Post-hemorrhagic hydrocephalus: Recent advances and new therapeutic insights.

Science.gov (United States)

Chen, Qianwei; Feng, Zhou; Tan, Qiang; Guo, Jing; Tang, Jun; Tan, Liang; Feng, Hua; Chen, Zhi

2017-04-15

Post-hemorrhagic hydrocephalus (PHH), also referred to as progressive ventricular dilatation, is caused by disturbances in cerebrospinal fluid (CSF) flow or absorption following hemorrhage in the brain. As one of the most serious complications of neonatal/adult intraventricular hemorrhage (IVH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI), PHH is associated with increased morbidity and disability of these events. Common sequelae of PHH include neurocognitive impairment, motor dysfunction, and growth impairment. Non-surgical measures to reduce increased intracranial pressure (ICP) in PHH have shown little success and most patients will ultimately require surgical management, such as external ventricular drainage and shunting which mostly by inserting a CSF drainage shunt. Unfortunately, shunt complications are common and the optimum time for intervention is unclear. To date, there remains no comprehensive strategy for PHH management and it becomes imperative that to explore new therapeutic targets and methods for PHH. Over past decades, increasing evidence have indicated that hemorrhage-derived blood and subsequent metabolic products may play a key role in the development of IVH-, SAH- and TBI-associated PHH. Several intervention strategies have recently been evaluated and cross-referenced. In this review, we summarized and discussed the common aspects of hydrocephalus following IVH, SAH and TBI, relevant experimental animal models, clinical translation of in vivo experiments, and potential preventive and therapeutic targets for PHH. Copyright © 2017 Elsevier B.V. All rights reserved.

Imaging evaluation of post pancreatic surgery

International Nuclear Information System (INIS)

Scialpi, Michele; Scaglione, Mariano; Volterrani, Luca; Lupattelli, Luciano; Ragozzino, Alfonso; Romano, Stefania; Rotondo, Antonio

2005-01-01

The role of several imaging techniques in patients submitted to pancreatic surgery with special emphasis to single-slice helical computed tomography (CT) and multidetector-row CT (MDCT) was reviewed. Several surgical options may be performed such as Whipple procedure, distal pancreatectomy, central pancreatectomy, and total pancreatectomy. Ultrasound examination may be used to detect peritoneal fluid in the early post-operative period as well as lesion recurrence in long-term follow-up. Radiological gastrointestinal studies has a major role in evaluation of intestinal functionality. In spite of the advent of other imaging modalities, CT is the most effective after pancreatic surgery. On post-operative CT, the most common findings were small fluid peritoneal or pancreatic collections, stranding of the mesenteric fat with perivascular cuffing, reactive adenopathy and pneumobilia. In addition, CT may demonstrate early (leakage of anastomosis, pancreatico-jejunal fistula, haemorrage, acute pancreatitis of the remnant pancreas, peritonitis), and late (chronic fistula, abscess, aneurysms, anastomotic bilio-digestive stenosis, perianastomotic ulcers, biloma, and intra-abdominal bleeding) surgical complications. In the follow-up evaluation, CT may show tumor recurrence, liver and lymph nodes metastasis. Magnetic resonance may be used as alternative imaging modality to CT, when renal insufficiency or contrast sensitivity prevents the use of iodinated i.v. contrast material or when the biliary tree study is primarily requested. The knowledge of the type of surgical procedures, the proper identification of the anastomoses as well as the normal post-operative imaging appearances are essential for an accurate detection of the complications and recurrent disease

Imaging evaluation of post pancreatic surgery

Energy Technology Data Exchange (ETDEWEB)

Scialpi, Michele [Department of Radiology, ' Santissima Annunziata' Hospital, Via Bruno 1, I-74100 Taranto (Italy)]. E-mail: michelescialpi@libero.it; Scaglione, Mariano [Department of Radiology, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Volterrani, Luca [Institute of Radiology, University of Siena, I-53100 Siena (Italy); Lupattelli, Luciano [Institute of Radiology, University of Perugia, I-06122 Perugia (Italy); Ragozzino, Alfonso [Department of Radiology, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Romano, Stefania [Department of Radiology, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Rotondo, Antonio [Section of Radiology, Department ' Magrassi-Lanzara' , Second University, I-80138 Naples (Italy)

2005-03-01

The role of several imaging techniques in patients submitted to pancreatic surgery with special emphasis to single-slice helical computed tomography (CT) and multidetector-row CT (MDCT) was reviewed. Several surgical options may be performed such as Whipple procedure, distal pancreatectomy, central pancreatectomy, and total pancreatectomy. Ultrasound examination may be used to detect peritoneal fluid in the early post-operative period as well as lesion recurrence in long-term follow-up. Radiological gastrointestinal studies has a major role in evaluation of intestinal functionality. In spite of the advent of other imaging modalities, CT is the most effective after pancreatic surgery. On post-operative CT, the most common findings were small fluid peritoneal or pancreatic collections, stranding of the mesenteric fat with perivascular cuffing, reactive adenopathy and pneumobilia. In addition, CT may demonstrate early (leakage of anastomosis, pancreatico-jejunal fistula, haemorrage, acute pancreatitis of the remnant pancreas, peritonitis), and late (chronic fistula, abscess, aneurysms, anastomotic bilio-digestive stenosis, perianastomotic ulcers, biloma, and intra-abdominal bleeding) surgical complications. In the follow-up evaluation, CT may show tumor recurrence, liver and lymph nodes metastasis. Magnetic resonance may be used as alternative imaging modality to CT, when renal insufficiency or contrast sensitivity prevents the use of iodinated i.v. contrast material or when the biliary tree study is primarily requested. The knowledge of the type of surgical procedures, the proper identification of the anastomoses as well as the normal post-operative imaging appearances are essential for an accurate detection of the complications and recurrent disease.

Post-therapeutic imaging findings

Energy Technology Data Exchange (ETDEWEB)

Pollice, Saverio, E-mail: saveriopollice@hotmail.it [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy); Muto, Mario, E-mail: mutomar@tiscali.it [Department of Neuroradiology, “Cardarelli Hospital”, Naples (Italy); Scarabino, Tommaso, E-mail: tscarabino@hotmail.com [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy)

2015-05-15

Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

Post-therapeutic imaging findings

International Nuclear Information System (INIS)

Pollice, Saverio; Muto, Mario; Scarabino, Tommaso

2015-01-01

Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

Early Implementation of THAM for ICP Control: Therapeutic Hypothermia Avoidance and Reduction in Hypertonics/Hyperosmotics

Directory of Open Access Journals (Sweden)

F. A. Zeiler

2014-01-01

Full Text Available Background. Tromethamine (THAM has been demonstrated to reduce intracranial pressure (ICP. Early consideration for THAM may reduce the need for other measures for ICP control. Objective. To describe 4 cases of early THAM therapy for ICP control and highlight the potential to avoid TH and paralytics and achieve reduction in sedation and hypertonic/hyperosmotic agent requirements. Methods. We reviewed the charts of 4 patients treated with early THAM for ICP control. Results. We identified 2 patients with aneurysmal subarachnoid hemorrhage (SAH and 2 with traumatic brain injury (TBI receiving early THAM for ICP control. The mean time to initiation of THAM therapy was 1.8 days, with a mean duration of 5.3 days. In all patients, after 6 to 12 hours of THAM administration, ICP stability was achieved, with reduction in requirements for hypertonic saline and hyperosmotic agents. There was a relative reduction in mean hourly hypertonic saline requirements of 89.1%, 96.1%, 82.4%, and 97.0% for cases 1, 2, 3, and 4, respectively, comparing pre- to post-THAM administration. Mannitol, therapeutic hypothermia, and paralytics were avoided in all patients. Conclusions. Early administration of THAM for ICP control could potentially lead to the avoidance of other ICP directed therapies. Prospective studies of early THAM administration are warranted.

Evaluation of therapeutic patient education

OpenAIRE

D'Ivernois , Jean-François; Gagnayre , Rémi; Assal , Jean-Philippe; Golay , Alain; Libion , France; Deccache , Alain

2006-01-01

9 pages; These guidelines mainly focus on the principles of evaluating Therapeutic Patient Education; Over the past thirty years, therapeutic patient education (TPE) has become an essential part of the treatment of long-term diseases. Evaluations of this new practice are expected, and are sometimes imposed according to protocols and criteria that do not always reflect the complexity of changes taking place within patients and healthcare providers. Sometimes, expected results are not achieved ...

Randomized Controlled Evaluation of an Early Intervention to Prevent Post-Rape Psychopathology

OpenAIRE

Resnick, Heidi; Acierno, Ron; Waldrop, Angela E.; King, Lynda; King, Daniel; Danielson, Carla; Ruggiero, Kenneth J.; Kilpatrick, Dean

2007-01-01

A randomized between-group design was used to evaluate efficacy of a video intervention to reduce PTSD and other mental health problems, implemented prior to the forensic medical exam conducted within 72 hours post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) ages 15 or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and de...

Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry.

Science.gov (United States)

Alsharif, Naser Z.; And Others

1997-01-01

Explains structurally based therapeutic evaluation of drugs, which uses seven therapeutic criteria in translating chemical and structural knowledge into therapeutic decision making in pharmaceutical care. In a Creighton University (Nebraska) medicinal chemistry course, students apply the approach to solve patient-related therapeutic problems in…

Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period

Directory of Open Access Journals (Sweden)

Igor F. B. Masson

2014-01-01

Full Text Available Background: Physiotherapy in the plastic surgery post-operative (PO is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures. Aim: The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO. Design: This is a clinical trial prospective. Materials and Methods: Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels. Statistical Analysis: The test of equality for two proportions and the confidence interval test for mean to evaluate the distribution of variables. The significance level adopted for statistical tests was 5% (P < 0.05. Results: There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups. Conclusion: the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

[Opportunity and challenge of post-marketing evaluation of traditional Chinese medicine].

Science.gov (United States)

Du, Xiao-Xi; Song, Hai-Bo; Ren, Jing-Tian; Yang, Le; Guo, Xiao-Xin; Pang, Yu

2014-09-01

Post-marketing evaluation is a process which evaluate the risks and benefits of drug clinical application comprehensively and systematically, scientific and systematic results of post-marketing evaluation not only can provide data support for clinical application of traditional Chinese medicine, but also can be a reliable basis for the supervision department to develop risk control measures. With the increasing demands for treatment and prevention of disease, traditional Chinese medicine has been widely used, and security issues are also exposed. How to find risk signal of traditional Chinese medicine in the early stages, carry out targeted evaluation work and control risk timely have become challenges in the development of traditional Chinese medicine industry.

The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders.

Science.gov (United States)

Turner, Hannah; Bryant-Waugh, Rachel; Marshall, Emily

2015-10-01

The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lactate as an early predictor of psychomotor development in neonates with asphyxia receiving therapeutic hypothermia.

Science.gov (United States)

Polackova, Renata; Salounova, Dana; Kantor, Lumir

2017-12-04

This prospective study aimed to evaluate the relationship between persistently elevated lactate values in the arterial blood of newborns with grade II and III hypoxic ischemic encephalopathy (treated with therapeutic hypothermia) and psychomotor development at 24 months. 51 neonates of gestational age from 36 to 41 weeks receiving therapeutic hypothermia for moderate to severe hypoxic ischaemic encephalopathy had arterial blood lactate levels regularly analysed. At 24 months the infants' psychomotor development was evaluated and they were divided into two groups - those where the outcome was favourable (i.e. normal psychomotor development) and adverse (severe motor or sensory impairment or death). The lactate dynamics over time were retrospectively evaluated from the data collected, with the normal upper limit set at 4 mmol/L. Of the 51 affected neonates, 7 died over the course of the study. 34 of the remaining 44 infants demonstrated normal psychomotor findings at 2 years old, with adverse findings in 10 cases. Although both groups experienced significant reductions in lactate over time, there were statistically significant differences between them regarding currently measured lactate levels. Absolute lactate values and their development over time can be a used as an auxiliary factor in making early estimates of the long-term outcome for newborns with neonatal asphyxia being treated with therapeutic hypothermia.

Emotional Freedom Technique (EFT) Tapping for Post Sectio Caesaria Patient: Decrease Anxiety and Increase Early Mobilization

OpenAIRE

Rusmini, Rusmini; Suparmi, Suparmi; Musdalifah, Ulfah

2013-01-01

The objective of the study is to evaluate the level of anxiety and early mobilization using the Emotional Freedom Technique (EFT): Tapping on patients post partum post secsio Caesaria before and after intervention period both control and experimental group. Design Quasi-experimental two group design was applied in the study. Forty two mothers with primipara post secsio Caesaria were recruited. Data analysis in the study included correlation, paird t-test, and independent t-test. The findings ...

Discovery of dormancy associated antigens of Mycobacterium tuberculosis : novel targets for the development of post-exposure or therapeutic tuberculosis vaccines

NARCIS (Netherlands)

Lin, May Young

2009-01-01

The growing number of tuberculosis (TB) casualties urges development of not only more effective drugs and preventive vaccines but also development of post-exposure/therapeutic TB vaccines. Post-exposure/therapeutic TB vaccines are needed since 2 billion people worldwide harbor a latent Mycobacterium

Incidence of early post thyroidectomy hypocalcaemia effect of ...

African Journals Online (AJOL)

Background and aims: Early hypocalcaemia is a common complication following thyroid surgery. Objectives: The objectives of this paper are to identify the incidence and fate of early post thyroidectomy hypocalcaemia, and to study its relation to bilateral ligation of the inferior thyroid arteries, to the type of the operation, and ...

