementation: Current Clinical Findings.

    Science.gov (United States)

    Broadhead, G K; Chang, A; Grigg, J; McCluskey, P

    2016-12-09

    Saffron (Crocus savitus) is a Middle-Eastern herb with strong antioxidant properties. Its major constituents, safranal, crocin, and crocetin, are also antioxidants and bear structural similarities to other well-known natural antixodant substances, such as zeaxanthin. Given the role of oxidative stress in many diseases, considerable interest has been shown into the potential role of saffron supplementation as a treatment for a range of diseases. In vitro and animal studies have provided evidence that saffron and its constituents may be potent therapies for a range of pathologies, including Alzheimer's disease, age-related macular degeneration (AMD) and cardiac ischemia. Whether these findings translate into clinical efficacy, however, has as of yet been incompletely assessed. This makes assessing the role of saffron supplementation in these diseases difficult. Here, we review the current human clinical evidence supporting saffron supplementation as a treatment for a range of pathologies and the underlying science supporting its use.

  11. [Musculoskeletal shock wave therapy--current database of clinical research].

    Science.gov (United States)

    Rompe, J D; Buch, M; Gerdesmeyer, L; Haake, M; Loew, M; Maier, M; Heine, J

    2002-01-01

    During the past decade application of extracorporal shock waves became an established procedure for the treatment of various musculoskeletal diseases in Germany. Up to now the positive results of prospective randomised controlled trials have been published for the treatment of plantar fasciitis, lateral elbow epicondylitis (tennis elbow), and of calcifying tendinitis of the rotator cuff. Most recently, contradicting results of prospective randomised placebo-controlled trials with adequate sample size calculation have been reported. The goal of this review is to present information about the current clinical database on extracorporeal shock wave treatment (ESWT).

  12. Development of a current-controlled defibrillator for clinical tests.

    Science.gov (United States)

    Fischer, M; Schönegg, M; Schöchlin, J; Bolz, A

    2002-01-01

    The work presented here is only a part of the development for a new current-controlled defibrillator. In the diploma thesis "Development and construction of a current-controlled defibrillator for clinical tests" the most important part was the control and safety of the defibrillator. To ensure a safe circuit design, a risk-analysis and a Failure Mode and Effects Analysis (FMEA) were necessary. Another major part was the programming of a microcontroller in embedded C and a programmable logic device in Very High Speed Integrated Circuit Description Language (VHDL). The circuit had to be constructed, and the defibrillator was optically decoupled from the laptop for safety reasons. The waveform-data can be transmitted to the microcontroller from the laptop, and the logged data is then transmitted back.

  13. Study of the underlying electrochemistry of polycrystalline gold electrodes in aqueous solution and electrocatalysis by large amplitude fourier transformed alternating current voltammetry.

    Science.gov (United States)

    Lertanantawong, Benchaporn; O'Mullane, Anthony P; Surareungchai, Werasak; Somasundrum, Mithran; Declan Burke, L; Bond, Alan M

    2008-03-18

    Polycrystalline gold electrodes of the kind that are routinely used in analysis and catalysis in aqueous media are often regarded as exhibiting relatively simple double-layer charging/discharging and monolayer oxide formation/removal in the positive potential region. Application of the large amplitude Fourier transformed alternating current (FT-ac) voltammetric technique that allows the faradaic current contribution of fast electron-transfer processes to be emphasized in the higher harmonic components has revealed the presence of well-defined faradaic (premonolayer oxidation) processes at positive potentials in the double-layer region in acidic and basic media which are enhanced by electrochemical activation. These underlying quasi-reversible interfacial electron-transfer processes may mediate the course of electrocatalytic oxidation reactions of hydrazine, ethylene glycol, and glucose on gold electrodes in aqueous media. The observed responses support key assumptions associated with the incipient hydrous oxide adatom mediator (IHOAM) model of electrocatalysis.

  14. Endoscopic Ultrasound Elastography: Current Clinical Use in Pancreas.

    Science.gov (United States)

    Mondal, Utpal; Henkes, Nichole; Patel, Sandeep; Rosenkranz, Laura

    2016-08-01

    Elastography is a newer technique for the assessment of tissue elasticity using ultrasound. Cancerous tissue is known to be stiffer (hence, less elastic) than corresponding healthy tissue, and as a result, could be identified in an elasticity-based imaging. Ultrasound elastography has been used in the breast, thyroid, and cervix to differentiate malignant from benign neoplasms and to guide or avoid unnecessary biopsies. In the liver, elastography has enabled a noninvasive and reliable estimate of fibrosis. Endoscopic ultrasound has become a robust diagnostic and therapeutic tool for the management of pancreatic diseases. The addition of elastography to endoscopic ultrasound enabled further characterization of pancreas lesions, and several European and Asian studies have reported encouraging results. The current clinical role of endoscopic ultrasound elastography in the management of pancreas disorders and related literature are reviewed.

  15. Bacterial protein toxins: current and potential clinical use.

    Science.gov (United States)

    Fabbri, A; Travaglione, S; Falzano, L; Fiorentini, C

    2008-01-01

    Natural toxins are the product of a long-term evolution, and act on essential mechanisms in the most crucial and vital processes of living organisms. They can attack components of the protein synthesis machinery, actin polymerization, signal transduction pathways, intracellular trafficking of vesicles as well as immune and inflammatory responses. For this reason, toxins have increasingly being used as valuable tools for analysis of cellular physiology, and in the recent years, some of them are used medicinally for the treatment of human diseases. This review is devoted to protein toxins of bacterial origin, specifically those toxins that are currently used in therapy or those under study for their potential clinical applications. Bacterial protein toxins are all characterized by a specific mechanism of action that involves the central molecular pathways in the eukaryotic cell. Knowledge of their properties could be used for medical purposes.

  16. Curcumin: from ancient medicine to current clinical trials.

    Science.gov (United States)

    Hatcher, H; Planalp, R; Cho, J; Torti, F M; Torti, S V

    2008-06-01

    Curcumin is the active ingredient in the traditional herbal remedy and dietary spice turmeric (Curcuma longa). Curcumin has a surprisingly wide range of beneficial properties, including anti-inflammatory, antioxidant, chemopreventive and chemotherapeutic activity. The pleiotropic activities of curcumin derive from its complex chemistry as well as its ability to influence multiple signaling pathways, including survival pathways such as those regulated by NF-kappaB, Akt, and growth factors; cytoprotective pathways dependent on Nrf2; and metastatic and angiogenic pathways. Curcumin is a free radical scavenger and hydrogen donor, and exhibits both pro- and antioxidant activity. It also binds metals, particularly iron and copper, and can function as an iron chelator. Curcumin is remarkably non-toxic and exhibits limited bioavailability. Curcumin exhibits great promise as a therapeutic agent, and is currently in human clinical trials for a variety of conditions, including multiple myeloma, pancreatic cancer, myelodysplastic syndromes, colon cancer, psoriasis and Alzheimer's disease.

  17. Computed tomography colonography for the practicing radiologist:A review of current recommendations on methodology and clinical indications

    Institute of Scientific and Technical Information of China (English)

    Paola Scalise; Annalisa Mantarro; Francesca Pancrazi; Emanuele Neri

    2016-01-01

    Colorectal cancer(CRC) represents one of the most relevant causes of morbidity and mortality in Western societies. CRC screening is actually based on faecal occult blood testing, and optical colonoscopy still remains the gold standard screening test for cancer detection. However, computed tomography colonography(CT colonography) constitutes a reliable, minimally-invasive method to rapidly and effectively evaluate the entire colon for clinically relevant lesions. Furthermore, even if the benefits of its employment in CRC mass screening have not fully established yet, CT colonography may represent a reasonable alternative screening test in patients who cannot undergo or refuse colonoscopy. Therefore, the purpose of our review is to illustrate the most updated recommendations on methodology and the current clinical indications of CT colonography, according to the data of the existing relevant literature.

  18. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  19. Gold Rush!

    Science.gov (United States)

    Brahier, Daniel J.

    1997-01-01

    Describes a mathematical investigation of gold--how it is weighed, stored, used, and valued. For grades 3-4, children estimate the value of treasure chests filled with gold coins and explore the size and weight of gold bars. Children in grades 5-6 explore how gold is mined and used, and how the value of gold changes over time. (PVD)

  20. Implications on clinical scenario of gold nanoparticle radiosensitization in regards to photon energy, nanoparticle size, concentration and location

    Energy Technology Data Exchange (ETDEWEB)

    Lechtman, E; Mashouf, S; Pignol, J P [Department of Medical Biophysics, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N3M5 (Canada); Chattopadhyay, N; Cai, Z; Reilly, R, E-mail: Jean-Philippe.Pignol@sunnybrook.ca [Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario M5S 3M2 (Canada)

    2011-08-07

    Gold nanoparticle (AuNP) radiosensitization represents a novel approach to enhance the effectiveness of ionizing radiation. Its efficiency varies widely with photon source energy and AuNP size, concentration, and intracellular localization. In this Monte Carlo study we explored the effects of those parameters to define the optimal clinical use of AuNPs. Photon sources included {sup 103}Pd and {sup 125}I brachytherapy seeds; {sup 169}Yb, {sup 192}Ir high dose rate sources, and external beam sources 300 kVp and 6 MV. AuNP sizes were 1.9, 5, 30, and 100 nm. We observed a 10{sup 3} increase in the rate of photoelectric absorption using {sup 125}I compared to 6 MV. For a {sup 125}I source, to double the dose requires concentrations of 5.33-6.26 mg g{sup -1} of Au or 7.10 x 10{sup 4} 30 nm AuNPs per tumor cell. For 6 MV, concentrations of 1560-1760 mg g{sup -1} or 2.17 x 10{sup 7} 30 nm AuNPs per cell are needed, which is not clinically achievable. Examining the proportion of energy transferred to escaping particles or internally absorbed in the nanoparticle suggests two clinical strategies: the first uses photon energies below the k-edge and takes advantage of the extremely localized Auger cascade. It requires small AuNPs conjugated to tumor targeted moieties and nuclear localizing sequences. The second, using photon sources above the k-edge, requires a higher gold concentration in the tumor region. In this approach, energy deposited by photoelectrons is the main contribution to radiosensitization; AuNP size and cellular localization are less relevant.

  1. Implications on clinical scenario of gold nanoparticle radiosensitization in regards to photon energy, nanoparticle size, concentration and location

    Science.gov (United States)

    Lechtman, E.; Chattopadhyay, N.; Cai, Z.; Mashouf, S.; Reilly, R.; Pignol, J. P.

    2011-08-01

    Gold nanoparticle (AuNP) radiosensitization represents a novel approach to enhance the effectiveness of ionizing radiation. Its efficiency varies widely with photon source energy and AuNP size, concentration, and intracellular localization. In this Monte Carlo study we explored the effects of those parameters to define the optimal clinical use of AuNPs. Photon sources included 103Pd and 125I brachytherapy seeds; 169Yb, 192Ir high dose rate sources, and external beam sources 300 kVp and 6 MV. AuNP sizes were 1.9, 5, 30, and 100 nm. We observed a 103 increase in the rate of photoelectric absorption using 125I compared to 6 MV. For a 125I source, to double the dose requires concentrations of 5.33-6.26 mg g-1 of Au or 7.10 × 104 30 nm AuNPs per tumor cell. For 6 MV, concentrations of 1560-1760 mg g-1 or 2.17 × 107 30 nm AuNPs per cell are needed, which is not clinically achievable. Examining the proportion of energy transferred to escaping particles or internally absorbed in the nanoparticle suggests two clinical strategies: the first uses photon energies below the k-edge and takes advantage of the extremely localized Auger cascade. It requires small AuNPs conjugated to tumor targeted moieties and nuclear localizing sequences. The second, using photon sources above the k-edge, requires a higher gold concentration in the tumor region. In this approach, energy deposited by photoelectrons is the main contribution to radiosensitization; AuNP size and cellular localization are less relevant.

  2. Telecytology: Clinical applications, current challenges, and future benefits

    Directory of Open Access Journals (Sweden)

    Michael Thrall

    2011-01-01

    Full Text Available Telecytology is the interpretation of cytology material at a distance using digital images. For more than a decade, pioneering efforts to introduce telecytology into clinical practice have been reported. A Medline search for "telecytology" and "cytology" reveals a voluminous literature, though much of what has been published to date is based on technologies that are rapidly becoming obsolete. The technological limitations of previous techniques, including the transmission of static digital images and dynamic streaming images, have limited telecytology to minor niches. The primary problem with these technologies is that the remote viewer can only see a small fraction of the material on the original slides, introducing the possibility of diagnostic error based not only on image quality but also on image selection. Remote robotic microscopy offers one possible solution to this problem, but to date has found limited acceptance, principally attributable to slow operating times. Whole slide imaging seems to be a much more promising solution, though cytology-specific literature regarding its use is still scant. The advent of whole slide imaging opens up new possibilities for telecytology by enabling high-quality images of entire cytology specimens to be available to anyone, anywhere via the Internet. Although challenges remain, especially with regard to capturing the full microscopy experience including multiple planes of focus and sharp high-powered images, rapidly advancing technology promises to overcome these limitations. Increasing application of whole slide imaging technology in surgical pathology will undoubtedly also increase its application to cytology due to the increasing affordability and practicality of the equipment as it serves a larger number of useful roles within a pathology department. The current and expanding applications of telecytology for clinical practice, education, quality assurance, and testing will be reviewed.

  3. Current Clinical Indications for Small Bowel Capsule Endoscopy.

    Science.gov (United States)

    Rosa, Bruno; Cotter, José

    2015-01-01

    Small bowel capsule endoscopy is currently the first line diagnostic examination for many diseases affecting the small bowel. This article aims to review and critically address the current indications of small bowel capsule endoscopy in clinical practice. Bibliographic review of relevant and recent papers indexed in PubMed. Small bowel capsule endoscopy enables a non-invasive full-assessment of the small bowel mucosa, with high diagnostic yield even for subtle lesions. In patients with obscure gastrointestinal bleeding, diagnostic yield is higher when performed early after the onset of bleeding. Endoscopic treatment of angioectasias using balloon-assisted enteroscopy may contribute to reduce rebleeding, while the risk of rebleeding in patients with 'negative' small bowel capsule endoscopy is debatable. Cross-sectional imaging may be more accurate than small bowel capsule endoscopy for the diagnosis of large small bowel tumors. The Smooth Protruding Index on Capsule Endoscopy (SPICE score) may help to differentiate submucosal tumors from innocent bulges. Small bowel capsule endoscopy is also a key diagnostic instrument in patients with suspected Crohn's disease and non-diagnostic ileocolonoscopy; it may also influence prognosis and therapeutic management, by determining disease extent and activity in patients with known Crohn's disease. The role of small bowel capsule endoscopy to investigate possible complications in patients with non-responsive coeliac disease is evolving. Small bowel capsule endoscopy is a valuable diagnostic instrument for patients with obscure gastrointestinal bleeding and/or suspected small bowel tumors; it may also be a key examination in patients with suspected Crohn's disease, or patients with known Crohn's disease to fully assess disease extension and activity; finally, it may contribute for the diagnosis of complications of non-responsive coeliac disease.

  4. Reply to Comment on ‘Implications on clinical scenario of gold nanoparticle radiosensitization in regards to photon energy, nanoparticle size, concentration and location’

    Science.gov (United States)

    Pignol, Jean-Philippe; Lechtman, Eli

    2012-01-01

    In a comment on a recent paper by Lechtman et al (2011 Phys. Med. Biol. 56 4631-47), McMahon critiques one of Lechtman's conclusion that gold nanoparticle radiosensitization may not be applicable to megavoltage radiotherapy. He refers to recently published experimental studies showing radiosensitization with 6 MV x-rays and low gold concentrations. However those published studies show conflicting results, presenting survival curves with a small cell death increased with gold and some with no difference. In regards to gold nanoparticle radiosensitization physical, chemical, pharmacological and biological constraints all interplay. There are plenty of experimental and theoretical data to confirm the strong dependence to the primary photon energy and gold concentration. The manuscript of Lechtman added the dependence to microscopic localization, analysing the spatial distribution and the quality of secondary electrons, as a major player in the feasibility of the technique. We agree that radiobiological dose modification factor should be considered, but it is unlikely that accounting for a maximum RBE of 2 can compensate for the drastic decrease of photoelectric events shifting from kV to MV. Lechtman calculated that to achieve similar radiosensitization for low energy beams and intra-cellular gold concentration of 0.5%, concentrations 300 times higher are required for 6 MV beams. To date it seems unlikely that concentration higher than 1% could be achieved such that it is unlikely that megavoltage would yield a measurable clinical effect.

  5. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    Directory of Open Access Journals (Sweden)

    Scott Okuno

    2011-08-01

    Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  6. Clinical decision rules for acute bacterial meningitis: current insights

    Directory of Open Access Journals (Sweden)

    Viallon A

    2016-04-01

    Full Text Available Alain Viallon,1 Elisabeth Botelho-Nevers,2 Fabrice Zeni3 1Emergency Department, 2Department of Infectious Disease, 3Intensive Care Unit, University Hospital, Saint-Etienne, France Abstract: Acute community-acquired bacterial meningitis (BM requires rapid diagnosis so that suitable treatment can be instituted within 60 minutes of admitting the patient. The cornerstone of diagnostic examination is lumbar puncture, which enables microbiological analysis and determination of the cerebrospinal fluid (CSF cytochemical characteristics. However, microbiological testing is not sufficiently sensitive to rule out this diagnosis. With regard to the analysis of standard CSF cytochemical characteristics (polymorphonuclear count, CSF glucose and protein concentration, and CSF:serum glucose, this is often misleading. Indeed, the relatively imprecise nature of the cutoff values for these BM diagnosis markers can make their interpretation difficult. However, there are two markers that appear to be more efficient than the standard ones: CSF lactate and serum procalcitonin levels. Scores and predictive models are also available; however, they only define a clinical probability, and in addition, their use calls for prior validation on the population in which they are used. In this article, we review current methods of BM diagnosis. Keywords: meningitis, diagnosis, emergency

  7. Clinical proteomics: Current status, challenges, and future perspectives

    Directory of Open Access Journals (Sweden)

    Shyh-Horng Chiou

    2011-01-01

    Full Text Available This account will give an overview and evaluation of the current advances in mass spectrometry (MS-based proteomics platforms and technology. A general review of some background information concerning the application of these methods in the characterization of molecular sizes and related protein expression profiles associated with different types of cells under varied experimental conditions will be presented. It is intended to provide a concise and succinct overview to those clinical researchers first exposed to this foremost powerful methodology in modern life sciences of postgenomic era. Proteomic characterization using highly sophisticated and expensive instrumentation of MS has been used to characterize biological samples of complex protein mixtures with vastly different protein structure and composition. These systems are then used to highlight the versatility and potential of the MS-based proteomic strategies for facilitating protein expression analysis of various disease-related organisms or tissues of interest. Major MS-based strategies reviewed herein include (1 matrix-assisted laser desorption ionization-MS and electron-spray ionization proteomics; (2 one-dimensional or two-dimensional gel-based proteomics; (3 gel-free shotgun proteomics in conjunction with liquid chromatography/tandem MS; (4 Multiple reaction monitoring coupled tandem MS quantitative proteomics and; (5 Phosphoproteomics based on immobilized metal affinity chromatography and liquid chromatography-MS/MS.

  8. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    Directory of Open Access Journals (Sweden)

    Yoshihiro Abiko

    2012-01-01

    Full Text Available Patients with atypical odontalgia (AO complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i What is the prevalence of AO in the community?\t(ii What psychological problems are experienced by patients with AO? (iii Are there any comorbidities of AO? (iv Is local anesthesia effective for the relief of pain in AO? (v Are there any characteristic symptoms of AO other than spontaneous pain? (vi Are antidepressants effective for treatment of AO? (vii Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach.

  9. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    Science.gov (United States)

    Abiko, Yoshihiro; Matsuoka, Hirofumi; Chiba, Itsuo; Toyofuku, Akira

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) Are there any comorbidities of AO? (iv) Is local anesthesia effective for the relief of pain in AO? (v) Are there any characteristic symptoms of AO other than spontaneous pain? (vi) Are antidepressants effective for treatment of AO? (vii) Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach. PMID:22844283

  10. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    Energy Technology Data Exchange (ETDEWEB)

    Joglekar, Siddharth B. [Musculoskeletal Oncology, Mayo Clinic, Rochester, MN55905 (United States); Rose, Peter S.; Sim, Franklin, E-mail: sim.franklin@mayo.edu [Department of Orthopedics, Mayo Clinic, 200 1st ST SW, Rochester, MN 55905 (United States); Okuno, Scott [Department of Oncology, Mayo Clinic, Rochester, MN55905 (United States); Petersen, Ivy [Department of Radiation Oncology, Mayo Clinic, Rochester, MN55905 (United States)

    2011-08-08

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  11. SAPHO Syndrome: Current Developments and Approaches to Clinical Treatment.

    Science.gov (United States)

    Firinu, Davide; Garcia-Larsen, Vanessa; Manconi, Paolo Emilio; Del Giacco, Stefano R

    2016-06-01

    SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare autoimmune disease which, due to its clinical presentation and symptoms, is often misdiagnosed and unrecognized. Its main features are prominent inflammatory cutaneous and articular manifestations. Treatments with immunosuppressive drugs have been used for the management of SAPHO with variable results. To date, the use of anti-TNF-α agents has proved to be an effective alternative to conventional treatment for unresponsive or refractory SAPHO cases. TNF-α is a pro-inflammatory cytokine and pivotal regulator of other cytokines, including IL-1 β, IL-6, and IL-8, involved in inflammation, acute-phase response induction, and chemotaxis. IL-1 inhibition strategies with anakinra have shown efficacy as first and second lines of treatment. In this review, we will describe the main characteristics of biological drugs currently used for SAPHO syndrome. We also describe some of the promising therapeutic effects of ustekinumab, an antibody against the p40 subunit of IL-12 and IL-23, after failure of multiple drugs including anti-TNF-α and anakinra. We discuss the use and impact of the new anti-IL-1 antagonists involved in the IL-17 blockade, in particular for the most difficult-to-treat SAPHO cases.

  12. Currently Clinical Views on Genetics of Wilson′s Disease

    Directory of Open Access Journals (Sweden)

    Chen Chen

    2015-01-01

    Conclusions: Clinical genetics studies are necessary to understand the mechanism underlying WD at the molecular level from the genotype to the phenotype. Clinical genetics research benefits newly emerging medical treatments including stem cell transplantation and gene therapy for WD patients.

  13. Pediatric Clinical Trials: Current Scenario in the Asia Pacific Region

    Directory of Open Access Journals (Sweden)

    Saldanha LM

    2013-07-01

    Full Text Available Lisa Marie Saldanha,1 Saumya Nayak,1 Adeline Sng,1 Mei-Ling Long,1 Elisabeth Schrader,2 Amanur Rahman,3 Elvira Zenaida Lansang,1 Karen Wai,1 Ken Lee41Feasibility and Site Identification Asia, Quintiles East Asia Private Limited, Singapore; 2Quintiles Pediatric Center of Excellence, Durham, NC, USA; 3Faculty of Engineering, National University of Singapore, Singapore; 4Asia Site Services, Quintiles East Asia Private Limited, SingaporeObjective: This site survey was conducted to understand the current pediatric clinical trial landscape across countries in the Asia Pacific region, specifically in terms of interest, experience, capabilities, requirements of the ethics committee, patient availability, and overall challenges involved in conducting pediatric trials.Methods and materials: Between May and June 2012, an English language survey form was sent to sites (identified through Quintiles’ internal database with pediatric capability and referrals from doctors during a preliminary outreach. In July 2012, the responses from the completed survey forms were entered into SurveyMethods, a web-based central repository. Data analysis was performed in August–September 2012 using SurveyMethods.Results: Seventy-seven sites were contacted for this survey across the Asia Pacific region. Sixty-four percent (49 sites completed 63 surveys and confirmed interest to participate in clinical trials in the pediatric population. Seventy-one percent of the sites had prior experience. Eighty percent confirmed needing an assent from pediatric patients; 81%–95% confirmed acceptance of placebo-controlled and pharmacokinetic studies by ethics committees; and 37% cited challenges in conducting studies in this population.Conclusion: This survey indicates that there is a high level of interest among sites in the Asia Pacific region in conducting pediatric trials across various therapeutic indications. No major insurmountable challenges were identified in conducting

  14. Current status on performance of CT colonography and clinical indications

    Energy Technology Data Exchange (ETDEWEB)

    Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

    2013-08-15

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  15. Inter-Observer Agreement in Dysplasia Grading: Towards an Enhanced Gold Standard for Clinical Pathology Trials

    Science.gov (United States)

    Speight, Paul M.; Abram, Timothy J.; Floriano, Pierre N.; James, Robert; Vick, Julie; Thornhill, Martin H.; Murdoch, Craig; Freeman, Christine; Hegarty, Anne M; D’Apice, Katy; Kerr, A. Ross; Phelan, Joan; Corby, Patricia; Khouly, Ismael; Vigneswaran, Nadarajah; Bouquot, Jerry; Demian, Nagi M.; Weinstock, Y. Etan; Redding, Spencer W.; Rowan, Stephanie; Yeh, Chih-Ko; McGuff, H. Stan; Miller, Frank R.; McDevitt, John T.

    2015-01-01

    Objective Inter-observer agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. Study Design Two adjacent serial histological sections of oral lesions from 846 patients were independently scored by two different pathologists from a pool of four. In instances where the original two pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. Results Individual pathologist pair kappa values ranged from 0.251 – 0.706 (fair – good) before the 3-stage review process During the initial review phase, the two pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). Following the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. Conclusion The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis. PMID:26216170

  16. Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials.

    Science.gov (United States)

    Speight, Paul M; Abram, Timothy J; Floriano, Pierre N; James, Robert; Vick, Julie; Thornhill, Martin H; Murdoch, Craig; Freeman, Christine; Hegarty, Anne M; D'Apice, Katy; Kerr, A Ross; Phelan, Joan; Corby, Patricia; Khouly, Ismael; Vigneswaran, Nadarajah; Bouquot, Jerry; Demian, Nagi M; Weinstock, Y Etan; Redding, Spencer W; Rowan, Stephanie; Yeh, Chih-Ko; McGuff, H Stan; Miller, Frank R; McDevitt, John T

    2015-10-01

    Interobserver agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. Two adjacent serial histologic sections of oral lesions from 846 patients were independently scored by 2 different pathologists from a pool of 4. In instances where the original 2 pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. Individual pathologist pair κ values ranged from 0.251 to 0.706 (fair-good) before the 3-stage review process. During the initial review phase, the 2 pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). After the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Comparing image search behaviour in the ARRS GoldMiner search engine and a clinical PACS/RIS.

    Science.gov (United States)

    De-Arteaga, Maria; Eggel, Ivan; Do, Bao; Rubin, Daniel; Kahn, Charles E; Müller, Henning

    2015-08-01

    underrepresented, therefore RadLex was considered to be the best option for this task. The results show a surprising similarity between the usage behaviour in the two systems, but several subtle differences can also be noted. The average number of terms per query is 2.21 for GoldMiner and 2.07 for radTF, the used axes of RadLex (anatomy, pathology, findings, …) have almost the same distribution with clinical findings being the most frequent and the anatomical entity the second; also, combinations of RadLex axes are extremely similar between the two systems. Differences include a longer length of the sessions in radTF than in GoldMiner (3.4 and 1.9 queries per session on average). Several frequent search terms overlap but some strong differences exist in the details. In radTF the term "normal" is frequent, whereas in GoldMiner it is not. This makes intuitive sense, as in the literature normal cases are rarely described whereas in clinical work the comparison with normal cases is often a first step. The general similarity in many points is likely due to the fact that users of the two systems are influenced by their daily behaviour in using standard web search engines and follow this behaviour in their professional search. This means that many results and insights gained from standard web search can likely be transferred to more specialized search systems. Still, specialized log files can be used to find out more on reformulations and detailed strategies of users to find the right content.

  18. Current clinical approach to patients with disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Robson Luis Oliveira de Amorim

    Full Text Available Summary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.

  19. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same w

  20. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same

  1. Clinical management of achalasia: current state of the art

    Directory of Open Access Journals (Sweden)

    Krill JT

    2016-04-01

    Full Text Available Joseph T Krill, Rishi D Naik, Michael F Vaezi Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, Nashville, TN, USA Abstract: Achalasia is a primary disorder of esophageal motility. It classically presents with dysphagia to both solids and liquids but may be accompanied by regurgitation and chest pain. The gold standard for the diagnosis of achalasia is esophageal motility testing with manometry, which often reveals aperistalsis of the esophageal body and incomplete lower esophageal sphincter relaxation. The diagnosis is aided by complimentary tests, such as esophagogastroduodenoscopy and contrast radiography. Esophagogastroduodenoscopy is indicated to rule out mimickers of the disease known as “pseudoachalasia” (eg, malignancy. Endoscopic appearance of a dilated esophagus with retained food or saliva and a puckered lower esophageal sphincter should raise suspicion for achalasia. Additionally, barium esophagography may reveal a dilated esophagus with a distal tapering giving it a “bird’s beak” appearance. Multiple therapeutic modalities aid in the management of achalasia, the decision of which depends on operative risk factors. Conventional treatments include medical therapy, botulinum toxin injection, pneumatic dilation, and Heller myotomy. The last two are defined as the most definitive treatment options. New emerging therapies include peroral endoscopic myotomy, placement of self-expanding metallic stents, and endoscopic sclerotherapy. Keywords: achalasia, pseudoachalasia, pneumatic dilation, Heller myotomy, botulinum toxin injection, peroral endoscopic myotomy

  2. Simplified Symptom Pattern Method for verbal autopsy analysis: multisite validation study using clinical diagnostic gold standards

    Directory of Open Access Journals (Sweden)

    Lozano Rafael

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy can be a useful tool for generating cause of death data in data-sparse regions around the world. The Symptom Pattern (SP Method is one promising approach to analyzing verbal autopsy data, but it has not been tested rigorously with gold standard diagnostic criteria. We propose a simplified version of SP and evaluate its performance using verbal autopsy data with accompanying true cause of death. Methods We investigated specific parameters in SP's Bayesian framework that allow for its optimal performance in both assigning individual cause of death and in determining cause-specific mortality fractions. We evaluated these outcomes of the method separately for adult, child, and neonatal verbal autopsies in 500 different population constructs of verbal autopsy data to analyze its ability in various settings. Results We determined that a modified, simpler version of Symptom Pattern (termed Simplified Symptom Pattern, or SSP performs better than the previously-developed approach. Across 500 samples of verbal autopsy testing data, SSP achieves a median cause-specific mortality fraction accuracy of 0.710 for adults, 0.739 for children, and 0.751 for neonates. In individual cause of death assignment in the same testing environment, SSP achieves 45.8% chance-corrected concordance for adults, 51.5% for children, and 32.5% for neonates. Conclusions The Simplified Symptom Pattern Method for verbal autopsy can yield reliable and reasonably accurate results for both individual cause of death assignment and for determining cause-specific mortality fractions. The method demonstrates that verbal autopsies coupled with SSP can be a useful tool for analyzing mortality patterns and determining individual cause of death from verbal autopsy data.

  3. Currently Clinical Views on Genetics of Wilson′s Disease

    OpenAIRE

    Chen Chen; Bo Shen; Jia-Jia Xiao; Rong Wu; Sarah Jane Duff Canning; Xiao-Ping Wang

    2015-01-01

    Objective: The objective of this study was to review the research on clinical genetics of Wilson′s disease (WD). Data Sources: We searched documents from PubMed and Wanfang databases both in English and Chinese up to 2014 using the keywords WD in combination with genetic, ATP7B gene, gene mutation, genotype, phenotype. Study Selection: Publications about the ATP7B gene and protein function associated with clinical features were selected. Results: Wilson′s disease, also named hepat...

  4. Validation of IgG, IgM multiplex plasmonic gold platform in French clinical cohorts for the serodiagnosis and follow-up of Toxoplasma gondii infection.

    Science.gov (United States)

    Pomares, Christelle; Zhang, Bo; Arulkumar, Shylaja; Gonfrier, Geraldine; Marty, Pierre; Zhao, Su; Cheng, Steven; Tang, Meijie; Dai, Hongjie; Montoya, Jose G

    2017-03-01

    We report the use of the multiplexed T. gondii IgG, IgM test on plasmonic gold (pGOLD) platform in the setting of T. gondii infection by analyzing 244 sera from Nice, France (seroconversion, chronically infected, non-infected and newborns serum samples). Results were compared with commercial tests for the detection of IgG and IgM and their overall clinical final interpretation of a complete serological profile. The IgG and IgM test results on the platform were in agreement in, respectively, 95% and 93% with the commercial kits. When comparing with the overall clinical interpretation of the serological profile, the agreement reached 99.5% and 97.7% for IgG and IgM, respectively. This innovative pGOLD platform allows detection of both IgG and IgM simultaneously with only ~1 microliter of serum. The multiplexed IgG/IgM test on pGOLD platform is a strong candidate for its use in the massive screening programs for toxoplasmosis during pregnancy.

  5. Currently Clinical Views on Genetics of Wilson's Disease

    Institute of Scientific and Technical Information of China (English)

    Chen Chen; Bo Shen; Jia-Jia Xiao; Rong Wu; Sarah Jane Duff Canning; Xiao-Ping Wang

    2015-01-01

    Objective:The objective of this study was to review the research on clinical genetics of Wilson's disease (WD).Data Sources:We searched documents from PubMed and Wanfang databases both in English and Chinese up to 2014 using the keywords WD in combination with genetic,ATP7B gene,gene mutation,genotype,phenotype.Study Selection:Publications about the ATP7B gene and protein function associated with clinical features were selected.Results:Wilson's disease,also named hepatolenticular degeneration,is an autosomal recessive genetic disorder characterized by abnormal copper metabolism caused by mutations to the copper-transporting gene A TP7B.Decreased biliary copper excretion and reduced incorporation of copper into apoceruloplasmin caused by defunctionalization of ATP7B protein lead to accumulation of copper in many tissues and organs,including liver,brain,and cornea,finally resulting in liver disease and extrapyramidal symptoms.It is the most common genetic neurological disorder in the onset of adolescents,second to muscular dystrophy in China.Early diagnosis and medical therapy are of great significance for improving the prognosis of WD patients.However,diagnosis of this disease is usually difficult because of its complicated phenotypes.In the last 10 years,an increasing number of clinical studies have used molecular genetics techniques.Improved diagnosis and prediction of the progression of this disease at the molecular level will aid in the development of more individualized and effective interventions,which is a key to transition from molecular genetic research to the clinical study.Conclusions:Clinical genetics studies are necessary to understand the mechanism underlying WD at the molecular level from the genotype to the phenotype.Clinical genetics research benefits newly emerging medical treatments including stem cell transplantation and gene therapy for WD patients.

  6. Primary hyperparathyroidism: epidemiology, clinical features, diagnostic tools and current management

    Directory of Open Access Journals (Sweden)

    Andrea Percivale

    2015-12-01

    Full Text Available Primary hyperparathyroidism (PHPT is a clinical condition characterized by overactive parathyroid gland secretion of parathyroid hormone with concurrent alteration of the phosphocalcemic metabolism. We present a literature review on primary hyperparathyroidism addressing key on clinical presentation, causes, medical and surgical treatment at the best of our knowledge. Based on this review we confirm the role of serum calcium and serum level examination, as well as we define the definitive treatment for PHPT being parathyroidectomy. In case of contraindication for surgery, medical treatment can play a relevant role.

  7. Review of current and evolving clinical indications forendoscopic ultrasound

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    For the first several years after its development,endoscopic ultrasound (EUS) was primarily limited toidentification of pancreatic malignancies. Since thistime, the field of EUS has advanced at a tremendousspeed in terms of additional clinical diagnostic andtherapeutic uses. The combination of ultrasound withendoscopy provides a unique interventional modalitythat is a minimally invasive alternative to various surgicalinterventions. Given the expanding recommendedindications for EUS, this article will serve to review themost common uses with supporting evidence, while alsoexploring innovative endeavors that may soon becomecommon clinical practice.

  8. Ligand-targeted particulate nanomedicines undergoing clinical evaluations: current status

    NARCIS (Netherlands)

    Meel, van der Roy; Vehmeijer, Laurens J.C.; Kok, Robbert J.; Storm, Gert; Gaal, van Ethlinn V.B.

    2013-01-01

    Since the introduction of Doxil® on the market nearly 20 years ago, a number of nanomedicines have become part of treatment regimens in the clinic. With the exception of antibody–drug conjugates, these nanomedicines are all devoid of targeting ligands and rely solely on their physicochemical propert

  9. Current clinical trials testing combinations of immunotherapy and radiation.

    Science.gov (United States)

    Crittenden, Marka; Kohrt, Holbrook; Levy, Ronald; Jones, Jennifer; Camphausen, Kevin; Dicker, Adam; Demaria, Sandra; Formenti, Silvia

    2015-01-01

    Preclinical evidence of successful combinations of ionizing radiation with immunotherapy has inspired testing the translation of these results to the clinic. Interestingly, the preclinical work has consistently predicted the responses encountered in clinical trials. The first example came from a proof-of-principle trial started in 2001 that tested the concept that growth factors acting on antigen-presenting cells improve presentation of tumor antigens released by radiation and induce an abscopal effect. Granulocyte-macrophage colony-stimulating factor was administered during radiotherapy to a metastatic site in patients with metastatic solid tumors to translate evidence obtained in a murine model of syngeneic mammary carcinoma treated with cytokine FLT-3L and radiation. Subsequent clinical availability of vaccines and immune checkpoint inhibitors has triggered a wave of enthusiasm for testing them in combination with radiotherapy. Examples of ongoing clinical trials are described in this report. Importantly, most of these trials include careful immune monitoring of the patients enrolled and will generate important data about the proimmunogenic effects of radiation in combination with a variety of immune modulators, in different disease settings. Results of these studies are building a platform of evidence for radiotherapy as an adjuvant to immunotherapy and encourage the growth of this novel field of radiation oncology.

  10. Current approach to masked hypertension: From diagnosis to clinical management.

    LENUS (Irish Health Repository)

    Dolan, Eamon

    2013-11-28

    The term masked hypertension phenomenon was first described by the late Professor Thomas Pickering and is commonly defined as having a normal clinic blood pressure (BP) but an elevated "out of office" reading. In the main these elevated readings have been provided through ambulatory blood pressure monitoring (ABPM) but sometimes home BP monitoring is used. It is now largely accepted that ABPM gives a better classification of risk than clinic BP. Thus the elevated ABPM levels should relate to higher cardiovascular risk and it follows that these people might be regarded as being genuinely hypertensive and at higher cardiovascular risk. The problem for clinical practice is how to identify and manage these subjects. The phenomenon should be suspected in subjects who have had an elevated clinic BP at some time, in young subjects with normal or normal-high clinic BP who have early left ventricular hypertrophy, in subjects with a family history of hypertension in both parents, patients with multiple risks for cardiovascular disease and perhaps diabetic patients. It appears to be more prevalent in subjects of male gender, with younger age, higher heart rate, obesity or high cholesterol levels and in smokers. Those with masked hypertension are at higher risk of events such as stroke and have a higher prevalence of target organ damage, for example, nephropathy. In conclusion most of the debate around this topic relates to its reliable identification. Given the higher ambulatory readings there is an increases cardiovascular risk making this diagnosis important. This article is protected by copyright. All rights reserved.

  11. Current status and perspectives of interventional clinical trials for glioblastoma - analysis of ClinicalTrials.gov.

    Science.gov (United States)

    Cihoric, Nikola; Tsikkinis, Alexandros; Minniti, Giuseppe; Lagerwaard, Frank J; Herrlinger, Ulrich; Mathier, Etienne; Soldatovic, Ivan; Jeremic, Branislav; Ghadjar, Pirus; Elicin, Olgun; Lössl, Kristina; Aebersold, Daniel M; Belka, Claus; Herrmann, Evelyn; Niyazi, Maximilian

    2017-01-03

    The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

  12. The polymerase chain reaction: current and future clinical applications.

    OpenAIRE

    Lynch, J R; Brown, J. M.

    1990-01-01

    The polymerase chain reaction has undergone rapid improvement since its initial development, such that the technique currently permits rapid, accurate, predictive tests to be made in the field of prenatal diagnosis and has greatly aided forensic medicine. It is anticipated that the polymerase chain reaction will also facilitate advances in other fields, in particular preimplantation diagnosis, virology, bacteriology, and cancer therapy.

  13. Current trends in the clinical development of peptide therapeutics.

    Science.gov (United States)

    Saladin, Pauline M; Zhang, Bodi D; Reichert, Janice M

    2009-12-01

    The development of peptides as drugs is attracting increasing attention from the pharmaceutical industry. This interest is at least partially a consequence of the widespread acceptance of therapeutic proteins by physicians and patients, and because of improvements to problems such as a short half-life and delivery issues. The markets for peptide-based compounds can be substantial, with six peptide drugs attaining global sales of more than US $750 million in 2008. To track trends in the clinical development and marketing approval of peptides, Tufts Center for the Study of Drug Development and Ferring Research Institute compiled publically available data for peptides that entered clinical trials sponsored by commercial firms, with a focus on peptide therapeutics, but also including peptide vaccines and diagnostics. The results provide an historical overview of the development of peptide therapeutics, and may inform strategic planning in this area.

  14. CSF-1R Inhibitor Development: Current Clinical Status.

    Science.gov (United States)

    Peyraud, Florent; Cousin, Sophie; Italiano, Antoine

    2017-09-05

    Colony-stimulating factor 1 receptor (CSF-1R) and its ligands, CSF-1 and interleukin 34 (IL-34), regulate the function and survival of tumor-associated macrophages, which are involved in tumorigenesis and in the suppression of antitumor immunity. Moreover, the CSF-1R/CSF-1 axis has been implicated in the pathogenesis of pigmented villonodular synovitis (PVNS), a benign tumor of the synovium. As advanced or metastatic malignant solid tumors and relapsed/refractory PVNS remain unresolved therapeutic problems, new approaches are needed to improve the outcome of patients with these conditions. In solid tumors, targeting CSF-1R via either small molecules or antibodies has shown interesting results in vitro but limited antitumor activity in vivo. Concerning PVNS, clinical trials assessing CSF-1R inhibitors have revealed promising initial outcomes. Blocking CSF-1/CSF-1R signaling represents a promising immunotherapy approach and several new potential combination therapies for future clinical testing.

  15. Current clinical management strategies for benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiang-hua

    2008-01-01

    @@ This article summarizes the major new findings on clinical management for benign prostatic hyperplasia (BPH) that were presented at the annual meeting of the American Urological Association (AUA) in May 2008.The management of symptomatic BPH has been changed significantly over the last decade in response to the availability of new treatment options.Prior to the 1980s,open prostatectomy was the only widely accepted intervention for BPH.Since then,the advent of new medical therapies for BPH and the introduction of a range of minimally invasive therapies have provided for men with lower urinary tract symptoms (LUTS) secondary to BPH.1 In this year's AUA meeting,several new findings were reported in the filed of BPH which involved epidemiology,clinical progression,drug therapy and new technologies in surgical therapy of BPH.

  16. Current research on cigarette toxicity: critical appraisal in view of clinical laboratory

    Directory of Open Access Journals (Sweden)

    Prajwal Gyawali

    2016-06-01

    Full Text Available Cigarette smoking has been implicated as a potential risk factor for development and progression of chronic obstructive pulmonary disease (COPD and cardiovascular disease (CVD, including ischemic heart disease. Although, several methods are in existence to measuring cigarette toxicity, evidence regarding adoption of a gold standard technique is still imprecise. In this study, we reviewed articles describing methods of measuring cigarette toxicity in relation to clinical laboratory practice. A critical analysis of the benefits and limitations of each method in relation to low-middle income countries is discussed. [Int J Res Med Sci 2016; 4(6.000: 1785-1793

  17. Pleiotropic effects of niacin: Current possibilities for its clinical use.

    Science.gov (United States)

    Zeman, Miroslav; Vecka, Marek; Perlík, František; Staňková, Barbora; Hromádka, Robert; Tvrzická, Eva; Širc, Jakub; Hrib, Jakub; Žák, Aleš

    2016-12-01

    Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin's role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

  18. Everolimus-eluting stents: update on current clinical studies

    Directory of Open Access Journals (Sweden)

    Allocco DJ

    2011-07-01

    Full Text Available Dominic J Allocco, Anita A Joshi, Keith D DawkinsBoston Scientific Corporation, Natick, MA, USAAbstract: Everolimus-eluting stents (EES have become the most commonly implanted coronary stents worldwide. This review describes and analyzes the clinical data supporting the use of EES, focusing primarily on published, randomized, controlled trials. Everolimuseluting stents have been shown to have less restenosis, stent thrombosis, and periprocedural myocardial infarction compared with earlier generation paclitaxel-eluting stents (PES. Lower rates of adverse events for EES compared with PES were generally seen in all subgroups, with the notable exception of patients with diabetes mellitus. There have been fewer, randomized, clinical trials comparing EES with either sirolimus-eluting stents or zotarolimus-eluting stents, although very good results with EES have been observed in the trials that have been performed. Recent clinical trial data suggest that this excellent safety and efficacy profile is maintained in a next-generation EES designed to have improved mechanical properties and radiopacity.Keywords: drug-eluting stents, everolimus, Xience V, Promus, Promus ElementVideo Abstract:  http://dvpr.es/allocco  

  19. Clinical Challenges to Current Molecularly Targeted Therapies in Lung Cancer.

    Science.gov (United States)

    Chhabra, Gagan; Eggert, Ashley; Puri, Neelu

    Lung cancer is difficult to treat with a poor prognosis and a five year survival of 15%. Current molecularly targeted therapies are initially effective in non-small cell lung cancer (NSCLC) patients; however, they are plagued with difficulties including induced resistance and small therapeutically responsive populations. This mini review describes the mechanism of resistance to several molecularly targeted therapies which are currently being used to treat NSCLC. The major targets discussed are c-Met, EGFR, HER2, ALK, VEGFR, and BRAF. The first generation tyrosine kinase inhibitors (TKIs) resulted in resistance; however, second and third generation TKIs are being developed, which are generally more efficacious and have potential to treat NSCLC patients with resistance to first generation TKIs. Combination therapies could also be effective in preventing TKI resistance in NSCLC patients.

  20. Gold-Mining

    DEFF Research Database (Denmark)

    Raaballe, J.; Grundy, B.D.

    2002-01-01

    of operating gold mines. Asymmetric information on the reserves in the mine implies that, at a high enough price of gold, the manager of high type finds the extraction value of the company to be higher than the current market value of the non-operating gold mine. Due to this under valuation the maxim of market...... value maximization forces the manager of high type to extract the gold.The implications are three-fold. First, all managers (except the lowest type) extract the gold too soon compared to the first-best policy of leaving the gold in the mine forever. Second, a manager of high type extracts the gold...... sooner than a manager of lower type. Third, a non-operating gold mine is valued as being of the lowest type in the pool and all else equal, high-asymmetri mines are valued lower than low-asymmetri mines. In a qualitative sense these results are robust with respect to different assumptions (re cost...

  1. Coenzyme Q10 therapy in current clinical practice

    Directory of Open Access Journals (Sweden)

    Abhishek Soni

    2015-04-01

    Full Text Available Coenzyme Q10 (CoQ10 is a naturally occurring, lipid soluble, essential compound and is also known as ubiquinone. CoQ10 acts as an intermediate of the electron transport chain situated in membrane of mitochondria and vital for ATP production and cellular respiration. CoQ10 also serves as an intercellular antioxidant. All the clinical use of CoQ10 are based upon these two functions. CoQ10 levels are altered in a number of oncological as well as non-oncological diseases. Furthermore, recent data indicate that CoQ10 has an impact on the expression of many genes involved in metabolism, cellular transport, transcription control, and cell signaling, making CoQ10 a potent gene regulator. CoQ10 supplementation is useful in diseases associated with CoQ10 deficiency which includes primary and secondary CoQ10 deficiencies, fibromyalgia, diabetes mellitus, mitochondrial diseases, neurodegenerative diseases, cardiovascular disease, cancer, male infertility and periodontal disease. Clinical presentations of severe CoQ10 deficiency include severe infantile multisystemic disease, encephalomyopathy, isolated myopathy cerebellar ataxia and Leigh syndrome with growth retardation. Oral CoQ10 administration can correct CoQ10 deficiency since it increases CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. Future trends involving CoQ10 in many diseases needs more clinical trials for better understanding of CoQ10 efficacy. [Int J Res Med Sci 2015; 3(4.000: 817-825

  2. Gold Nanorods as Nanodevices for Bioimaging, Photothermal Therapeutics, and Drug Delivery.

    Science.gov (United States)

    Haine, Aung Thu; Niidome, Takuro

    2017-01-01

    Gold nanorods are promising metals in several biomedical applications such as bioimaging, thermal therapy, and drug delivery. Gold nanorods have strong absorption bands in near-infrared (NIR) light region and show photothermal effects. Since NIR light can penetrate deeply into tissues, their unique optical, chemical, and biological properties have attracted considerable clinical interest. Gold nanorods are expected to act not only as on-demand thermal converters for photothermal therapy but also as mediators of a controlled drug-release system responding to light irradiation. In this review, we discuss current progress using gold nanorods as bioimaging platform, phototherapeutic agents, and drug delivery vehicles.

  3. [Clinical neuropsychology in perspective: future challenges based on current developments].

    Science.gov (United States)

    Verdejo-García, Antonio; Tirapu-Ustárroz, Javier

    2012-02-01

    New lines of translational, interdisciplinary research are emerging among different fields of the neurosciences, which often point at clinical neuropsychology as the hinge discipline capable of linking the basic findings with their clinical implications and thereby endow them with some meaning for phenomenological experience. To establish the great lines of progress made in the fields of neuroscience and neuropsychology in recent years, so as to be able to foresee the strategic lines and priorities of neuroscience in the near future. To achieve this aim, the first step will be to identify the changes of paradigm that have taken place in the areas of neuroscience and psychology in the last two decades. The next step will be to propose new topics and fields of application that these changes in paradigm offer and demand from neuroscience. The false dichotomies of genes versus environment, mind versus brain, and reason versus emotion are considered, as are the new applications of neuropsychology to the understanding of psychopathological disorders, from the neurodegenerative to neurodevelopment, from 'dirty' drugs to cognitive and affective enhancers.

  4. Technological advances in perioperative monitoring: Current concepts and clinical perspectives.

    Science.gov (United States)

    Chilkoti, Geetanjali; Wadhwa, Rachna; Saxena, Ashok Kumar

    2015-01-01

    Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.

  5. [Pathogenesis, clinical picture, and current therapy of rosacea].

    Science.gov (United States)

    Gonser, L I; Gonser, C E; Schaller, M

    2016-01-01

    Rosacea is a common chronic inflammatory disease, especially in patients with fair skin and positive family history. Typical locations are forehead, nose, cheeks and chin; the periorbital region is usually not involved. Clinical features can be very heterogeneous. Besides different subtypes (erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea), which often overlap, various special forms of rosacea exist. Up to 60% of patients with cutaneous rosacea suffer from ocular rosacea. In Germany, brimonidine, metronidazol, azelaic acid, and ivermectin are approved for topical therapy of rosacea; for systemic therapy, doxycycline at a subantimicrobial dose (40 mg/day) is the only approved substance. In case of resistance to this therapy, contraindications or side effects, various alternative therapies are available, however off-label.

  6. Metallic gold beads in hyaluronic acid

    DEFF Research Database (Denmark)

    Pedersen, Dan Sonne; Tran, Thao Phuong; Smidt, Kamille;

    2013-01-01

    by exploiting macrophage-induced liberation of gold ions (dissolucytosis) from gold surfaces. Injecting gold beads in hyaluronic acid (HA) as a vehicle into the cavities of the brain can delay clinical signs of disease progression in the MS model, experimental autoimmune encephalitis (EAE). This study....... In conclusion, our findings support that bio-liberation of gold from metallic gold surfaces have anti-inflammatory properties similar to classic gold compounds, warranting further studies into the pharmacological potential of this novel gold-treatment and the possible synergistic effects of hyaluronic acid....

  7. Clinical characteristics and current therapies for inherited retinal degenerations.

    Science.gov (United States)

    Sahel, José-Alain; Marazova, Katia; Audo, Isabelle

    2014-10-16

    Inherited retinal degenerations (IRDs) encompass a large group of clinically and genetically heterogeneous diseases that affect approximately 1 in 3000 people (>2 million people worldwide) (Bessant DA, Ali RR, Bhattacharya SS. 2001. Molecular genetics and prospects for therapy of the inherited retinal dystrophies. Curr Opin Genet Dev 11: 307-316.). IRDs may be inherited as Mendelian traits or through mitochondrial DNA, and may affect the entire retina (e.g., rod-cone dystrophy, also known as retinitis pigmentosa, cone dystrophy, cone-rod dystrophy, choroideremia, Usher syndrome, and Bardet-Bidel syndrome) or be restricted to the macula (e.g., Stargardt disease, Best disease, and Sorsby fundus dystrophy), ultimately leading to blindness. IRDs are a major cause of severe vision loss, with profound impact on patients and society. Although IRDs remain untreatable today, significant progress toward therapeutic strategies for IRDs has marked the past two decades. This progress has been based on better understanding of the pathophysiological pathways of these diseases and on technological advances.

  8. Current and past strategies for bacterial culture in clinical microbiology.

    Science.gov (United States)

    Lagier, Jean-Christophe; Edouard, Sophie; Pagnier, Isabelle; Mediannikov, Oleg; Drancourt, Michel; Raoult, Didier

    2015-01-01

    A pure bacterial culture remains essential for the study of its virulence, its antibiotic susceptibility, and its genome sequence in order to facilitate the understanding and treatment of caused diseases. The first culture conditions empirically varied incubation time, nutrients, atmosphere, and temperature; culture was then gradually abandoned in favor of molecular methods. The rebirth of culture in clinical microbiology was prompted by microbiologists specializing in intracellular bacteria. The shell vial procedure allowed the culture of new species of Rickettsia. The design of axenic media for growing fastidious bacteria such as Tropheryma whipplei and Coxiella burnetii and the ability of amoebal coculture to discover new bacteria constituted major advances. Strong efforts associating optimized culture media, detection methods, and a microaerophilic atmosphere allowed a dramatic decrease of the time of Mycobacterium tuberculosis culture. The use of a new versatile medium allowed an extension of the repertoire of archaea. Finally, to optimize the culture of anaerobes in routine bacteriology laboratories, the addition of antioxidants in culture media under an aerobic atmosphere allowed the growth of strictly anaerobic species. Nevertheless, among usual bacterial pathogens, the development of axenic media for the culture of Treponema pallidum or Mycobacterium leprae remains an important challenge that the patience and innovations of cultivators will enable them to overcome. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  9. Dairy products on metabolic health: current research and clinical implications.

