Lifestyle Factors in Late Adolescence Associate With Later Development of Diverticular Disease Requiring Hospitalization.

Science.gov (United States)

Järbrink-Sehgal, M Ellionore; Schmidt, Peter T; Sköldberg, Filip; Hemmingsson, Tomas; Hagström, Hannes; Andreasson, Anna

2018-04-12

The burden of diverticular disease on society is high and is increasing with an aging population. It is therefore important to identify risk factors for disease development or progression. Many lifestyle behaviors during adolescence affect risk for later disease. We searched for adolescent lifestyle factors that affect risk of diverticular disease later in life. We performed a retrospective analysis of data from 43,772 men (age, 18-20 y) conscripted to military service in Sweden from 1969 through 1970, with a follow-up period of 39 years. All conscripts underwent an extensive mental and physical health examination and completed questionnaires covering alcohol consumption, smoking, and use of recreational drugs; cardiovascular fitness was assessed using an ergometer cycle at the time of conscription. Outcome data were collected from national registers to identify discharge diagnoses of diverticular disease until the end of 2009. We performed Cox regression analysis to determine whether body mass index, cardiovascular fitness, smoking, use of recreational drugs, alcohol consumption, and risky use of alcohol, at time of conscription are independent risk factors for development of diverticular disease. Overweight and obese men had a 2-fold increased risk of diverticular disease compared to normal-weight men (hazard ratio, 2.00; P diverticular disease requiring hospitalization (P = .009). Smoking (P = .003), but not use of recreational drugs (P = .11), was associated with an increased risk of diverticular disease requiring hospitalization. Risky use of alcohol, but not alcohol consumption per se, was associated with a 43% increase in risk of diverticular disease requiring hospitalization (P = .007). In a retrospective analysis of data from 43,772 men in Sweden, we associated being overweight or obese, a smoker, a high-risk user of alcohol, and/or having a low level of cardiovascular fitness in late adolescence with an increased risk of developing diverticular

78 FR 11521 - Control of Communicable Disease; Foreign-Requirements for Importers of Nonhuman Primates (NHP)

Science.gov (United States)

2013-02-15

... Part 71 Control of Communicable Disease; Foreign--Requirements for Importers of Nonhuman Primates (NHP... Primates (NHP) AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human... live nonhuman primates (NHPs) by extending existing requirements for the importation of Macaca...

Study partners should be required in preclinical Alzheimer's disease trials.

Science.gov (United States)

Grill, Joshua D; Karlawish, Jason

2017-12-06

In an effort to intervene earlier in Alzheimer's disease (AD), clinical trials are testing promising candidate therapies in preclinical disease. Preclinical AD trial participants are cognitively normal, functionally independent, and autonomous decision-makers. Yet, like AD dementia trials, preclinical trials require dual enrollment of a participant and a knowledgeable informant, or study partner. The requirement of dyadic enrollment is a barrier to recruitment and may present unique ethical challenges. Despite these limitations, the requirement should continue. Study partners may be essential to ensure participant safety and wellbeing, including overcoming distress related to biomarker disclosure and minimizing risk for catastrophic reactions and suicide. The requirement may maximize participant retention and ensure data integrity, including that study partners are the source of data that will ultimately instruct whether a new treatment has a clinical benefit and meaningful impact on the population health burden associated with AD. Finally, study partners are needed to ensure the scientific and clinical value of trials. Preclinical AD will represent a new model of care, in which persons with no symptoms are informed of probable cognitive decline and eventual dementia. The rationale for early diagnosis in symptomatic AD is equally applicable in preclinical AD-to minimize risk, maximize quality of life, and ensure optimal planning and communication. Family members and other sources of support will likely be essential to the goals of this new model of care for preclinical AD patients and trials must instruct this clinical practice.

A single-center, prospective, double-blind, sham-controlled, randomized study of the effect of a vibrating capsule on colonic transit in patients with chronic constipation.

Science.gov (United States)

Nelson, A D; Camilleri, M; Acosta, A; Boldingh, A; Busciglio, I; Burton, D; Ryks, M; Zinsmeister, A R

2017-07-01

In an open-label study of 26 patients with IBS-C and chronic constipation, treatment with a vibrating (VIBRANT) capsule twice a week for 7.5 weeks resulted in 88.5% responders. Effects on colonic transit are unclear. We aimed to compare effects of VIBRANT and sham capsule treatment on colonic transit in patients with functional constipation. Patients with functional constipation (Rome III criteria) were randomized to VIBRANT or sham capsule treatment for 8 weeks and underwent scintigraphic colonic transit measurements during week 8. We estimated the overall rate of colonic transit from the slope of progression of colonic geometric center over 48 hours. The capsule was activated 8 hours after ingestion, and the vibration sequence included 240 cycles. There were no significant group differences in overall colonic transit [GC48, 2.76 (IQR 2.42-4.03) for sham group and 3.46 (2.55-4.61) for active treatment group (P=.13)]. Additionally, the progression of the isotope through the colon was numerically faster, though not significantly different (slope, P=.14) in the VIBRANT capsule group compared to the sham group. Three participants in the VIBRANT capsule group had accelerated colonic transit at 32 hours and faster colonic transit slope compared to the 95th percentile of the sham group. Although there were no group differences between VIBRANT and sham capsule treatment on colonic transit, at least one (and possibly three) of 12 patients receiving the VIBRANT capsule had faster colonic transit. The vibration parameters to accelerate colonic transit in patients with functional constipation require further optimization. © 2017 John Wiley & Sons Ltd.

Minimum training requirement in ultrasound imaging of peripheral arterial disease.

Science.gov (United States)

Eiberg, J P; Hansen, M A; Grønvall Rasmussen, J B; Schroeder, T V

2008-09-01

To demonstrate the minimum training requirement when performing ultrasound of peripheral arterial disease. Prospective and blinded comparative study. 100 limbs in 100 consecutive patients suffering from peripheral arterial disease, 74% suffering critical limb ischemia, were enrolled during a 9 months period. One physician with limited ultrasound experience performed all the ultrasound examinations of the arteries of the most symptomatic limb. Before enrolling any patients 15 duplex ultrasound examinations were performed supervised by an experienced vascular technologist. All patients had a digital subtraction arteriography performed by an experienced vascular radiologist, unaware of the ultrasound result. The number of insufficiently insonated segments (non-diagnostic segments) was significantly reduced during the study; from 9% among the initial 50 limbs to 2% among the last 50 limbs (Pultrasound and arteriography from the initial 50 patients (overall Kappa=0.66, (95%-CI: 0.60-0.72); supragenicular Kappa=0.73 (95%-CI: 0.64-0.82); infragenicular Kappa=0.61 (95%-CI: 0.54-0.69)) to the last 50 patients (overall Kappa=0.66 (95%-CI: 0.60-0.72), supragenicular Kappa=0.67 (95%-CI: 0.57-0.76); infragenicular Kappa=0.66 (95%-CI: 0.58-0.73)). The minimum training requirement in ultrasound imaging of peripheral arterial disease appears to be less than 50 ultrasound examinations (probably only 15 examinations) for the supragenicular segments and 100 examinations for the infragenicular segments.

A 17 year-old girl with a demyelinating disease requiring mechanical ventilation: a case report

Directory of Open Access Journals (Sweden)

Katsenos Chrysostomos

2013-01-01

Full Text Available Abstract Background Demyelinating diseases cause destruction of the myelin sheath, while axons are relatively spared. Pathologically, demyelination can be the result of an inflammatory process, viral infection, acquired metabolic derangement and ischemic insult. Three diseases that can cause inflammatory demyelination of the CNS are: Multiple sclerosis (MS, Acute disseminated encephalomyelitis (ADEM and Acute hemorrhagic leucoencephalitis. Differentiation is not always easy and there is considerable overlaping. Data about adults with acute demyelination requiring ICU admission is limited. Case presentation A 17 year old Greek female was hospitalised in the ICU because of acute respiratory failure requiring mechanical ventilation. She had a history of febrile disease one month before, acute onset of paraplegia, diplopia, progressive arm weakness and dyspnea. Her consciousness was not impaired. A demyelinating central nervous system (CNS disease, possibly post infectious encephalomyelitis (ADEM was the underlying condition. The MRI of the brain disclosed diffused expanded cerebral lesions involving the optic nerve, basal ganglia cerebellum, pons and medulla oblongata. There was also extended involvement of the cervical and thoracic part of the spinal cord. CSF leukocyte count was elevated with lymphocyte predominance. The patient required mechanical ventilation for two months. Then she was transferred to a rehabilitation centre. Three years later she remains paraplegic. Since then she has not suffered any other demyelination attack. Conclusions Demyelinating diseases can cause acute respiratory failure when the spinal cord is affected. Severe forms of these diseases, making necessary ICU admission, is less frequently reported. Intensivists should be aware of the features of these rare diseases.

Safety and effectiveness of the Vibrant Soundbridge in treating conductive and mixed hearing loss: A systematic review.

Science.gov (United States)

Ernst, Arne; Todt, Ingo; Wagner, Jan

2016-06-01

For many years, the therapeutic approach for conductive and/or mixed hearing loss has consisted of middle ear surgery with replacement of defect ossicles, and if possible the application of a hearing aid. Advances in technology have led to the introduction of electronmagnetic active implantable devices such as the Vibrant Soundbridge (VSB). With its various coupling techniques for different pathophysiological situations in the middle ear, the VSB offers greater improvement in the hearing performance of affected persons. PubMed, OvidSP (MEDLINE), EMBASE (DIMDI), the National Institue for Health research (NIHR) Centre for Reviews and Dissemination (including the National Health Service Economic Evaluation Database, Database of Abstracts of Reviews of Effects, and Health Technology Assessment), and the Cochrane Library were searched to identify articles published between January 2006 and April 2014 that evaluated the safety and effectiveness of the VSB in comparison to no intervention, bone conduction hearing implants (BCHI), and middle ear surgery plus hearing aids for adults and children with conductive or mixed hearing loss. Study selection and data extraction was carried out by multiple reviewers. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence (2011); and a checklist available from the Evidence Analysis Library, Academy of Nutrition and Diabetics. Thirty-six publications were identified: 19 on VSB outcomes in 294 individuals, 13 on BCHI outcomes in 666 individuals, and four on middle ear surgery plus hearing aid outcomes in 43 individuals. Two systematic reviews were also identified. Heterogeneous outcome measures made it difficult to summarize data. In general, the VSB proved to be safe and effective when compared to no intervention and BCHI, and provided more and consistent hearing gain compared to middle ear surgery plus conventional hearing aids. As demonstrated in the literature, the VSB as an active device

Vibrant SoundBridge application to middle ear windows versus conventional hearing aids: a comparative study based on international outcome inventory for hearing aids.

Science.gov (United States)

Atas, Ahmet; Tutar, Hakan; Gunduz, Bulent; Bayazıt, Yıldırım A

2014-01-01

In this study, we aimed to compare the outcomes of satisfaction of the patients who used hearing aids preceding the vibrant sound bridge (VSB) application on middle ear windows (14 oval window and 5 round window). Nineteen adult patients with conductive or mixed hearing loss were included in the study. All patients used behind the ear hearing aids on the site which was selected for VSB application. The patients used hearing aids for at least 3 months before the VSB operation. The floating mass transducer (FMT) was placed on one of the middle ear windows (oval or round) in VSB operation. The patients were evaluated with International Outcome Inventory for Hearing Aids (IOI-HA) preoperatively after at least 3 months trial of conventional hearing aid and postoperatively after 3 months use of VSB. No perioperative problem was encountered. The total score of IOI-HA was significantly higher with VSB compared with conventional hearing aids (p 0.05). The IOI-HA scores were significantly higher with the middle ear implant than the conventional hearing aid regarding benefit and residual participation restrictions (p < 0.05). Although the scores for quality of life assessment was similar between VSB and hearing aid use, there was a superiority of VSB in terms of benefit and residual participation restrictions as well as overall IOI-HA scores as the FMT was placed on one of the middle ear windows.

Open Business Models: New Compensation Mechanisms for ...

International Development Research Centre (IDRC) Digital Library (Canada)

Meanwhile, despite having vibrant and diverse cultures, many developing ..... at other sites, and to the control of other diseases such as tuberculosis and malaria. ...... A core group of countries, including Brazil, Argentina, Chile, and Mexico are ...

Resource Requirements Planning for Hospitals Treating Serious Infectious Disease Cases

Energy Technology Data Exchange (ETDEWEB)

Vugrin, Eric D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Verzi, Stephen Joseph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Turnquist, Mark A. [Cornell Univ., Ithaca, NY (United States); Wyte-Lake, Tamar [Veterans Emergency Management Evaluation Center; Griffin, Ann R. [Veterans Emergency Management Evaluation Center; Ricci, Karen J. [Veterans Emergency Management Evaluation Center; Plotinsky, Rachel [Providence Health and Services, Renton, WA (United States)

2015-02-01

This report presents a mathematical model of the way in which a hospital uses a variety of resources, utilities and consumables to provide care to a set of in-patients, and how that hospital might adapt to provide treatment to a few patients with a serious infectious disease, like the Ebola virus. The intended purpose of the model is to support requirements planning studies, so that hospitals may be better prepared for situations that are likely to strain their available resources. The current model is a prototype designed to present the basic structural elements of a requirements planning analysis. Some simple illustrati ve experiments establish the mo del's general capabilities. With additional inve stment in model enhancement a nd calibration, this prototype could be developed into a useful planning tool for ho spital administrators and health care policy makers.

Systematic review to evaluate the safety, efficacy and economical outcomes of the Vibrant Soundbridge for the treatment of sensorineural hearing loss.

Science.gov (United States)

Bruchhage, Karl-Ludwig; Leichtle, Anke; Schönweiler, Rainer; Todt, Ingo; Baumgartner, Wolf-Dieter; Frenzel, Henning; Wollenberg, Barbara

2017-04-01

Introduced in the late 90s, the active middle ear implant Vibrant Soundbridge (VSB) is nowadays used for hearing rehabilitation in patients with mild to severe sensorineural hearing loss (SNHL) unable to tolerate conventional hearing aids. In experienced hands, the surgical implantation is fast done, safe and highly standardized. Here, we present a systematic review, after more than 15 years of application, to determine the efficacy/effectiveness and cost-effectiveness, as well as patient satisfaction with the VSB active middle ear implant in the treatment of mild to severe SNHL. A systematic search of electronic databases, investigating the safety and effectiveness of the VSB in SNHL plus medical condition resulted in a total of 1640 papers. After removing duplicates, unrelated articles, screening against inclusion criteria and after in-depth screening, the number decreased to 37 articles. 13 articles were further excluded due to insufficient outcome data. 24 studies remained to be systematically reviewed. Data was searched on safety, efficacy and economical outcomes with the VSB. Safety-oriented outcomes included complication/adverse event rates, damage to the middle/inner ear, revision surgery/explant rate/device failure and mortality. Efficacy outcomes were divided into audiological outcomes, including hearing thresholds, functional gain, speech perception in quiet and noise, speech recognition thresholds, real ear insertion gain and subjective outcomes determined by questionnaires and patient-oriented scales. Data related to quality of life (QALY, ICER) were considered under economical outcomes. The VSB turns out to be a highly reliable and a safe device which significantly improves perception of speech in noisy situations with a high sound quality. In addition, the subjective benefit of the VSB was found to be mostly significant in all studies. Finally, implantation with the VSB proved to be a cost-effective and justified health care intervention.

Converging requirements and emerging challenges to public health diseases surveillance and bio surveillance

International Nuclear Information System (INIS)

Rao, V.; Abel, T.

2009-01-01

Disease surveillance systems are a critical component of an early warning system for public health agencies to prepare and respond to major public health catastrophes. With a growing emphasis for more robust early indicator and warning systems to track emerging and dangerous diseases of suspicious nature, considerable emphasis is now placed on deployment of more expanded electronic disease surveillance systems. The architectural considerations for bio surveillance information system are based on collection, analysis and dissemination of human, veterinary and agricultural related disease surveillance to broader regional areas likely to be affected in the event of an emerging disease, or due to bioterrorism and better coordinate plans, preparations and response by governmental agencies and multilateral forums. The diseases surveillance systems architectures by intent and design could as well support biological threat monitoring and threat reduction initiatives. As an illustrative sample set, this paper will describe the comparative informatics requirements for a disease surveillance systems developed by CSC for the US Centers for Diseases Control and Prevention (CDC) currently operational nationwide, and biological weapons threat assessment developed as part of the Threat Agent Detection and Response (TADR) Network under the US Biological Threat Reduction Program and deployed at Uzbekistan, Kazakhstan, Georgia, and Azerbaijan.(author)

Congenital heart disease in the newborn requiring early intervention

Directory of Open Access Journals (Sweden)

Sin Weon Yun

2011-05-01

Full Text Available Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA, critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS, obstructed total anomalous pulmonary venous return (TAPVR, which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA is opened widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

Successful chronic disease care for Aboriginal Australians requires cultural competence.

Science.gov (United States)

Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret

2011-06-01

To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

U.S. College and University Student Health Screening Requirements for Tuberculosis and Vaccine-Preventable Diseases, 2012

Science.gov (United States)

Jewett, A.; Bell, T; Cohen, NJ.; Buckley, K.; Leino, V.; Even, S.; Beavers, S.; Brown, C.; Marano, N.

2016-01-01

Objective Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the U.S. college student health screening requirements among U.S. resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPD) as it relates to the American College Health Association (ACHA) Guidelines. Methods/Participants In April 2012, U.S. college health administrators (N=2858) were sent online surveys to assess their respective school’s TB screening and immunization requirements. Results Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). Conclusion Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges. PMID:26730492

Gap analysis of Mycoplasma bovis disease, diagnosis and control: An aid to identify future development requirements.

Science.gov (United States)

Calcutt, M J; Lysnyansky, I; Sachse, K; Fox, L K; Nicholas, R A J; Ayling, R D

2018-05-01

There is a worldwide problem of disease caused by Mycoplasma (M.) bovis in cattle; it has a significant detrimental economic and animal welfare impact on cattle rearing. Infection can manifest as a plethora of clinical signs including mastitis, pneumonia, arthritis, keratoconjunctivitis, otitis media and genital disorders that may result in infertility and abortion. Current diagnosis and control information are reviewed and analysed to identify gaps in knowledge of the causative organism in respect of the disease pathology, diagnosis and control methods. The main considerations are as follows: no vaccines are commercially available; antimicrobial resistance is increasing; diagnostic and antimicrobial sensitivity testing needs to be improved; and a pen-side test would facilitate more rapid diagnosis and implementation of treatment with antimicrobials. More data on host susceptibility, stress factors, immune response and infectious dose levels are required. The impact of asymptomatic carriers, M. bovis survival in the environment and the role of wildlife in transmitting the disease also needs investigation. To facilitate development of vaccines, further analysis of more M. bovis genomes, its pathogenic mechanisms, including variable surface proteins, is required, along with reproducible disease models. © 2018 Blackwell Verlag GmbH.

The role of the autoimmunity laboratory in autoimmune diseases

Directory of Open Access Journals (Sweden)

SS Hasson

2012-04-01

Full Text Available Laboratory testing is of great value when evaluating a patient with a suspected autoimmune disease. The results can confirm a diagnosis, estimate disease severity, aid in assessing prognosis and are useful to follow disease activity. Components of the laboratory exam include complete blood count with differential, comprehensive metabolic panel, inflammatory markers, autoantibodies, and flow cytometry. Currently, autoimmunity laboratories are very vibrant owing to the constant and increasing availability of new tests, mainly due to the detection of new autoantibodies. The main characteristic that differentiates the autoimmunity laboratory from other laboratories is the use of immunoassays such as enzyme-linked immunosorbent assay (ELISA, as basic techniques which determines antibodies (autoantibodies and not antigens. For this reason, immunoassay techniques must employ antigens as reagents. However, over the last few years, a significant trend at autoimmunity laboratories has been the gradual replacement of immunofluorescence microscopy by immunoassay. Nowadays the revolution of new technology has taken place significantly, for examples; recombinant DNA technology has allowed the production of large quantities of antigens for autoantibody analysis. Flow cytometry for the analysis of microsphere-based immunoassays allows the simultaneous measurement of several autoantibodies. In the same way, autoantigen microarrays provide a practical means to analyse biological fluids in the search for a high number of autoantibodies. We are now at the beginning of an era of multiplexed analysis, with a high capacity of autoantibody specificities. The future tendency in this field will include immunoassays with greater analytical sensitivity, specificity, simultaneous multiplexed capability, the use of protein microarrays, and the use of other technologies such as microfluidics.

Evaluating agricultural trade-offs in the age of sustainable development

NARCIS (Netherlands)

Kanter, David R.; Musumba, Mark; Wood, Sylvia L.R.; Palm, Cheryl; Antle, John; Balvanera, Patricia; Dale, Virginia H.; Havlik, Petr; Kline, Keith L.; Scholes, R.J.; Thornton, Philip; Tittonell, Pablo; Andelman, Sandy

2016-01-01

A vibrant, resilient and productive agricultural sector is fundamental to achieving the Sustainable Development Goals. Bringing about such a transformation requires optimizing a range of agronomic, environmental and socioeconomic outcomes from agricultural systems – from crop yields, to

Spatiotemporal simulation of urban growth patterns using agent-based modeling: The case of Tehran

NARCIS (Netherlands)

Jokar Arsanjani, J.; Helbich, M.; Vaz, E.

2013-01-01

Rapid urban growth is becoming a serious problem in most developing countries. Tehran, the capital of Iran, stands out as a vibrant metropolitan area, facing uncontrolled urban expansion. Public authorities and decision makers require planning criteria regarding possible spatial developments. To

US College and University Student Health Screening Requirements for Tuberculosis and Vaccine-Preventable Diseases, 2012

Science.gov (United States)

Jewett, Amy; Bell, Teal; Cohen, Nicole J.; Buckley, Kirsten; Leino, E. Victor; Even, Susan; Beavers, Suzanne; Brown, Clive; Marano, Nina

2016-01-01

Objective: Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases…

Characteristics and trends in required home care by GPs in Austria: diseases and functional status of patients

Directory of Open Access Journals (Sweden)

Pichler Ingrid

2006-10-01

Full Text Available Abstract Background Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients. This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria. Methods Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test. Results Patients with degenerative diseases of the central nervous system (65% caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53% were the largest groups among the 198 (1997 and 261 (2004 home care cases of the 11 (1997 and 13 (2004 practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile. Conclusion Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.

Control of communicable disease; foreign--requirements for importers of nonhuman primates (NHP). Final rule.

Science.gov (United States)

2013-02-15

The Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS), is amending regulations for the importation of live nonhuman primates (NHPs) by extending existing requirements for the importation of Macaca fascicularis (cynomolgus), Chlorocebus aethiops (African green), and Macaca mulatta (rhesus) monkeys to all NHPs with the exception of the filovirus testing requirement. Filovirus testing will only be required for Old World NHPs in quarantine that have illness consistent with filovirus infection or that die for any reason other than trauma during quarantine. HHS/CDC is also finalizing a provision to reduce the frequency at which importers of cynomolgus, African green, and rhesus monkeys are required to renew their special permits (from every 180 days to every 2 years). HHS/CDC is incorporating existing guidelines into the regulations and adding new provisions to address the following: NHPs imported as part of an animal act; NHPs imported or transferred by zoological societies; the transfer of NHPs from approved laboratories; and non-live imported NHP products. Finally, HHS/CDC is also requiring that all NHPs be imported only through ports of entry where a HHS/CDC quarantine station is located.

General Studies Writing (GSW) Digital Communication at Bowling Green State University: To Web 2.0 or Not To Web 2.0?

Science.gov (United States)

Mauk, Brianna

2017-01-01

First-year composition pedagogy and course communication (especially as implicitly endorsed by institutionally presented means) is often limiting in modes and modalities, which juxtaposes vibrant composing practices in the daily lives of students. Additionally, writing program requirements tend to value primarily alphabetic texts despite…

[Modeling of the financial reserves required by the livestock disease compensation fund of Lower Saxony for rebates in the course of disease outbreaks incorporating spatial restriction zones].

Science.gov (United States)

Denzin, Nicolai; Gerdes, Ursula

2015-01-01

One of the tasks of the livestock disease compensation funds of the federal states in Germany is the financial compensation of livestock holders for livestock losses and costs incurred for disease control measures due to certain diseases. Usually, one half of these services are financed through financial reserves built up with the contributions paid by the owners of the respective animal species. The other half is covered by the federal state itself. But there is hardly any reference to how to calculate aforementioned financial reserves. Basically, following an approach presented recently regarding estimations concerning the compensation fund of the federal state of Saxony-Anhalt, in a stochastic modeling of the required reserves concerning the fund of Lower Saxony the anticipated costs within the spatial restriction zones allocated to outbreaks were incorporated for the first time. The overall costs (including the federal state's stakes), the share of the comnensation fund (required reserves) and the the partial costs for a total of 25 categories and subcategories and subcategories of livestock species making up the latter were estimated. It became evident that overall costs/the share of the fund were particularly determined among the diseases by foot-and-mouth disease and among the cost factors by the costs incurred for the compensation of livestock value within the areas surrounding the outbreaks in which all susceptible animals are killed (culling zone). The 80th, 90 and 95th percentile of the established probability distribution of the overall costs referred to a financial volume of about 312, 409 and 540 million euro, while the respective percentiles of the probability distribution of the required reserves of the compensation fund amounted to 175, 225 and 296 million euro.

Proceedings of the first international conference on trends in cell and molecular biology: conference abstract book

International Nuclear Information System (INIS)

2015-01-01

This conference throws light on topics for understanding the importance of nanotechnology as a potential treatment option for some important diseases. Computational biology with its vibrant research outputs needs to be integrated with modern cell biology as a whole to understand, analyze and predict the impacts in a much better way. Papers relevant to INIS are indexed separately

Vibrant times for mechanical metamaterials

DEFF Research Database (Denmark)

Christensen, Johan; Kadic, Muamer; Kraft, Oliver

2015-01-01

Metamaterials are man-made designer matter that obtains its unusual effective properties by structure rather than chemistry. Building upon the success of electromagnetic and acoustic metamaterials, researchers working on mechanical metamaterials strive at obtaining extraordinary or extreme...... mass density, negative modulus, pentamode, anisotropic mass density, Origami, nonlinear, bistable, and reprogrammable mechanical metamaterials....

International vision requirements for driver licensing and disability pensions: using a milestone approach in characterization of progressive eye disease

Directory of Open Access Journals (Sweden)

Alain M Bron

2010-11-01

Full Text Available Alain M Bron1, Ananth C Viswanathan2, Ulrich Thelen3, Renato de Natale4, Antonio Ferreras5, Jens Gundgaard6, Gail Schwartz7, Patricia Buchholz81Department of Ophthalmology, University Hospital, Dijon, France; 2Glaucoma Research Unit, Moorfields Eye Hospital NHS Foundation Trust and Department of Genetics, University College of London Institute of Ophthalmology, London, UK; 3Private Practice, Munster, Germany; 4Ospedale Civile di Monselice, Monselice, Italy; 5Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; 6COWI, Kolding, Denmark; 7Wilmer Eye Institute, Johns Hopkins University, Glaucoma Consultants, Baltimore, MD, USA; 8Patricia Buchholz Consulting, Karlsruhe, GermanyObjective: Low vision that causes forfeiture of driver’s licenses and collection of disability pension benefits can lead to negative psychosocial and economic consequences. The purpose of this study was to review the requirements for holding a driver’s license and rules for obtaining a disability pension due to low vision. Results highlight the possibility of using a milestone approach to describe progressive eye disease.Methods: Government and research reports, websites, and journal articles were evaluated to review rules and requirements in Germany, Spain, Italy, France, the UK, and the US.Results: Visual acuity limits are present in all driver’s license regulations. In most countries, the visual acuity limit is 0.5. Visual field limits are included in some driver’s license regulations. In Europe, binocular visual field requirements typically follow the European Union standard of ≥120°. In the US, the visual field requirements are typically between 110° and 140°. Some countries distinguish between being partially sighted and blind in the definition of legal blindness, and in others there is only one limit.Conclusions: Loss of driving privileges could be used as a milestone to monitor progressive eye disease. Forfeiture could be standardized as a

Chronic diseases requiring hospitalization and risk of non-melanoma skin cancers-A population based study from Denmark

DEFF Research Database (Denmark)

Jensen, Annette Ø; Olesen, Anne B; Dethlefsen, Claus

2008-01-01

We examined the associations between chronic diseases requiring hospitalization and the risk of non-melanoma skin cancers (NMSCs) in a population-based case-control study of 4,187 patients diagnosed with a first primary NMSC in 1995 in Denmark. From the National Patient Registry covering all Danish.......99-15)), and skin diseases (IRR 5.28 (95% CI: 1.95-14)). Our study supports the presence of an association between certain chronic diseases and NMSC, and further suggests that these results unlikely are due to bias.Journal of Investigative Dermatology advance online publication, 4 October 2007; doi:10.1038/sj...... hospitals, we obtained data on hospitalizations with chronic diseases, recorded before the date of NMSC diagnosis. Using incidence density sampling, we selected 10 age-, gender-, and residence-matched controls from the Danish Civil Registration System. We used conditional logistic regression to compute...

Advances in environmental and occupational diseases 2004.

Science.gov (United States)

Frew, Anthony J

2005-06-01

2004 was another good year for publications on environmental and occupational disorders in our journal. The major focus is clearly on the environment and particularly on environmental risk factors for sensitization and asthma. There is a growing consensus that exposure to pets is good, provided there is enough of it. Low levels enhance sensitization, and higher levels protect against the consequences of that sensitization. Following on from previous work on cockroaches, we now see allergy to feral mice as an emergent problem--at least we now have the tools to study this properly. Emphasis seems to be swinging away from the outdoor environment as a cause of allergic disease and toward the indoor environment, which is, after all, where most of us spend most of our lives. New techniques for studying isocyanate allergy might kindle a revival of interest in the mechanisms of occupational asthma caused by low-molecular-weight compounds. But for all types of occupational allergy, prevention remains key, and it is good to see that comprehensive programs of allergen reduction can pay off in reduced rates of latex allergy in health care workers. Further work in the area of recombinant allergens is welcome but needs soon to be translated into new diagnostic and therapeutic strategies. This sector of allergy research remains vibrant, and the editors will continue to welcome outstanding contributions in this area.

Disease specific stress of tumor patients at the beginning of radiotherapy. Effect on psychosocial support requirement

International Nuclear Information System (INIS)

Sehlen, S.; Hollenhorst, H.; Schymura, B.; Firsching, M.; Duehmke, E.; Herschbach, P.

2001-01-01

Purpose: Radiotherapy brings a tumor patient into a special life situation in which different variables play a role of often unknown importance. The goal of this study was to investigate disease specific stress of tumor patients at the beginning of radiotherapy with established psychodiagnostic questionnaires and to evaluate the effect on psychosocial support requirement in order to reduce stress and to improve quality of life and compliance during radiotherapeutical treatment. Patients and Methods: 732 patients were screened, of whom 446 (60.9%) fulfilled the criteria for inclusion (refusals 21.0%, low Karnofsky performance status 6.6%, management problems 3.4%, language barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease specific aspects of stress in the questionnaire (Fragebogen zur Belastung von Krebspatienten, FBK), life situation (LS) and self-defined care requirements (BB) were self-rated by patients with different tumor types before radiotherapy. Medical and sociodemographic data were also documented. We investigated 446 patients (262 male, 184 female; median age 60.0 years) with different diagnoses. Results: Stress was observed mainly due to reduction of efficiency, anxiety and pain on the subscales. Women had a significant higher stress on subscales of pain (p=0.016) and anxiety (p=0.009), patients younger than 45 years in the subscale information (p=0.002) and patients older than 45 and younger than 60 years in the subscale anxiety (p=0.002) and the total score (p=0.003). Patients with mamma carcinoma had the highest stress. The maximum percentages of patients under high stress were found for the subscales of efficiency (43%) and anxiety (40%). The support requirement was characterized by the need of more medical information and dialogue with the doctor. We saw a significant correlation of high stress and high care requirement. Conclusions: Psychosocial support should be founded on psychosocial stress diagnostic and self-defined care

Models of Christian Leadership in Youth Ministry

Science.gov (United States)

Canales, Arthur David

2014-01-01

This article addresses four models of leadership that Christian communities may want to adopt to help them assess and articulate a more vibrant and dynamic youth ministry. In particular, this article will demonstrate that authentic Christian leadership for youth ministry is much more than teaching young people about pastoral skills, but requires a…

Vibroplasty for mixed and conductive hearing loss.

Science.gov (United States)

Luers, Jan Christoffer; Hüttenbrink, Karl-Bernd; Zahnert, Thomas; Bornitz, Matthias; Beutner, Dirk

2013-08-01

To summarize new application methods of an active middle ear implant (Vibrant Soundbridge) in patients with conductive or mixed hearing loss. Publications listed in the Medline/PubMed database. All publications published in English language; search term Vibrant Soundbridge AND floating mass transducer in all fields. Structured analysis of all publications. Extraction of significant findings and conclusions and audiometric data. Modern application methods of an active middle ear implant (VSB) open new therapeutic options for patients with various outer and middle ear diseases resulting in conductive or mixed hearing loss. Titanium couplers can help to couple the active middle ear implant in a standardized way to remnants of the ossicular chain or to the round window. Thus, the active middle ear implant has been established as an alternative treatment option for patients with mixed and conductive hearing. However, the heterogeneity of the studies published so far complicates the analysis of the audiometric results, and thus, the functional hearing gain after VSB implantation varies a lot.

Radio-protection and decontamination operations on the central vibrating channels of the reactor G 3; Radioprotection et operations de decontamination sur le couloir vibrant central de la pile G.3

Energy Technology Data Exchange (ETDEWEB)

Chassany, J Ph; Cohendy, G; Rodier, J [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

1965-07-01

The dose rate in the vibrating channels room of the discharge system, which is due to the contamination of one of the channels by a ruptured can after clad failure was high. It was necessary to intervene in order that normal maintenance could be carried out on this equipment. The operation was carried out from a neighbouring room using cleaning tubes, and then directly, after numerous precautions had been taken. Radio-protection was made very difficult because of the irradiation and of the powdery state of the contamination. The average individual integrated dose for the 122 persons having taken part in this 2-month operation was 362 mrem. Thanks to the close collaboration between the operational, emergency and radio-protection personnel, this operation was executed smoothly and rapidly. (authors) [French] Le debit de dose dans la salle des couloirs vibrants du systeme de dechargement, provenant de la contamination de l'un d'entre eux par une cartouche a rupture de gaine etait important. Une intervention a ete necessaire pour permettre l'entretien normal de ce materiel. Elle s'est faite d'abord a partir d'une salle voisine, en utilisant des tuyaux de lavage, puis directement, moyennant de nombreuses precautions. La radioprotection a ete rendue tres difficile a cause de l'irradiation et de la forme particulierement pulverulente de la contamination. La dose individuelle moyenne integree par les 122 agents ayant participe a cette operation qui a dure 2 mois, a ete de 362 mrem. C'est grace a la collaboration etroite de l'exploitation, de l'intervention et de la radioprotection qu'elle a pu se derouler aussi rapidement dans de bonnes conditions. (auteurs)

Principals, Trust, and Cultivating Vibrant Schools

Directory of Open Access Journals (Sweden)

Megan Tschannen-Moran

2015-03-01

Full Text Available Although principals are ultimately held accountable to student learning in their buildings, the most consistent research results have suggested that their impact on student achievement is largely indirect. Leithwood, Patten, and Jantzi proposed four paths through which this indirect influence would flow, and the purpose of this special issue is to examine in greater depth these mediating variables. Among mediating variables, we assert that trust is key. In this paper, we explore the evidence that points to the role that faculty trust in the principal plays in student learning and how principals can cultivate trust by attending to the five facets of trust, as well as the correlates of trust that mediate student learning, including academic press, collective teacher efficacy, and teacher professionalism. We argue that trust plays a role in each of the four paths identified by Leithwood, Patten, and Jantzi. Finally, we explore possible new directions for future research.

Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease.

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Haricharan, Ramanath N; Roberts, Jared M; Morgan, Traci L; Aprahamian, Charles J; Hardin, William D; Hilliard, Lee M; Georgeson, Keith E; Barnhart, Douglas C

2008-06-01

The purpose of the study was to measure the effect of splenectomy on packed-cell transfusion requirement in children with sickle cell disease. Thirty-seven sickle cell children who underwent splenectomies between January 2000 and May 2006 at a children's hospital were reviewed. Data were collected 6 months preoperatively to 12 months postsplenectomy. Paired t test, analysis of variance, and multivariable regression analyses were performed. Of 37 children with median age 11 years (range, 2-18 years), 34 (21 males) had data that allowed analyses. Twenty-six had Hgb-SS, 5 had Hgb-SC, and 3 had Hgb S-Thal. Laparoscopic splenectomy was attempted in 36 and completed successfully in 34 (94% success). The number of units transfused decreased by 38% for 0 to 6 months and by 45% for 6 to 12 months postsplenectomy. Postoperatively, hematocrit levels increased and reticulocytes concurrently decreased with a reduction in transfusion clinic visits. The decrease in transfusion was not influenced by spleen weight, age, or hemoglobin type. Two children had acute chest syndrome (6%), and 1 had severe pneumonia (3%). Laparoscopic splenectomy can be successfully completed in sickle cell children. Splenectomy significantly reduces the packed red cell transfusion requirement and frequency of clinic visits, in sickle cell children for at least 12 months postoperatively.

Physicians' Efficacy Requirements for Prescribing Medications to Persons with Alzheimer's Disease

Science.gov (United States)

Oremus, Mark; Wolfson, Christina; Bergman, Howard; Vandal, Alain C.

2007-01-01

Physicians (N=803) were contacted via postal survey and given two sets of efficacy measures for drug treatments in Alzheimer's disease: (a) the time that patients spend in a mild or moderate state of disease; (b) levels of modification to disease progression in the areas of cognition, behaviour, and mood, and ability to perform basic activities of…

Disease models of chronic inflammatory airway disease : applications and requirements for clinical trials

NARCIS (Netherlands)

Diamant, Zuzana; Clarke, Graham W.; Pieterse, Herman; Gispert, Juan

Purpose of reviewThis review will discuss methodologies and applicability of key inflammatory models of respiratory disease in proof of concept or proof of efficacy clinical studies. In close relationship with these models, induced sputum and inflammatory cell counts will be addressed for

Infectious diseases in oyster aquaculture require a new integrated approach.

Science.gov (United States)

Pernet, Fabrice; Lupo, Coralie; Bacher, Cédric; Whittington, Richard J

2016-03-05

Emerging diseases pose a recurrent threat to bivalve aquaculture. Recently, massive mortality events in the Pacific oyster Crassostrea gigas associated with the detection of a microvariant of the ostreid herpesvirus 1 (OsHV-1µVar) have been reported in Europe, Australia and New Zealand. Although the spread of disease is often viewed as a governance failure, we suggest that the development of protective measures for bivalve farming is presently held back by the lack of key scientific knowledge. In this paper, we explore the case for an integrated approach to study the management of bivalve disease, using OsHV-1 as a case study. Reconsidering the key issues by incorporating multidisciplinary science could provide a holistic understanding of OsHV-1 and increase the benefit of research to policymakers. © 2016 The Author(s).

The crosstalk between gut microbiota and obesity and related metabolic disorders.

Science.gov (United States)

Xu, Wen-Ting; Nie, Yong-Zhan; Yang, Zhen; Lu, Nong-Hua

2016-06-01

Obesity and related metabolic diseases are currently a threat to global public health. The occurrence and development of these conditions result from the combined effects of multiple factors. The human gut is a diverse and vibrant microecosystem, and its composition and function are a focus of research in the fields of life science and medicine. An increasing amount of evidence indicates that interactions between the gut microbiota and their genetic predispositions or dietary changes may be key factors that contribute to obesity and other metabolic diseases. Defining the mechanisms by which the gut microbiota influence obesity and related chronic metabolic diseases will bring about revolutionary changes that will enable practitioners to prevent and control metabolic diseases by targeting the gut microbiota.

Acute respiratory failure requiring mechanical ventilation in severe chronic obstructive pulmonary disease (COPD).

Science.gov (United States)

Gadre, Shruti K; Duggal, Abhijit; Mireles-Cabodevila, Eduardo; Krishnan, Sudhir; Wang, Xiao-Feng; Zell, Katrina; Guzman, Jorge

2018-04-01

There are limited data on the epidemiology of acute respiratory failure necessitating mechanical ventilation in patients with severe chronic obstructive pulmonary disease (COPD). The prognosis of acute respiratory failure requiring invasive mechanical ventilation is believed to be grim in this population. The purpose of this study was to illustrate the epidemiologic characteristics and outcomes of patients with underlying severe COPD requiring mechanical ventilation.A retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between January 2008 and December 2012 with a diagnosis of severe COPD and requiring invasive mechanical ventilation for acute respiratory failure.We evaluated 670 patients with an established diagnosis of severe COPD requiring mechanical ventilation for acute respiratory failure of whom 47% were male with a mean age of 63.7 ± 12.4 years and Acute physiology and chronic health evaluation (APACHE) III score of 76.3 ± 27.2. Only seventy-nine (12%) were admitted with a COPD exacerbation, 27(4%) had acute respiratory distress syndrome (ARDS), 78 (12%) had pneumonia, 78 (12%) had sepsis, and 312 (47%) had other causes of respiratory failure, including pulmonary embolism, pneumothorax, etc. Eighteen percent of the patients received a trial of noninvasive positive pressure ventilation. The median duration of mechanical ventilation was 3 days (interquartile range IQR 2-7); the median duration for ICU length of stay (LOS) was 5 (IQR 2-9) days and the median duration of hospital LOS was 12 (IQR 7-22) days. The overall ICU mortality was 25%. Patients with COPD exacerbation had a shorter median duration of mechanical ventilation (2 vs 4 days; P = .04), ICU (3 vs 5 days; P = .01), and hospital stay (10 vs 13 days; P = .01). The ICU mortality (9% vs 27%; P respiratory failure. A 1-unit increase in the APACHE III score was associated with a 1% decrease and having an active cancer was associated

Efficacy of respiratory endoscopy on subjects requiring further detailed examinations after initial asbestos-related disease screening

International Nuclear Information System (INIS)

Fukuoka, Kazuya; Uesaka, Ayuko; Kuribayashi, Kozo

2007-01-01

We evaluated the efficacy of respiratory endoscopy on subjects requiring further detailed examinations as a result of initial asbestos-related disease screening. The subjects consisted of 132 participants who underwent asbestos-related disease screening in our hospital between July 2005 and March 2006. According to their history of screening, the participants were classified into the initial screening group and the second screening group. The former consisted of 76 participants without prior screening, while the latter consisted of 56 participants who were referred to our hospital for the detailed examinations as a result of initial screening undergone elsewhere. The participants were examined concerning their history of asbestos exposure, and then underwent chest X-ray followed by chest computed tomography (CT). Respiratory endoscopic examinations were mainly performed in participants with suspected chest malignancies. There were no significant differences in the distribution of age or gender between the two screening groups. In both screening groups, more than 70% of the participants had a history of occupational exposure to asbestos. Radiological abnormalities were observed in 110 (83%) of all participants. Asbestos-related diseases were detected in a total of 90 (68%) cases. The breakdown of the 90 cases by disease was as follows: 60 cases had pleural plaque, 13 pulmonary fibrosis, 5 lung cancer (LC), 4 benign asbestos pleurisy, 4 round atelectasis, 2 diffuse pleural thickening, and 2 malignant pleural mesothelioma (MPM). The disease detection rate of LC and MPM was 3.8% and 1.5%, respectively. Respiratory endoscopic examinations were performed in a total of 15 cases. The breakdown of the 15 cases by examination was as follows: bronchoscopy was performed in 6 cases, thoracoscopy including video-assisted thoracoscopic surgery (VATS) in 8, and mediastinoscopy in 4. Two cases with early LC were diagnosed by videothoracoscopic lung biopsy. A diagnosis of MPM was

Moving beyond too little, too late: managing emerging infectious diseases in wild populations requires international policy and partnerships

Science.gov (United States)

Voyles, Jamie; Kilpatrick, A. Marm; Collins, James P.; Fisher, Matthew C.; Frick, Winifred F.; McCallum, Hamish I.; Willis, Craig K.R.; Blehert, David S.; Murray, Kris A.; Puschendorf, Robert; Rosenblum, Erica Bree; Bolker, Benjamin M.; Cheng, Tina L.; Langwig, Kate E.; Linder, Daniel L.; Toothman, Mary; Wilber, Mark Q.; Briggs, Cheryl J.

2015-01-01

Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and threaten ecosystems that sustain human societies (Fisher et al. 2012; Kilpatrick 2011). There have been recent calls for large-scale research approaches to combat threats EIDs pose to wildlife (Sleeman 2013). While it is true that developing new analytical models, diagnostic assays and molecular tools will significantly avance outr abilities to respond to disease threats, we also propose that addressing difficult problems in EIDs will require considerable shofts in international health policy and infrastructure. While there are currently international organizations responsbile for rapidly initiating and coordinating preventative measures to control infectious diseases in human, livestock, and arable systems, there are few comparable instiutions that have the authority to implement transnational responses to EIDs in wildlife. This absence of well-developed infastructure hampers the rapid responses necessary to mitigate international spread of EIDs.

Two to five repeated measurements per patient reduced the required sample size considerably in a randomized clinical trial for patients with inflammatory rheumatic diseases

Directory of Open Access Journals (Sweden)

Smedslund Geir

2013-02-01

Full Text Available Abstract Background Patient reported outcomes are accepted as important outcome measures in rheumatology. The fluctuating symptoms in patients with rheumatic diseases have serious implications for sample size in clinical trials. We estimated the effects of measuring the outcome 1-5 times on the sample size required in a two-armed trial. Findings In a randomized controlled trial that evaluated the effects of a mindfulness-based group intervention for patients with inflammatory arthritis (n=71, the outcome variables Numerical Rating Scales (NRS (pain, fatigue, disease activity, self-care ability, and emotional wellbeing and General Health Questionnaire (GHQ-20 were measured five times before and after the intervention. For each variable we calculated the necessary sample sizes for obtaining 80% power (α=.05 for one up to five measurements. Two, three, and four measures reduced the required sample sizes by 15%, 21%, and 24%, respectively. With three (and five measures, the required sample size per group was reduced from 56 to 39 (32 for the GHQ-20, from 71 to 60 (55 for pain, 96 to 71 (73 for fatigue, 57 to 51 (48 for disease activity, 59 to 44 (45 for self-care, and 47 to 37 (33 for emotional wellbeing. Conclusions Measuring the outcomes five times rather than once reduced the necessary sample size by an average of 27%. When planning a study, researchers should carefully compare the advantages and disadvantages of increasing sample size versus employing three to five repeated measurements in order to obtain the required statistical power.

Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases?

Directory of Open Access Journals (Sweden)

Simon Spedding

2013-12-01

Full Text Available Objective: Clarify the concept of vitamin D sufficiency, the relationship between efficacy and vitamin D status and the role of Vitamin D supplementation in the management of non-skeletal diseases. We outline reasons for anticipating different serum vitamin D levels are required for different diseases. Method: Review the literature for evidence of efficacy of supplementation and minimum effective 25-hydroxyvitamin D (25-OHD levels in non-skeletal disease. Results: Evidence of efficacy of vitamin supplementation is graded according to levels of evidence. Minimum effective serum 25-OHD levels are lower for skeletal disease, e.g., rickets (25 nmol/L, osteoporosis and fractures (50 nmol/L, than for premature mortality (75 nmol/L or non-skeletal diseases, e.g., depression (75 nmol/L, diabetes and cardiovascular disease (80 nmol/L, falls and respiratory infections (95 nmol/L and cancer (100 nmol/L. Conclusions: Evidence for the efficacy of vitamin D supplementation at serum 25-OHD levels ranging from 25 to 100 nmol/L has been obtained from trials with vitamin D interventions that change vitamin D status by increasing serum 25-OHD to a level consistent with sufficiency for that disease. This evidence supports the hypothesis that just as vitamin D metabolism is tissue dependent, so the serum levels of 25-OHD signifying deficiency or sufficiency are disease dependent.