From non-pharmacological treatments for post-traumatic stress disorder to novel therapeutic targets

NARCIS (Netherlands)

Hendriksen, Erik; Olivier, Berend; Oosting, Ronald S

2014-01-01

The development of new pharmacological therapies starts with target discovery. Finding new therapeutic targets for anxiety disorders is a difficult process. Most of the currently described drugs for post-traumatic stress disorder (PTSD) are based on the inhibition of serotonin reuptake. The

18F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response

International Nuclear Information System (INIS)

Martinez, V.; Grenier, G.; Fior, R.; Boue, F.; Castilla-Lievre, M.A.; Guillet-Caruba, C.; Desarnaud, S.

2012-01-01

To evaluate the potential of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for early therapeutic intervention in patients with probable or confirmed tuberculosis (TB). Twenty-one consecutive human immunodeficiency virus negative patients were prospectively included. All patients underwent 18 F-FDG PET/CT before and after 1 month of anti-tuberculosis treatment. The maximum standardised uptake value (SUV max ) of the most 18 F-FDG avid lesions was recorded. The median age of patients was 36 years (range 18-84); 33.3% were male, 80.9% were born in endemic countries, and 23.8% had a past history of TB. TB was confirmed on culture in 8, on histology in 9 and on the basis of clinical symptoms in 4 patients. 18 F-FDG PET/CT detected active pulmonary TB (n = 1), extrapulmonary (n = 10) or both (n = 10). The second 18 F-FDG PET/CT showed reduced radiotracer uptake intensity in 19 of 21 patients, with a median percentage decrease of SUV max of 31% (range 2-84). Two patients showed no improvement. TB was ruled out in one patient during follow-up; the final diagnosis was a non-Hodgkin's lymphoma. The other patient was smear-positive for 3 months. 18 F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB. (authors)

Early evaluation and value-based pricing of regenerative medicine technologies.

Science.gov (United States)

Koerber, Florian; Rolauffs, Bernd; Rogowski, Wolf

2013-11-01

Since the first pioneering scientists explored the potential of using human cells for therapeutic purposes the branch of regenerative medicine has evolved to become a mature industry. The focus has switched from 'what can be done' to 'what can be commercialized'. Timely health economic evaluation supports successful marketing by establishing the value of a product from a healthcare system perspective. This article reports results from a research project on early health economic evaluation in collaboration with developers, clinicians and manufacturers. We present an approach to determine an early value-based price for a new treatment of cartilage defects of the knee from the area of regenerative medicine. Examples of using evaluation results for the purpose of business planning, market entry, preparing the coverage decision and managed entry are discussed.

[Therapeutic effect of early applying hydrotherapy with Chinese drugs on children hypoxic ischemic encephalopathy].

Science.gov (United States)

Ma, Yun-Zhi; Zhai, Hong-Yin; Su, Chun-Ya

2009-02-01

To observe the therapeutic effect of hydrotherapy with Chinese drugs (HT-C) in early intervention on children hypoxic ischemic encephalopathy (HIE). HIE children were assigned to the treatment group and the control group, 50 in each, at random depending on the willingness of patients' parents. Both groups received the conventional functional training, according to the "0 -3-year-old early intervention outline", but for the treatment group, HT-C was applied additionally. Indexes for quality of sleep, gross motor function, severity of spasm and intellectual development were observed and compared before and after treatment to assess the therapeutic effects. Therapeutic effect in the treatment group was better than that in the control group in all the indexes observed, showing statistical significance (all P <0.05). Early intervention of HT-C could improve clinical symptom, promote the functional recovery and intellectual development in children HIE, and also could reduce or prevent the sequelae occurrence of the nervous system in them.

Therapeutic misconception in early phase gene transfer trials.

Science.gov (United States)

Henderson, Gail E; Easter, Michele M; Zimmer, Catherine; King, Nancy M P; Davis, Arlene M; Rothschild, Barbra Bluestone; Churchill, Larry R; Wilfond, Benjamin S; Nelson, Daniel K

2006-01-01

Many subjects in early phase clinical trials expect to benefit in some way from the research intervention. It is understandable that people hope for improvement in their condition, no matter what the evidence. Yet unreasonable expectation of medical benefit may reflect problems with informed consent: Investigators may not disclose clearly that direct medical benefit from an early phase experimental intervention is unlikely or impossible, or subjects may not appreciate the differences between treatment and research. This paper presents findings from recent interviews with researchers and subjects and analysis of consent forms in early phase gene transfer research, a cutting-edge technology often called 'gene therapy'. We use three variables to construct a composite measure of therapeutic misconception TM, tapping misconceptions about the purposes of early phase research and the potential for direct medical benefit in these trials. Our multivariate model demonstrates the importance of both subject- and study-level factors as predictors of this TM index: education, disease type, and communication by study personnel about the likelihood of benefit. We hope that this work will deepen the discussion of how to define and measure TM, and refine the specification of factors that are related to subjects' TM.

Early evaluation of coronary artery bypass grafts: CT or selective angiography

International Nuclear Information System (INIS)

Wilson, P.C.; Gutierrez, O.; Moss, A.

1984-01-01

A prospective study was performed in 27 patients to compare the value of computed tomography and selective angiography in assessing coronary artery graft patency in the early post-operative period. The sensitivity of CT to graft patency was 85% with no falsely patent determinations. Dynamic CT was not found useful in predicting graft stenosis. There were no complications associated with CT studies, and two related to selective angiography. It is concluded that CT is the procedure of choice for graft evaluation in the early post-operative period; but that angiography is mandatory for the assessment of late symptom recurrence. A review is made of the results described in previous series. (orig.)

Early post-treatment pseudo-progression amongst glioblastoma multiforme patients treated with radiotherapy and temozolomide: a retrospective analysis

International Nuclear Information System (INIS)

Gunjur, Ashray; Lau, Eddie; Taouk, Yamna; Ryan, Gail

2011-01-01

To evaluate the incidence and impact of early post-chemoradiation (cRT) 'pseudoprogression' (PsPD) amongst glioblastoma multiforme (GBM) patients treated with the current standard of care – 60 Gy conformal radiotherapy with concurrent low-dose temozolomide, followed by six cycles of high-dose temozolomide (the 'Stupp protocol'). Clinical notes and radiology reports for GBM patients treated as per the Stupp protocol were reviewed. PsPD was defined as apparent radiological progression on the first post-cRT scan, with further imaging within 3 months being stable or improving, while true early progression (ePD) was confirmed by continued progression in the subsequent 3 months following the first post-cRT scan. Of the 68 patients evaluated, 14 (21%) and 27 (40%) experienced PsPD and ePD, respectively; 3/14 (21%) patients experiencing PsPD and 14/27(52%), ePD were symptomatic for progression on first post-cRT follow-up (P = 0.096 for difference). Median survival for patients with ePD, PsPD and neither were 10.4, 27.4 and 13.0 months, respectively (P = 0.003 for ePD vs. PsPD, P = 0.19 for neither vs. PsPD groups). These data confirm a significant incidence of PsPD in post-cRT GBM patients, associated with improved median survival compared with those with neither ePD nor PsPD (not statistically significant). It appears likely that PsPD actually represents tumour response, conflicting with the traditional notion that increase in lesion size on contrast-enhanced imaging represents disease progression. Early post-cRT imaging should thus be interpreted with caution. Accompanying clinical symptoms are more commonly associated with ePD, but do not reliably distinguish PsPD from ePD.

Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

Science.gov (United States)

Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

2008-01-01

Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post

Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

Directory of Open Access Journals (Sweden)

Strobl Ralf

2008-02-01

Full Text Available Abstract Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets. Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute

Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology.

Science.gov (United States)

Resnick, Heidi; Acierno, Ron; Waldrop, Angela E; King, Lynda; King, Daniel; Danielson, Carla; Ruggiero, Kenneth J; Kilpatrick, Dean

2007-10-01

A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.

Comparison of efficacy of phenytoin and levetiractetam for prevention of early post traumatic seizures

International Nuclear Information System (INIS)

Khan, S.A.; Bhatti, S.N.; Afridi, E.A.K.; Zadran, K.K.; Shah, S.S.A.; Khan, A.A.

2016-01-01

The incidence of early post-traumatic seizures after civilian traumatic brain injury ranges 4-25%. The control of early post-traumatic seizure is mandatory because these acute insults may add secondary damage to the already damaged brain with poor outcome. Prophylactic use of anti-epileptic drugs have been found to be have variable efficacy against early post-traumatic seizures. The objective of this study was to compare the efficacy of Phenytion and Levetiracetam in prevention of early post-traumatic seizures in moderate to severe traumatic brain injury. Methods: This Randomized Controlled Trial was conducted in department of Neurosurgery, Ayub Medical College, Abbottabad from March, 2012 to March 2014. The patients with moderate to severe head injury were randomly allocated in two groups. Patients in group A were given phenytoin and patients in group B were given Levetiracetam. Patients were followed for one week to detect efficacy of drug in terms of early post traumatic seizures. Results: The 154 patients included in the study were equally divided into two groups. Out of 154 patients 115 (74.7%) were male while 29 (25.3%) were females. Age of patients ranges from 7-48 (24.15 ± 9.56) years. Ninety one (59.1%) patients had moderate head injury while 63 (40.9%) patients had severe head injury. Phenytoin was effective in preventing early post traumatic seizures in 73 (94.8%) patients whereas Levetiracetam effectively controlled seizures in 70 (90.95%) cases (p-value of .348). Conclusion: There is no statistically significant difference in the efficacy of Phenytoin and Levetiracetam in prophylaxis of early post-traumatic seizures in cases of moderate to severe traumatic brain injury. (author)

Development and evaluation of a training program for therapeutic radiographers as a basis for online adaptive radiation therapy for bladder carcinoma

International Nuclear Information System (INIS)

Foroudi, Farshad; Wong, Jacky; Kron, Tomas; Roxby, Paul; Haworth, Annette; Bailey, Alistair; Rolfo, Aldo; Paneghel, Andrea; Styles, Colin; Laferlita, Marcus; Tai, Keen Hun; Williams, Scott; Duchesne, Gillian

2010-01-01

Aims: Online adaptive radiotherapy requires a new level of soft tissue anatomy recognition and decision making by therapeutic radiographers at the linear accelerator. We have developed a therapeutic radiographer training workshop encompassing soft tissue matching for an online adaptive protocol for muscle invasive bladder cancer. Our aim is to present the training program, and its evaluation which compares pre and post training staff soft tissue matching and bladder contouring using Cone Beam Computer Tomography (CBCT). Materials and Methods: Prior to commencement of an online adaptive bladder protocol, a staff training program for 33 therapeutic radiographers, with a separate ethics approved evaluation component was developed. A multidisciplinary training program over two days was carried out with a total of 11 h of training, covering imaging technology, pelvic anatomy and protocol specific decision making in both practical and theoretical sessions. The evaluation included both pre training and post training testing of staff. Results: Pre training and post training, the standard deviations in the contoured bladder between participants in left-right direction were 0.64 vs 0.59 cm, superior-inferior 0.89 vs 0.77 cm and anterior-posterior direction was 0.88 vs 0.52 cm respectively. Similarly the standard deviation in the volume contoured decreased from 40.7 cc pre training to 24.5 cc post training. Time taken in contouring was reduced by the training program (19.8 vs 17.2 min) as was the discrepancy in choice of adaptive radiotherapy plans. The greatest reduction in variations in contouring was seen in staff whose pre training had the largest deviations from the reference radiation oncologist contours. Conclusion: A formalized staff training program is feasible, well received by staff and reduces variation in organ matching and contouring. The improvement was particularly noticed in staff who pre training had larger deviations from the reference standard.

Preclinical evaluation of VIS513, a therapeutic antibody against dengue virus, in non-human primates.

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Ong, Eugenia Z; Budigi, Yadunanda; Tan, Hwee Cheng; Robinson, Luke N; Rowley, Kirk J; Winnett, Alexander; Hobbie, Sven; Shriver, Zachary; Babcock, Gregory J; Ooi, Eng Eong

2017-08-01

Despite useful in vivo activity, no therapeutic against dengue virus (DENV) has demonstrated efficacy in clinical trials. Herein, we explored dosing and virological endpoints to guide the design of human trials of VIS513, a pan-serotype anti-DENV IgG1 antibody, in non-human primates (NHPs). Dosing VIS513 pre- or post-peak viremia in NHPs neutralized infectious DENV although RNAemia remained detectable post-treatment; differential interaction of human IgGs with macaque Fc-gamma receptors may delay clearance of neutralized DENV. Our findings suggest useful antiviral utility of VIS513 and highlight an important consideration when evaluating virological endpoints of trials for anti-DENV biologics. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters

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Jyoti V. Dube

2014-01-01

Full Text Available Background: Caesarean section has been a part of human culture since ancient times. It has been used effectively throughout the 20th century and among the major abdominal surgeries, it is the most common, oldest worldwide surgery performed in obstetrics. Despite the life saving advantages, there are several adverse consequences of caesarean delivery for a woman and to her household. The rate and risk of these complications increases due to the increasing incidence mainly in countries like India. The role of nurse midwife is to act in the best interest of patient and newborn and make the patient independent in carrying out the activities of daily living as soon as possible. This can lead to a faster recovery and shorter hospital stay. Also it can indirectly help in reducing the complications associated with prolonged bed rest and can improve the maternal newborn bonding. Aim and Objectives: The present study was done to evaluate the effect of planned early ambulation on selected biophysiological health parameters of post caesarean patients. Material and Methods: The study included total 500 study subjects, 250 in experimental and 250 in control group. Quasi experimental approach with multiple time series design was adopted for the study. The experimental group was given an early planned recommended ambulation technique starting from the day of surgery. This consisted of deep breathing exercise, cough exercise, leg exercise and early mobilization. Over and above, the routine general health care was given by the doctors and nurses. The control group received only by routine general care by doctors and nurses and mobilization on third post operative day as per strategy adopted by the hospital. The deep breathing exercises, coughing exercises and leg exercises were not given routinely and hence were not given to the control group. Post caesarean biophysiological parameters chart was used to assess the selected parameters for first five post operative

Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke.