    Science.gov (United States)

    Da Silva, Marine S; Rudkowska, Iwona

    2014-03-01

    Dairy products have been thought to have a beneficial role in the metabolic syndrome (MetS). MetS constitutes a cluster of risk factors for an increased mortality, including obesity, impaired glucose homeostasis, hypertension and atherogenic dyslipidemia. Individuals with MetS are also often in a chronic, low-grade inflammatory state. The objective of this review is to examine recent meta-analyses and clinical studies on the association between dairy products consumption and these MetS risk factors. Findings from studies demonstrate that weight loss related to dairy product intake is due to the combination of an energy-restricted diet with consumption of dairy products. Further, a limited number of studies have shown beneficial effects of dairy consumption on plasma lipids, blood pressure, glucose homeostasis or inflammatory and oxidative stress profiles. Overall, this review article suggests that adults should consume at least 2-3 servings of dairy products per day within a well-balanced diet and a healthy lifestyle for metabolic health. Yet, higher dairy product consumption may have additional beneficial effects, but more well-designed intervention studies are needed to ascertain these effects.

  10. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    Science.gov (United States)

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558

  11. Amyotrophic lateral sclerosis: clinical features and current treatment approaches

    Directory of Open Access Journals (Sweden)

    Tuba Tulay Koca

    2015-06-01

    Full Text Available Amyotrophic lateral sclerosis also known as Lou Gehring's disease, is the most common motor neuron disease characterized by motor neuron degeneration in the primary cortex, brainstem and spinal cord. This leads to widespread paralysis, respiratory insufficiency and death within an average of 3-5 years from disease onset. Majority of cases is sporadic and only 10% have a family story. One of the most interesting discovery in the field of neurodegeneration in recent years is genetic mutation in the C9orf72 (chromosome 9 open reading frame 72 gene, the most common mutation found to be causative of frontotemporal dementia, amyotrophic lateral sclerosis and concomitant of these two diseases. Currently curative therapy for amyotrophic lateral sclerosis is lacking. To date, one medication, Riluzole, has been proved to prolong survival, approximately 3-5 months, in amyotrophic lateral sclerosis. Researches aim to slow disease progression by targeting known pathophysiological pathways or genetics defects. Only symptomatic care to improve quality of life and survival is suggested. These includes respiratory and nutrition support; dysphagia and gastrostomy management; communication and mobility programs; spasticity prevention; pain medication; management of cognitive dysfunction, depression, mood dysorders (especially apathy, fatigue, sleep disturbance and prevention of deep venous thrombosis. [Archives Medical Review Journal 2015; 24(2.000: 182-194

  12. Current trends in the cardiovascular clinical trial arena (I

    Directory of Open Access Journals (Sweden)

    Pater Cornel

    2004-06-01

    Full Text Available Abstract The existence of effective therapies for most cardiovascular disease states, coupled with increased requirements that potential benefits of new drugs be evaluated on clinical rather than surrogate endpoints, makes it increasingly difficult to substantiate any incremental improvements in efficacy that these new drugs might offer. Compounding the problem is the highly controversial issue of comparing new agents with placebos rather than active pharmaceuticals in drug efficacy trials. Despite the recent consensus that placebos may be used ethically in well-defined, justifiable circumstances, the problem persists, in part because of increased scrutiny by ethics committees but also because of considerable lingering disagreement regarding the propriety and scientific value of placebo-controlled trials (and trials of antihypertensive drugs in particular. The disagreement also substantially affects the most viable alternative to placebo-controlled trials: actively controlled equivalence/noninferiority trials. To a great extent, this situation was prompted by numerous previous trials of this type that were marked by fundamental methodological flaws and consequent false claims, inconsistencies, and potential harm to patients. As the development and use of generic drugs continue to escalate, along with concurrent pressure to control medical costs by substituting less-expensive therapies for established ones, any claim that a new drug, intervention, or therapy is "equivalent" to another should not be accepted without close scrutiny. Adherence to proper methods in conducting studies of equivalence will help investigators to avoid false claims and inconsistencies. These matters will be addressed in the third article of this three-part series.

  13. Autoimmune liver serology: Current diagnostic and clinical challenges

    Institute of Scientific and Technical Information of China (English)

    Dimitrios P Bogdanos; Pietro Invernizzi; Ian R Mackay; Diego Vergani

    2008-01-01

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC),and the sclerosing cholangitis variants in adults and children.AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1).SMA,ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation.PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants,first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and nonspecific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA),also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH.Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens,and automated technologies such as ELISAs and bead assays,become available to complement (or even compete with) traditional immunofluorescence procedures.We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents,(2) diagnostic service laboratories that fulfill clinicians'requirements, and (3) the end-user,the physician providing patient care,who must properly interpret test results in the overall clinical context.

  14. HYPOPARATHYROIDISM: ETIOLOGY, CLINICAL MANIFESTATION, CURRENT DIAGNOSTICS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    N. G. Mokrysheva

    2016-01-01

    treatment with recombinant PTH is not widely used. Replacement therapy with recombinant human PTH is a  promising area, especially in severe clinical cases, refractory to conventional treatment.

  15. Stratification, Blinding and Placebo Effect in a Randomized, Double Blind Placebo-controlled Clinical Trial of Gold Bead Implantation in Dogs with Hip Dysplasia

    Directory of Open Access Journals (Sweden)

    Moe L

    2005-06-01

    Full Text Available The purpose of this study was to investigate the need for and choice of stratification factors, and the effects of blinding and placebo in a clinical experiment. Eighty dogs with canine hip dysplasia (CHD were included in a randomized, placebo-controlled and double blind clinical trial with stratified parallel group design, in which body weight and degree of CHD were used as stratification factors. Thirty-eight dogs were allocated to gold bead implantation and 42 to placebo. After six months, 33 of the 42 placebo-treated dogs received gold bead implantation in an open study lasting a further 18 months. The main outcome variable in the study was change in pain signs of CHD as assessed by the owner. No significant difference in the main outcome variable, regardless of the treatment given, could be detected in the two chosen stratification factors. The only factor to influence the main outcome variable significantly was age. The blinding procedure used in the study, in which 60% of the owners correctly guessed the treatment given, was found sufficient. Of those who guessed the treatment erroneously, 88% believed the treatment given was gold bead implantation. The treatment efficacy after six months in the blinded treatment group was found to be significantly larger compared to the efficacy obtained in the open study. A significant placebo effect was therefore detected. Conclusion and Clinical Relevance: The age of the dogs influenced the outcome of the CHD treatment, and is recommended as a stratification factor. A significant placebo effect has to be expected and an optimal blinding procedure is necessary in similar clinical studies.

  16. Excerpts from the 1st international NTNU symposium on current and future clinical biomarkers of cancer

    DEFF Research Database (Denmark)

    Robles, Ana I; Olsen, Karina Standahl; Tsui, Dana W T;

    2016-01-01

    The goal of biomarker research is to identify clinically valid markers. Despite decades of research there has been disappointingly few molecules or techniques that are in use today. The "1st International NTNU Symposium on Current and Future Clinical Biomarkers of Cancer: Innovation and Implement......The goal of biomarker research is to identify clinically valid markers. Despite decades of research there has been disappointingly few molecules or techniques that are in use today. The "1st International NTNU Symposium on Current and Future Clinical Biomarkers of Cancer: Innovation...

  17. Clinical results of α- Ceramic 88 gold alloy for metal-ceramic-crowns%傲丹特烤瓷用金合金临床试验观察

    Institute of Scientific and Technical Information of China (English)

    李阳; 王新知

    2012-01-01

    Objective To evaluate the clinical effect of metal -ceramic-crowns made of α- Ceramic 88 gold alloy. Methods Fifty-one patients with defected incisors or premolars were restored with α— Ceramic 88 gold alloy PFMs. Fifty cases as control were restored with HERA Bio N gold alloy PFMs. Before cementation, the fitness of the crowns was examined using a polyether indicator paste. The thickness of the polyether films at marginal sites was measured by the GALILEEO EZ image measuring system. All patients were followed up for 6 tol2 months. The clinical index was recorded at the time of delivery and return visit, including casting defects of the copings , marginal polishing performance , porcelain fracture,visual estimation of the marginal fitness ,mucosal allergy and adverse reactions. Results The α-Ceramic 88 gold alloy group showed as good clinical performance and biosafety as the control group . The mean thickness of the polyether films was not significantly different between the two alloys. Conclusion The clinical performance of α— Ceramic 88 gold alloy was as good as the HERA Bio N gold and fulfilled the requirement of clinical application .%目的 评价国产傲丹特α- Ceramic 88烤瓷用金合金的临床应用效果.方法 选取志愿患者101名,对每名患者的1颗缺损前牙或双尖牙进行烤瓷全冠修复,其中试验组51名,采用傲丹特α- Ceramic 88烤瓷用金合金;对照组50名,采用古莎-贺利氏Bio N烤瓷用金合金.两组均制取基底冠与牙体预备体之间的聚醚密合性检测膜,用GALILEO EZ612-300影像测量系统检测聚醚膜厚度,对比两组金合金烤瓷全冠的密合性.在患者试戴基底冠、初次戴牙、戴牙6~12个月复查时,记录各项临床观察指标:烤瓷冠内冠有无铸造缺陷、临床探查内冠边缘密合性、边缘抛光性、有无口腔黏膜过敏反应、牙周组织有无红肿,有无不良事件.结果 试验组及对照组临床观察各项指标均合格,应用

  18. Capsaicin: Current Understanding of Its Mechanisms and Therapy of Pain and Other Pre-Clinical and Clinical Uses

    Directory of Open Access Journals (Sweden)

    Victor Fattori

    2016-06-01

    Full Text Available In this review, we discuss the importance of capsaicin to the current understanding of neuronal modulation of pain and explore the mechanisms of capsaicin-induced pain. We will focus on the analgesic effects of capsaicin and its clinical applicability in treating pain. Furthermore, we will draw attention to the rationale for other clinical therapeutic uses and implications of capsaicin in diseases such as obesity, diabetes, cardiovascular conditions, cancer, airway diseases, itch, gastric, and urological disorders.

  19. De-identifying Swedish clinical text - refinement of a gold standard and experiments with Conditional random fields

    Directory of Open Access Journals (Sweden)

    Dalianis Hercules

    2010-04-01

    Full Text Available Abstract Background In order to perform research on the information contained in Electronic Patient Records (EPRs, access to the data itself is needed. This is often very difficult due to confidentiality regulations. The data sets need to be fully de-identified before they can be distributed to researchers. De-identification is a difficult task where the definitions of annotation classes are not self-evident. Results We present work on the creation of two refined variants of a manually annotated Gold standard for de-identification, one created automatically, and one created through discussions among the annotators. The data is a subset from the Stockholm EPR Corpus, a data set available within our research group. These are used for the training and evaluation of an automatic system based on the Conditional Random Fields algorithm. Evaluating with four-fold cross-validation on sets of around 4-6 000 annotation instances, we obtained very promising results for both Gold Standards: F-score around 0.80 for a number of experiments, with higher results for certain annotation classes. Moreover, 49 false positives that were verified true positives were found by the system but missed by the annotators. Conclusions Our intention is to make this Gold standard, The Stockholm EPR PHI Corpus, available to other research groups in the future. Despite being slightly more time-consuming we believe the manual consensus gold standard is the most valuable for further research. We also propose a set of annotation classes to be used for similar de-identification tasks.

  20. [Current situation in clinical trials with vaccines in the Czech Republic].

    Science.gov (United States)

    Čečetková, B; Smetana, J; Chlíbek, R

    2014-11-01

    Clinical trials are an important part of clinical research. The conduction of clinical trials is strictly regulated and has to comply with an approved protocol. Local regulatory authorities, independent ethic committees, sponsors of clinical trials as well as the investigators are involved from the submission until the very end of the trial. All clinical trials performed in the Czech Republic have to be approved by the State Institute for Drug Control and by the Ethics Committee. The regulatory bodies and independent ethics committees evaluate and continuously supervise the justification and protocol of the clinical trial, quality of the investigational medicinal products and, primarily, the safety of the participants (patients and/or healthy volunteers) in clinical trials. In the Czech Republic there are many advanced clinical research centres, either located in private practices or within hospitals. The investigators are able to conduct a wide variety of clinical trials and recruit a high number of subjects for the trials, as well as to comply with the Good Clinical Practice guidelines and other regulatory requirements. The aim of this article is to summarise the current situation of clinical trials in the Czech Republic as well as the opportunities for getting involved in clinical trials and obligations arising for health professionals from such an involvement.

  1. The influence of stabilizers on the production of gold nanoparticles by direct current atmospheric pressure glow microdischarge generated in contact with liquid flowing cathode

    Energy Technology Data Exchange (ETDEWEB)

    Dzimitrowicz, Anna; Jamroz, Piotr, E-mail: piotr.jamroz@pwr.edu.pl; Greda, Krzysztof; Nowak, Piotr; Nyk, Marcin; Pohl, Pawel [Wroclaw University of Technology, Faculty of Chemistry (Poland)

    2015-04-15

    Gold nanoparticles (Au NPs) were prepared by direct current atmospheric pressure glow microdischarge (dc-μAPGD) generated between a miniature argon flow microjet and a flowing liquid cathode. The applied discharge system was operated in a continuous flow liquid mode. The influence of various stabilizers added to the solution of the liquid cathode, i.e., gelatin (GEL), polyvinylpyrrolidone (PVP), or polyvinyl alcohol (PVA), as well as the concentration of the Au precursor (chloroauric acid, HAuCl{sub 4}) in the solution on the production growth of Au NPs was investigated. Changes in the intensity of the localized surface plasmon resonance (LSPR) band in UV/Vis absorption spectra of solutions treated by dc-μAPGD and their color were observed. The position and the intensity of the LSPR band indicated that relatively small nanoparticles were formed in solutions containing GEL as a capping agent. In these conditions, the maximum of the absorption LSPR band was at 531, 534, and 535 nm, respectively, for 50, 100, and 200 mg L{sup −1} of Au. Additionally, scanning electron microscopy (SEM) and dynamic light scattering (DLS) were used to analyze the structure and the morphology of obtained Au NPs. The shape of Au NPs was spherical and uniform. Their mean size was ca. 27, 73, and 92 nm, while the polydispersity index was 0.296, 0.348, and 0.456 for Au present in the solution of the flowing liquid cathode at a concentration of 50, 100, and 200 mg L{sup −1}, respectively. The production rate of synthesized Au NPs depended on the precursor concentration with mean values of 2.9, 3.5, and 5.7 mg h{sup −1}, respectively.

  2. Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study.

    Science.gov (United States)

    Bhanpuri, Nasir H; Bertucco, Matteo; Young, Scott J; Lee, Annie A; Sanger, Terence D

    2015-10-01

    Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia.

  3. Gold-gold junction electrodes:the disconnection method.

    Science.gov (United States)

    Dale, Sara E C; Vuorema, Anne; Ashmore, Ellen M Y; Kasprzyk-Horden, Barbara; Sillanpää, Mika; Denuault, Guy; Marken, Frank

    2012-02-01

    The formation of gold-gold junction electrodes for application in electroanalysis is described here based on electro-deposition from a non-cyanide gold plating bath. Converging growth of two hemispherical gold deposits on two adjacent platinum microelectrodes (both 100 µm diameter in glass, ca. 45 µm gap) followed by careful etching in aqueous chloride solution was employed. During growth both gold hemispheres "connect" and during etching "disconnection" is evident in a drop in current. Gold-gold junctions with sub-micron gaps are formed and applied for the electroanalytical detection of sub-micromolar concentrations of hydroquinone in 0.1 M phosphate buffer pH 7 (E(rev) = 0.04 V vs. SCE) and sub-micromolar concentration of dopamine in 0.1 M phosphate buffer pH 7 (E(rev) = 0.14 V vs. SCE). The potential future uses in analysis and limitations of gold-gold junction electrodes are discussed.

  4. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments.

    Science.gov (United States)

    Li, Hong-Yun; Hua, Ying-Hui

    2016-01-01

    Achilles tendinopathy is one of the most frequently ankle and foot overuse injuries, which is a clinical syndrome characterized by the combination of pain, swelling, and impaired performance. The two main categories of Achilles tendinopathy are classified according to anatomical location and broadly include insertional and noninsertional tendinopathy. The etiology of Achilles tendinopathy is multifactorial including both intrinsic and extrinsic factors. Failed healing response and degenerative changes were found in the tendon. The failed healing response includes three different and continuous stages (reactive tendinopathy, tendon disrepair, and degenerative tendinopathy). The histological studies have demonstrated an increased number of tenocytes and concentration of glycosaminoglycans in the ground substance, disorganization and fragmentation of the collagen, and neovascularization. There are variable conservative and surgical treatment options for Achilles tendinopathy. However, there has not been a gold standard of these treatments because of the controversial clinical results between various studies. In the future, new level I researches will be needed to prove the effect of these treatment options.

  5. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments

    Directory of Open Access Journals (Sweden)

    Hong-Yun Li

    2016-01-01

    Full Text Available Achilles tendinopathy is one of the most frequently ankle and foot overuse injuries, which is a clinical syndrome characterized by the combination of pain, swelling, and impaired performance. The two main categories of Achilles tendinopathy are classified according to anatomical location and broadly include insertional and noninsertional tendinopathy. The etiology of Achilles tendinopathy is multifactorial including both intrinsic and extrinsic factors. Failed healing response and degenerative changes were found in the tendon. The failed healing response includes three different and continuous stages (reactive tendinopathy, tendon disrepair, and degenerative tendinopathy. The histological studies have demonstrated an increased number of tenocytes and concentration of glycosaminoglycans in the ground substance, disorganization and fragmentation of the collagen, and neovascularization. There are variable conservative and surgical treatment options for Achilles tendinopathy. However, there has not been a gold standard of these treatments because of the controversial clinical results between various studies. In the future, new level I researches will be needed to prove the effect of these treatment options.

  6. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

    Science.gov (United States)

    Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

    2017-02-28

    Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

  7. 零流电位法研究人血清白蛋白在金表面的吸附%Investigation of adsorption of human serum albumin on gold surface by zero current potentiometry

    Institute of Scientific and Technical Information of China (English)

    郑凤凤; 梁耀东; 陈莉英; 李华; 程忠洲

    2012-01-01

    Aim To investigate the adsorption behavior of human serum albumin (HSA) on the gold surface in pH 7.0 phosphate buffer solution. Methods A novel electrochemically approach, zero current potentiometry, was used. Results The adsorption of HSA on the gold surface resulted in the gradual shifts of the recorded 1-E curve and zero current potential Elcp along potential axis in negative direction. The plot of zero current potential Etxp a-gainst adsorption time t showed that the adsorption of HSA on the gold surface involved two steps, adsorption and conformation change of HSA. And the apparent rate constant kobs the adsorption obtained was (4. 0 ± 1. 8) × 10-3 s-1 Conclusion Using zero current potentiometry, the adsorption of HSA on the gold surface can be probed in situ and continuously, without the destruction of the formed adsorption layer.%目的 在pH7.0磷酸盐缓冲液中研究人血清白蛋白(HSA)在金表面的吸附行为.方法 采用零流电位法.结果 HSA在金表面吸附使记录的I-E曲线及其零流电位Ezcp沿着电位轴逐渐负移.零流电位Ezcp与吸附时间t的关系曲线表明,HSA在金表面吸附经历了吸附和HSA构象改变两个连续阶段,吸附的表观速率常数kobs为(4.0±1.8)×10-3 s-1.结论 用零流电位法可以原位连续跟踪HSA在金表面的吸附过程,而且不损伤HSA吸附层.

  8. Current status and future prospects of the development of clinical Pharmacy in China: A SWOT analysis.

    Science.gov (United States)

    Rao, Yuefeng; Zhao, Qingwei; Zhang, Xiangyi; Yang, Hongyu; Lou, Yan; Zhang, Xingguo

    2016-03-01

    In many industrialized countries, clinical pharmacy has developed into a separate discipline and become a vital part of inpatient care in hospitals. However, as compared to many established branches of medicine, clinical pharmacy is still in its infancy, with much room for growth, improvement, and recognition by both the medical community and patients. In this study, a widely-recognized development strategy analysis tool, Strength, Weakness, Opportunity and Threat (SWOT), was used to systematically address several key issues to the development of clinical pharmacy in China. This analysis aims to provide feasible recommendations for the development of clinical pharmacy in China by identifying current problems and growth opportunities. Full development of clinical pharmacy as a mature clinical discipline will help promote the rational use of drugs by both clinicians and patients and lead to enhanced drug efficacy and safety.

  9. Current practices and guidelines for clinical next-generation sequencing oncology testing

    Institute of Scientific and Technical Information of China (English)

    Samuel P. Strom

    2016-01-01

    Next-generation sequencing (NGS) has been rapidly integrated into molecular pathology, dramatically increasing the breadth genomic of information available to oncologists and their patients. This review will explore the ways in which this new technology is currently applied to bolster care for patients with solid tumors and hematological malignancies, focusing on practices and guidelines for assessing the technical validity and clinical utility of DNA variants identified during clinical NGS oncology testing.

  10. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

  11. The current status and trend of clinical pharmacology in developing countries

    Science.gov (United States)

    2013-01-01

    Background Several international forums for promoting clinical pharmacology in developing countries have been held since 1980, and several clinical pharmacology programmes targeting developing countries were instituted such that the status of clinical pharmacology in developing countries is not where it was 50 years ago. Therefore, a survey and an appraisal of the literature on the current status of clinical pharmacology in developing countries were undertaken with a hope that it would enable development of appropriate strategies for further promotion of clinical pharmacology in these countries. Methods First, nine determinants (or enabling factors) for running a successful clinical pharmacology programme were identified, i.e., disease burden, drug situation, economic growth, clinical pharmacology activities, recognition, human capital, government support, international collaboration, and support for traditional/alternative medicines. These factors were then evaluated with regard to their current status in the developing countries that responded to an electronic questionnaire, and their historical perspective, using the literature appraisal. From these, a projected trend was constructed with recommendations on the way forward. Results Clinical pharmacology services, research and teaching in developing countries have improved over the past 50 years with over 90% of countries having the appropriate policies for regulation and rational use of medicines in place. Unfortunately, policy implementation remains a challenge, owing to a worsening disease burden and drug situation, versus fewer clinical pharmacologists and other competing priorities for the national budgets. This has led to a preference for training ‘a physician clinical pharmacologist’ in programmes emphasizing local relevancy and for a shorter time, and the training of other professionals in therapeutics for endemic diseases (task shifting), as the most promising strategies of ensuring rational use of

  12. Modern dental imaging: a review of the current technology and clinical applications in dental practice

    Energy Technology Data Exchange (ETDEWEB)

    Vandenberghe, Bart; Jacobs, Reinhilde [Katholieke Universiteit Leuven, Oral Imaging Centre, Faculty of Medicine, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Leuven (Belgium); Bosmans, Hilde [Katholieke Universiteit Leuven, Radiology Section, Department of Medical Diagnostic Sciences, Leuven (Belgium)

    2010-11-15

    A review of modern imaging techniques commonly used in dental practice and their clinical applications is presented. The current dental examinations consist of intraoral imaging with digital indirect and direct receptors, while extraoral imaging is divided into traditional tomographic/panoramic imaging and the more recently introduced cone beam computed tomography. Applications, limitations and current trends of these dental ''in-office'' radiographic techniques are discussed. (orig.)

  13. Data standards for clinical research data collection forms: current status and challenges.

    Science.gov (United States)

    Richesson, Rachel L; Nadkarni, Prakash

    2011-05-01

    Case report forms (CRFs) are used for structured-data collection in clinical research studies. Existing CRF-related standards encompass structural features of forms and data items, content standards, and specifications for using terminologies. This paper reviews existing standards and discusses their current limitations. Because clinical research is highly protocol-specific, forms-development processes are more easily standardized than is CRF content. Tools that support retrieval and reuse of existing items will enable standards adoption in clinical research applications. Such tools will depend upon formal relationships between items and terminological standards. Future standards adoption will depend upon standardized approaches for bridging generic structural standards and domain-specific content standards. Clinical research informatics can help define tools requirements in terms of workflow support for research activities, reconcile the perspectives of varied clinical research stakeholders, and coordinate standards efforts toward interoperability across healthcare and research data collection.

  14. PBOSPECTS FOR CLINICAL APPLICATION OF THE CURRENT ANTI-INFLAMMATORY DRUG MELOXICAM (AMELOTEX

    Directory of Open Access Journals (Sweden)

    M S Eliseev

    2008-01-01

    Full Text Available The paper presents data on the effectiveness, safety, tolerance, major mechanisms of action, and prospects for clinically using meloxicam, a current selective nonsteroidal anti-inflammatory drug, against cyclooxygenase-2. It describes the advantages of meloxicam for injections, which begins acting promptly and shows an adequate long analgesic effect.

  15. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play.

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-05-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

  16. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data: SPSS TwoStep Cluster analysis, Latent Gold and SNOB.

    Science.gov (United States)

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice

    2014-10-02

    There are various methodological approaches to identifying clinically important subgroups and one method is to identify clusters of characteristics that differentiate people in cross-sectional and/or longitudinal data using Cluster Analysis (CA) or Latent Class Analysis (LCA). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold LCA and SNOB LCA). The performance of these three methods was compared: (i) quantitatively using the number of subgroups detected, the classification probability of individuals into subgroups, the reproducibility of results, and (ii) qualitatively using subjective judgments about each program's ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained only pain intensity data collected for 52 weeks by text (SMS) messaging (n = 1,121 people), and the last dataset contained a range of clinical variables measured in low back pain patients (n = 543 people). Four artificial datasets (n = 1,000 each) containing subgroups of varying complexity were also analysed testing the ability of these clustering methods to detect subgroups and correctly classify individuals when subgroup membership was known. The results from the real clinical datasets indicated that the number of subgroups detected varied, the certainty of classifying individuals into those subgroups varied, the findings had perfect reproducibility, some programs were easier to use and the interpretability of the presentation of their findings also varied. The results from the artificial datasets

  17. Relativistic effects in homogeneous gold catalysis.

    Science.gov (United States)

    Gorin, David J; Toste, F Dean

    2007-03-22

    Transition-metal catalysts containing gold present new opportunities for chemical synthesis, and it is therefore not surprising that these complexes are beginning to capture the attention of the chemical community. Cationic phosphine-gold(i) complexes are especially versatile and selective catalysts for a growing number of synthetic transformations. The reactivity of these species can be understood in the context of theoretical studies on gold; relativistic effects are especially helpful in rationalizing the reaction manifolds available to gold catalysts. This Review draws on experimental and computational data to present our current understanding of homogeneous gold catalysis, focusing on previously unexplored reactivity and its application to the development of new methodology.

  18. Cancer theranostics with gold nanoshells.

    Science.gov (United States)

    Zhao, Jun; Wallace, Michael; Melancon, Marites P

    2014-09-01

    Gold nanoshells (AuNSs) present a vivid example of integrating nanoscience in order to solve a biomedical problem. AuNSs exhibit tunable surface plasmon resonance, which can be tuned to the near-infrared region in order to realize optimal tissue penetration. The highly efficient light-to-heat transformation by AuNSs during laser irradiation causes thermal damage to the tumor without damaging healthy organs. Transient nanobubbles can form around AuNSs during laser treatment and induce mechanical stress specifically in tumor cells. AuNSs also serve as a versatile platform for the delivery of various diagnostic and therapeutic agents. In this article, we describe the physicochemical properties of AuNSs in the context of their design, preparation and application in cancer theranostics. Ultimately, we look beyond the current research on AuNSs and discussed future challenges to their successful translation into clinical use.

  19. Comparison of current perception threshold electrical testing to clinical sensory testing for lingual nerve injuries.

    Science.gov (United States)

    Ziccardi, Vincent B; Dragoo, Joel; Eliav, Eli; Benoliel, Rafael

    2012-02-01

    We performed a retrospective study of lingual nerve injury assessment comparing the techniques of current perception threshold testing versus clinical sensory testing. We designed and implemented a cross-sectional study and enrolled a patient sample with lingual nerve injuries presenting for treatment to the principal investigator. The predictor variables were clinical sensory testing modalities (ie, temperature, nocioception, vibration, 2-point discrimination, brush stroke, and von Frey monofilament perception). The primary outcome variable was the electrical current perception thresholds of the tongue dorsum (neurometer measurements at 5, 250, and 2,000 Hz). Comparisons were established with the ipsilateral affected and contralateral unaffected lingual nerve distributions. The associations between the clinical sensory testing and current perception threshold measurements were assessed using correlation coefficients, with the level of statistical significance set at P thresholds at 2,000 Hz and the 2-point discrimination, reaction to brushing, reaction to vibration, and von Frey fiber thresholds, between the electrical stimulation thresholds at 250 Hz to the nociceptive and thermal thresholds, and between the electrical stimulation thresholds at 5 Hz to thermal stimuli. The significant correlations observed in the present study indicate that current perception threshold can be a complementary or alternative tool in the assessment and evaluation of lingual nerve injuries. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. The K-nearest neighbor algorithm predicted rehabilitation potential better than current Clinical Assessment Protocol.

    Science.gov (United States)

    Zhu, Mu; Chen, Wenhong; Hirdes, John P; Stolee, Paul

    2007-10-01

    There may be great potential for using computer-modeling techniques and machine-learning algorithms in clinical decision making, if these can be shown to produce results superior to clinical protocols currently in use. We aim to explore the potential to use an automatic, data-driven, machine-learning algorithm in clinical decision making. Using a database containing comprehensive health assessment information (the interRAI-HC) on home care clients (N=24,724) from eight community-care regions in Ontario, Canada, we compare the performance of the K-nearest neighbor (KNN) algorithm and a Clinical Assessment Protocol (the "ADLCAP") currently used to predict rehabilitation potential. For our purposes, we define a patient as having rehabilitation potential if the patient had functional improvement or remained at home over a follow-up period of approximately 1 year. The KNN algorithm has a lower false positive rate in all but one of the eight regions in the sample, and lower false negative rates in all regions. Compared using likelihood ratio statistics, KNN is uniformly more informative than the ADLCAP. This article illustrates the potential for a machine-learning algorithm to enhance clinical decision making.

  1. Theranostic liposomes for cancer diagnosis and treatment: current development and pre-clinical success.

    Science.gov (United States)

    Muthu, Madaswamy S; Feng, Si-Shen

    2013-02-01

    Liposomes are one of the effective drug delivery systems that are developed based on the nanotechnology concept. Liposomal formulation is the first nanomedicine approved by the US FDA for clinical application. Recently, the marketed liposomes and stealth liposomes have made impact for cancer therapy. In addition, a few receptor-targeted liposome products have been in different phases of clinical trials, which are yet to be marketed. In the present editorial, the advantages of vitamin E TPGS-coated liposomes over the currently available PEG-coated liposomes will be described and their great potentials for nanotheranostics for cancer imaging and therapy will be covered.

  2. Monoclonal antibody "gold rush".

    Science.gov (United States)

    Maggon, Krishan

    2007-01-01

    The market, sales and regulatory approval of new human medicines, during the past few years, indicates increasing number and share of new biologics and emergence of new multibillion dollar molecules. The global sale of monoclonal antibodies in 2006 were $20.6 billion. Remicade had annual sales gain of $1 billion during the past 3 years and five brands had similar increase in 2006. Rituxan with 2006 sales of $4.7 billion was the best selling monoclonal antibody and biological product and the 6th among the top selling medicinal brand. It may be the first biologic and monoclonal antibody to reach $10 billion annual sales in the near future. The strong demand from cancer and arthritis patients has surpassed almost all commercial market research reports and sales forecast. Seven monoclonal antibody brands in 2006 had sales exceeding $1 billion. Humanized or fully human monoclonal antibodies with low immunogenicity, enhanced antigen binding and reduced cellular toxicity provide better clinical efficacy. The higher technical and clinical success rate, overcoming of technical hurdles in large scale manufacturing, low cost of market entry and IND filing, use of fully human and humanized monoclonal antibodies has attracted funds and resources towards R&D. Review of industry research pipeline and sales data during the past 3 years indicate a real paradigm shift in industrial R&D from pharmaceutical to biologics and monoclonal antibodies. The antibody bandwagon has been joined by 200 companies with hundreds of new projects and targets and has attracted billions of dollars in R&D investment, acquisitions and licensing deals leading to the current Monoclonal Antibody Gold Rush.

  3. Atopic Dermatitis in Children: Current Clinical Guidelines for Diagnosis and Therapy

    Directory of Open Access Journals (Sweden)

    L. S. Namazova-Baranova

    2016-01-01

    Full Text Available Atopic dermatitis is a chronic multifactorial skin disease that is common enough in childhood. The article presents the current data on epidemiology and dynamics of incidence of pathological symptoms, pathogenesis basics, and key factors of the disease development, shows the current classification of the disease. The authors consider in detail the key principles of the diagnosis and peculiarities of a clinical aspect depending on age. Algorithms of a therapeutic approach, as well as basics of an individual hypoallergenic diet are proposed. General recommendations and possible prognosis for pediatric patients with atopic dermatitis are given.

  4. [Resource activation in clinical psychology and psychotherapy: review of theoretical issues and current research].

    Science.gov (United States)

    Groß, L J; Stemmler, M; de Zwaan, M

    2012-08-01

    This review summarises theoretical issues and current research on working with clients' resources and strengths in clinical psychology and psychotherapy. Resource activation is considered as an important common factor in psychotherapy. In general, resource activation means an explicit focus on resources, strengths and potentials of the clients. After defining the term resources, considerations with regard to therapeutic attitude, principles of resource activation, approaches to resource diagnostics and different research strategies are presented. Current research focuses especially on the relation between resource activation and process variables in out-patient treatment.

  5. Why Current PTH Assays Mislead Clinical Decision Making in Patients with Secondary Hyperparathyroidism.

    Science.gov (United States)

    Hocher, Berthold; Yin, Lianghong

    2017-02-10

    Preclinical studies in cell culture systems as well as in whole animal chronic kidney disease (CKD) models showed that parathyroid hormone (PTH), oxidized at the 2 methionine residues (positions 8 and 18), caused a loss of function. This was so far not considered in the development of PTH assays used in current clinical practice. Patients with advanced CKD are subject to oxidative stress, and plasma proteins (including PTH) are targets for oxidants. In patients with CKD, a considerable but variable fraction (about 70 to 90%) of measured PTH appears to be oxidized. Oxidized PTH (oxPTH) does not interact with the PTH receptor resulting in loss of biological activity. Currently used intact PTH (iPTH) assays detect both oxidized and non-oxPTH (n-oxPTH). Clinical studies demonstrated that bioactive, n-oxPTH, but not iPTH nor oxPTH, is associated with mortality in CKD patients.

  6. Do current clinical trials meet society's needs?: a critical review of recent evidence.

    Science.gov (United States)

    Pocock, Stuart J; Gersh, Bernard J

    2014-10-14

    This paper describes some important controversies regarding the current state of clinical trials research in cardiology. Topics covered include the inadequacy of trial research on medical devices, problems with industry-sponsored trials, the lack of head-to-head trials of new effective treatments, the need for wiser handling of drug safety issues, the credibility (or lack thereof) of trial reports in medical journals, problems with globalization of trials, the role of personalized (stratified) medicine in trials, the need for new trials of old drugs, the need for trials of treatment withdrawal, the importance of pragmatic trials of treatment strategies, and the limitations of observational comparative effectiveness studies. All issues are illustrated by recent topical trials in cardiology. Overall, we explore the extent to which clinical trials, as currently practiced, are successful in meeting society's expectations.

  7. Overcoming resistance to targeted therapies in NSCLC: current approaches and clinical application.

    Science.gov (United States)

    Maione, Paolo; Sacco, Paola Claudia; Sgambato, Assunta; Casaluce, Francesca; Rossi, Antonio; Gridelli, Cesare

    2015-09-01

    The discovery that a number of aberrant tumorigenic processes and signal transduction pathways are mediated by druggable protein kinases has led to a revolutionary change in nonsmall cell lung cancer (NSCLC) treatment. Epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) are the targets of several tyrosine kinase inhibitors (TKIs), some of them approved for treatment and others currently in clinical development. First-generation agents offer, in target populations, a substantial improvement of outcomes compared with standard chemotherapy in the treatment of advanced NSCLC. Unfortunately, drug resistance develops after initial benefit through a variety of mechanisms. Novel generation EGFR and ALK inhibitors are currently in advanced clinical development and are producing encouraging results in patients with acquired resistance to previous generation agents. The search for new drugs or strategies to overcome the TKI resistance in patients with EGFR mutations or ALK rearrangements is to be considered a priority for the improvement of outcomes in the treatment of advanced NSCLC.

  8. Exploring Current Sensory Enhancement Practices Within Videofluoroscopic Swallow Study (VFSS) Clinics.

    Science.gov (United States)

    Turkington, Leisa; Nund, Rebecca L; Ward, Elizabeth C; Farrell, Anna

    2017-04-01

    Whilst some research evidence supports the potential benefits of sensory enhancement strategies (SES) in dysphagia management, there is limited understanding of how SES are used in clinical services and the influencing drivers involved in selection during instrumental assessment. SES include modification of temperature, flavour, texture, chemesthetic qualities and bolus size of food/fluid. This study aimed to explore the use of SES within Australian Videofluoroscopic Swallow Study (VFSS) clinics providing adult services, via a qualitative methodology. Maximum variation sampling was used to select a cross section of speech-language pathologists (SLPs) with a range of experience working within 16 VFSS clinics across metropolitan and regional settings to participate in semi-structured, focus group or individual teleconference interviews. Content analysis of interview transcripts was conducted, with four themes emerging as influencing drivers of SES use, including: Patient factors influence SES use; Clinician factors influence SES use; Trials of SES require planning and organisation, and; Organisational barriers impact on SES use. These four themes were all connected through a single integrative theme: Extensive variations of SES procedures exist across clinical settings. Findings indicate that achieving alignment of clinical purpose and implementation of practices amongst VFSS clinicians will be complex given current diversity in SES use. Organisational issues and clinician training need to be addressed, and more research is needed to provide a stronger evidence base to inform clinical practice in this emerging area of dysphagia management.

  9. Current opinion in clinical sport psychology: from athletic performance to psychological well-being.

    Science.gov (United States)

    Moore, Zella E; Bonagura, Kehana

    2017-08-01

    Clinical sport psychology (CSP) is a contemporary, empirically informed model that employs a scope, style, and mode of practice built upon cutting-edge findings from both clinical and sport sciences, and that follows the sound methodological traditions of clinical psychology [1(••)]. Conceptualizing athletic performance and well-being through the context of empirical research in both athletic and nonathletic domains of functioning, CSP practice can involve the enhancement of athletic performance, and also the personal development and psychological well-being of performers. CSP intervention options expand (if desired) to include those currently considered to be outside of the purview of traditional sport psychology and within the domains of clinical/counseling psychology. Importantly, CSP does not imply that its practitioners must choose a population. CSPers can, if appropriate, assess and intervene with psychological disorders, performance dysfunction, and performance improvement, and/or can make appropriate referrals. Despite whether one personally addresses the variety of interpersonal, non-diagnosable, and clinical issues potentially presented, they must support a comprehensive, client-specific approach and engage in interventions based on sound evidence. Expanding practice boundaries, and with it one's roles and responsibilities, also results in expanded job opportunities. This scope highlights the clinical sport psychologist as the human behavior expert in the athletic milieu. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions

    Science.gov (United States)

    van Straten, Demian; Mashayekhi, Vida; de Bruijn, Henriette S.; Oliveira, Sabrina; Robinson, Dominic J.

    2017-01-01

    Photodynamic therapy (PDT) is a clinically approved cancer therapy, based on a photochemical reaction between a light activatable molecule or photosensitizer, light, and molecular oxygen. When these three harmless components are present together, reactive oxygen species are formed. These can directly damage cells and/or vasculature, and induce inflammatory and immune responses. PDT is a two-stage procedure, which starts with photosensitizer administration followed by a locally directed light exposure, with the aim of confined tumor destruction. Since its regulatory approval, over 30 years ago, PDT has been the subject of numerous studies and has proven to be an effective form of cancer therapy. This review provides an overview of the clinical trials conducted over the last 10 years, illustrating how PDT is applied in the clinic today. Furthermore, examples from ongoing clinical trials and the most recent preclinical studies are presented, to show the directions, in which PDT is headed, in the near and distant future. Despite the clinical success reported, PDT is still currently underutilized in the clinic. We also discuss the factors that hamper the exploration of this effective therapy and what should be changed to render it a more effective and more widely available option for patients. PMID:28218708

  11. Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions

    Directory of Open Access Journals (Sweden)

    Demian van Straten

    2017-02-01

    Full Text Available Photodynamic therapy (PDT is a clinically approved cancer therapy, based on a photochemical reaction between a light activatable molecule or photosensitizer, light, and molecular oxygen. When these three harmless components are present together, reactive oxygen species are formed. These can directly damage cells and/or vasculature, and induce inflammatory and immune responses. PDT is a two-stage procedure, which starts with photosensitizer administration followed by a locally directed light exposure, with the aim of confined tumor destruction. Since its regulatory approval, over 30 years ago, PDT has been the subject of numerous studies and has proven to be an effective form of cancer therapy. This review provides an overview of the clinical trials conducted over the last 10 years, illustrating how PDT is applied in the clinic today. Furthermore, examples from ongoing clinical trials and the most recent preclinical studies are presented, to show the directions, in which PDT is headed, in the near and distant future. Despite the clinical success reported, PDT is still currently underutilized in the clinic. We also discuss the factors that hamper the exploration of this effective therapy and what should be changed to render it a more effective and more widely available option for patients.

  12. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

    OpenAIRE

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-01-01

    Background In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Patients and methods. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retr...

  13. Gold Nanoparticle Microwave Synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Krantz, Kelsie E. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Christian, Jonathan H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Coopersmith, Kaitlin [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Washington, II, Aaron L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Murph, Simona H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-07-27

    At the nanometer scale, numerous compounds display different properties than those found in bulk material that can prove useful in areas such as medicinal chemistry. Gold nanoparticles, for example, display promise in newly developed hyperthermia therapies for cancer treatment. Currently, gold nanoparticle synthesis is performed via the hot injection technique which has large variability in final particle size and a longer reaction time. One underdeveloped area by which these particles could be produced is through microwave synthesis. To initiate heating, microwaves agitate polar molecules creating a vibration that gives off the heat energy needed. Previous studies have used microwaves for gold nanoparticle synthesis; however, polar solvents were used that partially absorbed incident microwaves, leading to partial thermal heating of the sample rather than taking full advantage of the microwave to solely heat the gold nanoparticle precursors in a non-polar solution. Through this project, microwaves were utilized as the sole heat source, and non-polar solvents were used to explore the effects of microwave heating only as pertains to the precursor material. Our findings show that the use of non-polar solvents allows for more rapid heating as compared to polar solvents, and a reduction in reaction time from 10 minutes to 1 minute; this maximizes the efficiency of the reaction, and allows for reproducibility in the size/shape of the fabricated nanoparticles.

  14. Gold Nanoparticle Microwave Synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Krantz, Kelsie E. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Christian, Jonathan H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Coopersmith, Kaitlin [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Washington, II, Aaron L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Murph, Simona H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-07-27

    At the nanometer scale, numerous compounds display different properties than those found in bulk material that can prove useful in areas such as medicinal chemistry. Gold nanoparticles, for example, display promise in newly developed hyperthermia therapies for cancer treatment. Currently, gold nanoparticle synthesis is performed via the hot injection technique which has large variability in final particle size and a longer reaction time. One underdeveloped area by which these particles could be produced is through microwave synthesis. To initiate heating, microwaves agitate polar molecules creating a vibration that gives off the heat energy needed. Previous studies have used microwaves for gold nanoparticle synthesis; however polar solvents were used that partially absorbed incident microwaves, leading to partial thermal heating of the sample rather than taking full advantage of the microwave to solely heat the gold nanoparticle precursors in a non-polar solution. Through this project, microwaves were utilized as the sole heat source, and non-polar solvents were used to explore the effects of microwave heating only as pertains to the precursor material. Our findings show that the use of non-polar solvents allows for more rapid heating as compared to polar solvents, a reduction in reaction time from 10 minutes to 1 minute, maximizes the efficiency of the reaction, and allows for reproducibility in the size/shape of the fabricated nanoparticles.

  15. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

    2011-08-15

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  16. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  17. ENTEROVIRUS INFECTION IN CHILDREN: CLINICAL AND EPIDEMIOLOGICAL FEATURES AT THE CURRENT STAGE

    Directory of Open Access Journals (Sweden)

    G. P. Martynova

    2016-01-01

    Full Text Available The article presents the current clinical and epidemiological features of enterovirus infection in children of Krasnoyarsk Territory. A retrospective analysis of the incidence of enterovirus infection and enterovirus meningitis in the period 2014—2015 according to the forms of state statistical reporting №2 «Information on infectious and parasitic diseases». Clinical and epidemiological analysis of enterovirus infection in 454 children who were treated at MBUZ «City Children's Infectious Hospital №1» in the period of seasonal rise of morbidity in 2014 revealed a prevalence of etiological structure of enteroviruses Coxsackie B, Coxsackie B5, Coxsackie B3, Coxsackie B4. The region recorded the different clinical forms of enterovirus infection (rash, myalgia, diarrhea, gerpangina, the structure of which is still, aseptic meningitis prevails.

  18. Developing genomic knowledge bases and databases to support clinical management: current perspectives.

    Science.gov (United States)

    Huser, Vojtech; Sincan, Murat; Cimino, James J

    2014-01-01

    Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

  19. Nationwide survey for current clinical status of amniocentesis and maternal serum marker test in Japan.

    Science.gov (United States)

    Miyake, Hidehiko; Yamada, Shigehito; Fujii, Yosuke; Sawai, Hideaki; Arimori, Naoko; Yamanouchi, Yasuko; Ozasa, Yuka; Kanai, Makoto; Sago, Haruhiko; Sekizawa, Akihiko; Takada, Fumio; Masuzaki, Hideaki; Matsubara, Yoichi; Hirahara, Fumiki; Kugu, Koji

    2016-10-01

    Prenatal testing has been provided in Japan over the past several decades. However, it is difficult to assess the clinical status of amniocentesis (AC) and maternal serum markers (MSM) because obstetricians can perform these tests without registration. This study aims to investigate the current clinical status of AC and MSM in Japan. We conducted a questionnaire study that was intended for a total of 5622 Japanese obstetrics/gynecology facilities during October 2013 to January 2014. The response rate was 40.8% (2295/5622). Of the 2295 facilities, 864 performed MSM (37.7%), 619 performed AC (27.0%) and 412 performed both (18.0%). The average number of MSM tests was 2.0 per month (range 0-52), and the average number of AC tests was 2.4 per month (range 0-30). Involvement of genetic professionals, such as clinical geneticists (CGs) and certified genetic counselors (CGCs), contribute to a content-rich explanation and management of difficult issues and lengthened the explanation time. Nevertheless, relatively few facilities employed these specialists (MSM: 96/864 and AC: 128/619). This is the first study to highlight the current clinical status of AC and MSM tests in Japan. Active involvement of CGs and CGCs can provide more appropriate genetic counseling for prenatal tests.

  20. Clinical data management: Current status, challenges, and future directions from industry perspectives

    Directory of Open Access Journals (Sweden)

    Zhengwu Lu

    2010-06-01

    Full Text Available Zhengwu Lu1, Jing Su21Smith Hanley Consulting, Houston, Texas; 2Department of Chemical Engineering, University of Massachusetts, Amherst, MA, USAAbstract: To maintain a competitive position, the biopharmaceutical industry has been facing the challenge of increasing productivity both internally and externally. As the product of the clinical development process, clinical data are recognized to be the key corporate asset and provide critical evidence of a medicine’s efficacy and safety and of its potential economic value to the market. It is also well recognized that using effective technology-enabled methods to manage clinical data can enhance the speed with which the drug is developed and commercialized, hence enhancing the competitive advantage. The effective use of data-capture tools may ensure that high-quality data are available for early review and rapid decision-making. A well-designed, protocol-driven, standardized, site workflow-oriented and documented database, populated via efficient data feed mechanisms, will ensure regulatory and commercial questions receive rapid responses. When information from a sponsor’s clinical database or data warehouse develops into corporate knowledge, the value of the medicine can be realized. Moreover, regulators, payer groups, patients, activist groups, patient advocacy groups, and employers are becoming more educated consumers of medicine, requiring monetary value and quality, and seeking out up-todate medical information supplied by biopharmaceutical companies. All these developments in the current biopharmaceutical arena demand that clinical data management (CDM is at the forefront, leading change, influencing direction, and providing objective evidence. Sustaining an integrated database or data repository for initial product registration and subsequent postmarketing uses is a long-term process to maximize return on investment for organizations. CDM should be the owner of driving clinical data

  1. Current Practices and Opportunities in a Resident Clinic Regarding the Care of Older Adults with Multimorbidity.

    Science.gov (United States)

    Schoenborn, Nancy L; Boyd, Cynthia M; McNabney, Matthew; Ray, Anushree; Cayea, Danelle

    2015-08-01

    Multimorbidity (≥2 chronic conditions) affects more than half of all older adults. The American Geriatrics Society developed and published guiding principles for the care of older adults with multimorbidity in 2012. Improved clinician training in caring for older adults with multimorbidity is needed, but it is not clear what opportunities arise within clinical encounters to apply the guiding principles or how clinicians at all stages of training currently practice in this area. This project aimed to characterize current practice and opportunities for improvement in an internal medicine residency clinic regarding the care of older adults with multimorbidity. Qualitative content analysis of audio-recorded clinic visits. Thirty clinic visits between 21 internal medicine residents and 30 of their primary care patients aged 65 and older with two or more chronic conditions were audio-recorded. Patients' mean age was 73.6, and they had on average 3.7 chronic conditions and took 12.6 medications. Transcripts of the audio-recorded visit discussions were analyzed using standard techniques of qualitative content analysis to describe the content and frequency of discussions in the clinic visits related to the five guiding principles: patient preferences, interpreting the evidence, prognosis, clinical feasibility, and optimizing therapies. All visits except one included discussions that were thematically related to at least one guiding principle, suggesting regular opportunities to apply the guiding principles in primary care encounters with internal medicine residents. Discussions related to some guiding principles occurred much more frequently than others. Patients presented a number of opportunities to incorporate the guiding principles that the residents missed, suggesting target areas for future educational interventions. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  2. Nicotine at clinically relevant concentrations affects atrial inward rectifier potassium current sensitive to acetylcholine.

    Science.gov (United States)

    Bébarová, Markéta; Matejovič, Peter; Švecová, Olga; Kula, Roman; Šimurdová, Milena; Šimurda, Jiří

    2017-02-03

    Nicotine abuse is associated with variety of diseases including arrhythmias, most often atrial fibrillation (AF). Altered inward rectifier potassium currents including acetylcholine-sensitive current I K(Ach) are known to be related to AF pathogenesis. Since relevant data are missing, we aimed to investigate I K(Ach) changes at clinically relevant concentrations of nicotine. Experiments were performed by the whole cell patch clamp technique at 23 ± 1 °C on isolated rat atrial myocytes. Nicotine was applied at following concentrations: 4, 40 and 400 nM; ethanol at 20 mM (∼0.09%). Nicotine at 40 and 400 nM significantly activated constitutively active component of I K(Ach) with the maximum effect at 40 nM (an increase by ∼100%); similar effect was observed at -110 and -50 mV. Changes at 4 nM nicotine were negligible on average. Coapplication of 40 nM nicotine and 20 mM ethanol (which is also known to activate this current) did not show cumulative effect. In the case of acetylcholine-induced component of I K(Ach), a dual effect of nicotine and its correlation with the current magnitude in control were apparent: the current was increased by nicotine in the cells showing small current in control and vice versa. The effect of 40 and 400 nM nicotine on acetylcholine-induced component of I K(Ach) was significantly different at -110 and -50 mV. We conclude that nicotine at clinically relevant concentrations significantly increased constitutively active component of I K(Ach) and showed a dual effect on its acetylcholine-induced component, similarly as ethanol. Synchronous application of nicotine and ethanol did not cause additive effect.

  3. Objective evaluation of methods to track motion from clinical cardiac-gated tagged MRI without the use of a gold standard

    Science.gov (United States)

    Parages, Felipe M.; Denney, Thomas S.; Brankov, Jovan G.

    2015-03-01

    Cardiac-gated MRI is widely used for the task of measuring parameters related to heart motion. More specifically, gated tagged MRI is the preferred modality to estimate local deformation (strain) and rotational motion (twist) of myocardial tissue. Many methods have been proposed to estimate cardiac motion from gated MRI sequences. However, when dealing with clinical data, evaluation of these methods is problematic due to the absence of gold-standards for cardiac motion. To overcome that, a linear regression scheme known as regression-without-truth (RWT) was proposed in the past. RWT uses priors to model the distribution of true values, thus enabling us to assess image-analysis algorithms without knowledge of the ground-truth. Furthermore, it allows one to rank methods by means of an objective figure-of-merit γ (i.e. precision). In this work we apply RWT to compare the performance of several gated MRI motion-tracking methods (e.g. non-rigid registration, feature based, harmonic phase) at the task of estimating myocardial strain and left-ventricle (LV) twist, from a population of 18 clinical human cardiac-gated tagged MRI studies.

  4. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe.