Towards the bibliography of life

Directory of Open Access Journals (Sweden)

David King

2011-11-01

Full Text Available This paper discusses how we intend to take forward the vision of a Bibliography of Life in the ViBRANT project. The underlying principle of the Bibliography is to provide taxonomists and others with a freely accessible bibliography covering the whole of life. Such a bibliography has been achieved for specific study areas within taxonomy, but not for “life” as a whole.The creation of such a comprehensive tool has been hindered by various social and technical issues. The social concerns focus on the willingness of users to contribute to the Bibliography. The technical concerns relate to the architecture required to deliver the Bibliography. These issues are discussed in the paper and approaches to addressing them within the ViBRANT project are described, to demonstrate how we can now seriously consider building a Bibliography of Life. We are particularly interested in the potential of the resulting tool to improve the quality of bibliographic references. Through analysing the large number of references in the Bibliography we will be able to add metadata by resolving known issues such as geographical name variations. This should result in a tool that will assist taxonomists in two ways. Firstly, it will be easier for them to discover relevant literature, especially pre-digital literature; and secondly, it will be easier for them to identify the canonical form for a citation.The paper also covers related issues relevant to building the tool in ViBRANT, including implementation and copyright, with suggestions as to how we could address them.

Valvular heart disease

OpenAIRE

Gelson, E; Gatzoulis, M; Johnson, M

2007-01-01

Valvular disease may be unmasked in pregnancy when physiological changes increase demands on the heart. Women with valvular heart disease require close follow-up during pregnancy, delivery, and postpartum

Outcomes of Tracheostomy in Children Requiring Surgery for Congenital Heart Disease.

Science.gov (United States)

Ortmann, Laura A; Manimtim, Winston M; Lachica, Charisse I

2017-02-01

Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children tracheostomy and surgery for congenital heart disease from January 2002 to May 2015. Forty-six tracheostomies were placed after surgery and four before. Single-ventricle anatomy was present in 12 (33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half. Median time between cardiac surgery and tracheostomy was 58 days. The most common indication for tracheostomy was multifactorial (30%) followed by airway malacia (22%). Median length to follow-up for survivors was 3.9 years (range 0.4-11.8 years). Survival to hospital discharge was 72%, and intermediate survival was 48%. Survival in those with systemic to pulmonary artery shunts at the time of tracheostomy was 22% compared to 59% for those with biventricular anatomy. Heart failure and multiple indications for tracheostomy were associated with worse outcome. There was no difference in survival for those discharged with a ventilator compared to those that were not. The most common cause of death after discharge was tracheostomy tube dislodgement/obstruction, accounting for 5 of 11 that died. Survival with a tracheostomy after cardiac surgery is poor, and children with systemic to pulmonary artery shunts are at especially high risk of death.

Efficacy of Various Scoring Systems for Predicting the 28-Day Survival Rate among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Emergency Intensive Care

Directory of Open Access Journals (Sweden)

Zhihong Feng

2017-01-01

Full Text Available We aimed to investigate the efficacy of four severity-of-disease scoring systems in predicting the 28-day survival rate among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD requiring emergency care. Clinical data of patients with AECOPD who required emergency care were recorded over 2 years. APACHE II, SAPS II, SOFA, and MEDS scores were calculated from severity-of-disease indicators recorded at admission and compared between patients who died within 28 days of admission (death group; 46 patients and those who did not (survival group; 336 patients. Compared to the survival group, the death group had a significantly higher GCS score, frequency of comorbidities including hypertension and heart failure, and age (P<0.05 for all. With all four systems, scores of age, gender, renal inadequacy, hypertension, coronary heart disease, heart failure, arrhythmia, anemia, fracture leading to bedridden status, tumor, and the GCS were significantly higher in the death group than the survival group. The prediction efficacy of the APACHE II and SAPS II scores was 88.4%. The survival rates did not differ significantly between APACHE II and SAPS II (P=1.519. Our results may guide triage for early identification of critically ill patients with AECOPD in the emergency department.

Symptoms of Celiac Disease

Science.gov (United States)

... tested for celiac disease and if negative the test should be repeated on a periodic basis. These conditions include insulin-dependent diabetes mellitus (requiring insulin therapy), Hashimoto’s thyroiditis, Turner’s syndrome, Williams syndrome, Graves disease and Sjogren’s disease. what turns ...

Type of Valvular Heart Disease Requiring Surgery in the 21st Century: Mortality and Length-of-Stay Related to Surgery

Science.gov (United States)

Boudoulas, Konstantinos Dean; Ravi, Yazhini; Garcia, Daniel; Saini, Uksha; Sofowora, Gbemiga G.; Gumina, Richard J.; Sai-Sudhakar, Chittoor B.

2013-01-01

Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac proce-dures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions. PMID:24339838

Celiac disease and new diseases related to gluten

Science.gov (United States)

Jiménez Ortega, Ana Isabel; Martínez García, Rosa María; Quiles Blanco, María José; Majid Abu Naji, Jamil Abdel; González Iglesias, María José

2016-07-12

Celiac disease is the most common chronic intestinal disease. Nowadays it´s known that this is a multisistemic pathology of immune mechanism, triggered by gluten, which occurs in genetically susceptible individuals. It affects approximately 1% of the world population, which is a very high prevalence, affects all age groups and has symptoms both digestive and extra-digestive. Since it is a disease that requires maintaining a gluten-free diet and medical monitoring for life, it is important to know it and establish its diagnosis properly. Along with celiac disease a number of new diseases related to gluten are diagnosed increasingly, including the non celiac gluten sensitivity or wheat allergy. The suffering of celiac disease, or other related diseases, by conditioning diet changes of the affected individual, it may be associated with nutritional imbalances that need to monitor and try to solve. Therefore patients with this problem need special nutritional advice.

[Prophylactic requirements for sanitary and epidemiological surveillance in dentistry].

Science.gov (United States)

Kaplan, B M; Maksimenko, L V; Fedotova, N N; Gololobova, T V; Konovalov, O E

2009-01-01

The paper outlines the requirements for sanitary-and-epidemiological surveillance to prevent dental diseases. The investigations pose tasks to medical prevention centers to solve the problems in tooth prophylaxis, such as organizational-and-methodological, sanitary-and-educational, health-improving, and others. The sanitary-and-hygienic requirements for therapeutic-and-prophylactic dental facilities are defined. A procedure for keeping a management protocol for the prevention of tooth diseases is described.

Use of nonhuman primates in obstructive lung disease research – is it required?

Directory of Open Access Journals (Sweden)

F. Dahlmann

2017-06-01

Full Text Available In times of increasing costs for health insurances, obstructive lung diseases are a burden for both the patients and the economy. Pulmonary symptoms of asthma and chronic obstructive pulmonary disease (COPD are similar; nevertheless, the diseases differ in pathophysiology and therapeutic approaches. Novel therapeutics are continuously developed, and nonhuman primates (NHPs provide valuable models for investigating novel biologicals regarding efficacy and safety.This review discusses the role of nonhuman primate models for drug development in asthma and COPD and investigates whether alternative methods are able to prevent animal experiments.

Informatics for neglected diseases collaborations.

Science.gov (United States)

Bost, Frederic; Jacobs, Robert T; Kowalczyk, Paul

2010-05-01

Many different public and private organizations from across the globe are collaborating on neglected diseases drug-discovery and development projects with the aim of identifying a cure for tropical infectious diseases. These neglected diseases collaborations require a global, secure, multi-organization data-management solution, combined with a platform that facilitates communication and supports collaborative work. This review discusses the solutions offered by 'Software as a Service' (SaaS) web-based platforms, despite notable challenges, and the evolution of these platforms required to foster efficient virtual research efforts by geographically dispersed scientists.

Vibrant Interior Reflects Lifestyle. 1974 Award Winning Architecture

Science.gov (United States)

American School and University, 1974

1974-01-01

The design of the student center at Essex Community College in Baltimore County, Maryland, reflects youthful lifestyles in the interior decor while providing exterior design to harmonize with existing campus buildings. (Author/MF)

Metabolic flexibility as an adaptation to energy resources and requirements in health and disease.

Science.gov (United States)

Smith, Reuben L; Soeters, Maarten R; Wüst, Rob C I; Houtkooper, Riekelt H

2018-04-24

The ability to efficiently adapt metabolism by substrate sensing, trafficking, storage and utilization, dependent on availability and requirement is known as metabolic flexibility. In this review, we discuss the breadth and depth of metabolic flexibility and its impact on health and disease. Metabolic flexibility is essential to maintain energy homeostasis in times of either caloric excess or caloric restriction, and in times of either low or high energy demand, such as during exercise. The liver, adipose tissue and muscle govern systemic metabolic flexibility and manage nutrient sensing, uptake, transport, storage and expenditure by communication via endocrine cues. At a molecular level, metabolic flexibility relies on the configuration of metabolic pathways which is regulated by key metabolic enzymes and transcription factors, many of which interact closely with the mitochondria. Disrupted metabolic flexibility, or metabolic inflexibility, however, is associated with many pathological conditions including metabolic syndrome, type 2 diabetes mellitus, and cancer. Multiple factors like dietary composition and feeding frequency, exercise training, and use of pharmacological compounds influence metabolic flexibility and will be discussed here. Lastly, we outline important advances in metabolic flexibility research and discuss medical horizons and translational aspects.

[Children's medically complex diseases unit. A model required in all our hospitals].

Science.gov (United States)

Climent Alcalá, Francisco José; García Fernández de Villalta, Marta; Escosa García, Luis; Rodríguez Alonso, Aroa; Albajara Velasco, Luis Adolfo

2018-01-01

The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. The MCC Unit has 6 beds and daily outpatient clinic. A total of 1,027 patients have been treated since the creation of the unit, with 243 from 2014. The median age was 24.2 months (IQ: 10.21-84.25). The large majority (92.59%) have multiple diseases, the most frequent chronic conditions observed were neurological (76.95%), gastrointestinal (63.78%), and respiratory diseases (61.72%). More than two-thirds (69.54%) of MCC are dependent on technology, 53.49% on respiratory support, and 35.80% on nutritional support. Hospital admission rates have increased annually. There have been 403 admissions since 2014, of which 8.93% were re-admissions within 30 days of hospital discharge. The median stay during 2014-2016 was 6 days (IQ: 3-14). The occupancy rate has been above 100% for this period. Currently, 210 patients remain on follow-up (86.42%), and 11 children (4.53%) were discharged to their referral hospitals. The mortality rate is 9.05% (22 deaths). The main condition of these 22 patients was neurological (9 patients). Infectious diseases were the leading cause of death. MCC should be treated in specialized units in tertiary or high-level hospitals. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Requirements of a coronary heart disease risk factor intervention ...

African Journals Online (AJOL)

Health education programmes to promote the prudent diet are required. The need for. appropriately trained health educators in schools, workplaces, health clinics and all hospitals has been identified. An extensive health education service should be expanded by including the use 'of mass media, particularly television, ...

Severe Chronic Upper Airway Disease (SCUAD) in children. Definition issues and requirements.

Science.gov (United States)

Karatzanis, A; Kalogjera, L; Scadding, G; Velegrakis, S; Kawauchi, H; Cingi, C; Prokopakis, E

2015-07-01

Upper airway diseases are extremely common, and a significant proportion of patients are not adequately controlled by contemporary treatment algorithms. The term SCUAD (Severe Chronic Upper Airway Disease) has been previously introduced to describe such cases. However, this term has not been adequately focused on children. This study aims to address the necessity of the term, as well as further details specifically for children. For this purpose, a review was performed of the current literature, with specific focus on issues regarding SCUAD in children. Paediatric SCUAD represents a heterogeneous group of patients and has significant clinical and socioeconomic implications. Relevant literature is generally lacking and questions regarding definition and pathogenesis remain unanswered. Accurate definition and acknowledgement of paediatric SCUAD cases may lead to better design of future clinical and molecular research protocols. This may provide improved understanding of the underlying disease processes, more accurate data regarding socioeconomic burden, and, above all, more successful treatment and prevention strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A systematic review of interventions by healthcare professionals to improve management of non-communicable diseases and communicable diseases requiring long-term care in adults who are homeless.

Science.gov (United States)

Hanlon, Peter; Yeoman, Lynsey; Gibson, Lauren; Esiovwa, Regina; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard

2018-04-07

Identify, describe and appraise trials of interventions delivered by healthcare professionals to manage non-communicable diseases (NCDs) and communicable diseases that require long-term care or treatment (LT-CDs), excluding mental health and substance use disorders, in homeless adults. Systematic review of randomised controlled trials (RCTs), non-RCTs and controlled before-after studies. Interventions characterised using Effective Practice and Organisation of Care (EPOC) taxonomy. Quality assessed using EPOC risk of bias criteria. Database searches (MEDLINE, Embase, PsycINFO, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Cochrane Central Register of Controlled Trials), hand searching reference lists, citation searches, grey literature and contact with study authors. Community. Adults (≥18 years) fulfilling European Typology of Homelessness criteria. Delivered by healthcare professionals managing NCD and LT-CDs. Primary outcome: unscheduled healthcare utilisation. mortality, biological markers of disease control, adherence to treatment, engagement in care, patient satisfaction, knowledge, self-efficacy, quality of life and cost-effectiveness. 11 studies were included (8 RCTs, 2 quasi-experimental and 1 feasibility) involving 9-520 participants (67%-94% male, median age 37-49 years). Ten from USA and one from UK. Studies included various NCDs (n=3); or focused on latent tuberculosis (n=4); HIV (n=2); hepatitis C (n=1) or type 2 diabetes (n=1). All interventions were complex with multiple components. Four described theories underpinning intervention. Three assessed unscheduled healthcare utilisation: none showed consistent reduction in hospitalisation or emergency department attendance. Six assessed adherence to specific treatments, of which four showed improved adherence to latent tuberculosis therapy. Three concerned education case management, all of which improved disease

Color-Changing Sensors for Detecting the Presence of Hypergolic Fuels

Science.gov (United States)

Roberson, Luke; Captain, Janine; Santiago-Maldonado, Edgardo; Starr, Stanley; DeVor, Robert

2013-01-01

Hypergolic fuel sensors were designed to incorporate novel chemochromic pigments into substrates for use in various methods of leak detection. There are several embodiments to this invention that would provide specific visual indication of hypergols used during and after transfer. The ability to incorporate these pigments into various polymer matrices provides a unique opportunity to manufacture nearly any type of sensor shape that is required. The vibrant color change from yellow to black instantaneously shows the worker the presence of hypergols in the area.

Pengaruh Faktor Psikologi Konsumen dan Online Store Environment Terhadap Purchase intention Pada E-commerce Model Bisnis C2C

OpenAIRE

Samiono, Bambang Eko

2018-01-01

The existence of the internet has put e-commerce on the concept of one stop shopping. Online trends provide a variety of ease in accessing and running a business with e-commerce. E-commerce C2C model is one of the most vibrant business models in e-commerce. Here business owner are required to be sensitive to the factors that affect consumers to purchase intention on online store. This study examines the influence of internal factors of the Online Store Environment (web quality and web brand) ...

Reversible hypothyroidism and Whipple's disease

Directory of Open Access Journals (Sweden)

Tran Huy A

2006-05-01

Full Text Available Abstract Background The major cause of primary hypothyroidism is autoimmune mediated with progressive and permanent destruction of the thyroid gland resulting in life-long replacement therapy. Treatable and reversible hypothyroidism is unusual and here forth is such a case due to infection of the thyroid gland with Tropheryma whippleii, Whipple disease. Case presentation A 45 year-old female presented with symptoms and signs consistent with primary hypothyroidism, which was also confirmed biochemically. Her response to thyroxine replacement therapy was poor however, requiring a significantly elevated amount. Further investigation revealed the presence of Whipple's disease involving the gastrointestinal trace and possibly the thyroid gland. Her thyroxine requirement decreased drastically following appropriate antimicrobial therapy for Whipple's disease to the extent that it was ceased. Thyrotropin releasing hormone testing in the steady state suggested there was diminished thyroid reserve due to Whipple's disease. Conclusion This is the first ante-mortem case report studying the possible involvement of the thyroid gland by Whipple's disease. Despite the normalization of her thyroid function test biochemically after antibiotic therapy, there is diminished thyroid reserve thus requiring close and regular monitoring.

Estimativa das necessidades energéticas em pacientes com doença renal crônica Estimating the energy requirement of chronic kidney disease patients

Directory of Open Access Journals (Sweden)

Juliana Cordeiro Dias Rodrigues

2013-02-01

Full Text Available Estabelecer as necessidades energéticas de pacientes com doença renal crônica é importante para que se possam tratar os distúrbios nutricionais encontrados nessa população. Segundo os guias de condutas voltados ao cuidado nutricional de pacientes com essa doença, a recomendação energética pode variar entre 30 e 40kcal/kg/dia. Contudo, trabalhos que avaliaram os componentes do gasto energético nos pacientes com doença renal crônica sugerem que as necessidades energéticas dessa população podem diferir do valor recomendado acima, a depender da condição clínica (presença de comorbidades, da modalidade de tratamento empregado e do nível de atividade física. Dessa forma, o presente trabalho tem como objetivo fazer uma revisão dos estudos sobre o gasto energético de pacientes com doença renal crônica, com o intuito de abordar as seguintes questões: (1 as atuais recomendações de energia para pacientes com doença renal crônica estão adequadas? (2 qual equação de predição poderia ser empregada para estimar as necessidades energéticas desse grupo de pacientes? Assim, esta revisão busca auxiliar o nutricionista ao estimar as necessidades energéticas de pacientes com doença renal crônica.Estimating the energy requirement of patients with chronic kidney disease is highly important for treating the nutritional disorders often seen in this population. According to the specific guidelines for patients with chronic kidney disease, the currently recommended daily energy intake varies from 30 to 40kcal/kg/day. However, studies that investigated energy expenditure components of patients with chronic kidney disease suggested that the energy requirement may differ from the one proposed earlier, depending on overall clinical condition (i.e. presence of comorbidities, treatment modality and level of physical activity. With this perspective in mind, the present study aims to review the studies assessing energy expenditure

Modeling seasonal behavior changes and disease transmission with application to chronic wasting disease.

Science.gov (United States)

Oraby, Tamer; Vasilyeva, Olga; Krewski, Daniel; Lutscher, Frithjof

2014-01-07

Behavior and habitat of wildlife animals change seasonally according to environmental conditions. Mathematical models need to represent this seasonality to be able to make realistic predictions about the future of a population and the effectiveness of human interventions. Managing and modeling disease in wild animal populations requires particular care in that disease transmission dynamics is a critical consideration in the etiology of both human and animal diseases, with different transmission paradigms requiring different disease risk management strategies. Since transmission of infectious diseases among wildlife depends strongly on social behavior, mechanisms of disease transmission could also change seasonally. A specific consideration in this regard confronted by modellers is whether the contact rate between individuals is density-dependent or frequency-dependent. We argue that seasonal behavior changes could lead to a seasonal shift between density and frequency dependence. This hypothesis is explored in the case of chronic wasting disease (CWD), a fatal disease that affects deer, elk and moose in many areas of North America. Specifically, we introduce a strategic CWD risk model based on direct disease transmission that accounts for the seasonal change in the transmission dynamics and habitats occupied, guided by information derived from cervid ecology. The model is composed of summer and winter susceptible-infected (SI) equations, with frequency-dependent and density-dependent transmission dynamics, respectively. The model includes impulsive birth events with density-dependent birth rate. We determine the basic reproduction number as a weighted average of two seasonal reproduction numbers. We parameterize the model from data derived from the scientific literature on CWD and deer ecology, and conduct global and local sensitivity analyses of the basic reproduction number. We explore the effectiveness of different culling strategies for the management of CWD

9 CFR 91.3 - General export requirements.

Science.gov (United States)

2010-01-01

... finds such tests are not necessary to prevent the exportation of diseased animals from the United States. (c) Testing. All samples for tests required by §§ 91.5 through 91.13 for exportation of animals under... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false General export requirements. 91.3...

Emergency surgery for Crohn's disease.

Science.gov (United States)

Smida, Malek; Miloudi, Nizar; Hefaiedh, Rania; Zaibi, Rabaa

2016-03-01

Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease. Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period. The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates

Dynamics of infectious diseases

International Nuclear Information System (INIS)

Rock, Kat; Brand, Sam; Moir, Jo; Keeling, Matt J

2014-01-01

Modern infectious disease epidemiology has a strong history of using mathematics both for prediction and to gain a deeper understanding. However the study of infectious diseases is a highly interdisciplinary subject requiring insights from multiple disciplines, in particular a biological knowledge of the pathogen, a statistical description of the available data and a mathematical framework for prediction. Here we begin with the basic building blocks of infectious disease epidemiology—the SIS and SIR type models—before considering the progress that has been made over the recent decades and the challenges that lie ahead. Throughout we focus on the understanding that can be developed from relatively simple models, although accurate prediction will inevitably require far greater complexity beyond the scope of this review. In particular, we focus on three critical aspects of infectious disease models that we feel fundamentally shape their dynamics: heterogeneously structured populations, stochasticity and spatial structure. Throughout we relate the mathematical models and their results to a variety of real-world problems. (review article)

Energy Expenditure in Infants in Health and Disease

Directory of Open Access Journals (Sweden)

Ross Shepherd

1997-01-01

Full Text Available Measurement of energy balance represents a basic theoretical concept in the determination of nutritional and fluid requirements in humans in health and disease. Infants have special nutrient requirements, more limited reserves and relative immaturity of organ function. Energy requirements of infants have been based either retrospectively on intakes required to achieve normal growth or on equations derived from energy expenditure studies performed early this century. Recently, improved techniques for studying resting energy expenditure (REE, total energy expenditure (TEE and metabolically active body compartments in infants have facilitated more accurate estimates of energy requirements. Such studies indicated that current reference values for energy requirements are overestimates, and that compared with measured values, predicted values vary markedly between the various predictive equations with wide co-efficients of variation. In disease states with altered body composition, such as cystic fibrosis and end-stage liver disease, predictive equations markedly underestimate both energy and fluid requirements. In cystic fibrosis, both TEE and REE are 25% higher than values in healthy infants. In extrahepatic biliary atresia, energy expenditure per unit body cell mass is markedly elevated, suggesting that this is a catabolic condition in infants. Current estimates of energy and fluid requirements in both health and disease in infants need reappraisal. Bedside and free living energy expenditure methodology should be used to define accurately components of energy requirement in individual infants.

Methods to Implement Innovation and Entrepreneurship in Physics

Science.gov (United States)

Arion, Douglas

2015-03-01

The physics community is beginning to become aware of the benefits of entrepreneurship and innovation education: greater enrollments, improved students satisfaction, a wider range of interesting research problems, and the potential for greater return from more successful alumni. This talk will suggest a variety of mechanisms by which physics departments can include entrepreneurship and innovation content within their programs - without necessarily requiring earth-shattering changes to the curriculum. These approaches will thus make it possible for departments to get involved with entrepreneurship and innovation, and grow those components into vibrant activities for students and faculty.

Towards business improvement districts in Denmark: Translating a neoliberal urban intervention model into the Nordic context

DEFF Research Database (Denmark)

Richner, Martin; Olesen, Kristian

2018-01-01

model is promoted as a market-based planning tool to support progressive planning goals of supporting town centres as vibrant commercial centres. Furthermore, the BID concept is, among Danish planners, perceived as a useful organisational framework for the construction of public–private partnerships...... as add-ons to area-based renewal initiatives in order to strengthen local community support. Such interpretations are not only in stark contrast to BIDs implemented elsewhere, but also require a significant reconfiguration of the model to fit local needs. However, despite the strong social focus...

Contemporary management of pericardial diseases.

Science.gov (United States)

Imazio, Massimo

2012-05-01

Pericardial diseases are relatively common in clinical practice, either as isolated disease or as manifestation of a systemic disorder. The aim of the present study is to review more recent updates on their contemporary management. The cause of pericardial diseases is varied according to the epidemiologic background, patient population, and clinical setting. Most cases remain idiopathic, and empiric anti-inflammatory therapy should be considered as first-line therapy in most cases with the possible adjunct of colchicine in the setting of inflammatory pericardial diseases, especially relapsing or not responding to first-line drugs. A triage has been proposed to select high-risk cases requiring admission and specific cause search. The prognosis of pericardial diseases is essentially determined by the cause. The most feared complication is constriction, the risk of which is higher in bacterial forms, intermediate for postpericardiotomy syndromes and systemic inflammatory diseases, low for viral and idiopathic cases. Chronic constriction has a definite surgical therapy, whereas transient cases should be recognized and may be reversible with empirical anti-inflammatory therapy. Contemporary management of pericardial diseases is largely empirical, although first clinical trials and new studies on diagnostic modalities and prognosis of pericardial diseases are bringing the contemporary management of pericardial diseases along a more evidence-based road. Integrated cardiovascular imaging is required for optimal management of the patient with suspected pericardial disease.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

Science.gov (United States)

Cramm, Jane Murray; Nieboer, Anna Petra

2016-09-21

Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative primary care solutions are still mainly focused on clinical and functional outcomes and health behaviors (e.g., smoking cessation, exercise, and diet) failing to address individuals' overall quality of life and well-being. Individuals' ability to achieve well-being can be assessed with great specificity through the application of social production function (SPF) theory. This theory asserts that people produce their own well-being by trying to optimize the achievement of instrumental goals (stimulation, comfort, status, behavioral confirmation, affection) that provide the means to achieve the larger, universal goals of physical and social well-being. A shift in focus from the management of physical function, disease limitations, and lifestyle behaviors alone to an approach that fosters self-management abilities such as self-efficacy and resource investment as well as overall quality of life, is urgently needed. Disease management interventions should be aimed at adequately addressing all difficulties chronically ill patients face in life, such as the effects of pain and fatigue on the ability to maintain a job and social life and to participate in activities promoting physical and social well-being. Patients' ability to maintain engagement in stimulating work and social activities with the people who are important to them may be even more important than aspects of disease self-management such as blood pressure or glycemic control. Interventions should aim to make chronically ill patients capable of

Cardiovascular diseases

International Nuclear Information System (INIS)

Kodama, Kazunori

1992-01-01

This paper is aimed to discuss the involvement of delayed radiation effects of A-bomb exposure in cardiovascular diseases. First, the relationship between radiation and cardiovascular diseases is reviewed in the literature. Animal experiments have confirmed the relationship between ionizing radiation and vascular lesions. There are many reports which describe ischemic heart disease, cervical and cerebrovascular diseases, and peripheral disease occurring after radiation therapy. The previous A-bomb survivor cohort studies, i.e., the RERF Life Span Study and Adult Health Study, have dealt with the mortality rate from cardiovascular diseases, the prevalence or incidence of cardiovascular diseases, pathological findings, clinical observation of arteriosclerosis, ECG abnormality, blood pressure abnormality, and cardiac function. The following findings have been suggested: (1) A-bomb exposure is likely to be involved in the mortality rate and incidence of ischemic heart disease and cerebrovascular diseases; (2) similarly, the involvement of A-bomb exposure is considered in the prevalence of the arch of aorta; (3) ECG abnormality corresponding to ischemic heart disease may reflect the involvement of A-bomb exposure. To confirm the above findings, further studies are required on the basis of more accurate information and the appropriate number of cohort samples. Little evidence has been presented for the correlation between A-bomb exposure and both rheumatic heart disease and congenital heart disease. (N.K.) 88 refs

[Autoimmune thyroid disease and other non-endocrine autoimmune diseases].

Science.gov (United States)

Dilas, Ljiljana Todorović; Icin, Tijana; Paro, Jovanka Novaković; Bajkin, Ivana

2011-01-01

Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens. They constitute heterogeneous group of disorders, in which multiple alterations in the immune system result in a spectrum of syndromes that either target specific organs or affect the body systematically. Recent epidemiological studies have shown a possible shift of one autoimmune disease to another or the fact that more than one autoimmune disease may coexist in a single patient or in the same family. Numerous autoimmune diseases have been shown to coexist frequently with thyroid autoimmune diseases. AUTOIMMNUNE THYROID DISEASE AND OTHER ORGAN SPECIFIC NON-ENDOCRINE AUTOIMMUNE DISEASES: This part of the study reviews the prevalence of autoimmune thyroid disease coexisting with: pernicious anaemia, vitiligo, celiac disease, autoimmune liver disease, miastenia gravis, alopecia areata and sclerosis multiplex, and several recommendations for screening have been given. AUTOIMMUNE THYROID DISEASE AND OTHER ORGAN NON-SPECIFIC NON-ENDOCRINE AUTOIMMUNE DISEASES: Special attention is given to the correlation between autoimmune thyroid disease and rheumatoid arthritis, systemic lupus erythematosus, syndrome Sjögren, systemic sclerosis and mixed connective tissue disease. Screening for autoimmune thyroid diseases should be recommended in everyday clinical practice, in patients with primary organ-specific or organ non-specific autoimmune disease. Otherwise, in patients with primary thyroid autoimmune disease, there is no good reason of seeking for all other autoimmune diseases, although these patients have a greater risk of developing other autoimmune disease. Economic aspects of medicine require further analyzing of these data, from cost/benefit point of view to justified either mandatory screening or medical practitioner judgment.

Coeliac disease

DEFF Research Database (Denmark)

Reilly, Norelle R; Husby, Steffen; Sanders, David S

2018-01-01

Coeliac disease is increasingly recognized as a global problem in both children and adults. Traditionally, the findings of characteristic changes of villous atrophy and increased intraepithelial lymphocytosis identified in duodenal biopsy samples taken during upper gastrointestinal endoscopy have...... been required for diagnosis. Although biopsies remain advised as necessary for the diagnosis of coeliac disease in adults, European guidelines for children provide a biopsy-sparing diagnostic pathway. This approach has been enabled by the high specificity and sensitivity of serological testing. However......, these guidelines are not universally accepted. In this Perspective, we discuss the pros and cons of a biopsy-avoiding pathway for the diagnosis of coeliac disease, especially in this current era of the call for more biopsies, even from the duodenal bulb, in the diagnosis of coeliac disease. In addition, a contrast...

The role of vitamin K in chronic aging diseases: inflammation, cardiovascular disease and osteoarthritis

Science.gov (United States)

Vitamin K is an enzyme cofactor required for the carboxylation of vitamin K dependent proteins, several of which have been implicated in diseases of aging. Inflammation is recognized as a crucial component of many chronic aging diseases, and evidence suggests vitamin K has an anti-inflammatory actio...

Essential nutrient requirements of the elderly

Directory of Open Access Journals (Sweden)

Skully R

2014-06-01

Full Text Available Robert Skully Department of Family Medicine, Grant Medical Center, OhioHealth, Columbus, OH, USA Abstract: Government-sponsored medical organizations in developed countries have established guidelines for daily nutritional requirements. For most nutrients there is general agreement surrounding these requirements, which are based on exhaustive scientific literature review. Differences in these recommendations exist because of genetic and environmental factors that result in differences in disease susceptibility, but also due to incomplete understanding of the roles of nutrients in disease prevention. This review briefly summarizes nutrient recommendations for older adults such as where those recommendations differ from those of younger adults; and includes areas of developing understanding such as the possible role of thiamine deficiency in patients with congestive heart failure, the need for some older adults to ingest absorbable forms of vitamin B12, the high prevalence of vitamin D deficiency, the potential role of vitamin K in bone health, the need for higher levels of protein intake in order to stimulate muscle protein synthesis as one ages, the role of calcium in osteoporosis, and the possible need for zinc supplementation in hospitalized patients. Keywords: vitamins, nutritional requirements, energy expenditure, energy consumption

Interstitial lung disease associated with connective tissue diseases

International Nuclear Information System (INIS)

Medina, Yimy F; Restrepo, Jose Felix; Iglesias, Antonio; Ojeda, Paulina; Matiz, Carlos

2007-01-01

An interstitial lung disease (ILD) belongs to a group of diffuse parenchyma lung diseases it should be differentiated from other pathologies among those are idiopathic and ILD associated to connective tissue diseases (CTD) New concepts have been developed in the last years and they have been classified in seven defined subgroups. It has been described the association of each one of these subgroups with CTD. Natural history and other aspects of its treatment is not known completely .For complete diagnose it is required clinical, image and histopathologic approaches. The biopsy lung plays an essential role. It is important to promote and to stimulate the subclasification of each subgroup with the purpose of knowing their natural history directing the treatment and to improve their outcome

Crohn Disease: Epidemiology, Diagnosis, and Management.

Science.gov (United States)

Feuerstein, Joseph D; Cheifetz, Adam S

2017-07-01

Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills. There are 3 main disease phenotypes: inflammatory, structuring, and penetrating. In addition to the underlying disease phenotype, up to a third of patients will develop perianal involvement of their disease. In addition, in some cases, extraintestinal manifestations may develop. The diagnosis is typically made with endoscopic and/or radiologic findings. Disease management is usually with pharmacologic therapy, which is determined on the basis of disease severity and underlying disease phenotype. Although the goal of management is to control the inflammation and induce a clinical remission with pharmacologic therapy, most patients will eventually require surgery for their disease. Unfortunately, surgery is not curative and patients still require ongoing therapy even after surgery for disease recurrence. Importantly, given the risks of complications from both Crohn disease and the medications used to treat the disease process, primary care physicians play an important role in optimizing the preventative care management to reduce the risk of complications. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Castleman disease (literature review

Directory of Open Access Journals (Sweden)

A. L. Melikyan

2016-01-01

Full Text Available Castleman disease (angiofollicular hyperplasia of lymph nodes – a rare benign lymphoproliferative disease with prolonged asymptomatic course, associated with a wide variety of autoimmune and oncological diseases and the risk of non-Hodgkin’s lymphoma. The rare occurrence of this disease and a variety of clinical course did not allow for a complete and consistent research on the etiology and pathogenesis and the standard therapies development. In recent years, the number of patients with Castleman disease in the Russian Federation has increased, which requires its recognition among non-neoplastic and neoplastic lymphadenopathy. The article provides an overview about clinical and histological variants of Castleman’s disease, its pathogenesis concepts, classification and treatment.

Regional Disease Surveillance Meeting - Final Paper

Energy Technology Data Exchange (ETDEWEB)

Lesperance, Ann M.; Mahy, Heidi A.

2006-08-08

On June 1, 2006, public health officials working in surveillance, epidemiological modeling, and information technology communities from the Seattle/Tacoma area and State of Washington met with members of the Pacific Northwest National Laboratory (PNNL) to discuss the current state of disease surveillance and gaps and needs to improve the current systems. The meeting also included a discussion of PNNL initiatives that might be appropriate to enhance disease surveillance and the current tools being used for disease surveillance. Participants broke out into two groups to identify critical gaps and needs for improving a surveillance system, and discuss the requirements for developing improved surveillance. Each group developed a list of key priorities summarizing the requirements for improved surveillance. The objective of this meeting was to work towards the development of an improved disease surveillance system.

A new proposal for randomized start design to investigate disease-modifying therapies for Alzheimer disease.

Science.gov (United States)

Zhang, Richard Y; Leon, Andrew C; Chuang-Stein, Christy; Romano, Steven J

2011-02-01

The increasing prevalence of Alzheimer disease (AD) and lack of effective agents to attenuate progression have accelerated research and development of disease modifying (DM) therapies. The traditional parallel group design and single time point analysis used in the support of past AD drug approvals address symptomatic benefit over relatively short treatment durations. More recent trials investigating disease modification are by necessity longer in duration and require larger sample sizes. Nevertheless, trial design and analysis remain mostly unchanged and may not be adequate to meet the objective of demonstrating disease modification. Randomized start design (RSD) has been proposed as an option to study DM effects, but its application in AD trials may have been hampered by certain methodological challenges. To address the methodological issues that have impeded more extensive use of RSD in AD trial and to encourage other researchers to develop novel design and analysis methodologies to better ascertain DM effects for the next generation of AD therapies, we propose a stepwise testing procedure to evaluate potential DM effects of novel AD therapies. Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-cog) is used for illustration. We propose to test three hypotheses in a stepwise sequence. The three tests pertain to treatment difference at two separate time points and a difference in the rate of change. Estimation is facilitated by the Mixed-effects Model for Repeated Measures approach. The required sample size is estimated using Monte Carlo simulations and by modeling ADAS-cog data from prior longitudinal AD studies. The greatest advantage of the RSD proposed in this article is its ability to critically address the question on a DM effect. The AD trial using the new approach would be longer (12-month placebo period plus 12-month delay-start period; total 24-month duration) and require more subjects (about 1000 subjects per arm for the non-inferiority margin

Management of thyroid eye disease

International Nuclear Information System (INIS)

Bartalena, Luigi; Tanda, Maria Laura; Marcocci, Claudio; Pinchera, Aldo

2002-01-01

Thyroid eye disease (TED) is the most frequent extrathyroidal manifestation of Graves' disease. In most instances it is mild and non-progressive, but in 3%-5% of cases it is severe. Non-severe TED requires only supportive measures, such as eye ointments, sunglasses and prisms. By contrast, severe TED requires aggressive treatment, either medical (high-dose glucocorticoids, orbital radiotherapy) or surgical (orbital decompression). The choice of treatment relies on the assessment of both TED severity and activity. Removal of controllable risk factors, especially cigarette smoking, is important to improve the course and the therapeutic outcome. A coordinated approach to the treatment of hyperthyroidism and TED is also required. Novel promising treatments, to be verified in large series of patients, include somatostatin analogues and cytokine antagonists. (orig.)

Management of thyroid eye disease

Energy Technology Data Exchange (ETDEWEB)

Bartalena, Luigi; Tanda, Maria Laura [Department of Endocrinology, University of Insubria, Ospedale di Circolo, Viale Borri, 57, 21100 Varese (Italy); Marcocci, Claudio; Pinchera, Aldo [Department of Endocrinology and Metabolism, University of Pisa, Pisa (Italy)

2002-08-01

Thyroid eye disease (TED) is the most frequent extrathyroidal manifestation of Graves' disease. In most instances it is mild and non-progressive, but in 3%-5% of cases it is severe. Non-severe TED requires only supportive measures, such as eye ointments, sunglasses and prisms. By contrast, severe TED requires aggressive treatment, either medical (high-dose glucocorticoids, orbital radiotherapy) or surgical (orbital decompression). The choice of treatment relies on the assessment of both TED severity and activity. Removal of controllable risk factors, especially cigarette smoking, is important to improve the course and the therapeutic outcome. A coordinated approach to the treatment of hyperthyroidism and TED is also required. Novel promising treatments, to be verified in large series of patients, include somatostatin analogues and cytokine antagonists. (orig.)

Management of Cushing disease.

Science.gov (United States)

Tritos, Nicholas A; Biller, Beverly M K; Swearingen, Brooke

2011-05-01

Cushing disease is caused by a corticotroph tumor of the pituitary gland. Patients with Cushing disease are usually treated with transsphenoidal surgery, as this approach leads to remission in 70-90% of cases and is associated with low morbidity when performed by experienced pituitary gland surgeons. Nonetheless, among patients in postoperative remission, the risk of recurrence of Cushing disease could reach 20-25% at 10 years after surgery. Patients with persistent or recurrent Cushing disease might, therefore, benefit from a second pituitary operation (which leads to remission in 50-70% of cases), radiation therapy to the pituitary gland or bilateral adrenalectomy. Remission after radiation therapy occurs in ∼85% of patients with Cushing disease after a considerable latency period. Interim medical therapy is generally advisable after patients receive radiation therapy because of the long latency period. Bilateral adrenalectomy might be considered in patients who do not improve following transsphenoidal surgery, particularly patients who are very ill and require rapid control of hypercortisolism, or those wishing to avoid the risk of hypopituitarism associated with radiation therapy. Adrenalectomized patients require lifelong adrenal hormone replacement and are at risk of Nelson syndrome. The development of medical therapies with improved efficacy might influence the management of this challenging condition.

Celiac disease

Directory of Open Access Journals (Sweden)

Holtmeier Wolfgang

2006-03-01

Full Text Available Abstract Celiac disease is a chronic intestinal disease caused by intolerance to gluten. It is characterized by immune-mediated enteropathy, associated with maldigestion and malabsorption of most nutrients and vitamins. In predisposed individuals, the ingestion of gluten-containing food such as wheat and rye induces a flat jejunal mucosa with infiltration of lymphocytes. The main symptoms are: stomach pain, gas, and bloating, diarrhea, weight loss, anemia, edema, bone or joint pain. Prevalence for clinically overt celiac disease varies from 1:270 in Finland to 1:5000 in North America. Since celiac disease can be asymptomatic, most subjects are not diagnosed or they can present with atypical symptoms. Furthermore, severe inflammation of the small bowel can be present without any gastrointestinal symptoms. The diagnosis should be made early since celiac disease causes growth retardation in untreated children and atypical symptoms like infertility or neurological symptoms. Diagnosis requires endoscopy with jejunal biopsy. In addition, tissue-transglutaminase antibodies are important to confirm the diagnosis since there are other diseases which can mimic celiac disease. The exact cause of celiac disease is unknown but is thought to be primarily immune mediated (tissue-transglutaminase autoantigen; often the disease is inherited. Management consists in life long withdrawal of dietary gluten, which leads to significant clinical and histological improvement. However, complete normalization of histology can take years.

Hashimoto's Disease

Science.gov (United States)

... diagnosed with hypothyroidism or had not yet started treatment for hypothyroidism. 4 Problems during pregnancy. The unborn baby's brain ... can last up to a year and requires treatment. Most often, thyroid function returns to normal as the ... from Hashimoto's disease treated during pregnancy? During pregnancy, ...

Puberty menorrhagia Requiring Inpatient Admission

Directory of Open Access Journals (Sweden)

AH Khosla

2010-06-01

Full Text Available INTRODUCTION: Puberty menorrhagia is a significant health problem in adolescent age group and severe cases may require admission and blood transfusion. Aim of this study was to evaluate the causes, associated complications and management of puberty menorrhagia. METHODS: Hospital records of all patients of puberty menorrhagia requiring admission were analyzed for etiology, duration since menarche, duration of bleeding, investigation profile and management. RESULTS: There were 18 patients of puberty menorrhagia requiring hospital admission. Etiology was anovulatory bleeding in 11 patients, bleeding disorders in five which included idiopathic thrombocytopenia purpura in three and one each with Von-Willebrand disease and leukemia. Two patients had hypothyroidism as the cause. Fourteen patients presented with severe anaemia and required blood transfusion. All except one responded to oral hormonal therapy. CONCLUSIONS: Puberty menorrhagia can be associated with severe complications and requiring blood transfusion. Although most common cause is anovulation but bleeding disorder, other medical condition and other organic causes must be ruled out in any patient of Puberty menorrhagia. KEYWORDS: anovulation, bleeding disorder, puberty, menorrhagia, anaemia.

Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases

DEFF Research Database (Denmark)

Chapple, Iain L C; Bouchard, Philippe; Cagetti, Maria Grazia

2017-01-01

Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requir......Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors...... to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc...... or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. AIM: To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. METHODS: One systematic...

Building a vibrant library association: the case of Uganda ...

African Journals Online (AJOL)

In recent years ULA has emphasized advocacy, and contributed to progress towards new legislation (freedom of information, copyright, the National Library Act) and policies (school libraries, East African Community e-government strategy) of importance to the library and information field in Uganda and beyond.

Rich and Vibrant Colours: 25 Years of Adult Education.

Science.gov (United States)

Hall, Budd L.

1992-01-01

Reviews the author's experiences in adult education over a quarter century; cites obstacles to adult education's role in social change and the lag in theoretical development. Depicts the future of adult education in response to three challenges: internationalization of the market, ecological awareness, and the theoretical and intellectual…

The School Librarian as Information Specialist: A Vibrant Species

Science.gov (United States)

Harris, Frances Jacobson

2011-01-01

In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.

Viral Disease Networks?

Science.gov (United States)

Gulbahce, Natali; Yan, Han; Vidal, Marc; Barabasi, Albert-Laszlo

2010-03-01

Viral infections induce multiple perturbations that spread along the links of the biological networks of the host cells. Understanding the impact of these cascading perturbations requires an exhaustive knowledge of the cellular machinery as well as a systems biology approach that reveals how individual components of the cellular system function together. Here we describe an integrative method that provides a new approach to studying virus-human interactions and its correlations with diseases. Our method involves the combined utilization of protein - protein interactions, protein -- DNA interactions, metabolomics and gene - disease associations to build a ``viraldiseasome''. By solely using high-throughput data, we map well-known viral associated diseases and predict new candidate viral diseases. We use microarray data of virus-infected tissues and patient medical history data to further test the implications of the viral diseasome. We apply this method to Epstein-Barr virus and Human Papillomavirus and shed light into molecular development of viral diseases and disease pathways.

Drug development for airway diseases: looking forward

NARCIS (Netherlands)

Holgate, Stephen; Agusti, Alvar; Strieter, Robert M.; Anderson, Gary P.; Fogel, Robert; Bel, Elisabeth; Martin, Thomas R.; Reiss, Theodore F.

2015-01-01

Advancing drug development for airway diseases beyond the established mechanisms and symptomatic therapies requires redefining the classifications of airway diseases, considering systemic manifestations, developing new tools and encouraging collaborations

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being"

OpenAIRE

Cramm, Jane; Nieboer, Anna

2016-01-01

textabstractBackground: Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative pri...

Neuromuscular diseases: Diagnosis and management.

Science.gov (United States)

Mary, P; Servais, L; Vialle, R

2018-02-01

Neuromuscular diseases (NMDs) affect the peripheral nervous system, which includes the motor neurons and sensory neurons; the muscle itself; or the neuromuscular junction. Thus, the term NMDs encompasses a vast array of different syndromes. Some of these syndromes are of direct relevance to paediatric orthopaedic surgeons, either because the presenting manifestation is a functional sign (e.g., toe-walking) or deformity (e.g., pes cavus or scoliosis) suggesting a need for orthopaedic attention or because orthopaedic abnormalities requiring treatment develop during the course of a known NMD. The main NMDs relevant to the orthopaedic surgeon are infantile spinal muscular atrophy (a motor neuron disease), peripheral neuropathies (chiefly, Charcot-Marie-Tooth disease), congenital muscular dystrophies, progressive muscular dystrophies, and Steinert myotonic dystrophy (or myotonic dystrophy type 1). Muscle weakness is a symptom shared by all these conditions. The paediatric orthopaedic surgeon must be familiar, not only with the musculoskeletal system, but also with many other domains (particularly respiratory and cardiac function and nutrition) that may interfere with the treatment and require preoperative management. Good knowledge of the natural history of each NMD is essential to ensure optimal timing of the therapeutic interventions, which must be performed under the best possible conditions in these usually frail patients. Timing is particularly crucial for the treatment of spinal deformities due to paraspinal muscle hypotonia during growth: depending on the disease and natural history, the treatment may involve non-operative methods or growing rods, followed by spinal fusion. A multidisciplinary approach is always required. Finally, the survival gains achieved in recent years increasingly require attention to preparing for adult life, to orthopaedic problems requiring treatment before the patient leaves the paediatric environment, and to the transition towards the

Immunotherapy of Human Papilloma Virus Induced Disease

Science.gov (United States)

van der Burg, Sjoerd H

2012-01-01

Immunotherapy is the generic name for treatment modalities aiming to reinforce the immune system against diseases in which the immune system plays a role. The design of an optimal immunotherapeutic treatment against chronic viruses and associated diseases requires a detailed understanding of the interactions between the target virus and its host, in order to define the specific strategies that may have the best chance to deliver success at each stage of disease. Recently, a first series of successes was reported for the immunotherapy of Human Papilloma Virus (HPV)-induced premalignant diseases but there is definitely room for improvement. Here I discuss a number of topics that in my opinion require more study as the answers to these questions allows us to better understand the underlying mechanisms of disease and as such to tailor treatment. PMID:23341861

[Addison's disease].