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Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura

2018-05-01

Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in

Evaluation of an interprofessional educational curriculum pilot course for practitioners working with post-stroke patients.

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Olaisen, Rho Henry; Mariscal-Hergert, Cheryl; Shaw, Alissa; Macchiavelli, Cecilia; Marsheck, Joanna

2014-03-01

This report describes the design and evaluation of an interprofessional pilot training course aimed at pre-licensure practitioners working with post-stroke patients in community-based settings. The course was developed by community-based practitioners from nine health professions. Course learning activities included traditional methods (lectures) and interactive modules (problem-based learning and exchange-based learning). The study's aim was to assess the program's effectiveness in adapting and incorporating knowledge, skills and self-confidence when delivering tertiary care in therapeutic pool environments; gauge adoption of course principles into practice, and assess overall course satisfaction. Methods of evaluation included conceptual mapping of course format, pre- and post-questionnaires, daily reflection questionnaires, course satisfaction survey and adoption survey, 10 weeks follow-up. Overall, the findings indicate students' knowledge, skills and self-confidence in delivering effective post-stroke care increased following the training. Students reported adopting clinical practices in 10 weeks follow-up. Implications for designing interprofessional curricula are discussed.

Randomized Controlled Evaluation of an Early Intervention to Prevent Post-Rape Psychopathology

Science.gov (United States)

Resnick, Heidi; Acierno, Ron; Waldrop, Angela E.; King, Lynda; King, Daniel; Danielson, Carla; Ruggiero, Kenneth J.; Kilpatrick, Dean

2007-01-01

A randomized between-group design was used to evaluate efficacy of a video intervention to reduce PTSD and other mental health problems, implemented prior to the forensic medical exam conducted within 72 hours post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) ages 15 or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with prior rape history relative to scores among women with prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior history who were in the video relative to standard care condition. Small effects indicating higher PTSD and BAI scores among women without a prior history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a video x prior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms. PMID:17585872

REM Desensitization as a New Therapeutic Method for Post- Traumatic Stress Disorder: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Khodabakhsh Ahmadi

2016-05-01

Full Text Available Aim: to evaluate potential efficacy of a new therapeutic approach in posttraumatic stress disorder in comparison with eye movement desensitization and reprocessing (EMDR, a standard treatment approach and controls. Methods: the study was designed using a randomized controlled trial methodology. Participants were recruited from military servicemen aged between 25 to 50 years who were admitting hospitals of Bushehr, Iran, with the final diagnosis of PTSD. Finally 33 male patients were devided into three subgroups: G1: EMDR; G2: REM Desensitization; and group 3: controls who received no therapy. Mississippi Scale for Posttraumatic Stress Disorder, Pittsburgh Sleep Quality Index (PSQI and a 37 item death anxiety questionnaire were used for measures. Results: multiple comparisons showed that intrusive thoughts were significantly more likely to improve with REM Desensitization versus EMDR (P=0.03, while depression was more responsive to EMDR (p=0.03. Among the Pittsburgh scale for the quality of sleep items, sleep quality (p=0.02, sleep duration (p=0.001, and total sleep quality score (p=0.002 were significantly more likely to improve in the REM Desensitization group. Change in the absolute death anxiety scores was not different between subgroups excepting EMDR versus control group (p=0.05. Conclusion: REM, desensitization, the new therapeutic approach to PTSD is a highly effective strategy, even more than EMDR, the standard treatment, in most of the evaluated subjects, with special emphasis on sleep symptoms, and also in the management of intrusive thoughts. Depression is the only factor in which, REM Desensitization was significantly less likely to represent a superior therapeutic effect than EMDR. Key words: post traumatic stress disorder (PTSD, eye movement desensitization and reprocessing, new treatment.

Early prediction of oral calcium and vitamin D requirements in post-thyroidectomy hypocalcaemia.

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Al-Dhahri, Saleh F; Mubasher, Mohamed; Al-Muhawas, Fida; Alessa, Mohammed; Terkawi, Rayan S; Terkawi, Abdullah S

2014-09-01

To optimize and individualize post-thyroidectomy hypocalcemia management. A multicenter prospective cohort study. Two tertiary care hospitals. parathyroid hormone (PTH) was measured preoperatively, then at 1 and 6 hours after surgery. The required doses of calcium and vitamin D were defined as those maintaining the patients asymptomatic and their cCa ≥ 2 mmol/L. They were used as an endpoint in a generalized linear mixed effect model (GLIMMEX) aiming to identify the best predictors of these optimal required doses. Models were evaluated by goodness of fit and Receiver Operating Characteristic (ROC) curves. One hundred and sixty-eight patients were analyzed; 85.1% were female, 49.3% had BMI > 30, and 64% had vitamin D deficiency. Post-thyroidectomy hypocalcemia was found in 25.6%, of whom 18 (41.9%) were symptomatic and received intravenous calcium. First hour percentage of drop in PTH correlated positively with the severity of hypocalcemia (P hypocalcemia by assisting in the early identification of those who are not at risk of hypocalcaemia and by guiding early effective management of those at risk. This may reduce complications and medical cost. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Understanding factors associated with early therapeutic alliance in PTSD treatment: adherence, childhood sexual abuse history, and social support.

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Keller, Stephanie M; Zoellner, Lori A; Feeny, Norah C

2010-12-01

Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as childhood sexual abuse (CSA) history and poor social support may impede the development of early alliance in those receiving PTSD treatment. We sought to examine treatment adherence, CSA history, and social support as factors associated with early alliance in individuals with chronic PTSD who were receiving either prolonged exposure therapy (PE) or sertraline. At pretreatment, participants (76.6% female; 64.9% Caucasian; mean age = 37.1 years, SD = 11.3) completed measures of trauma history, general support (Inventory of Socially Supportive Behaviors), and trauma-related social support (Social Reactions Questionnaire). Over the course of 10 weeks of PE or sertraline, they completed early therapeutic alliance (Working Alliance Inventory) and treatment adherence measures. Early alliance was associated with PE adherence (r = .32, p history was not predictive of a lower early alliance. Given the associations with adherence, clinicians may find it useful to routinely assess alliance early in treatment. Positive trauma support, not CSA history, may be particularly important in the development of a strong early therapeutic alliance. (c) 2010 APA, all rights reserved.

Therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy

Science.gov (United States)

Liu, Hui-Hui; Xiong, Guo-Xin; Zhang, Li-Ping

2017-06-01

To investigate the therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy, 19 patients with early diabetic retinopathy were randomly divided into a treatment group and a control group. The TaiYang, YangBai, YuYao and ZanZhu acupoints of patients in the treatment group were irradiated with a semiconductor laser combined with the oral compound Danshen dropping pills, while those in the control group only used the oral compound Danshen dropping pills. The indicators of vision, mean defect of light sensitivity in the visual field, renal function and fasting blood glucose, were examined to evaluate the efficacy. After treatment, the above indicators of patients in the two groups were significantly improved and there was a significant difference between the two groups. This showed that the compound Danshen dripping pills combined with the laser acupoint irradiation can improve the ischemic and anoxic state of early diabetic retinopathy and improve the visual field.

Therapeutic touch and post-Hurricane Hugo stress.

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Olson, M; Sneed, N; Bonadonna, R; Ratliff, J; Dias, J

1992-06-01

This repeated-session design sought to answer questions about the effectiveness of therapeutic touch in reduction of stress for 23 individuals following a natural disaster. In addition, methodological issues related to the average length of time for a therapeutic-touch treatment and a method of documenting the nonverbal interaction between subject and toucher were investigated. Findings indicate that stressed people report themselves to be less stressed following therapeutic touch (p = .05). Time of therapeutic-touch intervention varied significantly between the touchers, with a range of 6.8 to 20 minutes. Qualitative data examining the interaction of toucher and subject raised a number of questions that require further study.

[Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

Science.gov (United States)

Tarcía Kahihara, Carina; Ferreira, Ubirajora; Nardi Pedro, Renato; Matheus, Wagner Eduardo; Rodrigues Netto, Nelson

2006-10-01

To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence. Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis. Patients were divided into two groups: Group 1 included eight patients that started therapy within the first six months after surgery; Group 2 included 10 patients starting therapy after the sixth post operative month. All patients were evaluated by the pad test and number of incontinence pads per day. Evaluating pad tests before and after treatment, six patients in group 1 had a reduction of the amount of urine leak in comparison to seven patients in group 2. The statistical analysis showed significant differences before and after treatment for both groups (group 1: p = 0.028; group 2: p = 0.018). The evaluation of the number of pads showed: Group 1: all eight patients using pods had a reduction in the number of pads. Group 2: 5 of the eight patients using pads had a reduction and the other three continued using the same number. Statistical analysis comparing the number of pads per day before and after treatment showed a significant difference in group 1 (p = 0.004). There was no statistically significant difference in the number of pads per day before and after physiotherapy in group 2, although half of the patients showed a diminishment in the number of pads required after treatment. Results demonstrate that early indication of physiotherapy for the treatment of post radical prostatectomy urinary incontinence is better than delayed treatment. New works may be developed in the future to confirm our results.

Psychological aspects of therapeutic abortion after early prenatal diagnosis.

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Di Giusto, M; Lazzari, R; Giorgetti, T; Paesano, R; Pachi, A

1991-01-01

The early discovery of a fetal pathology creates a "crisis" situation fraught with psychic problems for the couple who must live through it. The Authors observed a group of patients in the second trimester of pregnancy. They had all requested therapeutic abortion since serious malformation of the fetus had been confirmed. By means of a questionnaire constructed for the purpose, certain characteristics of fetal malformation and of pregnancy were evidenced, as well as the way these were experienced by the patients. The immediate and delayed reactions to the diagnosis of malformation were also studied, as was the experience lived when faced with the choice of abortion.

Early versus delayed post-operative bathing or showering to prevent wound complications.

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Toon, Clare D; Sinha, Sidhartha; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2015-07-23

Many people undergo surgical operations during their life-time, which result in surgical wounds. After an operation the incision is closed using stiches, staples, steri-strips or an adhesive glue. Usually, towards the end of the surgical procedure and before the patient leaves the operating theatre, the surgeon covers the closed surgical wound using gauze and adhesive tape or an adhesive tape containing a pad (a wound dressing) that covers the surgical wound. There is currently no guidance about when the wound can be made wet by post-operative bathing or showering. Early bathing may encourage early mobilisation of the patient, which is good after most types of operation. Avoiding post-operative bathing or showering for two to three days may result in accumulation of sweat and dirt on the body. Conversely, early washing of the surgical wound may have an adverse effect on healing, for example by irritating or macerating the wound, and disturbing the healing environment. To compare the benefits (such as potential improvements to quality of life) and harms (potentially increased wound-related morbidity) of early post-operative bathing or showering (i.e. within 48 hours after surgery, the period during which epithelialisation of the wound occurs) compared with delayed post-operative bathing or showering (i.e. no bathing or showering for over 48 hours after surgery) in patients with closed surgical wounds. We searched The Cochrane Wounds Group Specialised Register (30th June 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); The Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; EBSCO CINAHL; the metaRegister of Controlled Trials (mRCT) and the International Clinical Trials Registry Platform (ICTRP). We considered all randomised trials conducted in patients who had undergone any surgical procedure and had surgical closure of

Therapeutic irradiation and brain injury

International Nuclear Information System (INIS)

Sheline, G.E.; Wara, W.M.; Smith, V.

1980-01-01

This is a review and reanalysis of the literature on adverse effects of therapeutic irradiation on the brain. Reactions have been grouped and considered according to time of appearance. The emphasis of the analysis is on delayed reactions, especially those that occur from a few months to several years after irradiation. All dose specifications were converted into equivalent megavoltage rads. The data were analyzed in terms of total dose, overall treatment time and number of treatment fractions. Also discussed were acute radiation reactions, early delayed radiation reactions, somnolence and leukoencephalopathy post-irradiation/chemotherapy and combined effects of radiation and chemotherapy

Post-evaluation of the neurophaties treatment post-trauma with therapeutic laser. Model in sciatic nerve of frog

Science.gov (United States)

Escobar, Antonio S.; Ocampo, Arcelia F. M.; Hernández, María G. H.; Jasso, José L. C.; Lira, Maricela O. F.; Flores, Mariana A.; Balderrama, Vicente L.

2010-05-01

The purpose of this study was to evaluate the compound nerve action potential amplitude and latency measured to determine the degree of myelination and the number of fibers stimulated in a model of stimulated frog sciatic nerve laser at 810 nm as perioperative treatment after injury. It used 30 bullfrogs (Rana catesbeiana) to obtain 60 sciatic nerves forming four groups, groups 1 and 2 worked with nerves in vitro, were dissected in humid chambers for placing isolated organ, was recorded on compound nerve action potential, the second group laser was applied at 24, 48, 72, 96 and 120 hours and at the same time were placed in 10% formalin. Groups 3 and 4 are worked in vivo localizing the nerve and causing damage through compression, occurred over the compound nerve action potential to assess the degree of myelination and the number of fibers stimulated, the group 4 was applied to 810 nm laser (500 Hz, 10 J, 200 mW) after injury, after 48 hours, three frogs were sacrificed by introducing the nerves in 10% formalin. The latency recorded by stimulating the sciatic nerve of frog to 0.5 mA and 100 ms in groups 1 and 2 show significant differences (p000), as to the extent, if any statistically significant difference. (pparesthesia (post-traumatic neuropathy).