    Science.gov (United States)

    O'Brien, P J; Fournel-Fleury, C; Bolliger, A P; Freeman, K P; Braun, J-P; Archer, J; Paltrinieri, S; Tvedten, H; Polizopoulou, Z S; Jensen, A L; Pastor, J; Lanevschi-Pietersma, A; Thoren-Tolling, K; Schwendenwien, I; Thoresen, S I; Bauer, N B; Ledieu, D; Cerón, J J; Palm, M; Papasouliotis, K; Gaál, T; Vajdovich, P

    2007-12-01

    After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP) was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has approved 23 colleges. The objectives, committees, basis for membership, constitution, bylaws, information brochure and certifying examination of the ECVCP have remained unchanged during this time except as directed by EBVS. The ECVCP declared full functionality based on the following criteria: 1) a critical mass of 65 members: 15 original diplomates approved by the EBVS to establish the ECVCP, 37 de facto diplomates, 7 diplomates certified by examination, and 5 elected honorary members; 2) the development and certification of training programs, laboratories, and qualified supervisors for residents; currently there are 18 resident training programs in Europe; 3) administration of 3 annual board-certifying examinations thus far, with an overall pass rate of 70%; 4) European consensus criteria for assessing the continuing education of specialists every 5 years; 5) organization of 8 annual scientific congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges in medicine and pathology; 7) development and strict adherence to a constitution and bylaws compliant with the EBVS; and 8) demonstration of compelling rationale, supporting data, and the support of members and other colleges for independence as a specialty college. Formal EBVS recognition of ECVCP as the regulatory body for the science and practice of veterinary clinical pathology in Europe will facilitate growth and development of the discipline and compliance of academic

  5. Stem cells for clinical use in cardiovascular medicine: current limitations and future perspectives.

    Science.gov (United States)

    Menasché, Philippe

    2005-10-01

    Cell transplantation is currently gaining a growing interest as a potential new means of improving the prognosis of patients with cardiac failure. The basic assumption is that left ventricular dysfunction is largely due to the loss of a critical number of cardiomyocytes and that it can be partly reversed by implantation of new contractile cells into the postinfarction scars. Primarily for practical reasons, autologous skeletal myoblasts have been the first to undergo clinical trials and now that the feasibility of the procedure is well established, efficacy data are expected from the ongoing randomized studies. Bone marrow stem cells are also generating a great deal of interest, particularly in patients with acute myocardial infarction, and are currently undergoing extensive clinical testing although recent data have raised a cautionary note about the transdifferentiation potential of these cells. While experimental studies and early-phase clinical trials tend to support the concept that cell therapy may enhance cardiac repair, several key issues still need to be addressed including (1) the optimal type of donor cells in relation to the clinical profile of the patients, (2) the mechanism by which cell engraftment improves cardiac function, (3) the optimization of cell survival, (4) the development of less invasive cell delivery techniques and (5) the potential benefits of cell transplantation in nonischemic heart failure. Current evidence suggests, however, that adult stem cells (myogenic or marrow-derived) fail to electromechanically integrate within the recipient heart, thereby mandating the search for second generation cell types able to achieve this goal which is the prerequisite for an effective enhancement of contractile function. Preliminary data suggest that cells that feature a true cardiomyogenic phenotype such as cardiac stem cells and cardiac-precommitted embryonic stem cells may fall in this category and carry the potential for ensuring a true

  6. Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

    Science.gov (United States)

    Stark, Margaret M; Norfolk, Guy A

    2011-08-01

    As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development.

  7. Neuroimaging in Alzheimer's disease: current role in clinical practice and potential future applications

    Directory of Open Access Journals (Sweden)

    Luiz Kobuti Ferreira

    2011-01-01

    Full Text Available 'Alzheimer's disease is the most common cause of dementia and its prevalence is expected to increase in the coming years. Therefore, accurate diagnosis is crucial for patients, clinicians and researchers. Neuroimaging techniques have provided invaluable information about Alzheimer's disease and, owing to recent advances, these methods will have an increasingly important role in research and clinical practice. The purpose of this article is to review recent neuroimaging studies of Alzheimer's disease that provide relevant information to clinical practice, including a new modality: in vivo amyloid imaging. Magnetic resonance imaging, single photon emission computed tomography and 18F-fluorodeoxyglucose-positron emission tomography are currently available for clinical use. Patients with suspected Alzheimer's disease are commonly investigated with magnetic resonance imaging because it provides detailed images of brain structure and allows the identification of supportive features for the diagnosis. Neurofunctional techniques such as single photon emission computed tomography and 18F-fluorodeoxyglucose-positron emission tomography can also be used to complement the diagnostic investigation in cases of uncertainty. Amyloid imaging is a non-invasive technique that uses positron emission tomography technology to investigate the accumulation of the β-amyloid peptide in the brain, which is a hallmark of Alzheimer's disease. This is a promising test but currently its use is restricted to very few specialized research centers in the world. Technological innovations will probably increase its availability and reliability, which are the necessary steps to achieve robust clinical applicability. Thus, in the future it is likely that amyloid imaging techniques will be used in the clinical evaluation of patients with Alzheimer's disease.

  8. 含金量样品分析检测方法现状%Gold Sample to the Analysis of Current Detection Method

    Institute of Scientific and Technical Information of China (English)

    周立红; 周西林

    2017-01-01

    In recent years were reviewed for the determination of various samples for the determination of gold content analysis method, the content involves the classification of the dry process and wet process analysis, and review of every method, respectively;Through related literature to the annuity content analysis to determine the progress of technology are reviewed, the determination of gold content analysis technology in the future development direction are proposed.%综述了近年来金含量测定的样品的各种分析测定的方法,内容涉及到干法分析和湿法分析的分类,并分别对各个方法进行点评;通过相关文献对这几年金含量分析测定技术的进展概况进行了综述,对金含量分析测定技术今后的发展方向提出建议.

  9. Current Clinical Applications and Future Potential of Diffusion Tensor Imaging in Traumatic Brain Injury.

    Science.gov (United States)

    Strauss, Sara; Hulkower, Miriam; Gulko, Edwin; Zampolin, Richard L; Gutman, David; Chitkara, Munish; Zughaft, Malka; Lipton, Michael L

    2015-12-01

    In the setting of acute central nervous system (CNS) emergencies, computed tomography (CT) and conventional magnetic resonance imaging (MRI) play an important role in the identification of life-threatening intracranial injury. However, the full extent or even presence of brain damage frequently escapes detection by conventional CT and MRI. Advanced MRI techniques such as diffusion tensor imaging (DTI) are emerging as important adjuncts in the diagnosis of microstructural white matter injury in the acute and postacute brain-injured patient. Although DTI aids in detection of brain injury pathology, which has been repeatedly associated with typical adverse clinical outcomes, the evolution of acute changes and their long-term prognostic implications are less clear and the subject of much active research. A major aim of current research is to identify imaging-based biomarkers that can identify the subset of TBI patients who are at risk for adverse outcome and can therefore most benefit from ongoing care and rehabilitation as well as future therapeutic interventions.The aim of this study is to introduce the current methods used to obtain DTI in the clinical setting, describe a set of common interpretation strategies with their associated advantages and pitfalls, as well as illustrate the clinical utility of DTI through a set of specific patient scenarios. We conclude with a discussion of future potential for the management of TBI.

  10. A national survey of Rett syndrome: age, clinical characteristics, current abilities, and health.

    Science.gov (United States)

    Cianfaglione, Rina; Clarke, Angus; Kerr, Mike; Hastings, Richard P; Oliver, Chris; Felce, David

    2015-07-01

    As part of a wider study to investigate the behavioral phenotype of a national sample of girls and women with Rett syndrome (RTT) in comparison to a well-chosen contrast group and its relationship to parental well-being, the development, clinical severity, current abilities and health of 91 participants were analyzed in relation to diagnostic, clinical and genetic mutation categories. Early truncating mutations or large deletions were associated with greater severity. Early regression was also associated with greater severity. All three were associated with lower current abilities. Epilepsy and weight, gastrointestinal and bowel problems were common co-morbidities. Participants with classic RTT had greater health problems than those with atypical RTT. A substantial minority of respondents reported fairly frequent signs of possible pain experienced by their relative with RTT. Overall, the study provides new data on the current abilities and general health of people with RTT and adds to the evidence that the severity of the condition and variation of subsequent disability, albeit generally within the profound range, may be related to gene mutation. The presence of certain co-morbidities represents a substantial ongoing need for better health. The experience of pain requires further investigation.

  11. Biomass processing over gold catalysts

    CERN Document Server

    Simakova, Olga A; Murzin, Dmitry Yu

    2014-01-01

    The book describes the valorization of biomass-derived compounds over gold catalysts. Since biomass is a rich renewable feedstock for diverse platform molecules, including those currently derived from petroleum, the interest in various transformation routes has become intense. Catalytic conversion of biomass is one of the main approaches to improving the economic viability of biorefineries.  In addition, Gold catalysts were found to have outstanding activity and selectivity in many key reactions. This book collects information about transformations of the most promising and important compounds derived from cellulose, hemicelluloses, and woody biomass extractives. Since gold catalysts possess high stability under oxidative conditions, selective oxidation reactions were discussed more thoroughly than other critical reactions such as partial hydrogenation, acetalization, and isomerization. The influence of reaction conditions, the role of the catalyst, and the advantages and disadvantages of using gold are pre...

  12. Clinical Risk Assessment in the Antiphospholipid Syndrome: Current Landscape and Emerging Biomarkers.

    Science.gov (United States)

    Chaturvedi, Shruti; McCrae, Keith R

    2017-07-01

    Laboratory criteria for the classification of antiphospholipid syndrome include the detection of a lupus anticoagulant and/or anticardiolipin and anti-β2-glycoprotein I antibodies. However, the majority of patients who test positive in these assays do not have thrombosis. Current risk-stratification tools are largely limited to the antiphospholipid antibody profile and traditional thrombotic risk factors. Novel biomarkers that correlate with disease activity and potentially provide insight into future clinical events include domain 1 specific anti-β2GPI antibodies, antibodies to other phospholipids or phospholipid/protein antigens (such as anti-PS/PT), and functional/biological assays such as thrombin generation, complement activation, levels of circulating microparticles, and annexin A5 resistance. Clinical risk scores may also have value in predicting clinical events. Biomarkers that predict thrombosis risk in patients with antiphospholipid antibodies have been long sought, and several biomarkers have been proposed. Ultimately, integration of biomarkers with established assays and clinical characteristics may offer the best chance of identifying patients at highest risk of APS-related complications.

  13. Omics-based biomarkers: current status and potential use in the clinic

    Directory of Open Access Journals (Sweden)

    Héctor Quezada

    2017-05-01

    Full Text Available In recent years, the use of high-throughput omics technologies has led to the rapid discovery of many candidate biomarkers. However, few of them have made the transition to the clinic. In this review, the promise of omics technologies to contribute to the process of biomarker development is described. An overview of the current state in this area is presented with examples of genomics, proteomics, transcriptomics, metabolomics and microbiomics biomarkers in the field of oncology, along with some proposed strategies to accelerate their validation and translation to improve the care of patients with neoplasms. The inherent complexity underlying neoplasms combined with the requirement of developing well-designed biomarker discovery processes based on omics technologies present a challenge for the effective development of biomarkers that may be useful in guiding therapies, addressing disease risks, and predicting clinical outcomes.

  14. Navigating the current landscape of clinical genetic testing for inherited retinal dystrophies.

    Science.gov (United States)

    Lee, Kristy; Garg, Seema

    2015-04-01

    Inherited eye disorders are a significant cause of vision loss. Genetic testing can be particularly helpful for patients with inherited retinal dystrophies because of genetic heterogeneity and overlapping phenotypes. The need to identify a molecular diagnosis for retinal dystrophies is particularly important in the era of developing novel gene therapy-based treatments, such as the RPE65 gene-based clinical trials and others on the horizon, as well as recent advances in reproductive options. The introduction of massively parallel sequencing technologies has significantly advanced the identification of novel gene candidates and has expanded the landscape of genetic testing. In a relatively short time clinical medicine has progressed from limited testing options to a plethora of choices ranging from single-gene testing to whole-exome sequencing. This article outlines currently available genetic testing and factors to consider when selecting appropriate testing for patients with inherited retinal dystrophies.

  15. Standards for scalable clinical decision support: need, current and emerging standards, gaps, and proposal for progress.

    Science.gov (United States)

    Kawamoto, Kensaku; Del Fiol, Guilherme; Lobach, David F; Jenders, Robert A

    2010-01-01

    Despite their potential to significantly improve health care, advanced clinical decision support (CDS) capabilities are not widely available in the clinical setting. An important reason for this limited availability of CDS capabilities is the application-specific and institution-specific nature of most current CDS implementations. Thus, a critical need for enabling CDS capabilities on a much larger scale is the development and adoption of standards that enable current and emerging CDS resources to be more effectively leveraged across multiple applications and care settings. Standards required for such effective scaling of CDS include (i) standard terminologies and information models to represent and communicate about health care data; (ii) standard approaches to representing clinical knowledge in both human-readable and machine-executable formats; and (iii) standard approaches for leveraging these knowledge resources to provide CDS capabilities across various applications and care settings. A number of standards do exist or are under development to meet these needs. However, many gaps and challenges remain, including the excessive complexity of many standards; the limited availability of easily accessible knowledge resources implemented using standard approaches; and the lack of tooling and other practical resources to enable the efficient adoption of existing standards. Thus, the future development and widespread adoption of current CDS standards will depend critically on the availability of tooling, knowledge bases, and other resources that make the adoption of CDS standards not only the right approach to take, but the cost-effective path to follow given the alternative of using a traditional, ad hoc approach to implementing CDS.

  16. Black gold

    CERN Document Server

    Fletcher, MW

    2016-01-01

    Following the Yom Kippur war of October 1973, OPEC raises the price of oil by 70% along with a 5% reduction in oil production. Len Saunders a highly skilled and knowledgeable British engineer for Jaguar motors, is approached by the UK energy commission in the January of 1974 to create a new propulsion system; using a secret document from a German WW2 scientist, that they have come into possession of. Len Saunders sets to work on creating the holy grail of energy. Seven years later 1981, Haidar Farooq the Kuwait oil minister working at OPEC and head of a secret organisation named Black Gold bec

  17. Effect of Gold Marker Seeds on Magnetic Resonance Spectroscopy of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Hossain, Murshed, E-mail: Murshed.Hossain@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Schirmer, Timo [Global MR Applied Science Laboratory, GE Healthcare, Munich (Germany); Richardson, Theresa; Chen, Lili; Buyyounouski, Mark K.; Ma Changming [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)

    2012-05-01

    Purpose: Magnetic resonance stereoscopic imaging (MRSI) of the prostate is an emerging technique that may enhance targeting and assessment in radiotherapy. Current practices in radiotherapy invariably involve image guidance. Gold seed fiducial markers are often used to perform daily prostate localization. If MRSI is to be used in targeting prostate cancer and therapy assessment, the impact of gold seeds on MRSI must be investigated. The purpose of this study was to quantify the effects of gold seeds on the quality of MRSI data acquired in phantom experiments. Methods and Materials: A cylindrical plastic phantom with a spherical cavity 10 centimeters in diameter wss filled with water solution containing choline, creatine, and citrate. A gold seed fiducial marker was put near the center of the phantom mounted on a plastic stem. Spectra were acquired at 1.5 Tesla by use of a clinical MRSI sequence. The ratios of choline + creatine to citrate (CC/Ci) were compared in the presence and absence of gold seeds. Spectra in the vicinity of the gold seed were analyzed. Results: The maximum coefficient of variation of CC/Ci induced by the gold seed was found to be 10% in phantom experiments at 1.5 T. Conclusion: MRSI can be used in prostate radiotherapy in the presence of gold seed markers. Gold seeds cause small effects (in the order of the standard deviation) on the ratio of the metabolite's CC/Ci in the phantom study done on a 1.5-T scanner. It is expected that gold seed markers will have similar negligible effect on spectra from prostate patients. The maximum of 10% of variation in CC/Ci found in the phantom study also sets a limit on the threshold accuracy of CC/Ci values for deciding whether the tissue characterized by a local spectrum is considered malignant and whether it is a candidate for local boost in radiotherapy dose.

  18. Dry age-related macular degeneration: A currently unmet clinical need.

    Science.gov (United States)

    Girmens, Jean-François; Sahel, José-Alain; Marazova, Katia

    2012-08-01

    Age-related macular degeneration (AMD) is a leading cause of severe visual impairment and disability in older people worldwide. Although considerable advances in the management of the neovascular form of AMD have been made in the last decade, no therapy is yet available for the advanced dry form of AMD (geographic atrophy). This review focuses on current trends in the development of new therapies targeting specific pathophysiological pathways of dry AMD. Increased understanding of the complex mechanisms that underlie dry AMD will help to address this largely unmet clinical need.

  19. A review of the current state of digital plate reading of cultures in clinical microbiology.

    Science.gov (United States)

    Rhoads, Daniel D; Novak, Susan M; Pantanowitz, Liron

    2015-01-01

    Digital plate reading (DPR) is increasingly being adopted as a means to facilitate the analysis and improve the quality and efficiency within the clinical microbiology laboratory. This review discusses the role of DPR in the context of total laboratory automation and explores some of the platforms currently available or in development for digital image capturing of microbial growth on media. The review focuses on the advantages and challenges of DPR. Peer-reviewed studies describing the utility and quality of these novel DPR systems are largely lacking, and professional guidelines for DPR implementation and quality management are needed. Further development and more widespread adoption of DPR is anticipated.

  20. [Current status of bone/cartilage tissue engineering towards clinical applications].

    Science.gov (United States)

    Ohgushi, Hajime

    2014-10-01

    Osteo/chondrogenic differentiation capabilities are seen after in vivo implantation of mesenchymal stem cells (MSCs), which are currently used for the patients having bone/cartilage defects. Importantly, the differentiation capabilities are induced by culturing technology, resulting in in vitro bone/cartilage formation. Especially, the in vitro bone tissue is useful for bone tissue regeneration. For cartilage regeneration, culture expanded chondrocytes derived from patient's normal cartilage are also used for the patients having cartilage damages. Recently, the cultured chondrocytes embedded in atelocollagen gel are obtainable as tissue engineered products distributed by Japan Tissue Engineering Co. Ltd. The products are available in the well-regulated hospitals by qualified orthopedic surgeons. The criteria for these hospitals/surgeons have been established. This review paper focuses on current status of bone/cartilage tissue engineering towards clinical applications in Japan.

  1. PDE-5 Inhibitors in Scleroderma Raynaud Phenomenon and Digital Ulcers: Current Status of Clinical Trials

    Directory of Open Access Journals (Sweden)

    Ann J. Impens

    2011-01-01

    Full Text Available Systemic sclerosis- (SSc- related vasculopathy, as manifested by Raynaud's Phenomenon (RP and digital ulcers (DUs, is associated with significant impairment of the quality of life and morbidity. The current vasoactive approach for SSc-RP, although employing vasodilators, is entirely off-label. PDE-5 inhibitors improve peripheral circulation, are well tolerated, and are widely used for various forms of constrictive vasculopathies. This class of medications has become one of the first lines of treatment of SSc-RP and SSc-DUs among rheumatologists that routinely treat SSc patients. Due to the lack of robust randomized clinical trials of PDE-5 inhibitors in SSc-RP/DUs, the PDE-5 inhibitors have not been FDA approved for these particular indications, which constitutes a significant barrier to prescribing this category of drugs. This paper reviews the current state of evidence-based knowledge in SSc-related vasculopathy and the use of PDE-5 inhibitors.

  2. The use of psychometrists in clinical neuropsychology: history, current status, and future directions.

    Science.gov (United States)

    Malek-Ahmadi, Michael; Erickson, Tom; Puente, Antonio E; Pliskin, Neil; Rock, Rachel

    2012-01-01

    In recent years, the National Academy of Neuropsychology and other professional neuropsychological organizations have published a number of articles and position papers regarding the use, education, and training of psychometrists ("technicians"). Although these documents provide guidelines for the suggested qualifications and training procedures of psychometrists, none make any mention of the need for a standardized credentialing process, which is commonly required of technicians in similar fields, especially in medical settings. Given the recent changes in current procedural Terminology codes used to bill for neuropsychological services and the interpretation of legislation disallowing the use of psychometrists in New York, the need for a standard credential for psychometrists is apparent. This article will review the history and current use of psychometrists in clinical neuropsychology and highlight the need and rationale for the credentialing of psychometrists.

  3. The clinical endocrinology workforce: current status and future projections of supply and demand.

    Science.gov (United States)

    Vigersky, Robert A; Fish, Lisa; Hogan, Paul; Stewart, Andrew; Kutler, Stephanie; Ladenson, Paul W; McDermott, Michael; Hupart, Kenneth H

    2014-09-01

    Many changes in health care delivery, health legislation, and the physician workforce that affect the supply and demand for endocrinology services have occurred since the first published workforce study of adult endocrinologists in 2003. The objective of the study was to assess the current adult endocrinology workforce data and provide the first analysis of the pediatric endocrinology workforce and to project the supply of and demand for endocrinologists through 2025. A workforce model was developed from an analysis of proprietary and publicly available databases, consultation with a technical expert panel, and the results of an online survey of board-certified endocrinologists. The Endocrine Society commissioned The Lewin Group to estimate current supply and to project gaps between supply and demand for endocrinologists. A technical expert panel of senior endocrinologists provided context, clinical information, and direction. The following were measured: 1) the current adult and pediatric endocrinology workforce and the supply of and demand for endocrinologists through 2025 and 2) the number of additional entrants into the endocrinology work pool that would be required to close the gap between supply and demand. Currently there is a shortage of approximately 1500 adult and 100 pediatric full-time equivalent endocrinologists. The gap for adult endocrinologists will expand to 2700 without an increase in the number of fellows trained. An increase in the prevalence of diabetes mellitus further expands the demand for adult endocrinologists. The gap can be closed in 5 and 10 years by increasing the number of fellowship positions by 14.4% and 5.5% per year, respectively. The gap between supply and demand for pediatric endocrinologists will close by 2016, and thereafter an excess supply over demand will develop at the current rate of new entrants into the work force. There are insufficient adult endocrinologists to satisfy current and future demand. A number of proactive

  4. Going for Gold

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    While the international gold price in February hit the highest point in 25 years at $541.20 per ounce for futures delivery, a new gold rush is sweeping across China. According to the World Gold Council, the London-based gold marketing organization funded by leading global gold mining firms, the purchase of gold products in China grew by 9 percent in the first nine

  5. Gold Nanoparticle-assisted Selective Photothermolysis of Adipose Tissue (NanoLipo

    Directory of Open Access Journals (Sweden)

    Wangzhong Sheng, MSc

    2014-12-01

    Conclusions: NanoLipo facilitates removal of a greater quantity of fat and requires less suction time (4 vs 10 minutes than conventional SAL. As the safety of poly(ethylene-glycol-coated gold nanorods is well-established, a clinical trial is currently being organized.

  6. Gold concentration in blood in relation to the number of gold restorations and contact allergy to gold.

    Science.gov (United States)

    Ahnlide, Ingela; Ahlgren, Camilla; Björkner, Bert; Bruze, Magnus; Lundh, Thomas; Möller, Halvor; Nilner, Krister; Schütz, Andrejs

    2002-10-01

    Previous studies have demonstrated an association between gold allergy and the presence of dental gold restorations. The aim of the present study was to investigate the relationship between the concentration of gold in blood (B-Au) and the number of tooth surfaces with gold alloys in subjects with and without contact allergy to gold. In 80 patients referred for patch testing because of eczematous disease, blood samples were taken and analyzed for B-Au using inductively coupled plasma mass spectrometry. The detection limit for the Au determination was 0.04 microg/L. In addition, a dentist made a clinical and radiological examination of the patients and registered the number of dental gold surfaces. Patients with dental gold restorations had a statistically significantly higher B-Au in Mann-Whitney U test (P = 0.025), (range < 0.04-1.07 microg/L) than patients without (range < 0.04-0.15 microg/L). Furthermore, a positive correlation was found between B-Au and the number of dental gold surfaces (P < 0.01). There was no statistically significant difference in B-Au between persons with and without contact allergy to gold. The study thus indicates that gold is released from dental restorations and taken tip into the circulation.

  7. Highly sensitive detection of influenza virus in saliva by real-time PCR method using sugar chain-immobilized gold nanoparticles; application to clinical studies

    Directory of Open Access Journals (Sweden)

    Yasuo Suda

    2015-09-01

    Full Text Available A highly sensitive and convenient method for detecting influenza virus was developed using modified end-point melt curve analysis of a RT-qPCR SYBR Green method and influenza virus-binding sugar chain-immobilized gold-nanoparticles (SGNP. Because SGNPs capture influenza viruses, the virus-SGNP complex was separated easily by centrifugation. Viral RNA was detected at very low concentrations, suggesting that SGNP increased sensitivity compared with standard methods. This method was applied to clinical studies. Influenza viruses were detected in saliva of patients or inpatients who had been considered influenza-free by a rapid diagnostic assay of nasal swabs. Furthermore, the method was applied to a human trial of prophylactic anti-influenza properties of yogurt containing Lactobacillus acidophilus L-92. The incidence of influenza viruses in saliva of the L-92 group was found to be significantly lower compared to the control group. Thus, this method was useful for monitoring the course of anti-influenza treatment or preventive measures against nosocomial infection.

  8. Mind-body CAM interventions: current status and considerations for integration into clinical health psychology.

    Science.gov (United States)

    Park, Crystal

    2013-01-01

    Complementary and alternative medicine (CAM) is increasingly used for treating myriad health conditions and for maintaining general health. The present article provides an overview of current CAM use with a specific focus on mind-body CAM and its efficacy in treating health conditions. Characteristics of CAM users are presented, and then evidence regarding the efficacy of mind-body treatments (biofeedback, meditation, guided imagery, progressive muscle relaxation, deep breathing, hypnosis, yoga, tai chi, and qi gong) is reviewed. Demographics associated with CAM use are fairly well-established, but less is known about their psychological characteristics. Although the efficacy of mind-body CAM modalities for health conditions is receiving a great deal of research attention, studies have thus far produced a weak base of evidence. Methodological limitations of current research are reviewed. Suggestions are made for future research that will provide more conclusive knowledge regarding efficacy and, ultimately, effectiveness of mind-body CAM. Considerations for clinical applications, including training and competence, ethics, treatment tailoring, prevention efforts, and diversity, conclude the article. Integration of CAM modalities into clinical health psychology can be useful for researchers taking a broader perspective on stress and coping processes, illness behaviors, and culture; for practitioners seeking to incorporate CAM perspectives into their work; and for policy makers in directing healthcare resources wisely. © 2012 Wiley Periodicals, Inc.

  9. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  10. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-03-02

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  11. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Michalina Jasiak-Zatonska

    2016-03-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune, demyelinating disorder of the central nervous system (CNS with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS, it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs. This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  12. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Monroe, Alan T.; Peddada, Anuj V. [Dept. of Radiation Oncology, Penrose Cancer Center, Colorado Springs (United States); Pikaart, Dirk [Dept. of Gynecologic Oncology, Penrose Cancer Center, Colorado Springs (United States)

    2013-06-15

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered.

  13. The association between current unemployment and clinically determined poor oral health.

    Science.gov (United States)

    Al-Sudani, Fouad Y H; Vehkalahti, Miira M; Suominen, Anna L

    2015-08-01

    The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  15. Cutaneous leishmaniasis in Syria: clinical features, current status and the effects of war.

    Science.gov (United States)

    Hayani, Kinan; Dandashli, Anwar; Weisshaar, Elke

    2015-01-01

    Cutaneous leishmaniasis (CL) is a worldwide disease caused by an infection with the protozoan parasite Leishmania transmitted via sand flies. It is endemic in many of the poorest countries of all continents. "Aleppo boil" is one of the recognised names given to this disease in the medical literature. Although CL used to be well-controlled and well-documented in Syria, its incidence has dramatically increased since the beginning of the war; however, there is lack of documentation. Here, we present the past and current epidemiological situation of the disease in Syria. We also draw attention to gross and highly unusual clinical variants of CL presented to the Department of Dermatology in Aleppo covering the important differential clinical diagnoses, since this disease is already known to mimic other conditions. Diagnostic procedures and treatment as well as prevention are summarised. Due to the increased ability to travel, and especially the flight of Syrians to neighbouring countries, as well as to Europe, CL may become a new threat in formerly unaffected regions. Through this account, we hope to give weight to the aspiration that CL does not remain a neglected and often clinically overlooked tropical dermatosis.

  16. Current status and prospects of clinical proteomics studies on detection of colorectal cancer: Hopes and fears

    Institute of Scientific and Technical Information of China (English)

    ME de Noo; RAEM Tollenaar; AM Deelder; LH Bouwman

    2006-01-01

    Colorectal adenocarcinoma (CRC) is the third most common type of cancer and the fourth most frequent cause of death due to cancer worldwide. Given the natural history of CRC, early diagnosis appears to be the most appropriate tool to reduce disease-related mortality. A field of recent interest is clinical proteomics, which was reported to lead to high sensitivity and specificities for early detection of several solid tumors. This emerging field uses mass spectrometry-based protein profiles/patterns of easy accessible body fluids to distinguish cancer from non-cancer patients. These discrepancies may be a result of: (1) proteins being abnormally produced or shed and added to the serum proteome, (2) proteins clipped or modified as a consequence of the disease process, or (3) proteins subtracted from the proteome owing to disease-related proteolytic degradation pathways. Therefore, protein pattern diagnostics would provide easy and reliable tools for detection of cancer. This paper focuses on the current status of clinical proteomics research in oncology and in colorectal cancer especially,and will reflect on pitfalls and fears in this relatively new area of clinical medicine, which are reproducibility issues and pre-analytical factors, statistical issues, and identification and nature of discriminating proteins/peptides.

  17. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Science.gov (United States)

    Natesan, Suganthini Krishnan; Chandrasekar, Pranatharthi H

    2016-01-01

    The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA) and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ) seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA) for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. PMID:27994475

  18. CARDIOVASCULAR DISEASES TREATMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN CURRENT CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    I. E. Sapozhnikova

    2016-01-01

    Full Text Available Aim. To evaluate cardiovascular diseases (CVD treatment in patients with type 2 diabetes mellitus (DM 2 in current clinical practice.Material and methods. A total of 200 patients with DM 2, who consented to take part in the questionnaire, were examined. Questionnaire, clinical and laboratory examinations were conducted.Results. There was a low frequency of CVD recognized and included into clinical diagnosis – angina, history of myocardial infarction and stroke. In majority of the patients decompensated carbohydrate metabolism was observed. This was due to lack of knowledge, inadequate or absent glucose self-monitoring, low frequency of combined glucoselowering therapy. Target level of blood pressure (BP was registered in 16% of hypertensive patients only. Basic reasons of this were: frequently prescribed mono-therapy, irrational combinations, inadequate dosage and frequent omissions of antihypertensive drugs intake and not appropriate BP self-monitoring. Low frequency of statins therapy and non-targeted cholesterol levels were also revealed in examined patients.Conclusion. Improvement of diagnostic tactics in patients with DM 2 is necessary as well as therapy correction taking into account these patients co-morbidity.

  19. CARDIOVASCULAR DISEASES TREATMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN CURRENT CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    I. E. Sapozhnikova

    2009-01-01

    Full Text Available Aim. To evaluate cardiovascular diseases (CVD treatment in patients with type 2 diabetes mellitus (DM 2 in current clinical practice.Material and methods. A total of 200 patients with DM 2, who consented to take part in the questionnaire, were examined. Questionnaire, clinical and laboratory examinations were conducted.Results. There was a low frequency of CVD recognized and included into clinical diagnosis – angina, history of myocardial infarction and stroke. In majority of the patients decompensated carbohydrate metabolism was observed. This was due to lack of knowledge, inadequate or absent glucose self-monitoring, low frequency of combined glucoselowering therapy. Target level of blood pressure (BP was registered in 16% of hypertensive patients only. Basic reasons of this were: frequently prescribed mono-therapy, irrational combinations, inadequate dosage and frequent omissions of antihypertensive drugs intake and not appropriate BP self-monitoring. Low frequency of statins therapy and non-targeted cholesterol levels were also revealed in examined patients.Conclusion. Improvement of diagnostic tactics in patients with DM 2 is necessary as well as therapy correction taking into account these patients co-morbidity.

  20. Infantile nystagmus syndrome: clinical characteristics, current theories of pathogenesis, diagnosis, and management.

    Science.gov (United States)

    Richards, Michael D; Wong, Agnes

    2015-12-01

    Infantile nystagmus syndrome (INS) is an important clinical diagnosis because it is a common presenting sign of many ocular, neurologic, and systemic diseases. Although INS has been studied for more than a century, its diagnosis and treatment remains a challenge to clinicians because of its varied manifestations and multiple associations, and its pathogenesis continues to rouse considerable scientific debate. Fueled by these challenges, recent basic research and clinical investigations have provided new insights into INS. New genetic discoveries and technological advances in ocular imaging have refined our understanding of INS subtypes and offer new diagnostic possibilities. Unexpected surgical outcomes have led to new understanding of its pathogenesis based on novel hypothesized pathways of ocular motor control. Comparative studies on nonhuman visual systems have also informed models of the neural substrate of INS in humans. This review brings together the classic profile of this disorder with recent research to provide an update on the clinical features of INS, an overview of the current theories on how and why INS develops, and a practical approach to the diagnosis and management of INS.

  1. [Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues].

    Science.gov (United States)

    Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji

    2014-11-01

    We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.

  2. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    Science.gov (United States)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  3. [Current recommendations about the diagnosis and treatment of testosterone deficit syndrome: Clinical guidelines].

    Science.gov (United States)

    Valero Rosa, José; Márquez López, Javier; Campos Hernández, Pablo; Puigvert Martínez, Ana; Prieto Castro, Rafael

    2013-09-01

    Testosterone deficit syndrome (TDS) is a clinical and biochemical syndrome associated with advanced age and characterized by some typical symptoms and decrease in serum testosterone levels, which can affect multiple organs and systems, deteriorating the quality of life of the males who suffer it. Due to the low specificity of the clinical picture, as well as that of the commonly used questionnaires, when there is a diagnostic suspicion, serum testosterone determination is necessary, without a current universally accepted determination method. The increased survival of males in the western world and their demand of a better quality of life,including the preservation of sexual activity, up to increasingly more advanced ages: together with the appearance of new ways of testosterone delivery, make this entity, clinical-biochemical, acquirean increasingly greater importance. From a therapeutic point of view, testosterone replacement therapy has precise indications, with individualized evaluation in each patient on the basis of risk/benefit, and with an adequate, well defined follow up, that will allow the control of possible adverse events. TRT is recommended in patients with diminished testosterone associated with muscle mass and strength loss, decrease of bone density of the lumbar spine or diminished libido and quality of erection. Contraindications for therapy would include active or non treated prostate cancer, PSA >4 ng/ml before evaluation, breast cancer, severe sleep apnea, infertility, hematocrit over 50% or severe LUTS due to BPH.

  4. Clinical Evaluation of the Immune Colloidal Gold Method for Rapid Qualitative and Quantitative Measurement of Thyroid-Stimulating Hormone as an Assay for Hypothyroidism.

    Science.gov (United States)

    Wang, Tingting; Sheng, Shiwei; Ruan, Meifang; Yan, Jing; Gu, Jianying; Jiang, Yumin; Gao, Yunchao; Lu, Hankui

    2016-11-01

    The immune colloidal gold (ICG) method of measuring thyroid-stimulating hormone (TSH) is a rapid and easy-to-perform test, allowing off-site measurements. This study compared the clinical utility of the first ICG-based qualitative and quantitative TSH test methods in China with the third-generation serum TSH assay used worldwide. Fingertip and venous blood was collected within 30 min from 283 patients initially suspected of hypothyroidism. TSH was measured in fingertip blood using ICG-based qualitative quantitative tests. Serum TSH in venous blood was tested using the third-generation serum TSH assay. Correlations between systems were tested by kappa or Spearman correlation coefficients. Compared with the third-generation serum TSH assay, the ICG-qualitative TSH test kit had a kappa coefficient of 0.86, a sensitivity of 85.00%, and a specificity of 99.38% in screening for hypothyroidism. The percentages of false negatives and false positives among all subjects were 6.38% and 0.35% respectively; the total consistency rate of the two methods was 93.26%. When compared with the third-generation serum TSH assay, the ICG-quantitative TSH analysis system had a Spearman correlation coefficient of 0.91, a sensitivity of 88.43%, and a specificity of 98.77%. The percentages of false negatives and false positives among all subjects were 4.95% and 0.71%, respectively; the total consistency rate of the two methods was 94.35%. Both ICG-based assays are easier and faster to perform than the third-generation, laboratory-based serum TSH assay method. The ICG-based methods showed acceptable performance in the simplified screening for hypothyroidism. ClinicalTrials.gov identifier, NCT01921452. Merck Serono Co., Ltd.

  5. Alternating Current Stimulation for Vision Restoration after Optic Nerve Damage: A Randomized Clinical Trial

    Science.gov (United States)

    Schittkowski, Michael P.; Antal, Andrea; Ambrus, Géza Gergely; Paulus, Walter; Dannhauer, Moritz; Michalik, Romualda; Mante, Alf; Bola, Michal; Lux, Anke; Kropf, Siegfried; Brandt, Stephan A.; Sabel, Bernhard A.

    2016-01-01

    Background Vision loss after optic neuropathy is considered irreversible. Here, repetitive transorbital alternating current stimulation (rtACS) was applied in partially blind patients with the goal of activating their residual vision. Methods We conducted a multicenter, prospective, randomized, double-blind, sham-controlled trial in an ambulatory setting with daily application of rtACS (n = 45) or sham-stimulation (n = 37) for 50 min for a duration of 10 week days. A volunteer sample of patients with optic nerve damage (mean age 59.1 yrs) was recruited. The primary outcome measure for efficacy was super-threshold visual fields with 48 hrs after the last treatment day and at 2-months follow-up. Secondary outcome measures were near-threshold visual fields, reaction time, visual acuity, and resting-state EEGs to assess changes in brain physiology. Results The rtACS-treated group had a mean improvement in visual field of 24.0% which was significantly greater than after sham-stimulation (2.5%). This improvement persisted for at least 2 months in terms of both within- and between-group comparisons. Secondary analyses revealed improvements of near-threshold visual fields in the central 5° and increased thresholds in static perimetry after rtACS and improved reaction times, but visual acuity did not change compared to shams. Visual field improvement induced by rtACS was associated with EEG power-spectra and coherence alterations in visual cortical networks which are interpreted as signs of neuromodulation. Current flow simulation indicates current in the frontal cortex, eye, and optic nerve and in the subcortical but not in the cortical regions. Conclusion rtACS treatment is a safe and effective means to partially restore vision after optic nerve damage probably by modulating brain plasticity. This class 1 evidence suggests that visual fields can be improved in a clinically meaningful way. Trial Registration ClinicalTrials.gov NCT01280877 PMID:27355577

  6. Gold in Modern Economy

    Directory of Open Access Journals (Sweden)

    Boryshkevych Olena V.

    2014-01-01

    Full Text Available The article studies the role of gold in modern economy. It analyses dynamics and modern state of the gold market. It studies volumes of contracts in exchange and off-exchange markets. In order to reveal changes of key features of the gold market, it focuses on the study of gold demand volumes, studies volumes and geographical changes in the world gold mining, and analyses volumes of monetary gold of central banks and its share in gold and currency reserves. It analyses price fluctuations in the gold market during 1968 – 2013 and identifies main factors that determine the gold price. It identifies interconnection between the state of the gold market and financial markets of countries. The study showed that namely geopolitical and economic instability restricts the spectrum of financial assets for investing and gold is not only a safe investment object but also a profitable one.

  7. Clinical and experimental studies on polyherbal formulations for diabetes:current status and future prospective

    Institute of Scientific and Technical Information of China (English)

    Ahmad Ghorbani

    2014-01-01

    Diabetes is a leading cause of morbidity and mortality in the world. There is currently an active search for antidiabetic drugs with greater effectiveness with fewer and less adverse side effects. Although numerous individual herbs have been experimentally or clinically reported to possess antidiabetic effects, considerably less research has been conducted on polyherbal compounds. It is believed that herbal compounds containing multiple plant products have synergistic antidiabetic effects and could enhance the desired actions. Several polyherbal formulations have been studied as therapeutic agents in diabetes management. To describe the current state of research on polyherbal compounds in the treatment of diabetes, an extensive review of literature was undertaken on several major databases. This paper presents what is known about the efifcacy of these polyherbal formulations and compare their antidiabetic effects with those of current oral hypoglycemic drugs as reference. The percent decrease in blood glucose, lipids and other biochemical parameters achieved by each product in diabetic animals and patients is reported. Also, the possible mechanisms responsible for hypoglycemic action of polyherbal formulations are discussed.

  8. Single gold nanoplasmonic sensor for clinical cancer diagnosis based on specific interaction between nucleic acids and protein.

    Science.gov (United States)

    Ma, Xingyi; Truong, Phuoc Long; Anh, Nguyen Hung; Sim, Sang Jun

    2015-05-15

    Plasmonic nanomaterials reveal noble optical properties for next-generation biosensors. Nanoplasmonic biosensors have become simple, sensitive, smart, and consistent with advanced healthcare programs requirements. Notably, an individual nanoparticle analysis can yield unique target information, based on which the next-generation biosensor is revolutionary for end-point detection (single or multiplex), and can be functionally extended to biological phenomena monitoring. Here, we present a single nanoplasmonic sensing technology based on localized surface plasmon resonance for label-free and real-time detection of highly reliable cancer markers (mutant gene and telomerase) in clinical samples. The sensor specifically detects mutant DNA, and can detect telomerase from as few as 10 HeLa cells. This approach can be easily translated to detect other pathological targets with high sensitivity and specificity, and monitor key interactions between biomolecules such as nucleic acids and proteins during disease development in real time. This system has great potential to be further developed for on-chip and simultaneous analysis of multiple targets and interactions. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Application of gold in the field of heterogeneous catalysis

    CERN Document Server

    Luo, Siwei

    2014-01-01

    Gold has been long thought as an inert metal which finds most of its use in jewelry and monetary exchange. However, catalysis by gold has rapidly become a hot topic in chemistry ever since Haruta and Hutchings found gold to be an extraordinary good heterogeneous catalyst in certain reactions. Here in this paper, several model reactions which made gold historically famous as a catalyst and a currently hot topic will be demonstrated, such as oxidation of CO, selective oxidation, and hydrodechlorination. Conclusions on the chemical nature of gold will be made as well as future perspectives of designing gold as a better catalyst.

  10. Improving performance in golf: current research and implications from a clinical perspective

    Directory of Open Access Journals (Sweden)

    Kerrie Evans

    2015-10-01

    Full Text Available ABSTRACTGolf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance.

  11. SHORT OVERVIEW OF CLINICAL TRIALS WITH CURRENT IMMUNOTHERAPEUTIC TOOLS FOR CANCER TREATMENT

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    T. S. Nepomnyashchikh

    2017-01-01

    Full Text Available Over last decade, a substantial progress has been made, with respect to understanding of cancer biology and its interplay with the host immune system. Different immunotherapeutic drugs based on recombinant cytokines and monoclonal antibodies are widely used in cancer therapy, and a large number of experimental cancer treatments have been developed, many of which are currently undergoing various stages of clinical trials. Recent endorsement of a recombinant oncolytic herpesvirus T-VEC for the treatment of melanoma was an important step towards a more safe and efficient anticancer therapeutics. In this review, we shall mention only some of the most promising cancer immunotherapy strategies, namely, immune checkpoint inhibitors, cellular therapy and oncolytic viruses. 

  12. The metabolic syndrome in patients with alcohol dependency: Current research and clinical implications.

    Science.gov (United States)

    Kahl, Kai G; Hillemacher, Thomas

    2016-10-01

    The relationship between alcohol dependency and disorders such as liver disease and cancer has been thoroughly researched. However, the effects of alcohol on cardiometabolic health remain controversial. Several reports found low to moderate alcohol consumption to be associated with a lower risk for cardiometabolic disorders. In contrast, excessive alcohol consumption has been related to an increased risk. Most of these studies were performed in non-clinical populations, therefore limiting the explanatory power to non-dependent patients. Only a few studies examined cardiovascular disorders and cardiovascular risk factors, in particular the metabolic syndrome (MetS), in alcohol dependent patients. We here present a narrative review of studies performed so far on the MetS in alcohol dependency, and provide current hypotheses on the association of alcohol dependency, appetite regulation and the development of the MetS.

  13. Clinical utility of current-generation dipole modelling of scalp EEG.

    Science.gov (United States)

    Plummer, C; Litewka, L; Farish, S; Harvey, A S; Cook, M J

    2007-11-01

    To investigate the clinical utility of current-generation dipole modelling of scalp EEG in focal epilepsies seen commonly in clinical practice. Scalp EEG recordings from 10 patients with focal epilepsy, five with Benign Focal Epilepsy of Childhood (BFEC) and five with Mesial Temporal Lobe Epilepsy (MTLE), were used for interictal spike dipole modelling using Scan 4.3 and CURRY 5.0. Optimum modelling parameters for EEG source localisation (ESL) were sought by the step-wise application of various volume conductor (forward) and dipole (inverse) models. Best-fit ESL solutions (highest explained forward-fit to measured data variance) were used to characterise best-fit forward and inverse models, regularisation effect, additional electrode effect, single-to-single spike and single-to-averaged spike variability, and intra- and inter-operator concordance. Inter-parameter relationships were examined. Computation times and interface problems were recorded. For both BFEC and MTLE, the best-fit forward model was the finite element method interpolated (FEMi) model, while the best-fit single dipole models were the rotating non-regularised and the moving regularised models. When combined, these forward-inverse models appeared to offer clinically meaningful ESL results when referenced to an averaged cortex overlay, best-fit dipoles localising to the central fissure region in BFEC and to the basolateral temporal region in MTLE. Single-to-single spike and single-to-averaged spike measures of concordance for dipole location and orientation were stronger for BFEC versus MTLE. The use of an additional pair of inferior temporal electrodes in MTLE directed best-fit dipoles towards the basomesial temporal region. Inverse correlations were noted between unexplained variance (RD) and dipole strength (Amp), RD and signal to noise ratio (SNR), and SNR and confidence ellipsoid (CE) volume. Intra- and inter-operator levels of agreement were relatively robust for dipole location and orientation

  14. Radiology of HIV/AIDS in China: Current status and clinical application

    Directory of Open Access Journals (Sweden)

    Hongjun Li

    2015-06-01

    Full Text Available HIV infection targets at the human in the human body and targeting damage to immune system to compromise the result in hypoimmunity. HIV associated damages to tissues and organs as well as AIDS related infections caused by various pathogens and neoplasms are clinically common. AIDS related diseases are the main cause of death in patients with AIDS. Therefore, early prevention as well as appropriate and immediate treatment against AIDS related diseases play key role in prolonging the survival period and improving quality of life in patients with AIDS. In recent years, medical radiology has gained rapid development, which plays an important role in diagnosing and treating HIV/AIDS related diseases. The findings by medical radiology constitute an important chain of evidence for HIV/AIDS related diseases. Developed from traditional morphological radiology to current functional and molecular radiology, the modern medical radiology is providing a flood of diagnostic information to guide clinical practice. It is expected to provide accurate data for the location of lesions as well as quantitatively and qualitatively radiological diagnosis. Based on the radiological data, the goal of individualized treatment can be achieved.

  15. Clinical utility of trabectedin for the treatment of ovarian cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Mascilini F

    2014-07-01

    Full Text Available Floriana Mascilini,* Giulia Amadio,* Maria Grazia Di Stefano, Manuela Ludovisi, Alessia Di Legge, Carmine Conte, Rosa De Vincenzo, Caterina Ricci, Valeria Masciullo, Vanda Salutari, Giovanni Scambia, Gabriella FerrandinaGynecologic Oncology Unit, Department of Oncology, Catholic University of Rome, Italy  *These authors contributed equally to this work Abstract: Among the pharmaceutical options available for treatment of ovarian cancer, attention has been increasingly focused on trabectedin (ET-743, a drug which displays a unique mechanism of action and has been shown to be active in several human malignancies. Currently, single agent trabectedin is approved for treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide, and in association with pegylated liposomal doxorubicin for treatment of patients with relapsed partially platinum-sensitive ovarian cancer. This review aims at summarizing the available evidence about the clinical role of trabectedin in the management of patients with epithelial ovarian cancer. Novel perspectives coming from a better understanding of trabectedin mechanisms of action and definition of patients subgroups likely susceptible to benefit of trabectedin treatment are also presented. Keywords: ET-743, ovarian cancer, clinical trials

  16. [Current neurophysiological tests and revised JSCN technical standards for clinical EEG].

    Science.gov (United States)

    Ishiyama, Yoji

    2003-06-01

    The purpose of this lecture is to review the development of current neurophysiology and the revised standard of society for clinical EEG. 1. The improvement of neurophysiological tests. 1) EEG and evoked potential: EEG and evoked potential testing includes the routine EEG recording, EEG monitoring in surgical operation, all night sleep polygraph for the diagnosis of sleep apnea syndrome and many kinds of brain evoked potentials. Especially, the P300 component in the ERP(event-related evoked potential) is useful for the testing of essential brain functions. 2) EMG and evoked EMG: These tests are applied for the diagnosis of neurogenic, myogenic and neuromuscular junction disorder, and also the single fiber EMG using micro needle electrode is useful for the diagnosis of myasthenia gravis. Motor and sensory nerve conduction velocity are calculated from the latency of evoked EMGs. Furthermore, the distribution of these conduction velocities in many nerve fibers is measured by the collision technique. 3) Other tests: Near-infrared spectroscopy for the testing of brain functions has made rapid progress, and the transcranial magnetic stimulation method has come to be used for evaluation of functional diseases in the pyramidal tract, cerebellum and the spinal cord. 2. The revised JSCN technical standards for clinical EEG. The revised recording conditions of ECI(electro cerebral inactivity: flat EEG) in brain death are the focus of this lecture.

  17. Human iPS Cell-Derived Germ Cells: Current Status and Clinical Potential.

    Science.gov (United States)

    Ishii, Tetsuya

    2014-10-13

    Recently, fertile spermatozoa and oocytes were generated from mouse induced pluripotent (iPS) cells using a combined in vitro and in vivo induction system. With regard to germ cell induction from human iPS cells, progress has been made particularly in the male germline, demonstrating in vitro generation of haploid, round spermatids. Although iPS-derived germ cells are expected to be developed to yield a form of assisted reproductive technology (ART) that can address unmet reproductive needs, genetic and/or epigenetic instabilities abound in iPS cell generation and germ cell induction. In addition, there is still room to improve the induction protocol in the female germline. However, rapid advances in stem cell research are likely to make such obstacles surmountable, potentially translating induced germ cells into the clinical setting in the immediate future. This review examines the current status of the induction of germ cells from human iPS cells and discusses the clinical potential, as well as future directions.

  18. Human iPS Cell-Derived Germ Cells: Current Status and Clinical Potential

    Directory of Open Access Journals (Sweden)

    Tetsuya Ishii

    2014-10-01

    Full Text Available Recently, fertile spermatozoa and oocytes were generated from mouse induced pluripotent (iPS cells using a combined in vitro and in vivo induction system. With regard to germ cell induction from human iPS cells, progress has been made particularly in the male germline, demonstrating in vitro generation of haploid, round spermatids. Although iPS-derived germ cells are expected to be developed to yield a form of assisted reproductive technology (ART that can address unmet reproductive needs, genetic and/or epigenetic instabilities abound in iPS cell generation and germ cell induction. In addition, there is still room to improve the induction protocol in the female germline. However, rapid advances in stem cell research are likely to make such obstacles surmountable, potentially translating induced germ cells into the clinical setting in the immediate future. This review examines the current status of the induction of germ cells from human iPS cells and discusses the clinical potential, as well as future directions.

  19. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Directory of Open Access Journals (Sweden)

    Natesan SK

    2016-12-01

    Full Text Available Suganthini Krishnan Natesan,1,2 Pranatharthi H Chandrasekar1 1Division of Infectious Diseases, Department of Internal Medicine, Wayne State University, 2John D Dingell VA Medical Center, Detroit, MI, USA Abstract: The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. Keywords: isavuconazole, aspergillosis, mucormycosis, efficacy, antifungal therapy, novel azole, tolerability, drug interactions

  20. Clinical Application of Six Current Classification Systems for Iatrogenic Bile Duct Injuries after Cholecystectomy.

    Science.gov (United States)

    Velidedeoglu, Mehmet; Arikan, Akif Enes; Uludag, Sezgin Server; Olgun, Deniz Cebi; Kilic, Fahrettin; Kapan, Metin

    2015-05-01

    Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively. We described type of injury for each patient according to current six different classifications. 9 patients underwent definitive biliary reconstruction. Bismuth, Strasberg-Bismuth, Stewart-Way and Neuhaus classifications do not consider vascular involvement, Siewert system does, but only for the tangential lesions without structural loss of duct and lesion with a structural defect of hepatic or common bile duct. Siewert, Neuhaus and Stewart-Way systems do not discriminate between lesions at or above bifurcation of the hepatic duct. The Hannover classification may resolve the missing aspects of other systems by describing additional vascular involvement and location of the lesion at or above bifurcation.

  1. Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials.

    Science.gov (United States)

    Köhne-Wömpner, C H; Schmoll, H J; Harstrick, A; Rustum, Y M

    1992-04-01

    5-Fluorouracil (5-FU) is still the mainstay of chemotherapy in patients with metastatic colorectal cancer. A prolonged infusion of 5-FU is more active than any other schedule of 5-FU used to date. Cisplatin does not improve treatment results compared with 5-FU alone and is not recommended outside clinical trials. Biomodulation of 5-FU is a major step forward in the treatment of colorectal cancer patients and as the standard chemotherapy for advanced colorectal cancer. Two schedules of folinic acid daily for 5-day (low and high doses) and weekly high dose in combination with daily or weekly 5-FU are the most widely used schedules. Although the response rates to either schedule are comparable, the profile of toxicity is different, being stomatitis for the daily schedule and diarrhea for the weekly schedule as the dose-limiting toxicity. Modulation of 5-FU by methotrexate is time dependent. An interval of 24 hours between methotrexate and 5-FU is necessary for effective modulation. Other modulators, like interferon and N-phosphonoactyl-L-aspartate (PALA), are promising treatment options currently under investigation in randomized trials. The data from phase II and III trials using modulation of 5-FU by folinic acid, PALA, or methotrexate, or using continuous infusion 5-FU indicate that all of these strategies are active. Randomized trials are currently underway to further investigate these therapeutic approaches and whether a specific modulation offers more therapeutic advantages.

  2. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

    Energy Technology Data Exchange (ETDEWEB)

    England, Christopher G. [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); Rui, Lixin [University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); Cai, Weibo [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2017-03-15

    Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future. (orig.)