Science.gov (United States)

Quinkler, M

2012-09-01

The clinical signs and symptoms of primary adrenal insufficiency are unspecific often causing a delayed diagnosis or even misdiagnosis. In the diagnostic work-up the short synacthen test is regarded as the gold standard. Hydrocortisone and fludrocortisone are the preferred therapy for Addison's disease. The management and surveillance of therapy requires experience and several aspects need to be followed to prevent side effects which might occur due to overtreatment or undertreatment. Very important aspects in therapy are the repeated teaching of the patient and relatives, the issuing of an emergency steroid card and the prescription of a glucocorticoid emergency set. Acute adrenal failure (adrenal crisis), which might be the first manifestation of adrenal insufficiency, is a life-threatening situation requiring immediate glucocorticoid administration and fluid substitution. The most common causes for an adrenal crisis are gastrointestinal infections and fever and discontinuation of glucocorticoid therapy. This article gives an up-to-date overview of diagnostic and therapeutic aspects of Addison's disease.

The management of gastro-oesophageal reflux disease.

Science.gov (United States)

Keung, Charlotte; Hebbard, Geoffrey

2016-02-01

If there are no features of serious disease, suspected gastro-oesophageal reflux disease can be initially managed with a trial of a proton pump inhibitor for 4-8 weeks. This should be taken 30-60 minutes before food for optimal effect. Once symptoms are controlled, attempt to withdraw acid suppression therapy. If symptoms recur, use the minimum dose that controls symptoms. Patients who have severe erosive oesophagitis, scleroderma oesophagus or Barrett's oesophagus require long-term treatment with a proton pump inhibitor. Lifestyle modification strategies can help gastro-oesophageal reflux disease. Weight loss has the strongest evidence for efficacy. Further investigation and a specialist referral are required if there is no response to proton pump inhibitor therapy. Atypical symptoms or signs of serious disease also need investigation.

Hyperparathyroidism of Renal Disease.

Science.gov (United States)

Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

2016-01-01

Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1.73 m(2)). Since the 1990s, improving medical management with vitamin D analogs, phosphate binders, and calcimimetic drugs has expanded the treatment options for patients with rHPT, but some patients still require a parathyroidectomy to mitigate the sequelae of this challenging disease.

Liver disease in pregnancy

Institute of Scientific and Technical Information of China (English)

Noel M Lee; Carla W Brady

2009-01-01

Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Hyperemesis gravidarum, preeclampsia/eclampsia, syndrome of hemolysis, elevated liver tests and low platelets (HELLP), acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy are pregnancy-specific disorders that may cause elevations in liver tests and hepatic dysfunction. Chronic liver diseases, including cholestatic liver disease, autoimmune hepatitis, Wilson disease, and viral hepatitis may also be seen in pregnancy. Management of liver disease in pregnancy requires collaboration between obstetricians and gastroenterologists/hepatologists. Treatment of pregnancy-specific liver disorders usually involves delivery of the fetus and supportive care, whereas management of chronic liver disease in pregnancy is directed toward optimizing control of the liver disorder. Cirrhosis in the setting of pregnancy is less commonly observed but offers unique challenges for patients and practitioners. This article reviews the epidemiology, pathophysiology, diagnosis, and management of liver diseases seen in pregnancy.

Adjuvant use of antibiotics with corticosteroids in inflammatory bowel disease exacerbations requiring hospitalisation: a retrospective cohort study and meta-analysis.

Science.gov (United States)

Gupta, V; Rodrigues, R; Nguyen, D; Sauk, J; Khalili, H; Yajnik, V; Ananthakrishnan, A N

2016-01-01

Patients hospitalised with an exacerbation of inflammatory bowel disease (IBD) often receive antibiotics in addition to intravenous steroids. However, their efficacy in this setting is unclear. To ascertain if the addition of antibiotics to intravenous steroids modifies short and long-term clinical outcomes. Our study included IBD patients hospitalised between 2009 and 2014 who received intravenous (IV) steroids with or without adjuvant antibiotics. Outcomes of interest included length of stay (LOS), need for medical and surgical rescue therapy during the hospitalisation, and at 90 and 365 days. A meta-analysis of previously published randomised trials was additionally performed. A total of 354 patients were included [145 ulcerative colitis (UC); 209 Crohn's disease (CD)]. In CD, combination of IV steroids and antibiotics did not change need for in-hospital medical rescue therapy, surgery or hospitalisations at 1 year but was associated with greater LOS (6.1 vs. 4.6 days, P = 0.02). In UC, patients receiving antibiotics were less likely to require in-hospital medical rescue therapy [odds ratio (OR): 0.42, 95% confidence interval (CI): 0.19-0.93] but experienced no statistically significant differences in LOS, in-hospital surgery, re-hospitalisations or surgery by 1 year. A meta-analysis of three relevant randomised trials demonstrated no difference in clinical improvement with antibiotics over placebo (OR: 1.08, 95% CI: 0.50-2.32). The addition of antibiotics to intravenous steroids for treatment of IBD exacerbations was associated with a reduced need for in-hospital medical rescue therapy in ulcerative colitis without significant long-term benefit, and did not affect short- or long-term outcomes in Crohn's disease. © 2015 John Wiley & Sons Ltd.

Rheumatic heart disease: infectious disease origin, chronic care approach.

Science.gov (United States)

Katzenellenbogen, Judith M; Ralph, Anna P; Wyber, Rosemary; Carapetis, Jonathan R

2017-11-29

Rheumatic heart disease (RHD) is a chronic cardiac condition with an infectious aetiology, causing high disease burden in low-income settings. Affected individuals are young and associated morbidity is high. However, RHD is relatively neglected due to the populations involved and its lower incidence relative to other heart diseases. In this narrative review, we describe how RHD care can be informed by and integrated with models of care developed for priority non-communicable diseases (coronary heart disease), and high-burden communicable diseases (tuberculosis). Examining the four-level prevention model (primordial through tertiary prevention) suggests primordial and primary prevention of RHD can leverage off existing tuberculosis control efforts, given shared risk factors. Successes in coronary heart disease control provide inspiration for similarly bold initiatives for RHD. Further, we illustrate how the Chronic Care Model (CCM), developed for use in non-communicable diseases, offers a relevant framework to approach RHD care. Systems strengthening through greater integration of services can improve RHD programs. Strengthening of systems through integration/linkages with other well-performing and resourced services in conjunction with policies to adopt the CCM framework for the secondary and tertiary prevention of RHD in settings with limited resources, has the potential to significantly reduce the burden of RHD globally. More research is required to provide evidence-based recommendations for policy and service design.

Incidence of Renal Failure Requiring Hemodialysis Following Transcatheter Aortic Valve Replacement.

Science.gov (United States)

Ladia, Vatsal; Panchal, Hemang B; O׳Neil, Terrence J; Sitwala, Puja; Bhatheja, Samit; Patel, Rakeshkumar; Ramu, Vijay; Mukherjee, Debabrata; Mahmud, Ehtisham; Paul, Timir K

2016-09-01

Studies have shown that iodinated radiocontrast use is associated with acute renal failure especially in the presence of chronic kidney disease and multiple factors modulate this risk. The purpose of this meta-analysis is to compare the incidence of renal failure requiring hemodialysis between transfemoral (TF) and transapical (TA) transcatheter aortic valve replacement using the Edwards valve. The PubMed database was searched from January 2000 through December 2014. A total of 10 studies (n = 2,459) comparing TF (n = 1,268) and TA (n = 1,191) TAVR procedures using the Edwards valve were included. Variables of interest were baseline logistic EuroSCORE, prevalence of diabetes mellitus, hypertension, peripheral arterial disease, chronic kidney disease and amount of contrast used. The primary endpoint was incidence of renal failure requiring hemodialysis. The odds ratio and 95% CI were computed and P renal failure requiring hemodialysis was higher with the Edwards valve. This suggests that the incidence of renal failure requiring hemodialysis after TAVR is associated with baseline comorbidities in the TA-TAVR group rather than the volume of contrast used. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

The elusive baseline of marine disease: are diseases in ocean ecosystems increasing?

Directory of Open Access Journals (Sweden)

Jessica R Ward

2004-04-01

Full Text Available Disease outbreaks alter the structure and function of marine ecosystems, directly affecting vertebrates (mammals, turtles, fish, invertebrates (corals, crustaceans, echinoderms, and plants (seagrasses. Previous studies suggest a recent increase in marine disease. However, lack of baseline data in most communities prevents a direct test of this hypothesis. We developed a proxy to evaluate a prediction of the increasing disease hypothesis: the proportion of scientific publications reporting disease increased in recent decades. This represents, to our knowledge, the first quantitative use of normalized trends in the literature to investigate an ecological hypothesis. We searched a literature database for reports of parasites and disease (hereafter "disease" in nine marine taxonomic groups from 1970 to 2001. Reports, normalized for research effort, increased in turtles, corals, mammals, urchins, and molluscs. No significant trends were detected for seagrasses, decapods, or sharks/rays (though disease occurred in these groups. Counter to the prediction, disease reports decreased in fishes. Formulating effective resource management policy requires understanding the basis and timing of marine disease events. Why disease outbreaks increased in some groups but not in others should be a priority for future investigation. The increase in several groups lends urgency to understanding disease dynamics, particularly since few viable options currently exist to mitigate disease in the oceans.

Management of hypoadrenocorticism (Addison’s disease in dogs

Directory of Open Access Journals (Sweden)

Lathan P

2018-02-01

Full Text Available Patty Lathan,1 Ann L Thompson2 1College of Veterinary Medicine, Mississippi State University, Starkville, MS, USA; 2School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia Abstract: Hypoadrenocorticism (HOAC; Addison’s disease is an endocrine condition seen in small animal practice. Dogs with this disease can present in a variety of ways from acute hypovolemic collapse to vague, chronic, waxing, and waning clinical signs. In the most common form of this disease, animals have both mineralocorticoid and glucocorticoid deficiency, resulting in hyponatremia and hyperkalemia, and signs of cortisol deficiency. The etiology may be immune-mediated destruction of the adrenal cortex, drug-induced adrenocortical necrosis (mitotane, enzyme inhibition (trilostane, or infiltrative processes such as neoplastic or fungal disease. Much less commonly, dogs have signs of cortisol deficiency, but no electrolyte changes. This is referred to as atypical HOAC. The veterinarian needs to have a clinical suspicion for HOAC to make a diagnosis in a timely manner. Treatment of dogs with an acute presentation prioritizes correcting the hypovolemia, hyperkalemia, acidosis, and hypoglycemia. Fluid therapy addresses most of these issues, but other directed therapies may be required in the most severe cases. For chronic management, all patients with Addison’s disease will require replacement of glucocorticoids (usually prednisone, and most patients require replacement of mineralocorticoids with either desoxycorticosterone pivalate or fludrocortisone. Atypical Addisonians do not require mineralocorticoid supplementation, but electrolytes should be monitored in case the need arises in the future. The prognosis for dogs treated for HOAC promptly and appropriately is excellent; most patients die from other diseases. However, if the diagnosis is missed, patients may die as a consequence of HOAC. Thus, knowledge of the hallmarks of Addison�

Addison's disease and its associations

OpenAIRE

Puttanna, Amar; Cunningham, Alana Rosaleen; Dainty, Philip

2013-01-01

Addison's disease is a relatively rare endocrine condition resulting from adrenal insufficiency due to various causes. Weight loss is a common feature; however, patients may be seen by a variety of specialists, even requiring acute admission before the diagnosis is made. Addison's disease is commonly associated with other autoimmune diseases. In some cases such as autoimmune polyendocrine syndromes (APS) types 1 and 2, these associations are more commonly found. We present a case of one such ...

Comorbid Conditions in Neonates With Congenital Heart Disease.

Science.gov (United States)

Krishnamurthy, Ganga; Ratner, Veniamin; Bacha, Emile; Aspelund, Gudrun

2016-08-01

The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of major noncardiac anomalies, and prematurity in infants with congenital heart disease. MEDLINE and PubMed. Mortality risk is significantly higher in patients with congenital heart disease and associated anomalies compared with those in whom the heart defect occurs in isolation. Although most noncardiac structural anomalies do not require surgery in the neonatal period, several require surgery for survival. Management of such infants poses multiple challenges. Premature infants with congenital heart disease face challenges imposed by their immature organ systems, which are susceptible to injury or altered function by congenital heart disease and abnormal circulatory physiology independent of congenital heart disease. For optimal outcomes in premature infants or in infants with multiple congenital anomalies, a collaborative interdisciplinary approach is necessary.

Epidemiology of acquired valvular heart disease.

Science.gov (United States)

Iung, Bernard; Vahanian, Alec

2014-09-01

Population-based studies including systematic echocardiographic examinations are required to assess the prevalence of valvular heart disease. In industrialized countries, the prevalence of valvular heart disease is estimated at 2.5%. Because of the predominance of degenerative etiologies, the prevalence of valvular disease increases markedly after the age of 65 years, in particular with regard to aortic stenosis and mitral regurgitation, which accounts for 3 in 4 cases of valvular disease. Rheumatic heart disease still represents 22% of valvular heart disease in Europe. The prevalence of secondary mitral regurgitation cannot be assessed reliably but it seems to be a frequent disease. The incidence of infective endocarditis is approximately 30 cases per million individiuals per year. Its stability is associated with marked changes in its presentation. Patients are getting older and staphylococcus is now becoming the microorganism most frequently responsible. Heath care-associated infections are the most likely explanation of changes in the microbiology of infective endocarditis. In developing countries, rheumatic heart disease remains the leading cause of valvular heart disease. Its prevalence is high, between 20 and 30 cases per 1000 subjects when using systematic echocardiographic screening. In conclusion, the temporal and geographical heterogeneity illustrates the effect of socioeconomic status and changes in life expectancy on the frequency and presentation of valvular heart disease. A decreased burden of valvular disease would require the elaboration of preventive strategies in industrialized countries and an improvement in the socioeconomic environment in developing countries. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Classification of diffuse lung diseases: why and how.

Science.gov (United States)

Hansell, David M

2013-09-01

The understanding of complex lung diseases, notably the idiopathic interstitial pneumonias and small airways diseases, owes as much to repeated attempts over the years to classify them as to any single conceptual breakthrough. One of the many benefits of a successful classification scheme is that it allows workers, within and between disciplines, to be clear that they are discussing the same disease. This may be of particular importance in the recruitment of individuals for a clinical trial that requires a standardized and homogeneous study population. Different specialties require fundamentally different things from a classification: for epidemiologic studies, a classification that requires categorization of individuals according to histopathologic pattern is not usually practicable. Conversely, a scheme that simply divides diffuse parenchymal disease into inflammatory and noninflammatory categories is unlikely to further the understanding about the pathogenesis of disease. Thus, for some disease groupings, for example, pulmonary vasculopathies, there may be several appropriate classifications, each with its merits and demerits. There has been an interesting shift in the past few years, from the accepted primacy of histopathology as the sole basis on which the classification of parenchymal lung disease has rested, to new ways of considering how these entities relate to each other. Some inventive thinking has resulted in new classifications that undoubtedly benefit patients and clinicians in their endeavor to improve management and outcome. The challenge of understanding the logic behind current classifications and their shortcomings are explored in various examples of lung diseases.

A Study on Sources of Health Financing in Nigeria: Implications for Health care Marketers and Planners

Directory of Open Access Journals (Sweden)

Rotimi Ayodele Gbadeyan

2016-01-01

Full Text Available There have been increasing difficulties in providing qualitative health care services to the public in Nigeria. The development has called for the need to examine ways through which government and other stakeholders resolve these crises in the health sector. The objective of this paper is to examine the level of Government spending to total Health expenditures in Nigeria. This study basically employs secondary data for analysis. The secondary data are provided from the World Bank Development indicators and Internet. The data was analyzed using the Pearson Correlation Coefficient Statistical technique. The result revealed a strong positive Correlation (r = 0.634 between Government Health Spending and Total Health Spending. This indicates that Government Health Spending constitutes a significant proportion of the Total Health Expenditures in Nigeria; despite complains about inadequate health financing. In conclusion, the Nigerian Health sector would become more vibrant, if the Government and the Private sector are ready to give the necessary commitments required to achieve the laudable objective of qualitative health for all. The study recommends for more Government Health funding towards tackling the prevalence of some chronic diseases such as HIV, Asthma, Tuberculosis, Meningitis and Paralysis, etc.

Effect of Experience of Internal Medicine Residents during Infectious Disease Elective on Future Infectious Disease Fellowship Application

Science.gov (United States)

2017-10-04

Experience of !ntcrnal Medicine Residents during Infectious Disease Elective on Future lntCctious Di~casc Fcllo\\vship Application Sb. GRANT N_UMBER...undefined. Since 2008 at our institution. internal medicine (!!vi) residents have been required to do a four-\\\\’eek inpatient !D rotation as an intern... Medicine Residents during Infectious Disease Elective on Fut ure Infectious Disease Fellowship Application ~ Poeter# 1440 .,...._,: OVfil"S~ ti

Diverticular Disease: Epidemiology and Management

Directory of Open Access Journals (Sweden)

Adam V Weizman

2011-01-01

Full Text Available Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction.

Diverticular disease: Epidemiology and management

Science.gov (United States)

Weizman, Adam V; Nguyen, Geoffrey C

2011-01-01

Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction. PMID:21876861

Bowel disease after radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Schofield, P.F.; Holden, D.; Carr, N.D. (Christie Hospital and Holt Radium Inst., Manchester (UK))

1983-06-01

The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery.

Tick-borne disease.

Science.gov (United States)

Bratton, Robert L; Corey, Ralph

2005-06-15

Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. If no symptoms follow exposure to tick bites, empiric treatment is not indicated. The same tick may harbor different infectious pathogens and transmit several with one bite. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases.

[Conflicts and vector-borne diseases

DEFF Research Database (Denmark)

Bygbjerg, Ib Christian

2010-01-01

Based on literature and personal experiences, vector-borne diseases and conflicts are reviewed. Simple rapid diagnostic tests for three important parasitoses are available. Resort is often made to case definitions and to presumptive treatment. Resistance is an emerging problem. Vaccines are still...... not available for most diseases. Promising preventive methods, including long-lasting impregnated bed-nets and tents, are available. War has been an impetus for disclosing life-cycles of vector-borne diseases and for control methods; peace, reconciliation and poverty reduction are required to achieve lasting...

Diseases of poverty and lifestyle, well-being and human development.

Science.gov (United States)

Singh, Ajai R; Singh, Shakuntala A

2008-01-01

on a robust mix of the temporal and the spiritual, with vibrant indigenous biomedical and related disciplines, for example, Ayurveda, Yoga, etc. It also has a burgeoning corpus of modern biomedical knowledge in active conversation with the rest of the world. It should be especially careful that, while it does not negate the fruits of economic development and scientific/biomedical advance that seem to beckon it in this century, it does not also forget the values that have added meaning and purpose to life; values that the ancients bequeathed it, drawn from their experiential knowledge down the centuries.The means that the developed have could combine with the recipes to make them meaningful that the developing have. That is the challenge ahead for mankind as it gropes its way out of poverty, disease, despair, alienation, anomie, and the ubiquitous all-devouring lifestyle stresses, and takes halting steps towards well-being and the glory of human development.

Appendectomy and Risk of Subsequent Diverticular Disease Requiring Hospitalization: A Population-Based Case-Control Study.

Science.gov (United States)

Sköldberg, Filip; Olén, Ola; Ekbom, Anders; Schmidt, Peter T

2018-07-01

Appendicitis and acute diverticulitis share clinical features and are both influenced by genetic and environmental factors. Appendectomy has been positively associated with diverticular disease in hospital-based case-control studies. The aim of the present study was to investigate, in a population-based setting, whether appendectomy, with or without appendicitis, is associated with an altered risk of hospitalization with diverticular disease. This was a population-based case-control study. The study was based on national healthcare and population registers. We studied 41,988 individuals hospitalized between 2000 and 2010 with a first-time diagnosis of colonic diverticular disease and 413,115 matched control subjects. The association between appendectomy with or without appendicitis and diverticular disease was investigated by conditional logistic regression, including a model adjusting for hospital use. A total of 2813 cases (6.7%) and 19,037 controls (4.6%) had a previous record of appendectomy (appendectomy with acute appendicitis: adjusted OR = 1.31 (95% CI, 1.24-1.39); without appendicitis: adjusted OR = 1.30 (95% CI, 1.23-1.38)). Appendectomy was most strongly associated with an increased risk of diverticular disease within 1 year (with appendicitis: adjusted OR = 2.26 (95% CI, 1.61-3.16); without appendicitis: adjusted OR = 3.98 (95% CI, 2.71-5.83)), but the association was still present ≥20 years after appendectomy (with appendicitis: adjusted OR = 1.22 (95% CI, 1.12-1.32); without appendicitis: adjusted OR = 1.19 (95% CI, 1.10-1.28)). Detailed clinical information on the cases was not available. There were unmeasured potential confounders, such as smoking and dietary factors. The findings are consistent with a hypothesis of appendectomy causing an increased risk of diverticular disease, for example, by affecting the mucosal immune system or the gut microbiome. However, several other mechanisms may contribute to, or account for, the positive association

Age-related hearing loss in dogs : Diagnosis with Brainstem-Evoked Response Audiometry and Treatment with Vibrant Soundbridge Middle Ear Implant.

NARCIS (Netherlands)

ter Haar, G.

2009-01-01

Age-related hearing loss (ARHL) is the most common cause of acquired hearing impairment in dogs. Diagnosis requires objective electrophysiological tests (brainstem evoked response audiometry [BERA]) evaluating the entire audible frequency range in dogs. In our laboratory a method was developed to

Celiac Disease Diagnosis and Management

Science.gov (United States)

Leffler, Daniel

2012-01-01

Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders but as the case of Ms. J illustrates, diagnosis is often delayed or missed. Based on serology studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward, and uses commonly available serologic tests, however the signs and symptoms of celiac disease are nonspecific and highly heterogeneous making diagnosis difficult. While celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, the gluten free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management. PMID:21990301

Quantifying trends in disease impact to produce a consistent and reproducible definition of an emerging infectious disease.

Science.gov (United States)

Funk, Sebastian; Bogich, Tiffany L; Jones, Kate E; Kilpatrick, A Marm; Daszak, Peter

2013-01-01

The proper allocation of public health resources for research and control requires quantification of both a disease's current burden and the trend in its impact. Infectious diseases that have been labeled as "emerging infectious diseases" (EIDs) have received heightened scientific and public attention and resources. However, the label 'emerging' is rarely backed by quantitative analysis and is often used subjectively. This can lead to over-allocation of resources to diseases that are incorrectly labelled "emerging," and insufficient allocation of resources to diseases for which evidence of an increasing or high sustained impact is strong. We suggest a simple quantitative approach, segmented regression, to characterize the trends and emergence of diseases. Segmented regression identifies one or more trends in a time series and determines the most statistically parsimonious split(s) (or joinpoints) in the time series. These joinpoints in the time series indicate time points when a change in trend occurred and may identify periods in which drivers of disease impact change. We illustrate the method by analyzing temporal patterns in incidence data for twelve diseases. This approach provides a way to classify a disease as currently emerging, re-emerging, receding, or stable based on temporal trends, as well as to pinpoint the time when the change in these trends happened. We argue that quantitative approaches to defining emergence based on the trend in impact of a disease can, with appropriate context, be used to prioritize resources for research and control. Implementing this more rigorous definition of an EID will require buy-in and enforcement from scientists, policy makers, peer reviewers and journal editors, but has the potential to improve resource allocation for global health.

Enterovesical fistulas complicating Crohn's disease: clinicopathological features and management.

Science.gov (United States)

Yamamoto, T; Keighley, M R

2000-08-01

Enterovesical fistula is a relatively rare condition in Crohn's disease. This study was undertaken to examine clinicopathological features and management of enterovesical fistula complicating Crohn's disease. Thirty patients with enterovesical fistula complicating Crohn's disease, treated between 1970 and 1997, were reviewed. Urological symptoms were present in 22 patients; pneumaturia in 18, urinary tract infection in 7, and haematuria in 2. In 5 patients clinical symptoms were successfully managed by conservative treatment, and they required no surgical treatment for enterovesical fistula. Twenty-five patients required surgery. All the patients were treated by resection of diseased bowel and pinching off the dome of the bladder. No patients required resection of the bladder. The Foley catheter was left in situ for an average of 2 weeks after operation. Three patients developed early postoperative complications; two bowel anastomotic leaks, and one intra-abdominal abscess. All these complications were associated with sepsis and multiple fistulas at the time of laparotomy. After a median follow-up of 13 years, 3 patients having postoperative sepsis (anastomotic leak or abscess) developed a recurrent fistula from the ileocolonic anastomosis to the bladder, which required further surgery. In the other 22 patients without postoperative complications there has been no fistula recurrence. In conclusion, the majority of patients with enterovesical fistula required surgical treatment: resection of the diseased bowel and oversewing the defect in the bladder. The fistula recurrence was uncommon, but the presence of sepsis and multiple fistulas at the time of laparotomy increased the incidence of postoperative complications and fistula recurrence.

Proteomic and metabolomic approaches to biomarker discovery

CERN Document Server

Issaq, Haleem J

2013-01-01

Proteomic and Metabolomic Approaches to Biomarker Discovery demonstrates how to leverage biomarkers to improve accuracy and reduce errors in research. Disease biomarker discovery is one of the most vibrant and important areas of research today, as the identification of reliable biomarkers has an enormous impact on disease diagnosis, selection of treatment regimens, and therapeutic monitoring. Various techniques are used in the biomarker discovery process, including techniques used in proteomics, the study of the proteins that make up an organism, and metabolomics, the study of chemical fingerprints created from cellular processes. Proteomic and Metabolomic Approaches to Biomarker Discovery is the only publication that covers techniques from both proteomics and metabolomics and includes all steps involved in biomarker discovery, from study design to study execution.  The book describes methods, and presents a standard operating procedure for sample selection, preparation, and storage, as well as data analysis...

Particular aspects regarding the effects of whole body vibration exposure

Directory of Open Access Journals (Sweden)

Picu Mihaela

2018-01-01

Full Text Available This paper analyses the influence of whole-body vibrations on human performance; for this it was investigated how a group of men (20-29 years of age and a group of woman (21–31 years of age answered to specific requirements after being subjected to vertical vibrations under controlled laboratory conditions for 10-25 min. The vibrations were generated by a vibrant system with known amplitudes and frequencies. Accelerations were measured with NetdB - complex system for measuring and analysing human vibration and they were found in the range 0.4 - 3.1m/s2. The subjects’ performances were determined for each vibration level using specific tests. It can be concluded that exposure to vibrations higher than those recommended by ISO 2631 significantly disrupts how subjects responded to tests requirements.

Healthy Places for Healthy People

Science.gov (United States)

Describes the Healthy Places for Healthy People technical assistance program that helps communities create walkable, healthy, economically vibrant places by engaging with local health care facility partners

Microbiological Monitoring for the Constellation Program: Current Requirements and Future Considerations

Science.gov (United States)

Ott, C. Mark

2007-01-01

Microbiological requirements for spaceflight are based on assessments of infectious disease risk which could impact crew health or mission success. The determination of risk from infectious disease is composed of several factors including (1) crew susceptibility, (2) crew exposure to the infectious disease agent, (3) the concentration of the infectious agent, and (4) the characteristics of the infectious agent. As a result of the Health Stabilization Program, stringent monitoring, and cleaning protocols, in-flight environmental microbial monitoring is not necessary for short-duration spaceflights. However, risk factors change for long-duration missions, as exemplified by the presence of medically significant organisms in the environments of both the Mir and International Space Station (ISS). Based upon this historical evidence, requirements for short duration usage aboard the Orion Crew Exploration Vehicle and Lunar Lander Vehicle will not require in-flight monitoring; however, as mission duration increases with a Lunar Outpost, an ability to detect microbial hazard will be necessary. The nature of the detection requirements will depend on the maturity of technology in a rapidly evolving marketplace. Regardless, the hardware will still need to maximize information to discipline experts and the crew, while minimizing the size, mass, power consumption, and crew time usage. The refinement of these monitors will be a major goal in our efforts to travel successfully to Mars.

Nutritional support of children with chronic liver disease

African Journals Online (AJOL)

The effect that chronic liver disease has on a child's nutritional status and ... even children with less severe liver disease require nutritional .... Reduced muscle bulk .... pain and fractures, palpation of the spine and assessment of pubertal stage.

Alzheimer disease therapeutics: focus on the disease and not just plaques and tangles.

Science.gov (United States)

Iqbal, Khalid; Liu, Fei; Gong, Cheng-Xin

2014-04-15

The bulk of AD research during the last 25 years has been Aβ-centric based on a strong faith in the Amyloid Cascade Hypothesis which is not supported by the data on humans. To date, Aβ-based therapeutic clinical trials on sporadic cases of AD have been negative. Although most likely the major reason for the failure is that Aβ is not an effective therapeutic target for sporadic AD, initiation of the treatment at mild to moderate stages of the disease is blamed as too late to be effective. Clinical trials on presymptomatic familial AD cases have been initiated with the logic that Aβ is a trigger of the disease and hence initiation of the Aβ immunotherapies several years before any clinical symptoms would be effective. There is an urgent need to explore targets other than Aβ. There is now increasing interest in inhibiting tau pathology, which does have a far more compelling rationale than Aβ. AD is multifactorial and over 99% of the cases are the sporadic form of the disease. Understanding of the various etiopathogenic mechanisms of sporadic AD and generation of the disease-relevant animal models are required to develop rational therapeutic targets and therapies. Treatment of AD will require both inhibition of neurodegeneration and regeneration of the brain. Copyright © 2014 Elsevier Inc. All rights reserved.

Pituitary gland imaging in Cushing's disease

International Nuclear Information System (INIS)

Bonneville, J.F.; Cattin, F.; Bonneville, F.; Schillo, F.; Jacquet, G.

2003-01-01

Specific MR techniques are r-required for optimal detection of adrenocorticotropic hormone secreting adenomas responsible for Cushing's disease. Adequate MR sequences, high resolution coronal T1 and T2 - weighted images, dynamic MR imaging, post-gadolinium delayed images, dose of gadolinium adjusted for each sequence can routinely demonstrate pituitary adenomas less than 3 mm in Cushing's disease. (authors)

Adult onset still's disease; a rare disease in Nigeria? | Ohagwu ...

African Journals Online (AJOL)

This is to highlight the fact that the disease while rare, requires a high index of suspicion for diagnosis. Both patients were males. The ages of the patients were 19 and 62 years. Both patients had high grade fever, symmetrical inflammatory polyarthritis and weight loss. The first patient had sore throat. On examination, both ...

Salt intake in kidney disease-a missed therapeutic opportunity?

NARCIS (Netherlands)

Lambers Heerspink, Hiddo J.; Navis, Gerjan; Ritz, Eberhard

Although significant progress has been made in the treatment of chronic kidney disease (CKD), treatment is not yet satisfactory, particularly when it is started in the late stages of the disease. Novel modes of intervention to mitigate the burden of disease are required. The reduction of dietary

9 CFR 113.212 - Bursal Disease Vaccine, Killed Virus.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bursal Disease Vaccine, Killed Virus..., DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.212 Bursal Disease Vaccine, Killed Virus. Bursal Disease Vaccine...

Granzyme A Is Required for Regulatory T-Cell Mediated Prevention of Gastrointestinal Graft-versus-Host Disease.

Directory of Open Access Journals (Sweden)

Sarvari Velaga

Full Text Available In our previous work we could identify defects in human regulatory T cells (Tregs likely favoring the development of graft-versus-host disease (GvHD following allogeneic stem cell transplantation (SCT. Treg transcriptome analyses comparing GvHD and immune tolerant patients uncovered regulated gene transcripts highly relevant for Treg cell function. Moreover, granzyme A (GZMA also showed a significant lower expression at the protein level in Tregs of GvHD patients. GZMA induces cytolysis in a perforin-dependent, FAS-FASL independent manner and represents a cell-contact dependent mechanism for Tregs to control immune responses. We therefore analyzed the functional role of GZMA in a murine standard model for GvHD. For this purpose, adoptively transferred CD4+CD25+ Tregs from gzmA-/- mice were analyzed in comparison to their wild type counterparts for their capability to prevent murine GvHD. GzmA-/- Tregs home efficiently to secondary lymphoid organs and do not show phenotypic alterations with respect to activation and migration properties to inflammatory sites. Whereas gzmA-/- Tregs are highly suppressive in vitro, Tregs require GZMA to rescue hosts from murine GvHD, especially regarding gastrointestinal target organ damage. We herewith identify GZMA as critical effector molecule of human Treg function for gastrointestinal immune response in an experimental GvHD model.

Wilson’s disease: Atypical imaging features

Directory of Open Access Journals (Sweden)

Venugopalan Y Vishnu

2016-10-01

Full Text Available Wilson’s disease is a genetic movement disorder with characteristic clinical and imaging features. We report a 17- year-old boy who presented with sialorrhea, hypophonic speech, paraparesis with repeated falls and recurrent seizures along with cognitive decline. He had bilateral Kayser Flescher rings. Other than the typical features of Wilson’s disease in cranial MRI, there were extensive white matter signal abnormalities (T2 and FLAIR hyperintensities and gyriform contrast enhancement which are rare imaging features in Wilson's disease. A high index of suspicion is required to diagnose Wilson’s disease when atypical imaging features are present.

Overview of IgG4 - Related Disease.

Science.gov (United States)

Opriţă, R; Opriţă, B; Berceanu, D; Diaconescu, I B

2017-01-01

Rationale (hypothesis): IgG4-related disease (IgG4-RD) is a pathological entity recently recognized by the medical world that can affect any organ or system. However, there is insufficient data about this disease in medical literature. Aim (objective): A more extensive clarification of the IgG4 molecule, the diversified aspects of IgG4-related disease, and the response of this disease to treatment, will provide a crucial understanding of the immune system and other diseases now known to be associated with IgG4. The MEDLINE online medical database was used, and, after a comprehensive review of medical articles regarding IgG4-RD, published after 2003, using the search words "IgG4- related disease" and "IgG4 molecule", we have described the clinical, pathological and therapeutic features of IgG4-RD, as well as the presence of the IgG4 molecule in the evolution, diagnosis and management of this syndrome. We characterized the potential disease mechanisms and discussed early observations related to treatment. Given the response to immunosuppressive therapy, it is hypothesized that IgG4-related disease is most likely an autoimmune disease. Therefore, IgG4-related disease is a fibro-inflammatory condition that can affect any organ and can lead to the formation of pseudotumoral lesions requiring differential diagnosis with various malignancies. Positive diagnostic criteria are histopathological and require at least two features out of the following three: dense limphoplasmocitary infiltrate, storiform fibrosis, obliterative phlebitis.

Intravenous Tranexamic Acid Decreases Allogeneic Transfusion Requirements in Periacetabular Osteotomy.

Science.gov (United States)

Bryan, Andrew J; Sanders, Thomas L; Trousdale, Robert T; Sierra, Rafael J

2016-01-01

Bernese (Ganz) periacetabular osteotomy is associated with significant blood loss and the need for perioperative transfusion. Tranexamic acid decreases blood loss and minimizes transfusion rates in total joint arthroplasty. However, no reports have described its use in patients undergoing Bernese periacetabular osteotomy. This study reports the use of intravenous tranexamic acid in these patients. The study included 137 patients (150 hips) who underwent isolated periacetabular osteotomy at a single institution between 2003 and 2014. Of these, 68 patients (75 hips) received intravenous tranexamic acid 1 g at the time of incision and 1 g at the time of closure. A group of 69 patients (75 hips) served as control subjects who underwent periacetabular osteotomy without administration of intravenous tranexamic acid. Thromboembolic disease was defined as deep venous thrombosis or pulmonary embolism occurring within 6 weeks of surgery. Outcomes measured included transfusion requirements, pre- and postoperative hemoglobin values, operative times, and thromboembolic disease rates. Aspirin was used as the thromboembolic prophylactic regimen in 95% of patients. The rate of allogeneic transfusion was 0 in the tranexamic acid group compared with 21% in the control group (P=.0001). No significant difference was found in the autologous cell salvage requirement (.96 vs 1.01; P=.43) or the thromboembolic disease rate between the tranexamic acid group and the control group (2.67% vs 1.33%; P=.31). The use of intravenous tranexamic acid led to a decreased transfusion requirement with no increased risk of thromboembolic disease in this contemporary cohort of patients undergoing periacetabular osteotomy. Copyright 2016, SLACK Incorporated.

Obesity and kidney disease

Directory of Open Access Journals (Sweden)

Geraldo Bezerra da Silva Junior

Full Text Available Abstract Obesity has been pointed out as an important cause of kidney diseases. Due to its close association with diabetes and hypertension, excess weight and obesity are important risk factors for chronic kidney disease (CKD. Obesity influences CKD development, among other factors, because it predisposes to diabetic nephropathy, hypertensive nephrosclerosis and focal and segmental glomerulosclerosis. Excess weight and obesity are associated with hemodynamic, structural and histological renal changes, in addition to metabolic and biochemical alterations that lead to kidney disease. Adipose tissue is dynamic and it is involved in the production of "adipokines", such as leptin, adiponectin, tumor necrosis factor-α, monocyte chemoattractant protein-1, transforming growth factor-β and angiotensin-II. A series of events is triggered by obesity, including insulin resistance, glucose intolerance, dyslipidemia, atherosclerosis and hypertension. There is evidence that obesity itself can lead to kidney disease development. Further studies are required to better understand the association between obesity and kidney disease.

Israel: Background and Relations with the United States

National Research Council Canada - National Science Library

Migdalovitz, Carol

2006-01-01

... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...

Israel: Background and Relations with the United States

National Research Council Canada - National Science Library

Migdalovitz, Carol

2008-01-01

... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...

Israel: Background and Relations with the United States

National Research Council Canada - National Science Library

Migdalovitz, Carol

2007-01-01

... its neighbors. Armed conflict has marked every decade of Israel's existence. Despite its unstable regional environment, Israel has developed a vibrant parliamentary democracy, albeit with relatively fragile governments...

Periodontal disease and systemic complications

Directory of Open Access Journals (Sweden)

Rui Vicente Oppermann

2012-01-01

Full Text Available Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health.

Wilson disease: more than meets the eye.

Science.gov (United States)

Kelly, Claire; Pericleous, Marinos

2018-02-15

Wilson disease is a rare but important disorder of copper metabolism, with a failure to excrete copper appropriately into bile. It is a multisystem condition with presentations across all branches of medicine. Diagnosis can be difficult and requires a high index of suspicion. It should be considered in unexplained liver disease particularly where neuropsychiatric features are also present. Treatments are available for all stages of disease. A particularly important presentation not to overlook is acute liver failure which carries a high mortality risk and may require urgent liver transplantation. Here, we provide an overview of this complex condition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Management of pilonidal disease.

Science.gov (United States)

Kallis, Michelle P; Maloney, Caroline; Lipskar, Aaron M

2018-06-01

Pilonidal disease, and the treatment associated with it, can cause significant morbidity and substantial burden to patients' quality of life. Despite the plethora of surgical techniques that have been developed to treat pilonidal disease, discrepancies in technique, recurrence rates, complications, time to return to work/school and patients' aesthetic satisfaction between treatment options have led to controversy over the best approach to this common acquired disease of young adults. The management of pilonidal disease must strike a balance between recurrence and surgical morbidity. The commonly performed wide excision without closure has prolonged recovery, while flap closures speed recovery time and improve aesthetics at the expense of increased wound complications. Less invasive surgical techniques have recently evolved and are straightforward, with minimal morbidity and satisfactory results. As with any surgical intervention, the ideal treatment for pilonidal disease would be simple and cost-effective, cause minimal pain, have a limited hospital stay, low recurrence rate and require minimal time off from school or work. Less invasive procedures for pilonidal disease may be favourable as an initial approach for these patients reserving complex surgical treatment for refractory disease.

New concepts in assessing sickle cell disease severity

NARCIS (Netherlands)

Schnog, JJB; Lard, LR; Rojer, RA; Van der Dijs, FPL; Muskiet, FAJ; Duits, AJ

Vasoocclusion leads to pain, chronic organ damage, and a decreased life expectancy in patients with sickle cell disease. Therapeutic options for sickle cell disease have usually been evaluated according to their capacity for reducing the frequency of vasoocclusive crises requiring clinical

HMG CoA reductase inhibitors (statins for people with chronic kidney disease not requiring dialysis

Directory of Open Access Journals (Sweden)

Suetonia C. Palmer

kidney disease were sparse. Statins clearly reduced risks of death, major cardiovascular events, and MI in people with CKD who did not have CVD at baseline (primary prevention. AUTHORS' CONCLUSIONS: Statins consistently lower death and major cardiovascular events by 20% in people with CKD not requiring dialysis. Statin-related effects on stroke and kidney function were found to be uncertain and adverse effects of treatment are incompletely understood. Statins have an important role in primary prevention of cardiovascular events and mortality in people who have CKD.

Proportion of patients in the Uganda rheumatic heart disease ...

African Journals Online (AJOL)

Proportion of patients in the Uganda rheumatic heart disease registry with advanced ... of Cardiology guidelines on the management of valvular heart disease. ... disease that require surgical treatment yet they cannot access this therapy due to ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

Ukraine Against Herself: To Be Euro-Atlantic, Eurasian, or Neutral? (Strategic Forum, Number 238, February 2009)

National Research Council Canada - National Science Library

Simon, Jeffrey

2009-01-01

... both ways. Since the Orange Revolution, Ukraine has made significant progress developing a Euro-Atlantic style democratic political system, demonstrated a vibrant open media and civil society, and successfully...

The United States and the Koreas - Adding Substance to Sunshine

National Research Council Canada - National Science Library

Hendricks, Robert H

2003-01-01

.... These include the development in South Korea of strong democratic institutions, a vibrant economy, and a professional military, juxtaposed to North Korea, variously described as a failing or failed...

Spatial modelling of disease using data- and knowledge-driven approaches.

Science.gov (United States)

Stevens, Kim B; Pfeiffer, Dirk U

2011-09-01

The purpose of spatial modelling in animal and public health is three-fold: describing existing spatial patterns of risk, attempting to understand the biological mechanisms that lead to disease occurrence and predicting what will happen in the medium to long-term future (temporal prediction) or in different geographical areas (spatial prediction). Traditional methods for temporal and spatial predictions include general and generalized linear models (GLM), generalized additive models (GAM) and Bayesian estimation methods. However, such models require both disease presence and absence data which are not always easy to obtain. Novel spatial modelling methods such as maximum entropy (MAXENT) and the genetic algorithm for rule set production (GARP) require only disease presence data and have been used extensively in the fields of ecology and conservation, to model species distribution and habitat suitability. Other methods, such as multicriteria decision analysis (MCDA), use knowledge of the causal factors of disease occurrence to identify areas potentially suitable for disease. In addition to their less restrictive data requirements, some of these novel methods have been shown to outperform traditional statistical methods in predictive ability (Elith et al., 2006). This review paper provides details of some of these novel methods for mapping disease distribution, highlights their advantages and limitations, and identifies studies which have used the methods to model various aspects of disease distribution. Copyright © 2011. Published by Elsevier Ltd.

Diseases of the Tricuspid Valve

Science.gov (United States)

... stenosis. Tricuspid Regurgitation Tricuspid regurgitation is also called tricuspid insufficiency or tricuspid incompetence. It means there is a ... require valve surgery. Tags: heart valves , tricuspid incompetence , ... tricuspid regurgitation , tricuspid stenosis , valve disease Related Links ...

CT and MR imaging of gynecological emergency disease

International Nuclear Information System (INIS)

Fujii, Shinya; Kinoshita, Toshibumi; Tahara, Takatoshi; Matsusue, Eiji; Ogawa, Toshihide

2004-01-01

We describe the CT and MRI findings of gynecologic emergency diseases: pelvic inflammatory disease, ectopic pregnancy, ovarian hemorrhage, ovarian torsion, rupture of ovarian tumor, eclampsia, and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Diagnostic keys to these diseases are presented in this review. CT and MRI play a complementary role to sonography in accurately diagnosing these diseases. In situations that require an exact, immediate diagnosis, radiologists should be familiar with the key imaging findings. (author)

Threats from emerging and re-emerging neglected tropical diseases (NTDs).

Science.gov (United States)

Mackey, Tim K; Liang, Bryan A

2012-01-01

Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (''EReNTDs''). We then identified common characteristics and risks associated with EReNTDs. Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Multi-sectorial efforts and targeted public-private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

Kienböck's Disease

Science.gov (United States)

... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Kienböcks Disease Email to a friend * required fields ...

Interstitial lung disease in systemic autoimmune rheumatic diseases: a comprehensive review.

Science.gov (United States)

Atzeni, Fabiola; Gerardi, Maria Chiara; Barilaro, Giuseppe; Masala, Ignazio Francesco; Benucci, Maurizio; Sarzi-Puttini, Piercarlo

2018-01-01

Interstitial lung diseases (ILDs) are among the most serious complications associated with systemic rheumatic diseases, and lead to significant morbidity and mortality; they may also be the first manifestation of connective tissue diseases (CTDs). The aim of this narrative review is to summarise the data concerning the pathogenesis of CTD/ILD and its distinguishing features in different rheumatic diseseas. Areas covered: The pathogenesis, clinical aspects and treatment of ILD associated with rheumatic systemic diseases and CTDs were reviewed by searching the PubMed, Medline, and Cochrane Library databases for papers published between 1995 and February 2017 using combinations of words or terms. Articles not written in English were excluded. Expert commentary: The management of CTD-ILD is challenging because of the lack of robust data regarding the treatments used, the heterogeneity of the diseases themselves, and the scarcity of well-defined outcome measures. Treatment decisions are often made clinically on the basis of functional, radiographic progression, and exacerbating factors such as age and the burden of comorbidities. Given the complexities of diagnosis and the paucity of treatment trials, the management of CTD patients with ILD requires multidisciplinary collaboration between rheumatologists and pulmonologists in CTD-ILD clinics.

Lyme disease: diagnostic issues and controversies.

Science.gov (United States)

Aguero-Rosenfeld, Maria E; Wormser, Gary P

2015-01-01

The diagnosis of Lyme disease is a controversial topic. Most practitioners and scientists recognize that Lyme disease is associated with certain objective clinical manifestations supported by laboratory evidence of infection with Borrelia burgdorferi sensu lato (the etiologic agent). There are others, however, who believe that patients with Lyme disease may have a wide variety of entirely nonspecific symptoms without any objective clinical manifestation and that laboratory evidence of infection by B. burgdorferi is not required to support the diagnosis. In reality, this perspective is not evidence based and would inevitably lead to innumerable misdiagnoses, given the high frequency of medically unexplained symptoms, such as fatigue and musculoskeletal pains, in the general population. Although those espousing this viewpoint do not believe that a positive laboratory test is required, nevertheless, they often seek out and promote alternative, unapproved testing methods that frequently provide false-positive results to justify their diagnosis. Herein, we provide a brief overview of Lyme disease testing, emphasizing current usage and limitations. We also discuss the use of nonvalidated procedures and the prospects for a reduction in such testing practices in the future.

75 FR 15601 - Greek Independence Day: a National Day of Celebration of Greek And American Democracy, 2010

Science.gov (United States)

2010-03-30

... in 1823, he acknowledged Greece as ``the first of civilized nations, [which] presented examples of... their community has strengthened the fabric of our country with its vibrant culture and unique...

21 CFR 610.47 - Hepatitis C virus (HCV) “lookback” requirements.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Hepatitis C virus (HCV) âlookbackâ requirements... Disease Agents § 610.47 Hepatitis C virus (HCV) “lookback” requirements. (a) If you are an establishment... after a donor tests reactive for evidence of hepatitis C virus (HCV) infection when tested under § 610...

Multi-taxa integrated landscape genetics for zoonotic infectious diseases: deciphering variables influencing disease emergence.