The post-therapeutic effect of rapamycin in mild traumatic brain-injured rats ensuing in the upregulation of autophagy and mitophagy.

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Wang, Changxing; Hu, Zhiying; Zou, Yang; Xiang, Mingjun; Jiang, Yuting; Botchway, Benson O A; Huo, Xue; Du, Xiaoxue; Fang, Marong

2017-09-01

Mild traumatic brain injury (mTBI), common in juveniles, has been reported to be caused by sports-related concussion. Many young children may suffer from post-concussion syndrome. mTBI, in early stages of life, could play a part in neuron apoptosis and degeneration, cognitive and motor coordination impairment, as well as dementia. Our study was aimed at further investigating the post-therapeutic efficacy of rapamycin in the recuperation of mTBI while at the same time investigating the metamorphosis in both autophagy and mitophagy in mTBI. We created a weight-drop rat mTBI model with the administration of rapamycin at 4 h after every mTBI. Behavioral tests of beam walking and open field task indicated the expected improvement of cognitive and motor coordination functions. Both Western blot and immunofluorescence examinations revealed increased Beclin-1 and PINK1 in the treated rats as well as reduction of caspase-3 and cytochrome C (Cyt C). More so, the TUNEL staining evidenced curtailment of apoptotic cells following treatment with rapamycin. The upregulation of Beclin-1 and PINK1 and the downregulation of caspase-3 and Cyt C extrapolate that rapamycin plays neuroprotective as well as anti-apoptotic role via interposition of both autophagy and mitophagy. © 2017 International Federation for Cell Biology.

A Video-Based Intervention on and Evaluation of Nursing Aides' Therapeutic Communication and Residents' Agitation During Mealtime in a Dementia Care Unit.

Science.gov (United States)

Levy-Storms, Lené; Harris, Lesley M; Chen, Xiao

2016-01-01

The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication. Additional analyses using specific CNAs' therapeutic communication behaviors indicated a significant negative association with refusals at post-test but not pretest. The findings suggest some communication mechanisms for how the intervention positively influenced residents' refusals.

Early evaluation of the therapeutic effectiveness in children with epilepsy by quantitative EEG: a model of Mozart K.448 listening--a preliminary study.

Science.gov (United States)

Lin, Lung-Chang; Ouyang, Chen-Sen; Chiang, Ching-Tai; Wu, Hui-Chuan; Yang, Rei-Cheng

2014-10-01

There are many treatments being developed for patients with epilepsy, including anti-epileptic drugs, ketogenic diet and vagus nerve stimulation. To date, there is a lack of valid methods to predict at an early stage the therapeutic effects on patients with epilepsy who receive one of these treatments. Our previous studies revealed that epileptiform discharges which were observed in patients with epilepsy were significantly decreased while listening to Mozart K.448. In this study, we attempted to develop a useful marker by utilizing a quantitative electroencephalogram (qEEG) method in analyzing the features of EEG to early evaluate the effect of the music on children with epilepsy, even without epileptiform discharges. EEG segments from 19 Taiwanese children who were selected from a large screen study of music effect (eight boys and 11 girls) diagnosed with epilepsy were analyzed. EEG examinations were performed in two parallel periods in each patient; before, and while listening to Mozart K.448's first movement (8 min 22s) and EEG data were compared by qEEG. EEG segments were classified into music effective/ineffective group. The term "effective" was defined as patient exposure to music resulting in over a 25% reduction in epileptiform discharges. On the contrary, the term "ineffective" was defined as patient exposure to music resulting in less than a 5% reduction in epileptiform discharges. There were four global feature descriptors selected for the music effective/ineffective classification. Two descriptors, DecorrTime_avg_AVG and DecorrTime_std_AVG, were related to the EEG feature "decorrelation" whereas the other two descriptors, RelPowGamma_avg_SNR and RelPowGamma_std_SNR, were related to "relative power of gamma." There were significantly higher RelPowGamma_std_SNR (0.190±0.133 vs. -0.026±0.119, p=0.0029), DecorrTime_std_AVG (0.005±0.004 vs. 0.0003±0.0016, p=0.0055), DecorrTime_avg_AVG (0.005±0.005 vs. -0.002±0.008, p=0.0179), and Rel

Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months.

Science.gov (United States)

Wagle, Jørgen; Farner, Lasse; Flekkøy, Kjell; Bruun Wyller, Torgeir; Sandvik, Leiv; Fure, Brynjar; Stensrød, Brynhild; Engedal, Knut

2011-01-01

To identify prognostic factors associated with functional outcome at 13 months in a sample of stroke rehabilitation patients. Specifically, we hypothesized that cognitive functioning early after stroke would predict long-term functional outcome independently of other factors. 163 stroke rehabilitation patients underwent a structured neuropsychological examination 2-3 weeks after hospital admittance, and their functional status was subsequently evaluated 13 months later with the modified Rankin Scale (mRS) as outcome measure. Three predictive models were built using linear regression analyses: a biological model (sociodemographics, apolipoprotein E genotype, prestroke vascular factors, lesion characteristics and neurological stroke-related impairment); a functional model (pre- and early post-stroke cognitive functioning, personal and instrumental activities of daily living, ADL, and depressive symptoms), and a combined model (including significant variables, with p value Stroke Scale; β = 0.402, p stroke cognitive functioning (Repeatable Battery of Neuropsychological Status, RBANS; β = -0.248, p = 0.001) and prestroke personal ADL (Barthel Index; β = -0.217, p = 0.002). Further linear regression analyses of which RBANS indexes and subtests best predicted long-term functional outcome showed that Coding (β = -0.484, p stroke cognitive functioning as measured by the RBANS is a significant and independent predictor of long-term functional post-stroke outcome. Copyright © 2011 S. Karger AG, Basel.

Post-evaluation of the neurophaties treatment post-trauma with therapeutic laser. Model in sciatic nerve of frog

International Nuclear Information System (INIS)

Escobar, Antonio S.; Ocampo, Arcelia F. M.; Hernandez, Maria G. H.; Jasso, Jose L. C.; Lira, Maricela O. F.; Flores, Mariana A.; Balderrama, Vicente L.

2010-01-01

The purpose of this study was to evaluate the compound nerve action potential amplitude and latency measured to determine the degree of myelination and the number of fibers stimulated in a model of stimulated frog sciatic nerve laser at 810 nm as perioperative treatment after injury. It used 30 bullfrogs (Rana catesbeiana) to obtain 60 sciatic nerves forming four groups, groups 1 and 2 worked with nerves in vitro, were dissected in humid chambers for placing isolated organ, was recorded on compound nerve action potential, the second group laser was applied at 24, 48, 72, 96 and 120 hours and at the same time were placed in 10% formalin. Groups 3 and 4 are worked in vivo localizing the nerve and causing damage through compression, occurred over the compound nerve action potential to assess the degree of myelination and the number of fibers stimulated, the group 4 was applied to 810 nm laser (500 Hz, 10 J, 200 mW) after injury, after 48 hours, three frogs were sacrificed by introducing the nerves in 10% formalin. The latency recorded by stimulating the sciatic nerve of frog to 0.5 mA and 100 ms in groups 1 and 2 show significant differences (p 000), as to the extent, if any statistically significant difference. (p<0.001 and p<0.000). The laser produces a favorable response in the treatment of paresthesia (post-traumatic neuropathy).

Hematopoietic cytokines as therapeutic players in early stages Parkinson’s disease

Directory of Open Access Journals (Sweden)

Kyle eFarmer

2015-07-01

Full Text Available Parkinson's disease (PD is a devastating age related neurodegenerative disease that is believed to have a lengthy prodromal state. It is critical to find methods of interfering with the progression of this early degenerative stage by inducing compensatory recovery processes to slow or prevent the eventual clinical symptoms. The current perspective article argues that immune system signalling molecules represent such a promising therapeutic approach. Two cytokines of interest are granulocyte macrophage-colony stimulating factor (GM-CSF and erythropoietin (EPO. These hematopoietic cytokines have been protective in models of stroke, neuronal injury, and more recently PD. It is our belief that these trophic cytokines can be used not only for cell protection but also regeneration. However, success is likely dependent on early intervention. This paper will outline our perspective on the development of novel trophic recovery treatments for PD. In particular, we present new data from our lab suggesting that EPO and GM-CSF can foster neural re-innervation in a mild or partial lesion PD model that could be envisioned as reflecting the early stages of the disease.

Incidence of Early Post Operative Infection after Primary Total Knee ...

African Journals Online (AJOL)

Incidence of Early Post Operative Infection after. Primary Total Knee Arthroplasty at an East African. Centre. Kigera JWM1, Kimpiatu P2. 1. School of Medicine, University of Nairobi. 2. PCEA Kikuyu Hospital. Correspondence to: Dr James Kigera, P.O Box 30197 – 00100 Nairobi. Email: jameskigera@yahoo.co.uk. Abstract.

DW-MRI as a biomarker to compare therapeutic outcomes in radiotherapy regimens incorporating temozolomide or gemcitabine in glioblastoma.

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Stefanie Galbán

Full Text Available The effectiveness of the radiosensitizer gemcitabine (GEM was evaluated in a mouse glioma along with the imaging biomarker diffusion-weighted magnetic resonance imaging (DW-MRI for early detection of treatment effects. A genetically engineered murine GBM model [Ink4a-Arf(-/- Pten(loxP/loxP/Ntv-a RCAS/PDGF(+/Cre(+] was treated with gemcitabine (GEM, temozolomide (TMZ +/- ionizing radiation (IR. Therapeutic efficacy was quantified by contrast-enhanced MRI and DW-MRI for growth rate and tumor cellularity, respectively. Mice treated with GEM, TMZ and radiation showed a significant reduction in growth rates as early as three days post-treatment initiation. Both combination treatments (GEM/IR and TMZ/IR resulted in improved survival over single therapies. Tumor diffusion values increased prior to detectable changes in tumor volume growth rates following administration of therapies. Concomitant GEM/IR and TMZ/IR was active and well tolerated in this GBM model and similarly prolonged median survival of tumor bearing mice. DW-MRI provided early changes to radiosensitization treatment warranting evaluation of this imaging biomarker in clinical trials.

Utility of Early Post-operative High Resolution Volumetric MR Imaging after Transsphenoidal Pituitary Tumor Surgery

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Patel, Kunal S.; Kazam, Jacob; Tsiouris, Apostolos J.; Anand, Vijay K.; Schwartz, Theodore H.

2014-01-01

Objective Controversy exists over the utility of early post-operative magnetic resonance imaging (MRI) after transsphenoidal pituitary surgery for macroadenomas. We investigate whether valuable information can be derived from current higher resolution scans. Methods Volumetric MRI scans were obtained in the early (30 days) post-operative periods in a series of patients undergoing transsphenoidal pituitary surgery. The volume of the residual tumor, resection cavity, and corresponding visual field tests were recorded at each time point. Statistical analyses of changes in tumor volume and cavity size were calculated using the late MRI as the gold standard. Results 40 patients met the inclusion criteria. Pre-operative tumor volume averaged 8.8 cm3. Early postoperative assessment of average residual tumor volume (1.18 cm3) was quite accurate and did not differ statistically from late post-operative volume (1.23 cm3, p=.64), indicating the utility of early scans to measure residual tumor. Early scans were 100% sensitive and 91% specific for predicting ≥ 98% resection (psurgery and a lack of decrease should alert the surgeon to possible persistent compression of the optic apparatus that may warrant re-operation. PMID:25045791

A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care

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Langhorn, Leanne; Sorensen, Jens C; Pedersen, Preben U

2010-01-01

A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care......A critical review of the literature on early rehabilitation of patients with post-traumatic amnesia in acute care...

[Post-marketing clinical study of traditional Chinese medicine--lessons learned from comprehensive evaluation of Fufang Zaoren capsule].

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Qing, Shan; Gao, Lin; Zhang, Li; Jia, Jian-Ping; Liu, Xin-Min; Ji, Shao-Liang; Yang, Xiao-Hui

2013-11-01

By comprehensive review and analysis of post-marketing clinical research on the efficacy and safety,we concluded that Fufang Zaoren capsule has certain therapeutic effects for insomnia, although current clinical research design needs improving. The post-marketing clinical studies also showed that it causes several adverse reactions at the recommended doses, such as chills, fever, dizziness, nausea, shortness of breath, chest tightness and palpitations, whereas high doses of Fufang Zaoren capsule can cause delayed extrapyramidal symptoms. Health Canada government website also prompted the L-tetrahydropalmatine in Fufang Zaoren capsule caused liver damage in pregnant women. The authors summarized the risk points, factors and risk control in the clinical use of Fufang Zaoren capsule and also present their perspective on the research status, existing problems and corresponding countermeasures in the post-marketing clinical re-evaluation of traditional Chinese medicine.

Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

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Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

2017-01-01

To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Therapeutic efficacy and safety evaluation of erythrocyte concentrate used in dogs

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Ildiko Barabasi

2016-11-01

Full Text Available Therapeutic efficacy and safety evaluation of erythrocyte concentrate used in dogs 1Ildikó BARABÁSI, 1Cristina ȘTEFǍNUȚ, 1Laurenţ OGNEAN 1University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400037, Manastur street, no.3-5, Cluj-Napoca, Romania *Corresponding author: lognean@yahoo.com   Keywords: dogs, erythrocyte concentrate, hematocrit, immune-mediated hemolytic anemia, transfusion therapy Introduction: The minimum dose of whole blood products as well as erythrocyte concentrate has been under a lot of debate, new equations for calculating the optimal dose being made up from a large variety of hematologists (Kisielewicz et al 2014; Helm and Knottenbelt, 2010; Gibson, 2007. Aim: The therapeutical efficacy of erythrocyte concentrates in dogs with different types of anemia by measuring the hematocrit level 6 hours after the transfusion and a complete blood count 5 days post-transfusion therapy. Materials and methods: Blood tests were performed with ADIVA hematological analyzer; the 6 hour post-transfusion hematocrit was determined by a micro hematocrit. On admission every patient received a routine blood test that included 40 hematological parameters and 21 biochemical parameters. In addition, a detailed examination of the blood smears was also performed by the ADIVA hematological analyzer with 26 parameters that mostly referred to red blood cell and white blood cell morphology. Blood typing was done using the RapidVet quick test kit. Patients received only type specific blood and to limit transfusion reaction occurrences, in addition, a crossmatch test was performed before every transfusion. Statistical analysis was accomplished with GraphPadInStat 3.0 and the graphical depiction of the obtained results was made using the Origin 8.5. graphics program. Results: Statistical analysis reveal that the total red blood cell count underwent very significant changes (p=0.0052 as well as the hemoglobin (p=0.0085. The hematocrit

Therapeutic Effect of Virtual Reality on Post-Stroke Patients: Randomized Clinical Trial.

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Pedreira da Fonseca, Erika; Ribeiro da Silva, Nildo Manoel; Pinto, Elen Beatriz

2017-01-01

The study aimed to check the therapeutic effect of virtual reality associated with conventional physiotherapy on gait balance and the occurrence of falls after a stroke. This was a randomized, blinded clinical trial conducted with post-stroke patients, randomized into two groups-treatment group and control group-and subjected to balance assessments by the Dynamic Gait Index and investigation of falls before and after 20 intervention sessions. Statistically significant difference was considered at P < .05. We selected 30 patients, but there were three segment losses, resulting in a total of 13 patients in the control group and 14 in the treatment group. There was an improvement in gait balance and reduced occurrence of falls in both groups. After intervention, the differences in gait balance in the control group (P = .047) and the reduction in the occurrence of falls in the treatment group (P = .049) were significant. However, in intergroup analysis, there was no difference in the two outcomes. Therapy with games was a useful tool for gait balance rehabilitation in post-stroke patients, with repercussions on the reduction of falls. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Prediction of acute renal allograft rejection in early post-transplantation period by soluble CD30.

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Dong, Wang; Shunliang, Yang; Weizhen, Wu; Qinghua, Wang; Zhangxin, Zeng; Jianming, Tan; He, Wang

2006-06-01

To evaluate the feasibility of serum sCD30 for prediction of acute graft rejection, we analyzed clinical data of 231 patients, whose serum levels of sCD30 were detected by ELISA before and after transplantation. They were divided into three groups: acute rejection group (AR, n = 49), uncomplicated course group (UC, n = 171) and delayed graft function group (DGF, n = 11). Preoperative sCD30 levels of three groups were 183 +/- 74, 177 +/- 82 and 168 +/- 53 U/ml, respectively (P = 0.82). Significant decrease of sCD30 was detected in three groups on day 5 and 10 post-transplantation respectively (52 +/- 30 and 9 +/- 5 U/ml respectively, P sCD30 values on day 5 post-transplantation (92 +/- 27 U/ml vs. 41 +/- 20 U/ml and 48 +/- 18 U/ml, P sCD30 levels on day 10 post-transplantation were virtually similar in patients of three groups (P = 0.43). Receiver operating characteristic (ROC) curve demonstrated that sCD30 level on day 5 post-transplantation could differentiate patients who subsequently suffered acute allograft rejection from others (area under ROC curve 0.95). According to ROC curve, 65 U/ml may be the optimal operational cut-off level to predict impending graft rejection (specificity 91.8%, sensitivity 87.1%). Measurement of soluble CD30 on day 5 post-transplantation might offer a noninvasive means to recognize patients at risk of impending acute graft rejection during early post-transplantation period.

A German e-learning-training in the context of early preventive intervention and child protection: preliminary findings of a pre-post evaluation.

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Bressem, Kristina; Ziegenhain, Ute; Doelitzsch, Claudia; Hofer, Alexandra; Besier, Tanja; Fegert, Joerg M; Kuenster, Anne K

2016-01-01

In recent years, a number of government-sponsored initiatives have been implemented in Germany that are focused on early preventive intervention in child protection. In response to the need for interdisciplinary training in this area, the internet-based e-learning program "Early Preventive Intervention and Child Protection" was developed for professionals in the child welfare and health care systems working with families with infants and toddlers. The program is currently undergoing evaluation for effectiveness and user satisfaction. In a pre-post design, users are requested to complete questionnaires that assess three measures of expertise: theoretical knowledge of relevant fields, the ability to correctly identify subtle signals of infant communication, and the ability to assess maternal sensitivity. This article presents the contents of the program and the pre-training results (N = 1.294 participants). Descriptive analyses as well as Pearson correlations and Bonferroni corrections of error were conducted using the statistical program SPSS v. 21.0. The findings show that a wide range of professionals are making use of the program, and that their existing theoretical knowledge about early preventive intervention, as well as their ability to identify subtle signals of infant communication, is relatively good. However, their ability to assess maternal sensitivity, which is considered a crucial indicator for the risk of child abuse, was low. The outcome of the pre-training results indicates that professionals working in the area of child protection need to develop more capability in recognizing maternal sensitivity, in order to ensure early detection of families who are at risk and thus in need of support. Finally, the number of years of professional experience did not correlate with the scores on any of the three measures, which emphasizes the importance of providing interdisciplinary training in this area for all those working in child and family services

Carotid artery stiffness evaluated early by wave intensity in normal left ventricular function in post-radiotherapy patients with nasopharyngeal carcinoma.

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Zhang, Zhuo; Luo, Runlan; Tan, Bijun; Qian, Jing; Duan, Yanfang; Wang, Nan; Li, Guangsen

2018-04-01

This study aims to assess carotid elasticity early in normal left ventricular function in post-radiotherapy patients with nasopharyngeal carcinoma (NPC) by wave intensity. Sixty-seven post-radiotherapy patients all with normal left ventricular function were classified into group NPC1 and group NPC2 based on their carotid intima-media thickness. Thirty age- and sex-matched NPC patients without any history of irradiation and chemotherapy were included as a control group. Carotid parameters, including stiffness constant (β), pressure-strain elastic modulus (Ep), arterial compliance (AC), stiffness constant pulse wave velocity (PWVβ), and wave intensity pulse wave velocity (PWVWI) were measured. There were no significant differences in conventional echocardiographic variables among the three groups. In comparison with the control group, β, Ep, PWVβ, and PWVWI were significantly increased, while AC was significantly decreased in the NPC1 and NPC2 groups, and there were differences between the NPC1 group and NPC2 group (all P < 0.05). This study suggested that carotid artery stiffness increased with reduced carotid compliance in post-RT with NPC.

Early post-operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review.

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Hindle, A; de la Piedad Garcia, X; Brennan, L

2017-03-01

This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes. © 2017 World Obesity Federation.

An exploration of therapeutic evaluation of traditional Chinese medicine in treatment of hepatic fibrosis

Directory of Open Access Journals (Sweden)

XU Lieming

2017-05-01

Full Text Available China has become one of the leading counties in the world to treat hepatic fibrosis with Chinese patent drugs. The therapeutic effect of traditional Chinese medicine (TCM should be evaluated from the aspects of short-term therapeutic effect, long-term therapeutic effect, and effect of relief of symptoms. This article introduces the results of our exploration of the application of liver stiffness measurement to evaluate therapeutic effect, five-year survival rate to assess long-term therapeutic effect, and a “TCM syndrome scale” to evaluate effect of relief of symptoms, suggesting that the Chinese patent drug Fuzheng Huayu capsules/tablets have a marked clinical effect in the treatment of hepatic fibrosis. It is recommended to use serological diagnostic models, conduct prospective studies with long-term follow-up, and analyze the samples and data accumulated over a long period of time, in order to perfect the methods for evaluating the outcome of hepatic fibrosis.

Prophylactic oral calcium supplementation therapy to prevent early post thyroidectomy hypocalcemia and evaluation of postoperative parathyroid hormone levels to detect hypocalcemia: A prospective randomized study.

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Arer, Ilker Murat; Kus, Murat; Akkapulu, Nezih; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; Caliskan, Kenan; Tarim, Mehmet Akin

2017-02-01

Postoperative hypocalcemia is the most common complication after total thyroidectomy. Postoperative parathyroid hormone (PTH) measurement is one of the methods to detect or prevent postoperative hypocalcemia. Prophylactic oral calcium supplementation is another method to prevent early postoperative hypocalcemia. The aim of this study is to detect the accurate timing of PTH and evaluate efficacy of routine oral calcium supplementation for postoperative hypocalcemia. A total of 106 patients were performed total thyroidectomy. Rotuine oral calcium supplementation was given to group 1 and no treatment to group 2 according to randomization. Serum calcium and PTH level of patients in group 2 at postoperative 6, 12 and 24 h and patients in both groups at postoperative day 7 were evaluated. Patients were compared according to age, sex, operation findings, serum calcium and PTH levels and symptomatic hypocalcemia. Half of the patients (50%) were in group 1. Most of the patients were female (83%). The most common etiology of thyroid disease was multinodular goiter (64.1%). Oral calcium supplementation was given to 18 (33.9%) patients in group 2. Symptomatic hypocalcemia for group 1 and 2 was found to be 1.9 and 33.9% respectively (p hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Early Therapeutic Alliance and Treatment Outcome in Individual and Family Therapy for Adolescent Behavior Problems

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Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.

2006-01-01

The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…

High-frequency spectral ultrasound imaging (SUSI) visualizes early post-traumatic heterotopic ossification (HO) in a mouse model.

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Ranganathan, Kavitha; Hong, Xiaowei; Cholok, David; Habbouche, Joe; Priest, Caitlin; Breuler, Christopher; Chung, Michael; Li, John; Kaura, Arminder; Hsieh, Hsiao Hsin Sung; Butts, Jonathan; Ucer, Serra; Schwartz, Ean; Buchman, Steven R; Stegemann, Jan P; Deng, Cheri X; Levi, Benjamin

2018-04-01

Early treatment of heterotopic ossification (HO) is currently limited by delayed diagnosis due to limited visualization at early time points. In this study, we validate the use of spectral ultrasound imaging (SUSI) in an animal model to detect HO as early as one week after burn tenotomy. Concurrent SUSI, micro CT, and histology at 1, 2, 4, and 9weeks post-injury were used to follow the progression of HO after an Achilles tenotomy and 30% total body surface area burn (n=3-5 limbs per time point). To compare the use of SUSI in different types of injury models, mice (n=5 per group) underwent either burn/tenotomy or skin incision injury and were imaged using a 55MHz probe on VisualSonics VEVO 770 system at one week post injury to evaluate the ability of SUSI to distinguish between edema and HO. Average acoustic concentration (AAC) and average scatterer diameter (ASD) were calculated for each ultrasound image frame. Micro CT was used to calculate the total volume of HO. Histology was used to confirm bone formation. Using SUSI, HO was visualized as early as 1week after injury. HO was visualized earliest by 4weeks after injury by micro CT. The average acoustic concentration of HO was 33% more than that of the control limb (n=5). Spectroscopic foci of HO present at 1week that persisted throughout all time points correlated with the HO present at 9weeks on micro CT imaging. SUSI visualizes HO as early as one week after injury in an animal model. SUSI represents a new imaging modality with promise for early diagnosis of HO. Copyright © 2018 Elsevier Inc. All rights reserved.

Evaluation of a modified contingency management intervention for consistent attendance in therapeutic workplace participants.

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Wong, Conrad J; Dillon, Erin M; Sylvest, Christine; Silverman, Kenneth

2004-06-11

In a therapeutic workplace business, drug abuse patients are hired as data entry operators and paid to perform data entry work contingent upon documented drug abstinence. Reliable attendance has been difficult to maintain despite the opportunity for operators to earn a living wage, 6 h per day, 5 days per week. A within-subject reversal design experiment evaluated a contingency management intervention that allowed for flexibility regarding when operators could arrive to work, yet maintained a contingency for reliable workplace attendance. Results from a within-subject reversal design experiment demonstrated the contingency management intervention to be effective in increasing the frequency of completed work shifts in four of five operators. Repeated measures ANOVA and Tukey's post-hoc tests of grouped data showed that the contingency management intervention significantly (P workplace participants.

Utility of early dynamic and delayed post-diuretic 18F-FDG PET/CT SUVmax in predicting tumour grade and T-stage of urinary bladder carcinoma: results from a prospective single centre study.

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Sharma, Abhishek; Mete, Uttam K; Sood, Ashwani; Kakkar, Nandita; Gorla, Arun K R; Mittal, Bhagwant R

2017-04-01

Accurate pre-treatment grading and staging of bladder cancer are vital for better therapeutic decision and prognosis. The aim of the present study was to evaluate the correlation between maximum standardized uptake value (SUV max ) calculated during early dynamic and post-diuretic fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT studies with grade and pT-stage of bladder cancer. 39 patients with suspected/proven bladder carcinoma underwent 10-min early dynamic pelvic imaging and delayed post-diuretic whole-body FDG PET/CT imaging. SUV max of the lesions derived from both studies was compared with grade and pT-stage. Relationship of SUV max with grade and pT-stage was analyzed using independent sample t-test and analysis of variance. SUV max of the early dynamic imaging showing tumour perfusion was independent from the SUV max of delayed imaging. High-grade tumours showed higher SUV max than low-grade tumours in the early dynamic imaging (5.4 ± 1.4 vs 4.7 ± 1.6; p-value 0.144) with statistically significant higher value in Stage pT1 tumours (6.8 ± 0.8 vs 5.5 ± 1.2; p-value 0.04). Non-invasive pTa tumours had significantly less SUV max than higher stage tumours during early dynamic imaging [F(4,29) = 6.860, p 0.001]. Early dynamic imaging may have a role in predicting the grade and aggressiveness of the bladder tumours and thus can help in treatment planning and prognostication. Advances in knowledge: Dynamic PET/CT is a limitedly explored imaging technique. This prospective pilot study demonstrates the utility of this modality as a potential adjunct to standard FDG PET/CT imaging in predicting the grade and aggressiveness of the bladder tumours and thus can impact the patient management.