  3. Current status and future developments of LC-MS/MS in clinical chemistry for quantification of biogenic amines

    NARCIS (Netherlands)

    de Jong, Wilhelmina H. A.; de Vries, Elisabeth G. E.; Kema, Ido P.

    Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is rapidly gaining ground in special clinical chemistry laboratories. It significantly increases the analytic potential in clinical chemistry, especially in the field of low molecular weight biomarker analysis. This review overviews current

  4. Current research and clinical trials for a vaccine against Chikungunya virus

    Directory of Open Access Journals (Sweden)

    Singh P

    2013-08-01

    Full Text Available Priyanka Singh,1 Mala Chhabra,1 Veena Mittal,1 Pankaj Sharma,1 Moshahid A Rizvi,2 Lakhvir Singh Chauhan,1 Arvind Rai1 1National Centre for Disease Control, Sham Nath Marg, 2Department of Biosciences, Jamia Millia Islamia, New Delhi, India Abstract: Chikungunya infection is a self-limiting Aedes mosquito-borne arboviral disease with variable clinical manifestations, ranging from asymptomatic illness to a very severe and crippling arthralgia. Until recently, Chikungunya was a little known disease that re-emerged in 2005–2006, leading to major outbreaks on the Indian Ocean Islands and in South East Asia, and eventually extending its range to temperate regions. It drew global attention due to its explosive onset, extensive geographic distribution, and high morbidity. Since re-emergence, an estimated one million symptomatic cases with 0.1% fatality per year have been reported globally. A lack of herd immunity, vector control, and globalization and trade are clearly a problem in the spread of this disease. The Chikungunya virus (CHIKV has also acquired biologically important mutations during its evolution, increasing its geographic reach. This disease has resulted in a loss of productivity in affected communities. The absence of a vaccine or an effective antiviral therapy makes dealing with this disease challenging for those involved in public health. There is an emergent need for an effective vaccine against CHIKV infection. The candidates that have been tested include attenuated living, nonliving and genetically engineered vaccines. Several of these vaccine candidates are in preclinical and clinical trials. This review outlines the current knowledge about chikungunya infection and vaccine development. Keywords: Chikungunya, outbreaks, epidemics, genotypes, vaccines, therapy

  5. Current State of Clinical Studies on Diagnosis and Treatment of Sudden Deafness in China

    Institute of Scientific and Technical Information of China (English)

    YU Yaping; YANG Shiming; GUO Wei; YANG Weiyan; GU Rui

    2006-01-01

    Objective To evaluate the current status of clinical studies on diagnosis and treatment of sudden deafness (SD) in China by retrospective reviewing articles on SD published in Chinese journals in the past 5 years.Special attention is given to whether the diagnosis and treatment standards established in 1996 by the otolaryngology branch of Chinese Medical Association (the"1996 standard") were followed. Methods The terms of "Sudden deafness" and "treatment" were used as the keywords in searching articles published between 2000 and 2004 in the Chinese biomedicine literature database and Chinese journal network. Principles of evidence-based medicine were applied in reviewing the articles. Results Two hundreds and thirty- four articles were identified, including 176 between 2000 and 2002 and 58 between 2003 and 2004. Among the 176 articles published between 2000 and 2002,effects of medications were studies in 126 articles, of which only 26 (20.6%) followed the"1996 standards".Eighty-nine (70.6%) were reported based on controlled clinical trials (CCT) and 36 (28.5%) met the criteria of randomized controlled trails (RCT). Of the 58 articles published between 2003 and 2004, drug effects were evaluated in 25 articles, which were all based on the "1996 standards". However, there lacked placebo control, follow-up data or statistical analysis in these papers. Only 6 articles reported side-effects from pharmacological treatment. Conclusions While a significant number of articles on SD were published in the past 5 years, the "1996 standards" were followed only in a small number of them. The standards may not be appropriate in guiding research and need to be modified for improved guidance to SD management. Multi-center, RCTs should be a crucial part in studies on SD.

  6. Deep brain stimulation for Parkinson disease in Australia: current scientific and clinical status.

    Science.gov (United States)

    Poortvliet, P C; Silburn, P A; Coyne, T J; Chenery, H J

    2015-02-01

    There is currently no cure for Parkinson disease (PD). Disease management is directed primarily at motor symptom relief, but the impact of non-motor symptoms associated with PD should not be underestimated. Medical and surgical treatment options aim to increase functional independence and quality of life. Deep brain stimulation (DBS) has proven to be a safe, effective and cost-efficient surgical treatment option. In 2009, the Australian referral guidelines, developed to provide a synopsis of DBS therapy for PD, were introduced, and since then novel findings have been reported regarding the timing of intervention, target selection and symptom management. Our aim is to provide an update of DBS for PD in Australia. Intervention at earlier stages of the disease can potentially improve quality of life over a longer period with greater possibilities for meaningful social and professional contributions. For less responsive motor symptoms (e.g. freezing of gait, postural instability), the pedunculopontine nucleus has emerged as a promising new surgical target. Traditional PD treatment is focused on improvement of motor symptoms, but the disorder is also characterised by non-motor symptoms, often undiagnosed or undisclosed, that have the potential to impact quality of life to a greater extent than motor symptoms. It is essential to identify and routinely monitor for non-motor symptoms as they can emerge at all stages of the disease or can result from treatment. Many of these current advances require long-term monitoring of treatment outcomes to improve future clinical practice, refine patient selection and ensure best patient outcomes.

  7. A Review of the Multi-Authored Monograph “The Medical (Clinical Psychology Diagnosis: Current State and Prospects”

    Directory of Open Access Journals (Sweden)

    Vachkov I.V.

    2017-06-01

    Full Text Available The monograph presents a number of articles written by leading domestic clinical psychologists on various issues connected with psychological diagnosis. The multi-authored monograph was written for the international research-to-practice conference “The medical (clinical psychology diagnosis: tradition and prospects”. The conference took place in Moscow on November 29-30, 2016. The book consists of the following sections: "Research methodology in clinical psychology", “The development of endogenous mental pathology diagnosis current trends”, “The development of clinical psychology diagnostics current trends: age aspects”, “The main problems of clinical-psychological prevention and rehabilitation”. The materials of the monograph may be interesting and useful for scientists, psychology lecturers, students and post-graduate students, as well as for specialists working in the field of public health, education and social support for the population.

  8. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Directory of Open Access Journals (Sweden)

    Trefoux Bourdet A

    2015-03-01

    Full Text Available Alice Trefoux Bourdet, Dominique Luton, Martin Koskas Department of Obstetrics and Gynecology, Bichat University Hospital, Paris Diderot University, Paris, France Abstract: Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA, an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s. Keywords: uterine fibroids, medical treatment, selective progesterone receptor modulator, ulipristal acetate, surgery

  9. T2* mapping of articular cartilage: current status of research and first clinical applications.

    Science.gov (United States)

    Andreisek, Gustav; Weiger, Markus

    2014-01-01

    T2* mapping is a relatively new method for the compositional assessment of the articular cartilage. Typically, a multigradient echo or an ultrashort echo time imaging technique with a range of short and very short echo times is used. In most studies, imaging is performed at a high field strength, that is, 3 and 7 T. Postprocessing includes exponential fitting of relaxation decay and manual region-of-interest-based measurements of T2* times on T2* maps. Detailed analyses of T2* times of articular cartilage have shown distinct T2* components with shorter and longer T2* times. Moreover, there is a zonal distribution with a significant depthwise gradient of T2*, with relatively short times near the osteochondral junction and relatively long times at the cartilage's surface. T2* times of normal articular cartilage at the knee are, when averaged over the whole cartilage thickness and using monoexponential fitting, approximately 20 milliseconds. The results of recent studies have shown a good test-retest as well as interreader and intrareader reliabilities for T2* mapping. This article provides a descriptive review of the current literature, briefly discusses the technique itself, and provides an outlook on future research questions and possible clinical applications.

  10. PI3K and Akt as molecular targets for cancer therapy: current clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    Ipsita PAL; Mahitosh MANDAL

    2012-01-01

    The PI3K-Akt pathway is a vital regulator of cell proliferation and survival.Alterations in the PIK3CA gene that lead to enhanced PI3K kinase activity have been reported in many human cancer types,including cancers of the colon,breast,brain,liver,stomach and lung.Deregulation of PI3K causes aberrant Akt activity.Therefore targeting this pathway could have implications for cancer treatment.The first generation PI3K-Akt inhibitors were proven to be highly effective with a low IC50,but later,they were shown to have toxic side effects and poor pharmacological properties and selectivity.Thus,these inhibitors were only effective in preclinical models.However,derivatives of these first generation inhibitors are much more selective and are quite effective in targeting the PI3K-Akt pathway,either alone or in combination.These second-generation inhibitors are essentially a specific chemical moiety that helps to form a strong hydrogen bond interaction with the PI3K/Akt molecule.The goal of this review is to delineate the current efforts that have been undertaken to inhibit the various components of the PI3K and Akt pathway in different types of cancer both in vitro and in vivo.Our focus here is on these novel therapies and their inhibitory effects that depend upon their chemical nature,as well as their development towards clinical trials.

  11. [Monogenic obesity - current status of molecular genetic research and clinical importance].

    Science.gov (United States)

    Aldhoon-Hainerová, Irena; Včelák, Josef; Zamrazilová, Hana

    2014-01-01

    Obesity and its comorbidities represent one of the major health problems worldwide. A positive energy balance due to inappropriate life-style changes plays a key role in the current obesity epidemic. The influence of genetic factors is also significant - several studies concluded that genes contribute to the development of obesity by 40-70%. Genetic variability predisposes an individual to tendency or resistance to increase body weight in obesogenic environment. Polygenic type of inheritance is responsible in most of obese individuals. However, an intensive research of the past 20 years has led to an identification of several genes causing monogenic forms of obesity. To date, several monogenic genes (leptin, leptin receptor, prohormon convertase 1, proopiomelanocortin, melanocortin 4 receptor, single-minded homolog 1, brain-derived neurotrophic factor, neurotrophic tyrosine kinase receptor type 2) that are either involved in the neuronal differentiation of the paraventricular nucleus or in the leptin-melanocortin pathway are known to cause obesity. Mutation carriers apart from severe early onset obesity manifest with additional phenotypic characteristics as adrenal insufficiency, impaired immunity and impaired fertility. This review provides an overview of molecular-genetic and clinical research in the field of monogenic obesities including therapeutical approaches.

  12. Current protocols in the generation of pluripotent stem cells: theoretical, methodological and clinical considerations

    Directory of Open Access Journals (Sweden)

    Brad B Swelstad

    2009-12-01

    Full Text Available Brad B Swelstad, Candace L KerrInstitute for Cell Engineering, Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MA, USAAbstract: Pluripotent stem cells have been derived from various embryonic, fetal and adult sources. Embryonic stem cells (ESCs and parthenogenic ESCs (pESCs are derived from the embryo proper while embryonic germ cells (EGCs, embryonal carcinoma cells (ECCs, and germ-line stem cells (GSC are produced from germ cells. ECCs were the first pluripotent stem cell lines established from adult testicular tumors while EGCs are generated in vitro from primordial germ cells (PGCs isolated in late embryonic development. More recently, studies have also demonstrated the ability to produce GSCs from adult germ cells, known as spermatogonial stem cells. Unlike ECCs, the source of GSCs are normal, non-cancerous adult tissue. The study of these unique cell lines has provided information that has led to the ability to reprogram somatic cells into an ESC-like state. These cells, called induced pluripotent stem cells (iPSCs, have been derived from a number of human fetal and adult origins. With the promises pluripotent stem cells bring to cell-based therapies there remain several considerations that need to be carefully studied prior to their clinical use. Many of these issues involve understanding key factors regulating their generation, including those which define pluripotency. In this regard, the following article discusses critical aspects of pluripotent stem cell derivation and current issues about their therapeutic potential.Keywords: pluripotency, stem cells, derivation, human

  13. Current protocols in the generation of pluripotent stem cells: theoretical, methodological and clinical considerations.

    Science.gov (United States)

    Swelstad, Brad B; Kerr, Candace L

    2009-12-22

    Pluripotent stem cells have been derived from various embryonic, fetal and adult sources. Embryonic stem cells (ESCs) and parthenogenic ESCs (pESCs) are derived from the embryo proper while embryonic germ cells (EGCs), embryonal carcinoma cells (ECCs), and germ-line stem cells (GSC) are produced from germ cells. ECCs were the first pluripotent stem cell lines established from adult testicular tumors while EGCs are generated in vitro from primordial germ cells (PGCs) isolated in late embryonic development. More recently, studies have also demonstrated the ability to produce GSCs from adult germ cells, known as spermatogonial stem cells. Unlike ECCs, the source of GSCs are normal, non-cancerous adult tissue. The study of these unique cell lines has provided information that has led to the ability to reprogram somatic cells into an ESC-like state. These cells, called induced pluripotent stem cells (iPSCs), have been derived from a number of human fetal and adult origins. With the promises pluripotent stem cells bring to cell-based therapies there remain several considerations that need to be carefully studied prior to their clinical use. Many of these issues involve understanding key factors regulating their generation, including those which define pluripotency. In this regard, the following article discusses critical aspects of pluripotent stem cell derivation and current issues about their therapeutic potential.

  14. Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines

    Science.gov (United States)

    Svensson, Åke; Möller, Halvor; Björkner, Bert; Bruze, Magnus; Leden, Ido; Theander, Jan; Ohlsson, Kjell; Linder, Carina

    2002-01-01

    Objective To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold. Methods Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM). Results Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM), there was a larger increase in serum TNFalpha (p < 0.05), sTNF-R1 (NS), and IL-1 ra (p < 0.05) in gold-allergic patients. Conclusions Cytokines are released in blood by GSTM in RA patients with gold allergy. To minimize the risk of acute adverse reactions the starting dose of GSTM should be lowered to 5 mg. Alternatively, patients should be patch-tested before gold therapy; in test-positive cases, 5 mg is recommended as the first dose. PMID:11860615

  15. Ultrasound Current Source Density Imaging in live rabbit hearts using clinical intracardiac catheter

    Science.gov (United States)

    Li, Qian

    Ultrasound Current Source Density Imaging (UCSDI) is a noninvasive modality for mapping electrical activities in the body (brain and heart) in 4-dimensions (space + time). Conventional cardiac mapping technologies for guiding the radiofrequency ablation procedure for treatment of cardiac arrhythmias have certain limitations. UCSDI can potentially overcome these limitations and enhance the electrophysiology mapping of the heart. UCSDI exploits the acoustoelectric (AE) effect, an interaction between ultrasound pressure and electrical resistivity. When an ultrasound beam intersects a current path in a material, the local resistivity of the material is modulated by the ultrasonic pressure, and a change in voltage signal can be detected based on Ohm's Law. The degree of modulation is determined by the AE interaction constant K. K is a fundamental property of any type of material, and directly affects the amplitude of the AE signal detected in UCSDI. UCSDI requires detecting a small AE signal associated with electrocardiogram. So sensitivity becomes a major challenge for transferring UCSDI to the clinic. This dissertation will determine the limits of sensitivity and resolution for UCSDI, balancing the tradeoff between them by finding the optimal parameters for electrical cardiac mapping, and finally test the optimized system in a realistic setting. This work begins by describing a technique for measuring K, the AE interaction constant, in ionic solution and biological tissue, and reporting the value of K in excised rabbit cardiac tissue for the first time. K was found to be strongly dependent on concentration for the divalent salt CuSO4, but not for the monovalent salt NaCl, consistent with their different chemical properties. In the rabbit heart tissue, K was determined to be 0.041 +/- 0.012 %/MPa, similar to the measurement of K in physiologic saline: 0.034 +/- 0.003 %/MPa. Next, this dissertation investigates the sensitivity limit of UCSDI by quantifying the relation

  16. Performance of InterVA for assigning causes of death to verbal autopsies: multisite validation study using clinical diagnostic gold standards

    Directory of Open Access Journals (Sweden)

    Flaxman Abraham D

    2011-08-01

    Full Text Available Abstract Background InterVA is a widely disseminated tool for cause of death attribution using information from verbal autopsies. Several studies have attempted to validate the concordance and accuracy of the tool, but the main limitation of these studies is that they compare cause of death as ascertained through hospital record review or hospital discharge diagnosis with the results of InterVA. This study provides a unique opportunity to assess the performance of InterVA compared to physician-certified verbal autopsies (PCVA and alternative automated methods for analysis. Methods Using clinical diagnostic gold standards to select 12,542 verbal autopsy cases, we assessed the performance of InterVA on both an individual and population level and compared the results to PCVA, conducting analyses separately for adults, children, and neonates. Following the recommendation of Murray et al., we randomly varied the cause composition over 500 test datasets to understand the performance of the tool in different settings. We also contrasted InterVA with an alternative Bayesian method, Simplified Symptom Pattern (SSP, to understand the strengths and weaknesses of the tool. Results Across all age groups, InterVA performs worse than PCVA, both on an individual and population level. On an individual level, InterVA achieved a chance-corrected concordance of 24.2% for adults, 24.9% for children, and 6.3% for neonates (excluding free text, considering one cause selection. On a population level, InterVA achieved a cause-specific mortality fraction accuracy of 0.546 for adults, 0.504 for children, and 0.404 for neonates. The comparison to SSP revealed four specific characteristics that lead to superior performance of SSP. Increases in chance-corrected concordance are attained by developing cause-by-cause models (2%, using all items as opposed to only the ones that mapped to InterVA items (7%, assigning probabilities to clusters of symptoms (6%, and using empirical

  17. Current and Future Clinical Applications of Zinc Transporter-8 in Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Bo Yi

    2015-01-01

    Conclusions: ZnT8 is a novel islet autoantigen with a widely potential for clinical applications in T1DM. However, before the large-scale clinical applications, there are still many problems to be solved.

  18. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice.

    Science.gov (United States)

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-06-01

    In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is inferior to combined V/Q scintigraphy; the difference is

  19. Magnetically mediated vortexlike assembly of gold nanoshells.

    Science.gov (United States)

    Sun, Jianfei; Dong, Jian; Sun, Dongke; Guo, Zhirui; Gu, Ning

    2012-04-24

    Gold nanoshells currently attract increasing research interests due to the important role in many subjects. For practical applications, random arrangement of the nanoparticles is often unfavored so that the assembly of gold nanoshells is becoming a central issue. We here proposed to utilize time-variant magnetic field to direct the assembly of gold nanoshells. It was discovered that the alternating magnetic field can mediate the vortex-like assembly of gold nanoshells. The mechanism was explored and thought to be relative with the electric field of induction which caused the thermal gradient on the substrate and the electric force. The vortexlike structure as well as the assembly mechanism will play an important role in research and application of gold nanomaterials.

  20. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy.

    Science.gov (United States)

    Dreischulte, Tobias; Fernandez-Llimos, Fernando

    2016-12-01

    Background The definitions that are being used for the terms 'clinical pharmacy' and 'pharmaceutical care' seem to have a certain overlap. Responsibility for therapy outcomes seems to be especially linked to the latter term. Both terms need clarification before a proper definition of clinical pharmacy can be drafted. Objective To identify current disagreements regarding the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care' and to assess to which extent pharmacists with an interest in Clinical Pharmacy are willing to accept responsibility for drug therapy outcomes. Setting The membership of the European Society of Clinical Pharmacy. Methods A total of 1,285 individuals affiliated with the European Society of Clinical Pharmacy were invited by email to participate in an online survey asking participants to state whether certain professional activities, providers, settings, aims and general descriptors constituted (a) 'Clinical Pharmacy only', (b) 'Pharmaceutical Care only', (c) 'both' or (d) 'neither'. Further questions examined pharmacists' willingness to accept ethical or legal responsibility for drug therapy outcomes, under current and ideal working conditions. Main outcome measures Level of agreement with a number of statements. Results There was disagreement (Pharmaceutical care also encompassed certain professional activities, constituted a scientific discipline and targeted cost effectiveness. The proportions of participants willing to accept legal responsibility under current/ideal working conditions were: safety (32.7%/64.3%), effectiveness (17.9%/49.2%), patient-centeredness (17.1%/46.2%), cost-effectiveness (20.3%/44.0%). Conclusions The survey identified key disagreements around the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care', which future discussions around a harmonised definition of 'Clinical Pharmacy' should aim to resolve. Further research is required to understand barriers and facilitators to pharmacists

  1. Reliability of clinical diagnosis and laboratory testing techniques currently used for identification of canine parvovirus enteritis in clinical settings

    Science.gov (United States)

    FAZ, Mirna; MARTÍNEZ, José Simón; QUIJANO-HERNÁNDEZ, Israel; FAJARDO, Raúl

    2016-01-01

    Canine parvovirus type 2 (CPV-2) is the main etiological agent of viral enteritis in dogs. Actually in literature, CPV-2 has been reported with clinical signs that vary from the classical disease, and immunochromatography test and PCR technique have been introduced to veterinary hospitals to confirm CPV-2 diagnosis and other infections. However, the reliability of these techniques has been poorly analyzed. In this study, we evaluated the sensitivity and specificity of veterinary clinical diagnosis, immunochromatography test and PCR technique. Our data indicate that variations in the clinical signs of CPV-2 complicate the gathering of an appropriate diagnosis; and immunochromatography test and PCR technique do not have adequate sensitivity to diagnose positive cases. PMID:27818461

  2. Gold nanoparticles as novel agents for cancer therapy.

    Science.gov (United States)

    Jain, S; Hirst, D G; O'Sullivan, J M

    2012-02-01

    Gold nanoparticles are emerging as promising agents for cancer therapy and are being investigated as drug carriers, photothermal agents, contrast agents and radiosensitisers. This review introduces the field of nanotechnology with a focus on recent gold nanoparticle research which has led to early-phase clinical trials. In particular, the pre-clinical evidence for gold nanoparticles as sensitisers with ionising radiation in vitro and in vivo at kilovoltage and megavoltage energies is discussed.

  3. Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines

    OpenAIRE

    Svensson, Ake; Möller, Halvor; Björkner, Bert; Bruze, Magnus; Leden, Ido; Theander, Jan; Ohlsson, Kjell; Linder, Carina

    2002-01-01

    Abstract Objective To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold. Methods Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM). Results Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM), there was a larger increase in serum TNFalpha (p < 0.05), sTNF-R1 (NS), and IL-1 ra (p ...

  4. Computational approaches to homogeneous gold catalysis.

    Science.gov (United States)

    Faza, Olalla Nieto; López, Carlos Silva

    2015-01-01

    Homogenous gold catalysis has been exploding for the last decade at an outstanding pace. The best described reactivity of Au(I) and Au(III) species is based on gold's properties as a soft Lewis acid, but new reactivity patterns have recently emerged which further expand the range of transformations achievable using gold catalysis, with examples of dual gold activation, hydrogenation reactions, or Au(I)/Au(III) catalytic cycles.In this scenario, to develop fully all these new possibilities, the use of computational tools to understand at an atomistic level of detail the complete role of gold as a catalyst is unavoidable. In this work we aim to provide a comprehensive review of the available benchmark works on methodological options to study homogenous gold catalysis in the hope that this effort can help guide the choice of method in future mechanistic studies involving gold complexes. This is relevant because a representative number of current mechanistic studies still use methods which have been reported as inappropriate and dangerously inaccurate for this chemistry.Together with this, we describe a number of recent mechanistic studies where computational chemistry has provided relevant insights into non-conventional reaction paths, unexpected selectivities or novel reactivity, which illustrate the complexity behind gold-mediated organic chemistry.

  5. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

    DEFF Research Database (Denmark)

    O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

    2007-01-01

    After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP)was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has...

  6. Gold ions bio-released from metallic gold particles reduce inflammation and apoptosis and increase the regenerative responses in focal brain injury

    DEFF Research Database (Denmark)

    Larsen, Agnete; Kolind, Kristian; Pedersen, Dan Sonne

    2008-01-01

    neural stem cell response. We conclude that bio-liberated gold ions possess pronounced anti-inflammatory and neuron-protective capacities in the brain and suggest that metallic gold has clinical potentials. Intra-cerebral application of metallic gold as a pharmaceutical source of gold ions represents......Traumatic brain injury results in loss of neurons caused as much by the resulting neuroinflammation as by the injury. Gold salts are known to be immunosuppressive, but their use are limited by nephrotoxicity. However, as we have proven that implants of pure metallic gold release gold ions which do...... not spread in the body, but are taken up by cells near the implant, we hypothesize that metallic gold could reduce local neuroinflammation in a safe way. Bio-liberation, or dissolucytosis, of gold ions from metallic gold surfaces requires the presence of disolycytes i.e. macrophages and the process...

  7. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence.

    Science.gov (United States)

    Yoshinaga, Keiichiro; Tamaki, Nagara

    2015-08-01

    Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.

  8. Current Situation and Evaluation of Clinical Studies on Acupuncture and Moxibustion Treatment of Peripheral Facial Paralysis at Selected Stages

    Institute of Scientific and Technical Information of China (English)

    LI Ying; WU Xi; HU Ka-ming; CHEN Xiao-qin

    2010-01-01

    @@ Peripheral facial paralysis is a frequently encountered disease with a high incidence, and it is one of the most common diseases in acupuncture and moxibustion treatment. Because there are rich literatures in clinical studies on acupuncture and moxibustion treatment for this disease, and clinically, it is divided into different stages, in the present paper the current situation of clinical studies about acupuncture and moxibustion treatment for peripheral facial paralysis according to different stages in resent years are analyzed and evaluated including the stage division,the optimal time for treatment, location of injured nerves and assessment of the therapeutic effect, etc.

  9. Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes.

    Science.gov (United States)

    Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney

    2014-10-21

    Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological (pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic (0%-41.3%) and laparoscopic (5.5%-29.3%) surgery regarding morbidity and anastomotic complications (respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be

  10. Dosing of ACE inhibitors in left ventricular dysfunction : Does current clinical dosing provide optimal benefit?

    NARCIS (Netherlands)

    Pinto, YM; van Geel, PP; Alkfaji, H; van Veldhuisen, DJ; van Gilst, WH

    1999-01-01

    In the present review, we discuss the role of clinical dosing of angiotensin converting enzyme (ACE) inhibitors in the treatment of left ventricular dysfunction. Although the precise mechanism of action of ACE inhibitors is still unresolved, the clinical efficacy of ACE inhibitors in the treatment o

  11. Blood gold concentrations in children with juvenile rheumatoid arthritis undergoing long-term oral gold therapy.

    Science.gov (United States)

    Giannini, E H; Brewer, E J; Person, D A

    1984-04-01

    During an uncontrolled, open-labelled, open-ended clinical trial of auranofin in children with juvenile rheumatoid arthritis (JRA) we obtained serial blood samples for the purpose of assessing gold content. Our objectives were (1) to observe the pattern of blood gold concentrations over a period of time in children undergoing long-term oral gold therapy, and (2) to observe the effect of changing dosage levels on blood gold concentrations. The initial dosage of auranofin was 0.1 mg/kg/day with allowable increases to 0.2 mg/kg/day. A concurrent nonsteroidal anti-inflammatory drug was allowed. Twenty-one patients were enrolled in the study, and we obtained 2 or more serial samples on 13 of the children. At a constant dosage of 0.1 mg/kg/day, steady state blood gold concentrations were attained in 11 to 13 weeks of therapy and, in the absence of a dosage change, remained remarkably constant through extended periods. The blood gold concentration was related to total daily dosage rather than to the cumulative amount of gold received. Increasing or decreasing the dose resulted in a direct effect on concentration. The clinical value of blood gold levels resulting from auranofin therapy in JRA will have to be established through double-blind controlled trials.

  12. Choosing relevant endpoints for older breast cancer patients in clinical trials: an overview of all current clinical trials on breast cancer treatment.

    Science.gov (United States)

    de Glas, N A; Hamaker, M E; Kiderlen, M; de Craen, A J M; Mooijaart, S P; van de Velde, C J H; van Munster, B C; Portielje, J E A; Liefers, G J; Bastiaannet, E

    2014-08-01

    With the ongoing ageing of western societies, the proportion of older breast cancer patients will increase. For several years, clinicians and researchers in geriatric oncology have urged for new clinical trials that address patient-related endpoints such as functional decline after treatment of older patients. The aim of this study was to present an overview of trial characteristics and endpoints of all currently running clinical trials in breast cancer, particularly in older patients. The clinical trial register of the United States National Institutes of Health Differences was searched for all current clinical trials on breast cancer treatment. Trial characteristics and endpoints were retrieved from the register and differences in characteristics between studies in older patients specifically (defined as a lower age-limit of 60 years or older) and trials in all patients were assessed using χ(2) tests. We included 463 clinical trials. Nine trials (2 %) specifically investigated breast cancer treatment in older patients. Ninety-one breast cancer trials included any patient-related endpoint (20 %), while five trials specifically addressing older patients included any patient-related endpoint (56 %, P = 0.02). Five of the trials in older patients incorporated a geriatric assessment (56 %). Clinical trials still rarely incorporate patient-related endpoints, even in trials that specifically address older patients. Trials that are specifically designed for older patients do not often incorporate a geriatric assessment in their design. This implicates that current clinical studies are not expected to fill the gap in knowledge concerning treatment of older breast cancer patients in the next decade.

  13. Three Gold Tablets in the Treatment of Urinary Tract Infection in 100 Cases of Clinical Research%三金片治疗尿路感染100例临床研究

    Institute of Scientific and Technical Information of China (English)

    杨杰; 姜宝法; 布乃滨

    2015-01-01

    To study the three gold tablets in the treatment of urinary tract infection clinical results. A case of urinary tract infection in our hospital-wide 100 patients were randomly divided into treatment group and control group, the treatment group received three gold pieces plus levofloxacin tablets in the treatment and control group using levofloxacin therapy. Three gold pieces for urinary tract infections in patients with good ef ect, the combination can significantly improve the ef ectiveness of treatment with levofloxacin tablets, the main symptoms significantly shorten the time for various types of urinary tract infections are the exact ef ect, worth clinical widely.%研究三金片治疗尿路感染的临床效果。收集我院属泌尿路感染范围的患者100例,随机分为治疗组和对照组,治疗组采用三金片加左氧氟沙星片治疗,对照组采用左氧氟沙星片治疗。三金片对尿路感染患者有较好的疗效,与左氧氟沙星片联合使用能够显著提高治疗的效果,主要症状消失时间显著缩短,对各种类型的尿路感染均有确切疗效,值得在临床广泛推广。

  14. Long-term cost–effectiveness of Oncotype DX® versus current clinical practice from a Dutch cost perspective

    NARCIS (Netherlands)

    Kip, Michelle Maria Aleida; Monteban, Helma; Steuten, Lotte Maria Gertruda

    2015-01-01

    This study analyzes the incremental cost–effectiveness of Oncotype DX® testing to support adjuvant chemotherapy recommendations, versus current clinical practice, for patients with estrogen receptor-positive (ER+), node-negative or micrometastatic (pN1mic) early-stage breast cancer in The

  15. Long-term cost–effectiveness of Oncotype DX® versus current clinical practice from a Dutch cost perspective

    NARCIS (Netherlands)

    Kip, Michelle; Monteban, Helma; Steuten, Lotte

    2015-01-01

    This study analyzes the incremental cost–effectiveness of Oncotype DX® testing to support adjuvant chemotherapy recommendations, versus current clinical practice, for patients with estrogen receptor-positive (ER+), node-negative or micrometastatic (pN1mic) early-stage breast cancer in The Netherland

  16. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

    DEFF Research Database (Denmark)

    O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

    2007-01-01

    congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges......) a critical mass of 65 members: 15 original diplomates approved by theEBVS to establish theECVCP, 37 de facto diplomates, 7 diplomates certified by examination, and 5 elected honorary members; 2) the development and certification of training programs, laboratories, and qualified supervisors for residents...

  17. Current status of psychology and clinical psychology in India - an appraisal.

    Science.gov (United States)

    Virudhagirinathan, Baboo Sankar; Karunanidhi, Subbiah

    2014-10-01

    This paper provides an overview of the social and cultural context for the emergence and development of psychology in India and also more specifically of the development of clinical psychology. It details the range of universities offering psychology programmes and the various bodies involved in supporting the development of the psychology. The paper also describes the development of clinical psychology in India and the variety of roles undertaken by clinical psychologists. Finally, it raises a number of issues facing the development of Indian psychology into the future.

  18. Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines

    Directory of Open Access Journals (Sweden)

    Theander Jan

    2002-02-01

    Full Text Available Abstract Objective To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold. Methods Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM. Results Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM, there was a larger increase in serum TNFalpha (p Conclusions Cytokines are released in blood by GSTM in RA patients with gold allergy. To minimize the risk of acute adverse reactions the starting dose of GSTM should be lowered to 5 mg. Alternatively, patients should be patch-tested before gold therapy; in test-positive cases, 5 mg is recommended as the first dose.

  19. Current issues in clinical research and the development of new pharmaceuticals.

    Science.gov (United States)

    Goldhammer, A

    2001-01-01

    As a normal part of the drug development process, U.S. pharmaceutical companies conduct many thousands of clinical trials each year. Only after a reasonable assurance of safety is made can the drug be given to patients who have the underlying medical condition that the drug is designed to treat. Patient welfare is assured by adhering to the Food and Drug Administration's interpretation of the "common rule" if the data will be used to support a licensing application. 21 CFR Part 50 sets forth the regulations along with the principles of informed consent and the use of institutional review boards (IRBs) that assure patients' rights are protected. Any potential conflict of interest on the part of a clinical investigator must be reported to the FDA. Pharmaceutical companies extensively monitor ongoing clinical trials for compliance with appropriate regulations. The recent revision of the Declaration of Helsinki governing placebo-controlled clinical trials may adversely impact drug development.

  20. Current situation of hospital-based endocrinology and clinical nutrition in Spain.

    Science.gov (United States)

    Angeles Gálvez Moreno, M

    2008-01-01

    In 2006, the Healthcare Commission of Spanish Society of Endocrinology and Nutrition did a survey in order to know the actual situation of endocrinology and clinical nutrition healthcare in Public Sanitary Systems in Spain. The survey has been more extensive than the last and it has taken up number and geographical distribution of specialists in Spain in addition to data about clinical assistance. The mean of public hospitals with endocrinologist participation has been 50%.

  1. Gold Nanoparticle-Biological Molecule Interactions and Catalysis

    Directory of Open Access Journals (Sweden)

    Jonathan G. Heddle

    2013-09-01

    Full Text Available This review gives a brief summary of the field of gold nanoparticle interactions with biological molecules, particularly those with possible catalytic relevance. Gold nanoparticles are well known as catalysts in organic chemistry but much is unknown regarding their potential as catalysts of reactions involving biological molecules such as protein and nucleic acids. Biological molecules may be the substrate for catalysis or, if they are the ligand coating the gold particle, may be the catalyst itself. In other cases biological molecules may form a template upon which gold nanoparticles can be precisely arrayed. As relatively little is currently known about the catalytic capabilities of gold nanoparticles in this area, this review will consider templating in general (including, but not restricted to, those which result in structures having potential as catalysts before going on to consider firstly catalysis by the gold nanoparticle itself followed by catalysis by ligands attached to gold nanoparticles, all considered with a focus on biological molecules.

  2. Preparation and characterization of gold-decorated graphite nanosheet composites.

    Science.gov (United States)

    Kim, Jungsoo; Nam, Dae Geun; Oh, Weon Tae

    2013-05-01

    Some composites of gold nanoparticles and graphite nanosheets were prepared by electrostatic interaction, and structurally and electrochemically characterized using X-ray diffraction, X-ray photoelectron spectroscopy, UVNis spectroscopy, transmission electron microscopy, and cyclic-voltammetry. Pristine graphite was chemically treated using aqueous acid solution, and dispersed inpoly(diallyldimethylammonium) chloride aqueous solution to prepare positively charged graphite nanosheets. The gold nanoparticles (GNPs) in this work were stabilized by sodium dodecyl sulfate, poly(sodium 4-styrene sulfonate), or poly(vinylpyrrolidone). Gold nanoparticles and graphite nanosheet composites with gold nanoparticles showed the characteristic surface plasmon band at -530 nm. The electrochemical properties of the graphite nanosheet composites with gold nanoparticles were studied by cyclic voltammetry, in which reduction potential and reduction current of gold nanoparticles were strongly dependent on the gold-wrapped stabilizer in the composites.

  3. Establishing Evidence-Based Indications for Proton Therapy: An Overview of Current Clinical Trials.

    Science.gov (United States)

    Mishra, Mark V; Aggarwal, Sameer; Bentzen, Soren M; Knight, Nancy; Mehta, Minesh P; Regine, William F

    2017-02-01

    To review and assess ongoing proton beam therapy (PBT) clinical trials and to identify major gaps. Active PBT clinical trials were identified from clinicaltrials.gov and the World Health Organization International Clinical Trials Platform Registry. Data on clinical trial disease site, age group, projected patient enrollment, expected start and end dates, study type, and funding source were extracted. A total of 122 active PBT clinical trials were identified, with target enrollment of >42,000 patients worldwide. Ninety-six trials (79%), with a median planned sample size of 68, were classified as interventional studies. Observational studies accounted for 21% of trials but 71% (n=29,852) of planned patient enrollment. The most common PBT clinical trials focus on gastrointestinal tract tumors (21%, n=26), tumors of the central nervous system (15%, n=18), and prostate cancer (12%, n=15). Five active studies (lung, esophagus, head and neck, prostate, breast) will randomize patients between protons and photons, and 3 will randomize patients between protons and carbon ion therapy. The PBT clinical trial portfolio is expanding rapidly. Although the majority of ongoing studies are interventional, the majority of patients will be accrued to observational studies. Future efforts should focus on strategies to encourage optimal patient enrollment and retention, with an emphasis on randomized, controlled trials, which will require support from third-party payers. Results of ongoing PBT studies should be evaluated in terms of comparative effectiveness, as well as incremental effectiveness and value offered by PBT in comparison with conventional radiation modalities. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. 我国黄金矿产资源综合利用现状与发展趋势%Current Situation and Development Trend of Comprehensive Utilization of Gold Mineral Resources in China

    Institute of Scientific and Technical Information of China (English)

    王子玉; 郭海军

    2014-01-01

    With rapid economic development in China , the demand of resources speeds up .The pro-gress of science and technology continues to expand the scope of gold gold resources development , from easy processing single gold resources to gold ore containing arsenic , sulfur and complex metal re-sources in the area with complex metal that is difficult to disposal .%随着我国国民经济快速稳定发展对资源的需求加快,黄金科技进步不断扩展黄金资源开发的范围,从性质单一的易处理黄金资源,迅速发展到含砷、含硫及含复杂金属的难处理金矿资源领域。

  5. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

  6. Current status of clinical nursing specialists and the demands of osteoporosis specialized nurses in Mainland China

    Directory of Open Access Journals (Sweden)

    Xu Tian

    2014-09-01

    Full Text Available The clinical nursing specialist (CNS is an expert who applies an expanded range of practical, theoretical, and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing. A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides high-quality clinical and evidence-based nursing practice and improves patient outcome. The CNS has been involved in healthcare practices for many years, with an increasingly diverse role. However, the training for the CNS in China is only in a preliminary developmental stage. The aim of this article is to review the history and development of the CNS role. Furthermore, the epidemiologic status of osteoporosis, as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS, will be discussed.

  7. The Necessity of Data Mining in Clinical Emergency Medicine; A Narrative Review of the Current Literatrue

    Science.gov (United States)

    Parva, Elahe; Boostani, Reza; Ghahramani, Zahra; Paydar, Shahram

    2017-01-01

    Clinical databases can be categorized as big data, include large quantities of information about patients and their medical conditions. Analyzing the quantitative and qualitative clinical data in addition with discovering relationships among huge number of samples using data mining techniques could unveil hidden medical knowledge in terms of correlation and association of apparently independent variables. The aim of this research is using predictive algorithm for prediction of trauma patients on admission to hospital to be able to predict the necessary treatment for patients and provided the necessary measures for the trauma patients who are before entering the critical situation. This study provides a review on data mining in clinical medicine. The relevant, recently-published studies of data mining on medical data with a focus on emergency medicine were investigated to tackle pros and cons of such approaches. The results of this study can be used in prediction of trauma patient’s status at six hours after admission to hospital. PMID:28507995

  8. The current state of adhesive dentistry: a guide for clinical practice.

    Science.gov (United States)

    Mante, Francis K; Ozer, Fusun; Walter, Ricardo; Atlas, Alan M; Saleh, Najeed; Dietschi, Didier; Blatz, Markus B

    2013-01-01

    Adhesive dentistry is key to minimally invasive, esthetic, and tooth-preserving dental restorations. These are typically realized by bonding various restorative materials, such as composite resins, ceramics, or even metal alloys, to tooth structures or other materials with composite resin luting agents. For optimal bond strengths and long-lasting clinical success, however, these material and tooth substrates require their respective pretreatment steps, based on their natures and compositions. Today, dental adhesion is used in almost all dental specialties. This article summarizes key aspects and guidelines for clinical success with adhesive dentistry and summarizes information presented at the 5th International Congress on Adhesive Dentistry.

  9. [Basic features in the current practice of clinical medicine in the tropics (I). Parasitic diseases].

    Science.gov (United States)

    Ramos, J M; de Górgolas, M; Cuadros, J; Malmierca, E

    2012-06-01

    In recent years an increasing number of physicians want to spend part of their medical training in health facilities in developing countries. Working in these areas requires good clinical skills, particularly where diagnostic resources are limited. Trainees will attend patients with many different parasitic diseases such as malaria and soil transmitted helminthic infections. The aim of this work is to provide basic concepts of epidemiology, clinical characteristics, diagnosis and treatment of the principal parasitic diseases that could occur in a rural health post in the tropics.

  10. Gold induced apoptsis study

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    2008-01-01

    Introduction   Cancer cells are highly thermo sensitive. On the basis of an article in Nature the idea arose, for a new non-invasive thermotherapy technique, based on radio frequency inductive heating of nano gold particles in an MR-scanner. Thermotherapy is getting considerably attention...... at the moment, especially in the fields of lasers, they though have some problems concerning the placement of the tumor in the human body. Local heating by MR has tremendous advance in comparison too lasers. The first step is to validate the hypothesis of the inductive heating of the gold nano particles trough...... in silico methods are here proposed for apoptosis studies and for AMG studies.   Methods   MR - heating of high concentration micrometer gold and low concentration nano gold.   CSLM of ethidum bromide stained cell lines, with and witout gold and automated image processing.   AMG gold uptake study...

  11. Current status of matrix-assisted laser desorption ionisation-time of flight mass spectrometry in the clinical microbiology laboratory.

    Science.gov (United States)

    Kok, Jen; Chen, Sharon C A; Dwyer, Dominic E; Iredell, Jonathan R

    2013-01-01

    The integration of matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) into many clinical microbiology laboratories has revolutionised routine pathogen identification. MALDI-TOF MS complements and has good potential to replace existing phenotypic identification methods. Results are available in a more clinically relevant timeframe, particularly in bacteraemic septic shock. Novel applications include strain typing and the detection of antimicrobial resistance, but these are not widely used. This review discusses the technical aspects, current applications, and limitations of MALDI-TOF MS.

  12. The impact of array genomic hybridization on mental retardation research: a review of current technologies and their clinical utility.

    Science.gov (United States)

    Zahir, F; Friedman, J M

    2007-10-01

    Our understanding of the causes of mental retardation is benefiting greatly from whole-genome scans to detect submicroscopic pathogenic copy number variants (CNVs) that are undetectable by conventional cytogenetic analysis. The current method of choice for performing whole-genome scans for CNVs is array genomic hybridization (AGH). Several platforms are available for AGH, each with its own strengths and limitations. This review discusses considerations that are relevant to the clinical use of whole-genome AGH platforms for the diagnosis of pathogenic CNVs in children with mental retardation. Whole-genome AGH studies are a maturing technology, but their high diagnostic utility assures their increasing use in clinical genetics.

  13. Current Concepts and Future Perspectives on Intraoperative Fluorescence Imaging in Cancer : Clinical Need

    NARCIS (Netherlands)

    van Dam, Gooitzen M.; Ntziachristos, Vasilis

    Progress with technology and regulatory approvals has recently allowed the successful clinical translation of fluorescence molecular imaging to intra-operative applications. Initial studies have demonstrated a promising outlook for imaging cancer micro-foci, margins and lymph-nodes. However, not all

  14. Global health training and international clinical rotations during residency: current status, needs, and opportunities.

    Science.gov (United States)

    Drain, Paul K; Holmes, King K; Skeff, Kelley M; Hall, Thomas L; Gardner, Pierce

    2009-03-01

    Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.

  15. Current role of anticholinergic drugs in the treatment of asthma : Key messages for clinical practice

    NARCIS (Netherlands)

    Pizzichini, Marcia M. M.; Kerstjens, Huib A. M.; Pizzichini, Emilio

    2015-01-01

    Anticholinergic bronchodilators such as tiotropium, a potent long-acting drug, are central to the symptomatic treatment of chronic obstructive pulmonary disease. Its role in asthma treatment has been recently investigated. This review critically evaluates documented evidence of clinical trials and a

  16. Clinical manifestations of hysteria: an epistemological perspective or how historical dynamics illuminate current practice.

    Science.gov (United States)

    Medeiros De Bustos, Elisabeth; Galli, Sylvio; Haffen, Emmanuel; Moulin, Thierry

    2014-01-01

    Hysteria has generated the most heated debates among physicians, from antiquity to the present day. It has been long confused with neuroses and neurological pathologies such as Parkinson's disease and epilepsy, principally associated with women and sexual disorders. The clinical manifestations must first be seen in their historical context, as interpretation varies according to the time period. Recently, the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association marked a break in the consensus that previously seemed to apply to the concept of hysteria and approach to the clinical manifestations. The clinical manifestations of hysteria are numerous and multifaceted, comprising 3 main classifications: paroxysms, attacks, and acute manifestations; long-lasting functional syndromes, and visceral events. Each main classification can be subdivided into several subgroups. The first main group of paroxysms, attacks, and acute manifestations includes major hysterical attacks, such as prodrome, trance and epileptic states, minor hysterical attacks such as syncope and tetany, twilight states, paroxysmal amnesia, and cataleptic attacks. The second group includes focal hysterical symptoms, paralyses, contractures and spasms, anesthesia, and sensory disorders. Visceral manifestations can be subdivided into spasms, pain, and general and trophic disorders. The diversity of the symptoms of hysteria and its changing clinical presentation calls into question the same hysterical attacks and the same symptoms, which have had only a few differences for over 2,000 years. A new definition of hysteria should be proposed, in that it is a phenomenon that is not pathological, but physiological and expressional.

  17. Cognitive deficits in geriatric depression: clinical correlates and implications for current and future treatment.

    Science.gov (United States)

    Morimoto, Sarah Shizuko; Alexopoulos, George S

    2013-12-01

    The purpose of this article is to identify the cognitive deficits commonly associated with geriatric depression and describe their clinical significance. The complex relationship between geriatric depression and dementia is summarized and possible shared mechanisms discussed. Evidence regarding whether the cognitive deficits in depression may be mitigated with medication or with computerized cognitive remediation is presented. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Oncologic photodynamic therapy: Basic principles, current clinical status and future directions

    NARCIS (Netherlands)

    van Straten, D. (Demian); Mashayekhi, V. (Vida); H.S. de Bruijn (Riette); S. Oliveira (Sabrina); D.J. Robinson (Dominic)

    2017-01-01

    textabstractPhotodynamic therapy (PDT) is a clinically approved cancer therapy, based on a photochemical reaction between a light activatable molecule or photosensitizer, light, and molecular oxygen. When these three harmless components are present together, reactive oxygen species are formed. These

  19. The gold rush 1925-35.

    Science.gov (United States)

    Keers, R Y

    1980-12-01

    Although from the time of Koch onwards there had been desultory experiments with a variety of gold preparations in the management of pulmonary tuberculosis, gold as a recognised and accepted treatment did not emerge until 1925. In that year Holger Mollgaard of Copenhagen introduced sanocrysin, a double thiosulphate of gold and sodium, with which he had conducted an extensive series of animal experiments. The results of these were considered to justify its use in clinical practice and two physicians, Secher and Faber, undeterred by its toxicity, reported enthusiastically in its favour. Other Danish physicians followed but, alarmed by violent reactions, modified the dosage, an example followed by British workers. Encouraging results continued to be reported although each series contained a significant proportion of failures, and toxicity remained high. The first properly planned and fully controlled clinical trial took place in the United States and produced a report which was wholly adverse and which sounded the death knell of gold therapy throughout America. Until 1934-35 gold was used extensively in Europe but thereafter there was a sudden and largely universal cessation of interest and within a few years gold, introduced with such éclat and carrying so many high hopes, had vanished from the therapy of tuberculosis even though, at that point, no better alternative was available.

  20. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

    Science.gov (United States)

    Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

    2016-04-01

    Clinical networks for paediatric and adolescent rheumatology are evolving, and their effect and role in the transition process between paediatric and adult services are unknown. We therefore explored the experiences of those involved to try and understand this further. Health professionals, young people with juvenile idiopathic arthritis and their families were recruited via five national health service paediatric and adolescent rheumatology specialist centres and networks across the UK. Seventy participants took part in focus groups and one-to-one interviews. Data was analysed using coding, memoing and mapping techniques to identify features of transitional services across the sector. Variation and inequities in transitional care exist. Although transition services in networks are evolving, development has lagged behind other areas with network establishment focusing more on access to paediatric rheumatology multidisciplinary teams. Challenges include workforce shortfalls, differences in service priorities, standards and healthcare infrastructures, and managing the legacy of historic encounters. Providing equitable high-quality clinically effective services for transition across the UK has a long way to go. There is a call from within the sector for more protected time, staff and resources to develop transition roles and services, as well as streamlining of local referral pathways between paediatric and adult healthcare services. In addition, there is a need to support professionals in developing their understanding of transitional care in clinical networks, particularly around service design, organisational change and the interpersonal skills required for collaborative working. Key messages • Transitional care in clinical networks requires collaborative working and an effective interface with paediatric and adult rheumatology.• Professional centrism and historic encounters may affect collaborative relationships within clinical networks.• Education

  1. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  2. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  3. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

    Directory of Open Access Journals (Sweden)

    Ali Habib

    2012-01-01

    Full Text Available This paper reviews the current published data regarding open transforaminal lumbar interbody fusion (TLIF in relation to minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. Introduction. MI-TLIF, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies. Currently, there is limited literature that compares TLIF directly to MI-TLIF. Thus, we seek to discuss the current literature on these techniques. Methods. Using a PubMed search, we reviewed recent publications of open and MI-TLIF, dating from 2002 to 2012. We discussed these studies and their findings in this paper, focusing on patient-reported outcomes as well as complications. Results. Data found in 14 articles of the literature was analyzed. Using these reports, we found mean follow-up was 20 months. The mean patient study size was 52. Seven of the articles directly compared outcomes of open TLIF with MI-TLIF, such as mean duration of surgery, length of post-operative stay, blood loss, and complications. Conclusion. Although high-class data comparing these two techniques is lacking, the current evidence supports MI-TLIF with outcomes comparable to that of the traditional, open technique. Further prospective, randomized studies will help to further our understanding of this minimally invasive technique.

  4. Phytomining for Artisanal Gold Mine Tailings Management

    Directory of Open Access Journals (Sweden)

    Baiq Dewi Krisnayanti

    2016-08-01

    Full Text Available Mine tailings are generally disposed of by artisanal and small scale gold miners in poorly constructed containment areas and this leads to environmental risk. Gold phytomining could be a possible option for tailings management at artisanal and small-scale gold mining (ASGM locations where plants accumulate residual gold in their above ground biomass. The value of metal recovered from plants could offset some of the costs of environmental management. Getting gold into plants has been repeatedly demonstrated by many research groups; however, a simple working technology to get gold out of plants is less well described. A field experiment to assess the relevance of the technology to artisanal miners was conducted in Central Lombok, Indonesia between April and June 2015. Tobacco was planted in cyanidation tailings (1 mg/kg gold and grown for 2.5 months before the entire plot area was irrigated with NaCN to induce metal uptake. Biomass was then harvested (100 kg, air dried, and ashed by miners in equipment currently used to ash activated carbon at the end of a cyanide leach circuit. Borax and silver as a collector metal were added to the tobacco ash and smelted at high temperature to extract metals from the ash. The mass of the final bullion (39 g was greater than the mass of silver used as a collector (31 g, indicating recovery of metals from the biomass through the smelt process. The gold yield of this trial was low (1.2 mg/kg dry weight biomass concentration, indicating that considerable work must still be done to optimise valuable metal recovery by plants at the field scale. However, the described method to process the biomass was technically feasible, and represents a valid technique that artisanal and small-scale gold miners are willing to adopt if the economic case is good.

  5. Clinical evaluations for transfer of juveniles to criminal court: current practices and future research.

    Science.gov (United States)

    Kruh, I P; Brodsky, S L

    1997-01-01

    Completing clinical evaluations of juveniles considered for transfer to criminal court requires specialized expertise. However, there is little empirical foundation upon which they can be based. Within each of the three major evaluation domains (amenability to treatment, risk for future violence, and sophistication/maturity), we ask the following questions: a) Can forensic examiners properly assess this area, and if so using what tools?; b) How can social science research clarify the transfer evaluation, particularly as it is impacted by systems issues?; and c) How should the evaluation be structured? In doing so, we review clinical suggestions for completing these evaluations and identify pertinent research directions. A number of general issues specific to these evaluations are also discussed.

  6. Multiple, sclerosis: clinical feature, pathogenesis and current therapeutical approaches; Encephalomyelitis disseminata: Klinik, Pathogenese und aktuelle Therapiekonzepte

    Energy Technology Data Exchange (ETDEWEB)

    Merkelbach, S.; Koelmel, C.; Schimrigk, K. [Universitaet des Saarlandes, Homburg/Saar (Germany). Neurologische Klinik

    2000-11-01

    Multiple sclerosis (MS) is considered as a T-cell mediated autoimmune disease. Caused by central nervous system demyelination and axonal damage varying clinical signs do occur either with relapsing-remitting or with chronic progressive course. Based on pathogenetic considerations immunomodulative and immunosuppressive therapeutical approaches are used to limit the disease progression. Clinical symptoms, diagnostic criteria, pathogenetical considerations, and consecutive therapeutical interventions are summarized. (orig.) [German] Die Encephalomyelitis disseminata oder Multiple Sklerose (ED oder MS) gilt als T-Zell-vermittelte Autoimmunerkrankung. Schubfoermig oder chronisch progredient kommt es im Zentralnervensystem infolge einer Demyelinisierung der weissen Substanz und axonaler Schaedigungen zu einer Vielzahl neurologischer Symptome. Basierend auf pathogenetischen Erkenntnissen werden derzeit immunmodulative und immunsuppressive Therapien eingesetzt, die den Krankheitsverlauf zumindest bremsen. Klinische Symptome, diagnostische Kriterien, pathogenetische Ueberlegungen und sich daraus ableitende Therapiekonzepte werden zusammenfassend dargestellt. (orig.)