Science.gov (United States)

Leo, Sarah S T; Gonzalez, Andrew; Millien, Virginie

2016-05-01

Zoonotic disease transmission systems involve sets of species interacting with each other and their environment. This complexity impedes development of disease monitoring and control programs that require reliable identification of spatial and biotic variables and mechanisms facilitating disease emergence. To overcome this difficulty, we propose a framework that simultaneously examines all species involved in disease emergence by integrating concepts and methods from population genetics, landscape ecology, and spatial statistics. Multi-taxa integrated landscape genetics (MTILG) can reveal how interspecific interactions and landscape variables influence disease emergence patterns. We test the potential of our MTILG-based framework by modelling the emergence of a disease system across multiple species dispersal, interspecific interaction, and landscape scenarios. Our simulations showed that both interspecific-dependent dispersal patterns and landscape characteristics significantly influenced disease spread. Using our framework, we were able to detect statistically similar inter-population genetic differences and highly correlated spatial genetic patterns that imply species-dependent dispersal. Additionally, species that were assigned coupled-dispersal patterns were affected to the same degree by similar landscape variables. This study underlines the importance of an integrated approach to investigating emergence of disease systems. MTILG is a robust approach for such studies and can identify potential avenues for targeted disease management strategies.

Disease: H01602 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available disease that typically requires long term management in the form of lifestyle modification, medical therapy ... Altern Med Rev 16:116-33 (2011) ... PMID:27041798 (description) ... AUTHORS ... Keung C, Hebbard G ... TITLE ... The management

Ollier disease

Directory of Open Access Journals (Sweden)

Jüppner Harald

2006-09-01

Full Text Available Abstract Enchondromas are common intraosseous, usually benign cartilaginous tumors, that develop in close proximity to growth plate cartilage. When multiple enchondromas are present, the condition is called enchondromatosis also known as Ollier disease (WHO terminology. The estimated prevalence of Ollier disease is 1/100,000. Clinical manifestations often appear in the first decade of life. Ollier disease is characterized by an asymmetric distribution of cartilage lesions and these can be extremely variable (in terms of size, number, location, evolution of enchondromas, age of onset and of diagnosis, requirement for surgery. Clinical problems caused by enchondromas include skeletal deformities, limb-length discrepancy, and the potential risk for malignant change to chondrosarcoma. The condition in which multiple enchondromatosis is associated with soft tissue hemangiomas is known as Maffucci syndrome. Until now both Ollier disease and Maffucci syndrome have only occurred in isolated patients and not familial. It remains uncertain whether the disorder is caused by a single gene defect or by combinations of (germ-line and/or somatic mutations. The diagnosis is based on clinical and conventional radiological evaluations. Histological analysis has a limited role and is mainly used if malignancy is suspected. There is no medical treatment for enchondromatosis. Surgery is indicated in case of complications (pathological fractures, growth defect, malignant transformation. The prognosis for Ollier disease is difficult to assess. As is generally the case, forms with an early onset appear more severe. Enchondromas in Ollier disease present a risk of malignant transformation of enchondromas into chondrosarcomas.

Organising care for people with diabetes and renal disease.

Science.gov (United States)

Dean, John

2012-02-01

Diabetes and chronic kidney disease (CKD) are two of the commonest long-term conditions. One-fifth of patients with diabetes will have CKD, and diabetes is the commonest cause of advanced kidney disease. For most patients these comorbidities will be managed in primary care with the focus on cardiovascular prevention. Many patients with more advanced disease and complications require joint care from multidisciplinary specialist teams in diabetes and renal disease to ensure that care is consistent and coordinated. Models of joint speciality care, include joint registry management, parallel clinics, shared consulting and case discussion, but require more evaluation than has currently been performed. These underpin more informal interactions between the specialist teams. A local model of care for diabetes and renal disease that incorporates the roles of primary care, members of multidisciplinary teams and speciality care should be agreed, resourced appropriately and its effectiveness monitored. © 2012 European Dialysis and Transplant Nurses Association/European Renal Care Association.

ANESTHETIC CONSIDERATION S IN CHRONIC OBSTRUCTIVE PULMON ARY DISEASE

Directory of Open Access Journals (Sweden)

Awati

2015-03-01

Full Text Available Chronic obstructive pulmonary disease (COPD is a spectrum of diseases that includes emphysema, chronic bronchitis, and small airway disease. It i s characterized by progressive increased resistance to breathing. Patients with marked obstructive pulmonary disease are at increased risk for both intraoperative and Postoperative pulmonary complications. These patients require thorough preoperative prepa ration, meticulous intraoperative management & postoperative care. This article describes anesthetic considerations in a patient with COPD.

Stockholm '98

Index Scriptorium Estoniae

1998-01-01

Live Music for Vibrant Dance-etendused 17.-23. aug. Rootsi balletikoolis, The Bomb Party - muusikaline etendus Göteborgi Ooperilt 18.-20. aug. Folkoperas ja Euroopa Liidu Noorteorkestri kontserdid 18., 22. aug

75 FR 67907 - National Native American Heritage Month, 2010

Science.gov (United States)

2010-11-04

... Proclamation For millennia before Europeans settled in North America, the indigenous peoples of this continent flourished with vibrant cultures and were the original stewards of the land. From generation to generation...

Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism

Directory of Open Access Journals (Sweden)

Giovanni Bianchin

2015-01-01

Full Text Available We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome, suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration was not optimal. The decision made was to position Vibrant Soundbridge, a middle ear implant, with an original surgical application due to hypoplasia of the tympanic cavity. Intubation procedure was complicated due to child craniofacial deformities. Postoperative hearing rehabilitation involved a multidisciplinary team, showing improved social skills and language development.

Novel combined management approaches to patients with diabetes, chronic kidney disease and cardiovascular disease.

Science.gov (United States)

Spaak, J

2017-03-01

Most patients we care for today suffer from more than one chronic disease, and multimorbidity is a rapidly growing challenge. Concomitant cardiovascular disease, renal dysfunction and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. These entities commonly overlap due to their negative effects on vascular function and an accelerated atherosclerosis progression. At the same time, a progressive subspecialisation has caused the cardiologist to treat 'only' the heart, nephrologists 'only' the kidneys and endocrinologists' 'only' diabetes. Studies and guidelines follow the same pattern. This often requires patients to visit specialists for each field, with a risk of both under-diagnosis and under-treatment. From the patient's perspective, there is a great need for coordination and facilitation of the care, not only to reduce disease progression but also to improve quality of life. Person-centred integrated clinics for patients with cardiovascular disease, renal dysfunction and diabetes are a promising approach for complex chronic disease management.

Dracunculiasis (guinea worm disease).

Science.gov (United States)

Greenaway, Chris

2004-02-17

Dracunculiasis (guinea worm disease) is a parasitic disease that is limited to remote, rural villages in 13 sub-Saharan African countries that do not have access to safe drinking water. It is one the next diseases targeted for eradication by the World Health Organization. Guinea worm disease is transmitted by drinking water containing copepods (water fleas) that are infected with Dracunculiasis medinensis larvae. One year after human ingestion of infected water a female adult worm emerges, typically from a lower extremity, producing painful ulcers that can impair mobility for up to several weeks. This disease occurs annually when agricultural activities are at their peak. Large proportions of economically productive individuals of a village are usually affected simultaneously, resulting in decreased agricultural productivity and economic hardship. Eradication of guinea worm disease depends on prevention, as there is no effective treatment or vaccine. Since 1986, there has been a 98% reduction in guinea worm disease worldwide, achieved primarily through community-based programs. These programs have educated local populations on how to filter drinking water to remove the parasite and how to prevent those with ulcers from infecting drinking-water sources. Complete eradication will require sustained high-level political, financial and community support.

Decreased activity of daily living produced by the combination of Alzheimer's disease and lower limb fracture in elderly requiring nursing care.

Science.gov (United States)

Inagawa, Toshimitsu; Hamagishi, Toshio; Takaso, Yuji; Hitomi, Yoshiaki; Kambayashi, Yasuhiro; Hibino, Yuri; Shibata, Aki; Ngoc, Nguyen T M; Okochi, Jiro; Hatta, Kotaro; Takamuku, Kiyoshi; Konoshita, Tadashi; Nakamura, Hiroyuki

2013-01-01

Alzheimer's disease (AD) impairs cognitive functions, subsequently decreasing activity of daily living (ADL), and is frequently accompanied by lower limb fracture including hip fracture in the elderly. However, there have been few studies on what kinds of physical functions are affected or what degrees of dysfunction are produced by this combination. This study aims to clarify the relationship between decreased ADL and the combination of AD and lower limb fracture. We examined present illness and ADL in 4340 elderly aged 82.8 ± 9.36 years [average ± standard deviation (SD)] requiring nursing care and compared ADL between elderly with and without AD or lower limb fracture treated with surgery or conservatively using analysis of covariance (ANCOVA), with age and sex as covariants. We recognized that activities of cognitive function (p lower than in those without the disease, even after adjusting for sex and age. Activities of bed mobility (p fracture treated with surgery were significantly lower, which differed from the results of AD. Significant interactions of AD and fracture treated with surgery on the ADL scores for bed mobility (p fracture alone. We obtained almost the same results for fractures treated conservatively as for fractures treated with surgery. These results demonstrated that the combined effects of AD and lower limb fracture were significantly greater than expected additive effects of AD and fracture, suggesting that the combination of AD and lower limb fracture has synergistic effects on almost all types of ADL except cognitive functions.

Genotator: A disease-agnostic tool for genetic annotation of disease

Directory of Open Access Journals (Sweden)

Jung Jae-Yoon

2010-10-01

data that remains current with the pace of research in the disease fields. Genotator's algorithm appropriately transforms query terms to match the input requirements of each targeted databases and accurately resolves named synonyms to ensure full coverage of the genetic results with official nomenclature. Genotator generates an excel-style output that is consistent across disease queries and readily importable to other applications.

Genotator: a disease-agnostic tool for genetic annotation of disease.

Science.gov (United States)

Wall, Dennis P; Pivovarov, Rimma; Tong, Mark; Jung, Jae-Yoon; Fusaro, Vincent A; DeLuca, Todd F; Tonellato, Peter J

2010-10-29

fields. Genotator's algorithm appropriately transforms query terms to match the input requirements of each targeted databases and accurately resolves named synonyms to ensure full coverage of the genetic results with official nomenclature. Genotator generates an excel-style output that is consistent across disease queries and readily importable to other applications.

Lyme Disease Presenting as a Spontaneous Knee Effusion.

Science.gov (United States)

Matzkin, Elizabeth; Suslavich, Kaytelin; Curry, Emily J

2015-11-01

Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

The Determinants of Lifelong Learning

Directory of Open Access Journals (Sweden)

Jasmina Sinanovic

2016-02-01

Full Text Available The aim of this paper is to introduce drivers of lifelong learning and to emphasize its importance in modern life. Developed economies throughout the world are driven more by knowledge and globalization than were economies of even the recent past. European economies of the 20th century were largely driven by manufacturing and the need to industrialize. Filling such economies with functional workers required education systems of similar design, that turned out masses of equally-educated workers in large batches. Increased automation, the widespread introduction of computer technologies and communications, and cheaper transportation have combined to encourage firms to be lean, international, and changing. Computer technologies encouraged sharing of documents, speeded workflow from design to production. Cheaper transportation allowed an increase in internationalization of workforces. These major shifts drove change from industrialized to knowledge-based economies. Paper discusses how two simple English words came together, stayed together, and grew into a powerful term driving new political initiatives, and continue to influence political, economic, social, and even cultural currents. Today's developed societies are rapidly aging, live longer and have fewer children. In order to continue to grow vibrant economies, and to fully enjoy the benefits of these vibrant economies, citizens need to continue to renew knowledge and skills during entire lifetime. As the major technological, economic, and social currents change, so must citizens adapt by never ceasing to learn throughout their lifetimes.

Palestinian Education and the Debate Over Textbooks

National Research Council Canada - National Science Library

Pina, Aaron D

2005-01-01

.... interests in the region. From their perspective, a diverse, balanced curriculum may serve as a benchmark toward greater peace, democratization, and the development of a vibrant civil society in the Palestinian Territories...

EPA Seeks Public Input for National Plan to Manage PFAS at First Community Engagement Event

Science.gov (United States)

New Englanders know that our part of the country is special. New England boasts vibrant communities, many with histories dating to before the American Revolution. Our environment is also unique and wonderful.

Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis)

International Nuclear Information System (INIS)

Escribano, J.; Ruza, M.; Gonzalez, J.; Acosta, A.

2000-01-01

Kikuchi-Fujimoto's disease is a rare but increasingly frequent cause of cervical adenopathy. It usually affects young women who also present fever and weight loss. ultrasonography and computed tomography of adenopathies usually show findings typical of benign disease (they are numerous, homogeneous, slightly or moderately increased in size, their normal echo structure is unchanged, they are clearly delimited and the surrounding tissues present no alterations, although in a few cases central necrosis has been described). Diagnosis is by ganglion biopsy showing typical findings. The disease is benign and self-limiting and treatment is not required. We believe that the disease should be included in the differential diagnosis of adenopathies, especially cervical adenophathies in young patients. (Author) 14 refs

New Directions in Chronic Disease Management

Directory of Open Access Journals (Sweden)

Hun-Sung Kim

2015-06-01

Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

Smoking does influence disease behaviour and impacts the need for therapy in Crohn's disease in the biologic era.

Science.gov (United States)

Nunes, T; Etchevers, M J; Domènech, E; García-Sánchez, V; Ber, Y; Peñalva, M; Merino, O; Nos, P; Garcia-Planella, E; Casbas, A G; Esteve, M; Taxonera Samsó, C; Montoro Huguet, M; Gisbert, J P; Martín Arranz, M D; García-Sepulcre, M F; Barreiro-de Acosta, M; Beltrán, B; Alcaide Suárez, N; Saro Gismera, C; Cabriada, J L; Cañas-Ventura, A; Gomollón, F; Panés, J

2013-10-01

Recently, the notion that smoking may adversely affect Crohn's disease (CD) outcomes has been challenged by the suggestion that the widespread use of immunosuppressants and anti-TNF drugs might offset the adverse effects of tobacco. To reassess the influence of tobacco smoking on disease phenotype and complications on a time-dependent analysis, taking into account the different therapeutic interventions. We designed a retrospective cohort study of 3224 patients with Crohn's disease. The data were collected from the Spanish national inflammatory bowel disease registry (ENEIDA), including information regarding demographics, clinical characteristics, disease complications, therapeutic interventions and smoking status. Patients were classified as nonsmokers, smokers and former smokers, according to their present and past smoking habits. In the univariate analysis, smokers had more strictures (22.6% vs. 19.3%, P < 0.05) and less colonic involvement (7.2% vs. 10.9%, P < 0.05), and were more frequently under treatment with steroids (91.6% vs. 85.8%, P < 0.05), immunosuppressants (73.5% vs. 63.6% P < 0.05) or anti-TNF drugs (31.4% vs. 25.1%, P < 0.05) than nonsmokers. In the time-dependent multivariate analysis, smokers were found to have a significantly decreased survival free of stricturing disease (HR: 1.5, CI 95% 1.18-1.90) or perianal complications (HR: 1.50, CI 95% 1.01-1.46), and had a higher risk for requiring thiopurine therapy (HR: 1.20, CI 95% 1.05-1.30). These results suggest that, despite the widespread use of immunosuppressants and anti-TNF drugs, smokers with Crohn's disease still have a more severe disease course, with increased therapeutic requirements when compared with nonsmokers. © 2013 John Wiley & Sons Ltd.

Threats from emerging and re-emerging neglected tropical diseases (NTDs

Directory of Open Access Journals (Sweden)

Tim K. Mackey

2012-08-01

Full Text Available Background: Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. Methods: We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (‘‘EReNTDs’’. We then identified common characteristics and risks associated with EReNTDs. Results: Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Discussion: Multi-sectorial efforts and targeted public–private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

National disease management plans for key chronic non-communicable diseases in Singapore.

Science.gov (United States)

Tan, C C

2002-07-01

In Singapore, chronic, non-communicable diseases, namely coronary heart disease, stroke and cancer, account for more than 60% of all deaths and a high burden of disability and healthcare expenditure. The burden of these diseases is likely to rise with our rapidly ageing population and changing lifestyles, and will present profound challenges to our healthcare delivery and financing systems over the next 20 to 30 years. The containment and optimal management of these conditions require a strong emphasis on patient education and the development of integrated models of healthcare delivery in place of the present uncoordinated, compartmentalised way of delivering healthcare. To meet these challenges, the Ministry of Health's major thrusts are disease control measures which focus mainly on primary prevention; and disease management, which coordinates the national effort to reduce the incidence of these key diseases and their predisposing factors and to ameliorate their long-term impact by optimising control to reduce mortality, morbidity and complications, and improving functional status through rehabilitation. The key initiatives include restructuring of the public sector healthcare institutions into two clusters, each comprising a network of primary health care polyclinics, regional hospitals and tertiary institutions. The functional integration of these healthcare elements within each cluster under a common senior administrative and professional management, and the development of common clinical IT systems will greatly facilitate the implementation of disease management programmes. Secondly, the Ministry is establishing National Disease Registries in coronary heart disease, cancer, stroke, myopia and kidney failure, which will be valuable sources of clinical and outcomes data. Thirdly, in partnership with expert groups, national committees and professional agencies, the Ministry will produce clinical practice guidelines which will assist doctors and healthcare

Hyper-spectral frequency selection for the classification of vegetation diseases

OpenAIRE

Dijkstra, Klaas; van de Loosdrecht, Jaap; Schomaker, Lambert; Wiering, Marco

2017-01-01

Reducing the use of pesticides by early visual detection of diseases in precision agriculture is important. Because of the color similarity between potato-plant diseases, narrow band hyper-spectral imaging is required. Payload constraints on unmanned aerial vehicles require reduc- tion of spectral bands. Therefore, we present a methodology for per-patch classification combined with hyper-spectral band selection. In controlled experiments performed on a set of individual leaves, we measure the...

Coding in Muscle Disease.

Science.gov (United States)

Jones, Lyell K; Ney, John P

2016-12-01

Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy. Procedural coding for electrodiagnostic studies and neuromuscular ultrasound is also reviewed.

Understanding requirements of novel healthcare information systems for management of advanced prostate cancer.

Science.gov (United States)

Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C

2012-01-01

Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.

Creating Great Neighborhoods: Density in Your Community

Science.gov (United States)

This report highlights nine community-led efforts to create vibrant neighborhoods through density, discusses the connections between smart growth and density, and introduces design principles to ensure that density becomes a community asset.

Future requirements for and supply of ophthalmologists for an aging population in Singapore.

Science.gov (United States)

Ansah, John P; De Korne, Dirk; Bayer, Steffen; Pan, Chong; Jayabaskar, Thiyagarajan; Matchar, David B; Lew, Nicola; Phua, Andrew; Koh, Victoria; Lamoureux, Ecosse; Quek, Desmond

2015-11-17

Singapore's population, as that of many other countries, is aging; this is likely to lead to an increase in eye diseases and the demand for eye care. Since ophthalmologist training is long and expensive, early planning is essential. This paper forecasts workforce and training requirements for Singapore up to the year 2040 under several plausible future scenarios. The Singapore Eye Care Workforce Model was created as a continuous time compartment model with explicit workforce stocks using system dynamics. The model has three modules: prevalence of eye disease, demand, and workforce requirements. The model is used to simulate the prevalence of eye diseases, patient visits, and workforce requirements for the public sector under different scenarios in order to determine training requirements. Four scenarios were constructed. Under the baseline business-as-usual scenario, the required number of ophthalmologists is projected to increase by 117% from 2015 to 2040. Under the current policy scenario (assuming an increase of service uptake due to increased awareness, availability, and accessibility of eye care services), the increase will be 175%, while under the new model of care scenario (considering the additional effect of providing some services by non-ophthalmologists) the increase will only be 150%. The moderated workload scenario (assuming in addition a reduction of the clinical workload) projects an increase in the required number of ophthalmologists of 192% by 2040. Considering the uncertainties in the projected demand for eye care services, under the business-as-usual scenario, a residency intake of 8-22 residents per year is required, 17-21 under the current policy scenario, 14-18 under the new model of care scenario, and, under the moderated workload scenario, an intake of 18-23 residents per year is required. The results show that under all scenarios considered, Singapore's aging and growing population will result in an almost doubling of the number of

Dosimetry-based treatment for Graves' disease.

Science.gov (United States)

Hyer, Steve L; Pratt, Brenda; Gray, Matthew; Chittenden, Sarah; Du, Yong; Harmer, Clive L; Flux, Glenn D

2018-06-01

The aim of this retrospective study was to assess the long-term outcome of a personalized dosimetry approach in Graves' disease aiming to render patients euthyroid from a planned thyroid absorbed dose of 60 Gy. A total of 284 patients with Graves' disease were followed prospectively following administration of radioiodine calculated to deliver an absorbed dose of 60 Gy. Patients with cardiac disease were excluded. Outcomes were analysed at yearly intervals for up to 10 years with a median follow-up of 37.5 months. A single radioiodine administration was sufficient to render a patient either euthyroid or hypothyroid in 175 (62%) patients, the remainder requiring further radioiodine. The median radioactivity required to deliver 60 Gy was 77 MBq. Less than 2% patients required 400-600 MBq, the standard activity administered in many centres. In the cohort receiving a single administration, 38, 32 and 26% were euthyroid on no specific thyroid medication at 3, 5 and 10 years, respectively. Larger thyroid volumes were associated with the need for further therapy. The presence of nodules on ultrasonography did not adversely affect treatment outcome. A personalized dosimetric approach delayed the long-term onset of hypothyroidism in 26% of patients. This was achieved using much lower administered activities than currently recommended. Future studies will aim to identify those patients who would benefit most from this approach.

Early vitrectomy effective for Norrie disease.

Science.gov (United States)

Walsh, Mark K; Drenser, Kimberly A; Capone, Antonio; Trese, Michael T

2010-04-01

To review our experience with Norrie disease to determine if early vitrectomy abrogates the natural history of this rare disease; namely, bilateral no light perception visual acuity and phthisis bulbi. We retrospectively reviewed the medical records of all patients seen in our tertiary care pediatric retinal clinical practice from 1988 through 2008 with a potential diagnosis of Norrie disease. Inclusion required not only clinical findings consistent with Norrie disease but also genetics and/or a family history consistent with Norrie disease. Medical record review revealed 14 boys with clinically diagnosed Norrie disease and either Norrie disease gene (NDP) mutations noted on genetic testing (13 patients) and/or a clear family history consistent with Norrie disease (4 patients). All 14 boys with definite Norrie disease had vitrectomy with or without lensectomy in at least 1 eye prior to 12 months of age. Of the 14 boys with definite Norrie disease, 7 maintained at least light perception visual acuity in 1 eye and 3 had no light perception visual acuity bilaterally; visual acuity data were not available for 4 patients. Only 2 of 24 (8%) eyes became phthisical. Historically, no treatment has been offered to mitigate the dismal natural history of Norrie disease. We recommend consideration of early vitrectomy in Norrie disease.

Pulmonary hypertension in chronic obstructive and interstitial lung diseases

DEFF Research Database (Denmark)

Andersen, Charlotte U; Mellemkjær, Søren; Nielsen-Kudsk, Jens Erik

2013-01-01

, and is considered one of the most frequent types of PH. However, the prevalence of PH among patients with COPD and ILD is not clear. The diagnosis of PH in chronic lung disease is often established by echocardiographic screening, but definitive diagnosis requires right heart catheterization, which...... is not systematically performed in clinical practice. Given the large number of patients with chronic lung disease, biomarkers to preclude or increase suspicion of PH are needed. NT-proBNP may be used as a rule-out test, but biomarkers with a high specificity for PH are still required. It is not known whether specific...... treatment with existent drugs effective in pulmonary arterial hypertension (PAH) is beneficial in lung disease related PH. Studies investigating existing PAH drugs in animal models of lung disease related PH have indicated a positive effect, and so have case reports and open label studies. However...

Animal models of cardiovascular diseases.

Science.gov (United States)

Zaragoza, Carlos; Gomez-Guerrero, Carmen; Martin-Ventura, Jose Luis; Blanco-Colio, Luis; Lavin, Begoña; Mallavia, Beñat; Tarin, Carlos; Mas, Sebastian; Ortiz, Alberto; Egido, Jesus

2011-01-01

Cardiovascular diseases are the first leading cause of death and morbidity in developed countries. The use of animal models have contributed to increase our knowledge, providing new approaches focused to improve the diagnostic and the treatment of these pathologies. Several models have been developed to address cardiovascular complications, including atherothrombotic and cardiac diseases, and the same pathology have been successfully recreated in different species, including small and big animal models of disease. However, genetic and environmental factors play a significant role in cardiovascular pathophysiology, making difficult to match a particular disease, with a single experimental model. Therefore, no exclusive method perfectly recreates the human complication, and depending on the model, additional considerations of cost, infrastructure, and the requirement for specialized personnel, should also have in mind. Considering all these facts, and depending on the budgets available, models should be selected that best reproduce the disease being investigated. Here we will describe models of atherothrombotic diseases, including expanding and occlusive animal models, as well as models of heart failure. Given the wide range of models available, today it is possible to devise the best strategy, which may help us to find more efficient and reliable solutions against human cardiovascular diseases.

Addison's disease and its associations.

Science.gov (United States)

Puttanna, Amar; Cunningham, Alana Rosaleen; Dainty, Philip

2013-07-26

Addison's disease is a relatively rare endocrine condition resulting from adrenal insufficiency due to various causes. Weight loss is a common feature; however, patients may be seen by a variety of specialists, even requiring acute admission before the diagnosis is made. Addison's disease is commonly associated with other autoimmune diseases. In some cases such as autoimmune polyendocrine syndromes (APS) types 1 and 2, these associations are more commonly found. We present a case of one such patient who presented to the acute medical team having been referred to the gastrointestinal services in the previous year for persistent vomiting and weight loss. On review of history, the cause of vomiting and weight loss was questioned and combined with subsequent biochemical testing a diagnosis of Addison's disease was made. The patient was also noted to have other associated endocrine and autoimmune conditions.

Empowering Patients with Chronic Diseases

DEFF Research Database (Denmark)

Bestek, Mate; Meglič, Matic; Kurent, Blaž

2012-01-01

Background: Chronic diseases require most of the resources in todays healthcare systems. Healthcare systems, as such, are thus not sustainable in the long term. Solutions to this problem are needed and a lot of research is focused on finding new approaches to more sustainable healthcare systems...... himself to become empowered. The patient needs to see data about his health in order to start thinking about new decisions in life that can lead to change in his behaviour. Objective: We have approached the problem of empowering patients with chronic diseases from a biological, psychological, sociological....... We want to develop extensible technology to support even more new interventions for different chronic diseases. We want the technology to enable semantic interoperability with other systems. Methods: We have collaborated with doctors in order to model the care plans for different chronic diseases...

Are functional foods redefining nutritional requirements?

Science.gov (United States)

Jones, Peter J; Varady, Krista A

2008-02-01

Functional foods are increasing in popularity owing to their ability to confer health and physiological benefits. Nevertheless, the notion that functional foods improve health when providing nutrients at levels above and beyond existing recommended intakes is inconsistent with the definition of requirement. This disparity highlights the need for an alternative definition of nutrient requirement. The present objective is to examine distinctions between optimization of health, as defined by what we currently deem as required intakes, versus adding physiological benefit using bioactive agents found in functional foods. Presently, requirement is defined as the lowest amount of intake of a nutrient that will maintain a defined level of nourishment for a specific indicator of adequacy. In contrast, functional foods are described as ingredients that are not necessary for body function, yet provide added physiological benefit that confer better overall health. Plant sterols are one example of such an ingredient. Plant sterols lower plasma cholesterol concentrations, and may thus be considered essential nutrients in physiological situations where circulating cholesterol concentrations are high. Similarly, intakes of omega-3 fats beyond existing requirement may confer additional health benefits such as hypolipidemic and anti-diabetic effects. These examples underscore the inconsistencies between what is defined as a nutrient requirement versus what is identified as a health benefit of a functional food. Such discrepancies emphasize the need for a more all-encompassing definition of a nutrient requirement; that is, one that moves beyond the prevention of overt deficiency to encompass improved health and disease risk reduction.

Inflammatory bowel diseases: principles of nutritional therapy

Directory of Open Access Journals (Sweden)

Campos Fábio Guilherme

2002-01-01

Full Text Available Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants still need further evaluation through prospective and randomized trials.

Yelavarthy Nayudamma

Indian Academy of Sciences (India)

IAS Admin

of Governors of the International Development and Research. Council (IDRC). ... A Turning Point. Nayudamma went to a primary school in Yelavarru, high school in .... technology-led changes in leather industry, vibrant global trade of.

Do leadership styles matter in microfinance performance? Empirical ...

African Journals Online (AJOL)

... been concerned with building vibrant institutions within the financial sector. In this direction, managers of these institutions need to bring their leadership styles to ... style should be encouraged for the management of microfinance institutions.

Your Microbes and You

Science.gov (United States)

... the healthy bacteria are filling all those little niches so that the more dangerous bacteria can’t ... normal mice have vibrant bacterial communities and a rich variety of immune cells and molecules on their ...

76 FR 13120 - Requirements for Importers of Nonhuman Primates

Science.gov (United States)

2011-03-10

... Requirements for Importers of Nonhuman Primates AGENCY: Centers for Disease Control and Prevention (CDC... primates (NHPs). Written comments were to be received on or before March 7, 2011. We have received a... regulations (42 CFR 71.53) for the imporation of live nonhuman primates (NHPs) by extending existing...

9 CFR 113.205 - Newcastle Disease Vaccine, Killed Virus.

Science.gov (United States)

2010-01-01

... Virus. 113.205 Section 113.205 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.205 Newcastle Disease Vaccine, Killed Virus. Newcastle Disease Vaccine...

Paediatric Crohn's disease: a radiological review

International Nuclear Information System (INIS)

Ali, S.I.; Carty, H.M.L.

2000-01-01

Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close co-operation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution. (orig.)

Hepatobiliary Disorders in Celiac Disease: An Update

Directory of Open Access Journals (Sweden)

Kaushal K. Prasad

2011-01-01

Full Text Available This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.

DOSim: An R package for similarity between diseases based on Disease Ontology

Science.gov (United States)

2011-01-01

Background The construction of the Disease Ontology (DO) has helped promote the investigation of diseases and disease risk factors. DO enables researchers to analyse disease similarity by adopting semantic similarity measures, and has expanded our understanding of the relationships between different diseases and to classify them. Simultaneously, similarities between genes can also be analysed by their associations with similar diseases. As a result, disease heterogeneity is better understood and insights into the molecular pathogenesis of similar diseases have been gained. However, bioinformatics tools that provide easy and straight forward ways to use DO to study disease and gene similarity simultaneously are required. Results We have developed an R-based software package (DOSim) to compute the similarity between diseases and to measure the similarity between human genes in terms of diseases. DOSim incorporates a DO-based enrichment analysis function that can be used to explore the disease feature of an independent gene set. A multilayered enrichment analysis (GO and KEGG annotation) annotation function that helps users explore the biological meaning implied in a newly detected gene module is also part of the DOSim package. We used the disease similarity application to demonstrate the relationship between 128 different DO cancer terms. The hierarchical clustering of these 128 different cancers showed modular characteristics. In another case study, we used the gene similarity application on 361 obesity-related genes. The results revealed the complex pathogenesis of obesity. In addition, the gene module detection and gene module multilayered annotation functions in DOSim when applied on these 361 obesity-related genes helped extend our understanding of the complex pathogenesis of obesity risk phenotypes and the heterogeneity of obesity-related diseases. Conclusions DOSim can be used to detect disease-driven gene modules, and to annotate the modules for functions and

Clinical epidemiology and disease burden of nonalcoholic fatty liver disease

Science.gov (United States)

Perumpail, Brandon J; Khan, Muhammad Ali; Yoo, Eric R; Cholankeril, George; Kim, Donghee; Ahmed, Aijaz

2017-01-01

Nonalcoholic fatty liver disease (NAFLD) is defined as the presence of hepatic fat accumulation after the exclusion of other causes of hepatic steatosis, including other causes of liver disease, excessive alcohol consumption, and other conditions that may lead to hepatic steatosis. NAFLD encompasses a broad clinical spectrum ranging from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis, and finally hepatocellular carcinoma (HCC). NAFLD is the most common liver disease in the world and NASH may soon become the most common indication for liver transplantation. Ongoing persistence of obesity with increasing rate of diabetes will increase the prevalence of NAFLD, and as this population ages, many will develop cirrhosis and end-stage liver disease. There has been a general increase in the prevalence of NAFLD, with Asia leading the rise, yet the United States is following closely behind with a rising prevalence from 15% in 2005 to 25% within 5 years. NAFLD is commonly associated with metabolic comorbidities, including obesity, type II diabetes, dyslipidemia, and metabolic syndrome. Our understanding of the pathophysiology of NAFLD is constantly evolving. Based on NAFLD subtypes, it has the potential to progress into advanced fibrosis, end-stage liver disease and HCC. The increasing prevalence of NAFLD with advanced fibrosis, is concerning because patients appear to experience higher liver-related and non-liver-related mortality than the general population. The increased morbidity and mortality, healthcare costs and declining health related quality of life associated with NAFLD makes it a formidable disease, and one that requires more in-depth analysis. PMID:29307986

Implications of multiple risk factors for delineation of disease control zones: Case study on foot-and-mouth disease occurrence in Uganda

DEFF Research Database (Denmark)

Chrisostom, Ayebazibwe; Okurut, Ademun Anna Rose; Tjørnehøj, Kirsten

2013-01-01

strategies to promote disease control and livestock trade in endemic countries was to introduce the concept of disease-free zones within which specific sanitary and market standards have to be met. In Africa, it is only Namibia, Botswana and South Africa that have ever had FMD free OIE-declared zones......, water, animal products, utensils and livestock-human contacts. Like other developing countries, animal production and marketing are heavily constrained by limited access to lucrative international markets because of failure to meet the required standards by the World Trade Organization. One of the major....... In pursuit of possibilities of beef export to EU and other markets within Africa by the year 2020, Uganda delineated two disease control zones (DCZs) in areas with large livestock populations and as a consequence high risk for FMD, thus requiring high capital investment. This paper highlights the multiple...

Towards the disease biomarker in an individual patient using statistical health monitoring

NARCIS (Netherlands)

Engel, J.; Blanchet, L.M.; Engelke, U.F.; Wevers, R.A.; Buydens, L.M.

2014-01-01

In metabolomics, identification of complex diseases is often based on application of (multivariate) statistical techniques to the data. Commonly, each disease requires its own specific diagnostic model, separating healthy and diseased individuals, which is not very practical in a diagnostic setting.

Consensus Recommendations for the Diagnostic Investigation of Dogs with Suspected Glomerular Disease

NARCIS (Netherlands)

Littman, M.P.; Daminet, S.; Grauer, G.F.; Lees, G.E.; van Dongen, A.M.|info:eu-repo/dai/nl/097672637

2013-01-01

Background The International Renal Interest Society (IRIS) offers guidelines for chronic kidney disease and acute kidney injury. As dogs with glomerular disease may present differently and require different treatment than those with whole nephron or tubular disease, the IRIS Canine

Does multifocal papillary micro-carcinoma require radioiodine ablation?

International Nuclear Information System (INIS)

Punda, A.; Markovic, V.; Eterovic, D.

2015-01-01

Full text of publication follows. Background: the thyroid carcinomas smaller than 1 cm (micro-carcinomas) comprise a significant fraction of papillary carcinomas. Excluding clinical micro-carcinomas, which present as metastatic disease, the micro-carcinomas diagnosed by ultrasound/FNAC or incidentally have very good prognosis. However, whether or not these papillary micro-carcinomas require post-surgical radioiodine ablation remains a matter of debate. Hypothesis: multi-focality is present in majority of clinical papillary micro-carcinomas and this characteristic can be used to identify the subset of non-clinical micro-carcinomas with greater malignant potential. Methods: the data on types of differentiated thyroid carcinomas diagnosed in the period 2008-2011 in the University Hospital Split were collected. Results: there were 359 patients with thyroid carcinoma, 329 (92%) of which had papillary carcinoma. About 61% (202/329) of papillary carcinomas were micro-carcinomas; most of them were diagnosed by ultrasound/FNAC (134/202= 66%), the rest were incidentalomas (48/202=24%) and clinical micro carcinomas (20/202=10%). Sixty percent (12/20) of patients with clinical micro-carcinoma and 23 patients with non-clinical micro-carcinoma (23/182=13%) had multifocal disease. Conclusion: multifocal disease is a frequent characteristic of clinical papillary thyroid micro-carcinomas, suggesting that multi-focality presents an early stage of non-clinical micro-carcinomas with more aggressive behaviour. Thus multifocal, but not uni-focal papillary micro-carcinomas may require radioiodine ablation. (authors)

IDRC in Peru

International Development Research Centre (IDRC) Digital Library (Canada)

Internet. One example is Punto J, a vibrant website where young people advise their peers ... areas such as trade, banking, and social services. ... Scaling up rural innovations. Funding: ... investment, but they lack capacity. The ... ECUADOR.

Determinants of Informal Employment: A Case of Tanzania's ...

African Journals Online (AJOL)

industry. A Logit regression model is employed in estimating factors that influence the choice ... International Labour Organization (ILO) (2013), the informal economy ... This study uses primary data which was collected in six most vibrant urban.

Reclaim “Education” in environmental and sustainability education research

DEFF Research Database (Denmark)

Sund, Per; Lysgaard, Jonas Greve

2013-01-01

Without contextualization and explicit links to centuries of relevant educational theories, research presentations at conferences risk appearing disconnected from teaching method development or evaluation. Environmental and Sustainability Education (ESE), is a highly vibrant research area...

36 CFR 251.54 - Proposal and application requirements and procedures.

Science.gov (United States)

2010-07-01

..., DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.54 Proposal and application requirements and... activity does not materially impact the characteristics or functions of the environmentally sensitive...-disposal facilities; (3) The availability of sufficient potable drinking water; (4) The risk of disease...

Gastro-oesophageal reflux disease and non-asthma lung disease

Directory of Open Access Journals (Sweden)

R. S. Morehead

2009-12-01

Full Text Available Gastro-oesophageal reflux disease (GERD is a common disorder in Western countries, and its relationship to airways disorders (e.g. asthma has been well established. Lung diseases other than asthma have also been associated with GERD, but the nature and scope of this relationship has not been fully defined. Diseases that have been associated with GERD include bronchiolitis syndromes, idiopathic pulmonary fibrosis, scleroderma and nontubercular mycobacterial infection. Diagnostic evaluation centres upon proving both reflux and pulmonary aspiration, which may be accomplished in some cases by lung biopsy. However, in many cases a compatible clinical and radiographic picture coupled with proof of proximal reflux by combined oesophageal probe testing may suffice for a provisional diagnosis and allow institution of anti-reflux measures. Proton-pump inhibitors are the medications of choice for GERD; other interventions shown to reduce reflux are weight loss, elevation of the head of the bed and avoidance of recumbency after meals. However, acid suppression therapy does not address non-acid reflux that may be important in disease pathogenesis in select patients, and lifestyle modifications often fail. Laparoscopic fundoplication is the procedure of choice for medically refractory GERD with excellent short-term results with respect to respiratory symptoms associated with GERD; however, long-term studies document a significant percentage of patients requiring ongoing acid suppression therapy.

Functional Foods and Nutraceuticals as Dietary Intervention in Chronic Diseases; Novel Perspectives for Health Promotion and Disease Prevention.

Science.gov (United States)

Adefegha, Stephen Adeniyi

2017-12-27

Functional foods describe the importance of foods in promoting health and preventing diseases aside their primary role of providing the body with the required amount of essential nutrients such as proteins, carbohydrates, vitamins, fats, and oils needed for its healthy survival. This review explains the interaction of functional food bioactive compounds including polyphenols (phenolic acids [hydroxybenzoic acids and hydroxycinnamic acids], flavonoids [flavonols, flavones, flavanols, flavanones, isoflavones, proanthocyanidins], stilbenes, and lignans), terpenoids, carotenoids, alkaloids, omega-3 and polyunsaturated fatty acids, among others with critical enzymes (α- amylase, α- glucosidase, angiotensin-I converting enzyme [ACE], acetylcholinesterase [AChE], and arginase) linked to some degenerative diseases (type-2 diabetes, cardiovascular diseases [hypertension], neurodegenerative diseases [Alzheimer's disease] and erectile dysfunction). Different functional food bioactive compounds may synergistically/additively confer an overwhelming protection against these degenerative diseases by modulating/altering the activities of these critical enzymes of physiological importance.

[Lung Cancer as an Occupational Disease].

Science.gov (United States)

Baur, X; Woitowitz, H-J

2016-08-01

Lung cancer is one of the most frequently encountered cancer types. According to the latest WHO data, about 10 % of this disease are due to occupational exposure to cancerogens. Asbestos is still the number one carcinogen. Further frequent causes include quarz and ionizing radiation (uranium mining). Probable causes of the disease can be identified only with the help of detailed occupational history taken by a medical specialist and qualified exposure assessment. Without clarifying the cause of the disease, there is neither a correct insurance procedure nor compensation for the victim, and furthermore, required preventive measures cannot be initiated. © Georg Thieme Verlag KG Stuttgart · New York.

[Neonatal ABO incompatibility underlies a potentially severe hemolytic disease of the newborn and requires adequate care].

Science.gov (United States)

Senterre, T; Minon, J-M; Rigo, J

2011-03-01

ABO allo-immunization is the most frequent hemolytic disease of the newborn and ABO incompatibility is present in 15-25 % of pregnancies. True ABO alloimmunization occurs in approximately one out of 150 births. Intensity is generally lower than in RhD allo-immunization. We report on three cases showing that ABO allo-immunization can lead to severe hemolytic disease of the newborn with potentially threatening hyperbilirubinemia and complications. Early diagnosis and adequate care are necessary to prevent complications in ABO incompatibility. A direct antiglobulin test is the cornerstone of diagnosis and should be performed at birth on cord blood sampling in all group infants born to O mothers, especially if of African origin. Risk factor analysis and attentive clinical monitoring during the first days of life are essential. Vigilance is even more important for infants discharged before the age of 72 h. Every newborn should be assessed for the risk of developing severe hyperbilirubinemia and should be examined by a qualified healthcare professional in the first days of life. Treatment depends on the total serum bilirubin level, which may increase very rapidly in the first 48 h of life in cases of hemolytic disease of the newborn. Phototherapy and, in severe cases, exchange transfusion are used to prevent hyperbilirubinemia encephalopathy. Intravenous immunoglobulins are used to reduce exchange transfusion. Treatments of severe hemolytic disease of the newborn should be provided and performed by trained personnel in neonatal intensive care units. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Therapeutic approaches for celiac disease

Science.gov (United States)

Plugis, Nicholas M.; Khosla, Chaitan

2015-01-01

Celiac disease is a common, lifelong autoimmune disorder for which dietary control is the only accepted form of therapy. A strict gluten-free diet is burdensome to patients and can be limited in efficacy, indicating there is an unmet need for novel therapeutic approaches to supplement or supplant dietary therapy. Many molecular events required for disease pathogenesis have been recently characterized and inspire most current and emerging drug-discovery efforts. Genome-wide association studies (GWAS) confirm the importance of human leukocyte antigen genes in our pathogenic model and identify a number of new risk loci in this complex disease. Here, we review the status of both emerging and potential therapeutic strategies in the context of disease pathophysiology. We conclude with a discussion of how genes identified during GWAS and follow-up studies that enhance susceptibility may offer insight into developing novel therapies. PMID:26060114

Valvular heart disease in pregnancy.

Science.gov (United States)

Windram, Jonathan D; Colman, Jack M; Wald, Rachel M; Udell, Jacob A; Siu, Samuel C; Silversides, Candice K

2014-05-01

In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling from a cardiologist with expertise in pregnancy. For women with moderate- and high-risk valve lesions, appropriate risk stratification and management during pregnancy will optimise outcomes. Pregnancy in women with high-risk lesions, such as severe aortic stenosis, severe mitral stenosis and those with mechanical valves, requires careful planning and coordination of antenatal care by a multidisciplinary team. The purpose of this overview is to describe the expected haemodynamic changes in pregnancy, review pregnancy risks for women with valvular heart disease and discuss strategies for management. Copyright © 2014. Published by Elsevier Ltd.

Achieving sustainable plant disease management through evolutionary principles.

Science.gov (United States)

Zhan, Jiasui; Thrall, Peter H; Burdon, Jeremy J

2014-09-01

Plants and their pathogens are engaged in continuous evolutionary battles and sustainable disease management requires novel systems to create environments conducive for short-term and long-term disease control. In this opinion article, we argue that knowledge of the fundamental factors that drive host-pathogen coevolution in wild systems can provide new insights into disease development in agriculture. Such evolutionary principles can be used to guide the formulation of sustainable disease management strategies which can minimize disease epidemics while simultaneously reducing pressure on pathogens to evolve increased infectivity and aggressiveness. To ensure agricultural sustainability, disease management programs that reflect the dynamism of pathogen population structure are essential and evolutionary biologists should play an increasing role in their design. Copyright © 2014 Elsevier Ltd. All rights reserved.

Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease.

Science.gov (United States)

Ou, Chien-Yu; Lee, Tao-Chen; Lee, Tsung-Han; Huang, Yu-Hua

2015-04-01

Adjacent segment disease is an important complication after fusion of degenerative lumbar spines. However, the role of body mass index (BMI) in adjacent segment disease has been addressed less. To examine the relationship between BMI and adjacent segment disease after lumbar fusion for degenerative spine diseases. For this retrospective study, we enrolled 190 patients undergoing lumbar fusion surgery for degeneration. BMI at admission was documented. Adjacent segment disease was defined by integration of the clinical presentations and radiographic criteria based on the morphology of the dural sac on magnetic resonance images. Adjacent segment disease was identified in 13 of the 190 patients, accounting for 6.8%. The interval between surgery and diagnosis as adjacent segment disease ranged from 21 to 66 months. Five of the 13 patients required subsequent surgical intervention for clinically relevant adjacent segment disease. In the logistic regression model, BMI was a risk factor for adjacent segment disease after lumbar fusion for degenerative spine diseases (odds ratio, 1.68; 95% confidence interval, 1.27-2.21; P disease rate by 67.6%. The patients were subdivided into 2 groups based on BMI, and up to 11.9% of patients with BMI ≥ 25 kg/m were diagnosed as having adjacent segment disease at the last follow-up. BMI is a risk factor for adjacent segment disease in patients undergoing lumbar fusion for degenerative spine diseases. Because BMI is clinically objective and modifiable, controlling body weight before or after surgery may provide opportunities to reduce the rate of adjacent segment disease and to improve the outcome of fusion surgery.

Sex Differences in Health Care Requirements Aboard U.S. Navy Ships

Science.gov (United States)

1990-03-20

asymptomatic in females, and yet may lead to serious complications, requires more sensitive laboratory and test capabilities than currently exist aboard...DISEASES OF THE DIGESTIVE SYSTEM (520-579) 18.0 28.1 14.7 1.92 522 Diseases of pulp or periapical tissues .08 .00 .11 -- 523 Gingival or periodontal ...ORGANIZATION 6b OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATiON Naval Health Research Center (if apicable ) Chief 40 Bureau of Medicine and Surgery 6c ADDRESS

9 CFR 93.313 - Appearance of disease among horses in quarantine.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Appearance of disease among horses in...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.313 Appearance of disease among horses in quarantine. If any contagious disease appears among horses during the quarantine period special...