Early life trauma, post-traumatic stress disorder, and allostatic load in a sample of American Indian adults.

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Thayer, Zaneta; Barbosa-Leiker, Celestina; McDonell, Michael; Nelson, Lonnie; Buchwald, Dedra; Manson, Spero

2017-05-06

Among American Indians, prior research has found associations between early life trauma and the development of post-traumatic stress disorder (PTSD) in adulthood. Given the physiological changes associated with PTSD, early life trauma could indirectly contribute to chronic disease risk. However, the impact of early life trauma on adult physical health in this population has not been previously investigated. We evaluated associations among early life trauma, PTSD, and 13 physiological biomarkers that index cardiovascular, metabolic, neuroendocrine, anthropometric, and immune function in adulthood by conducting correlation and structural equation modeling path analyses (N = 197). Physiological systems were analyzed individually as well as in a composite measure of allostatic load. We found early life trauma was related to PTSD, which in turn was related to elevated allostatic load in adulthood. Among the various components of allostatic load, the neuroendocrine system was the only one significantly related to early life stress and subsequent PTSD development. Changes in allostatic load might reflect adaptive adjustments that maximize short-term survival by enhancing stress reactivity, but at a cost to later health. Interventions should focus on improving access to resources for children who experience early life trauma in order to avoid PTSD and other harmful sequelae. © 2016 Wiley Periodicals, Inc.

Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma

NARCIS (Netherlands)

Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Haigentz, Missak; Takes, Robert P.; Silver, Carl E.; Hartl, Dana M.; Strojan, Primoz; Rinaldo, Alessandra; de Bree, Remco; Dietz, Andreas; Gregoire, Vincent; Paleri, Vinidh; Langendijk, Johannes A.; Vander Poorten, Vincent; Hinni, Michael L.; Rodrigo, Juan P.; Suarez, Carlos; Mendenhall, William M.; Werner, Jochen A.; Genden, Eric M.; Ferlito, Alfio

The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side

Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation

NARCIS (Netherlands)

Staal, M. J.; Holm, A. F.; Mooij, J. J. A.; Albers, F. W. J.; Bartels, H.

2007-01-01

Objective: Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by means of chronic electrical stimulation of the vestibulocochlear nerve. Patients: Inclusion criteria were severe, chronic, therapeutically refractory, unilateral tinnitus and severe hearing loss at the

Evaluation of post-tensioning of a curved continuous girder using long-gauge fiber optic sensors

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Abdel-Jaber, Hiba; Glisic, Branko

2014-03-01

Streicker Bridge is a pedestrian bridge on the Princeton University campus. It consists of a main span and four curved continuous girders (legs). The main span and the southeast leg of the bridge are equipped with fiber optic strain and temperature sensors, allowing the bridge to also function as an on-campus laboratory for the Structural Health Monitoring research group. Parallel sensors were embedded at critical cross-sections in the deck prior to the pouring of concrete. The deck of the southeast leg experienced early age cracking within a few days of concrete pouring, which was detected by the strain sensors. Post-tensioning was then performed and it is assumed that it closed off the cracks. Evaluation of post-tensioning forces is complex due to the existence of the cracks, and this paper researches a procedure to estimate the post-tensioning forces at cracked and uncracked locations. The obtained post-tensioning forces were compared to design forces and conclusions regarding the status of post-tensioning were made. This is important as it gives information on the actual health condition and performance of the structure. It also provides information on the safety of the structure. The objective of this paper is to present a methodology for the evaluation of the post-tensioning force along the deck based on strain measurements. The monitoring system, results, data analysis method, and conclusions regarding the bridge health condition and performance are presented in this paper.

Production and evaluation of Lutetium-177 maltolate as a possible therapeutic agent

International Nuclear Information System (INIS)

Hakimi, A.; Jalilian, A. R.; Bahrami Samani, A.; Ghannadi Maragheh, M.

2012-01-01

Development of oral therapeutic radiopharmaceuticals is a new concept in radiopharmacy. Due to the interesting therapeutic properties of 177 Lu and oral bioavailability of maltolate (MAL) metal complexes, 177 Lu-maltolate ( 177 Lu-MAL) was developed as a possible therapeutic compound for ultimate oral administration. The specific activity of 2.6-3 GBq/mg was obtained by irradiation of natural Lu 2 O 3 sample with thermal neutron flux of 4x10 13 n.cm -2 .s -1 for Lu-177. The product was converted into chloride form which was further used for labeling maltol (MAL). At optimized conditions a radiochemical purity of about >99% was obtained for 177 Lu-MAL shown by ITLC (specific activity, 970-1000 Mbq/mmole). The stability of the labeled compound as well as the partition coefficient was determined in the final solution up to 24h. Biodistribution studies of Lu-177 chloride and 177 Lu-MAL were carried out in wild-type rats for post-oral distribution phase data. Lu-MAL is a possible therapeutic agent in human malignancies for the bone palliation therapy so the efficacy of the compound should be tested in various animal models.

Time-window of early detection of response to concurrent chemoradiation in cervical cancer by using diffusion-weighted MR imaging: a pilot study

International Nuclear Information System (INIS)

Liu, Ying; Sun, Haoran; Bai, Renju; Ye, Zhaoxiang

2015-01-01

To investigate the feasibility of DWI in evaluating early therapeutic response of uterine cervical cancer to concurrent chemoradiation (CCR) and establish optimal time window for early detection of treatment response. This was a prospective study and informed consent was obtained from all patients. Thirty-three patients with uterine cervical cancer who received CCR underwent conventional MRI and DWI examinations prior to therapy (base-line) and at 3 days (postT1), 7 days (postT2), 14 days (postT3), 1 month (postT4) and 2 months (postT5) after the therapy initiated. Tumor response was determined by comparing the base-line and postT5 MRI by using RECIST criterion. Percentage ADC change (γADC) of complete response (CR) group at each follow up time was greater than that of partial response (PR) group, and the differences were significant at postT3 (p = 0.007), postT4 (p = 0.001), and postT5 (p = 0.019). There was positive correlation between γADC at each follow-up time and percentage size reduction at postT5. The day of 14 after the therapy initiated can be considered as the optimal time for monitoring early treatment response of uterine cervical cancer to CCR, and the representative and sensitive index was γADC. With the cut-off value of 35.4 %, the sensitivity and specificity for prediction of CR group were 100 % and 73.1 %, respectively. It is feasible to use DWI to predict and monitor early treatment response in patients with uterine cervical cancer that undergoing CCR, and optimal time window for early detection of tumor response is the day of 14 after therapy initiated

Post-mortem CT evaluation of atlanto-occipital dissociation.

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Madadin, Mohammed; Samaranayake, Ravindra Priyalal; O'Donnell, Chris; Cordner, Stephen

2017-02-01

Atlanto-occipital dissociation injury is an important injury in forensic pathology practice. Radiological diagnosis of atlanto-occipital dissociation clinically is assessed by direct measurement of occipito-vertebral skeletal relationships. Different measurements may be used to diagnose atlanto-occipital dissociation, including the basion-dens interval (BDI) and basion-axial interval (BAI). It is not known whether the normal ante-mortem measurements of BDI and BAI described in the literature are applicable to post-mortem CT images of the occipito-cervical junction (OCJ) or whether these measurements could be affected by early post-mortem changes. This study aims to compare post-mortem BDI and BAI measurements with ante-mortem values. Post-mortem CT scans of the cervical spines of 100 deceased adults were reviewed, and the BDI and BAI were measured. Different parameters were recorded in each case. The results from this study suggest that there are no effects of post-mortem changes on the measurement of BAI as relied upon clinically. There appear to be some effects of fully established rigor mortis on BDI measurement, shortening it. This may have consequences for the post mortem diagnosis of atlanto-occipital dissociation. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Early post-traumatic epilepsy following serious craniocerebral trauma, with emphasis on EEG and CT findings

International Nuclear Information System (INIS)

Goeller, T.

1981-01-01

In the study on hand, eighty patients with craniocerebral trauma were regularly examined by EEG. Twenty-two of the patients had clinically observable fits. In five other patients, only the EEG revealed paroxysmal events in the first week following trauma. In six patients who were observed to have fits, no corresponding EEG equivalent could be recorded for technical reasons. In case of early epileptical fits, CT always revealed an intercranial hemorrhage, except for two cases, the findings being in agreement with the lateral location of the focus as determined by EEG. The seriousness of cranial injury was directly related to the number of fits observed in the first post-traumatic week. Patients over thirty showed an increase of eraly post-traumatic fits. The lethality of patients with early fits was significantly increased as compared with patients without early fits. EEG examination as early as possible after the craniocerebral trauma is necessary and useful, both for detection of lesions and for appropriate drug therapy. (orig./MG) [de

Applied Gamification: Reframing Evaluation in Post-Secondary Classrooms

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Kulpa, Anastasia

2017-01-01

This piece reports on an early attempt at gamification (reframing post-secondary classrooms drawing on the structure of games). The attempt began in the 2011-2012 academic year and is structured to allow students substantial autonomy in determining which assignments, and how many of them, to complete over the course of the semester. Initial…

Therapeutic properties and uses of marine invertebrates in the ancient Greek world and early Byzantium.

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Voultsiadou, Eleni

2010-07-20

Marine organisms are currently investigated for the therapeutic potential of their natural products with very promising results. The human interest for their use in healing practices in the Eastern Mediterranean goes back to the antiquity. An attempt is made in the present work to investigate the therapeutic properties of marine invertebrates and the ways they were used in the medical practice during the dawn of the western medicine. The classical Greek texts of the Ancient Greek (Classical, Hellenistic and Roman) and early Byzantine period were studied and the data collected were analysed in order to extract detailed information on the parts of animal bodies and the ways they were used for healing purposes. Thirty-eight marine invertebrates were recorded for their therapeutic properties and uses in 40 works of 20 classical authors, covering a time period of 11 centuries (5th c. BC to 7th c. AD). The identified taxa were classified into 7 phyla and 11 classes of the animal kingdom, while molluscs were the dominant group. Marine invertebrates were more frequently used for their properties relevant to digestive, genitourinary and skin disorders. Flesh, broth, skeleton, or other special body parts of the animals were prepared as drinks, collyria, suppositories, cataplasms, compresses, etc. Marine invertebrates were well known for their therapeutic properties and had a prominent role in the medical practice during the Ancient Greek and the early Byzantine period. The diversity of animal species and their medicinal uses reflect the maritime nature of the Greek civilization, which flourished on the coasts and islands of the Aegean Sea. Most of them were common species exploited by humans for food or other everyday uses. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Undergraduate nursing students writing therapeutic letters to families: an educational strategy.

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Erlingsson, Christen

2009-02-01

Writing therapeutic letters to families is discussed in this article as an educational strategy encouraging students to think reflectively about family nursing. At the University of Kalmar, Sweden, undergraduate nursing students in a primary care module interviewed families using the Calgary Family Assessment Model and wrote therapeutic letters to these families. This article describes (a) the examination process, which was the context for writing therapeutic letters, (b) results of analyses of the letters, and (c) student's post-examination evaluation comments. Results indicate that most students needed encouragement to focus on the family's strengths and resources instead of focusing on own feelings or problems they perceived the family as having. Students also needed support in relinquishing their hierarchical role of "expert nurse." Students' evaluation comments showed that writing therapeutic letters provided students with opportunities to reflect about the connections between family nursing theory and the family itself.

Effects of therapeutic plasma exchange on early allograft dysfunction after liver transplantation.

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Choe, Wonho; Kwon, Seog-Woon; Kim, Sung-Soo; Hwang, Shin; Song, Gi-Won; Lee, Sung-Gyu

2017-06-01

Early allograft dysfunction (EAD) is a serious complication of liver transplantation (LT) and is associated with graft failure, which can result in patient mortality. Due to the shortage of organs for retransplantation, only a small proportion of EAD patients undergo retransplantation. Thus, liver support is needed for most patients with EAD. We evaluated the effects of therapeutic plasma exchange (TPE) in EAD patients. EAD was defined as a sustained hyperbilirubinemia (≥10 mg/dL) within 30 days of LT without concurrent biliary complications. In a 13-year period, 107 EAD patients underwent TPE while 36 EAD patients did not. We investigated the laboratory and clinical outcomes of TPE and non-TPE groups. The TPE group showed 1-month and 1-year survival rates of 82.2% and 53.8%, respectively, whereas the non-TPE group showed 58.3% and 22.2%, respectively. In TPE group, statistically significant decreases (P higher INR on the day of EAD onset increased the risk. TPE effectively removed plasma bilirubin and improved coagulation function in EAD patients, with higher survival in the TPE group than in the non-TPE group. TPE may be an effective liver support for EAD patients. J. Clin. Apheresis 32:147-153, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

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Rajanna, Vijay; Vo, Patrick; Barth, Jerry; Mjelde, Matthew; Grey, Trevor; Oduola, Cassandra; Hammond, Tracy

2016-03-01

A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building

Behavioral Problems and Emotional Difficulties at Children and Early Adolescents of the Veterans of War with Post-Traumatic Stress Disorder.