  7. Current Status of Clinical and Experimental Researches on Cognitive Impairment in Diabetes

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This article reviews the clinical and experimental researches on cognitive impairment related to diabetes in the recent decade. Most clinical studies indicate that the cognitive impairment in patients with type 1 diabetes mellitus is related to recurrent hypoglycemia closely. There is little research about whether or not hyperglycemia is related to cognitive impairment in patients with type 1 diabetes mellitus. Most studies indicate that the cognitive impairment in type 2 diabetes involves multiple factors through multiple mechanisms, including blood glucose, blood lipid, blood pressure, level of insulin, medication, chronic complication, etc. But, there has been no large-scale, multi-center, randomized controlled clinical trial in China recently. And what is more, some problems exist in this field of research, such as the lack of golden criterion of cognitive function measurement, different population of studied objects, and incomprehensive handling of confounding factors. Experimental studies found that hippocampal long-term potentiation (LTP) was impaired,which were manifested by impairment of spatial memory and decreased expression of LTP, but its relation to hyperglycemia, the duration of diabetes, learning and memory has always been differently reported by different researches. Thus, there are a lot of unknown things to be explored and studied in order to clarify its mechanism. TCM has abundant clinical experience in treating cerebral disease with medicine that enforces the kidney and promotes wit. However, there has been no research on treating diabetic cognitive impairment,which requires work to be done actively and TCM to be put into full play, in order to improve the treatment of diabetes and enhance living quality of patients.

  8. Current and future use of the mannitol bronchial challenge in everyday clinical practice

    DEFF Research Database (Denmark)

    Porsbjerg, Celeste; Backer, Vibeke; Joos, Guy;

    2009-01-01

    OBJECTIVES: Asthma is a disease associated with inflammation, airway hyperresponsiveness (AHR) and airflow limitation. Clinical diagnosis and management of asthma often relies on assessment of lung function and symptom control, but these factors do not always correlate well with underlying inflam...... from inhaled corticosteroid therapy. CONCLUSION: In the future, mannitol BCT may be added to lung function and symptom assessment to aid in the everyday management of asthma....

  9. Current and Future Clinical Applications of Zinc Transporter-8 in Type 1 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    Bo Yi; Gan Huang; Zhi-Guang Zhou

    2015-01-01

    Objective:To evaluate the utility of zinc transporter-8 (ZnT8) in the improvement of type 1 diabetes mellitus (T1DM) diagnosis and prediction,and to explore whether ZnT8 is a potential therapeutic target in T l DM.Data Sources:A search was conducted within the medical database PubMed for relevant articles published from 2001 to 2015.The search terms are as follows:"ZnT8," "type 1 diabetes," "latent autoimmune diabetes in adults," "type 2 diabetes," "islet autoantibodies," "zinc supplement," "T cells," "β cell," "immune therapy." We also searched the reference lists of selected articles.Study Selection:English-language original articles and critical reviews concerning ZnT8 and the clinical applications of islet autoantibodies in diabetes were reviewed.Results:The basic function of ZnT8 is maintaining intracellular zinc homeostasis,which modulates the process of insulin biosynthesis,storage,and secretion.Autoantibodies against ZnT8 (ZnT8A) and ZnT8-specific T cells are the reliable biomarkers for the identification,stratification,and characterization ofTl DM.Additionally,the results from the animal models and clinical trials have shown that ZnT8 is a diabetogenic antigen,suggesting the possibility of ZnT8-specific immunotherapy as an alternative for T1DM therapy.Conclusions:ZnT8 is a novel islet autoantigen with a widely potential for clinical applications in T1DM.However,before the large-scale clinical applications,there are still many problems to be solved.

  10. Stem Cells of Dental Origin: Current Research Trends and Key Milestones towards Clinical Application

    Science.gov (United States)

    About, Imad

    2016-01-01

    Dental Mesenchymal Stem Cells (MSCs), including Dental Pulp Stem Cells (DPSCs), Stem Cells from Human Exfoliated Deciduous teeth (SHED), and Stem Cells From Apical Papilla (SCAP), have been extensively studied using highly sophisticated in vitro and in vivo systems, yielding substantially improved understanding of their intriguing biological properties. Their capacity to reconstitute various dental and nondental tissues and the inherent angiogenic, neurogenic, and immunomodulatory properties of their secretome have been a subject of meticulous and costly research by various groups over the past decade. Key milestone achievements have exemplified their clinical utility in Regenerative Dentistry, as surrogate therapeutic modules for conventional biomaterial-based approaches, offering regeneration of damaged oral tissues instead of simply “filling the gaps.” Thus, the essential next step to validate these immense advances is the implementation of well-designed clinical trials paving the way for exploiting these fascinating research achievements for patient well-being: the ultimate aim of this ground breaking technology. This review paper presents a concise overview of the major biological properties of the human dental MSCs, critical for the translational pathway “from bench to clinic.”

  11. Current progress of siRNA/shRNA therapeutics in clinical trials.

    Science.gov (United States)

    Burnett, John C; Rossi, John J; Tiemann, Katrin

    2011-09-01

    Through a mechanism known as RNA interference (RNAi), small interfering RNA (siRNA) molecules can target complementary mRNA strands for degradation, thus specifically inhibiting gene expression. The ability of siRNAs to inhibit gene expression offers a mechanism that can be exploited for novel therapeutics. Indeed, over the past decade, at least 21 siRNA therapeutics have been developed for more than a dozen diseases, including various cancers, viruses, and genetic disorders. Like other biological drugs, RNAi-based therapeutics often require a delivery vehicle to transport them to the targeted cells. Thus, the clinical advancement of numerous siRNA drugs has relied on the development of siRNA carriers, including biodegradable nanoparticles, lipids, bacteria, and attenuated viruses. Most therapies permit systemic delivery of the siRNA drug, while others use ex vivo delivery by autologous cell therapy. Advancements in bioengineering and nanotechnology have led to improved control of delivery and release of some siRNA therapeutics. Likewise, progress in molecular biology has allowed for improved design of the siRNA molecules. Here, we provide an overview of siRNA therapeutics in clinical trials, including their clinical progress, the challenges they have encountered, and the future they hold in the treatment of human diseases.

  12. Immunotherapy and therapeutic vaccines in prostate cancer:an update on current strategies and clinical implications

    Institute of Scientific and Technical Information of China (English)

    B Harpreet Singh; James L Gulley

    2014-01-01

    In recent years, immunotherapy has emerged as a viable and attractive strategy for the treatment of prostate cancer. While there are multiple ways to target the immune system, therapeutic cancer vaccines and immune checkpoint inhibitors have been most successful in late-stage clinical trials. The landmark Food and Drug Administration approval of sipuleucel-T for asymptomatic or minimally symptomatic metastatic prostate cancer set the stage for ongoing phase III trials with the cancer vaccine PSA-TRICOM and the immune checkpoint inhibitor ipilimumab. A common feature of these immune-based therapies is the appearance of improved overall survival without short-term changes in disease progression. This class effect appears to be due to modulation of tumor growth rate kinetics, in which the activated immune system exerts constant immunologic pressure that slows net tumor growth. Emerging data suggest that the ideal population for clinical trials of cancer vaccines is patients with lower tumor volume and less aggressive disease. Combination strategies that combine immunotherapy with standard therapies have been shown to augment both immune response and clinical beneift.

  13. Drug development and nonclinical to clinical translational databases: past and current efforts.

    Science.gov (United States)

    Monticello, Thomas M

    2015-01-01

    The International Consortium for Innovation and Quality (IQ) in Pharmaceutical Development is a science-focused organization of pharmaceutical and biotechnology companies. The mission of the Preclinical Safety Leadership Group (DruSafe) of the IQ is to advance science-based standards for nonclinical development of pharmaceutical products and to promote high-quality and effective nonclinical safety testing that can enable human risk assessment. DruSafe is creating an industry-wide database to determine the accuracy with which the interpretation of nonclinical safety assessments in animal models correctly predicts human risk in the early clinical development of biopharmaceuticals. This initiative aligns with the 2011 Food and Drug Administration strategic plan to advance regulatory science and modernize toxicology to enhance product safety. Although similar in concept to the initial industry-wide concordance data set conducted by International Life Sciences Institute's Health and Environmental Sciences Institute (HESI/ILSI), the DruSafe database will proactively track concordance, include exposure data and large and small molecules, and will continue to expand with longer duration nonclinical and clinical study comparisons. The output from this work will help identify actual human and animal adverse event data to define both the reliability and the potential limitations of nonclinical data and testing paradigms in predicting human safety in phase 1 clinical trials. © 2014 by The Author(s).

  14. Stem Cells of Dental Origin: Current Research Trends and Key Milestones towards Clinical Application

    Directory of Open Access Journals (Sweden)

    Athina Bakopoulou

    2016-01-01

    Full Text Available Dental Mesenchymal Stem Cells (MSCs, including Dental Pulp Stem Cells (DPSCs, Stem Cells from Human Exfoliated Deciduous teeth (SHED, and Stem Cells From Apical Papilla (SCAP, have been extensively studied using highly sophisticated in vitro and in vivo systems, yielding substantially improved understanding of their intriguing biological properties. Their capacity to reconstitute various dental and nondental tissues and the inherent angiogenic, neurogenic, and immunomodulatory properties of their secretome have been a subject of meticulous and costly research by various groups over the past decade. Key milestone achievements have exemplified their clinical utility in Regenerative Dentistry, as surrogate therapeutic modules for conventional biomaterial-based approaches, offering regeneration of damaged oral tissues instead of simply “filling the gaps.” Thus, the essential next step to validate these immense advances is the implementation of well-designed clinical trials paving the way for exploiting these fascinating research achievements for patient well-being: the ultimate aim of this ground breaking technology. This review paper presents a concise overview of the major biological properties of the human dental MSCs, critical for the translational pathway “from bench to clinic.”

  15. Immunotherapy and therapeutic vaccines in prostate cancer: an update on current strategies and clinical implications

    Directory of Open Access Journals (Sweden)

    B Harpreet Singh

    2014-06-01

    Full Text Available In recent years, immunotherapy has emerged as a viable and attractive strategy for the treatment of prostate cancer. While there are multiple ways to target the immune system, therapeutic cancer vaccines and immune checkpoint inhibitors have been most successful in late-stage clinical trials. The landmark Food and Drug Administration approval of sipuleucel-T for asymptomatic or minimally symptomatic metastatic prostate cancer set the stage for ongoing phase III trials with the cancer vaccine PSA-TRICOM and the immune checkpoint inhibitor ipilimumab. A common feature of these immune-based therapies is the appearance of improved overall survival without short-term changes in disease progression. This class effect appears to be due to modulation of tumor growth rate kinetics, in which the activated immune system exerts constant immunologic pressure that slows net tumor growth. Emerging data suggest that the ideal population for clinical trials of cancer vaccines is patients with lower tumor volume and less aggressive disease. Combination strategies that combine immunotherapy with standard therapies have been shown to augment both immune response and clinical benefit.

  16. GOLD NANOPARTICLES: A REVIVAL IN PRECIOUS METAL ADMINISTRATION TO PATIENTS

    Science.gov (United States)

    Thakor, AS; Jokerst, J; Zaveleta, C; Massoud, TF; Gambhir, SS

    2011-01-01

    Gold has been used as a therapeutic agent to treat a wide variety of rheumatic diseases including psoriatic arthritis, juvenile arthritis and discoid lupus erythematosus. Although the use of gold has been largely superseded by newer drugs, gold nanoparticles are being used effectively in laboratory based clinical diagnostic methods whilst concurrently showing great promise in vivo either as a diagnostic imaging agent or a therapeutic agent. For these reasons, gold nanoparticles are therefore well placed to enter mainstream clinical practice in the near future. Hence, the present review summarizes the chemistry, pharmacokinetics, bio-distribution, metabolism and toxicity of bulk gold in humans based on decades of clinical observation and experiments in which gold was used to treat patients with rheumatoid arthritis. The beneficial attributes of gold nanoparticles, such as their ease of synthesis, functionalization and shape control are also highlighted demonstrating why gold nanoparticles are an attractive target for further development and optimization. The importance of controlling the size and shape of gold nanoparticles to minimize any potential toxic side effects is also discussed. PMID:21846107

  17. Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

    Directory of Open Access Journals (Sweden)

    Ferrández Oscar

    2012-07-01

    Full Text Available Abstract Background The increased use and adoption of Electronic Health Records (EHR causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI, which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity and precision (equivalent to positive predictive value metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches

  18. CMS Industries awarded gold, crystal

    CERN Multimedia

    2006-01-01

    The CMS collaboration honoured 10 of its top suppliers in the seventh annual awards ceremony The representatives of the firms that recieved the CMS Gold and Crystal Awards stand with their awards after the ceremony. The seventh annual CMS Awards ceremony was held on Monday 13 March to recognize the industries that have made substantial contributions to the construction of the collaboration's detector. Nine international firms received Gold Awards, and General Tecnica of Italy received the prestigious Crystal Award. Representatives from the companies attended the ceremony during the plenary session of CMS week. 'The role of CERN, its machines and experiments, beyond particle physics is to push the development of equipment technologies related to high-energy physics,'said CMS Awards Coordinator Domenico Campi. 'All of these industries must go beyond the technologies that are currently available.' Without the involvement of good companies over the years, the construction of the CMS detector wouldn't be possible...

  19. Switchable Imbibition in Nanoporous Gold

    CERN Document Server

    Xue, Yahui; Duan, Huiling; Weissmueller, Joerg; Huber, Patrick

    2014-01-01

    Spontaneous imbibition enables the elegant propelling of nano-flows because of the dominance of capillarity at small length scales. The imbibition kinetics are, however, solely determined by the static geometry of the porous host, the capillarity, and the fluidity of the imbibed liquid. This makes active control particularly challenging. Here, we show for aqueous electrolyte imbibition in nanoporous gold that the fluid flow can be reversibly switched on and off through electric potential control of the solid-liquid interfacial tension, i.e. we can accelerate the imbibition front, stop it, and have it proceed at will. Simultaneous measurements of the mass flux and the electrical current allow us to document simple scaling laws for the imbibition kinetics, and to explore the charge flow dynamics in the metallic nanopores. Our findings demonstrate that the high electric conductivity along with the pathways for ionic and/or fluid transport render nanoporous elemental gold a versatile, accurately controllable elec...

  20. Physical Activity in Clinical Pediatric Weight Management Programs: Current Practices and Recommendations.

    Science.gov (United States)

    Kist, Christopher; Gier, Amanda; Tucker, Jared; Barbieri, Teresa F; Johnson-Branch, Sonya; Moore, Lindy; Picard, Sarah; Lukasiewicz, Gloria; Coleman, Nailah

    2016-11-01

    Physical activity (PA) is essential for youth weight management. FOCUS on a Fitter Future (FFF), a group of health care professionals from 25 children's hospitals, sponsored by the Children's Hospital Association, examined current care practices for overweight and obese youth with the goal of building consensus on outcome measurements and quality improvement for pediatric weight management programs (WMPs). WMPs completed a survey regarding PA practices, including testing, assessment and intervention. Consistency in general treatment practices was noted with variability in implementation. All programs included PA assessment and counseling. A majority of programs measured aerobic fitness, and more than half evaluated muscular fitness. Most offered group exercise sessions. Programs differed in availability of resources, assessment tools, interventions and outcome measures. Based on current practice and research, the FFF PA subgroup recommends key components for inclusion in a pediatric WMP: exercise testing, body composition assessment, PA and sedentary behaviors measures, individual exercise counseling, and group exercise programming. © The Author(s) 2015.

  1. Clinical skills training in obstetrics - a descriptive survey of current practice in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Johansen, Marianne; Lottrup, Pernille

    2012-01-01

    The Danish National Board of Health has recommended that labor wards establish regular obstetric emergency skills training programs. The aim of this study was to describe current practice in Denmark. A questionnaire was sent to all obstetric departments in Denmark in 2008. All responded. Simulation......-based training was conducted in 26/28 obstetrical departments. Settings for the training programs were mainly local. Training was provided for shoulder dystocia, postpartum bleeding and basic neonatal resuscitation in almost all the departments, but was not organized in a uniform way. Neither the program itself...... nor the participants' performance was evaluated in a structured or validated way. Obstetric emergency skills training is being actively conducted in the majority of the Danish labor wards. However, it still remains a challenge to ensure the uniform organization and evaluation of the current training...

  2. Current trends in research and clinical issues in the study of personality and its disorders

    DEFF Research Database (Denmark)

    Simonsen, Erik; Sørensen, Per; Pedersen, Liselotte

    2014-01-01

    lecture (Simonsen), a young researchers' symposium (Hopwood, Sharp, and Kaess), and special lectures on the Danish philosopher Soeren Kierkegaard and the poet Hans Christian Andersen. In this article we will survey the presentations and highlight the important issues in order to underline the current......The International Society for the Study of Personality Disorders (ISSPD) celebrated its 25th anniversary in September 2013 in Copenhagen and commemorated the First International Congress at the same site. The overall theme of the congress was "Bridging Personality and Psychopathology: The Person...... Behind the Illness." More than 400 abstracts were submitted, and the program included 8 keynote presentations, 18 invited symposia, a debate on current controversial issues in the classification of personality disorders (Fossati, Tyrer, Livesley, and Krueger), an ISSPD award lecture (Silk), a jubilee...

  3. Regeneration of tissues of the oral complex: current clinical trends and research advances.

    Science.gov (United States)

    Nguyen, Thomas T; Mui, Brennan; Mehrabzadeh, Mahsa; Chea, Yannie; Chaudhry, Zoya; Chaudhry, Kamran; Tran, Simon D

    2013-01-01

    Regenerative therapy in oral health care is limited by both the body's natural capacity for regeneration and the materials and methods currently available. Research on various aspects of regenerative therapy, such as tissue engineering and stem cell and gene therapy, has produced promising results. Compelling advances, ranging from the discovery and characterization of stem cell populations in oral tissue to the engineering and transplantation of whole tooth structures, could result in exciting new treatment methods for clinicians in the near future. In this review, we discuss the limitations of natural healing and regeneration of various tissues of the oral complex, including teeth, periodontium and salivary glands, and summarize current treatment methods for tissue damage as well as research advances in oral tissue regeneration.

  4. Dry age-related macular degeneration: A currently unmet clinical need

    OpenAIRE

    Girmens, Jean-François; Sahel, José-Alain; Marazova, Katia

    2012-01-01

    Age-related macular degeneration (AMD) is a leading cause of severe visual impairment and disability in older people worldwide. Although considerable advances in the management of the neovascular form of AMD have been made in the last decade, no therapy is yet available for the advanced dry form of AMD (geographic atrophy). This review focuses on current trends in the development of new therapies targeting specific pathophysiological pathways of dry AMD. Increased understanding of the complex...

  5. 黄金工业特征污染物综合治理装备现状及发展趋势%Current status of comprehensive treatment equipment intended for featured pollutants in gold industry and its development trend

    Institute of Scientific and Technical Information of China (English)

    吴铃; 丁成; 李延吉; 高飞翔; 迟崇哲

    2015-01-01

    黄金工业特征污染物综合治理装备是黄金工业实现绿色、和谐、可持续发展的重要技术支撑。介绍了黄金工业特征污染物综合治理装备的分类、应用工艺、相应结构、功能实现过程与应用特点等现状,统计分析了治理装备在黄金矿山的应用状况,并对黄金工业特征污染物综合治理装备及技术的未来发展趋势进行了研讨。%Comprehensive treatment equipment intended for featured pollutants in gold industry is important tech-nical support for green,harmonious and sustainable development of gold industry.The paper gives an overview of the classification,application,structure,function completion process and application characteristics of comprehensive treat-ment equipment intended for featured pollutants in gold industry.The application status of the treatment equipment in gold mines is showed by statistical analysis.And discussions are made about the development trend of the equipment and technology for comprehensive treatment of featured pollutants in gold industry.

  6. Current technological advances in magnetic resonance with critical impact for clinical diagnosis and therapy.

    Science.gov (United States)

    Runge, Val M

    2013-12-01

    The last 5 years of technological advances with major impact on clinical magnetic resonance (MR) are discussed, with greater emphasis on those that are most recent. These developments have already had a critical positive effect on clinical diagnosis and therapy and presage continued rapid improvements for the next 5 years. This review begins with a discussion of 2 topics that encompass the breadth of MR, in terms of anatomic applications, contrast media, and MR angiography. Subsequently, innovations are discussed by anatomic category, picking the areas with the greatest development, starting with the brain, moving forward to the liver and kidney, and concluding with the musculoskeletal system, breast, and prostate. Two final topics are then considered, which will likely, with time, become independent major fields in their own right, interventional MR and MR positron emission tomography (PET).The next decade will bring a new generation of MR contrast media, with research focused on substantial improvements (>100-fold) in relaxivity (contrast effect), thus providing greater efficacy, safety, and tissue targeting. Magnetic resonance angiography will see major advances because of the use of compressed sensing, in terms of spatial and temporal resolution, with movement away from nondynamic imaging. The breadth of available techniques and tissue contrast has greatly expanded in brain imaging, benefiting both from the introduction of new basic categories of imaging techniques, such as readout-segmented echo planar imaging and 3D fast spin echo imaging with variable flip angles, and from new refinements specific to anatomic areas, such as double inversion recovery and MP2RAGE. Liver imaging has benefited from the development of techniques to easily and rapidly assess lipid, and will see, overall, a marked improvement in the next 5 years from new techniques on the verge of clinical introduction, such as controlled aliasing in parallel imaging results in higher acceleration

  7. MO-FG-BRA-02: Modulation of Clinical Orthovoltage X-Ray Spectrum Further Enhances Radiosensitization of Cancer Cells Targeted with Gold Nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, T; Reynoso, F; Cho, J; Quini, C; Cortez, M; Manohar, N; Krishnan, S; Cho, S [UT MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: To assess the potential to amplify radiosensitization of cancer cells targeted with gold nanoparticles by augmenting selective spectral components of X-ray beam. Methods: Human prostate cancer cells were treated for 24h with gold nanorods conjugated to goserelin acetate or pegylated, systematically washed and irradiated with 250 kVp X-rays (25mA, 0.25mm Cu- filter, 8x8cm{sup 2} field size, 50cm SSD) with or without an additional 0.25 mm Erbium (Er) filter. As demonstrated in a companion Monte Carlo study, Er-filter acted as an external target to feed Erbium K-shell X-ray fluorescence photons (∼50 keV) into the 250 kVp beam. After irradiation, we performed measurements of clonogenic viability with doses between 0 -6Gy, irreparable DNA damage assay to measure double-strand breaks via γH2AX-foci staining, and production of stable reactive oxygen species (ROS). Results: The clonogenic assay for the group treated with conjugated nanoparticles showed radiosensitization enhancement factor (REF), calculated at the 10% survival fraction aisle, of (1.62±0.07) vs. (1.23±0.04) with/without the Er-filter in the 250 kVp beam, respectively. The group treated with pegylated nanoparticles, albeit retained in modest amounts within the cells, also showed statistically significant REF (1.13±0.09) when the Erbium filter was added to the beam. No significant radiosensitization was observed for other groups. Measurements of ROS levels showed increments of (1.9±0.2) vs. (1.4±0.1) for combined treatment with targeted nanoparticles and Er-filtered beam. γH2AX-foci showed 50% increase for the same treatment combination, confirming the enhanced radiosensitization in a consistent fashion. Conclusion: Our study demonstrates the feasibility of enhancing radiosensitization of cancer cells by combining actively targeted gold nanoparticles and modulating the X-ray spectrum in the desired energy range. The established technique will not only help develop strategies to maximize

  8. Non-inferiority clinical trials: Practical issues and current regulatory perspective

    Directory of Open Access Journals (Sweden)

    Sandeep K Gupta

    2011-01-01

    Full Text Available Non-inferiority clinical trials are being performed with an increasing frequency now-a-days, because it helps in finding a new treatment that have approximately the same efficacy, but may offer other benefits such as better safety profile. Non-inferiority clinical trials aim to demonstrate that the test product is no worse than the comparator by more than a pre-specified small amount. There are several fundamental differences between non-inferiority and superiority trials. Some practical issues concerning the non-inferiority trials are assay sensitivity, choice of the non-inferiority margin, sample size estimation, choice of active-control, and analysis of non-inferiority clinical trials. For serious infections such as hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia, community-acquired bacterial pneumonia, and acute bacterial skin and skin structure infections, the United States Food and Drug Administration (US FDA has recently recommended that it is possible to define a reliable and consistent estimate of the efficacy of active treatment relative to placebo from available data, which can serve as the basis for defining a new inferiority margin for an active-controlled, non-inferiority trial. But for some indications with a high rate of resolution without antibacterial drug therapy such as acute bacterial sinusitis (ABS, acute bacterial exacerbation of chronic bronchitis (ABECB, and acute bacterial otitis media (ABOM, the US FDA has recommended that the available data will not support the use of a non-inferiority design and other trial designs (i.e., superiority designs should be used to provide the evidence of effectiveness in these three indications.

  9. Clinical utility of recombinant adenoviral human p53 gene therapy: current perspectives

    Directory of Open Access Journals (Sweden)

    Chen GX

    2014-10-01

    Full Text Available Guang-xia Chen,1,* Shu Zhang,2–4,* Xiao-hua He,1 Shi-yu Liu,1 Chao Ma,2–4 Xiao-Ping Zou2–4 1Department of Gastroenterology, First People’s Hospital of Xuzhou, Xuzhou, Jiangsu Province, People’s Republic of China; 2Department of Gastroenterology, Drum Tower Hospital, 3Medical School of Nanjing University, 4Jiangsu Clinical Medical Center of Digestive Disease, Nanjing, People’s Republic of China *These authors have contributed equally to the paperAbstract: Gene therapy has promised to be a highly effective antitumor treatment by introducing a tumor suppressor gene or the abrogation of an oncogene. Among the potential therapeutic transgenes, the tumor suppressor gene p53 serves as an attractive target. Restoration of wild-type p53 function in tumors can be achieved by introduction of an intact complementary deoxyribonucleic acid copy of the p53 gene using a suitable viral vector, in most cases an adenoviral vector (Adp53. Preclinical in vitro and in vivo studies have shown that Adp53 triggers a dramatic tumor regression response in various cancers. These viruses are engineered to lack certain early proteins and are thus replication defective, including Gendicine, SCH-58500, and Advexin. Several types of tumor-specific p53-expressing conditionally replicating adenovirus vectors (known as replication-competent CRAdp53 vectors have been developed, such as ONYX 015, AdDelta24-p53, SG600-p53, OBP-702, and H101. Various clinical trials have been conducted to investigate the safety and efficiency of these adenoviral vectors. In this review we will talk about the biological mechanisms, clinical utility, and therapeutic potentials of the replication-deficient Adp53-based and replication-competent CRAdp53-based gene therapy.Keywords: adenovirus, Adp53, CRAdp53

  10. Cross-sectional imaging of biliary tumors: current clinical status and future developments

    Energy Technology Data Exchange (ETDEWEB)

    Zech, Christoph J.; Schoenberg, Stefan O.; Reiser, Maximilian; Helmberger, Thomas [Institute of Clinical Radiology, Munich University Hospitals-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich (Germany)

    2004-07-01

    Extrahepatic cholangiocarcinoma, including hilar cholangiocarcinoma, is a relatively rare diagnosis. However, it frequently has been associated with major problems in diagnostics and clinical management from its first comprehensive description by Klatskin up until today. In this article, cholangiocarcinoma, representing the most common biliary tumor, as well as the differential diagnoses of benign and malignant biliary obstruction, will be discussed. The latest improvements of cross-sectional imaging modalities (sonography, CT, MRI and PET) and their diagnostic values for detection and staging will be displayed. A practical imaging-based diagnostic approach to obstructive biliary disease will be proposed. (orig.)

  11. CURRENT PERSPECTIVES OF POTTER'S GLOBAL BIOETHICS AS A BRIDGE BETWEEN CLINICAL (PERSONALIZED) AND PUBLIC HEALTH ETHICS.

    Science.gov (United States)

    Turina, Iva Sorta-Bilajac; Brkljacić, Morana; Grgas-Bile, Cecilija; Gajski, Domagoj; Racz, Aleksandar; Cengić, Tomislav

    2015-12-01

    In the context of modern scientific and technological developments in biomedicine and health care, and the potential consequences of their application on humans and the environment, Potter's global bioethics concept resurfaces. By actualizing Potter's original thoughts on individual bioethical issues, the universality of two of his books, which today represent the backbone of the world bioethical literature, "Bioethics--Bridge to the Future" and "Global Bioethics: Building on the Leopold Legacy", is emphasized. Potter's global bioethics today can legitimately be viewed as a bridge between clinical personalized ethics on the one hand and ethics of public health on the other.

  12. Clinical utility of recombinant adenoviral human p53 gene therapy: current perspectives

    OpenAIRE

    2014-01-01

    Guang-xia Chen,1,* Shu Zhang,2–4,* Xiao-hua He,1 Shi-yu Liu,1 Chao Ma,2–4 Xiao-Ping Zou2–4 1Department of Gastroenterology, First People’s Hospital of Xuzhou, Xuzhou, Jiangsu Province, People’s Republic of China; 2Department of Gastroenterology, Drum Tower Hospital, 3Medical School of Nanjing University, 4Jiangsu Clinical Medical Center of Digestive Disease, Nanjing, People’s Republic of China *These authors have contributed equally...

  13. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review of the current evidence

    Directory of Open Access Journals (Sweden)

    Dürsteler KM

    2015-06-01

    Full Text Available Kenneth M Dürsteler,1,2 Eva-Maria Berger,1 Johannes Strasser,1 Carlo Caflisch,2 Jochen Mutschler,2 Marcus Herdener,2 Marc Vogel1 1Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland; 2Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland Background: Cocaine use continues to be a public health problem, yet there is no proven effective pharmacotherapy for cocaine dependence. A promising approach to treating cocaine dependence may be agonist-replacement therapy, which is already used effectively in the treatment of opioid and tobacco dependence. The replacement approach for cocaine dependence posits that administration of a long-acting stimulant medication should normalize the neurochemical and behavioral perturbations resulting from chronic cocaine use. One potential medication to be substituted for cocaine is methylphenidate (MPH, as this stimulant possesses pharmacobehavioral properties similar to those of cocaine. Aim: To provide a qualitative review addressing the rationale for the use of MPH as a cocaine substitute and its clinical potential in the treatment of cocaine dependence. Methods: We searched MEDLINE for clinical studies using MPH in patients with cocaine abuse/dependence and screened the bibliographies of the articles found for pertinent literature. Results: MPH, like cocaine, increases synaptic dopamine by inhibiting dopamine reuptake. The discriminative properties, reinforcing potential, and subjective effects of MPH and cocaine are almost identical and, importantly, MPH has been found to substitute for cocaine in animals and human volunteers under laboratory conditions. When taken orally in therapeutic doses, its abuse liability, however, appears low, which is especially true for extended-release MPH preparations. Though there are promising data in the literature, mainly from case reports and

  14. Prehospital Emergency Ultrasound: A Review of Current Clinical Applications, Challenges, and Future Implications

    Directory of Open Access Journals (Sweden)

    Mazen J. El Sayed

    2013-01-01

    Full Text Available Imaging modalities in the prehospital setting are helpful in the evaluation and management of time-sensitive emergency conditions. Ultrasound is the main modality that has been applied by emergency medical services (EMS providers in the field. This paper examines the clinical applications of ultrasound in the prehospital setting. Specific focus is on applications that provide essential information to guide triage and management of critical patients. Challenges of this modality are also described in terms of cost impact on EMS agencies, provider training, and skill maintenance in addition to challenges related to the technical aspect of ultrasound.

  15. Clinical trial design in chronic obstructive pulmonary disease: current perspectives and considerations with regard to blinding of tiotropium

    Directory of Open Access Journals (Sweden)

    Beeh Kai-Michael

    2012-06-01

    Full Text Available Abstract Randomised, double-blind, controlled trials are considered the gold standard for evaluating a pharmacological agent, as they minimise any potential bias. However, it is not always possible to perform double-blind trials, particularly for medications delivered via specific devices, e.g. inhalers. In such cases, open-label studies can be employed instead. Methods used to minimise any potential bias introduced by open-label study design include randomisation, crossover study design, and objective measurements of primary efficacy and safety variables. Concise reviews analysing the effect of blinding procedures of comparator drugs on outcomes in respiratory trials are limited. Here, we compare data from different chronic obstructive pulmonary disease trials with once-daily indacaterol versus a blinded or non-blinded comparator. The clinical trial programme for indacaterol, a once-daily, long-acting β2-agonist, used tiotropium as a comparator either in an open-label or blinded fashion. Data from these studies showed that the effects of tiotropium were consistent for forced expiratory volume in 1 second, an objective measure, across blinded and non-blinded studies. The data were consistent with previous studies of double-blind tiotropium, suggesting that the open-label use of tiotropium did not introduce treatment bias. The effect of tiotropium on subjective measures (St George’s Respiratory Questionnaire; transition dyspnoea index varied slightly across blinded and non-blinded studies, indicating that minimal bias was introduced by using open-label tiotropium. Importantly, the studies used randomised, open-label tiotropium patients to treatment allocation, a method shown to minimise bias to a greater degree than blinding. In conclusion, it is important when reporting a clinical trial to be transparent about who was blinded and how the blinding was performed; if the design is open-label, additional efforts must be made to minimise risk of

  16. Cysteine-cystine redox cycling in a gold-gold dual-plate generator-collector microtrench sensor.

    Science.gov (United States)

    Hammond, Jules L; Gross, Andrew J; Estrela, Pedro; Iniesta, Jesus; Green, Stephen J; Winlove, C Peter; Winyard, Paul G; Benjamin, Nigel; Marken, Frank

    2014-07-15

    Thiols and disulfides are ubiquitous and important analytical targets. However, their redox properties, in particular on gold sensor electrodes, are complex and obscured by strong adsorption. Here, a gold-gold dual-plate microtrench dual-electrode sensor with feedback signal amplification is demonstrated to give well-defined (but kinetically limited) steady-state voltammetric current responses for the cysteine-cystine redox cycle in nondegassed aqueous buffer media at pH 7 down to micromolar concentration levels.

  17. Gold in the Books

    Institute of Scientific and Technical Information of China (English)

    江河

    2002-01-01

    In the present Chinese market, more and more businessmen turn to the profit-making trade. Even some counters in the bookstores are selling gold rings, necklaces, bracelets, etc. One day a school teacher asked a store assistant,“Why are you selling gold in your bookstore?”

  18. Antioxidant therapies for wound healing: a clinical guide to currently commercially available products.

    Science.gov (United States)

    Fitzmaurice, S D; Sivamani, R K; Isseroff, R R

    2011-01-01

    Many facets of wound healing under redox control require a delicate balance between oxidative stress and antioxidants. While the normal physiology of wound healing depends on low levels of reactive oxygen species and oxidative stress, an overexposure to oxidative stress leads to impaired wound healing. Antioxidants are postulated to help control wound oxidative stress and thereby accelerate wound healing. Many antioxidants are available over the counter or by prescription, but only one, Medihoney®, has been specifically FDA approved for wound healing. Here we review the existing evidence for the use of antioxidants for wound healing, with a review of the pertinent animal and clinical studies. Natural products and naturally derived antioxidants are becoming more popular, and we specifically review the evidence for the use of naturally derived antioxidants in wound healing. Antioxidant therapy for wound healing is promising, but only few animal studies and even fewer clinical studies are available. Because only few products have undergone FDA approval, the consumer is advised to scrutinize them for purity and contaminants prior to use, and this may require direct contact with the companies that sell them. As a field of science, the use of antioxidants for wound healing is in its infancy, and future studies will better elucidate the role of antioxidants in wound healing.

  19. Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev

    2014-09-01

    Full Text Available Giant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as “an aggressive, potentially malignant lesion”, the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3: 475-485

  20. Policies for patient access to clinical data via PHRs: current state and recommendations.

    Science.gov (United States)

    Collins, Sarah A; Vawdrey, David K; Kukafka, Rita; Kuperman, Gilad J

    2011-12-01

    Healthcare delivery organizations are increasingly using online personal health records (PHRs) to provide patients with direct access to their clinical information; however, there may be a lack of consistency in the data made available. We aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients. A cross-sectional survey was administered by telephone structured interview to 21 organizations to determine the types of data made available to patients through PHRs and the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR experts, and snowball sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded. Interviews were conducted with 17 organizations for a response rate of 81%. Half of the organizations had explicit governance in the form of a written policy that outlined the data types made available to patients. Overall, 88% of the organizations used a committee structure for the decision-making process and included senior management and information services. All organizations sought input from clinicians. Discussion There was considerable variability in the types of clinical data and the time frame for releasing these data to patients. Variability in data release policies may have implications for PHR use and adoption. Future policy activities, such as requirement specification for the latter stages of Meaningful Use, should be leveraged as an opportunity to encourage standardization of functionality and broad deployment of PHRs.

  1. Transcutaneous Ultrasound: Elastographic Lymph Node Evaluation. Current Clinical Applications and Literature Review.

    Science.gov (United States)

    Chiorean, Liliana; Barr, Richard G; Braden, Barbara; Jenssen, Christian; Cui, Xin-Wu; Hocke, Michael; Schuler, Andreas; Dietrich, Christoph F

    2016-01-01

    Distinguishing malignant versus benign lymphadenopathies is a major diagnostic dilemma in clinical medicine. Metastatic deposits in normal-sized lymph nodes (LNs) can be smaller than a millimeter, thus presenting a diagnostic challenge. In most clinical settings, however, enlarged LNs detected on imaging need to be classified as malignant or benign. Ultrasound seems to be a very reliable method for LN characterization because of the high resolution, especially in the subcutaneous areas. However, B-mode and Doppler-ultrasound criteria for characterization of a lymphadenopathy as benign or malignant are lacking specificity. Newer methods such as elastography seem to be valuable for identifying metastatic deposits within LNs and may help discriminate malignant and benign LNs. This review summarizes the different elastographic methods available and provides an overview of the relevant publications. According to the literature, elastography can be used for identifying metastatic deposits, to guide fine needle aspiration and to non-invasively choose the most suspicious LN of a group of enlarged LNs for targeted biopsy.

  2. Thalamic DBS with a constant-current device in essential tremor: A controlled clinical trial.

    Science.gov (United States)

    Wharen, Robert E; Okun, Michael S; Guthrie, Barton L; Uitti, Ryan J; Larson, Paul; Foote, Kelly; Walker, Harrison; Marshall, Frederick J; Schwalb, Jason; Ford, Blair; Jankovic, Joseph; Simpson, Richard; Dashtipour, Khashayar; Phibbs, Fenna; Neimat, Joseph S; Stewart, R Malcolm; Peichel, DeLea; Pahwa, Rajesh; Ostrem, Jill L

    2017-07-01

    This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications. The primary outcome measure was a rater-blinded assessment of the change in the target limb tremor score in the stimulation-on versus stimulation-off state six months following surgery. Multiple secondary outcomes were assessed at one-year follow-up, including motor, mood, and quality-of-life measures. 127 patients were implanted with VIM DBS. The blinded, primary outcome variable (n = 76) revealed a mean improvement of 1.25 ± 1.26 points in the target limb tremor rating scale (TRS) score in the arm contralateral to DBS (p < 0.001). Secondary outcome variables at one year revealed significant improvements (p ≤ 0.001) in quality of life, depression symptoms, and ADL scores. Forty-seven patients had a second contralateral VIM-DBS, and this group demonstrated reduction in second-sided tremor at 180 days (p < 0.001). Serious adverse events related to the surgery included infection (n = 3), intracranial hemorrhage (n = 3), and device explantation (n = 3). Unilateral and bilateral constant-current VIM DBS significantly improves upper extremity tremor, ADL, quality of life, and depression in patients with severe ET. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Clinical Pharmacology of Current and Future Drugs for the Acute Treatment of Migraine

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer

    2012-01-01

    Migraine is a common disorder with a female prevalence of 17% and a male prevalence of 9%. Migraine is most often disabling and the patients need treatment of the attacks. The introduction of triptans has been a revolution for many migraine patients but only a minority of patients use...... with no more adverse events than placebo, but only one quarter of migraine patients have been pain-free after 2 hours in phase III studies. The development of current CGRP antagonists has been stopped....

  4. Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

    Directory of Open Access Journals (Sweden)

    Donny L. F. Chang

    2013-01-01

    Full Text Available Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

  5. EFFECTIVENESS OF DIADYNAMIC CURRENT AND MENS IN HEEL PAIN: A RANDOMIZED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Anand B. Heggannavar

    2015-04-01

    Full Text Available Relevance: Heel pain is one of the most common conditions leading to functional disabilities seen worldwide. There are different methods to manage heel pain, conservatively, and/or surgically. Physiotherapy treatment, as a part of conservative management, involves reduction of pain and improvement of functional ability by various approaches like exercise therapy, electrotherapy and manual therapy techniques. Various studies have shown that Diadynamic current and MENS along with conventional treatments give significant beneficial effects in pain reliving. Hence the present study was undertaken to compare and see the effect of Diadynamic current and MENS in heel pain. Participants: 30 subjects (mean age 25.73 ± 6.56 diagnosed with heel pain were recruited from Out-Patient Department of Physiotherapy of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Method: Subjects were randomly allocated into 2 groups namely Group A (n=15 who received Diadynamic current along with conventional treatment as Therapeutic ultrasound and strengthening and stretching exercises and Group B (n=15 who received MENS with conventional treatment same as in group A for 7 days. The outcome measures were Visual Analog Scale (VAS for pain, Pain disability index (PDI and foot disability index (FDI for functional disability. Analysis: Within group and between group analyses after intervention was done to assess changes using paired t-test and unpaired t - test. Result: Mean difference of VAS scores for Group A was 6.9 ± 1.48 and for Group B was 4.3 ± 2.43. Mean difference of PDI scores for Group A was 274 ± 117 and for Group B was 171 ± 99.Mean difference of FDI scores for Group A was 0.36 ± 0.24 and for Group B was 0.15 ± 0.15. Intra group comparison was statistically significant with p= <0.001 for both the groups in terms of VAS, PDI and FDI respectively. Inter group comparison was statistically significant with p= 0.005, 0.031, 0.007 for VAS, PDI

  6. How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

    Directory of Open Access Journals (Sweden)

    Hyun-Woo Cho

    Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

  7. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    Science.gov (United States)

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  8. Non-alcoholic fatty liver disease in obese adults: clinical aspects and current management strategies.

    Science.gov (United States)

    Pallayova, M; Taheri, S

    2014-10-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder whose prevalence is strongly linked to the current epidemic of obesity in many western countries. The prevalence of NAFLD is two to four times higher in populations with pre-existing metabolic comorbidities than in the general population. The diagnosis of primary NAFLD involves establishing the presence of hepatic steatosis or steatohepatitis by imaging or histology, along with establishing the non-alcoholic nature of the disease process and excluding competing aetiologies for hepatic steatosis. Among the indirect serum biomarkers, the NAFLD fibrosis score can help to identify patients with NAFLD and with higher likelihood of having fibrosis or cirrhosis. A liver biopsy should be considered in NAFLD patients at increased risk for steatohepatitis/advanced fibrosis and in cases where a liver biopsy is necessary to exclude co-existing chronic liver diseases and other aetiologies for hepatic steatosis. The treatment and management recommendations for obesity-associated NAFLD are aimed towards weight reduction. The currently available interventions employed to promote weight loss and improve the metabolic responses in NAFLD include lifestyle modification, pharmacotherapy and bariatric surgery.

  9. Finite element model predicts current density distribution for clinical applications of tDCS and tACS

    Directory of Open Access Journals (Sweden)

    Toralf eNeuling

    2012-09-01

    Full Text Available Transcranial direct current stimulation (tDCS has been applied in numerous scientific studies over the past decade. However, the possibility to apply tDCS in therapy of neuropsychiatric disorders is still debated. While transcranial magnetic stimulation (TMS has been approved for treatment of major depression in the United States by the Food and Drug Administration (FDA, tDCS is not as widely accepted. One of the criticisms against tDCS is the lack of spatial specificity. Focality is limited by the electrode size (35 cm2 are commonly used and the bipolar arrangement. However, a current flow through the head directly from anode to cathode is an outdated view. Finite element (FE models have recently been used to predict the exact current flow during tDCS. These simulations have demonstrated that the current flow depends on tissue shape and conductivity. Toface the challenge to predict the location, magnitude and direction of the current flow induced by tDCS and transcranial alternating current stimulation (tACS, we used a refined realistic FE modeling approach. With respect to the literature on clinical tDCS and tACS, we analyzed two common setups for the location of the stimulation electrodes which target the frontal lobe and the occipital lobe, respectively. We compared lateral and medial electrode configuration with regard to theirusability. We were able to demonstrate that the lateral configurations yielded more focused stimulation areas as well as higher current intensities in the target areas. The high resolution of our simulation allows one to combine the modeled current flow with the knowledge of neuronal orientation to predict the consequences of tDCS and tACS. Our results not only offer a basis for a deeper understanding of the stimulation sites currently in use for clinical applications but also offer a better interpretation of observed effects.

  10. SGLT 2 Inhibitors: A New Therapeutic Target And Its Role In Current Clinical Practice

    Directory of Open Access Journals (Sweden)

    PV Shiji

    2015-10-01

    Full Text Available Diabetes, one of the major life style diseases, is associated with high morbidity and mortality owing to its microvascular and macrovascular complications. The chance of development of various complications can be effectively prevented by tight glycemic control. We have various groups of drugs like Biguanides, Sulfonyl ureas, Glitazones, Alpha-glucosidase inhibitors, Incretin based therapy, Insulin and Insulin analogues in the armamentarium to treat diabetes. But still, the number of patients attaining glycemic targets are relatively low and various adverse effect limit the use of some of these drugs, especially in special groups. Hence there is ongoing research to develop newer and newer drugs which provide sustained blood glucose reduction with minimal adverse effects. SGLT-2 inhibitors are a new group of drugs recently approved by FDA to treat Diabetes. In this review we discuss about mechanism of action, various adverse effects and the clinical role of various SGLT-2 Inhibitors.

  11. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems.

    Science.gov (United States)

    Vaquero, Juan José; Kinahan, Paul

    2015-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.

  12. [History, current state and future perspective of tuberculosis research and clinical medicine].

    Science.gov (United States)

    Ito, Yutaka; Mishima, Michiaki

    2011-08-01

    Since Robert Koch identified Mycobacterium tuberculosis as causative agent of tuberculosis (TB) in 1882, TB research has developed in various fields, such as bacteriology, immunology, genomic study and genetic susceptibility. These research results have led to the knowledge concerning cellular immunity and the development of biochemical and gene diagnostic approach for M. tuberculosis, interferon-gamma release assay for latent TB infection and epidemiologic study using variable numbers of tandem repeats. After Selman A. Waksman isolated streptomycin, various drugs came to be used. Standard of the TB treatments has been revised several times up to now. Discovery of the novel drugs potential for multidrug-resistant TB is challenged. Close relationships among basic research, clinical medicine and health service are crucial to improving global control of TB.

  13. Current and future initiatives for vascular health management in clinical practice

    Directory of Open Access Journals (Sweden)

    Cameron JD

    2013-05-01

    Full Text Available James D Cameron,1 Roland Asmar,2 Harry Struijker-Boudier,3 Kohji Shirai,4 Yuriy Sirenko,5 Yulia Kotovskaya,6 Jirar Topouchian71Monash Cardiovascular Research Centre, Clayton, Melbourne, Victoria, Australia; 2Roland Asmar, Foundation Medical Research Institutes, Paris, France; 3Department of Pharmacology, Maastricht University, Maastricht, The Netherlands; 4Department of Vascular Function, Sakura Hospital, Toho University, Tokyo, Japan; 5Institute of Cardiology, Kiev, Ukraine; 6ESH Hypertension Excellence Center of Peoples Friendship University of Russia, Moscow, Russia; 7Department of Diagnosis and Therapeutics, Hôtel-Dieu University Hospital, Paris, FranceAbstract: Central arterial structure and function comprise a primary determinant of vascular health, and are integral to the important concept of ventriculo-vascular coupling or interaction. Central aortic stiffening is a major influence on central blood pressure, and directly relates to coronary perfusion. The joint session of the International Society of Vascular Health (Eastern Region and the Ukrainian Congress of Cardiology was held in Kiev, Ukraine, on September 23, 2011; it provided an expert forum to discuss arterial evaluations, clinical applications, and progress toward translating arterial protection into cardiovascular benefits. The conclusions of the expert panel were:1. Aortic stiffness is not presently a treatment target but may be useful for substratifying cardiovascular risk in individuals in order to better target the intensity of conventional therapy, and it may be useful in assessing response to treatment.2. Crosstalk between macro- and microcirculation in hypertension has important implications for pharmacological treatment. An antihypertensive regimen should abolish the vicious cycle between the increased resistance in the microcirculation and the increased stiffness of the larger arteries. Such treatment should be based on drugs with multiple actions on the vascular tree

  14. Current and future directions in clinical fatigue management: An update for emergency medicine practitioners.

    Science.gov (United States)

    Cheng, Yi Han; Roach, Gregory D; Petrilli, Renee Ma

    2014-12-01

    Physicians worldwide are working round the clock to meet the demands of healthcare systems, especially in acute medical settings such as EDs. Demanding shift work schedules cause fatigue and thus deterioration in mood and motor performance. This article explores the effects of sleep deprivation, focusing on cognition, executive decision-making and the implications for clinical care. Humans are capable of functioning and even adapting to sleep restriction; however, clinicians should be aware of pitfalls and absolute minimums for sleep. Fatigue management training shows promise in enhancing safety in aviation and might have a role in medical shift work. Strategic napping improves performance during night shift in the ED, but does not fully negate fatigue. Drugs offer limited benefit for performance under sleep-deprived conditions, and whenever possible, sleep and/or strategic napping takes precedence.

  15. Radio-guided localization of clinically occult breast lesions: current modalities and future directions.

    Science.gov (United States)

    Aydogan, Fatih; Velidedeoglu, Mehmet; Kilic, Fahrettin; Yilmaz, Halit

    2014-01-01

    The extensive availability of breast cancer screening programs and improvement in diagnostic imaging have led to more frequent detection of suspicious and clinically occult breast lesions. Early detection of tumor is important for breast-conserving treatment. Incomplete excision is a major risk factor for local recurrence. Following precise localization and removing the entire lesion while achieving adequate clear margins is the key factor for successful management of non-palpable breast lesions. For this purpose, several techniques such as wire-guided localization, intra-operative ultrasound guided resection, radio-guided occult lesion localization and radioactive seed localization have been described and applied. In this article, we overview the two commonly used localization techniques, radio-guided occult lesion localization and wire-guided localization, particularly describing their advantages and drawbacks.

  16. Current aspects of the clinic, diagnosis and treatment of acquired myasthenia gravis (review. Part 1: diagnostics

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    S. N. Bardakov

    2016-01-01

    Full Text Available Acquired myasthenia gravis is an autoimmune disease, based on the imbalance of humoral and cellular immunity, characterized by weakness and fatigue of skeletal muscles, and in some cases involvement of the heart muscle. In most cases, the object of the autoimmune destruction is peripheral nicotinic acetylcholine receptors of the postsynaptic membrane of the neuromuscular synapse. In myasthenia gravis there has been identified a number of other antigenic targets: muscle-specific tyrosine kinase, lowdensity lipoprotein receptor-related protein 4, titin, and ryanodine receptors skeletal muscles. Their specificity and pathogenetic role have been disclosed, but it is about 15-20% of seronegative forms that require further immunological research. Accurate diagnosis depends on the efficient detection of clinical forms of myasthenia gravis and full analysis of the autoimmune mechanisms underlying the disease.

  17. Growth hormone and treatment outcomes: expert review of current clinical practice.

    Science.gov (United States)

    Cassorla, Fernando; Cianfarani, Stefano; Haverkamp, Fritz; Labarta, Jose I; Loche, Sandro; Luo, Xiaoping; Maghnie, Mohamad; Mericq, Veronica; Muzsnai, Agota; Norgren, Svante; Ojaniemi, Marja; Pribilincova, Zuzana; Quinteiro, Sofia; Savendahl, Lars; Spinola e Castro, Angela; Gasteyger, Christoph

    2011-12-01

    Although there are guidelines for treatment of short stature, open questions regarding optimal management of growth hormone therapy still exist. Experts attending six international meetings agree that successful therapy results in the patient attaining mid-parental height, and relies on correct diagnosis and early intervention. Experts advocate patient followup every 3-6 months, and that growth and adherence should be monitored at each visit. Growth response is variable, and an accepted definition of good/poor response is lacking. Combined with patient education and regular patient follow-up, a definition of treatment response could lead to improved treatment outcomes. Few experts use prediction models in clinical practice, but all agree that pharmacogenetics might improve prediction, enable early therapy modulation, and promote growth. Poor growth is often due to low adherence. Guidance on optimal management of growth hormone therapy is required, with focus on early diagnosis, dosing, treatment monitoring, adherence, and motivation.

  18. The placebo response in clinical trials-the current state of play.

    Science.gov (United States)

    Enck, Paul; Klosterhalfen, Sibylle

    2013-04-01

    While randomized, placebo-controlled double-blinded trials have become the pharmacological standard over the last 60 years, the gain in knowledge of the mechanisms behind the placebo response in recent years has raised substantial concerns about the appropriateness of some of its underlying assumptions. The following questions will be addressed: Is the assumed model of drug and placebo being additive (still) valid? Does the likelihood of receiving active treatment affect the placebo response? What is the size of the placebo response in "active comparator studies"? Minimizing the placebo response/maximizing the drug-placebo difference? How to maximize the placebo response in daily medicine? What is the placebo response with personalized medicines in the future? This and other questions require answers that can only be generated with more experimental studies on the placebo response and with thorough meta- and re-analyses of placebo responses in clinical trials.