Chronic obstructive pulmonary disease and comorbidity: possible implications in the disease management

Directory of Open Access Journals (Sweden)

Pierluigi Paggiaro

2011-04-01

Full Text Available Chronic obstructive pulmonary disease (COPD is becoming the first cause of pulmonary disability and death. Because of the increase in the mean age of the population, COPD is frequently associated with important comorbidities that require medical attention. In the last 10 years many observational studies (large surveys of population or databases of the main health organisations or of General Practitioners in different Countries have extensively documented that many diseases (cardiovascular diseases, metabolic syndrome, osteoporosis, diabetes, depression, and lung cancer have a higher prevalence in COPD patients than in non-COPD ones (after correction for many confounding factors, such as smoking habit. There are two different views relating the association between COPD and comorbidities. These comorbidities may be just randomly associated with COPD (due to common risk factors including age, but many data support the hypothesis that chronic inflammation derived from airway wall and lung parenchima of COPD patients may “spill over” the systemic circulation and mediate, at least partially, negative effects on other organs or systems. Some comorbidities seem more commonly associated with the functional abnormalities of COPD (like skeletal muscle dysfunction and malnutrition, or osteoporosis, which are related to the inactivity due to dyspnoea, while for others the systemic effect of some cytokines (IL-6,TNFalfa, etc. or mediators (CRP, serum amyloid A, etc. may play a role.Since comorbidities represent major causes of death in COPD patients, and are responsible of poorer quality of life and hospitalisation during COPD exacerbations, their presence requires a new approach, including an interdisciplinary co-operation and the use of specific strategies able to affect the several pulmonary and extra-pulmonary components of the disease. New pharmacologic options (such as roflumilast active on both pulmonary and extra-pulmonary inflammation might be

[Controversies and dilemmas on the use of beta-blockers in treatment of associated cardiovascular disease in patients with chronic obstructive pulmonary disease].

Science.gov (United States)

Pescaru, Camelia; Tudorache, Voicu; Oancea, Cristian

2010-01-01

In the last decade, chronic obstructive pulmonary disease (COPD) has been considered a syndrome with multiple phenotypical facets and systemic components. Chronic diseases are associated, in time, with several comorbidities. Cardiovascular disease represents the most common comorbidity in COPD, increases its handicap and mortality indices. Most entities associated with cardiovascular disease require treatment with beta-blockers. However, beta-blockers are a "two-edged sword" when administered in obstructive pulmonary disorder. The use of beta-blockers should be assessed by their action on three areas: their effect on FEV1, their effect on bronchial hyperreactivity, the result obtained when additionally administering beta-agonists. The result of beta-blocker administration is influenced by the involvement of several other factors: the cardioselectivity of the beta-blocker, the dosage, the concomitant administration of beta-agonists, the stage of the disease (stable or exacerbation of COPD), smoker status etc. Their administration under strict monitoring results in a decreased morbidity and mortality, including in patients who had undergone cardiovascular surgery. The overall conclusion is that beta-blockers may be administered in COPD associated with cardiac comorbidity, but this administration requires utmost care.

Postoperative hypocalcemia after thyroidectomy for Graves' disease.

Science.gov (United States)

Pesce, Catherine E; Shiue, Zita; Tsai, Hua-Ling; Umbricht, Christopher B; Tufano, Ralph P; Dackiw, Alan P B; Kowalski, Jeanne; Zeiger, Martha A

2010-11-01

It is believed that patients who undergo thyroidectomy for Graves' disease are more likely to experience postoperative hypocalcemia than patients undergoing total thyroidectomy for other indications. However, no study has directly compared these two groups of patients. The aim of this study was to determine whether there was an increased incidence or severity of postoperative hypocalcemia in patients who underwent thyroidectomy for Graves' disease. An institutional review board-approved database was created of all patients who underwent thyroidectomy from 1998 to 2009 at the Johns Hopkins Hospital. There were a total of 68 patients with Graves' disease who underwent surgery. Fifty-five patients who underwent total thyroidectomy were randomly selected and served as control subjects. An analysis was conducted that examined potential covariates for postoperative hypocalcemia, including age, gender, ethnicity, preoperative alkaline phosphatase level, size of goiter, whether parathyroid tissue or glands were present in the specimen, and the reason the patient underwent surgery. Specific outcomes examined were calcium levels on postoperative day 1, whether or not patients experienced symptoms of hypocalcemia, whether or not Rocaltrol was required, the number of calcium tablets prescribed upon discharge, whether or not postoperative tetany occurred, and calcium levels 1 month after discharge. Each outcome was analyzed using a logistic regression. Graves' disease patients had a significantly (p-value Graves' disease and no patient in the control group were readmitted with tetany (p = 0.033). There was a trend, though not significant, toward patients with Graves' disease having a higher prevalence of hypocalcemia the day after thyroidectomy and 1 month later. Patients with Graves' disease are more likely to require increased dosages of calcium as well as experience tetany postoperatively than patients undergoing total thyroidectomy for other indications. This suggests that

Canadian initiative leading the way for equitable health systems and ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-04-27

Apr 27, 2016 ... Home · Resources · Publications ... The field of health systems research has grown into a vibrant community. IDRC grantees are actively involved in Health Systems Global, a newinternational agency that gathers researchers, ...

Stimulating Public Interest in Lunar Exploration and Enhancing Science Literacy Through Library Programs

Science.gov (United States)

Shipp, S.; Nelson, B.; Stockman, S.; Weir, H.; Carter, B.; Bleacher, L.

2008-07-01

Libraries are vibrant learning places, seeking partners in science programming. LPI's Explore! program offers a model for public engagement in lunar exploration in libraries, as shown by materials created collaboratively with the LRO E/PO team.

Pulmonary Hypertension in Congenital Heart Disease: Beyond Eisenmenger Syndrome.

Science.gov (United States)

Krieger, Eric V; Leary, Peter J; Opotowsky, Alexander R

2015-11-01

Patients with adult congenital heart disease have an increased risk of developing pulmonary hypertension. There are several mechanisms of pulmonary hypertension in patients with adult congenital heart disease, and understanding them requires a systematic approach to define the patient's hemodynamics and physiology. This article reviews the updated classification of pulmonary hypertension in patients with adult congenital heart disease with a focus on pathophysiology, diagnostics, and the evaluation of pulmonary hypertension in special adult congenital heart disease populations. Copyright © 2015 Elsevier Inc. All rights reserved.

Web-based infectious disease reporting using XML forms.

Science.gov (United States)

Liu, Danhong; Wang, Xia; Pan, Feng; Xu, Yongyong; Yang, Peng; Rao, Keqin

2008-09-01

Exploring solutions for infectious disease information sharing among hospital and public health information systems is imperative to the improvement of disease surveillance and emergent response. This paper aimed at developing a method to directly transmit real-time data of notifiable infectious diseases from hospital information systems to public health information systems on the Internet by using a standard eXtensible Markup Language (XML) format. The mechanism and work flow by which notifiable infectious disease data are created, reported and used at health agencies in China was evaluated. The capacity of all participating providers to use electronic data interchange to submit transactions of data required for the notifiable infectious disease reporting was assessed. The minimum data set at national level that is required for reporting for national notifiable infectious disease surveillance was determined. The standards and techniques available worldwide for electronic health data interchange, such as XML, HL7 messaging, CDA and ATSM CCR, etc. were reviewed and compared, and an XML implementation format needed for this purpose was defined for hospitals that are able to access the Internet to provide a complete infectious disease reporting. There are 18,703 county or city hospitals in China. All of them have access to basic information infrastructures including computers, e-mail and the Internet. Nearly 10,000 hospitals possess hospital information systems used for electronically recording, retrieving and manipulating patients' information. These systems collect 23 data items required in the minimum data set for national notifiable infectious disease reporting. In order to transmit these data items to the disease surveillance system and local health information systems instantly and without duplication of data input, an XML schema and a set of standard data elements were developed to define the content, structure and semantics of the data set. These standards

Merkel cell tumor of the skin treated with localized radiotherapy: are widely negative margins required?

Directory of Open Access Journals (Sweden)

David Parda

2011-03-01

Full Text Available Merkel’s cell carcinoma is a rare cutaneous tumor that can affect a wide variety of sites throughout the body. Commonly, it affects the skin alone and the management of limited disease can be confusing since the natural history of the disease involves distant metastasis. Traditional management has required wide local excision with negative margins of resection. We describe a case treated with local therapy alone and review the literature to suggest that complete microscopic excision may not be required if adjuvant radiotherapy is used.

Radiation-Induced Organizing Pneumonia: A Characteristic Disease that Requires Symptom-Oriented Management.

Science.gov (United States)

Otani, Keisuke; Seo, Yuji; Ogawa, Kazuhiko

2017-01-27

Radiation-induced organizing pneumonia (RIOP) is an inflammatory lung disease that is occasionally observed after irradiation to the breast. It is a type of secondary organizing pneumonia that is characterized by infiltrates outside the irradiated volume that are sometimes migratory. Corticosteroids work acutely, but relapse of pneumonia is often experienced. Management of RIOP should simply be symptom-oriented, and the use of corticosteroids should be limited to severe symptoms from the perspective not only of cost-effectiveness but also of cancer treatment. Once steroid therapy is started, it takes a long time to stop it due to frequent relapses. We review RIOP from the perspective of its diagnosis, epidemiology, molecular pathogenesis, and patient management.

Approaches to the Surveillance of Foodborne Disease: A Review of the Evidence.

Science.gov (United States)

Ford, Laura; Miller, Megge; Cawthorne, Amy; Fearnley, Emily; Kirk, Martyn

2015-12-01

Foodborne disease surveillance aims to reduce the burden of illness due to contaminated food. There are several different types of surveillance systems, including event-based surveillance, indicator-based surveillance, and integrated food chain surveillance. These approaches are not mutually exclusive, have overlapping data sources, require distinct capacities and resources, and can be considered a hierarchy, with each level being more complex and resulting in a greater ability to detect and control foodborne disease. Event-based surveillance is generally the least resource-intensive system and makes use of informal data sources. Indicator-based surveillance is seen as traditional notifiable disease surveillance and consists of routinely collected data. Integrated food chain surveillance is viewed as the optimal practice for conducting continuous risk analysis for foodborne diseases, but also requires significant ongoing resources and greater multisectoral collaboration compared to the other systems. Each country must determine the most appropriate structure for their surveillance system for foodborne diseases based on their available resources. This review explores the evidence on the principles, minimum capabilities, and minimum requirements of each type of surveillance and discusses examples from a range of countries. This review forms the evidence base for the Strengthening the Surveillance and Response for Foodborne Diseases: A Practical Manual.

Vector borne diseases

OpenAIRE

Melillo Fenech, Tanya

2010-01-01

A vector-borne disease is one in which the pathogenic microorganism is transmitted from an infected individual to another individual by an arthropod or other agent. The transmission depends upon the attributes and requirements of at least three different Iiving organisms : the pathologic agent which is either a virus, protozoa, bacteria or helminth (worm); the vector, which is commonly an arthropod such as ticks or mosquitoes; and the human host.

Nonmotor symptoms in a malaysian Parkinson's disease population.

Science.gov (United States)

Azmin, Shahrul; Khairul Anuar, Abdul Manaf; Tan, Hui Jan; Nafisah, Wan Yahya; Raymond, Azman Ali; Hanita, Othman; Shah, Shamsul Azhar; Norlinah, Mohamed Ibrahim

2014-01-01

Background. The nonmotor symptoms are important determinants of health and quality of life in Parkinson's disease but are not well recognized and addressed in clinical practice. This study was conducted to determine the prevalence of nonmotor symptoms and their impact on quality of life in patients with Parkinson's disease. Methods. This was a cross-sectional study among patients with idiopathic Parkinson's disease. Exclusion criteria were a Mini Mental State Examination score of diet playing a role in this observation requires further study.

Thiazolidinediones and Parkinson Disease: A Cohort Study.

Science.gov (United States)

Connolly, John G; Bykov, Katsiaryna; Gagne, Joshua J

2015-12-01

Thiazolidinediones, a class of medications indicated for the treatment of type 2 diabetes mellitus, reduce inflammation and have been shown to provide a therapeutic benefit in animal models of Parkinson disease. We examined the association between treatment with thiazolidinediones and the onset of Parkinson disease in older individuals. We performed a cohort study of 29,397 Medicare patients enrolled in state pharmaceutical benefits programs who initiated treatment with thiazolidinediones or sulfonylureas during the years 1997 through 2005 and had no prior diagnosis of Parkinson disease. New users of thiazolidinediones were propensity score matched to new users of sulfonylureas and followed to determine whether they were diagnosed with Parkinson disease. We used Cox proportional hazards models to compare time to diagnosis of Parkinson disease in the propensity score-matched populations. To assess the association with duration of use, we performed several analyses that required longer continuous use of medications. In the primary analysis, thiazolidinedione users had a hazard ratio for a diagnosis of Parkinson disease of 1.09 (95% confidence interval: 0.71, 1.66) when compared with sulfonylurea users. Increasing the duration-of-use requirements to 10 months did not substantially change the association; the hazard ratios ranged from 1.00 (95% confidence interval: 0.49, 2.05) to 1.17 (95% confidence interval: 0.60, 2.25). Thiazolidinedione use was not associated with a longer time to diagnosis of Parkinson disease than was sulfonylurea use, regardless of duration of exposure. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Occupational lung diseases in Australia.

Science.gov (United States)

Hoy, Ryan F; Brims, Fraser

2017-11-20

Occupational exposures are an important determinant of respiratory health. International estimates note that about 15% of adult-onset asthma, 15% of chronic obstructive pulmonary disease and 10-30% of lung cancer may be attributable to hazardous occupational exposures. One-quarter of working asthmatics either have had their asthma caused by work or adversely affected by workplace conditions. Recently, cases of historical occupational lung diseases have been noted to occur with new exposures, such as cases of silicosis in workers fabricating kitchen benchtops from artificial stone products. Identification of an occupational cause of a lung disease can be difficult and requires maintaining a high index of suspicion. When an occupational lung disease is identified, this may facilitate a cure and help to protect coworkers. Currently, very little information is collected regarding actual cases of occupational lung diseases in Australia. Most assumptions about many occupational lung diseases are based on extrapolation from overseas data. This lack of information is a major impediment to development of targeted interventions and timely identification of new hazardous exposures. All employers, governments and health care providers in Australia have a responsibility to ensure that the highest possible standards are in place to protect workers' respiratory health.

Ocular Manifestations of Mosquito-Transmitted Diseases.

Science.gov (United States)

Karesh, James W; Mazzoli, Robert A; Heintz, Shannon K

2018-03-01

Of the 3,548 known mosquito species, about 100 transmit human diseases. Mosquitoes are distributed globally throughout tropical and temperate regions where standing water sources are available for egg laying and the maturation of larva. Female mosquitoes require blood meals for egg production. This is the main pathway for disease transmission. Mosquitoes carry several pathogenic organisms responsible for significant ocular pathology and vision loss including West Nile, Rift Valley, chikungunya, dengue viruses, various encephalitis viruses, malarial parasites, Francisella tularensis, microfilarial parasites, including Dirofilaria, Wuchereria, and Brugia spp., and human botfly larvae. Health care providers may not be familiar with many of these mosquito-transmitted diseases or their associated ocular findings delaying diagnosis, treatment, and recovery of visual function. This article aims to provide an overview of the ocular manifestations associated with mosquito-transmitted diseases.

Requirements for laboratory animals in health programmes*

OpenAIRE

Held, J. R.

1981-01-01

Laboratory animals are essential for the successful execution of many health programmes. A wide variety of animal models is used in the worldwide efforts to improve the control of various diseases, and in the basic research needed to improve health care. Biomedical programmes require specially-bred animals reared under controlled conditions, with close attention given to such factors as physical environment, nutrition, microbiological status, and genetic background. The need for a regular sup...

When does food refusal require professional intervention?

OpenAIRE

Dovey, Terence M.; Farrow, Claire V.; Martin, Clarissa I.; Isherwood, Elaine; Halford, Jason C.G.

2009-01-01

Food refusal can have the potential to lead to nutritional deficiencies, which increases the risk of a variety of communicable and non-communicable diseases. Deciding when food refusal requires professional intervention is complicated by the fact that there is a natural and appropriate stage in a child's development that is characterised by increased levels of rejection of both previously accepted and novel food items. Therefore, choosing to intervene is difficult, which if handled badly can ...

Animal Models of Cardiovascular Diseases

Directory of Open Access Journals (Sweden)

Carlos Zaragoza

2011-01-01

Full Text Available Cardiovascular diseases are the first leading cause of death and morbidity in developed countries. The use of animal models have contributed to increase our knowledge, providing new approaches focused to improve the diagnostic and the treatment of these pathologies. Several models have been developed to address cardiovascular complications, including atherothrombotic and cardiac diseases, and the same pathology have been successfully recreated in different species, including small and big animal models of disease. However, genetic and environmental factors play a significant role in cardiovascular pathophysiology, making difficult to match a particular disease, with a single experimental model. Therefore, no exclusive method perfectly recreates the human complication, and depending on the model, additional considerations of cost, infrastructure, and the requirement for specialized personnel, should also have in mind. Considering all these facts, and depending on the budgets available, models should be selected that best reproduce the disease being investigated. Here we will describe models of atherothrombotic diseases, including expanding and occlusive animal models, as well as models of heart failure. Given the wide range of models available, today it is possible to devise the best strategy, which may help us to find more efficient and reliable solutions against human cardiovascular diseases.

Congenital and Acquired Valvular Heart Disease in Pregnancy.

Science.gov (United States)

Goldstein, Sarah A; Ward, Cary C

2017-08-24

The number of pregnancies complicated by valvular heart disease is increasing. This review describes the hemodynamic effects of clinically important valvular abnormalities during pregnancy and reviews current guideline-driven management strategies. Valvular heart disease in women of childbearing age is most commonly caused by congenital abnormalities and rheumatic heart disease. Regurgitant lesions are well tolerated, while stenotic lesions are associated with a higher risk of pregnancy-related complications. Management of symptomatic disease during pregnancy is primarily medical, with percutaneous interventions considered for refractory symptoms. Most guidelines addressing the management of valvular heart disease during pregnancy are based on case reports and observational studies. Additional investigation is required to further advance the care of this growing patient population.

Dengue virus requires the CC-chemokine receptor CCR5 for replication and infection development.

Science.gov (United States)

Marques, Rafael E; Guabiraba, Rodrigo; Del Sarto, Juliana L; Rocha, Rebeca F; Queiroz, Ana Luiza; Cisalpino, Daniel; Marques, Pedro E; Pacca, Carolina C; Fagundes, Caio T; Menezes, Gustavo B; Nogueira, Maurício L; Souza, Danielle G; Teixeira, Mauro M

2015-08-01

Dengue is a mosquito-borne disease that affects millions of people worldwide yearly. Currently, there is no vaccine or specific treatment available. Further investigation on dengue pathogenesis is required to better understand the disease and to identify potential therapeutic targets. The chemokine system has been implicated in dengue pathogenesis, although the specific role of chemokines and their receptors remains elusive. Here we describe the role of the CC-chemokine receptor CCR5 in Dengue virus (DENV-2) infection. In vitro experiments showed that CCR5 is a host factor required for DENV-2 replication in human and mouse macrophages. DENV-2 infection induces the expression of CCR5 ligands. Incubation with an antagonist prevents CCR5 activation and reduces DENV-2 positive-stranded (+) RNA inside macrophages. Using an immunocompetent mouse model of DENV-2 infection we found that CCR5(-/-) mice were resistant to lethal infection, presenting at least 100-fold reduction of viral load in target organs and significant reduction in disease severity. This phenotype was reproduced in wild-type mice treated with CCR5-blocking compounds. Therefore, CCR5 is a host factor required for DENV-2 replication and disease development. Targeting CCR5 might represent a therapeutic strategy for dengue fever. These data bring new insights on the association between viral infections and the chemokine receptor CCR5. © 2015 John Wiley & Sons Ltd.

Curcumin and autoimmune disease.

Science.gov (United States)

Bright, John J

2007-01-01

The immune system has evolved to protect the host from microbial infection; nevertheless, a breakdown in the immune system often results in infection, cancer, and autoimmune diseases. Multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease, myocarditis, thyroiditis, uveitis, systemic lupus erythromatosis, and myasthenia gravis are organ-specific autoimmune diseases that afflict more than 5% of the population worldwide. Although the etiology is not known and a cure is still wanting, the use of herbal and dietary supplements is on the rise in patients with autoimmune diseases, mainly because they are effective, inexpensive, and relatively safe. Curcumin is a polyphenolic compound isolated from the rhizome of the plant Curcuma longa that has traditionally been used for pain and wound-healing. Recent studies have shown that curcumin ameliorates multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease in human or animal models. Curcumin inhibits these autoimmune diseases by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways in immune cells. Although the beneficial effects of nutraceuticals are traditionally achieved through dietary consumption at low levels for long periods of time, the use of purified active compounds such as curcumin at higher doses for therapeutic purposes needs extreme caution. A precise understanding of effective dose, safe regiment, and mechanism of action is required for the use of curcumin in the treatment of human autoimmune diseases.

Emergency medical technician education and training.

Science.gov (United States)

Lauro, Joseph; Sullivan, Francis; Williams, Kenneth A

2013-12-03

Emergency Medical Services (EMS) training and education are vital and vibrant aspects of a young and evolving profession. This article provides a perspective on this effort in the United States and reviews current activity in Rhode Island.

Outcome Mapping Virtual Learning Community - Phase III | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Indeed, the OMLC affirmed its position as a vibrant community of practice ... a virtual space (www.outcomemapping.ca), and online interaction will be the key driver. ... communication technology (ICT) on social and human development is new ...

Information for Change 2011: Digital Publishing in West Africa ...

International Development Research Centre (IDRC) Digital Library (Canada)

There is a lively blog universe, and there is a vibrant multimedia and mixed media sector. ... region have been using digital production and work-flow technology for some years, ... Reality check: Will cellphones really solve Africa's problems?

77 FR 33595 - African-American Music Appreciation Month, 2012

Science.gov (United States)

2012-06-07

... United States of America A Proclamation As a long-cherished piece of American culture, music offers a vibrant soundtrack to the story of our people and our Union. At times when words alone could not bring us...

Streptococcus suis meningitis can require a prolonged treatment course

Directory of Open Access Journals (Sweden)

Jean Dejace

2017-12-01

Full Text Available We report a case of recrudescent Streptococcus suis meningitis requiring a prolonged treatment course. A few similar cases can be found in the burgeoning literature on what remains a relatively uncommon disease in humans, and these patients should be monitored carefully upon completion of therapy. Keywords: Meningitis, Relapse, Duration, Streptococcus suis

Filling the gap 115 years after Ronald Ross: the distribution of the Anopheles coluzzii and Anopheles gambiae s.s from Freetown and Monrovia, West Africa.

Directory of Open Access Journals (Sweden)

Dziedzom K de Souza

Full Text Available It was in Freetown, Sierra Leone, that the malaria mosquito Anopheles coastalis, now known as Anopheles gambiae, was first discovered as the vector of malaria, in 1899. That discovery led to a pioneering vector research in Sierra Leone and neighbouring Liberia, where mosquito species were extensively characterized. Unfortunately, the decade long civil conflicts of the 1990s, in both countries, resulted in a stagnation of the once vibrant research on disease vectors. This paper attempts to fill in some of the gaps on what is now known of the distribution of the sibling species of the An. gambiae complex, and especially the An. coluzzii and An. gambiae s.s, formerly known as the An. gambiae molecular M and S forms respectively, in the cities of Freetown and Monrovia.

Psychosocial impact of inherited and autoimmune blistering diseases

Directory of Open Access Journals (Sweden)

Swaranjali V. Jain, B Med Sci (Hons MD

2018-03-01

Full Text Available Inherited and autoimmune blistering diseases are rare, chronic, and often severe disorders that have the potential to significantly affect patients’ quality of life. The effective management of these conditions requires consideration of the physical, emotional, and social aspects of the disease. Self-esteem is integral to patients’ ability to cope with their illness, participate in treatment, and function in society. This article discusses quality-of-life studies of patients with blistering diseases with a particular focus on self-esteem issues that patients may face.

Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

Directory of Open Access Journals (Sweden)

Anna Weiss

2015-09-01

Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

Gaucher disease: haematological presentations and complications.

Science.gov (United States)

Thomas, Alison S; Mehta, Atul; Hughes, Derralynn A

2014-05-01

Gaucher disease (GD) is an autosomal recessive lysosomal storage disease, caused by deficiency of the enzyme glucocerebrosidase, required for the degradation of glycosphingolipids. Clinical manifestations include hepatosplenomegaly, thrombocytopenia, bone disease and a bleeding diathesis, frequently resulting in presentation to haematologists. Historically managed by splenectomy, transfusions and orthopaedic surgery, the development of specific therapy in the form of intravenous enzyme replacement therapy in the 1990s has resulted in dramatic improvements in haematological and visceral disease. Recognition of complications, including multiple myeloma and Parkinson disease, has challenged the traditional macrophage-centric view of the pathophysiology of this disorder. The pathways by which enzyme deficiency results in the clinical manifestations of this disorder are poorly understood; altered inflammatory cytokine profiles, bioactive sphingolipid derivatives and alterations in the bone marrow microenvironment have been implicated. Further elucidating these pathways will serve to advance our understanding not only of GD, but of associated disorders. © 2014 John Wiley & Sons Ltd.

Contribution of Neuroepigenetics to Huntington's Disease.

Science.gov (United States)

Francelle, Laetitia; Lotz, Caroline; Outeiro, Tiago; Brouillet, Emmanuel; Merienne, Karine

2017-01-01

Unbalanced epigenetic regulation is thought to contribute to the progression of several neurodegenerative diseases, including Huntington's disease (HD), a genetic disorder considered as a paradigm of epigenetic dysregulation. In this review, we attempt to address open questions regarding the role of epigenetic changes in HD, in the light of recent advances in neuroepigenetics. We particularly discuss studies using genome-wide scale approaches that provide insights into the relationship between epigenetic regulations, gene expression and neuronal activity in normal and diseased neurons, including HD neurons. We propose that cell-type specific techniques and 3D-based methods will advance knowledge of epigenome in the context of brain region vulnerability in neurodegenerative diseases. A better understanding of the mechanisms underlying epigenetic changes and of their consequences in neurodegenerative diseases is required to design therapeutic strategies more effective than current strategies based on histone deacetylase (HDAC) inhibitors. Researches in HD may play a driving role in this process.

Pediatric Non-Alcoholic Fatty Liver Disease

Directory of Open Access Journals (Sweden)

Haley Bush

2017-06-01

Full Text Available Abstract: With the increase in the prevalence of obesity, non-alcoholic fatty liver disease (NAFLD has become among the leading causes of chronic liver disease in the pediatric age group. Once believed to be a “two-hit process”, it is now clear that the actual pathophysiology of NAFLD is complex and involves multiple pathways. Moreover, NAFLD is not always benign, and patients with non-alcoholic steatohepatitis (NASH are at increased risk of developing advanced stages of liver disease. It has also been shown that NAFLD is not only a liver disease, but is also associated with multiple extrahepatic manifestations, including cardiovascular diseases, type 2 diabetes, and low bone mineral density. Although the data is scarce in the pediatric population, some studies have suggested that long-term mortality and the requirement of liver transplantation will continue to increase in patients with NAFLD. More studies are needed to better understand the natural history of NAFLD, especially in the pediatric age group.

Foodborne disease control: a transnational challenge.

Science.gov (United States)

Käferstein, F K; Motarjemi, Y; Bettcher, D W

1997-01-01

In the globalized political economy of the late 20th century, increasing social, political, and economic interdependence is occurring as a result of the rapid movement of people, images, values, and financial transactions across national borders. Another consequence of the increase in transnational trade, travel, and migration is the greater risk of cross-border transmission of infectious diseases. As the world becomes more interconnected, diseases spread more rapidly and effectively. With more than one million people crossing international borders every day, and with the globalization of food production, manufacturing, and marketing, the risk of infectious disease transmission is greater. Economic globalization has also increased the need for governmental budget austerity, and consequent national preparedness has been eroded. The emergence of new infectious diseases, as well as the reemergence of old ones, thus represents a crucial transnational policy issue. These problems cannot be resolved by national governments alone; they require international cooperation. This article analyzes the role of foodborne disease surveillance programs, nationally and internationally, in the control of foodborne diseases.

Coastal zone: Shelf-EEZ and land sea interface

Digital Repository Service at National Institute of Oceanography (India)

Desai, B.N.; Parulekar, A

Among the few vibrant ecotopes is the coastal zone, where multifaceted interactions among air, sea and land are dynamically balanced. An area of intense clash of interest of user community, the coastal zone harbouring vast potential of renewable...

Clinical Characteristics and Outcomes of Patients With Cellulitis Requiring Intensive Care

NARCIS (Netherlands)

Cranendonk, Duncan R.; van Vught, Lonneke A.; Wiewel, Maryse A.; Cremer, Olaf L.; Horn, Janneke; Bonten, Marc J.; Schultz, Marcus J.; van der Poll, Tom; Wiersinga, W. Joost

2017-01-01

Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis

Clinical Characteristics and Outcomes of Patients With Cellulitis Requiring Intensive Care

NARCIS (Netherlands)

Cranendonk, Duncan R; van Vught, Lonneke A; Wiewel, Maryse A; Cremer, Olaf L; Horn, Janneke; Bonten, Marc J; Schultz, Marcus J; van der Poll, Tom; Wiersinga, W Joost

Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing

Inhaled Antibiotic Therapy in Chronic Respiratory Diseases

Directory of Open Access Journals (Sweden)

Diego J. Maselli

2017-05-01

Full Text Available The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM. These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics. Subsequent research advances focused on the development of antibiotic agents able to achieve high tissue concentrations capable of reducing the bacterial load of difficult-to-treat organisms in hosts with chronic respiratory conditions. In this review, we focus on the evidence regarding the use of antibiotic therapies administered through the respiratory system via inhalation, nebulization or aerosolization, specifically in patients with chronic respiratory diseases that include CF, non-CF bronchiectasis and NTM. However, further research is required to address the potential benefits, mechanisms of action and applications of inhaled antibiotics for the management of difficult-to-treat infections in patients with chronic respiratory diseases.

White matter disease of the brain

International Nuclear Information System (INIS)

Melville, G.E.; Fernandez, R.E.; Kishore, P.R.S.; Lee, S.H.

1987-01-01

The white matter disorders that are discussed in this chapter are subdivided into those disorders within which there is breakdown of normal myelin, termed myelinoclastic, and those diseases involving either formation or maintenance of abnormal myeline, termed dysmyelinating. CT is a well-established technique for studying white matter disease. Magnetic resonance imaging (MRI) is a new noninvasive technique which has shown greater sensitivity to white matter abnormalities. However, because of the rarity of may white matter diseases coupled with limited availability of MR facilities, the MRI experience in evaluating these patients is not extensive yet. Some patients may not be suitable for MRI because of the longer period of patient immobility that is required to avoid motion artifacts

Gaucher disease and other storage disorders.

Science.gov (United States)

Grabowski, Gregory A

2012-01-01

In 1882, Philippe Gaucher described a 32-year-old woman with massive splenomegaly and unusually large cells in the spleen, which he called a "primary epithelioma of the spleen." The systemic nature and inheritance of the disease and its variants involving the viscera and CNS were described over the next century. The delineation of the causal enzymatic defects, genetics, molecular pathology, and genomics have provided pathogenic insights into the phenotypic spectrum and the bases for development of specific therapies for what is now known as Gaucher disease. As a prototype, the clinically and economically successful intracellular enzyme therapy provided the impetus for the expansion of similar research and therapeutic developments for other lysosomal storage diseases (LSDs) and orphan diseases, including Fabry, Pompe, and Niemann-Pick diseases, as well as several mucopolysaccharidoses. Continuing studies of such LSDs, which occur as a group in more than 7000 live births, have revealed the complex molecular interdigitation with the autophagy and apoptotic pathways and proteostasis and the impact of disruptions of the lysosomal/autophagy and proteostasis systems on more common diseases has been recognized. Examples include age-related neurodegenerative diseases (eg, Parkinson disease and Gaucher disease), idiopathic hypertrophic myocardiopathies, stroke and renal failure (eg, Fabry disease), and Nonalcoholic Fatty Liver Disease/Nonalcoholic SteatoHepatitis (NAFLD/NASH) and atherosclerosis (eg, lysosomal acid lipase deficiencies). Although perceived as rare, the availability of treatment and the impact of the LSDs on more common diseases require their integration into routine clinical practice.

Ebola virus disease: radiology preparedness.

Science.gov (United States)

Bluemke, David A; Meltzer, Carolyn C

2015-02-01

At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

Biomarker-driven phenotyping in Parkinson disease: a translational missing link in disease-modifying clinical trials

Science.gov (United States)

Espay, Alberto J.; Schwarzschild, Michael A.; Tanner, Caroline M.; Fernandez, Hubert H; Simon, David K.; Leverenz, James B.; Merola, Aristide; Chen-Plotkin, Alice; Brundin, Patrik; Kauffman, Marcelo A.; Erro, Roberto; Kieburtz, Karl; Woo, Daniel; Macklin, Eric A.; Standaert, David G.; Lang, Anthony E.

2016-01-01

Past clinical trials of putative neuroprotective therapies have targeted Parkinson disease (PD) as a single pathogenic disease entity. From an Oslerian clinico-pathologic perspective, the wide complexity of PD converges into Lewy bodies and justifies a reductionist approach to PD: a single-mechanism therapy can affect most of those sharing the classic pathologic hallmark. From a systems-biology perspective, PD is a group of disorders that, while related by sharing the feature of nigral dopamine-neuron degeneration, exhibit unique genetic, biological and molecular abnormalities, which probably respond differentially to a given therapeutic approach, particularly for strategies aimed at neuroprotection. Under this model, only biomarker-defined, homogenous subtypes of PD are likely to respond optimally to therapies proven to affect the biological processes within each subtype. Therefore, we suggest that precision medicine applied to PD requires a reevaluation of the biomarker-discovery effort. This effort is currently centered on correlating biological measures to clinical features of PD and on identifying factors that predict whether various prodromal states will convert into the classical movement disorder. We suggest, instead, that subtyping of PD requires the reverse view, where abnormal biological signals (i.e., biomarkers) rather than clinical definitions are used to define disease phenotypes. Successful development of disease-modifying strategies will depend on how relevant the specific biological processes addressed by an intervention are to the pathogenetic mechanisms in the subgroup of targeted patients. This precision-medicine approach will likely yield smaller but well-defined subsets of PD amenable to successful neuroprotection. PMID:28233927

Elimination of neglected diseases in latin america and the Caribbean: a mapping of selected diseases.

Directory of Open Access Journals (Sweden)

Maria Cristina Schneider

2011-02-01

Full Text Available In Latin America and the Caribbean, around 195 million people live in poverty, a situation that increases the burden of some infectious diseases. Neglected diseases, in particular, are often restricted to poor, marginalized sections of the population. Tools exist to combat these diseases, making it imperative to work towards their elimination. In 2009, the Pan American Health Organization (PAHO received a mandate to support the countries in the Region in eliminating neglected diseases and other poverty-related infections. The objective of this study is to analyze the presence of selected diseases using geo-processing techniques. Five diseases with information available at the first sub-national level (states were mapped, showing the presence of the disease ("hotspots" and overlap of diseases ("major hotspots". In the 45 countries/territories (approximately 570 states of the Region, there is: lymphatic filariasis in four countries (29 states, onchocerciasis in six countries (25 states, schistosomiasis in four countries (39 states, trachoma in three countries (29 states, and human rabies transmitted by dogs in ten countries (20 states. Of the 108 states with one or more of the selected diseases, 36 states present the diseases in overlapping areas ("major hotspots". Additional information about soil-transmitted helminths was included. The analysis suggests a majority of the selected diseases are not widespread and can be considered part of an unfinished agenda with elimination as a goal. Integrated plans and a comprehensive approach, ensuring access to existing diagnostic and treatment methods, and establishing a multi-sectoral agenda that addresses social determinants, including access to adequate water and sanitation, are required. Future studies can include additional diseases, socio-economic and environmental variables.

Elimination of neglected diseases in latin america and the Caribbean: a mapping of selected diseases.

Science.gov (United States)

Schneider, Maria Cristina; Aguilera, Ximena Paz; Barbosa da Silva Junior, Jarbas; Ault, Steven Kenyon; Najera, Patricia; Martinez, Julio; Requejo, Raquel; Nicholls, Ruben Santiago; Yadon, Zaida; Silva, Juan Carlos; Leanes, Luis Fernando; Periago, Mirta Roses

2011-02-15

In Latin America and the Caribbean, around 195 million people live in poverty, a situation that increases the burden of some infectious diseases. Neglected diseases, in particular, are often restricted to poor, marginalized sections of the population. Tools exist to combat these diseases, making it imperative to work towards their elimination. In 2009, the Pan American Health Organization (PAHO) received a mandate to support the countries in the Region in eliminating neglected diseases and other poverty-related infections. The objective of this study is to analyze the presence of selected diseases using geo-processing techniques. Five diseases with information available at the first sub-national level (states) were mapped, showing the presence of the disease ("hotspots") and overlap of diseases ("major hotspots"). In the 45 countries/territories (approximately 570 states) of the Region, there is: lymphatic filariasis in four countries (29 states), onchocerciasis in six countries (25 states), schistosomiasis in four countries (39 states), trachoma in three countries (29 states), and human rabies transmitted by dogs in ten countries (20 states). Of the 108 states with one or more of the selected diseases, 36 states present the diseases in overlapping areas ("major hotspots"). Additional information about soil-transmitted helminths was included. The analysis suggests a majority of the selected diseases are not widespread and can be considered part of an unfinished agenda with elimination as a goal. Integrated plans and a comprehensive approach, ensuring access to existing diagnostic and treatment methods, and establishing a multi-sectoral agenda that addresses social determinants, including access to adequate water and sanitation, are required. Future studies can include additional diseases, socio-economic and environmental variables.

International consensus on Vibrant Soundbridge(R) implantation in children and adolescents.

NARCIS (Netherlands)

Cremers, C.W.R.J.; O'Connor, A.F.; Helms, J.; Roberson, J.; Claros, P.; Frenzel, H.; Profant, M.; Schmerber, S.; Streitberger, C.; Baumgartner, W.D.; Orfila, D.; Pringle, M.; Cenjor, C.; Giarbini, N.; Jiang, D.; Snik, A.F.M.

2010-01-01

OBJECTIVE: Active middle ear implants augment hearing in patients with sensorineural, conductive, and mixed hearing losses with great success. However, the application of active middle ear implants has been restricted to compromised ears in adults only. Recently, active middle ear implants have been

Creating a vibrant innovation ecosystem : the High Tech Campus Eindhoven case

NARCIS (Netherlands)

Romme, A.G.L.

2017-01-01

The High Tech Campus Eindhoven is a campus-based ecosystem for high-tech R&D, located in the city of Eindhoven (Netherlands). It is currently home to more than 140 companies and institutions, involving more than 10,000 product developers, researchers, entrepreneurs, and service providers. The

Olympic opening ceremony was a vibrant feast of fun and energy.

Science.gov (United States)

Crawford, Linda

2012-08-08

If director Danny Boyle's intention at the Olympic opening ceremony was to provide a snapshot of Britain today, he succeeded. It was an inspired feast of energy, colour and vibrancy - as well as being great fun.

Diagnosis and management of Crohn's disease.

Science.gov (United States)

Wilkins, Thad; Jarvis, Kathryn; Patel, Jigneshkumar

2011-12-15

Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn's disease include osteoporosis, inflammatory arthropathies, scleritis, nephrolithiasis, cholelithiasis, and erythema nodosum. Acute phase reactants, such as C-reactive protein level and erythrocyte sedimentation rate, are often increased with inflammation and may correlate with disease activity. Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status. Colonoscopy with ileoscopy, capsule endoscopy, computed tomography enterography, and small bowel follow-through are often used to diagnose Crohn's disease. Ultrasonography, computed axial tomography, scintigraphy, and magnetic resonance imaging can assess for extraintestinal manifestations or complications (e.g., abscess, perforation). Mesalamine products are often used for the medical management of mild to moderate colonic Crohn's disease. Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment. Patients with moderate to severe Crohn's disease are treated with corticosteroids, azathioprine, 6-mercaptopurine, or anti-tumor necrosis factor agents (e.g., infliximab, adalimumab). Severe disease may require emergent hospitalization and a multidisciplinary approach with a family physician, gastroenterologist, and surgeon.

Coeliac disease: to biopsy or not?

Science.gov (United States)

Reilly, Norelle R; Husby, Steffen; Sanders, David S; Green, Peter H R

2018-01-01

Coeliac disease is increasingly recognized as a global problem in both children and adults. Traditionally, the findings of characteristic changes of villous atrophy and increased intraepithelial lymphocytosis identified in duodenal biopsy samples taken during upper gastrointestinal endoscopy have been required for diagnosis. Although biopsies remain advised as necessary for the diagnosis of coeliac disease in adults, European guidelines for children provide a biopsy-sparing diagnostic pathway. This approach has been enabled by the high specificity and sensitivity of serological testing. However, these guidelines are not universally accepted. In this Perspective, we discuss the pros and cons of a biopsy-avoiding pathway for the diagnosis of coeliac disease, especially in this current era of the call for more biopsies, even from the duodenal bulb, in the diagnosis of coeliac disease. In addition, a contrast between paediatric and adult guidelines is presented.

Virtual Surgery in Congenital Heart Disease

DEFF Research Database (Denmark)

Sørensen, Thomas Sangild; Mosegaard, Jesper; Kislinskiy, Stefan

2014-01-01

et al., Cardiol Young 13:451–460, 2003). In combination with the availability of virtual models of congenital heart disease (CHD), techniques for computer- based simulation of cardiac interventions have enabled early clinical exploration of the emerging concept of virtual surgery (Sorensen et al...... Teaching, diagnosing, and planning of therapy in patients with complex structural cardiovascular heart disease require profound understanding of the three-dimensional (3D) nature of cardiovascular structures in these patients. To obtain such understanding, modern imaging modalities provide high...

Micronutrients in the life cycle: Requirements and sufficient supply

Directory of Open Access Journals (Sweden)

K. Biesalski Hans

2018-06-01

Full Text Available Macronutrients (fat, protein, carbohydrates deliver energy and important material to ensure the entire body composition. Micronutrients are needed to keep this process of continuous construction and re-construction running. Consequently, the requirement for micronutrients will differ depending on the individual need which is related to the different metabolic conditions within the life cycle. Within the first 1000 days of life, from conception to the end of the second year of life the requirement for micronutrients is high and if the supply is inadequate that might have consequences for physical and at least cognitive development. In particular, iron, iodine, vitamin D and folate are micronutrients which might become critical during that period. Due to the fact that clinical symptoms of deficiencies develop late, but inadequate supply of one or more micronutrients may have consequences for health the term hidden hunger has been introduced to describe that situation. In particular the time period of pregnancy and early childhood is critical and hidden hunger is a worldwide problem, affecting >2 billion people, primarily females and children. The importance of different requirements during the life cycle is usually not considered. In addition, we do not really know what the individual requirement is. The estimation of the requirement is based on studies calculating the supply of a micronutrient to avoid a deficiency disease within a healthy population and is not based on sound scientific methodology or data. We need to consider that at different moments in the life cycle the supply might become critical in particular in case of a disease or sudden increase of metabolic turnover. In this narrative review we summarize data from studies dealing with different micronutrient requirements in pregnancy, exercise, vegan diet, adolescents and elderly. Knowledge of critical periods and related critical micronutrients might help to avoid hidden hunger and

Disease-Related Detection with Electrochemical Biosensors: A Review.

Science.gov (United States)

Huang, Ying; Xu, Jin; Liu, Junjie; Wang, Xiangyang; Chen, Bin

2017-10-17

Rapid diagnosis of diseases at their initial stage is critical for effective clinical outcomes and promotes general public health. Classical in vitro diagnostics require centralized laboratories, tedious work and large, expensive devices. In recent years, numerous electrochemical biosensors have been developed and proposed for detection of various diseases based on specific biomarkers taking advantage of their features, including sensitivity, selectivity, low cost and rapid response. This article reviews research trends in disease-related detection with electrochemical biosensors. Focus has been placed on the immobilization mechanism of electrochemical biosensors, and the techniques and materials used for the fabrication of biosensors are introduced in details. Various biomolecules used for different diseases have been listed. Besides, the advances and challenges of using electrochemical biosensors for disease-related applications are discussed.

Magnetic resonance imaging of valvular heart disease

DEFF Research Database (Denmark)

Søndergaard, Lise; Ståhlberg, F; Thomsen, C

1999-01-01

The optimum management of patients with valvular heart diseases requires accurate and reproducible assessment of the valvular lesion and its hemodynamic consequences. Magnetic resonance imaging (MRI) techniques, such as volume measurements, signal-void phenomena, and velocity mapping, can be used...... in an integrated approach to gain qualitative and quantitative information on valvular heart disease as well as ventricular dimensions and functions. Thus, MRI may be advantageous to the established diagnostic tools in assessing the severity of valvular heart disease as well as monitoring the lesion and predicting...... the optimal timing for valvular surgery. This paper reviews the validation of these MRI techniques in assessing valvular heart disease and discusses some typical pitfalls of the techniques, including suggestions for solutions.J. Magn. Reson. Imaging 1999;10:627-638....

Satisfying regulatory and accreditation requirements for quality control.

Science.gov (United States)

Ehrmeyer, Sharon S

2013-03-01

The Clinical Laboratory Improvement Amendments of 1988 (CLIA) requires all US clinical laboratories that test "materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease..." to be regulated. The CLIA mandates are site neutral; based on test complexity; and focus on the three phases of the testing process (preanalytical, analytical, and postanalytical). Many testing sites choose to meet the CLIA requirements by following the testing standards of a professional accreditation organization deemed by the Centers for Medicare and Medicaid Services. The three principal organizations are The Joint Commission, the College of American Pathologists, and COLA. Copyright © 2013 Elsevier Inc. All rights reserved.

Presentation to the Manitoba ethanol advisory panel

International Nuclear Information System (INIS)

2002-01-01

The Manitoba Chambers of Commerce, representing the entire spectrum of businesses from all regions of Manitoba, has long advocated for alternative fuels based on agricultural products. Some of the major questions that must be answered in this debate on the ethanol industry in Manitoba are: (1) What are the benefits of a vibrant ethanol industry? (2) What are the facts about ethanol, and are those facts getting out to the public? (3) and How do we foster a vibrant ethanol industry in Manitoba? This document places the emphasis on the third issue raised. The Manitoba Chambers of Commerce endorses the idea of a mandated blend of ethanol. It also believes that Manitoba should maintain its gasoline tax-gasohol preference. The Manitoba Chambers of Commerce recommends against the government controlling the size and number of ethanol facilities in the province. It also recommends that funding not be afforded to the creation of new programs designed for the specific purpose of providing financial assistance to the ethanol industry. Government awareness campaigns should be limited to issues within the public interest, dealing with environmental and consumer issues and benefits. The government should commit to the enhancement of the vitality of new generation cooperatives (NGCs) in Manitoba. Emphasis by the government should be placed on ensuring that the required infrastructure and partnerships are in place to foster the development and commercialization of innovations in this field. The Manitoba Chambers of Commerce recommended that the provincial government facilitate partnerships through the sponsoring of provincial conferences, while pursuing its partnership efforts with the federal and other provincial governments

[Infectious diseases - a specialty of internal medicine].

Science.gov (United States)

Fätkenheuer, G; Jung, N; Kern, W V; Fölsch, U R; Salzberger, B

2018-04-01

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

SHELL DISEASES AND TOXINS REGULATED BY LAW

Directory of Open Access Journals (Sweden)

Natalija Topić Popović

1999-06-01

Full Text Available There is a long tradition of cultivating shells in Croatia, and the shell industry has a good perspective of further development. Since shells are delicate organisms that require special breeding conditions and climate, they are also subject to many diseases. Bonamiosis, haplospioridiosis, marteiliosis, microcytosis and perkinsosis are stated by the International Bureau for Epizootics as shell diseases that, in keeping with law, must be reported, and iridovirosis as a disease of a potential international importance. The same diseases are regulated by the Veterinary Law from 1997 as infectious diseases prevention of which is of an interest for the Republic of Croatia. Although, according to the law, it does not have to be prevented, in this article the disease Mytilicola is also described. According to the Health Department Statute from 1994, eatable part of shells are being tested for toxins of some marine dinoflagelates that can damage human health, and these are PSP (Paralytic Shellfish Poison, DSP (Diarrhoeic Shellfish Poison and NSP (Neuroparalytic Shellfish Poison.

7 CFR 205.206 - Crop pest, weed, and disease management practice standard.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Crop pest, weed, and disease management practice... Requirements § 205.206 Crop pest, weed, and disease management practice standard. (a) The producer must use management practices to prevent crop pests, weeds, and diseases including but not limited to: (1) Crop...