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Selimbasic, Zihnet; Sinanovic, Osman; Avdibegovic, Esmina; Brkic, Maja; Hamidovic, Jasmin

2017-02-01

Behavioral problems and emotional difficulties at children of the veterans of war with post-traumatic stress disorder (PTSD) have not been researched entirely. In our country, which has a lot of persons suffering from some psychological traumas, this trauma seems to continue. The aim of this study was to determine the exposure, manifestations of behavioral problems and emotional difficulties at children and early adolescents, whose fathers were the veterans of war demonstrating post-traumatic stress disorder symptoms. The analyzed group comprised 120 school age children (10-15 years of age), whose parents/fathers were the veterans of war. The children were divided into two groups, and each group into the following two age sub-groups: 10-12 (children) and 13-15 (early adolescents) according to PTSD presence at their fathers - veterans of war. PTSD symptoms at fathers, veterans of war, were assessed using the Harvard Trauma Questionnaire-Bosnia and Herzegovina version and MKB-10 - audit of criteria. To assess the behavioral problems of children, the Child Behavior Checklist for parents was used, and to evaluate the neuroticism at children Hanes-Scale of neuroticism-extraversion was used while the depression level was evaluated using the Depression self-rating scale (DSRS). To analyze the obtained results, SPSS 17 program was used. The value p post-traumatic stress disorder show significant difference at neuroticism sub-scales (ppost-traumatic stress disorder show significant differences in competencies, behavior, emotional difficulties and neuroticism. Significant correlation was found between psychopathology of parents - fathers the veterans of war and their children. Impact of psychological conditions of fathers - the veterans of war with post-traumatic stress disorder to children is strong and they represent a significant risky group for development of mental disorders.

Identification of relevant ICF categories by geriatric patients in an early post-acute rehabilitation facility.

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Grill, Eva; Stucki, Gerold; Boldt, Christine; Joisten, Susanne; Swoboda, Walter

To describe functioning and health of elderly patients in an early post-acute rehabilitation facility and to identify the most common problems using the International Classification of Functioning, Disability and Health (ICF). Cross-sectional survey in a convenience sample of elderly patients requiring rehabilitation in an early post-acute rehabilitation facility. The second-level categories of the ICF were used to collect information on patients' problems. For the ICF components Body Functions, Body Structures and Activities and Participation, absolute and relative frequencies of impairments/limitations in the study population were reported. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. The mean age in the sample was 79.9 years. Sixty-nine percent of the patients were female. In 150 patients, 82 ICF categories (34%) had a prevalence of 30% or above. The 82 categories included 22 categories (45%) of the component Body Functions, six categories (15%) of the component Body Structures, 25 categories (34%) of the component Activities and Participation and 29 (57%) categories of the component Environmental Factors. This study is a first step towards the development of ICF Core Sets for geriatric patients in early post-acute rehabilitation facilities.

Early Changes in Apparent Diffusion Coefficient From Diffusion-Weighted MR Imaging During Radiotherapy for Prostate Cancer

International Nuclear Information System (INIS)

Park, Sung Yoon; Kim, Chan Kyo; Park, Byung Kwan; Park, Won; Park, Hee Chul; Han, Deok Hyun; Kim, Bohyun

2012-01-01

Purpose: To investigate the feasibility of diffusion-weighted MRI (DWI) as an early and reproducible change indicator in patients receiving radiotherapy for prostate cancer (PC). Methods and Materials: Eight consecutive patients with biopsy-proven PC underwent DWI at 3T. All patients who received external-beam radiotherapy had four serial MR scans, as follows: before therapy (PreTx); after 1 week of therapy (PostT1); after 3 weeks of therapy (PostT2); and 1 month after the completion of therapy (PostT3). At each time, the apparent diffusion coefficient (ADC) was measured in tumors and normal tissues. For reproducibility of the ADC measurement, five patients also had two separate pretreatment DWI scans at an interval of −3 mm 2 /s in sequence, respectively. Compared with PreTx, PostT1 (p = 0.005), PostT2 (p = 0.003), and PostT3 (p −3 mm 2 /s in sequence, respectively. Reproducibility of ADC measurements was confirmed with a mean difference in ADC of –0.04 in peripheral zone and –0.017 in transition zone between two separate pretreatment MR scans. The mean PSA levels from PreTx to PostT3 were 9.05, 9.18, 9.25, and 4.11 ng/mL in sequence, respectively. Conclusions: DWI, as a reproducible biomarker, has the potential to evaluate the early therapeutic changes of PC to radiotherapy.

Design and evaluation of NEUROBike: a neurorehabilitative platform for bedridden post-stroke patients.

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Monaco, Vito; Galardi, Giuseppe; Coscia, Martina; Martelli, Dario; Micera, Silvestro

2012-11-01

Over the past decades, a large number of robotic platforms have been developed which provide rehabilitative treatments aimed at recovering walking abilities in post-stroke patients. Unfortunately, they do not significantly influence patients' performance after three months from the accident. One of the main reasons underlying this result seems to be related to the time of intervention. Specifically, although experimental evidences suggest that early (i.e., first days after the injury) and intense neuro-rehabilitative treatments can significantly favor the functional recovery of post-stroke patients, robots require patients to be verticalized. Consequently, this does not allow them to be treated immediately after the trauma. This paper introduces a new robotic platform, named NEUROBike, designed to provide neuro-rehabilitative treatments to bedridden patients. It was designed to provide an early and well-addressed rehabilitation therapy, in terms of kinesiology, efforts, and fatigue, accounting for exercises functionally related to daily motor tasks. For this purpose, kinematic models of leg-joint angular excursions during both walking and sit-to-stand were developed and implemented in control algorithms leading both passive and active exercises. Finally, a set of pilot tests was carried out to evaluate the performance of the robotic platform on healthy subjects.

A suite of standard post-tagging evaluation metrics can help assess tag retention for field-based fish telemetry research

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Gerber, Kayla M.; Mather, Martha E.; Smith, Joseph M.

2017-01-01

Telemetry can inform many scientific and research questions if a context exists for integrating individual studies into the larger body of literature. Creating cumulative distributions of post-tagging evaluation metrics would allow individual researchers to relate their telemetry data to other studies. Widespread reporting of standard metrics is a precursor to the calculation of benchmarks for these distributions (e.g., mean, SD, 95% CI). Here we illustrate five types of standard post-tagging evaluation metrics using acoustically tagged Blue Catfish (Ictalurus furcatus) released into a Kansas reservoir. These metrics included: (1) percent of tagged fish detected overall, (2) percent of tagged fish detected daily using abacus plot data, (3) average number of (and percent of available) receiver sites visited, (4) date of last movement between receiver sites (and percent of tagged fish moving during that time period), and (5) number (and percent) of fish that egressed through exit gates. These metrics were calculated for one to three time periods: early ( 5 days early in the study. On average, tagged Blue Catfish visited 9 (50%) and 13 (72%) of 18 within-reservoir receivers early and at the end of the study, respectively. At the end of the study, 73% of all tagged fish were detected moving between receivers. Creating statistical benchmarks for individual metrics can provide useful reference points. In addition, combining multiple metrics can inform ecology and research design. Consequently, individual researchers and the field of telemetry research can benefit from widespread, detailed, and standard reporting of post-tagging detection metrics.

A suite of standard post-tagging evaluation metrics can help assess tag retention for field-based fish telemetry research

Science.gov (United States)

Gerber, Kayla M.; Mather, Martha E.; Smith, Joseph M.

2017-01-01

Telemetry can inform many scientific and research questions if a context exists for integrating individual studies into the larger body of literature. Creating cumulative distributions of post-tagging evaluation metrics would allow individual researchers to relate their telemetry data to other studies. Widespread reporting of standard metrics is a precursor to the calculation of benchmarks for these distributions (e.g., mean, SD, 95% CI). Here we illustrate five types of standard post-tagging evaluation metrics using acoustically tagged Blue Catfish (Ictalurus furcatus) released into a Kansas reservoir. These metrics included: (1) percent of tagged fish detected overall, (2) percent of tagged fish detected daily using abacus plot data, (3) average number of (and percent of available) receiver sites visited, (4) date of last movement between receiver sites (and percent of tagged fish moving during that time period), and (5) number (and percent) of fish that egressed through exit gates. These metrics were calculated for one to three time periods: early (of the study (5 months). Over three-quarters of our tagged fish were detected early (85%) and at the end (85%) of the study. Using abacus plot data, all tagged fish (100%) were detected at least one day and 96% were detected for > 5 days early in the study. On average, tagged Blue Catfish visited 9 (50%) and 13 (72%) of 18 within-reservoir receivers early and at the end of the study, respectively. At the end of the study, 73% of all tagged fish were detected moving between receivers. Creating statistical benchmarks for individual metrics can provide useful reference points. In addition, combining multiple metrics can inform ecology and research design. Consequently, individual researchers and the field of telemetry research can benefit from widespread, detailed, and standard reporting of post-tagging detection metrics.

Breastfeeding Initiation and Duration in First-Time Mothers: Exploring the Impact of Father Involvement in the Early Post-Partum Period

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Theresa Hunter

2014-12-01

Full Text Available Background: The early post-partum period is a crucial time for breastfeeding support. Mothers who have physical and emotional support during this period are more likely to be successful in breastfeeding. This study examined the relationship between father involvement and support for breast feeding initiation and duration in first-time mothers. Methods: Overall, 146 women who attended a childbirth education class or breastfeeding course at BABS were asked to fill out the Childbirth Experiences Survey, which explored key topics such as (1 breastfeeding initiation, (2 early post-partum breastfeeding, (3 breastfeeding plan, (4 post-partum breastfeeding support and (5 breast feeding duration. This was a voluntary self-reported questionnaire. The surveys were completed by the mothers during the post-partum period. Results: 45.9% (n=67 of mothers received helped from their husband or partner with breastfeeding while in the hospital, while 54.1% (n=79 of mothers did not receive support from their partners. Mothers who received early post-partum breastfeeding support were more likely to continue breastfeeding after leaving the hospital. Conclusion: First-time mothers who identified as having breastfeeding support from their partners, the infant’s father, during the early post-partum period were more likely to initiate breastfeeding and had longer breastfeeding durations.

Evaluation of early efficacy endpoints for proof-of-concept trials.

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Chen, Cong; Sun, Linda; Li, Chih-Lin

2013-03-11

A Phase II proof-of-concept (POC) trial usually uses an early efficacy endpoint other than a clinical endpoint as the primary endpoint. Because of the advancement in bioscience and technology, which has yielded a number of new surrogate biomarkers, drug developers often have more candidate endpoints to choose from than they can handle. As a result, selection of endpoint and its effect size as well as choice of type I/II error rates are often at the center of heated debates in design of POC trials. While optimization of the trade-off between benefit and cost is the implicit objective in such a decision-making process, it is seldom explicitly accounted for in practice. In this research note, motivated by real examples from the oncology field, we provide practical measures for evaluation of early efficacy endpoints (E4) for POC trials. We further provide optimal design strategies for POC trials that include optimal Go-No Go decision criteria for initiation of Phase III and optimal resource allocation strategies for conducting multiple POC trials in a portfolio under fixed resources. Although oncology is used for illustration purpose, the same idea developed in this research note also applies to similar situations in other therapeutic areas or in early-stage drug development in that a Go-No Go decision has to rely on limited data from an early efficacy endpoint and cost-effectiveness is the main concern.

Post-market drug evaluation research training capacity in Canada: an environmental scan of Canadian educational institutions.

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Wiens, Matthew O; Soon, Judith A; MacLeod, Stuart M; Sharma, Sunaina; Patel, Anik

2014-01-01

Ongoing efforts by Health Canada intended to modernize the legislation and regulation of pharmaceuticals will help improve the safety and effectiveness of drug products. It will be imperative to ensure that comprehensive and specialized training sites are available to train researchers to support the regulation of therapeutic products. The objective of this educational institution inventory was to conduct an environmental scan of educational institutions in Canada able to train students in areas of post-market drug evaluation research. A systematic web-based environmental scan of Canadian institutions was conducted. The website of each university was examined for potential academic programs. Six core programmatic areas were determined a priori as necessary to train competent post-market drug evaluation researchers. These included biostatistics, epidemiology, pharmacoepidemiology, health economics or pharmacoeconomics, pharmacogenetics or pharmacogenomics and patient safety/pharmacovigilance. Twenty-three academic institutions were identified that had the potential to train students in post-market drug evaluation research. Overall, 23 institutions taught courses in epidemiology, 22 in biostatistics, 17 in health economics/pharmacoeconomics, 5 in pharmacoepidemiology, 5 in pharmacogenetics/pharmacogenomics, and 3 in patient safety/pharmacovigilance. Of the 23 institutions, only the University of Ottawa offered six core courses. Two institutions offered five, seven offered four and the remaining 14 offered three or fewer. It is clear that some institutions may offer programs not entirely reflected in the nomenclature used for this review. As Heath Canada moves towards a more progressive licensing framework, augmented training to increase research capacity and expertise in drug safety and effectiveness is timely and necessary.

Early Head Start Evaluation

Data.gov (United States)

U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

Therapeutic evaluation of sorafenib for hepatocellular carcinoma using contrast-enhanced ultrasonography: Preliminary result.