  19. Scaling-up recombinant plasmid DNA for clinical trial: current concern, solution and status.

    Science.gov (United States)

    Ismail, Ruzila; Allaudin, Zeenathul Nazariah; Lila, Mohd-Azmi Mohd

    2012-09-07

    Gene therapy and vaccines are rapidly developing field in which recombinant nucleic acids are introduced in mammalian cells for enhancement, restoration, initiation or silencing biochemical function. Beside simplicity in manipulation and rapid manufacture process, plasmid DNA-based vaccines have inherent features that make them promising vaccine candidates in a variety of diseases. This present review focuses on the safety concern of the genetic elements of plasmid such as propagation and expression units as well as their host genome for the production of recombinant plasmid DNA. The highlighted issues will be beneficial in characterizing and manufacturing plasmid DNA for save clinical use. Manipulation of regulatory units of plasmid will have impact towards addressing the safety concerns raised in human vaccine applications. The gene revolution with plasmid DNA by alteration of their plasmid and production host genetics will be promising for safe delivery and obtaining efficient outcomes.

  20. 三种烤瓷桥临床修复六年的回顾分析%The 6-year clinical comparison of compound galvano-ceramic bridges with gold alloy and Ni-Cr alloy ceramic bridges

    Institute of Scientific and Technical Information of China (English)

    孙凤; 张相嗥; 刘峰; 周团锋; 孙萍

    2008-01-01

    目的 追踪观察金沉积基底冠熔结镍铬桥体烤瓷桥、金合金烤瓷桥和镍铬合金烤瓷桥的临床效果,为评价不同烤瓷桥临床修复的远期效果提供参考.方法 制作金沉积基底冠熔结镍铬桥体烤瓷桥(A组)35件,同期分别制作金合金烤瓷桥(B组)和镍铬合金烤瓷桥(c组)各35件,临床检查105件修复体的边缘密合性,随访复查修复体的基牙继发龋和修复体折裂、折断、脱落情况.结果 105件修复体平均随访6年.A组边缘密合性好(100%),明显好于B组(91%)与C组(77%)(P0.05).其余修复体均无桥架松动、折断以及修复体脱落.结论 金沉积基底冠熔结镍铬桥体烤瓷桥有良好的边缘密合度,强度可满足临床要求,有临床应用价值.但其与常规铸造合金烤瓷桥一样,需谨慎使用,提倡用于无髓基牙烤瓷桥修复.%Objective To evaluate and compare effects of compound galvano-ceramic bridges with Ni-Cr alloy ceramic bridges and gold alloy ceramic bridges in clinic.Methods A total of 105 bridges were made for 103 patients.Of them,35 were compound galvano-ceramic bridges,35 Ni-Cr alloy ceramic bridges,and 35 gold alloy ceramic bridges respectively.The marginal fitness and fracture of ceramic bridges were checked and caries or second caries of all abutments were also examined in clinic at 6 years after cementation.Results The marginal fitness of compound galvano-ceramic bridges was evaluated as good in 100% of the bridges,which was better than the fitness of gold alloy ceramic bridges(91%) and Ni-Cr alloy ceramic bridges(77%)(P0.05).None of compound galvano-ceramic bridge was found out caries or second caries of abutments.Two of 35(6%) gold alloy ceramic bridges was found out second caries of abutments and five of 35(14%) Ni-Cr alloy ceramic bridges were found out caries or second caries of abutments at 6 years.None of frameworks of all bridges was loose or broken.Conclusions The 6-year clinical study on compound galvano

  1. Clinical Potential of Regulatory T Cell Therapy in Liver Diseases: An Overview and Current Perspectives

    Science.gov (United States)

    Jeffery, Hannah C.; Braitch, Manjit Kaur; Brown, Solomon; Oo, Ye Htun

    2016-01-01

    The increasing demand for liver transplantation and the decline in donor organs has highlighted the need for alternative novel therapies to prevent chronic active hepatitis, which eventually leads to liver cirrhosis and liver cancer. Liver histology of chronic hepatitis is composed of both effector and regulatory lymphocytes. The human liver contains different subsets of effector lymphocytes that are kept in check by a subpopulation of T cells known as Regulatory T cells (Treg). The balance of effector and regulatory lymphocytes generally determines the outcome of hepatic inflammation: resolution, fulminant hepatitis, or chronic active hepatitis. Thus, maintaining and adjusting this balance is crucial in immunological manipulation of liver diseases. One of the options to restore this balance is to enrich Treg in the liver disease patients. Advances in the knowledge of Treg biology and development of clinical grade isolation reagents, cell sorting equipment, and good manufacturing practice facilities have paved the way to apply Treg cells as a potential therapy to restore peripheral self-tolerance in autoimmune liver diseases (AILD), chronic rejection, and posttransplantation. Past and on-going studies have applied Treg in type-1 diabetes mellitus, systemic lupus erythematosus, graft versus host diseases, and solid organ transplantations. There have not been any new therapies for the AILD for more than three decades; thus, the clinical potential for the application of autologous Treg cell therapy to treat autoimmune liver disease is an attractive and novel option. However, it is fundamental to understand the deep immunology, genetic profiles, biology, homing behavior, and microenvironment of Treg before applying the cells to the patients. PMID:27656181

  2. Clinical potential of regulatory T cell therapy in liver diseases: An overview and current perspectives

    Directory of Open Access Journals (Sweden)

    Hannah Claire Jeffery

    2016-09-01

    Full Text Available The increasing demand for liver transplantation and the decline in donor organs has highlighted the need for alternative novel therapies to prevent chronic active hepatitis, which eventually leads to liver cirrhosis and liver cancer. Liver histology of chronic hepatitis is composed of both effector and regulatory lymphocytes. The human liver contains different subsets of effector lymphocytes, that are kept in check by a subpopulation of T cells known as Regulatory T cells (Treg. The balance of effector and regulatory lymphocytes generally determines the outcome of hepatic inflammation: resolution, fulminant hepatitis or chronic active hepatitis. Thus, maintaining and adjusting this balance is crucial in immunological manipulation of liver diseases. One of the options to restore this balance is to enrich Treg in the liver disease patients.Advances in the knowledge of Treg biology and development of clinical grade isolation reagents, cell sorting equipment and Good Manufacturing Practice (GMP facilities have paved the way to apply Treg cells as a potential therapy to restore peripheral self-tolerance in autoimmune liver diseases, chronic rejection and post-transplantation. Past and on-going studies have applied Treg in type-1 diabetes mellitus, systemic lupus erythematosus, graft versus host diseases (GVHD and solid organ transplantations. There have not been any new therapies for the autoimmune liver diseases for more than three decades; thus the clinical potential for the application of autologous Treg cell therapy to treat autoimmune liver disease is an attractive and novel option. However, it is fundamental to understand the deep immunology, genetic profiles, biology, homing behavior and microenvironment of Treg before applying the cells to the patients.

  3. Current Antibiotic Resistance Trend in Clinical Isolates of Staphylococcus aureus from a Tertiary Care Hospital

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    Zahra Ravesh-Barakzai

    2015-10-01

    Full Text Available Background: Staphylococcus aureus (S. aureus has remained always an important pathogen of common infections acquired in community and as  well as serious nosocomial infections. With advent of penicillins and cephalosporins, infections could be effectively treated, but with the global emergence of Methicillin Resistant Staphylococcus aureus strains (MRSA physicians were  again left  with limited treatment options. This scenario of increasing resistance is even more intense and challenging for developing countries like Pakistan. Hence with this background the study was carried out to establish the frequency of MRSA in clinical specimens and look into the available antibiotic treatment options.Methods: Samples of  pus, blood, urine, body fluids and catheter tips submitted for culture  in  Microbiology department between  August  to  September  2012,  from outdoor and indoor adult patients of Pakistan Institute of Medical Sciences Islamabad, yielding growth of S. aureus were included in the study. After identification by  standard  methods, antibiotic susceptibility of  the  isolates  was performed by Kirby Baeur disc diffusion method. The study was retrospective descriptive and observational.Results: Total  106  S.  aureus  were  isolated. 45.3%  of  them  were  MRSA  and majorities were from pus samples of hospitalized patients. All MRSA were 100% sensitive to vancomycin, whereas 87.5% to chloramphenicol. To rest of the non – beta lactam drugs, resistance of 80% or more was noted.Conclusion: S. aureus is a common clinical isolate from patients in this region ofPakistan and significant number were MRSA especially from hospitalized patients. Treatment options are limited to vancomycin and chloramphenicol.

  4. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice

    Institute of Scientific and Technical Information of China (English)

    Stefania Angeloni; Cinzia Leboffe; Antonella Parente; Mario Venditti; Alessandra Giordano; Manuela Merli; Oliviero Riggio

    2008-01-01

    AIM:To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice.METHODS:All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study.SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was>250 cells/mm3,and empirically treated with cefotaxime.RESULTS:Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women;mean age:58.6±11.2 years).Prevalence of SBP,in our population,was 17%.Ascitic fluid culture was positive in nine (24%)cases only.Eleven episodes were nosocomial and 71%community-acquired.Treatment with cefotaxime was successful in 59% of cases,while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h.Change of antibiotic therapy led to the resolution of infection in 87% of episodes.Among the cases with positive culture,the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series.In these cases,the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime.CONCLUSIOM:In clinical practice,ascitic PMN count is a valid tool for starting a prompt antibiotic treatment and evaluating its efficacy.The initial treatment with cefotaxime failed more frequently than expected.An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding.A different first-line antibiotic treatment should be investigated.

  5. Multiple gold-dimer detection from large scattering background

    Science.gov (United States)

    Hong, Xin; Jin, Zheng

    2016-10-01

    Gold nanoparticles exhibit unique plasmonic optical properties in visible to near infrared band. Especially the coupling effect existing at the gap between a closely linked particle pair can make the local field strongly enhanced. These properties make gold particles more attractive to be employed as molecular probes in biomedical related fundamental and clinical researches. However in the bio-system exist many large molecules or groups, whose optical signals can strongly depress the gold particles without detectable. In this paper, we proposed a method to extract the targets which are labelled by gold dimer pairs from large scattering background.

  6. Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States

    Science.gov (United States)

    Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul

    2016-01-01

    In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%–40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%–100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics. PMID:27314832

  7. Targeting breast cancer through its microenvironment: current status of preclinical and clinical research in finding relevant targets.

    Science.gov (United States)

    Nienhuis, H H; Gaykema, S B M; Timmer-Bosscha, H; Jalving, M; Brouwers, A H; Lub-de Hooge, M N; van der Vegt, B; Overmoyer, B; de Vries, E G E; Schröder, C P

    2015-03-01

    It is increasingly evident that not only breast cancer cells, but also the tissue embedding these cells: the tumor microenvironment, plays an important role in tumor progression, metastasis formation and treatment sensitivity. This review focuses on the current knowledge of processes by which the microenvironment affects breast cancer, including formation of the metastatic niche, metabolic stimulation, stimulation of tumor cell migration, immune modulation, angiogenesis and matrix remodeling. The number of drugs targeting key factors in these processes is expanding, and the available clinical data is increasing. Therefore current strategies for intervention and prediction of treatment response are outlined. At present, targeting the formation of the metastatic niche and metabolic stimulation by the breast cancer microenvironment, are already showing clinical efficacy. Intervening in the stimulation of tumor cell migration and immune modulation by the microenvironment upcoming fields of great research interest. In contrast, targeting microenvironmental angiogenesis or matrix remodeling appears to be of limited clinical relevance in breast cancer treatment so far. Further research is warranted to optimize intervention strategies and develop predictive tests for the relevance of targeting involved factors within the microenvironment in order to optimally personalize breast cancer treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research.

    Science.gov (United States)

    Bornstein, Michael M; Horner, Keith; Jacobs, Reinhilde

    2017-02-01

    Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest.

  9. Photodynamic therapy (PDT) and photodiagnosis (PD) using endogenous photosensitization induced by 5-aminolevulinic acid (ALA): current clinical and development status

    Science.gov (United States)

    Marcus, Stuart L.; Sobel, Russel S.; Golub, Allyn L.; Carroll, Ronald L.; Lundahl, Scott L.; Shulman, D. Geoffrey

    1996-04-01

    Exogenous provision of ALA to many tissues results in the accumulation of sufficient quantities of the endogenous photosensitizer protoporphyrin IX, (PpIX), to produce a photodynamic effect. Therefore, ALA may be considered the only current PDT agent in clinical development which is a biochemical precursor of a photosensitizer. Topical ALA application, followed by exposure to activating light (ALA PDT), has been reported effective for the treatment of a variety of dermatologic diseases including cutaneous T-cell lymphoma, superficial basal cell carcinoma, Bowen's disease, and actinic (solar) keratoses, and is also being examined for treatment of acne and hirsutism. PpIX induced by ALA application also may serve as a fluorescence detection marker for photodiagnosis (PD) of malignant and pre- malignant conditions of the urinary bladder and other organs. Local internal application of ALA has also been used for selective endometrial ablation in animal model systems and is beginning to be examined in human clinical studies. Systemic, oral administration of ALA has been used for ALA PDT of superficial head and neck cancer, various gastrointestinal cancers, and the condition known as Barrett's esophagus. This brief paper reviews the current clinical and development status of ALA PDT.

  10. PRESCRIBING OF ANTIHYPERTENSIVE AGENTS IN PUBLIC PRIMARY CARE CLINICS – IS IT IN ACCORDANCE WITH CURRENT EVIDENCE?

    Directory of Open Access Journals (Sweden)

    SAJARI J

    2010-01-01

    Full Text Available Background: Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines. Methods: A cross-sectional survey to describe the prescribing pattern of antihypertensive agents was carried out in 2 publicprimary care clinics in Selangor from May to June 2009. Hypertensive patients on pharmacological treatment for ≥1 year who attended the clinics within the study period of 7 weeks were selected. Appropriate use of antihypertensive agents was defined based on current evidence and the recommendations by the Malaysian Clinical Practice Guidelines (CPG on the Management of Hypertension, 2008. Data were obtained from patients’ medical records and were analysed using the SPSS software version 16.0. Results: A total of 400 hypertensive patients on treatment were included. Mean age was 59.5 years (SD ±10.9, range 28 to91 years, of which 52.8% were females and 47.2% were males. With regards to pharmacotherapy, 45.7% were on monotherapy,43.3% were on 2 agents and 11.0% were on ≥3 agents. Target blood pressure of <140/90mmHg was achieved in 51.4% of patients on monotherapy, and 33.2% of patients on combination of ≥2 agents. The commonest monotherapy agents being prescribed were β-blockers (atenolol or propranolol, followed by the short-acting calcium channel blocker (nifedipine. The commonest combination of 2-drug therapy prescribed was β-blockers and short-acting calcium channel blocker. Conclusion: This study shows that the prescribing pattern of antihypertensive agents in the 2 primary care clinics was not in accordance with current evidence and guidelines.

  11. Late sodium current block for drug-induced long QT syndrome: Results from a prospective clinical trial.

    Science.gov (United States)

    Johannesen, L; Vicente, J; Mason, J W; Erato, C; Sanabria, C; Waite-Labott, K; Hong, M; Lin, J; Guo, P; Mutlib, A; Wang, J; Crumb, W J; Blinova, K; Chan, D; Stohlman, J; Florian, J; Ugander, M; Stockbridge, N; Strauss, D G

    2016-02-01

    Drug-induced long QT syndrome has resulted in many drugs being withdrawn from the market. At the same time, the current regulatory paradigm for screening new drugs causing long QT syndrome is preventing drugs from reaching the market, sometimes inappropriately. In this study, we report the results of a first-of-a-kind clinical trial studying late sodium (mexiletine and lidocaine) and calcium (diltiazem) current blocking drugs to counteract the effects of hERG potassium channel blocking drugs (dofetilide and moxifloxacin). We demonstrate that both mexiletine and lidocaine substantially reduce heart-rate corrected QT (QTc) prolongation from dofetilide by 20 ms. Furthermore, all QTc shortening occurs in the heart-rate corrected J-Tpeak (J-Tpeak c) interval, the biomarker we identified as a sign of late sodium current block. This clinical trial demonstrates that late sodium blocking drugs can substantially reduce QTc prolongation from hERG potassium channel block and assessment of J-Tpeak c may add value beyond only assessing QTc.

  12. Galvanic gold plating for fixed dental prosthesis.

    Science.gov (United States)

    Ozcelik, Tuncer Burak; Yilmaz, Burak

    2013-07-01

    Metal ceramic partial fixed dental prostheses have been commonly used for the replacement of missing teeth for many years. Because of an increase in the price of gold, base metal alloys have been the choice of alloy for the fabrication of metal ceramic restorations in many dental clinics. Some major disadvantages of base metals are their corrosion and the dark coloration they may cause at the crown margins. This article describes a galvanic gold-plating technique, which is used to minimize corrosion and improve the esthetics of metal ceramic restorations fabricated with Cr-Co base metal alloys. This technique involves the deposition of a 6 μm to 8 μm 24 K gold layer directly onto the Cr-Co cast prosthesis framework. The technique improves metal surface properties, making them more biocompatible and usable, however, requires additional equipment and experienced laboratory technicians. Clinical studies should be performed to corroborate the long term success of this technique.

  13. Phase transitions and kinetic properties of gold nanoparticles confined between two-layer graphene nanosheets

    Science.gov (United States)

    Wang, Gang; Wu, Nanhua; Chen, Jionghua; Wang, Jinjian; Shao, Jingling; Zhu, Xiaolei; Lu, Xiaohua; Guo, Lucun

    2016-11-01

    The thermodynamic and kinetic behaviors of gold nanoparticles confined between two-layer graphene nanosheets (two-layer-GNSs) are examined and investigated during heating and cooling processes via molecular dynamics (MD) simulation technique. An EAM potential is applied to represent the gold-gold interactions while a Lennard-Jones (L-J) potential is used to describe the gold-GNS interactions. The MD melting temperature of 1345 K for bulk gold is close to the experimental value (1337 K), confirming that the EAM potential used to describe gold-gold interactions is reliable. On the other hand, the melting temperatures of gold clusters supported on graphite bilayer are corrected to the corresponding experimental values by adjusting the εAu-C value. Therefore, the subsequent results from current work are reliable. The gold nanoparticles confined within two-layer GNSs exhibit face center cubic structures, which is similar to those of free gold clusters and bulk gold. The melting points, heats of fusion, and heat capacities of the confined gold nanoparticles are predicted based on the plots of total energies against temperature. The density distribution perpendicular to GNS suggests that the freezing of confined gold nanoparticles starts from outermost layers. The confined gold clusters exhibit layering phenomenon even in liquid state. The transition of order-disorder in each layer is an essential characteristic in structure for the freezing phase transition of the confined gold clusters. Additionally, some vital kinetic data are obtained in terms of classical nucleation theory.

  14. Clinical utility of apixaban in the prevention and treatment of venous thromboembolism: current evidence

    Directory of Open Access Journals (Sweden)

    Zalpour A

    2014-11-01

    Full Text Available Ali Zalpour,1 Thein Hlaing Oo21Division of Pharmacy – Clinical Programs, 2Section of Thrombosis and Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAAbstract: Anticoagulation with heparin and vitamin K antagonist has been the mainstay of prevention and treatment of venous thromboembolism (VTE for many years. In recent years, novel oral anticoagulants such as dabigatran etexilate (a direct thrombin inhibitor and rivaroxaban, apixaban, and edoxaban (a direct factor Xa inhibitor have emerged for the prevention and treatment of VTE. Novel oral anticoagulants have been shown to be noninferior to vitamin K antagonist or heparin in the prevention and treatment of VTE. This review specifically examines the role of apixaban in the prevention and treatment of VTE based on the available literature. The management of apixaban in the perioperative setting is also explored because some patients on apixaban may require surgical intervention. Finally, we discuss the management of apixaban-induced major bleeding complications, the relevance of drug–drug interactions, and patient education.Keywords: new oral anticoagulants, apixaban, venous thromboembolism, thromboprophylaxis

  15. Amyotrophic lateral sclerosis: from current developments in the laboratory to clinical implications.

    Science.gov (United States)

    Cozzolino, Mauro; Ferri, Alberto; Carrì, Maria Teresa

    2008-03-01

    Amyotrophic lateral sclerosis (ALS) is a late-onset progressive degeneration of motor neurons occurring both as a sporadic and a familial disease. The etiology of ALS remains unknown, but one fifth of instances are due to specific gene defects, the best characterized of which is point mutations in the gene coding for Cu/Zn superoxide dismutase (SOD1). Because sporadic and familial ALS affect the same neurons with similar pathology, it is hoped that understanding these gene defects will help in devising therapies effective in both forms. A wealth of evidence has been collected in rodents made transgenic for mutant SOD1, which represent the best available models for familial ALS. Mutant SOD1 likely induces selective vulnerability of motor neurons through a combination of several mechanisms, including protein misfolding, mitochondrial dysfunction, oxidative damage, cytoskeletal abnormalities and defective axonal transport, excitotoxicity, inadequate growth factor signaling, and inflammation. Damage within motor neurons is enhanced by noxious signals originating from nonneuronal neighboring cells, where mutant SOD1 induces an inflammatory response that accelerates disease progression. The clinical implication of these findings is that promising therapeutic approaches can be derived from multidrug treatments aimed at the simultaneous interception of damage in both motor neurons and nonmotor neuronal cells.

  16. Reporting unit size and measurement uncertainty: current Australian practice in clinical chemistry and haematology.

    Science.gov (United States)

    Hawkins, Robert C; Badrick, Tony

    2015-08-01

    In this study we aimed to compare the reporting unit size used by Australian laboratories for routine chemistry and haematology tests to the unit size used by learned authorities and in standard laboratory textbooks and to the justified unit size based on measurement uncertainty (MU) estimates from quality assurance program data. MU was determined from Royal College of Pathologists of Australasia (RCPA) - Australasian Association of Clinical Biochemists (AACB) and RCPA Haematology Quality Assurance Program survey reports. The reporting unit size implicitly suggested in authoritative textbooks, the RCPA Manual, and the General Serum Chemistry program itself was noted. We also used published data on Australian laboratory practices.The best performing laboratories could justify their chemistry unit size for 55% of analytes while comparable figures for the 50% and 90% laboratories were 14% and 8%, respectively. Reporting unit size was justifiable for all laboratories for red cell count, >50% for haemoglobin but only the top 10% for haematocrit. Few, if any, could justify their mean cell volume (MCV) and mean cell haemoglobin concentration (MCHC) reporting unit sizes.The reporting unit size used by many laboratories is not justified by present analytical performance. Using MU estimates to determine the reporting interval for quantitative laboratory results ensures reporting practices match local analytical performance and recognises the inherent error of the measurement process.

  17. Surgical templates for dental implant positioning; current knowledge and clinical perspectives

    Directory of Open Access Journals (Sweden)

    Mohammed Zaheer Kola

    2015-01-01

    Full Text Available Dental implants have been used in a variety of different forms for many years. Since the mid-20 th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

  18. [Regeneration of endocrine gastroenteropancreatic system in experimental and clinical pathology: concept development and current problems].

    Science.gov (United States)

    Ivanova, V F

    2013-01-01

    Literature review contains the literature data and the results of author's own investigations describing the coming into being and the development of the concepts on the regeneration of endocrine gastroenteropancreatic (GEP) system under the conditions of norm, experimental and clinical pathology. Data analysis permitted to reveal the similarities and differences in the course of this process in various organs of the digestive system. Endocrine GEP system renewal occurs at different levels of its organization. At the tissue level, the endocrine cells renewal occurs via the transformation of exocrine cells into the endocrine ones and as a result of differentiation from stem cells via the "agranular" cell stage which are precursors of the endocrine cells. This pathway of regeneration is the major one after the damage. Regeneration at cellular level occurs through mitotic division of the differentiated endocrine cells (early stage of regeneration) and as a result of the formation granules with different hormonal profile in D-cells. At the intracellular level, the regeneration is realized through the intracellular structure restoration after their damage induced by the increase of cell functional activity accompanied by degranulation and dystrophic changes development

  19. Translating ocular biomechanics into clinical practice: current state and future prospects.

    Science.gov (United States)

    Girard, Michaël J A; Dupps, William J; Baskaran, Mani; Scarcelli, Giuliano; Yun, Seok H; Quigley, Harry A; Sigal, Ian A; Strouthidis, Nicholas G

    2015-01-01

    Biomechanics is the study of the relationship between forces and function in living organisms and is thought to play a critical role in a significant number of ophthalmic disorders. This is not surprising, as the eye is a pressure vessel that requires a delicate balance of forces to maintain its homeostasis. Over the past few decades, basic science research in ophthalmology mostly confirmed that ocular biomechanics could explain in part the mechanisms involved in almost all major ophthalmic disorders such as optic nerve head neuropathies, angle closure, ametropia, presbyopia, cataract, corneal pathologies, retinal detachment and macular degeneration. Translational biomechanics in ophthalmology, however, is still in its infancy. It is believed that its use could make significant advances in diagnosis and treatment. Several translational biomechanics strategies are already emerging, such as corneal stiffening for the treatment of keratoconus, and more are likely to follow. This review aims to cultivate the idea that biomechanics plays a major role in ophthalmology and that the clinical translation, lead by collaborative teams of clinicians and biomedical engineers, will benefit our patients. Specifically, recent advances and future prospects in corneal, iris, trabecular meshwork, crystalline lens, scleral and lamina cribrosa biomechanics are discussed.

  20. Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice.

    Science.gov (United States)

    Venkatachalam, Sridhar; Wu, Geru; Ahmad, Masood

    2017-08-22

    The right ventricle has unique structural and functional characteristics. It is now well recognized that the so-called forgotten ventricle is a key player in cardiovascular physiology. Furthermore, there is accumulating evidence that demonstrates right ventricular dysfunction as an important marker of morbidity and mortality in several commonly encountered clinical situations such as heart failure, pulmonary hypertension, pulmonary embolism, right ventricular myocardial infarction, and adult congenital heart disease. In contrast to the left ventricle, echocardiographic assessment of right ventricular function is more challenging as volume estimations are not possible without the use of three-dimensional (3D) echocardiography. Guidelines on chamber quantification provide a standardized approach to assessment of the right ventricle. The technique and limitations of each of the parameters for RV size and function need to be fully understood. In this era of multimodality imaging, echocardiography continues to remain a useful tool for the initial assessment and follow-up of patients with right heart pathology. Several novel approaches such as 3D and strain imaging of the right ventricle have expanded the usefulness of this indispensable modality. © 2017, Wiley Periodicals, Inc.

  1. Mucopolysaccharidosis type IVA (Morquio A disease): clinical review and current treatment.

    Science.gov (United States)

    Tomatsu, S; Montaño, A M; Oikawa, H; Smith, M; Barrera, L; Chinen, Y; Thacker, M M; Mackenzie, W G; Suzuki, Y; Orii, T

    2011-06-01

    Mucopolysaccharidosis IVA (MPS IVA), also known as Morquio A, is a rare, autosomal recessive disorder caused by a deficiency of the lysosomal enzyme N-acetylgalatosamine-6-sulfate-sulfatase (GALNS), which catalyzes a step in the catabolism of glycosaminoglycans (GAGs), keratan sulfate (KS) and chondroitin-6-sulfate (C6S). It leads to accumulation of the KS and C6S, mainly in bone and cornea, causing a systemic skeletal chondrodysplasia. MPS IVA has a variable age of onset and variable rate of progression. Common presenting features include elevation of urinary and blood KS, marked short stature, hypoplasia of the odontoid process, pectus carinatum, kyphoscoliosis, genu valgum, laxity of joints and corneal clouding; however there is no central nervous system impairment. Generally, MPS IVA patients with a severe form do not survive beyond the third decade of life whereas those patients with an attenuated form may survive over 70 years. There has been no effective therapy for MPS IVA, and care has been palliative. Enzyme replacement therapy (ERT) and hematopoietic stem cell therapy (HSCT) have emerged as a treatment for mucopolysaccharidoses disorders, including Morquio A disease. This review provides an overview of the clinical manifestations, diagnosis and symptomatic management of patients with MPS IVA and describes potential perspectives of ERT and HSCT. The issue of treating very young patients is also discussed.

  2. Current evaluation of the clinical utility of Fluoromethylcholine-(18F PET/CT in Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Jean-Nöel Talbot

    2008-12-01

    Full Text Available This short review is dedicated to the current status of the assessment of a new PET radiopharmaceutical, fluoromethylcholine-(18F or FCH, which is taken-up by prostate cancer tissue, in contrary to fluorodeoxyglucose-(18F or FDG. It seems that FCH could become "the FDG of prostate cancer", with the same type of achievements (detection of distant metastases and of occult recurrences, restaging prior to invasive treatments, and the same drawbacks (false negative results in case of small lesions, in particular lymph nodes metastases, and false positive results in case of infection/inflammation, in particular prostatitis. Current evidence is summarised and discussed for each of the potential settings of FCH PET/CT imaging in prostate cancer. The perspectives for granting a marketing authorisation to a FCH preparation are briefly analysed.Esta breve revisão é dedicada ao estado atual da avaliação de um novo radiofármaco PET, a fluormetilcolina-(18F ou FCH, que é captada pelo tecido do câncer de próstata, ao contrário da fluordesoxiglicose-(18F ou FDG. Parece que a FCH poderia se tornar "a FDG do câncer de próstata", com o mesmo tipo de funções (detecção de metástases distantes e de recorrências ocultas, antes de tratamentos invasivos, e os mesmos inconvenientes (falso resultado negativo no caso de pequenas lesões, em especial das metástase de nodos linfáticos, e de falsos resultados positivos em caso de infecção/inflamação, em particular prostatite. Evidência atual é resumida e discutida para cada uma das definições potenciais da imagem FCH PET/CT em câncer de próstata. As perspectivas para a concessão de uma autorização de comercialização para uma preparação de FCH são analisadas brevemente.

  3. Clinical Uses of Botulinum Neurotoxins: Current Indications, Limitations and Future Developments

    Directory of Open Access Journals (Sweden)

    Sheng Chen

    2012-10-01

    Full Text Available Botulinum neurotoxins (BoNTs cause flaccid paralysis by interfering with vesicle fusion and neurotransmitter release in the neuronal cells. BoNTs are the most widely used therapeutic proteins. BoNT/A was approved by the U.S. FDA to treat strabismus, blepharospam, and hemificial spasm as early as 1989 and then for treatment of cervical dystonia, glabellar facial lines, axillary hyperhidrosis, chronic migraine and for cosmetic use. Due to its high efficacy, longevity of action and satisfactory safety profile, it has been used empirically in a variety of ophthalmological, gastrointestinal, urological, orthopedic, dermatological, secretory, and painful disorders. Currently available BoNT therapies are limited to neuronal indications with the requirement of periodic injections resulting in immune-resistance for some indications. Recent understanding of the structure-function relationship of BoNTs prompted the engineering of novel BoNTs to extend therapeutic interventions in non-neuronal systems and to overcome the immune-resistance issue. Much research still needs to be done to improve and extend the medical uses of BoNTs.

  4. [Current status of clinical and molecular-biological research on familial periodic paralysis].

    Science.gov (United States)

    Shishiba, Y

    1997-12-01

    Types of periodic paralysis seen in Japan are numerous: the one most frequently seen is hypokalemic periodic paralysis. Among them, approximately 50% are secondary to thyrotoxicosis. Number of families of familial hyperkalemic periodic paralysis have also been reported so far. Several cases of hyperkalemic periodic paralysis secondary to thyrotoxicosis have also been reported exclusively from Japan. As the pathogenesis of hypokalemic periodic paralysis, depolarization block induced by membrane permeability change in the face of hypokalemia triggered by excess insulin was strongly suggested and supported experimentally in part. Recent linkage analysis on familial hypokalemic periodic paralysis revealed that the abnormality is linked to a mutation in voltage-gated Ca channel. The difficulty remains how to explain the cause of hypokalemia which is almost always preceding the attack of periodic paralysis of this type. The cause of hyperkalemic periodic paralysis was shown to be the mutation in voltage-gated Na channel. Failure of inactivation of the channel causes an increase in inward sodium current which results in depolarization and accumulation of potassium. The explanation of the pathogenesis of paralysis is straight-forward when compared to that of hypokalemic periodic paralysis.

  5. Clinical roundtable monograph. Current treatment options for metastatic breast cancer: what now?

    Science.gov (United States)

    Rugo, Hope S; O'Shaughnessy, Joyce A; Perez, Edith A

    2011-11-01

    Approximately 30% of patients with breast cancer will develop metastatic breast disease. Metastatic breast cancer is considered an incurable disease, with complete remission rarely achieved after treatment. The goal of treatment for metastatic breast cancer patients is to increase overall survival time and delay disease progression while ameliorating symptoms and improving or maintaining quality of life. Single-agent therapeutic regimens are appropriate for most metastatic breast cancer patients. Patients with the luminal A subtype of breast cancer, which is more indolent in nature and tends to be more sensitive to treatment in general, often respond well to single-agent therapy. Several chemotherapy regimens are recommended for the treatment of metastatic breast cancer. Compared with single-agent regimens, these combination regimens often produce a greater improvement in the rate of objective response as well as a prolongation of progression-free survival. There is little evidence, however, of improvement in overall survival. Combination chemotherapy regimens are often associated with a greater degree of toxicity depending on schedules and doses used. The use of bevacizumab in metastatic breast cancer is currently a topic of controversy. It is hoped that forthcoming trial data will enable the identification of a group of patients, based on tumor biology, who could benefit from bevacizumab-based therapy.

  6. Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence.

    Science.gov (United States)

    Anaszewicz, Marzena; Budzyński, Jacek

    2017-05-01

    Obesity is a well-known atherosclerosis risk factor; however, its role and the importance of undernutrition in atrial fibrillation (AF) pathogenesis are still not well understood. The aim of this study was to present the current state of knowledge on this issue in different groups of patients. Systematic review of papers published between 1980 and 2016. The literature shows contradicting views regarding the impact of nutritional status on the risk, course, and complications of AF. On the one hand, it has been revealed that overweight, obesity, and high birth mass increase the risk of AF, and that their reduction is linked to an improved course of AF and reduced all-cause and cardiovascular mortality. On the other hand, a so-called obesity paradox has been found, which shows lower all-cause mortality in overweight patients with AF compared to those of normal weight or who are underweight. It has also been shown, although based on a small number of studies, that the relationship between nutritional status and risk of AF and its complication may be U-shaped, which means that not only patients with obesity, but also individuals with underweight, cachexia, and low birth weight may have an increased risk and poor outcome of AF. The relationship between patients' nutritional status and the course of AF has become clearer but it requires further studies examining the importance of weight reduction on AF course. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  7. Managing Lymphoma with Non-FDG Radiotracers: Current Clinical and Preclinical Applications

    Directory of Open Access Journals (Sweden)

    Fan-Lin Kong

    2013-01-01

    Full Text Available Nuclear medicine imaging modalities such as positron emission tomography (PET and single-photon emission computed tomography (SPECT have played a prominent role in lymphoma management. PET with [18F]Fluoro-2-deoxy-D-glucose (FDG is the most commonly used tool for lymphoma imaging. However, FDG-PET has several limitations that give the false positive or false negative diagnosis of lymphoma. Therefore, development of new radiotracers with higher sensitivity, specificity, and different uptake mechanism is in great demand in the management of lymphoma. This paper reviews non-FDG radiopharmaceuticals that have been applied for PET and SPECT imaging in patients with different types of lymphoma, with attention to diagnosis, staging, therapy response assessment, and surveillance for disease relapse. In addition, we introduce three radiolabeled anti-CD20 antibodies for radioimmunotherapy, which is another important arm for lymphoma treatment and management. Finally, the relatively promising radiotracers that are currently under preclinical development are also discussed in this paper.

  8. Current experimental perspectives on the clinical progression of alcoholic liver disease.

    Science.gov (United States)

    Breitkopf, Katja; Nagy, Laura E; Beier, Juliane I; Mueller, Sebastian; Weng, Honglei; Dooley, Steven

    2009-10-01

    Chronic alcohol abuse is an important cause of morbidity and mortality throughout the world. Liver damage due to chronic alcohol intoxication initially leads to accumulation of lipids within the liver and with ongoing exposure this condition of steatosis may first progress to an inflammatory stage which leads the way for fibrogenesis and finally cirrhosis of the liver. While the earlier stages of the disease are considered reversible, cirrhotic destruction of the liver architecture beyond certain limits causes irreversible damage of the organ and often represents the basis for cancer development. This review will summarize current knowledge about the molecular mechanisms underlying the different stages of alcoholic liver disease (ALD). Recent observations have led to the identification of new molecular mechanisms and mediators of ALD. For example, plasminogen activator inhibitor 1 was shown to play a central role for steatosis, the anti-inflammatory adipokine, adiponectin profoundly regulates liver macrophage function and excessive hepatic deposition of iron is caused by chronic ethanol intoxication and increases the risk of hepatocellular carcinoma development.

  9. Lymph node-positive prostate cancer: current issues, emerging technology and impact on clinical outcome.

    Science.gov (United States)

    Adams, Julia; Cheng, Liang

    2011-09-01

    Lymph node metastasis in patients with prostate cancer indicates a poorer prognosis compared with patients without lymph node metastasis; however, some patients with node-positive disease have long-term survival. Many studies have attempted to discern what characteristics of lymph node metastasis are prognostically significant. These characteristics include nodal tumor volume, number of positive lymph nodes, lymph node density, extranodal extension, lymphovascular invasion and tumor dedifferentiation. Favorable characteristics of regional lymph node involvement included a smaller tumor size and smaller tumor volume. However, the current staging system for prostate cancer does not provide different subclassifications for patients with node-positive prostate cancer. In recent years numerous advanced technologies for the detection of lymph node metastasis have been developed, including molecular imaging techniques and the CellSearch Circulating Tumor Cell System. With the increased detection of patients with prostate cancer, emergence of new technology to identify lymph node metastasis and the number of radical prostatectomies being performed on the rise, subclassifying patients with lymph node-positive disease is imperative. Subclassification would provide a better picture of patient prognosis and allow for a better understanding of targeted therapies to treat patients with lymph node metastasis.

  10. Percutaneous patent foramen ovale occlusion: current evidence and evolving clinical practice.

    Science.gov (United States)

    Leong, Ming Chern; Uebing, Anselm; Gatzoulis, Michael A

    2013-11-15

    Patent foramen ovale (PFO) has long been implicated with cryptogenic stroke, migraine and decompression illness. PFO is common and its implicated pathologies cause devastating neurological sequelae; and hence have drawn the attention of medical practitioners across disciplines. The pathogenesis is hypothesized to be caused by micro-emboli or neuro-hormones which would otherwise being filtered by the lungs, astraying into the systemic circulation via the atrial communication especially during Valsalva maneuver. Treatment options have been proposed; among others are medical therapy, PFO closure or both. While medical therapy as secondary prevention is being adopted by most centers in the world, PFO closure is performed in selected patients only. The reason being is that most studies linking PFO to these pathologies are observational in nature. And these associations do not equate to a firm cause and effect relationship. For causal relationship to be established, good quality prospective data is required. Recently, there has been emergence of new prospective trials which improve the understanding of PFO closure in these pathologies. This article reviews the associations between PFO and the three main implicated pathologies as well as the evidence for PFO closure in the current era.

  11. Remotely-Supervised Transcranial Direct Current Stimulation (tDCS for Clinical Trials: Guidelines for Technology and Protocols

    Directory of Open Access Journals (Sweden)

    Leigh E Charvet

    2015-03-01

    Full Text Available The effect of transcranial direct current stimulation (tDCS is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: 1 training of staff in tDCS treatment and supervision, 2 assessment of the user’s capability to participate in tDCS remotely, 3 ongoing training procedures and materials including assessments of the user and/or caregiver, 4 simple and fail-safe electrode preparation techniques and tDCS headgear, 5 strict dose control for each session, 6 ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol, with corresponding corrective steps as required, 7 monitoring for treatment-emergent adverse effects, 8 guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population’s level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

  12. 16 CFR Appendix to Part 23 - Exemptions Recognized in the Assay for Quality of Gold Alloy, Gold Filled, Gold Overlay, Rolled...

    Science.gov (United States)

    2010-01-01

    ... Quality of Gold Alloy, Gold Filled, Gold Overlay, Rolled Gold Plate, Silver, and Platinum Industry...—Exemptions Recognized in the Assay for Quality of Gold Alloy, Gold Filled, Gold Overlay, Rolled Gold Plate... be considered in any assay for quality of a gold filled, gold overlay and rolled gold plate industry...

  13. Barefoot running: an evaluation of current hypothesis, future research and clinical applications.

    Science.gov (United States)

    Tam, Nicholas; Astephen Wilson, Janie L; Noakes, Timothy D; Tucker, Ross

    2014-03-01

    Barefoot running has become a popular research topic, driven by the increasing prescription of barefoot running as a means of reducing injury risk. Proponents of barefoot running cite evolutionary theories that long-distance running ability was crucial for human survival, and proof of the benefits of natural running. Subsequently, runners have been advised to run barefoot as a treatment mode for injuries, strength and conditioning. The body of literature examining the mechanical, structural, clinical and performance implications of barefoot running is still in its infancy. Recent research has found significant differences associated with barefoot running relative to shod running, and these differences have been associated with factors that are thought to contribute to injury and performance. Crucially, long-term prospective studies have yet to be conducted and the link between barefoot running and injury or performance remains tenuous and speculative. The injury prevention potential of barefoot running is further complicated by the complexity of injury aetiology, with no single factor having been identified as causative for the most common running injuries. The aim of the present review was to critically evaluate the theory and evidence for barefoot running, drawing on both collected evidence as well as literature that have been used to argue in favour of barefoot running. We describe the factors driving the prescription of barefoot running, examine which of these factors may have merit, what the collected evidence suggests about the suitability of barefoot running for its purported uses and describe the necessary future research to confirm or refute the barefoot running hypotheses.

  14. Antidepressant monotherapy and combination of antidepressants in the treatment of resistant depression in current clinical practice: A retrospective study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Höschl, Cyril

    2010-11-01

    Abstract Objectives. The aim of this study was to compare efficacy of antidepressant monotherapies and combinations of antidepressants in the treatment of resistant patients in current clinical practice. Methods. We reviewed chart documents of resistant depressive inpatients treated at least 4 weeks with a new treatment. Depressive symptoms and clinical status were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form and Clinical Global Impression at the baseline, week 2 and in the end of treatment. Results. We identified 81 patients (27 with combinations and 51 with monotherapies) that were suitable for analyses. The combination group achieved higher reduction of MADRS score (14.6 vs 10.2 pts., p=0.02) and response rate (≥ 50% reduction of MADRS, 67% vs 39%, p=0.03). Number needed to treat for response was 4. Conclusions. Based on our results, we suggest that combination of antidepressants might be more effective than monotherapy in clinical practice.

  15. Amide proton transfer imaging in clinics: Basic concepts and current and future use in brain tumors and stoke

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Jahng, Geon Ho [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Jeong, Ha Kyu [Philips Korea, Seoul (Korea, Republic of)

    2016-12-15

    Amide proton transfer (APT) imaging is gaining attention as a relatively new in vivo molecular imaging technique that has higher sensitivity and spatial resolution than magnetic resonance spectroscopy imaging. APT imaging is a subset of the chemical exchange saturation transfer mechanism, which can offer unique image contrast by selectively saturating protons in target molecules that get exchanged with protons in bulk water. In this review, we describe the basic concepts of APT imaging, particularly with regard to the benefit in clinics from the current literature. Clinical applications of APT imaging are described from two perspectives: in the diagnosis and monitoring of the treatment response in brain glioma by reflecting endogenous mobile proteins and peptides, and in the potential for stroke imaging with respect to tissue acidity.

  16. Subchronic inhalation toxicity of gold nanoparticles

    Directory of Open Access Journals (Sweden)

    Chung Yong

    2011-05-01

    Full Text Available Abstract Background Gold nanoparticles are widely used in consumer products, including cosmetics, food packaging, beverages, toothpaste, automobiles, and lubricants. With this increase in consumer products containing gold nanoparticles, the potential for worker exposure to gold nanoparticles will also increase. Only a few studies have produced data on the in vivo toxicology of gold nanoparticles, meaning that the absorption, distribution, metabolism, and excretion (ADME of gold nanoparticles remain unclear. Results The toxicity of gold nanoparticles was studied in Sprague Dawley rats by inhalation. Seven-week-old rats, weighing approximately 200 g (males and 145 g (females, were divided into 4 groups (10 rats in each group: fresh-air control, low-dose (2.36 × 104 particle/cm3, 0.04 μg/m3, middle-dose (2.36 × 105 particle/cm3, 0.38 μg/m3, and high-dose (1.85 × 106 particle/cm3, 20.02 μg/m3. The animals were exposed to gold nanoparticles (average diameter 4-5 nm for 6 hours/day, 5 days/week, for 90-days in a whole-body inhalation chamber. In addition to mortality and clinical observations, body weight, food consumption, and lung function were recorded weekly. At the end of the study, the rats were subjected to a full necropsy, blood samples were collected for hematology and clinical chemistry tests, and organ weights were measured. Cellular differential counts and cytotoxicity measurements, such as albumin, lactate dehydrogenase (LDH, and total protein were also monitored in a cellular bronchoalveolar lavage (BAL fluid. Among lung function test measurements, tidal volume and minute volume showed a tendency to decrease comparing control and dose groups during the 90-days of exposure. Although no statistically significant differences were found in cellular differential counts, histopathologic examination showed minimal alveoli, an inflammatory infiltrate with a mixed cell type, and increased macrophages in the high-dose rats. Tissue

  17. Subchronic inhalation toxicity of gold nanoparticles.

    Science.gov (United States)

    Sung, Jae Hyuck; Ji, Jun Ho; Park, Jung Duck; Song, Moon Yong; Song, Kyung Seuk; Ryu, Hyeon Ryol; Yoon, Jin Uk; Jeon, Ki Soo; Jeong, Jayoung; Han, Beom Seok; Chung, Yong Hyun; Chang, Hee Kyung; Lee, Ji Hyun; Kim, Dong Won; Kelman, Bruce J; Yu, Il Je

    2011-05-14

    Gold nanoparticles are widely used in consumer products, including cosmetics, food packaging, beverages, toothpaste, automobiles, and lubricants. With this increase in consumer products containing gold nanoparticles, the potential for worker exposure to gold nanoparticles will also increase. Only a few studies have produced data on the in vivo toxicology of gold nanoparticles, meaning that the absorption, distribution, metabolism, and excretion (ADME) of gold nanoparticles remain unclear. The toxicity of gold nanoparticles was studied in Sprague Dawley rats by inhalation. Seven-week-old rats, weighing approximately 200 g (males) and 145 g (females), were divided into 4 groups (10 rats in each group): fresh-air control, low-dose (2.36 × 104 particle/cm3, 0.04 μg/m3), middle-dose (2.36 × 105 particle/cm3, 0.38 μg/m3), and high-dose (1.85 × 106 particle/cm3, 20.02 μg/m3). The animals were exposed to gold nanoparticles (average diameter 4-5 nm) for 6 hours/day, 5 days/week, for 90-days in a whole-body inhalation chamber. In addition to mortality and clinical observations, body weight, food consumption, and lung function were recorded weekly. At the end of the study, the rats were subjected to a full necropsy, blood samples were collected for hematology and clinical chemistry tests, and organ weights were measured. Cellular differential counts and cytotoxicity measurements, such as albumin, lactate dehydrogenase (LDH), and total protein were also monitored in a cellular bronchoalveolar lavage (BAL) fluid. Among lung function test measurements, tidal volume and minute volume showed a tendency to decrease comparing control and dose groups during the 90-days of exposure. Although no statistically significant differences were found in cellular differential counts, histopathologic examination showed minimal alveoli, an inflammatory infiltrate with a mixed cell type, and increased macrophages in the high-dose rats. Tissue distribution of gold nanoparticles showed a dose

  18. Using a clinical protocol for orthognathic surgery and assessing a 3-dimensional virtual approach: current therapy.

    Science.gov (United States)

    Quevedo, Luis A; Ruiz, Jessica V; Quevedo, Cristobal A

    2011-03-01

    Oral and maxillofacial surgeons who perform orthognathic surgery face major changes in their practices, and these challenges will increase in the near future, because the extraordinary advances in technology applied to our profession are not only amazing but are becoming the standard of care as they promote improved outcomes for our patients. Orthognathic surgery is one of the favorite areas of practicing within the scope of practice of an oral and maxillofacial surgeon. Our own practice in orthognathic surgery has completed over 1,000 surgeries of this type. Success is directly related to the consistency and capability of the surgical-orthodontic team to achieve predictable, stable results, and our hypothesis is that a successful result is directly related to the way we take our records and perform diagnosis and treatment planning following basic general principles. Now that we have the opportunity to plan and treat 3-dimensional (3D) problems with 3D technology, we should enter into this new era with appropriate standards to ensure better results, instead of simply enjoying these new tools, which will clearly show not only us but everyone what we do when we perform orthognathic surgery. Appropriate principles need to be taken into account when implementing this new technology. In other words, new technology is welcome, but we do not have to reinvent the wheel. The purpose of this article is to review the current protocol that we use for orthognathic surgery and compare it with published protocols that incorporate new 3D and virtual technology. This report also describes our approach to this new technology.

  19. Inhibition of the fibroblast growth factor receptor (FGFR) pathway: the current landscape and barriers to clinical application.

    Science.gov (United States)

    Chae, Young Kwang; Ranganath, Keerthi; Hammerman, Peter S; Vaklavas, Christos; Mohindra, Nisha; Kalyan, Aparna; Matsangou, Maria; Costa, Ricardo; Carneiro, Benedito; Villaflor, Victoria M; Cristofanilli, Massimo; Giles, Francis J

    2016-12-22

    The fibroblast growth factor/fibroblast growth factor receptor (FGF/FGFR) is a tyrosine kinase signaling pathway that has a fundamental role in many biologic processes including embryonic development, tissue regeneration, and angiogenesis. Increasing evidence indicates that this pathway plays a critical role in oncogenesis via gene amplification, activating mutations, or translocation in tumors of various histologies. With multiplex sequencing technology, the detection of FGFR aberrations has become more common and is tied to cancer cell proliferation, resistance to anticancer therapies, and neoangiogenesis. Inhibition of FGFR signaling appears promising in preclinical studies, suggesting a pathway of clinical interest in the development of targeted therapy. Phase I trials have demonstrated a manageable toxicity profile. Currently, there are multiple FGFR inhibitors under study with many non-selective (multi-kinase) inhibitors demonstrating limited clinical responses. As we progress from the first generation of non-selective drugs to the second generation of selective FGFR inhibitors, it is clear that FGFR aberrations do not behave uniformly across cancer types; thus, a deeper understanding of biomarker strategies is undoubtedly warranted. This review aims to consolidate data from recent clinical trials with a focus on selective FGFR inhibitors. As Phase II clinical trials emerge, concentration on patient selection as it pertains to predicting response to therapy, feasible methods for overcoming toxicity, and the likelihood of combination therapies should be utilized. We will also discuss qualities that may be desirable in future generations of FGFR inhibitors, with the hope that overcoming these current barriers will expedite the availability of this novel class of medications.

  20. A Critical Analysis of Rejection in Vascularized Composite Allotransplantation: Clinical, cellular and molecular aspects, Current Challenges, and Novel Concepts

    Directory of Open Access Journals (Sweden)

    Karim A Sarhane

    2013-11-01

    Full Text Available Advances in microsurgical techniques and immunomodulatory protocols have contributed to the expansion of Vascularized Composite Allotransplantation (VCA with very encouraging immunological, functional, and cosmetic results. Rejection remains however a major hurdle that portends serious threats to recipients. Rejection features in VCA have been described in a number of studies, and an international consensus on the classification of rejection was established. Unfortunately, current available diagnostic methods carry many shortcomings that, in certain cases, pose a great diagnostic challenge to physicians especially in borderline rejection cases. In this review, we revisit the features of acute skin rejection in hand and face transplantation at the clinical, cellular and molecular levels. The multiple challenges in diagnosing rejection and in defining chronic and antibody-mediated rejection in VCA are then presented, and we finish by analyzing current research directions and novel concepts aiming at improving available diagnostic measures.

  1. Infections and urolithiasis: current clinical evidence in prophylaxis and antibiotic therapy.

    Science.gov (United States)

    Zanetti, Giampaolo; Paparella, Stefano; Trinchieri, Alberto; Prezioso, Domenico; Rocco, Francesco; Naber, Kurt G

    2008-03-01

    Urinary tract infections and urosepsis are complications which can precede or follow a kidney stone treatment. Often the stones themselves are the source of infection, whether they are infection stones or not. Systemic infections are difficult to foresee, and neither a pre-operative negative urine culture nor an antibiotic prophylaxis avoid infectious complications for certain. The primary predictive risk factors of urosepsis are: patient conditions, urinary tract infection or a history of recurrent infections, characteristics of the stone, and anatomy of the urinary tract. Infection stones are still a matter of debate, concerning both the aetiology of the disease and its treatment. Positive cultures are not only found with struvite stones, but also with apatite and calcium oxalate stones. Currently, a long-term antibiotic therapy is advised in patients affected by infection stones. Antibiotic therapy should prevent not only septic complications but also recurrence or re-growth of stones after treatment. Different antibiotic modalities are recommended, sometimes together with urease inhibitors. Mid-stream urine culture is the easiest available pre-treatment parameter notwithstanding its poor predictive value. In case of suspected or proven urinary infection, an appropriate antibiotic therapy should always be administered prior to surgical procedure. There is, however, controversy regarding the antibiotic use, its role, expediency, and duration of prophylaxis in relation to the various surgical procedures, and the way infectious complications are considered and classified. When antibiotic prophylaxis is considered, its duration should be clearly established prior to surgery; duration may vary depending on the type of surgery or the type of antibiotic. Furthermore, prophylaxis should be administered only for a limited amount of time. In infection stones, in immuno-compromised patients or in patients with anatomical anomalies or diabetes, the risk of post

  2. Prelude to Gold

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    FEMALE Chinese athletes Fu Mingxia and Wang Junxia recorded outstanding performances at 1996 Atlanta Olympic Games. Fu Mingxia won gold medals in both platform and springboard diving, and in so doing became the first double medal winner in Olympic diving since 1960. Wang Junxia, the holder of several world records in women’s long distance events, struggled against the odds and captured gold in the 5,000-meter event,

  3. Gold nanoprobes for theranostics

    Science.gov (United States)

    Panchapakesan, Balaji; Book-Newell, Brittany; Sethu, Palaniappan; Rao, Madhusudhana; Irudayaraj, Joseph

    2011-01-01

    Gold nanoprobes have become attractive diagnostic and therapeutic agents in medicine and life sciences research owing to their reproducible synthesis with atomic level precision, unique physical and chemical properties, versatility of their morphologies, flexibility in functionalization, ease of targeting, efficiency in drug delivery and opportunities for multimodal therapy. This review highlights some of the recent advances and the potential for gold nanoprobes in theranostics. PMID:22122586

  4. The Gold Standard Programme

    DEFF Research Database (Denmark)

    Neumann, Tim; Rasmussen, Mette; Ghith, Nermin

    2013-01-01

    To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.......To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates....