Cost of illness of Crohn's disease.

Science.gov (United States)

Bodger, Keith

2002-01-01

Crohn's disease is a chronic inflammatory bowel disease of unknown aetiology which affects around 35,000 people in the UK (population 56.8 million). The potential for onset in early adult life, disease chronicity and a need for hospitalisation and surgery mean that the disease can be associated with substantial healthcare costs. Cost-of-illness studies focusing on direct medical costs have identified that over half the average costs associated with the disease relate to hospital costs. Estimates of the contribution of drug costs to the total direct economic burden have varied between 4.6 and 25%. Figures for average annual direct costs per patient in the US have been put at between US dollars 6561 (1990 values) and US dollars 12,417 (1994 values), whereas European studies have given much lower cost estimates (US dollars 655, 1994 values). However, all studies have highlighted that much of the total cost of illness relates to extensive interventions required by a small proportion of severely affected individuals. Indirect costs associated with reduced productivity in Crohn's disease can be high, with long periods of absenteeism and early disability. However, most patients (90%) remain in the workforce and life expectancy is relatively normal. A variety of drugs are employed for the treatment of Crohn's disease, both in an attempt to induce clinical remission in active disease and to maintain remission once this has been achieved. Comparative data on cost effectiveness is lacking, though crude estimates based on randomised trials suggest that the frequently prescribed aminosalicylates, which have only modest efficacy, are a relatively costly drug option. The costs associated with adverse drug effects, particularly for corticosteroids, have not been formally quantified. Despite high costs, new drug therapies for more severe disease, such as anti-tumour necrosis factor (TNF-alpha) antibodies, may prove a cost-effective option if the need for hospitalisation is reduced

Weathering the storm: Improving therapeutic interventions for cytokine storm syndromes by targeting disease pathogenesis.

Science.gov (United States)

Weaver, Lehn K; Behrens, Edward M

2017-03-01

Cytokine storm syndromes require rapid diagnosis and treatment to limit the morbidity and mortality caused by the hyperinflammatory state that characterizes these devastating conditions. Herein, we discuss the current knowledge that guides our therapeutic decision-making and personalization of treatment for patients with cytokine storm syndromes. Firstly, ICU-level supportive care is often required to stabilize patients with fulminant disease while additional diagnostic evaluations proceed to determine the underlying cause of cytokine storm. Pharmacologic interventions should be focused on removing the inciting trigger of inflammation and initiation of an individualized immunosuppressive regimen when immune activation is central to the underlying disease pathophysiology. Monitoring for a clinical response is required to ensure that changes in the therapeutic regimen can be made as clinically warranted. Escalation of immunosuppression may be required if patients respond poorly to the initial therapeutic interventions, while a slow wean of immunosuppression in patients who improve can limit medication-related toxicities. In certain scenarios, a decision must be made whether an individual patient requires hematopoietic cell transplantation to prevent recurrence of disease. Despite these interventions, significant morbidity and mortality remains for cytokine storm patients. Therefore, we use this review to propose a clinical schema to guide current and future attempts to design rational therapeutic interventions for patients suffering from these devastating conditions, which we believe speeds the diagnosis of disease, limits medication-related toxicities, and improves clinical outcomes by targeting the heterogeneous and dynamic mechanisms driving disease in each individual patient.

Retrieval of radiology reports citing critical findings with disease-specific customization.

Science.gov (United States)

Lacson, Ronilda; Sugarbaker, Nathanael; Prevedello, Luciano M; Ivan, Ip; Mar, Wendy; Andriole, Katherine P; Khorasani, Ramin

2012-01-01

Communication of critical results from diagnostic procedures between caregivers is a Joint Commission national patient safety goal. Evaluating critical result communication often requires manual analysis of voluminous data, especially when reviewing unstructured textual results of radiologic findings. Information retrieval (IR) tools can facilitate this process by enabling automated retrieval of radiology reports that cite critical imaging findings. However, IR tools that have been developed for one disease or imaging modality often need substantial reconfiguration before they can be utilized for another disease entity. THIS PAPER: 1) describes the process of customizing two Natural Language Processing (NLP) and Information Retrieval/Extraction applications - an open-source toolkit, A Nearly New Information Extraction system (ANNIE); and an application developed in-house, Information for Searching Content with an Ontology-Utilizing Toolkit (iSCOUT) - to illustrate the varying levels of customization required for different disease entities and; 2) evaluates each application's performance in identifying and retrieving radiology reports citing critical imaging findings for three distinct diseases, pulmonary nodule, pneumothorax, and pulmonary embolus. Both applications can be utilized for retrieval. iSCOUT and ANNIE had precision values between 0.90-0.98 and recall values between 0.79 and 0.94. ANNIE had consistently higher precision but required more customization. Understanding the customizations involved in utilizing NLP applications for various diseases will enable users to select the most suitable tool for specific tasks.

Patients with Treatment-Requiring Chronic Graft versus Host Disease after Allogeneic Stem Cell Transplantation Have Altered Metabolic Profiles due to the Disease and Immunosuppressive Therapy: Potential Implication for Biomarkers

Directory of Open Access Journals (Sweden)

Håkon Reikvam

2018-01-01

Full Text Available Chronic graft versus host disease (cGVHD is a common long-term complication after allogeneic hematopoietic stem cell transplantation. The objective of our study was to compare the metabolic profiles for allotransplant recipients and thereby identify metabolic characteristics of patients with treatment-requiring cGVHD. The study included 51 consecutive patients (29 men and 22 women; median age: 44 years, range: 15–66 years transplanted with peripheral blood stem cells derived from human leukocyte antigen-matched family donors. All serum samples investigated by global metabolomic profiling were collected approximately 1 year posttransplant (median 358 days. Thirty-one of the 51 patients (61% had cGVHD 1 year posttransplant. The affected organs were (number of patients liver/bile duct (23, eyes (15, gastrointestinal tract (14, skin (13, mouth (10, lungs (3, and urogenital tract (1. We compared the metabolic profile for patients with and without cGVHD, and a Random Forrest Classification Analysis then resulted in 75% accuracy in differentiating the two groups. The 30 top-ranked metabolites from this comparison included increased levels of bile acids, several metabolites from the cytokine-responsive kynurenine pathway for tryptophan degradation, pro-inflammatory lipid metabolites, phenylalanine and tyrosine metabolites derived from the gut microbial flora, and metabolites reflecting increased oxidative stress. However, nine of these 30 top-ranked metabolites were probably altered due to cyclosporine or steroid treatment, and we therefore did a hierarchical clustering analysis including all 51 patients but only based on the other 21 cGVHD-specific metabolites. This analysis identified three patient subsets: one cluster included mainly patients without cGVHD and had generally low metabolite levels; another cluster included mainly patients with cGVHD (most patients with at least three affected organs and high metabolite levels, and the last

The critical role of social workers in home-based primary care.

Science.gov (United States)

Reckrey, Jennifer M; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine

2014-01-01

The growing homebound population has many complex biomedical and psychosocial needs and requires a team-based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The Mount Sinai Visiting Doctors Program (MSVD), a large interdisciplinary home-based primary care program in New York City, has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers' individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home-based clinical programs is essential in the interdisciplinary care of our most needy patients.

Local seed businesses in Uganda: a market-oriented approach towards community seed production

NARCIS (Netherlands)

Mastenbroek, A.

2015-01-01

The integrated seed sector development (ISSD) programme aims to improve food security and economic development, by providing smallholder farmers with sustainable access to quality seed of superior varieties. The specific objective of the programme is to create a vibrant, pluralistic and

Language, Learners and Levels. Progression and Variation

NARCIS (Netherlands)

Haan, P.J.M. de; Vries, C.M. de; Vuuren, S. van

2017-01-01

Learner Corpus Research (LCR) is a vibrant discipline, which combines methodological rigour in the analysis of authentic learner data with a focus on practical pedagogical application. Following earlier successful conferences in Louvain and Bergen, the third LCR conference, hosted by Radboud

Neuroethik – Geschichte, Definition und Gegenstandsbereich eines neuen Wissenschaftsgebiets

NARCIS (Netherlands)

Müller, Sabine; Bittlinger, Merlin; Brukamp, Kirsten; Christen, Markus; Friedrich, Orsolya; Gruber, M. C.; Leefmann, Jon; Merkel, Grischa; Nagel, Saskia K.; Stier, Marco; Jox, Ralf J.

2018-01-01

Definition of the problem: Fifteen years after establishing neuroethics as an international academic field, neuroethics has emerged as a vibrant, dynamic area of scientific research. Arguments: Within a short period of a few years, specific conferences, journals, research funding programs,

Soft Power in Indian Foreign Policy

International Development Research Centre (IDRC) Digital Library (Canada)

2011-09-03

Sep 3, 2011 ... ... its vibrant (if at times chaotic) democracy, its free media, ... poverty, social challenge and internal v iolence, is .... available in other Asian tourist desti nations, and the .... being motivated above all by the search for markets ...

Linkage between psychological contract and employee retention ...

African Journals Online (AJOL)

... initiating organizational culture that promotes transparency on policies and procedures that effect employees and creating a humane work environment that accommodates cooperation, consensus and employees' participation. This is necessary if organizations need to maintain their vibrant and resourceful workforce that ...

Revising the South African guidelines for human settlement planning and design (the red book)

CSIR Research Space (South Africa)

Van Niekerk, Willemien

2015-11-01

Full Text Available The Guidelines for Human Settlement Planning and Design, commonly known as the Red Book, is a South African publication aimed at providing practical guidance to built environment professionals in support of the creation of sustainable and vibrant...

Towards One Health disease surveillance: The Southern African Centre for Infectious Disease Surveillance approach

Directory of Open Access Journals (Sweden)

Esron D. Karimuribo

2012-06-01

Full Text Available Africa has the highest burden of infectious diseases in the world and yet the least capacity for its risk management. It has therefore become increasingly important to search for ‘fit-for- purpose’ approaches to infectious disease surveillance and thereby targeted disease control. The fact that the majority of human infectious diseases are originally of animal origin means we have to consider One Health (OH approaches which require inter-sectoral collaboration for custom-made infectious disease surveillance in the endemic settings of Africa. A baseline survey was conducted to assess the current status and performance of human and animal health surveillance systems and subsequently a strategy towards OH surveillance system was developed. The strategy focused on assessing the combination of participatory epidemiological approaches and the deployment of mobile technologies to enhance the effectiveness of disease alerts and surveillance at the point of occurrence, which often lies in remote areas. We selected three study sites, namely the Ngorongoro, Kagera River basin and Zambezi River basin ecosystems. We have piloted and introduced the next-generation Android mobile phones running the EpiCollect application developed by Imperial College to aid geo-spatial and clinical data capture and transmission of this data from the field to the remote Information Technology (IT servers at the research hubs for storage, analysis, feedback and reporting. We expect that the combination of participatory epidemiology and technology will significantly improve OH disease surveillance in southern Africa.

Towards one health disease surveillance: the Southern African Centre for Infectious Disease Surveillance approach.

Science.gov (United States)

Karimuribo, Esron D; Sayalel, Kuya; Beda, Eric; Short, Nick; Wambura, Philemon; Mboera, Leonard G; Kusiluka, Lughano J M; Rweyemamu, Mark M

2012-06-20

Africa has the highest burden of infectious diseases in the world and yet the least capacity for its risk management. It has therefore become increasingly important to search for 'fit-for- purpose' approaches to infectious disease surveillance and thereby targeted disease control. The fact that the majority of human infectious diseases are originally of animal origin means we have to consider One Health (OH) approaches which require inter-sectoral collaboration for custom-made infectious disease surveillance in the endemic settings of Africa. A baseline survey was conducted to assess the current status and performance of human and animal health surveillance systems and subsequently a strategy towards OH surveillance system was developed. The strategy focused on assessing the combination of participatory epidemiological approaches and the deployment of mobile technologies to enhance the effectiveness of disease alerts and surveillance at the point of occurrence, which often lies in remote areas. We selected three study sites, namely the Ngorongoro, Kagera River basin and Zambezi River basin ecosystems. We have piloted and introduced the next-generation Android mobile phones running the EpiCollect application developed by Imperial College to aid geo-spatial and clinical data capture and transmission of this data from the field to the remote Information Technology (IT) servers at the research hubs for storage, analysis, feedback and reporting. We expect that the combination of participatory epidemiology and technology will significantly improve OH disease surveillance in southern Africa.

Chronic parotitis: a challenging disease entity.

Science.gov (United States)

Harbison, John M; Liess, Benjamin D; Templer, Jerry W; Zitsch, Robert P; Wieberg, Jessica A

2011-03-01

Chronic parotitis is a troubling clinical condition characterized by repeated infection and inflammation of the parotid gland caused by decreased salivary flow or obstruction. Unilateral swelling, pain, and other associated symptoms occur during acute exacerbations of the disease. A variety of laboratory and radiographic tools are available to aid in the diagnosis. Multiple treatment options have been proposed, ranging from conservative medical management to surgical interventions. We present 2 patients with bilateral chronic parotitis who attempted prolonged medical management and ultimately required surgical parotidectomy for control of their disease.

A view on sphingolipids and disease.

Science.gov (United States)

Kolter, Thomas

2011-09-01

Sphingolipid and glycosphingolipid levels and expression of sphingolipid metabolizing enzymes are altered in a variety of diseases or in response to drug treatment. Inherited defects of enzymes and other proteins required for the lysosomal degradation of these lipids lead to human sphingolipidoses. Also genetic defects that affect sphingolipid biosynthesis are known. Although the molecular details are often far from clear, (glyco)sphingolipids have been implicated to play a role in atherosclerosis, insulin resistance, cancer, and infections by pathogens. More general aspects of selected diseases are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Can we Predict Disease Course with Clinical Factors?

Science.gov (United States)

Vegh, Zsuzsanna; Kurti, Zsuzsanna; Golovics, Petra A; Lakatos, Peter L

2018-01-01

The disease phenotype at diagnosis and the disease course of Crohn's disease (CD) and ulcerative colitis (UC) show remarkable heterogeneity across patients. This review aims to summarize the currently available evidence on clinical and some environmental predictive factors, which clinicians should evaluate in the everyday practice together with other laboratory and imaging data to prevent disease progression, enable a more personalized therapy, and avoid negative disease outcomes. In recent population-based epidemiological and referral cohort studies, the evolution of disease phenotype of CD and UC varied significantly. Most CD and severe UC patients still require hospitalization or surgery/colectomy during follow-up. A change in the natural history of inflammatory bowel diseases (IBD) with improved outcomes in parallel with tailored positioning of aggressive immunomodulator and biological therapy has been suspected. According to the currently available literature, it is of major importance to refer IBD cases at risk for adverse disease outcomes as early during the disease course as possible. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Differentiating Crohn's disease from intestinal tuberculosis at ...

African Journals Online (AJOL)

patients with non-caseating granulomas, as these suggest a very real possibility of ITB. ... There were no significant differences in smoking status, symptom duration or perianal disease. ..... CD, requires a degree of immune competence. This is ...

Eliminating Hairy Cell Leukemia Minimal Residual Disease

Science.gov (United States)

In this trial, patients with hairy cell leukemia who have disease-related symptoms that require treatment will be randomly assigned to receive cladribine with either concurrent rituximab or rituximab at least 6 months after completing cladribine therapy.

Feline heartworm disease

International Nuclear Information System (INIS)

Holmes, R.A.

1993-01-01

The recognition of heartworm (Dirofilaria immitis) infection in cats is increasing. In general, clinical signs displayed by cats are vague and can easily be confused with other respiratory or gastrointestinal disorders. As more data are gathered on feline heartworm disease, it is becoming apparent that cats respond to heartworms in a fashion uniquely different from dogs. Therefore, diagnostic and therapeutic methods that have been extrapolated from canine heartworm disease require modification to be applied to cats. Although no adulticide or microfilaricide drugs or preventives have been approved by the Food and Drug Administration, literature that describes treatment methods is becoming available. Because of the toxicity of thiacetarsamide sodium in cats, symptomatic, supportive treatment may be most appropriate for elimination of adult worms. As with dogs, the macrolide antibiotics (ivermectin and milbemycin oxime) seem to be efficacious as microfilaricides and preventives

Gaucher disease. Unusual presentation and mini-review.

Science.gov (United States)

Rizk, Tamer M; Ariganjoye, Rafiu O; Alsaeed, Gihad I

2015-07-01

We aim to describe an 8-year-old boy with an unusual clinical presentation of Gaucher disease (GD). Gaucher disease is a progressive lysosomal storage disorder due to deficiency of the specific enzyme glucocerebrosidase with varying clinical features, but often involving the monocytes-macrophages systems. This child ran a progressive course with a devastating outcome. Three distinct GD subtypes have been described with varying clinical features based on the presence or absence of neurologic involvement. Gaucher disease diagnosis is obtained via: enzyme activity assay, gene mutation study, bone marrow aspiration in addition to multiple other tests that have been successfully used in diagnosis of cases of GD. Treatment modalities include enzyme replacement treatment, substrate reduction therapy, bone marrow transplantation, blood transfusion, and surgery are available management modalities for GD. Gaucher disease is a chronic disease requiring a multidisciplinary team approach with regular follow up with multiple subspecialties.

The role of ADAMs in disease pathophysiology.

LENUS (Irish Health Repository)

Duffy, Michael J

2012-02-01

The ADAMs are a family of multidomain transmembrane and secreted proteins involved in both proteolysis and cell adhesion. Altered expression of specific ADAMs is implicated in the pathophysiology of several diseases including rheumatoid arthritis, Alzheimer\\'s disease, cardiac hypertrophy, asthma and cancer. Of these different diseases, it is in cancer where most research has been carried out. Multiple ADAMs, including ADAM-9, ADAM-10, ADAM-12, ADAM-15 and ADAM-17, have been shown to play a role in either cancer formation or progression. Consistent with these findings, increased expression of specific ADAMs in several cancer types was found to correlate with features of aggressive disease and poor prognosis. Currently, selective ADAM inhibitors against ADAM-10 and ADAM-17 are undergoing clinical trials for the treatment of cancer. Further work is required in order to establish a causative role for ADAMs in rheumatoid arthritis, Alzheimer\\'s disease, cardiac hypertrophy and asthma.

An Unusual Cause of Postaural Swelling: Kimura’s Disease

Directory of Open Access Journals (Sweden)

Purodha Prasad

2017-07-01

Full Text Available Introduction: Kimura’s disease (KD is an allergic inflammatory disorder of unknown etiology endemic in Orientals. Kimura’s disease was first mentioned by Kimm and Szeto in China in 1937. Kimura’s disease is commonly encountered in Asia and is mostly reported in Japan, China, Singapore and Honkong. However, only a few cases have been reported in the Indian subcontinent. Case Report: A case of Kimura’s disease in a young male managed by surgery is reported in addition to a literature review. Conclusion: Diagnosis is made on the basis of histopathological analysis, clinical presentation, and laboratory investigations. Long term follow-up is required as Kimura’s disease is prone for recurrence.

Mediterranean diet recommended not only in cardiovascular diseases

Directory of Open Access Journals (Sweden)

Małgorzata Chudzińska

2017-06-01

Full Text Available The Mediterranean diet is characterized by high consumption of vegetables, fruits,  cereals, nuts, olive oil (rich in monounsaturated fatty acids, fish (rich in Omega - 3 fatty acids and moderate consumption of dry red wine. The positive impact of the diet on life expectancy and cardiovascular disease has been widely discussed, but further studies prove that it is also beneficial in supporting treatment of other civilization diseases such as diabetes, obesity, cancer, infertility and neurodegenerative or autoimmune diseases. Although certain studies on the effects of the Mediterranean diet still require further action, they undoubtedly give hope that the proper nutrition can have a significant impact on the prevention and treatment of civilization diseases.

Rhizoctonia disease of tulip : characterization and dynamics of the pathogens

NARCIS (Netherlands)

Schneider, J.H.M.

1998-01-01

Rhizoctonia disease causes severe losses during the production cycle of tulip. The complex nature of the disease requires a precise characterization of the causal pathogens. Typical bare patches are caused by R. solani AG 2-t. Bulb rot symptoms are, apart from AG 2-t isolates, caused by R.

[Gender issues in the epidemiology of cardiovascular diseases].

Science.gov (United States)

Härtel, Ursula

2007-06-01

In the last decade our knowledge about sex differences in the epidemiology of cardiovascular diseases has substantially increased. However; most information relates to coronary heart disease, and relatively little information is available on other forms of heart disease or cerebrovascular diseases. In the present paper, first, the age-adjusted mortality and morbidity rates of men and women across different European countries will be described as well as differences in case-fatality after myocardial infarction. Second, gender differences regarding the impact of traditional and novel risk factors on the development of coronary heart disease will be addressed, together with recent evidence from cardiac rehabilitation research. In general, we can say that significant sex differences exist at each stage of coronary heart disease, which need to be taken into account in primary prevention, acute therapy, and long-term rehabilitation. Further research is required on other forms of cardiovascular diseases, which are more prevalent among women than among men, especially in higher age groups.

Substantial need for early diagnosis, rehabilitation and treatment of chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Lange, Peter; Marott, Jacob Louis; Dahl, Morten

2012-01-01

Our goal was to estimate the number of individuals with chronic obstructive pulmonary disease (COPD) in the Capital Region of Denmark and the need of resources required to implement the regional management programme for COPD.......Our goal was to estimate the number of individuals with chronic obstructive pulmonary disease (COPD) in the Capital Region of Denmark and the need of resources required to implement the regional management programme for COPD....

Disease-Related Detection with Electrochemical Biosensors: A Review

Directory of Open Access Journals (Sweden)

Ying Huang

2017-10-01

Full Text Available Rapid diagnosis of diseases at their initial stage is critical for effective clinical outcomes and promotes general public health. Classical in vitro diagnostics require centralized laboratories, tedious work and large, expensive devices. In recent years, numerous electrochemical biosensors have been developed and proposed for detection of various diseases based on specific biomarkers taking advantage of their features, including sensitivity, selectivity, low cost and rapid response. This article reviews research trends in disease-related detection with electrochemical biosensors. Focus has been placed on the immobilization mechanism of electrochemical biosensors, and the techniques and materials used for the fabrication of biosensors are introduced in details. Various biomolecules used for different diseases have been listed. Besides, the advances and challenges of using electrochemical biosensors for disease-related applications are discussed.

Newer Vaccines against Mosquito-borne Diseases.

Science.gov (United States)

Aggarwal, Anju; Garg, Neha

2018-02-01

Mosquitos are responsible for a number of protozoal and viral diseases. Malaria, dengue, Japanese encephalitis (JE) and chikungunya epidemics occur commonly all over the world, leading to marked mortality and morbidity in children. Zika, Yellow fever and West Nile fever are others requiring prevention. Environmental control and mosquito bite prevention are useful in decreasing the burden of disease but vaccination has been found to be most cost-effective and is the need of the hour. RTS,S/AS01 vaccine is the first malaria vaccine being licensed for use against P. falciparum malaria. Dengvaxia (CYD-TDV) against dengue was licensed first in Mexico in 2015. A Vero-cell derived, inactivated and alum-adjuvanted JE vaccine based on the SA14-14-2 strain was approved in 2009 in North America, Australia and various European countries. It can be used from 2 mo of age. In India, immunization is carried out in endemic regions at 1 y of age. Another inactivated Vero-cell culture derived Kolar strain, 821564XY, JE vaccine is being used in India. Candidate vaccines against dengue, chikungunya and West Nile fever are been discussed. A continued research and development of new vaccines are required for controlling these mosquito-borne diseases.

Surgery for luminal Crohn’s disease

Science.gov (United States)

Yamamoto, Takayuki; Watanabe, Toshiaki

2014-01-01

Many patients with Crohn’s disease (CD) require surgery. Indications for surgery include failure of medical treatment, bowel obstruction, fistula or abscess formation. The most common surgical procedure is resection. In jejunoileal CD, strictureplasty is an accepted surgical technique that relieves the obstructive symptoms, while preserving intestinal length and avoiding the development of short bowel syndrome. However, the role of strictureplasty in duodenal and colonic diseases remains controversial. In extensive colitis, after total colectomy with ileorectal anastomosis (IRA), the recurrence rates and functional outcomes are reasonable. For patients with extensive colitis and rectal involvement, total colectomy and end-ileostomy is safe and effective; however, a few patients can have subsequent IRA, and half of the patients will require proctectomy later. Proctocolectomy is associated with a high incidence of delayed perineal wound healing, but it carries a low recurrence rate. Patients undergoing proctocolectomy with ileal pouch-anal anastomosis had poor functional outcomes and high failure rates. Laparoscopic surgery has been introduced as a minimal invasive procedure. Patients who undergo laparoscopic surgery have a more rapid recovery of bowel function and a shorter hospital stay. The morbidity also is lower, and the rate of disease recurrence is similar compared with open procedures. PMID:24415860

Parkinson's disease proteins: Novel mitochondrial targets for cardioprotection

OpenAIRE

Mukherjee, Uma A.; Ong, Sang-Bing; Ong, Sang-Ging; Hausenloy, Derek J.

2015-01-01

Ischemic heart disease (IHD) is the leading cause of death and disability worldwide. Therefore, novel therapeutic targets for protecting the heart against acute ischemia/reperfusion injury (IRI) are required to attenuate cardiomyocyte death, preserve myocardial function, and prevent the onset of heart failure. In this regard, a specific group of mitochondrial proteins, which have been linked to familial forms of Parkinson's disease (PD), may provide novel therapeutic targets for cardioprotect...

Prevalence of chronic kidney disease after preeclampsia.

Science.gov (United States)

Lopes van Balen, Veronica Agatha; Spaan, Julia Jeltje; Cornelis, Tom; Spaanderman, Marc Erich August

2017-06-01

Preeclampsia (PE), an endothelial disease that affects kidney function during pregnancy, is correlated to an increased future risk of cardiovascular and chronic kidney disease. The Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline emphasizes the combined role of glomerular filtration rate (GFR) and albuminuria in determining the frequency of monitoring of kidney function. In this study we evaluated the prevalence of CKD in women with a history of PE. We investigated how many seemingly healthy women required monitoring of kidney function according to the KDIGO guideline. We included 775 primiparous women with a history of PE. They were at least 4 months postpartum, and had no pre-existing hypertension, diabetes or kidney disease. We estimated GFR by the CKD-Epidemiology equation and urinary albumin loss by albumin creatinine ratio in a 24-h urine collection. Most women, 669 (86.3 %), had a normal GFR and absent albuminuria. Based on the KDIGO guideline, 13.7 % would require at least yearly monitoring of kidney function. Only 1.4 % were classified to be at high risk for kidney function deterioration. Monitoring of kidney function seems relevant for about one in seven women with a history of PE, mainly due to albuminuria. Albuminuria should be evaluated postpartum to identify those women that need further monitoring of kidney function.

Gastroesophageal reflux disease and Barrett's Esophagus

NARCIS (Netherlands)

Bergman, J. J. G. H. M.

2005-01-01

Several articles have been published during the last year that may affect the management of patients with gastroesophageal reflux disease (GERD) and/or Barrett's esophagus in the near future. A new method of measuring esophageal pH has been introduced that does not require an indwelling transnasal

Multiple myeloma with extramedullary disease.

Science.gov (United States)

Oriol, Albert

2011-11-01

Plasmacytoma is a tumor mass consisting of atypical plasma cells. Incidence of plasmacytomas associated with multiple myeloma range from 7% to 17% at diagnosis and from 6% to 20% during the course of the disease. In both situations, occurrence of extramedullary disease has been consistently associated with a poorer prognosis of myeloma. Extramedullary relapse or progression occurs in a variety of clinical circumstances and settings, and therefore requires individualization of treatment. Alkylating agents, bortezomib, and immunomodulatory drugs, along with corticoids, have been used to treat extramedullary relapse but, because of the relatively low frequency or detection rate of extramedullary relapse, no efficacy data are available from controlled studies in this setting.

[Anesthesia and Alzheimer disease - Current perceptions].

Science.gov (United States)

Marques, Ana Filipa Vieira da Silva Ferreira; Lapa, Teresa Alexandra Santos Carvalho

It has been speculated that the use of anesthetic agents may be a risk factor for the development of Alzheimer disease. The objective of this review is to describe and discuss pre-clinical and clinical data related to anesthesia and this disease. Alzheimer disease affects about 5% of the population over 65 years old, with age being the main risk factor and being associated with a high morbidity. Current evidence questions a possible association between anesthesia, surgery, and long-term cognitive effects, including Alzheimer disease. Although data from some animal studies suggest an association between anesthesia and neurotoxicity, this link remains inconclusive in humans. We performed a review of the literature in which we selected scientific articles in the PubMed database, published between 2005 and 2016 (one article from 1998 due to its historical relevance), in English, which address the possible relationship between anesthesia and Alzheimer disease. 49 articles were selected. The possible relationship between anesthetic agents, cognitive dysfunction, and Alzheimer disease remains to be clarified. Prospective cohort studies or randomized clinical trials for a better understanding of this association will be required. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Microbial disease and the coral holobiont

Science.gov (United States)

Bourne, David G.; Garren, Melissa; Work, Thierry M.; Rosenberg, Eugene; Smith, Garriet W.; Harvell, C. Drew

2009-01-01

Tropical coral reefs harbour a reservoir of enormous biodiversity that is increasingly threatened by direct human activities and indirect global climate shifts. Emerging coral diseases are one serious threat implicated in extensive reef deterioration through disruption of the integrity of the coral holobiont – a complex symbiosis between the coral animal, endobiotic alga and an array of microorganisms. In this article, we review our current understanding of the role of microorganisms in coral health and disease, and highlight the pressing interdisciplinary research priorities required to elucidate the mechanisms of disease. We advocate an approach that applies knowledge gained from experiences in human and veterinary medicine, integrated into multidisciplinary studies that investigate the interactions between host, agent and environment of a given coral disease. These approaches include robust and precise disease diagnosis, standardised ecological methods and application of rapidly developing DNA, RNA and protein technologies, alongside established histological, microbial ecology and ecological expertise. Such approaches will allow a better understanding of the causes of coral mortality and coral reef declines and help assess potential management options to mitigate their effects in the longer term.

[Emerging infectious diseases: complex, unpredictable processes].

Science.gov (United States)

Guégan, Jean-François

2016-01-01

In the light of a double approach, at first empirical, later theoretical and comparative, illustrated by the example of the Buruli ulcer and its mycobacterial agent Mycobacterium ulcerans on which I focused my research activity these last ten years by studying determinants and factors of emerging infectious or parasitic diseases, the complexity of events explaining emerging diseases will be presented. The cascade of events occurring at various levels of spatiotemporal scales and organization of life, which lead to the numerous observed emergences, nowadays requires better taking into account the interactions between host(s), pathogen(s) and the environment by including the behavior of both individuals and the population. In numerous research studies on emerging infectious diseases, microbial hazard is described rather than infectious disease risk, the latter resulting from the confrontation between an association of threatening phenomena, or hazards, and a susceptible population. Beyond, the theme of emerging infectious diseases and its links with global environmental and societal changes leads to reconsider some well-established knowledge in infectiology and parasitology. © Société de Biologie, 2017.

Demographic, genetic, and environmental factors that modify disease course.

Science.gov (United States)

Marrie, Ruth Ann

2011-05-01

As with susceptibility to disease, it is likely that multiple factors interact to influence the phenotype of multiple sclerosis and long-term disease outcomes. Such factors may include genetic factors, socioeconomic status, comorbid diseases, and health behaviors, as well as environmental exposures. An improved understanding of the influence of these factors on disease course may reap several benefits, such as improved prognostication, allowing us to tailor disease management with respect to intensity of disease-modifying therapies and changes in specific health behaviors, in the broad context of coexisting health issues. Such information can facilitate appropriately adjusted comparisons within and between populations. Elucidation of these factors will require careful study of well-characterized populations in which the roles of multiple factors are considered simultaneously. Copyright © 2011 Elsevier Inc. All rights reserved.

[The notion of occupational skin disease. Medical and legal aspects].

Science.gov (United States)

Elsner, P; Schliemann, S

2015-03-01

The different definitions of skin disease in medicine and in law are frequently confusing for dermatologists. While a skin disease may be defined medically referring to the definition of health by the WHO as a pathological condition of the skin leading to a disruption of the physical, mental and social well-being of the individual, legal definitions vary depending on the field of insurance law that is referred to. In the law of private health insurance, a skin disease is defined as an anomalous condition of the skin requiring medical treatment that exists independently of the subjective judgement of the insured person and needs to be objectively confirmed by a medical evaluation. In contrast, in the law of the social health insurance, the Federal Court of Social Justice defines disease as irregular physical or mental condition, deviating from the perception of a healthy human being that requires medical treatment or leads to inability to work. Substantial bodily disfigurement may be regarded as an irregular physical condition. In the law of the statutory accident insurance, occupational skin diseases are defined under clause 5101 of the occupational disease regulation as serious or repeatedly relapsing skin diseases that have forced a person to refrain from any work activities causal for the development, the aggravation or the recurrence of the disease. The Federal Court of Social Justice interprets the term "skin disease" from the protective purpose of the law, i.e. the protection against the economic and health consequences of the exposure to harmful agents and a thereby forced change of profession. This broad interpretation of the term "skin disease" leads to the recognition of diseases of the conjunctiva of the eye or diseases of the blood vessels of the skin due to cold damage as skin diseases according to clause 5101. For the correct treatment and possibly notification of occupational skin diseases in collaboration with various insurance carriers

The neglected tropical diseases of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination.

Directory of Open Access Journals (Sweden)

Peter J Hotez

Full Text Available The neglected tropical diseases (NTDs represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC. Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions.

Laparoscopic management of cystic disease of the liver.

Science.gov (United States)

Albrink, M H; McAllister, E W; Rosemurgy, A S; Karl, R C; Carey, L C

1994-04-01

Laparoscopic surgical procedures are increasing in scope and in variety. The benefits of decreased wound morbidity and pain have been well documented for multiple procedures that have traditionally required laparotomy. Although there are few controlled studies to document them, these benefits may be evident from simple clinical observation. Cystic disease of the liver is a condition that is treated largely for symptomatic reasons. The so-called noninvasive or radiographic guided methods of treatment for cystic disease of the liver are fraught with high recurrence rates. We present four cases of cystic disease of the liver treated laparoscopically, followed with pertinent discussion.

77 FR 42482 - Submission for OMB Review; Comment Request

Science.gov (United States)

2012-07-19

... rehabilitation of essential public infrastructure and facilities necessary to generate or retain private sector jobs and investments, attract private sector capital, and promote vibrant economic ecosystems, regional competitiveness and innovation. The EAA Program provides a wide range of technical, planning and infrastructure...

AN EMPIRICAL ASSESSMENT OF THE RELATIONSHIP OF

African Journals Online (AJOL)

ETIWISTIC

2013-05-06

May 6, 2013 ... Adeyemi College of Education, Ondo bile.ruth@yahoo.com ... relationship between teachers‟ leadership roles, and students‟ attitudes ... experiences and ethical orientations towards all vibrant aspects of good life ... students‟ academic performance are expected to perform their roles ... Other methods of.

Efficient generation of optical twisters using helico-conical beams

DEFF Research Database (Denmark)

Daria, Vincent Ricardo Mancao; Palima, Darwin; Glückstad, Jesper

2012-01-01

of theoretical, experimental and technical issues associated with this vibrant and exciting field. The volume is an authoritative reference for academic researchers and graduate students engaged in theoretical or experimental study of optical angular momentum and its applications. It will also benefit...

Accommodating oversize and overweight loads : technical report.

Science.gov (United States)

2012-07-01

Adequate management of oversize/overweight (OS/OW) permit loads throughout the state of Texas is : critical to maintaining a vibrant state economy. The growth in the number and size of permit loads in recent : years is clear evidence that new tools a...

Animal coloration: sexy spider scales.

Science.gov (United States)

Taylor, Lisa A; McGraw, Kevin J

2007-08-07

Many male jumping spiders display vibrant colors that are used in visual communication. A recent microscopic study on a jumping spider from Singapore shows that three-layered 'scale sandwiches' of chitin and air are responsible for producing their brilliant iridescent body coloration.

Transient Receptor Potential channels: What's happening? Reflections in the wake of the 2009 TRP Meeting, Karolinska Institutet, Stockholm.

Science.gov (United States)

Goswami, Chandan; Islam, Md Shahidul

2010-01-01

More than 150 participants from 25 countries gathered in Stockholm during 25(th) to 27(th) Sept 2009 to attend the meeting "TRP channels: from sensory signaling to human disease" and enjoyed an international, intensive and vibrant meeting. This meeting shed lights on the recent advances made in this field of research in different sectors of biology, and identified directions for future research and the areas where TRP channels could be used as potential targets for prevention and treatment of human diseases. The participants of this meeting shared their recent largely unpublished data, state-of-the-art techniques and their critical views which would push research in this field forward in the new decade. Another major outcome of this meeting was the realization that extensive work remains to be done to develop the necessary tools and enhance the quality of research in this area so that the prevailing controversies can be resolved. In this report we summarize the latest scientific excitements, some critical issues, as well as some future directions for research that were addressed and discussed in this meeting.

Clinico-Histologic Conferences: Histology and Disease

Science.gov (United States)

Shaw, Phyllis A.; Friedman, Erica S.

2012-01-01

Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical…

Lysosomal storage diseases: current diagnostic and therapeutic options

International Nuclear Information System (INIS)

Malinova, V.; Honzik, T.

2013-01-01

Lysosomal storage diseases are rare genetic diseases caused by insufficient activity of some of the lysosomal enzymes and/or transport proteins. Initial symptoms may appear any time from the neonatal period to late adulthood; early forms tend to have a severe course with rapid progression and unfavorable prognosis. There is multisystem involvement with continuous progression of symptoms and involvement of metabolically active organs or tissues – the bone marrow, liver, bones, skeletal muscles, myocardium, or CNS. The diagnosis is definitively confirmed by demonstration of reduced activity of the particular enzyme and by mutation analysis. Some of the storage diseases can be effectively treated by intravenous administration of recombinant enzymes or by limiting the amount of the substrate stored. In a small number of lysosomal storage diseases, bone marrow transplantation is successful. Multidisciplinary collaboration, including genetic counselling and prenatal diagnosis in patient families, is required. The first part of the paper deals with general characteristics of lysosomal storage diseases and the most common diseases that are currently treatable in the Czech Republic (Gaucher’s disease, Pompe disease, Fabry disease, Niemann–Pick disease, cholesterol ester storage disease). The second part of the paper deals with mucopolysaccharidase, another group of rare lysosomal storage diseases. (author)

The ethical dimensions of wildlife disease management in an evolutionary context.

Science.gov (United States)

Crozier, Gkd; Schulte-Hostedde, Albrecht I

2014-08-01

Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is 'good' science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values - freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios.

Huntington's disease: a clinical review

Directory of Open Access Journals (Sweden)

Roos Raymund AC

2010-12-01

Full Text Available Abstract Huntington disease (HD is a rare neurodegenerative disorder of the central nervous system characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. Prevalence in the Caucasian population is estimated at 1/10,000-1/20,000. Mean age at onset of symptoms is 30-50 years. In some cases symptoms start before the age of 20 years with behavior disturbances and learning difficulties at school (Juvenile Huntington's disease; JHD. The classic sign is chorea that gradually spreads to all muscles. All psychomotor processes become severely retarded. Patients experience psychiatric symptoms and cognitive decline. HD is an autosomal dominant inherited disease caused by an elongated CAG repeat (36 repeats or more on the short arm of chromosome 4p16.3 in the Huntingtine gene. The longer the CAG repeat, the earlier the onset of disease. In cases of JHD the repeat often exceeds 55. Diagnosis is based on clinical symptoms and signs in an individual with a parent with proven HD, and is confirmed by DNA determination. Pre-manifest diagnosis should only be performed by multidisciplinary teams in healthy at-risk adult individuals who want to know whether they carry the mutation or not. Differential diagnoses include other causes of chorea including general internal disorders or iatrogenic disorders. Phenocopies (clinically diagnosed cases of HD without the genetic mutation are observed. Prenatal diagnosis is possible by chorionic villus sampling or amniocentesis. Preimplantation diagnosis with in vitro fertilization is offered in several countries. There is no cure. Management should be multidisciplinary and is based on treating symptoms with a view to improving quality of life. Chorea is treated with dopamine receptor blocking or depleting agents. Medication and non-medical care for depression and aggressive behavior may be required. The progression of the disease leads to a complete dependency in daily life, which

Schwann cell myelination requires Dynein function

Directory of Open Access Journals (Sweden)

Langworthy Melissa M

2012-11-01

Full Text Available Abstract Background Interaction of Schwann cells with axons triggers signal transduction that drives expression of Pou3f1 and Egr2 transcription factors, which in turn promote myelination. Signal transduction appears to be mediated, at least in part, by cyclic adenosine monophosphate (cAMP because elevation of cAMP levels can stimulate myelination in the absence of axon contact. The mechanisms by which the myelinating signal is conveyed remain unclear. Results By analyzing mutations that disrupt myelination in zebrafish, we learned that Dynein cytoplasmic 1 heavy chain 1 (Dync1h1, which functions as a motor for intracellular molecular trafficking, is required for peripheral myelination. In dync1h1 mutants, Schwann cell progenitors migrated to peripheral nerves but then failed to express Pou3f1 and Egr2 or make myelin membrane. Genetic mosaic experiments revealed that robust Myelin Basic Protein expression required Dync1h1 function within both Schwann cells and axons. Finally, treatment of dync1h1 mutants with a drug to elevate cAMP levels stimulated myelin gene expression. Conclusion Dync1h1 is required for retrograde transport in axons and mutations of Dync1h1 have been implicated in axon disease. Our data now provide evidence that Dync1h1 is also required for efficient myelination of peripheral axons by Schwann cells, perhaps by facilitating signal transduction necessary for myelination.

Contribution of Neuroepigenetics to Huntington’s Disease

Science.gov (United States)

Francelle, Laetitia; Lotz, Caroline; Outeiro, Tiago; Brouillet, Emmanuel; Merienne, Karine

2017-01-01

Unbalanced epigenetic regulation is thought to contribute to the progression of several neurodegenerative diseases, including Huntington’s disease (HD), a genetic disorder considered as a paradigm of epigenetic dysregulation. In this review, we attempt to address open questions regarding the role of epigenetic changes in HD, in the light of recent advances in neuroepigenetics. We particularly discuss studies using genome-wide scale approaches that provide insights into the relationship between epigenetic regulations, gene expression and neuronal activity in normal and diseased neurons, including HD neurons. We propose that cell-type specific techniques and 3D-based methods will advance knowledge of epigenome in the context of brain region vulnerability in neurodegenerative diseases. A better understanding of the mechanisms underlying epigenetic changes and of their consequences in neurodegenerative diseases is required to design therapeutic strategies more effective than current strategies based on histone deacetylase (HDAC) inhibitors. Researches in HD may play a driving role in this process. PMID:28194101

Occupational Lung Disease: Clinical-Pathological-Radiological Correlation

International Nuclear Information System (INIS)

Carrillo Bayona, Jorge Alberto; Rivera Bernal, Aura Lucia; Ojeda Paulina; Paez Garcia, Diana Sofia

2008-01-01

People are exposed to hundreds of substances daily, some of which may induce pulmonary injury. Occupational Lung Disease diagnosis requires 4 elements: Exposure to the harmful agent, adequate latency between exposure and beginning of the symptoms, syndrome with post-exposure abnormalities, and exclusion of other conditions which may otherwise explain signs and symptoms. Several occupational lung disease classifications based on structural or functional injury, type of agent, or both have been proposed. Generally, 5 groups are considered: Pneumoconiosis, hypersensitivity pneumonitis, toxic fumes exposure, asthma, and occupational lung infections. Conventional radiographs and in specific situations, CT, are crucial elements for the diagnosis of Occupational Lung Disease. In the patient with respiratory symptoms and altered imaging studies, the possibility of Occupational Lung Disease should be considered. Radiologist should be familiar the variety of substances that cause these entities and their radiological features. In this article Occupational Lung diseases are reviewed, including diagnostic criteria, classification, physiopathology, clinical and radiological manifestations as well as their corresponding histopathological features.

Diagnostic criteria for Menière's disease.

Science.gov (United States)

Lopez-Escamez, Jose A; Carey, John; Chung, Won-Ho; Goebel, Joel A; Magnusson, Måns; Mandalà, Marco; Newman-Toker, David E; Strupp, Michael; Suzuki, Mamoru; Trabalzini, Franco; Bisdorff, Alexandre

2015-01-01

This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes two categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

Thyroid cancer in Graves' disease: is surgery the best treatment for Graves' disease?

Science.gov (United States)

Tamatea, Jade A U; Tu'akoi, Kelson; Conaglen, John V; Elston, Marianne S; Meyer-Rochow, Goswin Y

2014-04-01

Graves' disease is a common cause of thyrotoxicosis. Treatment options include anti-thyroid medications or definitive therapy: thyroidectomy or radioactive iodine (I(131) ). Traditionally, I(131) has been the preferred definitive treatment for Graves' disease in New Zealand. Reports of concomitant thyroid cancer occurring in up to 17% of Graves' patients suggest surgery, if performed with low morbidity, may be the preferred option. The aim of this study was to determine the rate of thyroid cancer and surgical outcomes in a New Zealand cohort of patients undergoing thyroidectomy for Graves' disease. This study is a retrospective review of Waikato region patients undergoing thyroid surgery for Graves' disease during the 10-year period prior to 1 December 2011. A total of 833 patients underwent thyroid surgery. Of these, 117 were for Graves' disease. Total thyroidectomy was performed in 82, near-total in 33 and subtotal in 2 patients. Recurrent thyrotoxicosis developed in one subtotal patient requiring I(131) therapy. There were two cases of permanent hypoparathyroidism and one of permanent recurrent laryngeal nerve palsy. Eight patients (6.8%) had thyroid cancer detected, none of whom had overt nodal disease. Five were papillary microcarcinomas (one of which was multifocal), two were papillary carcinomas (11 mm and 15 mm) and one was a minimally invasive follicular carcinoma. Thyroid cancer was identified in approximately 7% of patients undergoing surgery for Graves' disease. A low complication rate (<2%) of permanent hypoparathyroidism and nerve injury (<1%) supports surgery being a safe alternative to I(131) especially for patients with young children, ophthalmopathy or compressive symptoms. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Double burden of noncommunicable and infectious diseases in developing countries

DEFF Research Database (Denmark)

Bygbjerg, I C

2012-01-01

On top of the unfinished agenda of infectious diseases in low- and middle-income countries, development, industrialization, urbanization, investment, and aging are drivers of an epidemic of noncommunicable diseases (NCDs). Malnutrition and infection in early life increase the risk of chronic NCDs...... for limited funds, is an important policy consideration requiring new thinking and approaches....

IgG4-related disease

DEFF Research Database (Denmark)

Detlefsen, Sönke; Klöppel, Günter

2018-01-01

disease (IgG4-RD). The histologic key findings are lymphoplasmacytic infiltration rich in IgG4-positive plasma cells combined with storiform fibrosis and obliterative phlebitis. Among the organs mainly affected by IgG4-RD are the pancreas and the extrahepatic bile ducts. The pancreatic and biliary...... alterations have been described under the terms autoimmune pancreatitis (AIP) and sclerosing cholangitis, respectively. These diseases are currently more precisely called IgG4-related pancreatitis (or type 1 AIP to distinguish it from type 2 AIP that is unrelated to IgG4-RD) and IgG4-related sclerosing...... cholangitis (IgG4-related SC). Clinically and grossly, both diseases commonly imitate pancreatic and biliary adenocarcinoma, tumors that are well known for their dismal prognosis. As IgG4-RD responds to steroid treatment, making a resection of a suspected tumor unnecessary, a biopsy is often required...

Improving the detection of coeliac disease.

Science.gov (United States)

Lau, Michelle S Y; Hopper, Andrew D; Sanders, David S

2016-01-01

The common presentation of coeliac disease has shifted from the historically classical symptoms of malabsorption in childhood to non-classical symptoms in adulthood such as irritable bowel syndrome-type symptoms, anaemia, chronic fatigue, change in bowel habit, abdominal pain and osteoporosis. A combination of coeliac serology and duodenal biopsy is required to diagnose coeliac disease in adults. Testing for IgA-tissue transglutaminase antibodies should be carried out as a first-line screening test. Advise patients to eat a gluten-containing diet for six weeks before their investigations to ensure the serological and histological results are not affected. A confirmatory duodenal biopsy is mandatory to ensure that patients are correctly diagnosed with coeliac disease. A lifelong strict gluten-free diet is the only effective treatment currently available. All patients should be referred to a specialist dietitian for guidance and support. Annual follow-up can begin when the disease is stable and patients are managing well on their diet.

Usefulness of data from primary care for real-time surveillance of diseases.

NARCIS (Netherlands)

Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

2006-01-01

Background: The increased threat of bioterrorism and the outbreaks of new infectious diseases require rapid identification of clusters of illness. The increased availability of electronic data in health care makes real-time surveillance of diseases possible. Therefore, we investigated the

Financing drug discovery for orphan diseases.

Science.gov (United States)

Fagnan, David E; Gromatzky, Austin A; Stein, Roger M; Fernandez, Jose-Maria; Lo, Andrew W

2014-05-01

Recently proposed 'megafund' financing methods for funding translational medicine and drug development require billions of dollars in capital per megafund to de-risk the drug discovery process enough to issue long-term bonds. Here, we demonstrate that the same financing methods can be applied to orphan drug development but, because of the unique nature of orphan diseases and therapeutics (lower development costs, faster FDA approval times, lower failure rates and lower correlation of failures among disease targets) the amount of capital needed to de-risk such portfolios is much lower in this field. Numerical simulations suggest that an orphan disease megafund of only US$575 million can yield double-digit expected rates of return with only 10-20 projects in the portfolio. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Nanoparticle-based therapy for respiratory diseases

Directory of Open Access Journals (Sweden)

ADRIANA L. DA SILVA

2013-03-01

Full Text Available Nanotechnology is an emerging science with the potential to create new materials and strategies involving manipulation of matter at the nanometer scale (<100 nm. With size-dependent properties, nanoparticles have introduced a new paradigm in pharmacotherapy – the possibility of cell-targeted drug delivery with minimal systemic side effects and toxicity. The present review provides a summary of published findings, especially regarding to nanoparticle formulations for lung diseases. The available data have shown some benefits with nanoparticle-based therapy in the development of the disease and lung remodeling in respiratory diseases. However, there is a wide gap between the concepts of nanomedicine and the published experimental data and clinical reality. In addition, studies are still required to determine the potential of nanotherapy and the systemic toxicity of nanomaterials for future human use.

FCDD: A Database for Fruit Crops Diseases.

Science.gov (United States)

Chauhan, Rupal; Jasrai, Yogesh; Pandya, Himanshu; Chaudhari, Suman; Samota, Chand Mal

2014-01-01

Fruit Crops Diseases Database (FCDD) requires a number of biotechnology and bioinformatics tools. The FCDD is a unique bioinformatics resource that compiles information about 162 details on fruit crops diseases, diseases type, its causal organism, images, symptoms and their control. The FCDD contains 171 phytochemicals from 25 fruits, their 2D images and their 20 possible sequences. This information has been manually extracted and manually verified from numerous sources, including other electronic databases, textbooks and scientific journals. FCDD is fully searchable and supports extensive text search. The main focus of the FCDD is on providing possible information of fruit crops diseases, which will help in discovery of potential drugs from one of the common bioresource-fruits. The database was developed using MySQL. The database interface is developed in PHP, HTML and JAVA. FCDD is freely available. http://www.fruitcropsdd.com/

Cardiovascular Disease, Mitochondria, and Traditional Chinese Medicine

Directory of Open Access Journals (Sweden)

Jie Wang

2015-01-01

Full Text Available Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we show that cardiovascular disease is negatively affected by mutations in mitochondrial DNA and that TCM can be used to treat cardiovascular disease by regulating the structure and function of mitochondria via increases in mitochondrial electron transport and oxidative phosphorylation, modulation of mitochondrial-mediated apoptosis, and decreases in mitochondrial ROS. However further research is still required to identify the mechanism by which TCM affects CVD and modifies mitochondrial DNA.

Disease-related malnutrition: influence on body composition and prognosis

OpenAIRE

Pirlich, Matthias

2010-01-01

Disease-related malnutrition is a frequent clincal problem with severe medical and economic impact. This work summarizes studies on body composition analysis, risk factors, prevalence and prognostic impact of malnutrition. The diagnosis of malnutrition in patients with chronic liver disease is hampered by hyperhydration and requires body composition analysis. Using four different methods for body composition analysis (total body potassium counting, anthropometry, bioelectrical impedance analy...

Medical management of chronic liver diseases (CLD) in children (part II): focus on the complications of CLD, and CLD that require special considerations.

Science.gov (United States)

El-Shabrawi, Mortada H F; Kamal, Naglaa M

2011-12-01

with antibiotics, use of vasopressin analogs (terlipressin), and renal replacement therapy if needed. Hepatopulmonary syndrome and portopulmonary hypertension are best managed by liver transplantation. Provision of an adequate caloric supply, nutrition, and vitamin/mineral supplements for the management of growth failure, required vaccinations, and special care for ensuring psychologic well-being should be ensured. Anticoagulation might be attempted in acute portal vein thrombosis. Some CLDs, such as extrahepatic biliary atresia (EHBA), Crigler-Najjar syndrome, and Indian childhood cirrhosis, require special considerations. For EHBA, Kasai hepatoportoenterostomy is the current standard surgical approach in combination with nutritional therapy and supplemental fat and water soluble vitamins, minerals, and trace elements. In type 1 Crigler-Najjar syndrome, extensive phototherapy is the mainstay of treatment, in association with adjuvant therapy to bind photobilirubin such as calcium phosphate, cholestyramine, or agar, until liver transplantation can be carried out. Treating Indian childhood cirrhosis with penicillamine early in the course of the disease and at doses similar to those used to treat Wilson disease decreases the mortality rate by half. New hopes for the future include extracorporeal liver support devices (the molecular adsorbent recirculating system [MARS®] and Prometheus®), hepatocyte transplantation, liver-directed gene therapy, genetically engineered enzymes, and therapeutic modalities targeting fibrogenesis. Hepapoietin, a naturally occurring cytokine that promotes hepatocyte growth, is under extensive research.

MRI/MRA evaluation of sickle cell disease of the brain

International Nuclear Information System (INIS)

Zimmerman, Robert A.

2005-01-01

Sickle cell disease is a major cause of pediatric stroke. Understanding the disease that affects the brain as infarctions, both clinically apparent and silent, requires an understanding of how the blood vessels are affected, the way in which both the brain and the blood vessels are imaged by MRI and MRA and the mechanism of injury. (orig.)

Prion diseases: immunotargets and therapy

Directory of Open Access Journals (Sweden)

Burchell JT

2016-06-01

adaptive immune response. Although more research into mechanisms and safety is required, these immunotherapies offer novel therapeutic targets for prion diseases. Keywords: neurodegeneration, immunization, spongiform encephalopathies, PrPC, PrPSc, tansmissible spongiform encephalopathies Creutzfeldt-Jacob disease, dendritice cells, Alzheimer disease

Genome engineering of stem cell organoids for disease modeling.

Science.gov (United States)

Sun, Yingmin; Ding, Qiurong

2017-05-01

Precision medicine emerges as a new approach that takes into account individual variability. Successful realization of precision medicine requires disease models that are able to incorporate personalized disease information and recapitulate disease development processes at the molecular, cellular and organ levels. With recent development in stem cell field, a variety of tissue organoids can be derived from patient specific pluripotent stem cells and adult stem cells. In combination with the state-of-the-art genome editing tools, organoids can be further engineered to mimic disease-relevant genetic and epigenetic status of a patient. This has therefore enabled a rapid expansion of sophisticated in vitro disease models, offering a unique system for fundamental and biomedical research as well as the development of personalized medicine. Here we summarize some of the latest advances and future perspectives in engineering stem cell organoids for human disease modeling.

Photodynamic therapy for periodontal disease

Science.gov (United States)

Weersink, Robert A.

2002-05-01

Periodontal disease is a family of chronic inflammatory conditions caused by bacterial infections.' It is manifested in red, swollen gingiva (gums) and can lead to destruction of the connective tissue and bone that hold teeth in place. Conventional treatments typically require some form of invasive surgery, depending on the disease stage at time of detection. Photodynamic Therapy (PDT) is the use of light-activated drugs (photosensitizers) for treatment of a variety of conditions 2 such as solid tumors, pre-malignancies, macular degeneration and actinic keratitis. There have been a number of studies of PDT as an antibacterial agent. 3'4 Depending on the photosensitizer and strain of bacteria, significant killing (several LOGS) can be achieved.

New partnership for African development | CRDI - Centre de ...

International Development Research Centre (IDRC) Digital Library (Canada)

... to promote business relationships between Canadian companies and African partners. ... This affirmation of African leadership marks a dramatic and important ... Unlike previous development plans, NEPAD places an emphasis not on aid but ... most vibrant components of African economic activity operate in the informal ...

Programme on Integrated Seed Sector Development in Ethiopia

NARCIS (Netherlands)

Walsh, Stephen; Thijssen, M.H.

2016-01-01

The programme on Integrated Seed Sector Development in Ethiopia aims to strengthen the development of a vibrant, market-oriented and pluralistic seed sector in the country, where quality seed of superior varieties is available and affordable for a larger number of farmers, thereby contributing to

75 FR 71003 - America Recycles Day, 2010

Science.gov (United States)

2010-11-19

... help create green jobs, support a vibrant American recycling and refurbishing industry, and advance our..., including the recycling of electronic products. The increased use of electronics and technology in our homes... harmful effects of the improper handling and disposal of these products. Currently, most discarded...

Encouraging students to ask right questions

Indian Academy of Sciences (India)

Lawrence

of academics, right from formal teaching and handling research projects ... always thought that an ideal education system is one which strives ... of Applied Physics, Journal of Biomedical Technology, Applied ... students have attended many international and national confer- ... I dream of a vibrant, creative, knowledge-based.

Preface

NARCIS (Netherlands)

Nijholt, Anton; Romão, Teresa; Reidsma, Dennis; Nijholt, Antinus; Romão, Teresa; Reidsma, Dennis

2012-01-01

These are the proceedings of the 9th International Conference on Advances in Computer Entertainment ACE 2012). ACE has become the leading scientific forum for dissemination of cutting-edge research results in the area of entertainment computing. Interactive entertainment is one of the most vibrant

Politicologie 2.0: Gender in het kerncurriculum

NARCIS (Netherlands)

Bonjour, S.; Mügge, L.; Roggeband, C.

2016-01-01

Over the past decades, gender and politics has become a vibrant and recognised international research field. Scholars have shown that gender is central to politics. Gendered equalities and inequalities are shaped and reproduced in political processes and institutions. In this article, we examine to

Radical Ground: Israeli and Palestinian activists and joint protest against the Wall

NARCIS (Netherlands)

Pallister-Wilkins, P.

2009-01-01

This paper will seek to address a new and vibrant development within the field of Israeli-Palestinian socio-politics and social movement studies. By interrogating the received wisdom surrounding social movements as agents bearing collective claims as expressed by Charles Tilly (2004), this paper

Materialitetens trosbekendelse

DEFF Research Database (Denmark)

Thomsen, Torsten Bøgh

2016-01-01

Populærvidenskabelig introduktion til og eksemplificering af politologen Jane Bennetts teorier om "vital materialisme" og "vibrerende materialitet", sådan som hun formulerede dem i udgivelsen "Vibrant Matter - A Political Ecology of Things" fra 2010, som allerede har opnået klassikerstatus indenf...

Advances in Computer Entertainment.

NARCIS (Netherlands)

Nijholt, Antinus; Romão, T.; Reidsma, Dennis; Unknown, [Unknown

2012-01-01

These are the proceedings of the 9th International Conference on Advances in Computer Entertainment ACE 2012). ACE has become the leading scientific forum for dissemination of cutting-edge research results in the area of entertainment computing. Interactive entertainment is one of the most vibrant

Preface (to: Advances in Computer Entertainment)

NARCIS (Netherlands)

Romão, Teresa; Nijholt, Antinus; Romão, Teresa; Reidsma, Dennis

2012-01-01

These are the proceedings of the 9th International Conference on Advances in Computer Entertainment ACE 2012). ACE has become the leading scientific forum for dissemination of cutting-edge research results in the area of entertainment computing. Interactive entertainment is one of the most vibrant

Fulltext PDF

Indian Academy of Sciences (India)

power of youth: a team led by a vibrant young captain, playing fearless cricket in the ... of expectation or carry the burden of reputation. The nation ... Einstein working out of a patent office is able to radically change our view of space and time,.

Making 21st Century Knowledge Complexes: Technopoles of the world revisited

NARCIS (Netherlands)

Miao, Julie Tian; Benneworth, Paul Stephen; Phelps, Nicholas A.

2015-01-01

The world has changed profoundly since the publication of the influential book Technopoles of the World. As policy-makers and practitioners attempt to harness science, technology and innovation to create dynamic and vibrant cities many wonder how relevant Manuel Castells and Peter Hall's messages

Synergy management at knowledge locations

NARCIS (Netherlands)

van Winden, Willem; Carvalho, Luis; Miao, Julie Tian; Benneworth, Paul; Phelps, Nicholas A.

The world has changed profoundly since the publication of the influential book Technopoles of the World. As policy-makers and practitioners attempt to harness science, technology and innovation to create dynamic and vibrant cities many wonder how relevant Manuel Castells and Peter Hall's messages

75 FR 68784 - Healthy Indoor Environment Protocols for Home Energy Upgrades

Science.gov (United States)

2010-11-09

... carefully crafted to stimulate the growth of a vibrant, private sector- led market for residential energy... collaboration to help overcome barriers to these recommended healthy homes actions. Additional resources... assistance and other home energy retrofit program guidance and training materials, and collaboration to help...

Battle of the Sexes

NARCIS (Netherlands)

Bulte, E.H.; Tu, Q.; List, J.

2015-01-01

A vibrant literature has emerged that explores the economic implications of the sex ratio (the ratio of men to women in the population), including changes in fertility rates, educational outcomes, labor supply, and household purchases. Previous empirical efforts, however, have paid less attention to

An observational study on the association of nonalcoholic fatty liver disease and metabolic syndrome with gall stone disease requiring cholecystectomy.

Science.gov (United States)

Ahmed, Farah; Baloch, Qamaruddin; Memon, Zahid Ali; Ali, Iqra

2017-05-01

Recognition of Non alcoholic fatty liver disease (NAFLD) and metabolic syndrome in patients with gallstones undergoing laparoscopic or open cholecystectomy, along with it we will also study the life style of patients with gall stones. Patients with gallstones have associated NAFLD, with concurrent metabolic syndrome and these ailments share similar factors for example obesity, hypertriglyceridemia and diabetes mellitus. Factors like body mass index, gender, raised lipid levels, use of contraceptives and alcohol and having diabetes, physical inactiveness, multiparous women, water with excessive iron content, metabolic syndrome, and NAFLD are accountable factors for gallstones formation. This was a case series done at Surgical Unit 1 of Civil Hospital Karachi. Selective samples of 88 patients were included. Duration was 3 months. We included both sexes with ultrasound proof of gall stone irrespective of cholecystitis. Excluded patients with history of seropositive viral hepatitis, autoimmune and wilson's disease. As these conditions can act as a confounder to our variables. Nafld was present in 62.5%(n = 55) while 28.4% (n = 25) had metabolic syndrome. 26.94% had BMI less than 18, 32.12 had BMI between 18 and 25 and majority had BMI greater than 25 i.e in 40.93%. Of all 46.6% had a family history of cholelithiasis. Gallstone patients with NAFLD reported about their first degree relative being suffering from cholelithiasis at a significant p-value of 0.034 while this was not significant in cases of metabolic syndrome and the p -value was 0.190. We found association of metabolic syndrome with gallstones and NAFLD. Non alcoholic fatty liver was highly prevalent in our study subjects. Huge percentage of first degree relatives of gall stone patients had gallstones and this relation was more pronounced patients who had associated NAFLD.

Coding in Stroke and Other Cerebrovascular Diseases.

Science.gov (United States)

Korb, Pearce J; Jones, William

2017-02-01

Accurate coding is critical for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of coding principles for patients with strokes and other cerebrovascular diseases and includes an illustrative case as a review of coding principles in a patient with acute stroke.

Attachment retained overdentures: a report on their maintenance requirements.

Science.gov (United States)

Shaw, M J

1984-07-01

Twenty-three patients who received attachment retained overdentures between 1964 and 1977 are reviewed. One third of the patients examined had carious abutment teeth, oral hygiene was poor, and periodontal disease prevalent. Overdentures opposed by natural teeth required more extensive prosthetic maintenance than overdentures opposed by a conventional complete denture. Three quarters of the teeth retaining the prostheses were functioning adequately after a mean period of 7 years.

Japanese Guideline for Allergic Conjunctival Diseases

Directory of Open Access Journals (Sweden)

Etsuko Takamura

2011-01-01

Full Text Available The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic conjunctival disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition revised in 2010. Allergic conjunctival disease is defined as “a conjunctival inflammatory disease associated with a Type I allergy accompanied by some subjective or objective symptoms.” Allergic conjunctival disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic conjunctival diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic conjunctival disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs.

Disease burden of chronic lymphocytic leukaemia within the European Union.

Science.gov (United States)

Watson, Louise; Wyld, Peter; Catovsky, Daniel

2008-10-01

Whilst Chronic lymphocytic leukaemia (CLL) is considered a rare disease, to our knowledge, the current prevalence of CLL within the European Union (EU) member states is not published. Understanding the number of individuals with CLL is vital to assess disease burden within the wider population. Using 2002 data from the International Agency for Research on Cancer, we estimated the number of individuals with CLL (ICD-10 C91.1) from those reported for all leukaemias (C91-95) and extrapolated the figures by the population increase within the EU between 2002 and 2006, the last year with fully updated community population estimates. One- and 5-yr partial prevalence estimates are reported (i.e. the number of individuals still living 1-5 yr post-diagnosis). We then applied proportional estimates from the literature to assess those requiring immediate treatment, those under observation and their likely progression rates. We found that within the 27 EU states plus Iceland, Norway and Lichtenstein, 1- and 5-yr CLL partial prevalence estimates totalled approximately 13,952 and 46,633 individuals respectively in 2006. By applying Binet staging to the 1-yr estimate, 40% of patients will be stage B/C and require immediate treatment. Thus, 5581 individuals may be treated within the first year of diagnosis. Of the 60% (8371) under observation, by 5 yr up to 33% (2763) may have more advanced disease with increased risk of mortality. Whilst CLL is a rare disease, the number of individuals burdened by the disease within the EU is considerable and thousands of patients require treatment and physician care, which has cost implications for member states.

Interprofessional Collaborative Practice Models in Chronic Disease Management.

Science.gov (United States)

Southerland, Janet H; Webster-Cyriaque, Jennifer; Bednarsh, Helene; Mouton, Charles P

2016-10-01

Interprofessional collaboration in health has become essential to providing high-quality care, decreased costs, and improved outcomes. Patient-centered care requires synthesis of all the components of primary and specialty medicine to address patient needs. For individuals living with chronic diseases, this model is even more critical to obtain better health outcomes. Studies have shown shown that oral health and systemic disease are correlated as it relates to disease development and progression. Thus, inclusion of oral health in many of the existing and new collaborative models could result in better management of chronic illnesses and improve overall health outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Zinc absorption in inflammatory bowel disease

International Nuclear Information System (INIS)

Valberg, L.S.; Flanagan, P.R.; Kertesz, A.; Bondy, D.C.

1986-01-01

Zinc absorption was measured in 29 patients with inflammatory bowel disease and a wide spectrum of disease activity to determine its relationship to disease activity, general nutritional state, and zinc status. Patients with severe disease requiring either supplementary oral or parenteral nutrition were excluded. The mean 65ZnCl2 absorption, in the patients, determined using a 65Zn and 51Cr stool-counting test, 45 +/- 17% (SD), was significantly lower than the values, 54 +/- 16%, in 30 healthy controls, P less than 0.05. Low 65ZnCl2 absorption was related to undernutrition, but not to disease activity in the absence of undernutrition or to zinc status estimated by leukocyte zinc measurements. Mean plasma zinc or leukocyte zinc concentrations in patients did not differ significantly from controls, and only two patients with moderate disease had leukocyte zinc values below the 5th percentile of normal. In another group of nine patients with inflammatory bowel disease of mild-to-moderate severity and minimal nutritional impairment, 65Zn absorption from an extrinsically labeled turkey test meal was 31 +/- 10% compared to 33 +/- 7% in 17 healthy controls, P greater than 0.1. Thus, impairment in 65ZnCl2 absorption in the patients selected for this study was only evident in undernourished persons with moderate or severe disease activity, but biochemical evidence of zinc deficiency was uncommon, and clinical features of zinc depletion were not encountered

Global epidemiology of celiac disease

Directory of Open Access Journals (Sweden)

S. V. Bykova

2018-01-01

Full Text Available The review presents the data on the prevalence of celiac disease in various world regions. The numbers of patients with celiac disease continues to rise every year. According to some authors, this is to be related not only to improvement in diagnosis, but to other extrinsic factors, as well, that require additional studies. In the 1980s the prevalence of this disease was 1.05%, and by the beginning of 2000s, it amounted to 1.99%. In particular, from 1993 to 2002 in Britain its incidence increased from 6 to 13.3 per 100,000. Both raised awareness of doctors and conduction of epidemiological studies play a decisive role in the improvement of the diagnosis of celiac disease. The information cumulated up to now makes it possible to conclude that the highest diagnostic rates of celiac disease can be found in the risk groups. They include 1st and 2nd degree relatives of patients with celiac disease, patients with autoimmune disorders (type 1 diabetes mellitus, autoimmune thyroiditis; those with clinical signs of an intestinal disorder, such as chronic diarrhea, as well as patients with anemia, osteoporosis and high transaminase levels of unknown origin. According to the Finnish epidemiological study, the prevalence of celiac disease, depending on the risk group, may vary from 6.6 to 16.3%. The guidelines by the American College of Gastroenterology, British Society of Gastroenterology, North-American Society of Pediatric Gastroenterology, and the Russian Consensus on Diagnosis and Treatment of Celiac Disease in Adults and Children all recommend thorough examination of patients from the risk groups. Active diagnosis of celiac disease (screening has been recognized as one of the approaches to primary prevention to autoimmune disorders and cancer.

Fisetin and Its Role in Chronic Diseases.

Science.gov (United States)

Pal, Harish C; Pearlman, Ross L; Afaq, Farrukh

2016-01-01

Chronic inflammation is a prolonged and dysregulated immune response leading to a wide variety of physiological and pathological conditions such as neurological abnormalities, cardiovascular diseases, diabetes, obesity, pulmonary diseases, immunological diseases, cancers, and other life-threatening conditions. Therefore, inhibition of persistent inflammation will reduce the risk of inflammation-associated chronic diseases. Inflammation-related chronic diseases require chronic treatment without side effects. Use of traditional medicines and restricted diet has been utilized by mankind for ages to prevent or treat several chronic diseases. Bioactive dietary agents or "Nutraceuticals" present in several fruits, vegetables, legumes, cereals, fibers, and certain spices have shown potential to inhibit or reverse the inflammatory responses and several chronic diseases related to chronic inflammation. Due to safe, nontoxic, and preventive benefits, the use of nutraceuticals as dietary supplements or functional foods has increased in the Western world. Fisetin (3,3',4',7-tetrahydroxyflavone) is a dietary flavonoid found in various fruits (strawberries, apples, mangoes, persimmons, kiwis, and grapes), vegetables (tomatoes, onions, and cucumbers), nuts, and wine that has shown strong anti-inflammatory, anti-oxidant, anti-tumorigenic, anti-invasive, anti-angiogenic, anti-diabetic, neuroprotective, and cardioprotective effects in cell culture and in animal models relevant to human diseases. In this chapter, we discuss the beneficial pharmacological effects of fisetin against different pathological conditions with special emphasis on diseases related to chronic inflammatory conditions.

Diagnostic and treatment difficulties in Crohn's disease

Directory of Open Access Journals (Sweden)

Ioana Păunică

2016-11-01

Full Text Available Inflammatory bowel diseases are related to a special pathology having a great psychosocial and economic impact, being represented by chronic diseases which often affects the adult/ active population and that require a long-term treatment. The incidence of Crohn's disease has recorded an increasing trend amongst the general population. However, the incidence of regional enteritis is somewhat lower than in the case of ulcerohemorrhagic rectocolitis. The highest prevalence of Crohn's disease is encountered among the populations with a high standard of living; the onset of the disease occurs between 15 and 35 years, but there are also rare cases with onset in childbirth or over 60 years of age. Men and women are approximate equally affected by Crohn's disease. The main purpose of the treatment is to keep under control the disease, and to increase the quality of life with the following goals: diminishing intestinal inflammatory lesions, relieving symptoms and inducing remission, preventing relapses and complications, as well as maintaining proper nutrition. Appropriate treatment should be adapted to the different clinical-evolutionary forms of Crohn's disease, the succession of different treatment methods being therefore different. Surgical treatment plays a much more limited role in Crohn's disease than in ulcerhemorrhagic rectocolitis. Operational interventions are frequently followed by relapses, and surgical resections should be limited to macroscopically affected segments.

Learning lessons from operational research in infectious diseases: can the same model be used for noncommunicable diseases in developing countries?

Directory of Open Access Journals (Sweden)

Bosu WK

2014-12-01

Full Text Available William K Bosu Department of Epidemics and Disease Control, West African Health Organisation, Bobo-Dioulasso, Burkina Faso Abstract: About three-quarters of global deaths from noncommunicable diseases (NCDs occur in developing countries. Nearly a third of these deaths occur before the age of 60 years. These deaths are projected to increase, fueled by such factors as urbanization, nutrition transition, lifestyle changes, and aging. Despite this burden, there is a paucity of research on NCDs, due to the higher priority given to infectious disease research. Less than 10% of research on cardiovascular diseases comes from developing countries. This paper assesses what lessons from operational research on infectious diseases could be applied to NCDs. The lessons are drawn from the priority setting for research, integration of research into programs and routine service delivery, the use of routine data, rapid-assessment survey methods, modeling, chemoprophylaxis, and the translational process of findings into policy and practice. With the lines between infectious diseases and NCDs becoming blurred, it is justifiable to integrate the programs for the two disease groups wherever possible, eg, screening for diabetes in tuberculosis. Applying these lessons will require increased political will, research capacity, ownership, use of local expertise, and research funding. Keywords: infectious diseases, noncommunicable diseases, operational research, developing countries, integration

The Analysis of the Disease Spectrum in China

Directory of Open Access Journals (Sweden)

Xin Zhang

2014-01-01

Full Text Available Analysis of the related risks of disease provides a scientific basis for disease prevention and treatment, hospital management, and policy formulation by the changes in disease spectrum of patients in hospital. Retrospective analysis was made to the first diagnosis, age, gender, daily average cost of hospitalized patients, and other factors in the First Affiliated Hospital of Nanjing Medical University during 2006–2013. The top 4 cases were as follows: cardiovascular disease, malignant tumors, lung infections, and noninsulin dependent diabetes mellitus. By the age of disease analysis, we found a younger age trend of cardiovascular disease, and the age of onset of cancer or diabetes was somewhat postponed. The average daily cost of hospitalization and the average daily cost of the main noncommunicable diseases were both on the rise. Noncommunicable diseases occupy an increasingly important position in the constitution of the disease, and they caused an increasing medical burden. People should pay attention to health from the aspects of lifestyle changing. Hospitals should focus on building the appropriate discipline. On the other hand, an integrated government response is required to tackle key risks. Multiple interventions are needed to lower the burden of these diseases and to improve national health.

Development of a preliminary composite disease activity index in psoriatic arthritis.

LENUS (Irish Health Repository)

Mumtaz, Aizad

2012-02-01

OBJECTIVES: To develop a preliminary composite psoriatic disease activity index (CPDAI) for psoriasis and psoriatic arthritis. METHODS: Five domains were assessed and specific instruments were employed for each domain to determine the extent of domain involvement and the effect of that involvement on quality of life\\/function. Disease activity for each domain was then graded from 0 to 3 giving a CPDAI range of 0-15. Patient and physician global disease activity measures were also recorded and an independent physician was asked to indicate if treatment change was required. Bivariate correlation analysis was performed. Factor, tree analysis and standardised response means were also calculated. RESULTS: Significant correlation was seen between CPDAI and both patient (r = 0.834) and physician (r = 0.825) global disease activity assessments (p = 0.01). Tree analysis revealed that 96.3% of patients had their treatment changed when CPDAI values were greater than 6; no patient had their treatment changed when CPDAI values were less than 5. CONCLUSION: CPDAI correlates well with patient and physician global disease activity assessments and is an effective tool that clearly distinguishes those who require a treatment change from those who do not.

[Pregnancy in systemic autoimmune diseases: Myths, certainties and doubts].

Science.gov (United States)

Danza, Álvaro; Ruiz-Irastorza, Guillermo; Khamashta, Munther

2016-10-07

Systemic autoimmune diseases especially affect young women during childbearing age. The aim of this review is to update systemic lupus erythematosus, antiphospholipid syndrome and systemic sclerosis management during pregnancy. These diseases present variable maternal and fetal risks. Studies show that an appropriate disease control and a reasonable remission period prior to pregnancy are associated with satisfactory obstetric outcomes. Antiphospholipid autoantibodies profile, anti-Ro/anti-La antibodies, pulmonary pressure and activity evaluation are crucial to assess the pregnancy risk. Monitoring requires a multidisciplinary team, serial analytic controls and Doppler ultrasound of maternal and fetal circulation. Evaluation of the activity of the disease is essential. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Frequency of gingival and periodontal diseases among troops deployed in operational area

International Nuclear Information System (INIS)

Yousaf, A.; Manzoor, M.A.; Rafi, S.

2014-01-01

Objective: To find the Frequency of Gingival and Periodontal Diseases among Troops Deployed in Operational Area and to evaluate the treatment needs which might be helpful in oral health policy planning and specific intervention against periodontal disease. Design: Descriptive study. Place and Duration of Study: The study was conducted at 140 mobile dental unit Swat from Dec 2009 to June 2011. Subjects and Methods: the periodontal status of 1500 personnels of Pakistan Army was examined using Basic periodontal Examination Index. Data was evaluated by SPSS version 16. Percentage of various gingival and periodontal disease traits was calculated and treatment needs determined. Results: Out of total 1500 subjects 12.8% subjects were having satisfactory periodontal health and required no treatment whereas 38.3% were having gingivitis requiring oral hygiene instruction and prophylaxis. Gingivitis modified by local factors was seen in 23.5% and required oral hygiene instruction and correction of modifying factors. Some (13.6%) were having mild periodontitis and required scaling, root planning and oral hygiene instruction whereas 11.8% were having moderate or advance periodontitis and required comprehensive periodontal treatment including surgical treatment. Conclusion: A large number of cases (82.7%) of gingivitis and periodontitis were detected in subject population which shows lack of awareness and self -consciousness among troops regarding their oral hygiene. (author)

[Respiratory treatments in neuromuscular disease].

Science.gov (United States)

Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

2014-10-01

In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

When can nutritional therapy impact liver disease?

Science.gov (United States)

Bozeman, Matthew C; Benns, Matthew V; McClave, Stephen A; Miller, Keith R; Jones, Christopher M

2014-10-01

This article reviews the current literature regarding nutritional therapy in liver disease, with an emphasis on patients progressing to liver failure as well as surgical patients. Mechanisms of malnutrition and sarcopenia in liver failure patients as well as nutritional assessment, nutritional requirements of this patient population, and goals and methods of therapy are discussed. Additionally, recommendations for feeding, micronutrient, branched chain amino acid supplementation, and the use of pre- and probiotics are included. The impact of these methods can have on patients with advanced disease and those undergoing surgical procedures will be emphasized.

A rivastigmine patch for the treatment of Alzheimer's disease and Parkinson's disease dementia.

Science.gov (United States)

Cummings, Jeffrey; Winblad, Bengt

2007-11-01

Rivastigmine patch is the first transdermal treatment to be approved for Alzheimer's disease (AD) and Parkinson's disease dementia in the USA and for AD in Europe. It provides smooth, continuous drug delivery, and has the potential to maintain rivastigmine concentrations within an optimal therapeutic window while avoiding the peaks and troughs associated with oral drug delivery. The target dose, rivastigmine 9.5 mg/24 h patch (a 10 cm(2) patch), is given once daily and requires a simple one-step dose titration to the therapeutic dose. In a 24-week study in 1195 AD patients, the rivastigmine 9.5 mg/24 h patch provided similar efficacy to the highest dose range of capsules, with approximately three-times fewer reports of nausea and vomiting. Patients in the 9.5 mg/24 h patch and 12 mg/day capsule groups evidenced significant improvements versus placebo on both primary outcome measures: the Alzheimer's Disease Assessment Scale-Cognitive subscale; and Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change; in addition to the following secondary outcome measures: Alzheimer's Disease Cooperative Study-Activities of Daily Living scale; Mini-Mental State Examination; and Trail Making Test Part A for assessment of attention, visual tracking and motor processing speed. Treatment differences on the Neuropsychiatric Inventory and Ten Point Clock-drawing Test did not reach statistical significance in this study. The patch may be the optimal way to treat dementia patients with rivastigmine.

Autoimmune diseases and infections as risk factors for schizophrenia

DEFF Research Database (Denmark)

Benros, Michael E; Mortensen, Preben B; Eaton, William W

2012-01-01

Immunological hypotheses have become increasingly prominent when studying the etiology of schizophrenia. Autoimmune diseases, and especially the number of infections requiring hospitalization, have been identified as significant risk factors for schizophrenia in a dose-response relationship, whic...... diseases and infections should be considered in the treatment of individuals with schizophrenia symptoms, and further research is needed of the immune system's possible contributing pathogenic factors in the etiology of schizophrenia....

Assessment of disease-specific knowledge in Australian children with inflammatory bowel disease and their parents.

Science.gov (United States)

Day, Andrew S; Mylvaganam, Gaithri; Shalloo, Nollaig; Clarkson, Cathy; Leach, Steven T; Lemberg, Daniel A

2017-08-01

Disease-specific knowledge may influence disease outcome and quality of life in children with inflammatory bowel disease (IBD). This prospective study aimed to define IBD-related knowledge in a group of Australian children with IBD and their parents using a validated measure of disease-specific knowledge, the Inflammatory Bowel Disease Knowledge Inventory Device (IBD-KID). Children (less than 18 years) diagnosed with IBD who were members of the Australian patient support organisation were identified. Each family was sent copies of the IBD-KID. Children aged 10-18 years and all parents were asked to complete the IBD-KID and to also provide demographic details and disease characteristics. Replies were received from 196 families: 262 parents and 128 children completed questionnaires. Most children had a diagnosis of Crohn disease (65%) and 51% were male. Children diagnosed in the preceding 6 years scored higher than those with longer time since diagnosis. Parents had better scores in the IBD-KID than the children (P parents and children had poor understanding of key management issues for IBD (such as side effects of steroids), important outcomes (e.g. growth) and the use of complementary therapies. Consistent patterns of IBD-related knowledge were noted in this large group of Australian children with IBD and their parents. Measurement of disease-related knowledge with the IBD-KID can identify gaps in understanding, thereby permitting focused educational activities. Although these knowledge gaps may impact upon outcomes, further prospective studies are now required to elucidate the relationships between enhanced knowledge and specific outcomes. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Risk and safety requirements for diagnostic and therapeutic procedures in allergology

DEFF Research Database (Denmark)

Kowalski, Marek L; Ansotegui, Ignacio; Aberer, Werner

2016-01-01

One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin...... attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk...... associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access...

[Chronic disease management: mistaken approach in the elderly].

Science.gov (United States)

Veras, Renato Peixoto

2012-12-01

Lifestyle changes, including unhealthy eating habits and high rates of physical inactivity and stress, along with an increase in life expectancy have been accompanied by increasing rates of chronic non-communicable diseases. Chronic diseases are the main causes of death and disability in Brazil. Chronic disease management is one of the most important challenges facing health managers who are constantly seeking interventions and strategies to reduce costs and hospital admissions and to prevent other conditions. However, most existing models of health care have focused exclusively on disease, but it is a mistaken approach. An integrated approach is required to effectively meet patient needs. The purpose of this article was to further discuss policies and strategies for the development of new models of care for the elderly with an emphasis on prevention and resolution actions.

Ventricular arrhythmias in Chagas disease

Directory of Open Access Journals (Sweden)

Marco Paulo Tomaz Barbosa

2015-02-01

Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

The Cellular Chaperone Heat Shock Protein 90 Is Required for Foot-and-Mouth Disease Virus Capsid Precursor Processing and Assembly of Capsid Pentamers.

Science.gov (United States)

Newman, Joseph; Asfor, Amin S; Berryman, Stephen; Jackson, Terry; Curry, Stephen; Tuthill, Tobias J

2018-03-01

Productive picornavirus infection requires the hijacking of host cell pathways to aid with the different stages of virus entry, synthesis of the viral polyprotein, and viral genome replication. Many picornaviruses, including foot-and-mouth disease virus (FMDV), assemble capsids via the multimerization of several copies of a single capsid precursor protein into a pentameric subunit which further encapsidates the RNA. Pentamer formation is preceded by co- and posttranslational modification of the capsid precursor (P1-2A) by viral and cellular enzymes and the subsequent rearrangement of P1-2A into a structure amenable to pentamer formation. We have developed a cell-free system to study FMDV pentamer assembly using recombinantly expressed FMDV capsid precursor and 3C protease. Using this assay, we have shown that two structurally different inhibitors of the cellular chaperone heat shock protein 90 (hsp90) impeded FMDV capsid precursor processing and subsequent pentamer formation. Treatment of FMDV permissive cells with the hsp90 inhibitor prior to infection reduced the endpoint titer by more than 10-fold while not affecting the activity of a subgenomic replicon, indicating that translation and replication of viral RNA were unaffected by the drug. IMPORTANCE FMDV of the Picornaviridae family is a pathogen of huge economic importance to the livestock industry due to its effect on the restriction of livestock movement and necessary control measures required following an outbreak. The study of FMDV capsid assembly, and picornavirus capsid assembly more generally, has tended to be focused upon the formation of capsids from pentameric intermediates or the immediate cotranslational modification of the capsid precursor protein. Here, we describe a system to analyze the early stages of FMDV pentameric capsid intermediate assembly and demonstrate a novel requirement for the cellular chaperone hsp90 in the formation of these pentameric intermediates. We show the added complexity

Nutritional-related diseases and management: newspaper ...

African Journals Online (AJOL)

The study showed that many people are ignorant of the importance of eating a balanced diet and eating right to prevent nutritional diseases. This is why the newspapers topics or health tips on diet and nutrition had the highest percentage frequency, because of its importance the needed emphasis it requires. Therefore, it is ...

Creutzfeldt-Jakob disease surveillance in Australia: update to December 2014.

Science.gov (United States)

Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona; Masters, Colin L; Collins, Steven J

2016-06-30

Nation-wide surveillance of human transmissible spongiform encephalopathies (also known as prion diseases), the most common being Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Prospective surveillance has been undertaken since 1993 and over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements concomitant with the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness of prion diseases in the health care setting. In 2014, routine national surveillance continued and this brief report provides an update of the cumulative surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2014, and retrospectively to 1970.

Creutzfeldt-Jakob disease surveillance in Australia: update to December 2015.

Science.gov (United States)

Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona A; Masters, Colin L; Collins, Steven J

2016-09-30

Nation-wide surveillance of human transmissible spongiform encephalopathies (also known as prion diseases), the most common being Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Prospective surveillance has been undertaken since 1993 and over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements concomitant with the delineation of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness of prion diseases in the health care setting. In 2015, routine national surveillance continued and this brief report provides an update of the cumulative surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2015, and retrospectively to 1970.

PET molecular imaging in stem cell therapy for neurological diseases

Energy Technology Data Exchange (ETDEWEB)

Wang, Jiachuan; Zhang, Hong [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Nuclear Medicine, Hangzhou, Zhejiang (China); Zhejiang University, Medical PET Center, Hangzhou (China); Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou (China); Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou (China); Tian, Mei [University of Texas, M.D. Anderson Cancer Center, Department of Experimental Diagnostic Imaging, Houston, TX (United States)

2011-10-15

Human neurological diseases such as Alzheimer's disease, Parkinson's disease, Huntington's disease, spinal cord injury and multiple sclerosis are caused by loss of different types of neurons and glial cells in the brain and spinal cord. At present, there are no effective therapies against these disorders. Discovery of the therapeutic potential of stem cells offers new strategies for the treatment of neurological diseases. Direct assessment of stem cells' survival, interaction with the host and impact on neuronal functions after transplantation requires advanced in vivo imaging techniques. Positron emission tomography (PET) is a potential molecular imaging modality to evaluate the viability and function of transplanted tissue or stem cells in the nervous system. This review focuses on PET molecular imaging in stem cell therapy for neurological diseases. (orig.)

Late-Onset Glycogen Storage Disease Type II (Pompe's Disease) with a Novel Mutation: A Malaysian Experience.

Science.gov (United States)

Fu Liong, Hiew; Abdul Wahab, Siti Aishah; Yakob, Yusnita; Lock Hock, Ngu; Thong, Wong Kum; Viswanathan, Shanthi

2014-01-01

Pompe's disease (acid maltase deficiency, glycogen storage disease type II) is an autosomal recessive disorder caused by a deficiency of lysosomal acid α-1,4-glucosidase, resulting in excessive accumulation of glycogen in the lysosomes and cytoplasm of all tissues, most notably in skeletal muscles. We present a case of adult-onset Pompe's disease with progressive proximal muscles weakness over 5 years and respiratory failure on admission, requiring prolonged mechanical ventilation. Electromyography showed evidence of myopathic process with small amplitudes, polyphasic motor unit action potentials, and presence of pseudomyotonic discharges. Muscle biopsy showed glycogen-containing vacuoles in the muscle fibers consistent with glycogen storage disease. Genetic analysis revealed two compound heterozygous mutations at c.444C>G (p.Tyr148∗) in exon 2 and c.2238G>C (p.Trp746Cys) in exon 16, with the former being a novel mutation. This mutation has not been reported before, to our knowledge. The patient was treated with high protein diet during the admission and subsequently showed good clinical response to enzyme replacement therapy with survival now to the eighth year. Conclusion. In patients with late-onset adult Pompe's disease, careful evaluation and early identification of the disease and its treatment with high protein diet and enzyme replacement therapy improve muscle function and have beneficial impact on long term survival.

Cell-based therapies for chronic kidney disease

NARCIS (Netherlands)

van Koppen, A.N.

2013-01-01

Chronic kidney disease (CKD) may lead to end-stage renal failure, requiring renal replacement strategies. Development of new therapies to reduce progression of CKD is therefore a major global public health target. The aim of this thesis was to investigate whether cell-based therapies have the

Radiologic examination of duodenum in celia disease

International Nuclear Information System (INIS)

Tomei, E.; Diacinti, D.; Gentile, F.; Picarelli, A.; Francone, A.

1988-01-01

Celiac disease (CD) is the most common form of malabsorption in childhood when it presents with diarrhea and groeth failure, a jejunal biopsy is considered the first diagnostic investigation by some authors. In adulthood, clinical symptoms of CD may mimik several different disease, such as peptic ulcer and IBS, and the first diagnostic investigation is an upper GI series. Radiological features of duodenum and small bowel were evaluated in twenty patients with adult onset celiac disease. Sign of duodenitis such as thickened folds, mucosal nodules, dilatation of duodenum and erosions were observed in 19 out of 20 patients (95%); particulary, thickened folds in 71 (85%), nodularity in 16 (80%), duodenal dilatation in 12 (60%) and erosions in 4 (20%). In celiac disease the lesions are more severe in the upper part of small bowel, and duodenitis may be the unique sign of CD. Duodenitis may be part of a disease involving the entire small bowel; so, a duodenitis observed in the upper gastrointestinal tract requires the study of the entire small bowel - which seems to be very important in the case of celiac disease

Feminism and Multiculturalism: Parallels and Intersections

Science.gov (United States)

Reynolds, Amy L.; Constantine, Madonna G.

2004-01-01

Increasingly, the psychological literature has begun to address both feminist and multicultural concerns, although these fields have rarely incorporated each others' diverse and vibrant ideas. This article explores the connections between feminist and multicultural psychology, and encourages the profession to more fully embrace and affirm both…

The Rise of Computing Research in East Africa: The Relationship between Funding, Capacity and Research Community in a Nascent Field

Science.gov (United States)

Harsh, Matthew; Bal, Ravtosh; Wetmore, Jameson; Zachary, G. Pascal; Holden, Kerry

2018-01-01

The emergence of vibrant research communities of computer scientists in Kenya and Uganda has occurred in the context of neoliberal privatization, commercialization, and transnational capital flows from donors and corporations. We explore how this funding environment configures research culture and research practices, which are conceptualized as…

Creating a Safe Haven for University Students: How Are We Doing?

Science.gov (United States)

Sanders, Mark

2012-01-01

Too frequently, and often too late, academic librarians learn of patron experiences involving problem patrons, misdemeanor criminal activity, or poorly secured areas. Regrettably, these experiences can irrevocably diminish perceptions of access to the vibrant learning spaces and services offered by our institutions. This article assesses the…

The Ultimate Cookbook for Cultural Managers : Social Security in International Context

NARCIS (Netherlands)

D. Molenaar (Dick)

2017-01-01

markdownabstractActivities of artists are rarely limited to their own country. Nowadays artists (and other cultural professionals) are very mobile and easily accept a job offer or an activity abroad. All these situations show a vibrant and highly mobile sector that is not defined by borders.

At the Intersection of College & Community

Science.gov (United States)

Pierce, Dennis

2016-01-01

By purchasing abandoned facilities and transforming them into vibrant hubs for culture and education, community colleges are fulfilling one of their key missions: revitalizing their communities. But these types of projects can be fraught with challenges as well. Here's how Austin Community College (Texas), Manchester Community College…

Getting What You Pay For? A Look at America's Top-Ranked Public Universities

Science.gov (United States)

Poliakoff, Michael; Alacbay, Armand

2014-01-01

America's great public universities were founded with the highest expectations of academic excellence and service to their states. Overall, these institutions, often called the "flagship universities," do a poor job of ensuring that undergraduate students engage in an intellectually vibrant campus culture and leave with a solid…

Malmo: A city in transition

DEFF Research Database (Denmark)

Anderson, Tessa Kate

2014-01-01

become a multicultural city with vibrant neighbourhoods and successful new developments such as the Western Harbour. The Øresund bridge has increased its linkages with Denmark and Europe providing easy access for employment and residential opportunities. The success of the city will be measured in its...

How School Districts Can Support Deeper Learning: The Need for Performance Alignment. Executive Summary. Deeper Learning Research Series

Science.gov (United States)

Honig, Meredith I.; Rainey, Lydia R.

2015-01-01

School district leaders nationwide aspire to help their schools become vibrant places for learning--where students have meaningful academic opportunities "and" develop critical thinking and problem-solving skills, the ability to communicate effectively, and other deeper learning capacities that are essential to success in later life.…

Lafora disease: epidemiology, pathophysiology and management.

LENUS (Irish Health Repository)

Monaghan, Thomas S

2010-07-01

Lafora disease is a rare, fatal, autosomal recessive, progressive myoclonic epilepsy. It may also be considered as a disorder of carbohydrate metabolism because of the formation of polyglucosan inclusion bodies in neural and other tissues due to abnormalities of the proteins laforin or malin. The condition is characterized by epilepsy, myoclonus and dementia. Diagnostic findings on MRI and neurophysiological testing are not definitive and biopsy or genetic studies may be required. Therapy in Lafora disease is currently limited to symptomatic management of the epilepsy, myoclonus and intercurrent complications. With a greater understanding of the pathophysiological processes involved, there is justified hope for future therapies.