  5. Joining the Gold Rush

    Institute of Scientific and Technical Information of China (English)

    LIU BO

    2006-01-01

    @@ Flush with advanced technology and large amounts of capital, overseas mining firms are carving a place in the Chinese gold industry Dozens of Western mining companies, particularly those from Canada, are making the journey into the kind of remote corners in China that other overseas investors shy away from. What are they looking for? The answer is one of the most precious substances on the planet: gold.

  6. Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

    Science.gov (United States)

    McGregor, Alison H

    2016-01-01

    Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

  7. The Institute of Medical Illustrators (IMI) Gold Awards 2016.

    Science.gov (United States)

    The IMI Awards celebrate the medical illustration profession, bringing together the disciplines of clinical photography, medical art, illustration, graphic design and video within healthcare. Here are the Gold Award winning entries for 2016.

  8. Electrochemical investigation of 18k gold in acidic electrolyte

    Directory of Open Access Journals (Sweden)

    Grekulović Vesna J.

    2009-01-01

    Full Text Available The results of an attempt in using cyclic voltammetry for characterization of gold, silver, copper and 18-k gold alloys by their anodic behavior in 1 mol/dm3 H2SO4 are presented in this paper. Gold alloys containing 75 mass% Au are named as 18-k gold, but it is usually three component alloy containing 75 mass% Au, 12.5 mass% Ag and 12.5 mass% Cu as the main components. Investigated alloys were obtained by melting powders of pure metals mixed in corresponding ratio, casting, cooling in air, rolling and drawing in the wire shape. To achieve the required mechanical properties, the alloys had heat-treated three times. Each alloy exhibits characteristic current peaks on voltammogram that can be used to recognize the kind of present alloying metal in gold. Also, the content of the alloying metal can be roughly estimated from the peak value of current densities.

  9. Recovery of gold from spent matrices using supercritical carbon dioxide / Pieter Gideon van Zyl

    OpenAIRE

    2007-01-01

    The feasibility of recovering gold preloaded onto activated carbon by supercritical carbon dioxide (sc-CO2) was investigated in view of the actuality of a more environmentally friendly process for the retrieval of gold from real-world matrices (ion-exchange resin, cellulose, activated carbon) than the harsh elution methods currently employed. Several complexes of gold(I) and gold(III) were synthesised and characterised (AA, uv/visible), and their solubility in sc-CO2 investi...

  10. [The clinical effectiveness of the application of interferential currents for the combined treatment of onychopathies associated with psoriasis and eczema].

    Science.gov (United States)

    Nemchaninova, O B; Lykova, S G; Pozdnyakova, O N; Reshetnikova, T B; Makhnovets, E N; Simonova, E P; Spitsyna, A V

    2016-01-01

    The frequency of the development of clinically significant changes in the nail plates was estimated in the present study that included 454 patients presenting with psoriasis and 140 patients with eczema characterized by the localization of the pathological process on the skin of the wrists and/or feet. The changes in the nail plates were shown to occur in 56,2% of the patients with psoriasis and in 90,7% of those suffering from eczema. The capillaroscopy of the microvessels feeding the affected nails was carried out to determine the type of the capillaroscopic picture. The patients with onychopathies were largely characterized by the spastic-atonic type of the changes in the microcirculatory bed. The changes of this type were documented in 86,5% of the patients with psoriatic onychopathy and in 83,9% of those presenting with onychodystrophy associated with eczema. The effectiveness of the combined treatment including the application of interferential currents was estimated in comparison with that of standard therapy. It was shown that the use of interferential currents for the treatment of the patients with psoriasis results in a decrease of the severity index of nail damage by 47,8% in comparison with 18,1% in the case of standard medicamentous therapy. Similarly, a 77,2 and 51,3% decrease of the index of severity was documented in the patients with eczema after their treatment with the use of interferential currents and standard medicamentous therapy, respectively.

  11. Prospective ECG-triggered coronary CT angiography: clinical value of noise-based tube current reduction method with iterative reconstruction.

    Directory of Open Access Journals (Sweden)

    Junlin Shen

    Full Text Available OBJECTIVES: To evaluate the clinical value of noise-based tube current reduction method with iterative reconstruction for obtaining consistent image quality with dose optimization in prospective electrocardiogram (ECG-triggered coronary CT angiography (CCTA. MATERIALS AND METHODS: We performed a prospective randomized study evaluating 338 patients undergoing CCTA with prospective ECG-triggering. Patients were randomly assigned to fixed tube current with filtered back projection (Group 1, n = 113, noise-based tube current with filtered back projection (Group 2, n = 109 or with iterative reconstruction (Group 3, n = 116. Tube voltage was fixed at 120 kV. Qualitative image quality was rated on a 5-point scale (1 = impaired, to 5 = excellent, with 3-5 defined as diagnostic. Image noise and signal intensity were measured; signal-to-noise ratio was calculated; radiation dose parameters were recorded. Statistical analyses included one-way analysis of variance, chi-square test, Kruskal-Wallis test and multivariable linear regression. RESULTS: Image noise was maintained at the target value of 35HU with small interquartile range for Group 2 (35.00-35.03HU and Group 3 (34.99-35.02HU, while from 28.73 to 37.87HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 20% and 51% reduction in effective dose for Group 2 (2.9 mSv and Group 3 (1.8 mSv were achieved compared with Group 1 (3.7 mSv. After adjustment for scan characteristics, iterative reconstruction was associated with 26% reduction in effective dose. CONCLUSION: Noise-based tube current reduction method with iterative reconstruction maintains image noise precisely at the desired level and achieves consistent image quality. Meanwhile, effective dose can be reduced by more than 50%.

  12. Clinical and neurobiological advances in promoting regeneration of the ventral root avulsion lesion

    NARCIS (Netherlands)

    Eggers, R.; Tannemaat, Martijn R; De Winter, F.; Malessy, Martijn J A; Verhaagen, J.

    2016-01-01

    Root avulsions due to traction to the brachial plexus causes complete and permanent loss of function. Until fairly recent, such lesions were considered impossible to repair. Here we review clinical repair strategies and current progress in experimental ventral root avulsion lesions. The current gold

  13. Relating Tuberculosis (TB) Contact Characteristics to QuantiFERON-TB-Gold and Tuberculin Skin Test Results in the Toronto Pediatric TB Clinic.

    Science.gov (United States)

    Rose, Winsley; Read, Stanley E; Bitnun, Ari; Rea, Elizabeth; Stephens, Derek; Pongsamart, Wanatpreeya; Kitai, Ian

    2015-06-01

    Few data relate interferon-γ-release-assay results in children to source case sputum status, the best predictor of infectiousness of tuberculosis (TB) patients. We evaluated the QuantiFERON-Gold-in-tube assay (QFT) and tuberculin skin test (TST) in children with different types of TB exposure. The TST and QFT were performed in referred TB-exposed children and adolescents who had not undergone prior TST screening (tested in parallel), and the QFT was performed in referred TST-positive individuals. Source case characteristics were obtained from referring public health units. We excluded children with known immunocompromising conditions and those known to have TB disease at the time of evaluation. For 103 patients tested in parallel, overall test agreement was very good in the Bacillus Calmette-Guerein (BCG) unimmunized contacts (κ = 0.83) and contacts of household smear-positive (HS+) cases (κ = 0.67), but test agreement was poor in those with lower-risk contact (κ = 0.34). Only 3 of 59 HS+ patients were QFT-positive and TST-negative. On multivariate analysis, a positive QFT was strongly associated with HS+ exposure (odds ratio [OR], 6.6; 95% confidence interval [CI], 2.2-20]) but not BCG; and a positive TST was associated with BCG alone. For 92 referred TST-positive individuals, the QFT was negative in 21% of HS+ contacts, 65% of lower-risk contacts (OR, 6.8; 95% CI, 1.9-25), and 82% of the patients with unknown contact history (OR, 15.5; 95% CI, 5-54). Application of the Canadian 2010 guidelines would exclude from treatment 43 (72%) of the 73 TST+, QFT- patients. For close contacts of HS+ individuals, the QFT added little sensitivity to the TST for detection of TB infection. The QFT correlated much better with exposure than the TST, especially in BCG-immunized children, and it has the greatest potential benefit for evaluation of those at lower risk of latent TB infection. © The Author 2014. Published by Oxford University Press on behalf of the Pediatric

  14. Gum arabic-coated radioactive gold nanoparticles cause no short-term local or systemic toxicity in the clinically relevant canine model of prostate cancer

    Directory of Open Access Journals (Sweden)

    Axiak-Bechtel SM

    2014-10-01

    Full Text Available Sandra M Axiak-Bechtel,1 Anandhi Upendran,2,3 Jimmy C Lattimer,1 James Kelsey,3,4 Cathy S Cutler,4 Kim A Selting,1 Jeffrey N Bryan,1 Carolyn J Henry,1,5 Evan Boote,6 Deborah J Tate,1 Margaret E Bryan,7 Kattesh V Katti,3,8 Raghuraman Kannan3,8 1Department of Veterinary Medicine and Surgery, 2Department of Physics, University of Missouri, Columbia, MO, USA; 3Nanoparticle Biochem, Inc., and Shasun-NBI LLC, Columbia, MO, USA; 4Missouri University Research Reactor, 5Department of Internal Medicine, University of Missouri, Columbia, MO, USA; 6Spectrum Health, Grand Rapids, MI, USA; 7Department of Statistics, 8Department of Radiology, University of Missouri, Columbia, MO, USA Introduction: Gum arabic-coated radioactive gold nanoparticles (GA-198AuNPs offer ­several advantages over traditional brachytherapy in the treatment of prostate cancer, including homogenous dose distribution and higher dose-rate irradiation. Our objective was to determine the short-term safety profile of GA-198AuNPs injected intralesionally. We proposed that a single treatment of GA-198AuNPs would be safe with minimal-to-no evidence of systemic or local toxicity.Methods: Nine dogs with spontaneously occurring prostatic cancer were treated. Injections were performed with ultrasound or computerized tomography guidance. Complete blood counts, chemistry panels, and urinalyses were performed at weekly intervals for 1 month and imaging was repeated 4 weeks postinjection. Planar scintigraphic images were obtained within 30 minutes of injection.Results: No statistically significant difference was found in any hematologic or biochemical parameter studied, nor was any evidence of tumor swelling or abscessation found in eight dogs with repeat imaging; one dog died secondary to urethral obstruction 12 days following injection. At 30 minutes postinjection, an average of 53% of injected dose in seven dogs was retained in the prostate, with loss of remaining activity in the bladder and

  15. Hippocampal-dependent neurocognitive impairment following cranial irradiation observed in pre-clinical models: current knowledge and possible future directions.

    Science.gov (United States)

    Tomé, Wolfgang A; Gökhan, Şölen; Gulinello, Maria E; Brodin, N Patrik; Heard, John; Mehler, Mark F; Guha, Chandan

    2016-01-01

    We reviewed the literature for studies pertaining to impaired adult neurogenesis leading to neurocognitive impairment following cranial irradiation in rodent models. This compendium was compared with respect to radiation dose, converted to equivalent dose in 2 Gy fractions (EQD2) to allow for direct comparison between studies. The effects of differences between animal species and the dependence on animal age as well as for time after irradiation were also considered. One of the major sites of de novo adult neurogenesis is the hippocampus, and as such, this review also focuses on assessing evidence related to the expression and potential effects of inflammatory cytokines on neural stem cells in the subgranular zone of the dentate gyrus and whether this correlates with neurocognitive impairment. This review also discusses potential strategies to mitigate the detrimental effects on neurogenesis and neurocognition resulting from cranial irradiation, and how the rationale for these strategies compares with the current outcome of pre-clinical studies.

  16. The role of stem cell therapy in multiple sclerosis: An overview of the current status of the clinical studies

    Directory of Open Access Journals (Sweden)

    Rokhsareh Meamar

    2016-01-01

    Full Text Available The complexity of multiple sclerosis (MS and the incompetence of a large number of promised treatments for MS urge us to plan new and more effective therapeutic approaches that aim to suppress ongoing autoimmune responses and induction of local endogenous regeneration. Emerging data propose that hematopoietic, mesenchymal, and neural stem cells have the potential to restore self-tolerance, provide in situ immunomodulation and neuroprotection, as well as promote regeneration. Thus, in this article, we will first provide an overview of the cell sources for proposed mechanisms that contribute to the beneficial effects of stem cell transplantation, the ideal route and/or timing of stem cell-based therapies for each main stem cell group, and finally, an overview of the current status of stem cell research in clinical trial stages in MS by comparable and healthy therapeutic effects of different stem cell therapies for MS patients.

  17. Relationship of Clinical and Pathologic Nodal Staging in Locally Advanced Breast Cancer: Current Controversies in Daily Practice?

    Science.gov (United States)

    De Felice, Francesca; Musio, Daniela; Bulzonetti, Nadia; Raffetto, Nicola; Tombolini, Vincenzo

    2014-01-01

    Systemic neo-adjuvant therapy plays a primary role in the management of locally advanced breast cancer. Without having any negative effect in overall survival, induction chemotherapy potentially assures a surgery approach in unresectable disease or a conservative treatment in technically resectable disease and acts on a well-vascularized tumor bed, without the modifications induced by surgery. A specific issue has a central function in the neo-adjuvant setting: lymph nodes status. It still represents one of the strongest predictors of long-term prognosis in breast cancer. The discussion of regional radiation therapy should be a matter of debate, especially in a pathological complete response. Currently, the indication for radiotherapy is based on the clinical stage before the surgery, even for the irradiation of the loco-regional lymph nodes. Regardless of pathological down-staging, radiation therapy is accepted as standard adjuvant treatment in locally advanced breast cancer. PMID:25247013

  18. Robot-assisted and computer-enhanced therapies for children with cerebral palsy: current state and clinical implementation.

    Science.gov (United States)

    Meyer-Heim, Andreas; van Hedel, Hubertus J A

    2013-06-01

    The field of pediatric neurorehabilitation has rapidly evolved with the introduction of technological advancements over recent years. Rehabilitation robotics and computer-assisted systems can complement conventional physiotherapeutics or occupational therapies. These systems appear promising, especially in children, where exciting and challenging virtual reality scenarios could increase motivation to train intensely in a playful therapeutic environment. Despite promising experience and a large acceptance by the patients and parents, so far, only a few therapy systems have been evaluated in children, and well-designed randomized controlled studies in this field are still lacking. This narrative review aims to provide an overview about the to-date robot-assisted and computer-based therapies and the current level of evidence and to share the authors experience about the clinical implication of these new technologies available for children with cerebral palsy.

  19. Gold nanocrystals with DNA-directed morphologies

    Science.gov (United States)

    Ma, Xingyi; Huh, June; Park, Wounjhang; Lee, Luke P.; Kwon, Young Jik; Sim, Sang Jun

    2016-09-01

    Precise control over the structure of metal nanomaterials is important for developing advanced nanobiotechnology. Assembly methods of nanoparticles into structured blocks have been widely demonstrated recently. However, synthesis of nanocrystals with controlled, three-dimensional structures remains challenging. Here we show a directed crystallization of gold by a single DNA molecular regulator in a sequence-independent manner and its applications in three-dimensional topological controls of crystalline nanostructures. We anchor DNA onto gold nanoseed with various alignments to form gold nanocrystals with defined topologies. Some topologies are asymmetric including pushpin-, star- and biconcave disk-like structures, as well as more complex jellyfish- and flower-like structures. The approach of employing DNA enables the solution-based synthesis of nanocrystals with controlled, three-dimensional structures in a desired direction, and expands the current tools available for designing and synthesizing feature-rich nanomaterials for future translational biotechnology.

  20. State of the art of current 3-D scoliosis classifications: a systematic review from a clinical perspective.

    Science.gov (United States)

    Donzelli, Sabrina; Poma, Salvatore; Balzarini, Luca; Borboni, Alberto; Respizzi, Stefano; Villafane, Jorge Hugo; Zaina, Fabio; Negrini, Stefano

    2015-10-16

    Scoliosis is a complex three dimensional (3D) deformity: the current lack of a 3D classification could hide something fundamental for scoliosis prognosis and treatment. A clear picture of the actually existing 3D classifications lacks. The aim of this systematic review was to identify all the 3D classification systems proposed until now in the literature with the aim to identify similarities and differences mainly in a clinical perspective.After a MEDLINE Data Base review, done in November 2013 using the search terms "Scoliosis/classification" [Mesh] and "scoliosis/classification and Imaging, three dimensional" [Mesh], 8 papers were included with a total of 1164 scoliosis patients, 23 hyperkyphosis and 25 controls, aged between 8 and 20 years, with curves from 10° to 81° Cobb, and various curve patterns. Six studies looked at the whole 3D spine and found classificatory parameters according to planes, angles and rotations, including: Plane of Maximal Curvature (PMC), Best Fit Plane, Cobb angles in bodily plane and PMC, Axial rotation of the apical vertebra and of the PMC, and geometric 3D torsion. Two studies used the regional (spinal) Top View of the spine and found classificatory parameters according to its geometrical properties (area, direction and barycenter) including: Ratio of the frontal and the sagittal size, Phase, Directions (total, thoracic and lumbar), and Shift. It was possible to find similarities among 10 out of the 16 the sub-groups identified by different authors with different methods in different populations.In summation, the state of the art of 3D classification systems include 8 studies which showed some comparability, even though of low level. The most useful one in clinical everyday practice, is far from being defined. More than 20 years passed since the definition of the third dimension of the scoliosis deformity, now the time has come for clinicians and bioengineers to start some real clinical application, and develop means to make this

  1. Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives12

    Science.gov (United States)

    Young, Sera L.; Mbuya, Mduduzi N. N.; Chantry, Caroline J.; Geubbels, Eveline P.; Israel-Ballard, Kiersten; Cohan, Deborah; Vosti, Stephen A.; Latham, Michael C.

    2011-01-01

    In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world. PMID:22332055

  2. PHYSICAL THERAPY FOLLOWING ANTERIOR CERVICAL DISCECTOMY AND FUSION: A STUDY OF CURRENT CLINICAL PRACTICE AND THERAPIST BELIEFS

    Directory of Open Access Journals (Sweden)

    Brian T. Swanson

    2015-04-01

    Full Text Available Background: Anterior cervical discectomy and fusion (ACDF is a commonly performed surgical procedure. However, there is substantial debate regarding the role of physical therapy following this procedure. Therefore, we sought to determine current physical therapy practice following ACDF surgery, as well as determine physical therapists beliefs regarding rehabilitation following ACDF. Methods: One hundred and eighty three licensed Physical Therapists were invited to participate in a descriptive internet based survey; a total of 53 (29% completed the survey. Physical Therapists were assessed for their current practice, asked to rate the clinical usefulness of various treatment modalities, and indicate their recommendations regarding post-operative physical therapy for subjects following anterior discectomy and fusion. Results were then assessed for frequency distributions, with chi-square analysis for association between demographic data and practice recommendations. Results: The results indicate that Physical Therapists believe patients achieve superior outcomes with the inclusion of post-operative physical therapy, with a low risk of harm. Specific treatments indicated as most useful included endurance exercise (60.4%, isometric strengthening (56.6%, and stretching (45.3%. Other treatment options are discussed in detail. Conclusion: Physical Therapists identified specific activities that they felt were most appropriate for rehabilitation following ACDF surgery. These findings may help to direct both appropriate therapy prescription following ACDF, as well as future research.

  3. GOLD IS EARNED FROM THE PRODUCTION OF THAI GOLD LEAF

    Directory of Open Access Journals (Sweden)

    Dirk Bax

    2010-06-01

    Full Text Available Thai people like to cover sacred objects or things dear to them with gold leaf.. Statues of Buddha are sometimes covered with so many layers of gold leaf that they become formless figures, that can hardly be recognized. Portraits of beloved ancestors, statues of elephants and grave tombs are often covered with gold leaf. If one considers the number of Thai people and the popularity of the habit, the amount of gold involved could be considerable.

  4. Plant Extract (Bupleurum falcatum) as a Green Factory for Biofabrication of Gold Nanoparticles.

    Science.gov (United States)

    Lee, You Jeong; Cha, Song-Hyun; Lee, Kyoung Jin; Kim, Yeong Shik; Cho, Seonho; Park, Youmie

    2015-09-01

    This work describes a biofabrication process for gold nanoparticles in which the plant extract (Bupleurum falcatum) is used as a reducing agent to convert gold ions to gold nanoparticles. Biofabricated gold nanoparticles with spherical shapes were observed with an average diameter of 10.5 ± 2.3 nm. The color of the gold nanoparticles was purple, with a surface plasmon resonance peak at 542 nm. The face-centered cubic structure of crystalline gold was confirmed by high-resolution X-ray diffraction patterns. The biofabricated gold nanoparticles demonstrated excellent catalytic activity towards the 4-nitrophenol reduction reaction. The current report suggests that plant extracts are valuable natural sources for the biofabrication of gold nanoparticles with excellent catalytic activities.

  5. Validity of Footprint Analysis to Determine Flatfoot Using Clinical Diagnosis as the Gold Standard in a Random Sample Aged 40 Years and Older

    OpenAIRE

    Pita-Fernández, Salvador; González-Martín, Cristina; Seoane-Pillado, Teresa; López-Calviño, Beatriz; Pértega-Díaz, Sonia; Gil-Guillén, Vicente

    2015-01-01

    Background Research is needed to determine the prevalence and variables associated with the diagnosis of flatfoot, and to evaluate the validity of three footprint analysis methods for diagnosing flatfoot, using clinical diagnosis as a benchmark. Methods We conducted a cross-sectional study of a population-based random sample ≥40 years old (n = 1002) in A Coruña, Spain. Anthropometric variables, Charlson’s comorbidity score, and podiatric examination (including measurement of Clarke’s angle, t...

  6. Comparison of the gold standard of hemoglobin measurement with the clinical standard (BGA) and noninvasive hemoglobin measurement (SpHb) in small children: a prospective diagnostic observational study.

    Science.gov (United States)

    Wittenmeier, Eva; Bellosevich, Sophia; Mauff, Susanne; Schmidtmann, Irene; Eli, Michael; Pestel, Gunther; Noppens, Ruediger R

    2015-10-01

    Collecting a blood sample is usually necessary to measure hemoglobin levels in children. Especially in small children, noninvasively measuring the hemoglobin level could be extraordinarily helpful, but its precision and accuracy in the clinical environment remain unclear. In this study, noninvasive hemoglobin measurement and blood gas analysis were compared to hemoglobin measurement in a clinical laboratory. In 60 healthy preoperative children (0.2-7.6 years old), hemoglobin was measured using a noninvasive method (SpHb; Radical-7 Pulse Co-Oximeter), a blood gas analyzer (clinical standard, BGAHb; ABL 800 Flex), and a laboratory hematology analyzer (reference method, labHb; Siemens Advia). Agreement between the results was assessed by Bland-Altman analysis and by determining the percentage of outliers. Sixty SpHb measurements, 60 labHb measurements, and 59 BGAHb measurements were evaluated. In 38% of the children, the location of the SpHb sensor had to be changed more than twice for the signal quality to be sufficient. The bias/limits of agreement between SpHb and labHb were -0.65/-3.4 to 2.1 g·dl(-1) . Forty-four percent of the SpHb values differed from the reference value by more than 1 g·dl(-1) . Age, difficulty of measurement, and the perfusion index (PI) had no influence on the accuracy of SpHb. The bias/limits of agreement between BGAHb and labHb were 1.14/-1.6 to 3.9 g·dl(-1) . Furthermore, 66% of the BGAHb values differed from the reference values by more than 1 g·dl(-1) . The absolute mean difference between SpHb and labHb (1.1 g·dl(-1) ) was smaller than the absolute mean difference between BGAHb and labHb (1.5 g·dl(-1) /P = 0.024). Noninvasive measurement of hemoglobin agrees more with the reference method than the measurement of hemoglobin using a blood gas analyzer. However, both methods can show clinically relevant differences from the reference method (ClinicalTrials.gov: NCT01693016). © 2015 John Wiley & Sons Ltd.

  7. Chemistry for oncotheranostic gold nanoparticles.

    Science.gov (United States)

    Trouiller, Anne Juliette; Hebié, Seydou; El Bahhaj, Fatima; Napporn, Teko W; Bertrand, Philippe

    2015-06-24

    This review presents in a comprehensive ways the chemical methods used to functionalize gold nanoparticles with focus on anti-cancer applications. The review covers the parameters required for the synthesis gold nanoparticles with defined shapes and sizes, method for targeted delivery in tumours, and selected examples of anti-cancers compounds delivered with gold nanoparticles. A short survey of bioassays for oncology based on gold nanoparticles is also presented.

  8. Injectable gold dermatitis and proteinuria: retreatment with auranofin.

    Science.gov (United States)

    Tosi, S; Cagnoli, M; Guidi, G; Murelli, M; Messina, K; Colombo, B

    1985-01-01

    Seven female patients with classical rheumatoid arthritis (RA), treated successfully with injectable gold salts (Fosfocrisolo ICI, 0.10 g/week, with a serum gold concentration of 200-400 mcg/dl), experienced severe gold side-effects after 3 to 20 months of therapy, requiring their withdrawal from gold despite the good results in both clinical and laboratory findings. Four patients showed mucocutaneous side-effects (2 dermatitis and 2 stomatitis) and three a moderate or severe proteinuria. Renal biopsy was performed in these patients, with a histological picture of membranous glomerulonephritis referable to gold therapy. Remission inducing drug (R.I.D.) therapy being mandatory in patients with a chronic progressive disease, and in view of the previous efficacy of gold salts, the patients were put on oral gold, Auranofin being administered 3 mg b.i.d. Both the mucocutaneous side-effects and the proteinuria ameliorated within 2 to 6 months, and the remission of the disease was maintained. The chemical and pharmacokinetic differences between the above two gold compounds are discussed.

  9. A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders.

    Science.gov (United States)

    Kekic, Maria; Boysen, Elena; Campbell, Iain C; Schmidt, Ulrike

    2016-03-01

    Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique, which can be used to selectively disrupt patterns of neural activity that are associated with symptoms of mental illness. tDCS has been implemented in numerous therapeutic trials across a range of patient populations, with a rapidly increasing number of studies being published each year. This systematic review aimed to evaluate the efficacy of tDCS in the treatment of psychiatric disorders. Four electronic databases were searched from inception until December 2015 by two independent reviewers, and 66 eligible studies were identified. Depression was the most extensively researched condition, followed by schizophrenia and substance use disorders. Data on obsessive compulsive disorder, generalised anxiety disorder, and anorexia nervosa were also obtained. The quality of included studies was appraised using a standardised assessment framework, which yielded a median score corresponding to "weak" on the three-point scale. This improved to "moderate" when case reports/series were excluded from the analysis. Overall, data suggested that tDCS interventions comprising multiple sessions can ameliorate symptoms of several major psychiatric disorders, both acutely and in the long-term. Nevertheless, the tDCS field is still in its infancy, and several methodological and ethical issues must be addressed before clinical efficacy can truly be determined. Studies probing the mechanisms of action of tDCS and those facilitating the definition of optimised stimulation protocols are warranted. Furthermore, evidence from large-scale, multi-centre randomised controlled trials is required if the transition of this therapy from the laboratory to the clinic is to be considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia.

    Science.gov (United States)

    Benussi, Alberto; Dell'Era, Valentina; Cotelli, Maria Sofia; Turla, Marinella; Casali, Carlo; Padovani, Alessandro; Borroni, Barbara

    Neurodegenerative cerebellar ataxias represent a group of disabling disorders for which we currently lack effective therapies. Cerebellar transcranial direct current stimulation (tDCS) is a non-invasive technique, which has been demonstrated to modulate cerebellar excitability and improve symptoms in patients with cerebellar ataxias. The present study investigated whether a two-weeks' treatment with cerebellar anodal tDCS could improve symptoms in patients with neurodegenerative cerebellar ataxia and could modulate cerebello-motor connectivity, at short and long term. We performed a double-blind, randomized, sham controlled trial with cerebellar tDCS (5 days/week for 2 weeks) in twenty patients with ataxia. Each patient underwent a clinical evaluation pre- and post-anodal tDCS or sham stimulation. A follow-up evaluation was performed at one and three months. Cerebello-motor connectivity was evaluated using transcranial magnetic stimulation (TMS) at baseline and at follow-up. Patients who underwent anodal tDCS showed a significant improvement in all performance scores (scale for the assessment and rating of ataxia, international cooperative ataxia rating scale, 9-hole peg test, 8-m walking time) and in cerebellar brain inhibition compared to patients who underwent sham stimulation. A two-weeks' treatment with anodal cerebellar tDCS improves symptoms in patients with ataxia and restores physiological cerebellar brain inhibition pathways. Cerebellar tDCS might represent a promising future therapeutic and rehabilitative approach in patients with neurodegenerative ataxia. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Micro-Computed Tomography Detection of Gold Nanoparticle-Labelled Mesenchymal Stem Cells in the Rat Subretinal Layer

    Science.gov (United States)

    Mok, Pooi Ling; Leow, Sue Ngein; Koh, Avin Ee-Hwan; Mohd Nizam, Hairul Harun; Ding, Suet Lee Shirley; Luu, Chi; Ruhaslizan, Raduan; Wong, Hon Seng; Halim, Wan Haslina Wan Abdul; Ng, Min Hwei; Idrus, Ruszymah Binti Hj.; Chowdhury, Shiplu Roy; Bastion, Catherine Mae-Lynn; Subbiah, Suresh Kumar; Higuchi, Akon; Alarfaj, Abdullah A.; Then, Kong Yong

    2017-01-01

    Mesenchymal stem cells are widely used in many pre-clinical and clinical settings. Despite advances in molecular technology; the migration and homing activities of these cells in in vivo systems are not well understood. Labelling mesenchymal stem cells with gold nanoparticles has no cytotoxic effect and may offer suitable indications for stem cell tracking. Here, we report a simple protocol to label mesenchymal stem cells using 80 nm gold nanoparticles. Once the cells and particles were incubated together for 24 h, the labelled products were injected into the rat subretinal layer. Micro-computed tomography was then conducted on the 15th and 30th day post-injection to track the movement of these cells, as visualized by an area of hyperdensity from the coronal section images of the rat head. In addition, we confirmed the cellular uptake of the gold nanoparticles by the mesenchymal stem cells using transmission electron microscopy. As opposed to other methods, the current protocol provides a simple, less labour-intensive and more efficient labelling mechanism for real-time cell tracking. Finally, we discuss the potential manipulations of gold nanoparticles in stem cells for cell replacement and cancer therapy in ocular disorders or diseases. PMID:28208719

  12. Micro-Computed Tomography Detection of Gold Nanoparticle-Labelled Mesenchymal Stem Cells in the Rat Subretinal Layer.

    Science.gov (United States)

    Mok, Pooi Ling; Leow, Sue Ngein; Koh, Avin Ee-Hwan; Mohd Nizam, Hairul Harun; Ding, Suet Lee Shirley; Luu, Chi; Ruhaslizan, Raduan; Wong, Hon Seng; Halim, Wan Haslina Wan Abdul; Ng, Min Hwei; Idrus, Ruszymah Binti Hj; Chowdhury, Shiplu Roy; Bastion, Catherine Mae-Lynn; Subbiah, Suresh Kumar; Higuchi, Akon; Alarfaj, Abdullah A; Then, Kong Yong

    2017-02-08

    Mesenchymal stem cells are widely used in many pre-clinical and clinical settings. Despite advances in molecular technology; the migration and homing activities of these cells in in vivo systems are not well understood. Labelling mesenchymal stem cells with gold nanoparticles has no cytotoxic effect and may offer suitable indications for stem cell tracking. Here, we report a simple protocol to label mesenchymal stem cells using 80 nm gold nanoparticles. Once the cells and particles were incubated together for 24 h, the labelled products were injected into the rat subretinal layer. Micro-computed tomography was then conducted on the 15th and 30th day post-injection to track the movement of these cells, as visualized by an area of hyperdensity from the coronal section images of the rat head. In addition, we confirmed the cellular uptake of the gold nanoparticles by the mesenchymal stem cells using transmission electron microscopy. As opposed to other methods, the current protocol provides a simple, less labour-intensive and more efficient labelling mechanism for real-time cell tracking. Finally, we discuss the potential manipulations of gold nanoparticles in stem cells for cell replacement and cancer therapy in ocular disorders or diseases.

  13. Micro-Computed Tomography Detection of Gold Nanoparticle-Labelled Mesenchymal Stem Cells in the Rat Subretinal Layer

    Directory of Open Access Journals (Sweden)

    Pooi Ling Mok

    2017-02-01

    Full Text Available Mesenchymal stem cells are widely used in many pre-clinical and clinical settings. Despite advances in molecular technology; the migration and homing activities of these cells in in vivo systems are not well understood. Labelling mesenchymal stem cells with gold nanoparticles has no cytotoxic effect and may offer suitable indications for stem cell tracking. Here, we report a simple protocol to label mesenchymal stem cells using 80 nm gold nanoparticles. Once the cells and particles were incubated together for 24 h, the labelled products were injected into the rat subretinal layer. Micro-computed tomography was then conducted on the 15th and 30th day post-injection to track the movement of these cells, as visualized by an area of hyperdensity from the coronal section images of the rat head. In addition, we confirmed the cellular uptake of the gold nanoparticles by the mesenchymal stem cells using transmission electron microscopy. As opposed to other methods, the current protocol provides a simple, less labour-intensive and more efficient labelling mechanism for real-time cell tracking. Finally, we discuss the potential manipulations of gold nanoparticles in stem cells for cell replacement and cancer therapy in ocular disorders or diseases.

  14. SU-E-T-359: Emulation of Yb-169 Gamma-Ray Spectrum Using Metal-Filtered 250 KVp X-Rays for Pre-Clinical Studies of Gold Nanoparticle-Aided Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Reynoso, F; Cho, S [UT MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: To develop an external beam surrogate of the Yb-169 brachytherapy source applying a filter-based spectrum modulation technique to 250 kVp x-rays. In-vitro/vivo studies performed with the modulated 250 kVp beam will help gauge the benefits of implementing gold nanoparticle-aided radiotherapy with the Yb-169 source. Methods: A previously validated MCNP5 model of the Phillips RT-250 orthovoltage unit was used to obtain the percentage depth dose (PDD) and filtered photon spectra for a variety of filtration and irradiation conditions. Photon spectra were obtained using the average flux F4 tally in air right after all collimation. A 30 x 30 x 30 cm{sup 3} water phantom was used to compute the PDD along the central axis (CAX) under the standards conditions of a 10 x 10 cm{sup 2} field size at 50 cm SSD. Cylindrical cells of 4 cm in diameter and the energy deposition F6 tally were used along the CAX to score the doses down to 20 cm depth. The number of particle history was set to 2 x 10{sup 8} in order to keep the relative uncertainty within each cell < 0.3%. The secondary electron spectrum within a gold-loaded tissue due to each photon spectrum was also calculated using EGSnrc and compared with that due to Yb-169 gamma rays. Results: Under the practical constraints for the spectrum modulation task, 250 kVp x-rays filtered by a 0.25 mm Erbium (Er) foil produced the best match with Yb-169 gamma rays, in terms of PDD and, more importantly, secondary electron spectrum. Conclusion: Modulation of 250kVp x-ray spectrum by an Er-filter was found effective in emulating the gamma ray spectrum of Yb-169. Possible benefits as predicted from the current MC model such as enhanced radiosensitization with the Er-filtered beam (as a surrogate of Yb-169) was confirmed with a separate in-vitro study. Supported by DOD/PCRP grant W81XWH-12-1-0198.

  15. Digging for Gold

    Science.gov (United States)

    Waters, John K.

    2012-01-01

    In the case of higher education, the hills are more like mountains of data that "we're accumulating at a ferocious rate," according to Gerry McCartney, CIO of Purdue University (Indiana). "Every higher education institution has this data, but it just sits there like gold in the ground," complains McCartney. Big Data and the new tools people are…

  16. GOLD PRESSURE VESSEL SEAL

    Science.gov (United States)

    Smith, A.E.

    1963-11-26

    An improved seal between the piston and die member of a piston-cylinder type pressure vessel is presented. A layer of gold, of sufficient thickness to provide an interference fit between the piston and die member, is plated on the contacting surface of at least one of the members. (AEC)

  17. Digging for Gold

    Science.gov (United States)

    Waters, John K.

    2012-01-01

    In the case of higher education, the hills are more like mountains of data that "we're accumulating at a ferocious rate," according to Gerry McCartney, CIO of Purdue University (Indiana). "Every higher education institution has this data, but it just sits there like gold in the ground," complains McCartney. Big Data and the new tools people are…

  18. Aiming for Gold

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Twenty-three years ago he claimed China’s first Olympic gold medal,with a win in the 50-meter pistol shooting competition.Now Xu Haifeng is leading the country’s modern pentathlon team in its bid for success at the Beijing Games

  19. Gold and gold working in Late Bronze Age Northern Greece

    Science.gov (United States)

    Vavelidis, M.; Andreou, S.

    2008-04-01

    Numerous objects of gold displaying an impressive variety of types and manufacturing techniques are known from the Late Bronze Age (LBA) contexts of Mycenaean Greece, but very little is known about the origin and processing of gold during the second millennium b.c. Ancient literature and recent research indicate that northern Greece is probably the richest gold-bearing region in Greece, and yet, very little evidence exists regarding the exploitation of its deposits and the production as well as use of gold in the area during prehistory. The unusual find of a group of small stone crucibles at the prehistoric settlement of Thessaloniki Toumba, one with visible traces of gold melting, proves local production and offers a rare opportunity to examine the process of on-site gold working. Furthermore, the comparison of the chemical composition of prehistoric artefacts from two settlements with those of gold deposits in their immediate areas supports the local extraction of gold and opens up the prospect for some of the Mycenaean gold to have originated in northern Greece. The scarcity of gold items in northern Greek LBA contexts may not represent the actual amount of gold produced and consumed, but could be a result of the local social attitudes towards the circulation and deposition of artefacts from precious metals.

  20. Agreement between a simple dyspnea-guided treatment algorithm for stable COPD and the GOLD guidelines: a pilot study

    Science.gov (United States)

    Cabrera, Carlos; Casanova, Ciro; Martín, Yolanda; Mirabal, Virginia; Sánchez, María del Carmen; Álvarez, Felisa; Juliá, Gabriel; Cabrera-Navarro, Pedro; García-Bello, Miguel Ángel; Marín, José María; de-Torres, Juan Pablo; Divo, Miguel; Celli, Bartolomé

    2016-01-01

    Introduction Guidelines recommendations for the treatment of COPD are poorly followed. This could be related to the complexity of classification and treatment algorithms. The purpose of this study was to validate a simpler dyspnea-based treatment algorithm for inhaled pharmacotherapy in stable COPD, comparing its concordance with the current Global Initiative for Obstructive Lung Disease (GOLD) guideline. Methods We enrolled patients who had been diagnosed with COPD in three primary care facilities and two tertiary hospitals in Spain. We determined anthropometric data, forced expiratory volume in the 1st second (percent), exacerbations, and dyspnea based on the modified Medical Research Council scale. We evaluated the new algorithm based on dyspnea and exacerbations and calculated the concordance with the current GOLD recommendations. Results We enrolled 100 patients in primary care and 150 attending specialized care in a respiratory clinic. There were differences in the sample distribution between cohorts with 41% vs 26% in grade A, 16% vs 12% in grade B, 16% vs 22% in grade C, and 27% vs 40% in grade D for primary and respiratory care, respectively (P=0.005). The coincidence of the algorithm with the GOLD recommendations in primary care was 93% and 91.8% in the respiratory care cohort. Conclusion A simple dyspnea-based treatment algorithm for inhaled pharmacotherapy of COPD could be useful in the management of COPD patients and concurs very well with the recommended schema suggested by the GOLD initiative. PMID:27354780

  1. Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents.

    Science.gov (United States)

    Miyamoto, S; Miyake, N; Jarskog, L F; Fleischhacker, W W; Lieberman, J A

    2012-12-01

    of comparable or superior efficacy and side-effect profiles to existing APDs; (2) development of novel (and presumably non-D(2)) mechanism APDs; (3) development of compounds to be used as adjuncts to APDs to augment efficacy by targeting specific symptom dimensions of schizophrenia and particularly those not responsive to traditional APD treatment. In addition, efforts are being made to determine if the products of susceptibility genes in schizophrenia, identified by genetic linkage and association studies, may be viable targets for drug development. Finally, a focus on early detection and early intervention aimed at halting or reversing progressive pathophysiological processes in schizophrenia has gained great influence. This has encouraged future drug development and therapeutic strategies that are neuroprotective. This article provides an update and critical review of the pharmacology and clinical profiles of current APDs and drugs acting on novel targets with potential to be therapeutic agents in the future.

  2. Gold-functionalized magnetic nanoparticles restrict growth of Pseudomonas aeruginosa

    Science.gov (United States)

    Niemirowicz, Katarzyna; Swiecicka, Izabela; Wilczewska, Agnieszka Z; Misztalewska, Iwona; Kalska-Szostko, Beata; Bienias, Kamil; Bucki, Robert; Car, Halina

    2014-01-01

    Superparamagnetic iron oxide nanoparticles (SPIONs) and their derivatives (aminosilane and gold-coated) have been widely investigated in numerous medical applications, including their potential to act as antibacterial drug carriers that may penetrate into bacteria cells and biofilm mass. Pseudomonas aeruginosa is a frequent cause of infection in hospitalized patients, and significant numbers of currently isolated clinical strains are resistant to standard antibiotic therapy. Here we describe the impact of three types of SPIONs on the growth of P. aeruginosa during long-term bacterial culture. Their size, structure, and physicochemical properties were determined using transmission electron microscopy, X-ray diffraction analysis, and Fourier transform infrared spectroscopy. We observed significant inhibition of P. aeruginosa growth in bacterial cultures continued over 96 hours in the presence of gold-functionalized nanoparticles (Fe3O4@Au). At the 48-hour time point, growth of P. aeruginosa, as assessed by the number of colonies grown from treated samples, showed the highest inhibition (decreased by 40%). These data provide strong evidence that Fe3O4@Au can dramatically reduce growth of P. aeruginosa and provide a platform for further study of the antibacterial activity of this nanomaterial. PMID:24855358

  3. The dosimetric feasibility of gold nanoparticle-aided radiation therapy (GNRT) via brachytherapy using low-energy gamma-/x-ray sources

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Hyun; Jones, Bernard L [Nuclear/Radiological Engineering and Medical Physics Programs, Georgia Institute of Technology, Atlanta, GA 30332-0405 (United States); Krishnan, Sunil [Department of Radiation Oncology, The University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (United States)], E-mail: scho@gatech.edu

    2009-08-21

    The preferential accumulation of gold nanoparticles within tumors and the increased photoelectric absorption due to the high atomic number of gold cooperatively account for the possibility of significant tumor dose enhancement during gold nanoparticle-aided radiation therapy (GNRT). Among the many conceivable ways to implement GNRT clinically, a brachytherapy approach using low-energy gamma-/x-ray sources (i.e. E{sub avg} < 100 keV) appears to be highly feasible and promising, because it may easily fulfill some of the technical and clinical requirements for GNRT. Therefore, the current study investigated the dosimetric feasibility of implementing GNRT using the following sources: {sup 125}I, 50 kVp and {sup 169}Yb. Specifically, Monte Carlo (MC) calculations were performed to determine the macroscopic dose enhancement factors (MDEF), defined as the ratio of the average dose in the tumor region with and without the presence of gold nanoparticles during the irradiation of the tumor, and the photo/Auger electron spectra within a tumor loaded with gold nanoparticles. The current study suggests that a significant tumor dose enhancement (e.g. >40%) could be achievable using {sup 125}I, 50 kVp and {sup 169}Yb sources and gold nanoparticles. When calculated at 1.0 cm from the center of the source within a tumor loaded with 18 mg Au g{sup -1}, macroscopic dose enhancement was 116, 92 and 108% for {sup 125}I, 50 kVp and {sup 169}Yb, respectively. For a tumor loaded with 7 mg Au g{sup -1}, it was 68, 57 and 44% at 1 cm from the center of the source for {sup 125}I, 50 kVp and {sup 169}Yb, respectively. The estimated MDEF values for {sup 169}Yb were remarkably larger than those for {sup 192}Ir, on average by up to about 70 and 30%, for 18 mg Au and 7 mg Au cases, respectively. The current MC study also shows a remarkable change in the photoelectron fluence and spectrum (e.g. more than two orders of magnitude) and a significant production (e.g. comparable to the number of

  4. Nanovaccines for malaria using Plasmodium falciparum antigen Pfs25 attached gold nanoparticles.

    Science.gov (United States)

    Kumar, Rajesh; Ray, Paresh C; Datta, Dibyadyuti; Bansal, Geetha P; Angov, Evelina; Kumar, Nirbhay

    2015-09-22

    Malaria transmission-blocking vaccines (TBV) targeting sexual stages of the parasite represent an ideal intervention to reduce the burden of the disease and eventual elimination at the population level in endemic regions. Immune responses against sexual stage antigens impair the development of parasite inside the mosquitoes. Target antigens identified in Plasmodium falciparum include surface proteins Pfs230 and Pfs48/45 in male and female gametocytes and Pfs25 expressed in zygotes and ookinetes. The latter has undergone extensive evaluation in pre-clinical and phase I clinical trials and remains one of the leading target antigens for the development of TBV. Pfs25 has a complex tertiary structure characterized by four EGF-like repeat motifs formed by 11 disulfide bonds, and it has been rather difficult to obtain Pfs25 as a homogenous product in native conformation in any heterologous expression system. Recently, we have reported expression of codon-harmonized recombinant Pfs25 in Escherichia coli (CHrPfs25) and which elicited highly potent malaria transmission-blocking antibodies in mice. In the current study, we investigated CHrPfs25 along with gold nanoparticles of different shapes, size and physicochemical properties as adjuvants for induction of transmission blocking immunity. The results revealed that CHrPfs25 delivered with various gold nanoparticles elicited strong transmission blocking antibodies and suggested that gold nanoparticles based formulations can be developed as nanovaccines to enhance the immunogenicity of vaccine antigens.

  5. Indacaterol vs tiotropium in COPD patients classified as GOLD A and B.

    Science.gov (United States)

    Mahler, Donald A; Kerstjens, Huib A M; Donohue, James F; Buhl, Roland; Lawrence, David; Altman, Pablo

    2015-08-01

    According to current GOLD strategy, patients with COPD classified as groups A and B may be treated with inhaled bronchodilators, either long-acting β2-agonist (LABA) or long-acting muscarinic antagonist (LAMA). However, there is little guidance on which class of agent is preferred and a lack of prospective data to differentiate the two. In this study, we performed post-hoc analyses of pooled data from two prospective, controlled clinical trials comparing the LABA indacaterol and LAMA tiotropium in 1422 patients with moderate airflow limitation and no history of exacerbations in the previous year. This population fits the definitions of GOLD A and B groups and could be further stratified by symptom severity using Baseline Dyspnea Index (i.e. modeling GOLD A or B) and inhaled corticosteroid (ICS) use at baseline. Outcomes measured after 12 weeks of treatment were lung function (forced expiratory volume in 1 s; FEV1), health status (St George's Respiratory Questionnaire; SGRQ), symptoms (Transition Dyspnea Index; TDI) and rescue medication use. In 'GOLD A' patients not receiving ICS, differences favored indacaterol versus tiotropium (trough FEV1 0.05 L; rescue medication use -0.41 puffs/day; TDI total score 0.94 points; SGRQ total score -3.13 units, all p indacaterol treatment increased trough FEV1 (0.055 L, p indacaterol for all variables. Our findings suggest that patients in GOLD groups A and B may experience greater benefits with indacaterol than with tiotropium. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Study of the leakage current of clinical dosimeters for teletherapy; Estudo da corrente de fuga de dosimetros clinicos para teleterapia

    Energy Technology Data Exchange (ETDEWEB)

    Damatto, Willian B.; Santos, Gelson P.; Potiens, Maria da Penha A.; Caldas, Linda V.E.; Vivolo, Vitor, E-mail: wbdamatto@ipen.b, E-mail: gpsantos@ipen.b, E-mail: mppalbu@ipen.b, E-mail: lcaldas@ipen.b, E-mail: vivolo@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2009-07-01

    This work demonstrates the importance of quality control of clinical dosemeters and therefore the equipment for radiotherapy treatment, exhibiting the necessary care related to answers and sensibilities and the possible defects of the clinical assembly

  7. Cytogenetic evaluation of gold nanorods using Allium cepa test.

    Science.gov (United States)

    Rajeshwari, A; Roy, Barsha; Chandrasekaran, Natarajan; Mukherjee, Amitava

    2016-12-01

    The current study reveals the impact of gold nanorods (NRs) capped with CTAB (cetyltrimethylammonium bromide) or PEG (polyethylene glycol) on Allium cepa. The morphology and surface charge of CTAB- and PEG-capped gold NRs were characterized by electron microscopic and zeta potential analyses. The chromosomal aberrations like clumped chromosome, chromosomal break, chromosomal bridge, diagonal anaphase, disturbed metaphase, laggard chromosome, and sticky chromosome were observed in the root tip cells exposed to different concentrations (0.1, 1, and 10 μg/mL) of CTAB- and PEG-capped gold NRs. We found that both CTAB- and PEG-capped gold NRs were able to induce toxicity in the plant system after 4-h interaction. At a maximum concentration of 10 μg/mL, the mitotic index reduction induced by CTAB-capped gold NRs was 40-fold higher than that induced by PEG-capped gold NRs. The toxicity of gold NRs was further confirmed by lipid peroxidation and oxidative stress analyses. The unbound CTAB also contributed to the toxicity in root tip cells, while PEG alone shows less toxicity to the cells. The vehicle control CTAB contributed to the toxic effects in root tip cells, while PEG alone did not show any toxicity to the cells. The results revealed that even though both the particles have adverse effects on A. cepa, there was a significant difference in the mitotic index and oxidative stress generation in root cells exposed to CTAB-capped gold NRs. Thus, this study concludes that the surface polymerization of gold NRs by PEG can reduce the toxicity of CTAB-capped gold NRs.

  8. Global demand for gold is another threat for tropical forests

    Science.gov (United States)

    Alvarez-Berríos, Nora L.; Aide, T. Mitchell

    2015-01-01

    The current global gold rush, driven by increasing consumption in developing countries and uncertainty in financial markets, is an increasing threat for tropical ecosystems. Gold mining causes significant alteration to the environment, yet mining is often overlooked in deforestation analyses because it occupies relatively small areas. As a result, we lack a comprehensive assessment of the spatial extent of gold mining impacts on tropical forests. In this study, we provide a regional assessment of gold mining deforestation in the tropical moist forest biome of South America. Specifically, we analyzed the patterns of forest change in gold mining sites between 2001 and 2013, and evaluated the proximity of gold mining deforestation to protected areas (PAs). The forest cover maps were produced using the Land Mapper web application and images from the MODIS satellite MOD13Q1 vegetation indices 250 m product. Annual maps of forest cover were used to model the incremental change in forest in ˜1600 potential gold mining sites between 2001-2006 and 2007-2013. Approximately 1680 km2 of tropical moist forest was lost in these mining sites between 2001 and 2013. Deforestation was significantly higher during the 2007-2013 period, and this was associated with the increase in global demand for gold after the international financial crisis. More than 90% of the deforestation occurred in four major hotspots: Guianan moist forest ecoregion (41%), Southwest Amazon moist forest ecoregion (28%), Tapajós-Xingú moist forest ecoregion (11%), and Magdalena Valley montane forest and Magdalena-Urabá moist forest ecoregions (9%). In addition, some of the more active zones of gold mining deforestation occurred inside or within 10 km of ˜32 PAs. There is an urgent need to understand the ecological and social impacts of gold mining because it is an important cause of deforestation in the most remote forests in South America, and the impacts, particularly in aquatic systems, spread well

  9. Monte-Carlo model development for evaluation of current clinical target volume definition for heterogeneous and hypoxic glioblastoma.

    Science.gov (United States)

    Moghaddasi, L; Bezak, E; Harriss-Phillips, W

    2016-05-07

    Clinical target volume (CTV) determination may be complex and subjective. In this work a microscopic-scale tumour model was developed to evaluate current CTV practices in glioblastoma multiforme (GBM) external radiotherapy. Previously, a Geant4 cell-based dosimetry model was developed to calculate the dose deposited in individual GBM cells. Microscopic extension probability (MEP) models were then developed using Matlab-2012a. The results of the cell-based dosimetry model and MEP models were combined to calculate survival fractions (SF) for CTV margins of 2.0 and 2.5 cm. In the current work, oxygenation and heterogeneous radiosensitivity profiles were incorporated into the GBM model. The genetic heterogeneity was modelled using a range of α/β values (linear-quadratic model parameters) associated with different GBM cell lines. These values were distributed among the cells randomly, taken from a Gaussian-weighted sample of α/β values. Cellular oxygen pressure was distributed randomly taken from a sample weighted to profiles obtained from literature. Three types of GBM models were analysed: homogeneous-normoxic, heterogeneous-normoxic, and heterogeneous-hypoxic. The SF in different regions of the tumour model and the effect of the CTV margin extension from 2.0-2.5 cm on SFs were investigated for three MEP models. The SF within the beam was increased by up to three and two orders of magnitude following incorporation of heterogeneous radiosensitivities and hypoxia, respectively, in the GBM model. However, the total SF was shown to be overdominated by the presence of tumour cells in the penumbra region and to a lesser extent by genetic heterogeneity and hypoxia. CTV extension by 0.5 cm reduced the SF by a maximum of 78.6  ±  3.3%, 78.5  ±  3.3%, and 77.7  ±  3.1% for homogeneous and heterogeneous-normoxic, and heterogeneous hypoxic GBMs, respectively. Monte-Carlo model was developed to quantitatively evaluate SF for genetically

  10. Monte-Carlo model development for evaluation of current clinical target volume definition for heterogeneous and hypoxic glioblastoma

    Science.gov (United States)

    Moghaddasi, L.; Bezak, E.; Harriss-Phillips, W.