Fishing diseased abalone to promote yield and conservation

Science.gov (United States)

Ben-Horin, Tal; Lafferty, Kevin D.; Bidegain, Gorka; Lenihan, Hunter S.

2016-01-01

Past theoretical models suggest fishing disease-impacted stocks can reduce parasite transmission, but this is a good management strategy only when the exploitation required to reduce transmission does not overfish the stock. We applied this concept to a red abalone fishery so impacted by an infectious disease (withering syndrome) that stock densities plummeted and managers closed the fishery. In addition to the non-selective fishing strategy considered by past disease-fishing models, we modelled targeting (culling) infected individuals, which is plausible in red abalone because modern diagnostic tools can determine infection without harming landed abalone and the diagnostic cost is minor relative to the catch value. The non-selective abalone fishing required to eradicate parasites exceeded thresholds for abalone sustainability, but targeting infected abalone allowed the fishery to generate yield and reduce parasite prevalence while maintaining stock densities at or above the densities attainable if the population was closed to fishing. The effect was strong enough that stock and yield increased even when the catch was one-third uninfected abalone. These results could apply to other fisheries as the diagnostic costs decline relative to catch value.

Fishing diseased abalone to promote yield and conservation.

Science.gov (United States)

Ben-Horin, Tal; Lafferty, Kevin D; Bidegain, Gorka; Lenihan, Hunter S

2016-03-05

Past theoretical models suggest fishing disease-impacted stocks can reduce parasite transmission, but this is a good management strategy only when the exploitation required to reduce transmission does not overfish the stock. We applied this concept to a red abalone fishery so impacted by an infectious disease (withering syndrome) that stock densities plummeted and managers closed the fishery. In addition to the non-selective fishing strategy considered by past disease-fishing models, we modelled targeting (culling) infected individuals, which is plausible in red abalone because modern diagnostic tools can determine infection without harming landed abalone and the diagnostic cost is minor relative to the catch value. The non-selective abalone fishing required to eradicate parasites exceeded thresholds for abalone sustainability, but targeting infected abalone allowed the fishery to generate yield and reduce parasite prevalence while maintaining stock densities at or above the densities attainable if the population was closed to fishing. The effect was strong enough that stock and yield increased even when the catch was one-third uninfected abalone. These results could apply to other fisheries as the diagnostic costs decline relative to catch value. © 2016 The Author(s).

South Asia's health promotion kaleidoscope.

Science.gov (United States)

Mukhopadhyay, Alok

2007-01-01

South Asia has 22 percent of the world's population but only 1.3 percent of the global income. Consequently 40 percent of the population is living in absolute poverty. However the health transition in some of its countries including India and Sri Lanka is a testimony to the fact that there are proven solutions to the problems of health and development within the region. The countries of the region have much in common, including a democratic political system, four major religions, a vibrant and living tradition of voluntarism and an extensive health infrastructure which is operating well below par. Despite the underlying unity, South Asia enjoys enormous cultural, linguistic and ethnic diversity. In this large, complex and vibrant region, health promotion is a challenging task, but it also holds the key to a dramatic change in the global health situation. Many of these solutions lie in wider areas of socio-political action. There are much needed shifts in the health promotion and development efforts, particularly in the area of poverty and social justice; gender inequity; population stabilisation; health and environment; control of communicable and non-communicable diseases; and urban health strategies. The principle of cooperation, partnership and intersectoral collaboration for health will be explored. Developing an appropriate, sustainable and people centred health and development strategy in the coming decades is an enormous challenge. There has been an attempt to focus on the emerging needs of the region, which call for health promotion, and involvement of civil society, private sector and the governments bestowed with the increased responsibility of ensuring health security for people. Strengthening the existing health systems, allocating adequate resources for health development and ensuring community participation are all prerequisites to the success of health promotion in the region.

The Treatment of Cushing's Disease

Science.gov (United States)

De Leo, Monica; Cozzolino, Alessia; Colao, Annamaria

2015-01-01

Cushing's disease (CD), or pituitary-dependent Cushing's syndrome, is a severe endocrine disease caused by a corticotroph pituitary tumor and associated with increased morbidity and mortality. The first-line treatment for CD is pituitary surgery, which is followed by disease remission in around 78% and relapse in around 13% of patients during the 10-year period after surgery, so that nearly one third of patients experience in the long-term a failure of surgery and require an additional second-line treatment. Patients with persistent or recurrent CD require additional treatments, including pituitary radiotherapy, adrenal surgery, and/or medical therapy. Pituitary radiotherapy is effective in controlling cortisol excess in a large percentage of patients, but it is associated with a considerable risk of hypopituitarism. Adrenal surgery is followed by a rapid and definitive control of cortisol excess in nearly all patients, but it induces adrenal insufficiency. Medical therapy has recently acquired a more important role compared to the past, due to the recent employment of novel compounds able to control cortisol secretion or action. Currently, medical therapy is used as a presurgical treatment, particularly for severe disease; or as postsurgical treatment, in cases of failure or incomplete surgical tumor resection; or as bridging therapy before, during, and after radiotherapy while waiting for disease control; or, in selected cases, as primary therapy, mainly when surgery is not an option. The adrenal-directed drug ketoconazole is the most commonly used drug, mainly because of its rapid action, whereas the glucocorticoid receptor antagonist, mifepristone, is highly effective in controlling clinical comorbidities, mainly glucose intolerance, thus being a useful treatment for CD when it is associated with diabetes mellitus. Pituitary-directed drugs have the advantage of acting at the site responsible for CD, the pituitary tumor. Among this group of drugs, the dopamine

Patterns of oral disease in adults with chronic kidney disease treated with hemodialysis.

Science.gov (United States)

Palmer, Suetonia C; Ruospo, Marinella; Wong, Germaine; Craig, Jonathan C; Petruzzi, Massimo; De Benedittis, Michele; Ford, Pauline; Johnson, David W; Tonelli, Marcello; Natale, Patrizia; Saglimbene, Valeria; Pellegrini, Fabio; Celia, Eduardo; Gelfman, Ruben; Leal, Miguel R; Torok, Marietta; Stroumza, Paul; Frantzen, Luc; Bednarek-Skublewska, Anna; Dulawa, Jan; Del Castillo, Domingo; Bernat, Amparo G; Hegbrant, Jorgen; Wollheim, Charlotta; Schon, Staffan; Gargano, Letizia; Bots, Casper P; Strippoli, Giovanni F M

2016-10-01

Oral disease is a potentially treatable determinant of mortality and quality of life. No comprehensive multinational study to quantify oral disease burden and to identify candidate preventative strategies has been performed in the dialysis setting. The ORAL disease in hemoDialysis (ORALD) study was a prospective study in adults treated with hemodialysis in Europe (France, Hungary, Italy, Poland, Portugal and Spain) and Argentina. Oral disease was assessed using standardized WHO methods. Participants self-reported oral health practices and symptoms. Sociodemographic and clinical factors associated with oral diseases were determined and assessed within nation states. Of 4726 eligible adults, 4205 (88.9%) participated. Overall, 20.6% were edentulous [95% confidence interval (CI), 19.4-21.8]. Participants had on average 22 (95% CI 21.7-22.2) decayed, missing or filled teeth, while moderate to severe periodontitis affected 40.6% (95% CI 38.9-42.3). Oral disease patterns varied markedly across countries, independent of participant demographics, comorbidity and health practices. Participants in Spain, Poland, Italy and Hungary had the highest mean adjusted odds of edentulousness (2.31, 1.90, 1.90 and 1.54, respectively), while those in Poland, Hungary, Spain and Argentina had the highest odds of ≥14 decayed, missing or filled teeth (23.2, 12.5, 8.14 and 5.23, respectively). Compared with Argentina, adjusted odds ratios for periodontitis were 58.8, 58.3, 27.7, 12.1 and 6.30 for Portugal, Italy, Hungary, France and Poland, respectively. National levels of tobacco consumption, diabetes and child poverty were associated with edentulousness within countries. Oral disease in adults on hemodialysis is very common, frequently severe and highly variable among countries, with much of the variability unexplained by participant characteristics or healthcare. Given the national variation and high burden of disease, strategies to improve oral health in hemodialysis patients will

Next Generation Microbiology Requirements

Science.gov (United States)

Ott, C. M.; Oubre, C. M.; Elliott, T. F.; Castro, V. A.; Pierson, D. L.

2012-01-01

As humans continue to explore deep into space, microorganisms will travel with them. The primary means to mitigate the risk of infectious disease are a combination of prudent spacecraft design and rigorous operational controls. The effectiveness of these methods are evaluated by microbiological monitoring of spacecraft, food, water, and the crew that is performed preflight, in-flight, and post-flight. Current NASA requirements associated with microbiological monitoring are based on culture-based methodology where microorganisms are grown on a semi-solid growth medium and enumerated. Subsequent identification of the organisms requires specialized labor and large equipment, which historically has been performed on Earth. Requirements that rely strictly on culture-based units limit the use of non-culture based monitoring technology. Specifically, the culture-based "measurement criteria" are Colony Forming Units (CFU, representing the growth of one microorganism at a single location on the agar medium) per a given volume, area, or sample size. As the CFU unit by definition is culture-based, these requirements limit alternative technologies for spaceflight applications. As spaceflight missions such as those to Mars extend further into space, culture-based technology will become difficult to implement due to the (a) limited shelf life of the culture media, (b) mass/volume necessary to carry these consumables, and (c) problems associated with the production of biohazardous material in the habitable volume of the spacecraft. In addition, an extensive amount of new knowledge has been obtained during the Space Shuttle, NASA-Mir, and International Space Station Programs, which gave direction for new or modified microbial control requirements for vehicle design and mission operations. The goal of this task is to develop and recommend a new set of requirements for vehicle design and mission operations, including microbiological monitoring, based upon "lessons learned" and new

Mapping Neurodegenerative Disease Onset and Progression.

Science.gov (United States)

Seeley, William W

2017-08-01

Brain networks have been of long-standing interest to neurodegeneration researchers, including but not limited to investigators focusing on conventional prion diseases, which are known to propagate along neural pathways. Tools for human network mapping, however, remained inadequate, limiting our understanding of human brain network architecture and preventing clinical research applications. Until recently, neuropathological studies were the only viable approach to mapping disease onset and progression in humans but required large autopsy cohorts and laborious methods for whole-brain sectioning and staining. Despite important advantages, postmortem studies cannot address in vivo, physiological, or longitudinal questions and have limited potential to explore early-stage disease except for the most common disorders. Emerging in vivo network-based neuroimaging strategies have begun to address these issues, providing data that complement the neuropathological tradition. Overall, findings to date highlight several fundamental principles of neurodegenerative disease anatomy and pathogenesis, as well as some enduring mysteries. These principles and mysteries provide a road map for future research. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

Health-related quality of life in children and adolescents with celiac disease

DEFF Research Database (Denmark)

Skjerning, Halfdan; Mahony, Ruth O; Husby, Steffen

2014-01-01

Celiac disease (CD) is a chronic inflammatory disease requiring constant management with a gluten-free diet (GFD). Little is known about how CD impacts on health-related quality of life (HRQOL) in children and adolescents, and how they feel about and cope with CD and GFD. This qualitative study...

Determinants for the development of visceral leishmaniasis disease.

Directory of Open Access Journals (Sweden)

Laura-Isobel McCall

2013-01-01

Full Text Available Leishmaniasis is a vector-borne neglected tropical disease associated with a spectrum of clinical manifestations, ranging from self-healing cutaneous lesions to fatal visceral infections. Among the most important questions in Leishmania research is why some species like L. donovani infect visceral organs, whereas other species like L. major remain in the skin. The determinants of visceral leishmaniasis are still poorly understood, although genomic, immunologic, and animal models are beginning to provide important insight into this disease. In this review, we discuss the vector, host, and pathogen factors that mediate the development of visceral leishmaniasis. We examine the progression of the parasite from the initial site of sand fly bite to the visceral organs and its ability to survive there. The identification of visceral disease determinants is required to understand disease evolution, to understand visceral organ survival mechanisms, and potentially to develop better interventions for this largely neglected disease.

Management of patients with chronic kidney disease

African Journals Online (AJOL)

This article deals with these aspects, including follow-up guidelines and management and treatment ... those with ischaemic heart disease also require cardiac review at least once a year. .... doses when fluid losses are high, e.g. sweating in hot environments, ... dried beans, lentils, offal, salmon, chocolate, cola drinks and.

CLINICIAN SENSITIZATION ON INTEGRATED DISEASE SURVEILLANCE AND RESPONSE IN FEDERAL MEDICAL CENTRE OWO, ONDO STATE, NIGERIA, 2016

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Olayinka Stephen Ilesanmi

2017-06-01

Full Text Available Background: For effective Integrated Disease Surveillance and Response (IDSR all health care workers involvement is required. Most trainings have often neglected the clinicians. Aim: This study aimed to identify gaps requiring capacity building in preventing infectious disease outbreak among health care workers in Federal Medical Centre, Owo, Ondo State. Methods: A cross sectional study of clinicians at the Federal Medical Centre, Owo was done. Data was collected using semi structured interviewer administered questionnaire. Data collected were analysed with SPSS version 21. Summary statistics was conducted to identify training need requirements. Results: The mean age of participant was 43 ± 5.9 years, 14(70% were male. Respondents who have worked for 10 years and above were 12(60%. In all, 5(25% respondent understood disease surveillance to be systematic collection of data and analysis in order to prevent diseases. Regarding respondent’s knowledge of notifiable diseases. Only 4(20% of the respondents knew malaria as a notifiable disease, Cholera knew by 11(55%, Ebola by 15(75% and Lassa by 13(65%. The main factor identified to be affecting prompt disease notification in Federal Medical Centre, Owo was lack of adequate training 12(60% while communication gap was identified by 7(35%. In all, 18(90% felt they do not know all that they needed about disease surveillance. Conclusion: Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of disease trends. Trainings that will improve the level of knowledge of clinician and communication channels will improve disease surveillance and notification.

Interactions between social structure, demography, and transmission determine disease persistence in primates.

Science.gov (United States)

Ryan, Sadie J; Jones, James H; Dobson, Andrew P

2013-01-01

Catastrophic declines in African great ape populations due to disease outbreaks have been reported in recent years, yet we rarely hear of similar disease impacts for the more solitary Asian great apes, or for smaller primates. We used an age-structured model of different primate social systems to illustrate that interactions between social structure and demography create 'dynamic constraints' on the pathogens that can establish and persist in primate host species with different social systems. We showed that this varies by disease transmission mode. Sexually transmitted infections (STIs) require high rates of transmissibility to persist within a primate population. In particular, for a unimale social system, STIs require extremely high rates of transmissibility for persistence, and remain at extremely low prevalence in small primates, but this is less constrained in longer-lived, larger-bodied primates. In contrast, aerosol transmitted infections (ATIs) spread and persist at high prevalence in medium and large primates with moderate transmissibility;, establishment and persistence in small-bodied primates require higher relative rates of transmissibility. Intragroup contact structure - the social network - creates different constraints for different transmission modes, and our model underscores the importance of intragroup contacts on infection prior to intergroup movement in a structured population. When alpha males dominate sexual encounters, the resulting disease transmission dynamics differ from when social interactions are dominated by mother-infant grooming events, for example. This has important repercussions for pathogen spread across populations. Our framework reveals essential social and demographic characteristics of primates that predispose them to different disease risks that will be important for disease management and conservation planning for protected primate populations.

Intravenous immunoglobulin G (IVIG) therapy for significant hyperbilirubinemia in ABO hemolytic disease of the newborn.

Science.gov (United States)

Miqdad, A M; Abdelbasit, O B; Shaheed, M M; Seidahmed, M Z; Abomelha, A M; Arcala, O P

2004-09-01

Although intravenous immunoglobulin G (IVIG) therapy has been reported in hyperbilirubinemia of Rh hemolytic disease, its use in ABO hemolytic disease has been reported in only a few studies. In our institute we have observed that almost 30% of babies with hyperbilirubinemia due to ABO hemolytic disease required exchange transfusion. To determine whether administration of IVIG to newborns with significant hyperbilirubinemia due to ABO hemolytic disease would reduce the need for exchange transfusion as a primary goal in these babies. This was a prospective study involving all newborns with significant hyperbilirubinemia due to direct Coombs-positive ABO hemolytic disease. All healthy term babies with ABO hemolytic disease with positive direct Coombs test in the period between 2000 and 2002 were identified. Significant hyperbilirubinemia was defined as hyperbilirubinemia requiring phototherapy and/or rising by 8.5 micromol/l per h (0.5 mg/dl per h) or more to require exchange transfusion. Babies were randomly assigned into two groups: group 1 (study group) received phototherapy plus IVIG (500 mg/kg); and group 2 (control group) received phototherapy alone. Exchange transfusion was carried out in any group if at any time the bilirubin level reached 340 micromol/l (20 mg/dl) or more, or rose by 8.5 micromol/l per h (0.5 mg/dl per h) in group 2. A total of 112 babies were enrolled over 2 years, 56 in each group. Exchange transfusion was carried out in four babies in the study group, while 16 babies in the control group required exchange. Late anemia was not of concern in either group. No adverse effects related to IVIG administration were recorded. Administration of IVIG to newborns with significant hyperbilirubinemia due to ABO hemolytic disease with positive direct Coomb's test reduces the need for exchange transfusion without producing immediate adverse effects.

Lack of school requirements and clinician recommendations for human papillomavirus vaccination

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Linda M. Niccolai

2018-04-01

Full Text Available Background: A strong recommendation from a clinician is one of the best predictors of human papillomavirus (HPV vaccination among adolescents, yet many clinicians do not provide effective recommendations. The objective of this study was to understand how the lack of school entry requirements for HPV vaccination influences clinicians’ recommendations. Design and Methods: Semi-structured interviews with a purposive sample of 32 clinicians were conducted in 2015 in Connecticut USA. Data were analysed using an iterative thematic approach in 2016-2017. Results: Many clinicians described presenting HPV vaccination as optional or non-urgent because it is not required for school entry. This was noted to be different from how other required vaccines were discussed. Even strong recommendations were often qualified by statements about the lack of requirements. Furthermore, lack of requirements was often raised initially by clinicians and not by parents. Many clinicians agreed that requirements would simplify the recommendation, but that parents may not agree with requirements. Personal opinions about school entry requirements were mixed. Conclusions: The current lack of school entry requirements for HPV vaccination is an important influence on clinicians’ recommendations that are often framed as optional or non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that remains strong and focused on disease prevention yet uncoupled from the lack of requirements that may encourage delays. Additionally, greater support for requirements among clinicians may be needed to successfully enact requirements in the future.

Mucopolysaccharidoses Causing Valvular Heart Disease: Report and Review of Surgical Management.

Science.gov (United States)

Encarnacion, Carlos O; Hang, Dustin; Earing, Michael; Mitchell, Michael E

2017-01-01

Mucopolysaccharidosis type I is a genetic disorder with impaired glycosaminoglycan degradation. Cardiac pathologic involvement in this subset of patients is predominantly valvular heart disease. Valvular heart disease seen in these patients will most likely require surgical intervention in their lifetime. Only a limited amount of reports are dedicated to the cardiac surgical management of mucopolysaccharidoses. We present the case of a 32-year-old female with Hurler-Scheie syndrome who required multiple valve replacements due to progression of valvular dysfunction and decline in the quality of life. Multidisciplinary evaluation and discussion early are crucial for quality of life optimization in this cohort of patients.

Critical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine.

Science.gov (United States)

Baker, Tim; Khalid, Karima; Acicbe, Ozlem; McGloughlin, Steve; Amin, Pravin

2017-12-01

Tropical disease results in a great burden of critical illness. The same life-saving and supportive therapies to maintain vital organ functions that comprise critical care are required by these patients as for all other diseases. In low income countries, the little available data points towards high mortality rates and big challenges in the provision of critical care. Improving critical care in low income countries requires a focus on hospital design, training, triage, monitoring & treatment modifications, the basic principles of critical care, hygiene and the involvement of multi-disciplinary teams. As a large proportion of critical illness from tropical disease is in low income countries, the impact and reductions in mortality rates of improved critical care in such settings could be substantial. Copyright © 2017. Published by Elsevier Inc.

Protective influence of healthful nutrition on mechanisms of environmental pollutant toxicity and disease risks.

Science.gov (United States)

Hoffman, Jessie B; Hennig, Bernhard

2017-06-01

Human exposures to environmental contaminants around the world contribute to the global burden of disease and thus require urgent attention. Exploring preventive measures against environmental exposure and disease risk is essential. While a sedentary lifestyle and/or poor dietary habits can exacerbate the deleterious effects resulting from exposure to toxic chemicals, much emerging evidence suggests that positive lifestyle changes (e.g., healthful nutrition) can modulate and/or reduce the toxicity of environmental pollutants. Our work has shown that diets high in anti-inflammatory bioactive food components (e.g., phytochemicals or polyphenols) are possible strategies for modulating and reducing the disease risks associated with exposure to toxic pollutants in the environment. Thus, consuming healthy diets rich in plant-derived bioactive nutrients may reduce the vulnerability to diseases linked to environmental toxic insults. This nutritional paradigm in environmental toxicology requires further study in order to improve our understanding of the relationships between nutrition and other lifestyle modifications and toxicant-induced diseases. © 2017 New York Academy of Sciences.

Hotspots in clinical management of severe liver diseases

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LYU Jiayu

2017-09-01

Full Text Available Severe liver diseases such as liver failure and acute decompensated cirrhosis have critical conditions and high mortality rates, and the prognosis of such patients is closely associated with early warning, timely dynamic assessment, and comprehensive and effective therapy. The patients require a series of effective clinical management measures for elimination of causative factors, organ support, and prevention and treatment of complications. Medical treatment-artificial liver-liver transplantation is an important modality for severe liver diseases. Granulocyte colony-stimulating factor, stem cell therapy, and bioartificial liver have a promising future, while there are still controversies over non-selective β-blocker. This article reviews the hotspots in the clinical management of severe liver diseases.

Phosphorus Regulation in Chronic Kidney Disease.

Science.gov (United States)

Suki, Wadi N; Moore, Linda W

2016-01-01

Serum phosphorus levels stay relatively constant through the influence of multiple factors-such as parathyroid hormone, fibroblast growth factor 23, and vitamin D-on the kidney, bone, and digestive system. Whereas normal serum phosphorus ranges between 3 mg/dL to 4.5 mg/dL, large cross-sectional studies have shown that even people with normal kidney function are sometimes found to have levels ranging between 1.6 mg/dL and 6.2 mg/dL. While this may partially be due to diet and the factors mentioned above, total understanding of these atypical ranges of serum phosphorus remains uncertain. Risks for bone disease are high in people aged 50 and older, and this group comprises a large proportion of people who also have chronic kidney disease. Consuming diets low in calcium and high in phosphorus, especially foods with phosphate additives, further exacerbates bone turnover. Existing bone disease increases the risk for high serum phosphorus, and higher serum phosphorus has been associated with increased adverse events and cardiovascular-related mortality both in people with chronic kidney disease and in those with no evidence of disease. Once kidney function has deteriorated to end-stage disease (Stage 5), maintaining normal serum phosphorus requires dietary restrictions, phosphate-binding medications, and dialysis. Even so, normal serum phosphorus remains elusive in many patients with Stage 5 kidney disease, and researchers are testing novel targets that may inhibit intestinal transport of phosphorus to achieve better phosphate control. Protecting and monitoring bone health should also aid in controlling serum phosphorus as kidney disease advances.

The base moments in etiological prevention of peri-odontal disease in children and adolescents

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Kharitonova T.L.

2011-03-01

Full Text Available Anatomical and physiological features of the growing organism requires a different approach to prevention and treatment of periodontal disease. This article presents the highlights of the etiological prevention of periodontal diseases, taking into account the anatomical and physiological, and psycho-emotional features of childhood, are based on current data on the prevalence periodontal disease in children, recent research findings in the etiology and patho-genesis of periodontal disease

The base moments in etiological prevention of peri-odontal disease in children and adolescents

OpenAIRE

Kharitonova T.L.; Suyetenkov D.Ye.; Gritsenko Е.А.; Lebedeva S.N.

2011-01-01

Anatomical and physiological features of the growing organism requires a different approach to prevention and treatment of periodontal disease. This article presents the highlights of the etiological prevention of periodontal diseases, taking into account the anatomical and physiological, and psycho-emotional features of childhood, are based on current data on the prevalence periodontal disease in children, recent research findings in the etiology and patho-genesis of periodontal disease

[Venous thromboembolic disease: presentation of a case].

Science.gov (United States)

Mirpuri-Mirpuri, P G; Álvarez-Cordovés, M M; Pérez-Monje, A

2013-01-01

Venous thromboembolic disease in its clinical spectrum includes both deep vein thrombosis and pulmonary thromboembolism, which is usually a complication of deep vein thrombosis. It is a relatively common disease with significant morbidity and requires an accurate diagnosis. They are numerous risk factors for venous thromboembolism, and there is evidence that the risk of thromboembolic disease increases proportionally to the number of predisposing risk factors present. The primary care physician should know the risk factors and suspect the presence of venous thromboembolic disease when there is a compatible clnical picture. The treatment for this pathology is anticoagulation. We report a patient with cardiovascular risk factors who was seen with pain in the right leg and shortness of breath and referred to the hospital with suspected venous thromboembolism, atrial fibrillation and pleural effusion. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening.

Science.gov (United States)

Marcellin, Patrick; Kutala, Blaise K

2018-02-01

CLDs represent an important, and certainly underestimated, global public health problem. CLDs are highly prevalent and silent, related to different, sometimes associated causes. The distribution of the causes of these diseases is slowly changing, and within the next decade, the proportion of virus-induced CLDs will certainly decrease significantly while the proportion of NASH will increase. There is an urgent need for effective global actions including education, prevention and early diagnosis to manage and treat CLDs, thus preventing cirrhosis-related morbidity and mortality. Our role is to increase the awareness of the public, healthcare professionals and public health authorities to encourage active policies for early management that will decrease the short- and long-term public health burden of these diseases. Because necroinflammation is the key mechanism in the progression of CLDs, it should be detected early. Thus, large-scale screening for CLDs is needed. ALT levels are an easy and inexpensive marker of liver necroinflammation and could be the first-line tool in this process. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Neglected tropical diseases: now more than just 'other diseases'--the post-2015 agenda.

Science.gov (United States)

Molyneux, David H

2014-09-01

Neglected tropical diseases (NTDs) have become recognised as important health problems facing at least a billion people in the low-income countries and the poorest communities in middle-income countries. WHO plays a leading role in developing strategies to address these diseases, pharmaceutical companies provide drug donations to treat or control the NTDs and many partners from different constituencies have become increasingly committed to their control or elimination. This review looks to the post-2015 agenda and emphasises that despite the progress made over recent years, if the targets established are to be achieved, then not only will additional financial resources be required to up-scale treatments and increase access, but increased applied and operational research will be necessary to address problems and human capacity in NTD skills will need to be strengthened. Continuing advocacy for the relevance of control or elimination of NTDs must be placed in the context of universal health coverage and access to donated essential medicines for the poor as a right. The evidence that investment in NTD interventions are cost-effective and impact not only on health, but also to enhance socio-economic development, must be refined and promulgated. The global burden of disease attributable to NTDs requires reassessment to appropriately define the true burden, while the potential for unexpected events, political, climatic, environmental as well as biological, have the potential to reduce future progress towards the agreed post-2015 targets. NTD progress towards the WHO Roadmap targets and the fulfilment of the World Health Assembly Resolution 66.12 of 2013 demand continued commitment from all partner constituencies when challenges emerge. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Diffusion MR imaging in sporadic Creutzfeldt-Jakob disease

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Burcak Cakir Pekoz

2014-08-01

Full Text Available Creutzfeldt-Jakob disease (CJD is a rare dementing disease and is thought to caused by a prion. It is characterized by rapidly progressive dementia, ataxia, myoclonus, akinetic mutism and eventual death. Brain biopsy or autopsy is required for a definitive diagnosis of CJD. Diffusion-weighted imaging became an important tool for early diagnosis of CJD because of the high sensitivity. We present 59-year-old female patient diagnosed as sporadic CJD with typical MR imagings. [Cukurova Med J 2014; 39(4.000: 880-883

Big Data for Infectious Disease Surveillance and Modeling

DEFF Research Database (Denmark)

Bansal, Shweta; Chowell, Gerardo; Simonsen, Lone

2016-01-01

We devote a special issue of the Journal of Infectious Diseases to review the recent advances of big data in strengthening disease surveillance, monitoring medical adverse events, informing transmission models, and tracking patient sentiments and mobility. We consider a broad definition of big data...... issue and highlight several cross-cutting areas that require further research, including representativeness, biases, volatility, and validation, and the need for robust statistical and hypotheses-driven analyses. Overall, we are optimistic that the big-data revolution will vastly improve the granularity...

DESIGN AND CALIBRATION OF A VIBRANT SAMPLE MAGNETOMETER: CHARACTERIZATION OF MAGNETIC MATERIALS

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Freddy P. Guachun

2018-01-01

Full Text Available This paper presents the process followed in the implementation of a vibrating sample magnetometer (VSM, constructed with materials commonly found in an electromagnetism laboratory. It describes the design, construction, calibration and use in the characterization of some magnetic materials. A VSM measures the magnetic moment of a sample when it is vibrated perpendicular to a uniform magnetic field; Magnetization and magnetic susceptibility can be determined from these readings. This instrument stands out for its simplicity, versatility and low cost, but it is very sensitive and capable of eliminating or minimizing many sources of error that are found in other methods of measurement, allowing to obtain very accurate and reliable results. Its operation is based on the law of magnetic induction of Lenz-Faraday that consists in measuring the induced voltage in coils of detection produced by the variation of the magnetic flux that crosses them. The calibration of the VSM was performed by means of a standard sample (Magnetite and verified by means of a test sample (Nickel.

Addison's disease - the difficulty of diagnosis

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Clara Preto

2018-04-01

Full Text Available Introduction: Primary adrenal insufficiency is a rare disease, especially in pediatric age. Case report: We report the case of a teenager with astenia with four months’ evolution, causing repeated visits to the emergency department during the previous month due gastrointestinal symptoms and a ten kilograms weight loss. In admission the patient had a reasonable general condition, hydrated and without cutaneous hyperpigmentation. Laboratory results showed hyponatremia, increased levels of corticotropin with normal cortisol levels, increased levels of renin with decreased aldosterone levels and presence of antissuprarrenal antibodies, allowing the diagnosis of autoimmune primary adrenal insufficiency. The boy started treatment with hydrocortisone and fludrocortisone with favorable response. Discussion/conclusions: The diagnosis of Addison’s disease requires a high degree of suspicion due its unspecific symptomatology. This disease often presents gastrointestinal symptoms. Thus, towards a patient with hyponatremia accompanied by constitutional and gastrointestinal symptoms, we must always consider this diagnosis.

[NSAID GASTROPATHY IN PATIENTS WITH COMORBID DISEASES].

Science.gov (United States)

Morozova, T E; Rykova, S M; Chukina, M A

2015-01-01

The widespread use in clinical practice of non-steroidal anti-inflammatory drugs (NSAIDs), largely due to the general trend towards an aging population and, as a consequence, increase the number of individuals with comorbid conditions and diseases, including the most common are diseases of the cardiovascular system, diseases of the joints and spine, requiring of therapy with, combining the anti-inflammatory and analgesic properties. However, NSAIDs not only have favorable effects, but have quite a wide range of adverse effects, an important place among which is NSAID-induced gastropathy. The article deals with the rational choice of NSAIDs in patients depending on the degree of cardiovascular risk and gastrointenstinalnogo, as well as the possibility of preventing NSAID-associated gastropathy. Particular attention is paid to the choice of individual NSAIDs with regard to their pharmacological properties.

Proportion of patients in the Uganda rheumatic heart disease ...

African Journals Online (AJOL)

. The optimum management strategy was determined according to the 2012 European Society of Cardiology guidelines on the management of valvular heart disease. Results: Out of the 551 patient's records evaluated, 398 (72.3%) required ...

Chronic obstructive pulmonary disease

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V K Vijayan

2013-01-01

Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

Strengthening foodborne diseases surveillance in the WHO African ...

African Journals Online (AJOL)

The new International Health Regulations (IHR) (2005) cover events of international importance including contaminated food and outbreaks of foodborne disease. The IHR (2005) and other international as well as regional agreements require Member States to strengthen surveillance systems including surveillance for ...

Epidemiology, Pathogenesis, and Control of a Tick-Borne Disease- Kyasanur Forest Disease: Current Status and Future Directions

Directory of Open Access Journals (Sweden)

Syed Z. Shah

2018-05-01

Full Text Available In South Asia, Haemaphysalis spinigera tick transmits Kyasanur Forest Disease Virus (KFDV, a flavivirus that causes severe hemorrhagic fever with neurological manifestations such as mental disturbances, severe headache, tremors, and vision deficits in infected human beings with a fatality rate of 3–10%. The disease was first reported in March 1957 from Kyasanur forest of Karnataka (India from sick and dying monkeys. Since then, between 400 and 500 humans cases per year have been recorded; monkeys and small mammals are common hosts of this virus. KFDV can cause epizootics with high fatality in primates and is a level-4 virus according to the international biosafety rules. The density of tick vectors in a given year correlates with the incidence of human disease. The virus is a positive strand RNA virus and its genome was discovered to code for one polyprotein that is cleaved post-translationally into 3 structural proteins (Capsid protein, Envelope Glycoprotein M and Envelope Glycoprotein E and 7 non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. KFDV has a high degree of sequence homology with most members of the TBEV serocomplex. Alkhurma virus is a KFDV variant sharing a sequence similarity of 97%. KFDV is classified as a NIAID Category C priority pathogen due to its extreme pathogenicity and lack of US FDA approved vaccines and therapeutics; also, the infectious dose is currently unknown for KFD. In India, formalin-inactivated KFDV vaccine produced in chick embryo fibroblast is being used. Nevertheless, further efforts are required to enhance its long-term efficacy. KFDV remains an understudied virus and there remains a lack of insight into its pathogenesis; moreover, specific treatment to the disease is not available to date. Environmental and climatic factors involved in disseminating Kyasanur Forest Disease are required to be fully explored. There should be a mapping of endemic areas and cross-border veterinary

[Expert consensus for the prevention of cardiovascular disease in Chinese women].

Science.gov (United States)

2017-06-01

Cardiovascular disease is the leading cause of death for Chinese women, which has not been paid enough attention at present. Chinese women account for 20 percent of 3.5 billion women all over the world. Health promotion and prevention are facing the rigorous challenge. The pathophysiological characteristics, clinical manifestations, disease diagnosis, drug metabolism and prevention strategies of woman cardiovascular diseases are different from those of men in some respects and require special attention. "Consensus for the prevention of cardiovascular diseases in Chinese women" is developed by Women Physician Committee of Chinese College Cardiovascular Physicians and Women's Health Work Group of Chinese Society of Cardiology, which is aimed at strengthening and promoting prevention of cardiovascular diseases in Chinese women.

Multilingual Communication and Language Acquisition: New Research Directions

Science.gov (United States)

Canagarajah, A. Suresh; Wurr, Adrian J.

2011-01-01

In this article, we outline the differences between a monolingual and multilingual orientation to language and language acquisition. The increasing contact between languages in the context of globalization motivates such a shift of paradigms. Multilingual communicative practices have remained vibrant in non-western communities for a long time. We…

Contes et identité : Wanto dans les contes gbaya et dans la ...

African Journals Online (AJOL)

... Gbaya identity by Gbaya artists. The fundamental role of Wanto in building Gbaya identity shows that oral literature is still vibrant and finds its place in new communication media. Keywords: Central African Republic (CAR/RCA), Gbaya identity; Gbaya oral tradition; oral tradition and new media, Wanto, the spider character.

Interdisciplinary Invitations: Exploring Gee's Bend Quilts

Science.gov (United States)

Mitchell, Rebecca; Whitin, Phyllis; Whitin, David

2012-01-01

Engaging with the quilts of Gee's Bend offers a rich opportunity for students in grades four through eight to develop appreciation for pattern, rhythm, and innovation while learning about history, entrepreneurship, and political activism. By easily accessing print, film, and Internet resources teachers can include these vibrant quilts and…

Early Childhood Directors as Socializers of Emotional Climate

Science.gov (United States)

Zinsser, Katherine M.; Denham, Susanne A.; Curby, Timothy W.; Chazan-Cohen, Rachel

2016-01-01

Early childhood centres are vibrant social communities where child and adult emotions are integral to learning. Previous research has focused on teaching practices that support children's social-emotional learning; fewer studies have attended to relevant centre-level factors, such as the emotional leadership practices of the centre director. The…

Introduction to "Early psychosis

DEFF Research Database (Denmark)

McGorry, Patrick; Nordentoft, Merete; Simonsen, Erik

2005-01-01

warrants careful analysis. The Third International Early Psychosis Conference proved to be a watershed and was the largest and most vibrant meeting to that point. This preface aims to set the scene for a selection of contributions, derived from the array of new evidence reported in Copenhagen, and recently...

Impact of Interdisciplinary Undergraduate Research in Mathematics and Biology on the Development of a New Course Integrating Five STEM Disciplines

Science.gov (United States)

Caudill, Lester; Hill, April; Hoke, Kathy; Lipan, Ovidiu

2010-01-01

Funded by innovative programs at the National Science Foundation and the Howard Hughes Medical Institute, University of Richmond faculty in biology, chemistry, mathematics, physics, and computer science teamed up to offer first- and second-year students the opportunity to contribute to vibrant, interdisciplinary research projects. The result was…

Envisaging Agency as Discourse Hybridity: A Butlerian Analysis of Secondary Classroom Discourses

Science.gov (United States)

Charteris, Jennifer

2016-01-01

Conceptualised from a range of sociological perspectives, and theorised extensively over the last 50 years, human agency is an integral element to lifelong learning. Poststructural theory with its decentred discursive construction of the learner offers a vibrant conception of classroom dynamics. This paper envisions how learner agency can be…

77 FR 9260 - Establishment of Dakota Grassland Conservation Area, North Dakota and South Dakota

Science.gov (United States)

2012-02-16

... under conservation protection. The area's strong and vibrant rural lifestyle, of which agriculture is the dominant land use, is one of the key components to ensuring habitat integrity and wildlife... conservation area are to protect 240,000 acres of wetland and 1.7 million acres of critical grassland habitat...

Entrepreneurship Education for a Sustainable Future

Science.gov (United States)

Lindner, Johannes

2018-01-01

Entrepreneurs keep our economy and society vibrant by implementing new ideas, which is why our society needs people with entrepreneurship competences. The development of our entrepreneurship competences does not begin with the start of our professional lives, but is initiated in earlier phases of our socialisation. Entrepreneurship education can…

Essays in household finance

NARCIS (Netherlands)

Djordjevic, Ljubica

2015-01-01

Household finance is a young and vibrant research field that continuously attracts public attention. There may be very few matters that people care so much about as their personal finance. Recent rise of academic interest in household finance is to a great extent due to households’ more active role

Practice and Research in Career Counseling and Development--2009

Science.gov (United States)

Hartung, Paul J.

2010-01-01

A review of the 2009 career counseling and development literature indicates that the field remains vital, vibrant, valid, and viable precisely 100 years after its founding. Using the field's 4 fundamental traditions of person-environment fit, life-span development, social cognition, and constructivism-social constructionism as lenses for…

An American Imperative: Transforming the Recruitment, Retention, and Renewal of Our Nation's Mathematics and Science Teaching Workforce

Science.gov (United States)

Business-Higher Education Forum (NJ1), 2007

2007-01-01

American students today have limited interest in studying mathematics and science, and academic achievement in these two foundational disciplines is demonstrably low. This reality poses an acute challenge to our ability to keep American society intellectually vibrant and to ensure that our economy is globally competitive. This Business-Higher…

From Deficit to Diversity: How Teachers of Recently Arrived Emergent Bilinguals Negotiate Ideological and Pedagogical Change

Science.gov (United States)

Ascenzi-Moreno, Laura

2017-01-01

Although the number and diversity of emergent bilingual students is rising, this population is viewed as homogeneous rather than vibrant and eclectic. This case study explores how two secondary teachers of English as a new language uncover the diversity of their recently arrived emergent bilingual population by implementing translanguaging…

Reflections of a "TPT" Enthusiast

Science.gov (United States)

Hicks, Jim

2014-01-01

Unparalleled academic journals not only provide a seaworthy vessel for the sharing and dissemination of innovative ideas, but also cause a perceptible wake with each new issue. For physics teaching enthusiasts, our flagship is "The Physics Teacher" ("TPT"), with its vibrant community of learners on board observing an extensive…

Child computer interaction SIG: towards sustainable thinking and being

NARCIS (Netherlands)

Read, J.; Hourcade, J.P.; Markopoulos, P.; Iversen, O.S.

The discipline of Child Computer Interaction (CCI) has been steadily growing and it is now firmly established as a community in its own right, having the annual IDC (Interaction and Design for Children) conference and its own journal and also enjoying its role as a highly recognisable and vibrant

Capacity Building for Social Innovation: A Collective Impact Approach

Science.gov (United States)

Szarleta, Ellen J.

2017-01-01

Business, nonprofit, and government institutions generally agree that a vibrant economy is critical to addressing the multi-faceted, complex issues faced by urban communities. Yet, despite significant targeted efforts aimed at revitalizing economic activity over the past few decades, the state of many communities remains unchanged. A collective…

Developing a Leadership Brand: The Heart of Effective School Leadership in Turbulent Times

Science.gov (United States)

Davis, Stephen H.; Leon, Ronald J.

2014-01-01

Faced with scarce resources and high expectations, school principals must increasingly rely upon the power of persuasion to promote ongoing school improvement. We maintain that the development of a vibrant and tangible leadership brand constructed upon a principal's core values and noble character can motivate stakeholders and stimulate school…

Total cardiovascular disease risk assessment: a review.

LENUS (Irish Health Repository)

Cooney, Marie Therese

2011-09-01

The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

Mesenteric panniculitis patients requiring emergency surgery: report of three cases.

Science.gov (United States)

Duman, Mustafa; Koçak, Osman; Fazli, Olgaç; Koçak, Cengiz; Atici, Ali Emre; Duman, Uğur

2012-04-01

Mesenteric panniculitis is a rare, benign disease characterized by a chronic non-specific inflammatory process of mesenteric fat tissue with unknown etiology. The small bowel mesentery is affected mostly. This process rarely involves the large intestine mesentery. Mesenteric panniculitis includes symptoms as abdominal pain, nausea and vomiting, diarrhea, constipation, and fever. In our cases, we had difficulty in the preoperative diagnosis as the clinical changes imitated an obstruction or ischemia of the small bowel. All the cases required emergency abdominal surgery and partial jejunal resection. The aim of this article was to present three cases of mesenteric panniculitis of the small bowel mesentery requiring emergency surgery together with a short review of the literature.

Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

Directory of Open Access Journals (Sweden)

Ali Harlak

2010-01-01

Full Text Available PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001. With an adjusted odds ratio of 1.3 (p<.001, body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

Comparison of complement fixation and ELISA for diagnosis of foot-and-mouth disease

International Nuclear Information System (INIS)

Caballero, P.H.; Gonzalez, S.; Orue, P.M.; Vergara, N.N.

1998-01-01

Foot-and-mouth disease (FMD) virus is characterised by its rapid transmission and its great antigenic variability which require a requires a rapid and accurate diagnosis in the laboratory, in order to initiate an immediate response for control. From these studies it is clear that Enzyme linked immunosorbent assay (ELISA) has the advantage over the Complement fixation test (CFT) of being a test of high sensitivity and specificity. Therefore, this technique is now used in our laboratory for diagnosis to detect FMD virus (O-A-C) in epithelia from animals affected by the disease. (author)

Late-Onset Glycogen Storage Disease Type II (Pompe’s Disease with a Novel Mutation: A Malaysian Experience

Directory of Open Access Journals (Sweden)

Hiew Fu Liong

2014-01-01

Full Text Available Pompe’s disease (acid maltase deficiency, glycogen storage disease type II is an autosomal recessive disorder caused by a deficiency of lysosomal acid α-1,4-glucosidase, resulting in excessive accumulation of glycogen in the lysosomes and cytoplasm of all tissues, most notably in skeletal muscles. We present a case of adult-onset Pompe’s disease with progressive proximal muscles weakness over 5 years and respiratory failure on admission, requiring prolonged mechanical ventilation. Electromyography showed evidence of myopathic process with small amplitudes, polyphasic motor unit action potentials, and presence of pseudomyotonic discharges. Muscle biopsy showed glycogen-containing vacuoles in the muscle fibers consistent with glycogen storage disease. Genetic analysis revealed two compound heterozygous mutations at c.444C>G (p.Tyr148* in exon 2 and c.2238G>C (p.Trp746Cys in exon 16, with the former being a novel mutation. This mutation has not been reported before, to our knowledge. The patient was treated with high protein diet during the admission and subsequently showed good clinical response to enzyme replacement therapy with survival now to the eighth year. Conclusion. In patients with late-onset adult Pompe’s disease, careful evaluation and early identification of the disease and its treatment with high protein diet and enzyme replacement therapy improve muscle function and have beneficial impact on long term survival.

The Emerging Role of MicroRNA-155 in Cardiovascular Diseases

Directory of Open Access Journals (Sweden)

Richard Y. Cao

2016-01-01

Full Text Available MicroRNAs have been demonstrated to be involved in human diseases, including cardiovascular diseases. Growing evidences suggest that microRNA-155, a typical multifunctional microRNA, plays a crucial role in hematopoietic lineage differentiation, immunity, inflammation, viral infections, and vascular remodeling, which is linked to cardiovascular diseases such as coronary artery disease, abdominal aortic aneurysm, heart failure, and diabetic heart disease. The effects of microRNA-155 in different cell types through different target genes result in different mechanisms in diseases. MicroRNA-155 has been intensively studied in atherosclerosis and coronary artery disease. Contradictory results of microRNA-155 either promoting or preventing the pathophysiological process of atherosclerosis illustrate the complexity of this pleiotropic molecule. Therefore, more comprehensive studies of the underlying mechanisms of microRNA-155 involvement in cardiovascular diseases are required. Furthermore, a recent clinical trial of Miravirsen targeting microRNA-122 sheds light on exploiting microRNA-155 as a novel target to develop effective therapeutic strategies for cardiovascular diseases in the near future.

Assessing Requirements Quality through Requirements Coverage

Science.gov (United States)

Rajan, Ajitha; Heimdahl, Mats; Woodham, Kurt

2008-01-01

In model-based development, the development effort is centered around a formal description of the proposed software system the model. This model is derived from some high-level requirements describing the expected behavior of the software. For validation and verification purposes, this model can then be subjected to various types of analysis, for example, completeness and consistency analysis [6], model checking [3], theorem proving [1], and test-case generation [4, 7]. This development paradigm is making rapid inroads in certain industries, e.g., automotive, avionics, space applications, and medical technology. This shift towards model-based development naturally leads to changes in the verification and validation (V&V) process. The model validation problem determining that the model accurately captures the customer's high-level requirements has received little attention and the sufficiency of the validation activities has been largely determined through ad-hoc methods. Since the model serves as the central artifact, its correctness with respect to the users needs is absolutely crucial. In our investigation, we attempt to answer the following two questions with respect to validation (1) Are the requirements sufficiently defined for the system? and (2) How well does the model implement the behaviors specified by the requirements? The second question can be addressed using formal verification. Nevertheless, the size and complexity of many industrial systems make formal verification infeasible even if we have a formal model and formalized requirements. Thus, presently, there is no objective way of answering these two questions. To this end, we propose an approach based on testing that, when given a set of formal requirements, explores the relationship between requirements-based structural test-adequacy coverage and model-based structural test-adequacy coverage. The proposed technique uses requirements coverage metrics defined in [9] on formal high-level software