    2016-05-01

    Clinical target volume (CTV) determination may be complex and subjective. In this work a microscopic-scale tumour model was developed to evaluate current CTV practices in glioblastoma multiforme (GBM) external radiotherapy. Previously, a Geant4 cell-based dosimetry model was developed to calculate the dose deposited in individual GBM cells. Microscopic extension probability (MEP) models were then developed using Matlab-2012a. The results of the cell-based dosimetry model and MEP models were combined to calculate survival fractions (SF) for CTV margins of 2.0 and 2.5 cm. In the current work, oxygenation and heterogeneous radiosensitivity profiles were incorporated into the GBM model. The genetic heterogeneity was modelled using a range of α/β values (linear-quadratic model parameters) associated with different GBM cell lines. These values were distributed among the cells randomly, taken from a Gaussian-weighted sample of α/β values. Cellular oxygen pressure was distributed randomly taken from a sample weighted to profiles obtained from literature. Three types of GBM models were analysed: homogeneous-normoxic, heterogeneous-normoxic, and heterogeneous-hypoxic. The SF in different regions of the tumour model and the effect of the CTV margin extension from 2.0-2.5 cm on SFs were investigated for three MEP models. The SF within the beam was increased by up to three and two orders of magnitude following incorporation of heterogeneous radiosensitivities and hypoxia, respectively, in the GBM model. However, the total SF was shown to be overdominated by the presence of tumour cells in the penumbra region and to a lesser extent by genetic heterogeneity and hypoxia. CTV extension by 0.5 cm reduced the SF by a maximum of 78.6  ±  3.3%, 78.5  ±  3.3%, and 77.7  ±  3.1% for homogeneous and heterogeneous-normoxic, and heterogeneous hypoxic GBMs, respectively. Monte-Carlo model was developed to quantitatively evaluate SF for genetically

  11. Understanding the GOLD 2011 Strategy as applied to a real-world COPD population

    DEFF Research Database (Denmark)

    Vestbo, J.; Vogelmeier, C.; Small, M.

    2014-01-01

    Study objectives: The aim of this analysis was to understand the implications of the GOLD 2011 multidimensional system for the assessment and management of COPD, using data from a real-world observational study. Methods: Data were drawn from the Adelphi Respiratory Disease Specific Programme...... burden, increased airflow limitation and exacerbation, and further illustrated the importance of including exacerbation history in the assessment of COPD to identify patients at high risk. As based on data from current clinical practice, this study also highlighted the frequent and potentially...

  12. Current methods of assessing the accuracy of three-dimensional soft tissue facial predictions: technical and clinical considerations.

    Science.gov (United States)

    Khambay, B; Ullah, R

    2015-01-01

    Since the introduction of three-dimensional (3D) orthognathic planning software, studies have reported on their predictive ability. The aim of this study was to highlight the limitations of the current methods of analysis. The predicted 3D soft tissue image was compared to the postoperative soft tissue. For the full face, the maximum and 95th and 90th percentiles, the percentage of 3D mesh points ≤ 2 mm, and the root mean square (RMS) error, were calculated. For specific anatomical regions, the percentage of 3D mesh points ≤ 2 mm and the distance between the two meshes at 10 landmarks were determined. For the 95th and 90th percentiles, the maximum difference ranged from 7.7 mm to 2.2 mm and from 3.7 mm to 1.5 mm, respectively. The absolute mean distance ranged from 0.98 mm to 0.56 mm and from 0.91 mm to 0.50 mm, respectively. The percentage of mesh with ≤ 2 mm for the full face was 94.4-85.2% and 100-31.3% for anatomical regions. The RMS error ranged from 2.49 mm to 0.94 mm. The majority of mean linear distances between the surfaces were ≤ 0.8 mm, but increased for the mean absolute distance. At present the use of specific anatomical regions is more clinically meaningful than the full face. It is crucial to understand these and adopt a protocol for conducting such studies.

  13. Ocular chrysiasis correlated with gold concentrations in the crystalline lens during chrysotherapy.

    Science.gov (United States)

    Gottlieb, N L; Major, J C

    1978-01-01

    The eyes of 11 patients with rheumatoid arthritis (RA) who received extended chrysotherapy (mean cumulative dose greater than 7 grams during a mean 6-year period) were examined biomicroscopically. Minute reddish-purple particles were seen in the cornea (corneal chrysiasis) in 5 and in the lens (lens chrysiasis) in 4 patients. Particulate deposits were absent in 11 other RA patients who had not received gold treatment. Seven crystalline lenses from 5 gold-treated patients were removed surgically because of incidental cataract formation and analyzed for gold content using neutron activation analysis. Although the mean lens gold concentration was higher in these patients than in non-gold-treated controls without RA (0.0073 microgram/grams versus 0.001 microgram/grams), the absolute gold level was markedly lower than that found in 25 diverse tissue analyzed previously. This finding is compatible with the absence of clinical gold-related lens disease or visual impairment.

  14. Spiky gold nanoshells.

    Science.gov (United States)

    Sanchez-Gaytan, Brenda L; Park, So-Jung

    2010-12-21

    We report a high-yield synthetic method for a new type of metal nanostructure, spiky gold nanoshells, which combine the morphological characteristics of hollow metal nanoshells and nanorods. Our method utilizes block copolymer assemblies and polymer beads as templates for the growth of spiky nanoshells. Various shapes of spiky metal nanoshells were prepared in addition to spherical nanoshells by using block copolymer assemblies such as rod-like micelles, vesicles, and bilayers as templates. Furthermore, spiky gold shells encapsulating magnetic nanoparticles or quantum dots were prepared based on the ability of block copolymers to self-assemble with various types of nanoparticles and molecules. The capability to encapsulate other materials in the core, the shape tunability, and the highly structured surface of spiky nanoshells should benefit a range of imaging, sensing, and medical applications of metal nanostructures.

  15. Gold induced apoptsis study

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    2008-01-01

    at the moment, especially in the fields of lasers, they though have some problems concerning the placement of the tumor in the human body. Local heating by MR has tremendous advance in comparison too lasers. The first step is to validate the hypothesis of the inductive heating of the gold nano particles trough......Introduction   Cancer cells are highly thermo sensitive. On the basis of an article in Nature the idea arose, for a new non-invasive thermotherapy technique, based on radio frequency inductive heating of nano gold particles in an MR-scanner. Thermotherapy is getting considerably attention...... the low energy radio frequencies. If the method is demonstrated to be feasible, next step is testing in cell line trials.   Confocal microscopy experiments on cells are very hard to do reliable and reproducible statistic on, due to the fact that that it’s user counting which makes the data. Automatic...

  16. The RHIC gold rush

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, T. [Department of Physics, North Carolina State University (United States)

    2003-06-01

    Physicists are colliding gold nuclei to recreate the fireball that existed in the very early universe, and they may have found evidence for quark-gluon plasma. What happens to ordinary matter as you heat it to higher and higher temperatures, or compress it to greater and greater densities? This simple question underpins a major effort to create extreme conditions in the lab, which has recently taken the shape of the Relativistic Heavy Ion Collider (RHIC). This machine has been colliding gold nuclei since 2000, and has produced tantalizing hints that a new state of matter - the quark-gluon plasma - is created in the reactions. But it has also sparked surprises that are sending researchers back to the drawing board. (U.K.)

  17. The RHIC gold rush

    CERN Document Server

    Schäfer, T

    2003-01-01

    Physicists are colliding gold nuclei to recreate the fireball that existed in the very early universe, and they may have found evidence for quark-gluon plasma. What happens to ordinary matter as you heat it to higher and higher temperatures, or compress it to greater and greater densities? This simple question underpins a major effort to create extreme conditions in the lab, which has recently taken the shape of the Relativistic Heavy Ion Collider (RHIC). This machine has been colliding gold nuclei since 2000, and has produced tantalizing hints that a new state of matter - the quark-gluon plasma - is created in the reactions. But it has also sparked surprises that are sending researchers back to the drawing board. (U.K.)

  18. Film Ace Takes Gold

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    "Really, I never, never expected to win this," said Chinese director Jia Zhangke on hearing he had taken the top award for his movie Still Life (Sanxia Haoren) at the Venice Film Festival, on September 9. A surprise late entry, Still Life quickly emerged as the favorite and the Gold Lion was again hugged by Chinese. The well-known Chinese director Zhang Yimou won the same award back in 1999, for Not One Less-also a

  19. JUNK: rubbish to gold

    OpenAIRE

    Hanson, Maria

    2015-01-01

    JUNK: rubbish to gold is a playful exploration of community economies (exchange, giving, bartering, gathering, earning, harvesting); putting on display the process of creating the ‘work of art’. Co-created and co-curated by Jivan Astfalck, Laura Bradshaw-Heap and Rachel Darbourne and partnered with charities, who supplied JUNK jewellery. During a public performance 31 jewellers ‘gifted’ their skills, (re)constructing pieces selected from a mountain of JUNK creating reimagined artworks for the...

  20. Rushing for gold

    DEFF Research Database (Denmark)

    Jønsson, Jesper Bosse; Bryceson, Deborah Fahy

    2009-01-01

    African rural dwellers have faced depressed economic prospects for several decades. Now, in a number of mineral-rich countries, multiple discoveries of gold and precious stones have attracted large numbers of prospective small-scale miners. While their 'rush' to, and activities within, mining sit...... affluent than the others, suggesting that movement can be rewarding for those willing to 'try their luck' with the hard work and social networking demands of mining another site....

  1. DNA Generated Electric Current Biosensor.

    Science.gov (United States)

    Hu, Lanshuang; Hu, Shengqiang; Guo, Linyan; Shen, Congcong; Yang, Minghui; Rasooly, Avraham

    2017-02-21

    In addition to its primary function as a genetic material, deoxyribonucleic acid (DNA) is also a potential biologic energy source for molecular electronics. For the first time, we demonstrate that DNA can generate a redox electric current. As an example of this new functionality, DNA generated redox current was used for electrochemical detection of human epidermal growth factor receptor 2 (HER2), a clinically important breast cancer biomarker. To induce redox current, the phosphate of the single stranded DNA aptamer backbone was reacted with molybdate to form redox molybdophosphate precipitate and generate an electrochemical current of ∼16.8 μA/μM cm(2). This detection of HER2 was performed using a sandwich detection assay. A HER2 specific peptide was immobilized onto a gold electrode surface for capturing HER2 in buffer and serum. The HER2 specific aptamer was used as both ligand to bind the captured HER2 and to generate a redox current signal. When tested for HER2 detection, the electrochemical current generated by the aptasensor was proportional to HER2 concentration in the range of 0.01 to 5 ng/mL, with a current generated in the range of ∼6.37 to 31.8 μA/cm(2) in both buffer and serum. This detection level is within the clinically relevant range of HER2 concentrations. This method of electrochemical signal amplification greatly simplifies the signal transduction of aptasensors, broadening their use for HER2 analysis. This novel approach of using the same aptamer as biosensor ligand and as transducer can be universally extended to other aptasensors for a wide array of biodetection applications. Moreover, electric currents generated by DNA or other nucleic acids can be used in molecular electronics or implanted devices for both power generation and measurement of output.

  2. World-class Xincheng gold deposit:An example from the giant Jiaodong gold province

    Institute of Scientific and Technical Information of China (English)

    Liqiang Yang; Jun Deng; Ruipeng Guo; Lin’nan Guo; Zhongliang Wang; Binghan Chen; Xudong Wang

    2016-01-01

    The Jiaodong gold deposits are currently the most important gold resources (with Au reserves of>4000 t) in China, and the leading gold-producing country globally (with Au production of w428 t in 2013). Jiaodong is also considered as perhaps the only world-class to giant gold accumulation on the planet where relatively young gold ores (ca. 130e120 Ma) were deposited in rocks that are 2 Ga older. The Xincheng world-class high-grade gold deposit, with a proven reserve of >200 t gold, is one of the largest deposits in the giant gold province of the Jiaodong Peninsula. It is located in the northwestern part of the Jiaobei Uplift, and hosted by ca. 132e123 Ma Xincheng quartz monzonites and monzogranites. Ore zones are structurally controlled by the NE-trending and NW-dipping Jiaojia Fault and subsidiary faults, and are mainly restricted to the footwall of the fault. The dominant disseminated-and stockwork-style ores are associated with strong sericitization, silicification, sulfidation and K-feldspathization, and minor carbonate wallrock alteration halos. The four mineralization stages are pyriteequartzesericite (stage 1), quartzepyrite (stage 2), quartzepolysulfide (stage 3) and quartzecarbonate (stage 4). Gold occurs dominantly as electrum, with lesser amounts of sulfide-hosted native gold and rare native silver and argentite, normally associated with pyrite, chalcopyrite, galena and sphalerite:the latter with proven resources of about 105 t Ag, 713 t Cu, and 5100 t S. There are three types of ore-related fluid inclusions: type 1 aqueous-carbonate (H2OeCO2), type 2 aqueous (liquid H2O þ vapor H2O), and type 3 CO2 (liquid CO2 and vapor CO2) inclusions. Homogeni-zation temperatures range from 221 to 304 ?C for type 1 inclusions, with salinities of 2.4e13.3 wt.%NaCl eq., and bulk densities of 0.858e1.022 g/cm3. The d34SCDT values of hydrothermal sulfides are 4.3e10.6&and d18O values of hydrothermal quartz have a median value of 13.0&. dD values of fluid inclusions in

  3. The dosimetric feasibility of gold nanoparticle-aided radiation therapy (GNRT) via brachytherapy using low-energy gamma-/x-ray sources.

    Science.gov (United States)

    Cho, Sang Hyun; Jones, Bernard L; Krishnan, Sunil

    2009-08-21

    The preferential accumulation of gold nanoparticles within tumors and the increased photoelectric absorption due to the high atomic number of gold cooperatively account for the possibility of significant tumor dose enhancement during gold nanoparticle-aided radiation therapy (GNRT). Among the many conceivable ways to implement GNRT clinically, a brachytherapy approach using low-energy gamma-/x-ray sources (i.e. E(avg) 40%) could be achievable using (125)I, 50 kVp and (169)Yb sources and gold nanoparticles. When calculated at 1.0 cm from the center of the source within a tumor loaded with 18 mg Au g(-1), macroscopic dose enhancement was 116, 92 and 108% for (125)I, 50 kVp and (169)Yb, respectively. For a tumor loaded with 7 mg Au g(-1), it was 68, 57 and 44% at 1 cm from the center of the source for (125)I, 50 kVp and (169)Yb, respectively. The estimated MDEF values for (169)Yb were remarkably larger than those for (192)Ir, on average by up to about 70 and 30%, for 18 mg Au and 7 mg Au cases, respectively. The current MC study also shows a remarkable change in the photoelectron fluence and spectrum (e.g. more than two orders of magnitude) and a significant production (e.g. comparable to the number of photoelectrons) of the Auger electrons within the tumor region due to the presence of gold nanoparticles during low-energy gamma-/x-ray irradiation. The radiation sources considered in this study are currently available and tumor gold concentration levels considered in this investigation are deemed achievable. Therefore, the current results strongly suggest that GNRT can be successfully implemented via brachytherapy with low energy gamma-/x-ray sources, especially with a high dose rate (169)Yb source.

  4. The 'price' of Olympic Gold.

    Science.gov (United States)

    Hogan, K; Norton, K

    2000-06-01

    In 1981 the Commonwealth Government established the Australian Institute of Sport (AIS). The Australian Sports Commission (ASC) which administers the AIS has 2 objectives: (1) excellence in sports performances; and (2) increased participation in sports and sports activities. State-based institutes of sport have also been established with the same or very similar objectives. Federal policy directs the bulk of the ASC budget to elite athlete programs. A smaller proportion goes towards community participation. The official reason is based on the notion of the 'trickle-down' or 'demonstration' effect. That is, a flow-on of benefits to the broader community in the form of increased participation as a direct result of elite sports success. The aims of this study were to determine the (1) spending pattern to elite sports programs for the 5 Olympics 1976/77 to 1995/96, (2) evidence for the two ASC objectives having been met, and (3) expected medal tally at the 2000 Olympic Games. Results show funding (in 1998 dollars), has accelerated from about $1.2 million (1976/77) to $106 million in (1997/98), particularly since the Games were awarded to Sydney. The total amount spent on elite athletes was $0.918 billion. In the period 1980-96 Australia won 25 gold and 115 total Olympic medals. This equates to approximately $37 million per gold and $8 million per medal in general. There was a significant linear relationship between money spent and total medals won. This was also found when all medal types were analysed independently. The predicted medal tally in 2000 (based on the cost per medal and the expenditure towards Sydney) indicates the medal count will be about 14+/-1 gold, 15+/-2 silver and 33+/-4 bronze. Based on our nation's record of international sporting achievement, there is little doubt we have fulfilled the ASC's first objective. Current data on physical activity patterns of Australians suggest the second objective has not been met. Focusing attention on and achieving

  5. Applications of gold nanoparticles in cancer nanotechnology

    Directory of Open Access Journals (Sweden)

    Weibo Cai

    2008-09-01

    Full Text Available Weibo Cai1,2, Ting Gao3, Hao Hong1, Jiangtao Sun11Departments of Radiology and Medical Physics, School of Medicine and Public Health, University of Wisconsin – Madison, Madison, Wisconsin, USA; 2University of Wisconsin Paul P. Carbone Comprehensive Cancer Center, Madison, Wisconsin, USA; 3Tyco Electronics Corporation, 306 Constitution Drive, Menlo Park, California, USAAbstract: It has been almost 4 decades since the “war on cancer” was declared. It is now generally believed that personalized medicine is the future for cancer patient management. Possessing unprecedented potential for early detection, accurate diagnosis, and personalized treatment of cancer, nanoparticles have been extensively studied over the last decade. In this review, we will summarize the current state-of-the-art of gold nanoparticles in biomedical applications targeting cancer. Gold nanospheres, nanorods, nanoshells, nanocages, and surface enhanced Raman scattering nanoparticles will be discussed in detail regarding their uses in in vitro assays, ex vivo and in vivo imaging, cancer therapy, and drug delivery. Multifunctionality is the key feature of nanoparticle-based agents. Targeting ligands, imaging labels, therapeutic drugs, and other functionalities can all be integrated to allow for targeted molecular imaging and molecular therapy of cancer. Big strides have been made and many proof-of-principle studies have been successfully performed. The future looks brighter than ever yet many hurdles remain to be conquered. A multifunctional platform based on gold nanoparticles, with multiple receptor targeting, multimodality imaging, and multiple therapeutic entities, holds the promise for a “magic gold bullet” against cancer.Keywords: gold nanoparticles, cancer, nanotechnology, optical imaging, nanomedicine, molecular therapy

  6. Histamine H3 receptors and its antagonism as a novel mechanism for antipsychotic effect: a current preclinical & clinical perspective

    Science.gov (United States)

    Mahmood, Danish

    2016-01-01

    Histamine H3 receptors are present as autoreceptors on histaminergic neurons and as heteroreceptors on nonhistaminergic neurones. They control the release and synthesis of histamine and several other key neurotransmitters in the brain. H3 antagonism may be a novel approach to develop a new class of antipsychotic medications given the gathering evidence reporting therapeutic efficacy in several central nervous system disorders. Several medications such as cariprazine, lurasidone, LY214002, bexarotene, rasagiline, raloxifene, BL-1020 and ITI-070 are being developed to treat the negative symptoms and cognitive impairments of schizophrenia. These medications works through diverse mechanisms which include agonism at metabotropic glutamate receptor (mGluR2/3), partial agonism at dopamine D2, D3 and serotonin 5-HT1A receptors, antagonism at D2, 5-HT2A, 5-HT2B and 5-HT7 receptors, combined dopamine antagonism with GABA agonist activity, inhibition of monoamine oxidase-B, modulation of oestrogen receptor, and activation of nuclear retinoid X receptor. However, still specific safe therapy for psychosis remains at large. Schizophrenia is a severe neuropsychiatric disorder result both from hyper- and hypo-dopaminergic transmission causing positive and negative symptoms, respectively. Pharmacological stimulation of dopamine release in the prefrontal cortex has been a viable approach in treating negative symptoms and cognitive deficits of schizophrenia symptoms that are currently not well treated and continue to represent significant unmet medical challenges. Administration of H3 antagonists/inverse agonists increase extracellular dopamine concentrations in rat prefrontal cortex, but not in the striatum suggesting that antagonism via H3 receptor may be a potential target for treating negative symptoms and cognitive deficits associated with schizophrenia. Further, insights are emerging into the potential role of histamine H3 receptors as a target of antiobesity therapeutics which

  7. Histamine H3 receptors and its antagonism as a novel mechanism for antipsychotic effect: a current preclinical & clinical perspective.

    Science.gov (United States)

    Mahmood, Danish

    2016-10-01

    Histamine H3 receptors are present as autoreceptors on histaminergic neurons and as heteroreceptors on nonhistaminergic neurones. They control the release and synthesis of histamine and several other key neurotransmitters in the brain. H3 antagonism may be a novel approach to develop a new class of antipsychotic medications given the gathering evidence reporting therapeutic efficacy in several central nervous system disorders. Several medications such as cariprazine, lurasidone, LY214002, bexarotene, rasagiline, raloxifene, BL-1020 and ITI-070 are being developed to treat the negative symptoms and cognitive impairments of schizophrenia. These medications works through diverse mechanisms which include agonism at metabotropic glutamate receptor (mGluR2/3), partial agonism at dopamine D2, D3 and serotonin 5-HT1A receptors, antagonism at D2, 5-HT2A, 5-HT2B and 5-HT7 receptors, combined dopamine antagonism with GABA agonist activity, inhibition of monoamine oxidase-B, modulation of oestrogen receptor, and activation of nuclear retinoid X receptor. However, still specific safe therapy for psychosis remains at large. Schizophrenia is a severe neuropsychiatric disorder result both from hyper- and hypo-dopaminergic transmission causing positive and negative symptoms, respectively. Pharmacological stimulation of dopamine release in the prefrontal cortex has been a viable approach in treating negative symptoms and cognitive deficits of schizophrenia symptoms that are currently not well treated and continue to represent significant unmet medical challenges. Administration of H3 antagonists/inverse agonists increase extracellular dopamine concentrations in rat prefrontal cortex, but not in the striatum suggesting that antagonism via H3 receptor may be a potential target for treating negative symptoms and cognitive deficits associated with schizophrenia. Further, insights are emerging into the potential role of histamine H3 receptors as a target of antiobesity therapeutics which

  8. Green Synthesis of Gold Nanoparticles

    Directory of Open Access Journals (Sweden)

    Hamid Reza Ghorbani

    2015-03-01

    Full Text Available There is an increased interest in understanding the toxicity and rational design of gold nanoparticles for biomedical applications in recent years. In this study gold nanoparticles were synthesized using dextrose as a reducing agent. The gold nanoparticles displayed characteristic Surface Plasmon Resonance peak at around 550 nm having a mean particle size of 75±30 nm. In order to identify and analyze nanoparticles, UV–Vis spectroscopy, Scanning electron microscopy (SEM, and dynamic light scattering (DLS were used.

  9. Gold nanostructures as photothermal therapy agent for cancer.

    Science.gov (United States)

    Choi, Jihye; Yang, Jaemoon; Jang, Eunji; Suh, Jin-Suck; Huh, Yong-Min; Lee, Kwangyeol; Haam, Seungjoo

    2011-12-01

    Well-designed photothermal nanostructures have attracted many scientists pursuing a better means to accurately diagnose cancer and assess the efficacy of treatment. Recently, gold-based nanostructures (nanoshells, nanorods and nanocages) have enabled photothermal ablation of cancer cells with near-infrared (NIR) light without damaging normal human tissues and in particular, animal studies and early clinical testing showed the great promise for these materials. In this review article, we first discuss the mechanism of the cellular death signaling by thermal stress and introduce the intrinsic properties of gold nanostructures as photothermal agent for cancer treatment. Then the overview follows for evolving researches for the synthesis of various types of gold nanostructures and for their biomedical applications. Finally we introduce the optimized therapeutic strategies involving nanoparticle surface modification and laser operation method for an enhanced accumulation of gold nanostructures to the target cancer as well as for an effective cancer cell ablation.

  10. The extractive metallurgy of gold

    Science.gov (United States)

    Kongolo, K.; Mwema, M. D.

    1998-12-01

    Mössbauer spectroscopy has been successfully used in investigation of the gold compounds present in ores and the gold species which occur during the process metallurgy of this metal. This paper is a survey of the basic recovery methods and techniques used in extractive metallurgy of gold. Process fundamentals on mineral processing, ore leaching, zinc dust cementation, adsorption on activated carbon, electrowinning and refining are examined. The recovery of gold as a by-product of the copper industry is also described. Alternative processing methods are indicated in order to shed light on new interesting research topics where Mössbauer spectroscopy could be applied.

  11. Cancer clinical research in Latin America: current situation and opportunities. Expert opinion from the first ESMO workshop on clinical trials, Lima, 2015.

    Science.gov (United States)

    Rolfo, Christian; Caglevic, Christian; Bretel, Denisse; Hong, David; Raez, Luis E; Cardona, Andres F; Oton, Ana B; Gomez, Henry; Dafni, Urania; Vallejos, Carlos; Zielinski, Christoph

    2016-01-01

    Latin America and the Caribbean have not yet developed strong clinical cancer research programmes. In order to improve this situation two international cancer organisations, the Latin American Society of Clinical Oncology (SLACOM) and the European Society of Medical Oncology (ESMO) worked closely with the Peruvian Cooperative Oncology Group (GECOPERU) and organised a clinical cancer research workshop held in Lima, Peru, in October 2015. Many oncologists from different Latin American countries participated in this gathering. The opportunities for and strengths of clinical oncology research in Latin American and Caribbean countries were identified as the widespread use of the Spanish language, the high cancer burden, growing access to information, improving patient education, access to new drugs for research centres, regional networks and human resources. However, there are still many weaknesses and problems including the long timeline for regulatory approval, lack of economic investment, lack of training and lack of personnel participating in clinical research, lack of cancer registries, insufficient technology and insufficient supplies for the diagnosis and treatment of cancer, few cancer specialists, low general levels of education and the negative attitude of government authorities towards clinical research.

  12. Cancer clinical research in Latin America: current situation and opportunities. Expert opinion from the first ESMO workshop on clinical trials, Lima, 2015

    Science.gov (United States)

    Rolfo, Christian; Caglevic, Christian; Bretel, Denisse; Hong, David; Raez, Luis E; Cardona, Andres F; Oton, Ana B; Gomez, Henry; Dafni, Urania; Vallejos, Carlos; Zielinski, Christoph

    2016-01-01

    Latin America and the Caribbean have not yet developed strong clinical cancer research programmes. In order to improve this situation two international cancer organisations, the Latin American Society of Clinical Oncology (SLACOM) and the European Society of Medical Oncology (ESMO) worked closely with the Peruvian Cooperative Oncology Group (GECOPERU) and organised a clinical cancer research workshop held in Lima, Peru, in October 2015. Many oncologists from different Latin American countries participated in this gathering. The opportunities for and strengths of clinical oncology research in Latin American and Caribbean countries were identified as the widespread use of the Spanish language, the high cancer burden, growing access to information, improving patient education, access to new drugs for research centres, regional networks and human resources. However, there are still many weaknesses and problems including the long timeline for regulatory approval, lack of economic investment, lack of training and lack of personnel participating in clinical research, lack of cancer registries, insufficient technology and insufficient supplies for the diagnosis and treatment of cancer, few cancer specialists, low general levels of education and the negative attitude of government authorities towards clinical research. PMID:27843620

  13. Gold recovery from low concentrations using nanoporous silica adsorbent

    Science.gov (United States)

    Aledresse, Adil

    gold adsorption shows the high affinity of the mesoporous material to the gold-thiosulphate ([Au (S2O3)2]3- ) ions. A high adsorption saturation level for these materials was found, up to 0.25 mmol (5 mg) Au/g of HMS from gold-thiosulphate solutions. When ammonia was added to the thiosulphate solutions, with or without added copper, the mesoporous material (HMS) achieved the maximum adsorption, 0.24 mmol (47 mg) Au/g of HMS at pH = 7, where as 0.14 mmol (28 mg) Au/g was adsorbed from ammonia-thiosulphate solution at pH > 6. For the fist time, a promising adsorbent system has been found that is capable of effectively concentrating gold thiosulphate complexes, whereas conventional carbon-in-pulp (CIP) and carbon-in-leach (CIL) systems fail. For process design of gold adsorption by HMS particles, certain engineering conditions and practical limitations have to be considered, including particle size of the MP-HMS. Therefore, several experiments have been conducted to enlarge the size of the very fine MP-HMS particles to a size (1--2mm) satisfying the engineering requirements for process design in a real practical and industrial process. The agglomerated mesoporous materials, using sodium metasilicate (Na 2SiO3) binder, adsorbed gold ions in the range of 51%--63% of what the parent HMS powder adsorb. That means the agglomerates can adsorb 19--23% of their own weight (or 190--230 mg Au per one gram of the agglomerated HMS) from [AuCL4]- which is still very satisfactory and acceptable comparing to the current used adsorbents.

  14. Nanomolar Trace Metal Analysis of Copper at Gold Microband Arrays

    Energy Technology Data Exchange (ETDEWEB)

    Wahl, A; Dawson, K; Sassiat, N; Quinn, A J; O' Riordan, A, E-mail: alan.oriordan@tyndall.ie [Nanotechnology Group, Tyndall National Institute, University College Cork, Lee Maltings, Cork (Ireland)

    2011-08-17

    This paper describes the fabrication and electrochemical characterization of gold microband electrode arrays designated as a highly sensitive sensor for trace metal detection of copper in drinking water samples. Gold microband electrodes have been routinely fabricated by standard photolithographic methods. Electrochemical characterization were conducted in 0.1 M H{sub 2}SO{sub 4} and found to display characteristic gold oxide formation and reduction peaks. The advantages of gold microband electrodes as trace metal sensors over currently used methods have been investigated by employing under potential deposition anodic stripping voltammetry (UPD-ASV) in Cu{sup 2+} nanomolar concentrations. Linear correlations were observed for increasing Cu{sup 2+} concentrations from which the concentration of an unknown sample of drinking water was estimated. The results obtained for the estimation of the unknown trace copper concentration in drinking was in good agreement with expected values.

  15. Solid gold nanostructures fabricated by electron beam deposition

    DEFF Research Database (Denmark)

    Mølhave, Kristian; Madsen, Dorte Nørgaard; Rasmussen, A.M.

    2003-01-01

    Direct writing with gold by electron beam deposition is a method for rapid fabrication of electrically conducting nanostructures. An environmental scanning electron microscope (ESEM) equipped with a source of the precursor gas dimethylacetylacetonate gold(Ill) was used to fabricate nanoscale tips...... and bridges. Transmission electron microscopy was used to study how the composition of these structures was affected when the background gas in the ESEM chamber and the electron beam parameters were varied. The nanostructures were layered composites of up to three different materials each characterized...... by a certain range of gold/carbon ratios. Above a certain threshold of ESEM chamber water vapor pressure and a certain threshold of electron beam current, the deposited tips contained a solid polycrystalline gold core. The deposition technique was used to fabricate free-standing nanowires and to solder free...

  16. Current Status and Future Prospects of Clinical Psychology: Toward a Scientifically Principled Approach to Mental and Behavioral Health Care.

    Science.gov (United States)

    Baker, Timothy B; McFall, Richard M; Shoham, Varda

    2008-11-01

    The escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective-disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional-economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions. Research has shown that numerous psychological interventions are efficacious, effective, and cost-effective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so. Clinical psychologists' failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s

  17. Turning lead into gold

    DEFF Research Database (Denmark)

    Jensen, Steffen Moltrup Ernø

    For years the field of entrepreneurship has been blinded by the alchemical promise of turning lead into gold, of finding the ones most likely to become the next Branson, Zuckerberg or Gates. The promise has been created in the midst of political and scientific agendas where certain individuals...... is not to accumulate state or market wealth, but for entrepreneurial skills to become tools towards the liberation of the individual from oppressive systems of control – essentially to add public value rather than economic value. In this presentation I will sketch an anarchist perspective on entrepreneurship, looking...

  18. Fabrication of highly sensitive gold nanourchins based electrochemical sensor for nanomolar determination of primaquine.

    Science.gov (United States)

    Thapliyal, Neeta Bachheti; Chiwunze, Tirivashe Elton; Karpoormath, Rajshekhar; Cherukupalli, Srinivasulu

    2017-05-01

    A gold nanourchins modified glassy carbon electrode (AuNu/GCE) was developed for the determination of antimalarial drug, primaquine (PQ). The surface of AuNu/GCE was characterized by electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and cyclic voltammetry (CV). EIS results indicated that the electron transfer process at AuNu/GCE was faster as compared to the bare electrode. The SEM and TEM image confirmed the presence and uniform dispersion of gold nanourchins on the GCE surface. Upon investigating the electrochemical behavior of PQ at AuNu/GCE, the developed sensor was found to exhibit high electrocatalytic activity towards the oxidation of PQ. Under optimal experimental conditions, the sensor showed fast and sensitive current response to PQ over a linear concentration range of 0.01-1μM and 0.001-1μM with a detection limit of 3.5nM and 0.9nM using differential pulse voltammetry (DPV) and square wave voltammetry (SWV), respectively. The AuNu/GCE showed good selectivity, reproducibility and stability. Further, the developed sensor was successfully applied to determine the drug in human urine samples and pharmaceutical formulations demonstrating its analytical applicability in clinical analysis as well as quality control. The proposed method thus provides a promising alternative in routine sensing of PQ as well as promotes the application of gold nanourchins in electrochemical sensors. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. SERS-based multiple biomarker detection using a gold-patterned microarray chip

    Science.gov (United States)

    Kim, Insup; Junejo, Inam-ur-Rehman; Lee, Moonkwon; Lee, Sangyeop; Lee, Eun Kyu; Chang, Soo-Ik; Choo, Jaebum

    2012-09-01

    We report a highly sensitive surface-enhanced Raman scattering (SERS)-based immunoassay platform for the multiplex detection of biomarkers. For this purpose, a gold-patterned microarray chip has been fabricated and used as a SERS detection template. Here, a typical sandwich immunocomplex protocol was adopted. Monoclonal antibodies were immobilized on gold patterned substrates, and then antigen solutions and polyclonal antibody-conjugated hollow gold nanospheres (HGNs) were sequentially added for the formation of sandwich immunocomplexes. Antigen biomarkers can be quantitatively assayed by monitoring the intensity change of a characteristic SERS peak of a reporter molecule adsorbed on the surfaces of HGNs. Under optimized assay conditions, the limits of detections (LODs) were determined to be 10 fg/mL for human IgG and 10-100 fg/mL for rabbit IgG. In addition, the SERS-based immunoassay technique can be applied in a wider dynamic concentration range with a good sensitivity compared to ELISA. The proposed method fulfills the current needs of high sensitivity and selectivity which are essential for the clinical diagnosis of a disease.

  20. Current clinical and epidemiological portrait of a patient with acute myocardial infarction (by the data of the regional vascular center

    Directory of Open Access Journals (Sweden)

    E. Yu. Kovalchuk

    2015-01-01

    Full Text Available Epidemiological and clinical presentation of acute myocardial infarction based upon the data collected in Regional Vascular Centre of Saint-Petersburg Scientific Research Institute of Emergency Care n. a. I. I. Dzhanelidze in 2009-2012 years. In the article, 4697 cases have been analyzed. Specific features of epidemiology and clinical presentation of acute myocardial infarction at the present stage have been considered.

  1. 钛合金烤瓷修复体与金合金烤瓷修复体临床效果的Meta分析%Clinical effect of gold alloy and titanium alloy porcelain-fused-to-metal: A meta-analysis of randomized controlled trails

    Institute of Scientific and Technical Information of China (English)

    李静; 尚慧娟; 胡媛媛; 李艳琴; 陈永吉

    2013-01-01

    Objective:To evaluate the clinical effect of gold alloy and titanium alloy porcelain-fused-to-metal (PFM)by performing a meta-analysis.Method:The relevant randomized controlled trials (RCTs) were electronically searched from the Cochrane Library,PubMed,CNKI,and Wanfang databases up to October,2012.After data extraction and quality evaluation of included RCTs,the meta-analysis was conducted using the RevMan 5.1 software.Result:Finally 15 RCTs involving 758 gold alloy PFMs and 920 titanium alloy PFMs were included.The result of meta-analysis showed that,compared with titanium alloy PFM,gold alloy PFM could significantly increased the satisfaction of the color of PFM (RR=0.35,95 % CI=0.22~0.55,P <0.001) and marginal fitness of PFM (RR=0.36,95 % CI=0.20~0.63,P =0.0004),could significantly decreased the risk of cervical margin′s coloration (RR=0.19,95 % CI=0.09~0.38,P <0.001),have the trend for decreasing the risk of gingivitis (RR=0.73,95 % CI=0.53~1.02,P =0.07) and porcelain/metal damage (RR=0.58,95 % CI=0.16~2.07,P =0.41).Conclusion:Based on currently evidence,the clinical effect of gold alloy PFM is better than titanium alloy PFM.Due to the limitations,the result of this meta-analysis should be further verified by conducting large sample,high quality,and blinding RCTs,and the "cost-effectiveness analysis" is also suggested as a outcome.%目的:采用Meta分析的方法评价钛合金与金合金烤瓷修复体的临床效果.方法:检索PubMed、Cochrane Library、中国知网和万方数据库中自建库至2012年10月间公开发表的比较钛合金与金合金烤瓷修复体临床效果的随机对照试验文献,进行资料提取及质量评价后,采用RevMan 5.1软件进行Meta分析.结果:共纳入15个研究,包括758例金合金修复体和920例钛合金修复体.Meta分析结果表明,与钛合金修复体相比,金合金修复体能显著提升修复体颜色(RR=0.35,95%CI=0.22~0.55,P<0.001)和边缘密合性(RR=0

  2. [Current controversies in glycemic control targets. What do the results of the latest clinical trials tell us about the approach to type 2 diabetes mellitus?].

    Science.gov (United States)

    Mauricio, Dídac; Rius, Ferran

    2010-09-01

    The aim of this article is to discuss the implications of the results obtained in the latest large-scale clinical trials designed to evaluate the effect of intensive glycemic control on the vascular complications associated with type 2 diabetes mellitus. The current scientific evidence is reviewed and the implications of the ACCORD (The Action to Control Cardiovascular Risk in Diabetes study group), ADVANCE (Action in Diabetes and Vascular disease: Preterax and Diamicron Modified Release Control Evaluation) and VADT (Veterans Affairs Diabetes Trial) clinical trials are discussed. General concerns of the studies and their implications for clinical practice and the management of type 2 diabetes, as well as the questions which still need to be answered by future clinical research are discussed.

  3. Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair: International Cartilage Repair Society Recommendations Based on Current Scientific Evidence and Standards of Clinical Care.

    Science.gov (United States)

    Mithoefer, Kai; Saris, Daniel B F; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

    2011-04-01

    To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project.

  4. Orofacial pain and occlusion: is there a link? An overview of current concepts and the clinical implications.

    Science.gov (United States)

    Racich, Michael J

    2005-02-01

    This paper addresses the current concepts in orofacial pain and occlusion and queries their possible relationship to each other. English-language peer-reviewed articles were identified using Medline (1990-2003), as well as a hand search. The key words occlusion, orofacial pain , and temporomandibular disorders (TMD) were used. Additional references from citations within the articles were obtained, and current textbooks were used as well. The textbooks provided contemporary concept overviews and further additional references.

  5. Standardization of calibration of clinic dosemeters using electric currents and charges; Padronizacao da calibracao de dosimetros clinicos utilizando cargas e correntes eletricas

    Energy Technology Data Exchange (ETDEWEB)

    Peres, Marcos Antonio de Lima

    1999-09-15

    Clinical dosimeters used in radiotherapy are calibrated in Latin American countries, including Brazil, as a complete 'system, i.e., ionization chamber and electrometer together. Some countries, as European ones, and USA calibrate them by component, i.e., ionisation chamber apart from electrometer. This method is more advantageous than the previous one, since it makes possible the automation of the calibration process, allowing the acquisition of data related to the chamber and the electrometer measurements independently, as well as the substitution of one of the components, in case of failure. This work proposes a method for standardisation of low intensity electric charge and currents in order to implement electric calibration of electrometers. This will make possible the implementation of a by components calibration technique, by components, of clinical dosimeters in Brazil. The results obtained with the calibration by components prove that the proposed method of standardisation of low electric charges and currents is viable. The difficulties found for the generation and measurement of low intensity electric charges and currents and the procedures adopted for the calibration by components are presented. Additionally, a current source was built to yield reference electric charges that will make possible the quality control clinical dosimeters. This source will also allow the user to identify the defective components of the dosimeters, through a simple verification test. (author)

  6. Gold electrodes from recordable CDs

    Science.gov (United States)

    Angnes; Richter; Augelli; Kume

    2000-11-01

    Gold electrodes are widely used in electrochemistry and electroanalytical chemistry. The notable performance when used in stripping analysis of many ionic species and the extraordinary affinity of thio compounds for its surface make these electrodes very suitable for many applications. This paper reports a simple and novel way to construct gold electrodes (CDtrodes) using recordable CDs as the gold source. The nanometer thickness of the gold layer of recordable disks (50-100 nm) favors the construction of band nanoelectrodes with areas as small as 10(-6) cm2. The plane surface can be easily used for the construction of conventional-sized gold electrodes for batch or flow injection analysis or even to obtain electrodes as large as 100 cm2. The low price of commercial recordable CDs allows a "one way use". The evaluation and applicability of these electrodes in the form of nanoelectrodes, in batch and associated with flow cells, are illustrated in this paper.

  7. Gold revolution--gold nanoparticles for modern medicine and surgery.

    Science.gov (United States)

    Rippel, Radoslaw A; Seifalian, Alexander M

    2011-05-01

    Nanotechnology is a new and exciting branch of science which offers enormous potential for development of medicine and surgery. Gold nanoparticles (GNP) is just one of a variety of nano products which will be available for physician of the future. GNP will give us more effective treatments and diagnosis. We are able to conjugate GNP with peptides, drugs, and other molecules to gain astonishing effects. High quality, non-invasive imaging will inevitably lead to astonishing accuracy diagnostic tools with effective use during surgery. The same principles may be used in the future for drug delivery and thermal treatment of cancer. Detailed DNA detection and regulation may become everyday use technology, in medicine with support from GNP based tools. Bacterial diagnostics and nerve repair are relatively poorly researched areas of application of GNP with possibly astonishing therapeutic effects. Non-invasive clearance of arteriosclerotic plagues with GNP shows a great prospect for further development of minimally invasive surgery. However, before all of those tools will become available for clinicians, in depth toxicology research as well as transitional research and design have to be done to ensure safe clinical practice with maximal benefit for patients.

  8. Antibacterial properties and mechanisms of gold-silver nanocages

    Science.gov (United States)

    Wang, Yulan; Wan, Jiangshan; Miron, Richard J.; Zhao, Yanbin; Zhang, Yufeng

    2016-05-01

    Despite the number of antibiotics used in routine clinical practice, bacterial infections continue to be one of the most important challenges faced in humans. The main concerns arise from the continuing emergence of antibiotic-resistant bacteria and the difficulties faced with the pharmaceutical development of new antibiotics. Thus, advancements in the avenue of novel antibacterial agents are essential. In this study, gold (Au) was combined with silver (Ag), a well-known antibacterial material, to form silver nanoparticles producing a gold-silver alloy structure with hollow interiors and porous walls (gold-silver nanocage). This novel material was promising in antibacterial applications due to its better biocompatibility than Ag nanoparticles, potential in photothermal effects and drug delivery ability. The gold-silver nanocage was then tested for its antibacterial properties and the mechanism involved leading to its antibacterial properties. This study confirms that this novel gold-silver nanocage has broad-spectrum antibacterial properties exerting its effects through the destruction of the cell membrane, production of reactive oxygen species (ROS) and induction of cell apoptosis. Therefore, we introduce a novel gold-silver nanocage that serves as a potential nanocarrier for the future delivery of antibiotics.

  9. Emerging advances in nanomedicine with engineered gold nanostructures

    Science.gov (United States)

    Webb, Joseph A.; Bardhan, Rizia

    2014-02-01

    Gold nanostructures possess unique characteristics that enable their use as contrast agents, as therapeutic entities, and as scaffolds to adhere functional molecules, therapeutic cargo, and targeting ligands. Due to their ease of synthesis, straightforward surface functionalization, and non-toxicity, gold nanostructures have emerged as powerful nanoagents for cancer detection and treatment. This comprehensive review summarizes the progress made in nanomedicine with gold nanostructures (1) as probes for various bioimaging techniques including dark-field, one-photon and two-photon fluorescence, photothermal optical coherence tomography, photoacoustic tomography, positron emission tomography, and surface-enhanced Raman scattering based imaging, (2) as therapeutic components for photothermal therapy, gene and drug delivery, and radiofrequency ablation, and (3) as a theranostic platform to simultaneously achieve both cancer detection and treatment. Distinct from other published reviews, this article also discusses the recent advances of gold nanostructures as contrast agents and therapeutic actuators for inflammatory diseases including atherosclerotic plaque and arthritis. For each of the topics discussed above, the fundamental principles and progress made in the past five years are discussed. The review concludes with a detailed future outlook discussing the challenges in using gold nanostructures, cellular trafficking, and translational considerations that are imperative for rapid clinical viability of plasmonic nanostructures, as well as the significance of emerging technologies such as Fano resonant gold nanostructures in nanomedicine.

  10. Current concepts in the diagnosis of blood stream infections. Are novel molecular methods useful in clinical practice?

    Science.gov (United States)

    Huttunen, Reetta; Syrjänen, Jaana; Vuento, Risto; Aittoniemi, Janne

    2013-11-01

    The decision on the right empirical treatment in bacteremia places particular demands on the clinician. As long as no microbiological diagnosis can be immediately drawn, the clinical diagnosis together with knowledge of local antimicrobial resistance must determine the antimicrobial choice. The use of several amplification, hybridization, and mass spectrometry methods has been studied in patient cohorts in comparison with blood culture-based conventional techniques. However, no clinical outcome trials have been conducted in which the use of these novel methods would guide antimicrobial therapy. Local differences in bacterial antimicrobial resistance cause differences in the regional need for molecular methods for the early detection of resistance mechanisms. The implementation of novel methods in clinical use requires active discussion between laboratory experts and clinicians. Providing rapid susceptibility results using conventional methods can lead to timely changes to appropriate antimicrobial therapy and the costs are lower than with the molecular methods. Gram-stain information in combination with clinical data is an underestimated, underused, rapid, and economical means of assessing the etiology of blood stream infection.

  11. Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people

    NARCIS (Netherlands)

    Hooper, L.; Abdelhamid, A.; Attreed, N.J.; Campbell, W.W.; Channell, A.M.; Chassagne, P.; Culp, K.R.; Fletcher, S.J.; Fortes, M.B.; Fuller, N.; Gaspar, P.M.; Gilbert, D.J.; Heathcote, A.C.; Kafri, M.W.; Kajii, F.; Lindner, G.; Mack, G.W.; Mentes, J.C.; Merlani, P.; Needham, R.A.; Olde Rikkert, M.G.M.; Perren, A.; Powers, J.; Ranson, S.C.; Ritz, P.; Rowat, A.M.; Sjostrand, F.; Smith, A.C.; Stookey, J.J.D.; Stotts, N.A.; Thomas, D.R.; Vivanti, A.; Wakefield, B.J.; Waldreus, N.; Walsh, N.P.; Ward, S.; Potter, J.F.; Hunter, P.

    2015-01-01

    BACKGROUND: There is evidence that water-loss dehydration is common in older people and associated with many causes of morbidity and mortality. However, it is unclear what clinical symptoms, signs and tests may be used to identify early dehydration in older people, so that support can be mobilised t

  12. Cost-benefit assessment of using electronic health records data for clinical research versus current practices: Contribution of the Electronic Health Records for Clinical Research (EHR4CR) European Project.

    Science.gov (United States)

    Beresniak, Ariel; Schmidt, Andreas; Proeve, Johann; Bolanos, Elena; Patel, Neelam; Ammour, Nadir; Sundgren, Mats; Ericson, Mats; Karakoyun, Töresin; Coorevits, Pascal; Kalra, Dipak; De Moor, Georges; Dupont, Danielle

    2016-01-01

    The widespread adoption of electronic health records (EHR) provides a new opportunity to improve the efficiency of clinical research. The European EHR4CR (Electronic Health Records for Clinical Research) 4-year project has developed an innovative technological platform to enable the re-use of EHR data for clinical research. The objective of this cost-benefit assessment (CBA) is to assess the value of EHR4CR solutions compared to current practices, from the perspective of sponsors of clinical trials. A CBA model was developed using an advanced modeling approach. The costs of performing three clinical research scenarios (S) applied to a hypothetical Phase II or III oncology clinical trial workflow (reference case) were estimated under current and EHR4CR conditions, namely protocol feasibility assessment (S1), patient identification for recruitment (S2), and clinical study execution (S3). The potential benefits were calculated considering that the estimated reduction in actual person-time and costs for performing EHR4CR S1, S2, and S3 would accelerate time to market (TTM). Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to manage uncertainty. Should the estimated efficiency gains achieved with the EHR4CR platform translate into faster TTM, the expected benefits for the global pharmaceutical oncology sector were estimated at €161.5m (S1), €45.7m (S2), €204.5m (S1+S2), €1906m (S3), and up to €2121.8m (S1+S2+S3) when the scenarios were used sequentially. The results suggest that optimizing clinical trial design and execution with the EHR4CR platform would generate substantial added value for pharmaceutical industry, as main sponsors of clinical trials in Europe, and beyond. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Relationship between Gold and Oil Prices and Stock Market Returns

    Directory of Open Access Journals (Sweden)

    Muhammad Mansoor Baig

    2013-10-01

    Full Text Available This study objective to examine the relationship between gold prices, oil prices and KSE100 return. This study important for the investor whose want to invest in real assets and financial assets. This study helps investor to achieve the portfolio diversification. This study uses the monthly data of gold prices, KSE100, and oil prices for the period of 2000 to 2010 (monthly. This study applied Descriptive statistics, Augmented Dickey Fuller test Phillip Perron test, Johansen and Jelseluis Co-integration test, Variance Decomposition test to find relationship. This study concludes that Gold prices growth, Oil prices growth and KSE100 return have no significant relationship in the long run. This study provides information to the investors who want to get the benefit of diversification by investing in Gold, Oil and stock market. In the current era Gold prices and oil prices are fluctuating day by day and investors think that stock returns may or may not affected by these fluctuations. This study is unique because it focuses on current issues and takes the current data in this research to help the investment institutions or portfolio managers.

  14. Silver-enhanced colloidal gold metalloimmunoassay for Schistosoma japonicum antibody detection.

    Science.gov (United States)

    Chu, Xia; Xiang, Zhi-Feng; Fu, Xin; Wang, Shi-Ping; Shen, Guo-Li; Yu, Ru-Qin

    2005-06-01

    A silver-enhanced colloidal gold metalloimmunoassay has been proposed for the determination of Schistosoma japonicum antibody (SjAb) in rabbit serum. The adult worm antigen of S. japonicum (SjAg) was adsorbed passively on the walls of a polystyrene microwell and then reacted with the desired SjAb. The colloidal gold-labeled goat anti-rabbit IgG secondary antibody was adsorbed on the walls of the polystyrene microwells through the reaction with SjAb, followed by the silver enhancement process, dissolution of silver metal atoms in an acidic solution, and determination of dissolved silver ions by anodic stripping voltammetry (ASV) at a glassy-carbon electrode. Assay conditions were optimized, including the reaction time of SjAg with SjAb, the interaction of SjAb with the colloidal gold-labeled secondary antibody, the dilution ratio of the colloidal gold-labeled secondary antibody and the silver enhancement time. The integration of the anodic stripping peak current depended linearly on the SjAb logarithmic concentration over the range of 6.4 ng/ml to 100 microg/ml. A detection limit as low as 3.0 ng/ml SjAb was achieved, which was better than the piezoelectric body acoustic wave sensor (detection limit of 7.2 microg/ml) and the renewable amperometric immunosensor (detection limit of 0.36 microg/ml). Rabbit serum samples with various degrees of infection were analyzed, and the results demonstrate that the proposed method meets the requirements of clinical analysis.

  15. Modelling world gold prices and USD foreign exchange relationship using multivariate GARCH model

    Science.gov (United States)

    Ping, Pung Yean; Ahmad, Maizah Hura Binti

    2014-12-01

    World gold price is a popular investment commodity. The series have often been modeled using univariate models. The objective of this paper is to show that there is a co-movement between gold price and USD foreign exchange rate. Using the effect of the USD foreign exchange rate on the gold price, a model that can be used to forecast future gold prices is developed. For this purpose, the current paper proposes a multivariate GARCH (Bivariate GARCH) model. Using daily prices of both series from 01.01.2000 to 05.05.2014, a causal relation between the two series understudied are found and a bivariate GARCH model is produced.

  16. Comparison of the copper and gold wire bonding processes for LED packaging*

    Institute of Scientific and Technical Information of China (English)

    Chen Zhaohui; Liu Yong; Liu Sheng

    2011-01-01

    Wire bonding is one of the main processes of the LED packaging which provides electrical interconnection between the LED chip and lead frame The gold wire bonding process has been widely used in LED packaging industry currently. However, due to the high cost of gold wire, copper wire bonding is a good substitute for the gold wire bonding which can lead to significant cost saving. In this paper, the copper and gold wire bonding processes on the high power LED chip are compared and analyzed with finite element simulation. This modeling work may provide guidelines for the parameter optimization of coppor wire bonding process on the high power LED packaging.

  17. Targeting breast cancer through its microenvironment : Current status of preclinical and clinical research in finding relevant targets

    NARCIS (Netherlands)

    Nienhuis, H. H.; Gaykema, S. B. M.; Timmer-Bosscha, H.; Jalving, M.; Brouwers, A. H.; Lub-de Hooge, M. N.; v