Science.gov (United States)

Shiozawa, Kazue; Watanabe, Manabu; Ikehara, Takashi; Kogame, Michio; Kikuchi, Yoshinori; Igarashi, Yoshinori; Sumino, Yasukiyo

2016-07-01

The present study aimed to determine the usefulness of contrast-enhanced ultrasonography (CEUS) with Sonazoid in evaluating the therapeutic response to sorafenib for hepatocellular carcinoma (HCC). In total, 26 patients with advanced HCC who received sorafenib and were followed up by CEUS were enrolled in the present study. CEUS was performed prior to and within 2-4 weeks of treatment, and the images of the target lesion in the post-vascular phase with a re-injection method were analyzed. The presence (+) or absence (-) of intratumoral necrosis and the intratumoral vascular architecture on micro-flow imaging (MFI) were compared prior to and subsequent to treatment. Target lesions that exhibited non-enhancement after re-injection were considered to indicate intratumoral necrosis. The intratumoral vascular architecture was classified into three groups, as follows: Vd, the intratumoral vessels visually narrowed or decreased; Vnc, the vessels remained unchanged; and Vi, the vessels were thickened or increased. Survival curves were estimated using the Kaplan-Meier method and compared using the log rank test between the intratumoral necrosis (+) and (-) groups, and among the Vd, Vnc and Vi groups. PVnc group and 5 patients in the Vi group. The MSTs in the Vd, Vnc and Vi groups were 15.6 months (95% CI, 5.0-23.3), 11.0 months (95% CI, 3.5-17.6) and 3.6 months (95% CI: 1.2-6.0), respectively. The P-value for the differences between the Vd and Vnc groups, Vd and Vi groups, and Vnc and Vi groups were 0.78, 0.016 and 0.047, respectively, which indicated that the survival time decreased significantly in the Vi group. Evaluation of intratumoral vascular architecture using MFI demonstrates promise for assessing the therapeutic response to sorafenib in patients with HCC.

Combined approach with therapeutic drug monitoring and pharmacogenomics in renal transplant recipients

Directory of Open Access Journals (Sweden)

S Manvizhi

2013-01-01

Full Text Available In patients undergoing renal transplantation, dose individualization for tacrolimus is routinely achieved with therapeutic drug monitoring (TDM. The patient started on 5.5 mg/day of tacrolimus had a significantly elevated tacrolimus trough concentration. The tacrolimus dose was regularly reduced following TDM at many time periods in the post transplant period but the tacrolimus concentration was consistently elevated. Genomic analysis done after four years revealed mutations in the genes encoding for CYP3A5 and MDR1 (2677G > T. Pharmacogenomics alongside TDM, will soon emerge as the backbone of dose individualization. But for genomics to be beneficial, it should be advocated in the pre-transplant or early post transplant period.

Will Synergizing Vaccination with Therapeutics Boost Measles Virus Eradication?

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Plemper, Richard K; Hammond, Anthea L

2014-01-01

Introduction Measles virus is a major human pathogen responsible for approximately 150,000 measles deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence combined with public anxieties about vaccination safety has increased vaccine refusal especially in the European region, which has resulted in measles resurgence in some areas. Areas covered Here, we discuss whether synergizing effective measles therapeutics with vaccination could contribute to solving an endgame conundrum of measles elimination by accelerating the eradication effort. Based on an anticipated use for protection of high-risk contacts of confirmed measles cases through post-exposure prophylaxis, we identify key elements of the desirable drug profile, review current disease management strategies and the state of experimental inhibitor candidates, evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics for the management of persistent viral infection of the CNS. Assuming a post-measles world with waning measles immunity, we contemplate the possible impact of therapeutics on controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles virus. Expert opinion Efficacious therapeutics given for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent patient population dictates the drug profile; the article must be safe and efficacious, orally available, shelf-stable at ambient temperature, and amenable to cost-effective manufacture

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox - an animal model of smallpox.

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Parker, Scott; Chen, Nanhai G; Foster, Scott; Hartzler, Hollyce; Hembrador, Ed; Hruby, Dennis; Jordan, Robert; Lanier, Randall; Painter, George; Painter, Wesley; Sagartz, John E; Schriewer, Jill; Mark Buller, R

2012-04-01

The human population is currently faced with the potential use of natural or recombinant variola and monkeypox viruses as biological weapons. Furthermore, the emergence of human monkeypox in Africa and its expanding environs poses a significant natural threat. Such occurrences would require therapeutic and prophylactic intervention with antivirals to minimize morbidity and mortality of exposed populations. Two orally-bioavailable antivirals are currently in clinical trials; namely CMX001, an ether-lipid analog of cidofovir with activity at the DNA replication stage and ST-246, a novel viral egress inhibitor. Both of these drugs have previously been evaluated in the ectromelia/mousepox system; however, the trigger for intervention was not linked to a disease biomarker or a specific marker of virus replication. In this study we used lethal, intranasal, ectromelia virus infections of C57BL/6 and hairless SKH1 mice to model human disease and evaluate exanthematous rash (rash) as an indicator to initiate antiviral treatment. We show that significant protection can be provided to C57BL/6 mice by CMX001 or ST-246 when therapy is initiated on day 6 post infection or earlier. We also show that significant protection can be provided to SKH1 mice treated with CMX001 at day 3 post infection or earlier, but this is four or more days before detection of rash (ST-246 not tested). Although in this model rash could not be used as a treatment trigger, viral DNA was detected in blood by day 4 post infection and in the oropharyngeal secretions (saliva) by day 2-3 post infection - thus providing robust and specific markers of virus replication for therapy initiation. These findings are discussed in the context of current respiratory challenge animal models in use for the evaluation of poxvirus antivirals. Copyright © 2012 Elsevier B.V. All rights reserved.

Music therapy for early cognitive rehabilitation post-childhood TBI: an intrinsic mixed methods case study.

Science.gov (United States)

Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen

2014-10-01

The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

Recent concepts concerning cerebral ischaemia in man and their implications in therapeutic evaluations

Energy Technology Data Exchange (ETDEWEB)

Depresseux, J C

1987-06-18

Recent concepts concerning focal cerebral ischaemia in man and resulting from the data obtained with positron emission tomography are reported. The evolutive steps in the ischaemic process are divided into: perfusion reserve; extraction reserve recruitment; ischaemic penumbra; lesional process and post-lesional developments. Circulatory and metabolic patterns corresponding to these evolutive steps are described and illustrated. The potentials of these data as guide-lines in therapeutic trial methodology are discussed.

Recent concepts concerning cerebral ischaemia in man and their implications in therapeutic evaluations

International Nuclear Information System (INIS)

Depresseux, J.C.

1987-01-01

Recent concepts concerning focal cerebral ischaemia in man and resulting from the data obtained with positron emission tomography are reported. The evolutive steps in the ischaemic process are divided into: perfusion reserve; extraction reserve recruitment; ischaemic penumbra; lesional process and post-lesional developments. Circulatory and metabolic patterns corresponding to these evolutive steps are described and illustrated. The potentials of these data as guide-lines in therapeutic trial methodology are discussed [fr

Key factors which concur to the correct therapeutic evaluation of herbal products in free radical-induced diseases.

Directory of Open Access Journals (Sweden)

Cesare eMancuso

2015-04-01

Full Text Available For many years now the world's scientific literature has been perfused with articles on the therapeutic potential of natural products, the vast majority of which have herbal origins, as in the case of free radical-induced diseases. What is often overlooked is the effort of researchers who take into consideration the preclinical and clinical evaluation of these herbal products, in order to demonstrate the therapeutic efficacy and safety. The first critical issue to be addressed in the early stages of the preclinical studies is related to pharmacokinetics, which is sometimes not very favorable, of some of these products, which limits the bioavailability after oral intake. In this regard, it is worthy underlining how it is often unethical to propose the therapeutic efficacy of a compound on the basis of preclinical results obtained with far higher concentrations to those which, hopefully, could be achieved in organs and tissues of subjects taking these products by mouth. The most widely used approach to overcome the problem related to the low bioavailability involves the complexation of the active ingredients of herbal products with non-toxic carriers that facilitate the absorption and distribution. Even the induction or inhibition of drug metabolizing enzymes by herbal products, and the consequent variations of plasma concentrations of co-administered drugs, are phenomena to be carefully evaluated as they can give rise to side-effects. This risk is even greater when considering that people lack the perception of the risk arising from an over use of herbal products that, by their very nature, are considered risk-free.

Blunting of the HPA-axis underlies the lack of preventive efficacy of early post-stressor single-dose Delta-9-tetrahydrocannabinol (THC).

Science.gov (United States)

Mayer, Tzur Alexander; Matar, Michael Alex; Kaplan, Zeev; Zohar, Joseph; Cohen, Hagit

2014-07-01

The therapeutic value of Delta-9-tetrahydrocannabinol (Δ9-THC) in the aftermath of trauma has recently raised interest. A prospective animal model for posttraumatic stress disorder was employed to assess the behavioral effects of a single dose of Δ9-THC administered intraperitoneally following exposure to psychogenic stress. Animals were exposed to predator scent stress and treated 1h later with Δ9-THC (1, 5 and 10mg/kg) or vehicle. The outcome measures included behavior in an elevated plus-maze and acoustic startle response 1, 6 and 24 h or 7 days after exposure and freezing behavior upon exposure to a trauma cue on day 8. Pre-set cut-off behavioral criteria classified exposed animals as those with "extreme," "minimal" or "intermediate" (partial) response. Circulating corticosterone levels were assessed over 2h after exposure with and without Δ9-THC. The behavioral effects of a CB1 antagonist (AM251) administered systemically 1h post exposure were evaluated. In the short term (1-6 h), 5 mg/kg of Δ9-THC effectively attenuated anxiety-like behaviors. In the longer-term (7 days), it showed no effect in attenuating PTSD-like behavioral stress responses, or freezing response to trauma cue. Δ9-THC significantly decreased corticosterone levels. In contrast, administration of AM251 (a CB1 antagonist/inverse agonist) 1 h post exposure attenuated long-term behavioral stress responses through activation of the HPA-axis. The demonstrated lack of preventive efficacy of early Δ9-THC treatment and reports of its anxiogenic effects in many individuals raises doubts not only regarding its potential clinical value, but also the advisability of clinical trials. The endocannabinoids exert complex effects on behavioral responses mediating glucocorticoid effects on memory of traumatic experiences. Copyright © 2014 Elsevier Inc. All rights reserved.

Traumatic Brain Injury Pathophysiology and Treatments: Early, Intermediate, and Late Phases Post-Injury

Science.gov (United States)

Algattas, Hanna; Huang, Jason H.

2014-01-01

Traumatic Brain Injury (TBI) affects a large proportion and extensive array of individuals in the population. While precise pathological mechanisms are lacking, the growing base of knowledge concerning TBI has put increased emphasis on its understanding and treatment. Most treatments of TBI are aimed at ameliorating secondary insults arising from the injury; these insults can be characterized with respect to time post-injury, including early, intermediate, and late pathological changes. Early pathological responses are due to energy depletion and cell death secondary to excitotoxicity, the intermediate phase is characterized by neuroinflammation and the late stage by increased susceptibility to seizures and epilepsy. Current treatments of TBI have been tailored to these distinct pathological stages with some overlap. Many prophylactic, pharmacologic, and surgical treatments are used post-TBI to halt the progression of these pathologic reactions. In the present review, we discuss the mechanisms of the pathological hallmarks of TBI and both current and novel treatments which target the respective pathways. PMID:24381049

Post-Occupancy Evaluation of Facilities Change

NARCIS (Netherlands)

van der Voordt, Theo; de Been, I.; Maarleveld, M.; Finch, E

2012-01-01

This chapter discusses possible aims, tools and deliverables of Post-Occupancy Evaluations (POE) (otherwise known as building-in-use studies), with a focus on interventions in supporting facilities. POE has a long tradition and has been applied in different fields (e.g. offices, educational

Evaluating Post-Earthquake Building Safety Using Economical MEMS Seismometers.

Science.gov (United States)

Hsu, Ting-Yu; Yin, Ren-Cheng; Wu, Yih-Min

2018-05-05

The earthquake early warning (EEW)-research group at National Taiwan University has been developing a microelectromechanical system-based accelerometer called “P-Alert”, designed for issuing EEWs. The main advantage of P-Alert is that it is a relatively economical seismometer. However, because of the expensive nature of commercial hardware for structural health monitoring (SHM) systems, the application of SHM to buildings remains limited. To determine the performance of P-Alert for evaluating post-earthquake building safety, we conducted a series of steel-frame shaking table tests with incremental damage. We used the fragility curves of different damage levels and the interstory drift ratios (calculated by the measured acceleration of each story using double integration and a filter) to gauge the potential damage levels. We concluded that the acceptable detection of damage for an entire building is possible. With improvements to the synchronization of the P-Alert sensors, we also anticipate a damage localization feature for the stories of a building.

An overview of leech and its therapeutic applications

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Parimannan Sivachandran

2015-05-01

Full Text Available Hirudotherapy has a broad spectrum of therapeutic application in the medical field ranging from cardiology, gynaecology, ophthalmology, plastic and reconstructive surgeries. In medieval and early modern medicine, leeches were used to remove blood from patients in an attempt to balance the biological humours. Leeches are widely used to treat venous congestion in microvascular replantation, free and conventional flap surgery and traumatology. Recently, Food and Drug Administration has approved the usage of live leeches as medical device for therapeutic applications. Presently, some of the leech species have declined dramatically in its population due to the over utilization of leech for medicinal purposes and also due to pollution in several parts of the world particularly in European and Asian countries. This review presents an overview of leech including the history, biology, classification, and its application as medical device. Further, it also covers the controversies and misconception related to leech species identification and complications of post hirudotherapy.

Identification of relevant ICF categories by patients with neurological conditions in early post-acute rehabilitation facilities.

Science.gov (United States)

Grill, Eva; Lipp, Berthold; Boldt, Christine; Stucki, Gerold; Koenig, Eberhard

To describe functioning and health of patients with neurological conditions in early post-acute rehabilitation facilities and to identify the most common problems using the International Classification of Functioning, Disability and Health (ICF). Cross-sectional survey in a convenience sample of patients with neurological conditions requiring rehabilitation in early post-acute facilities. The second-level categories of the ICF were used to collect information on patients' problems. For the ICF components Body Functions, Body Structures and Activities and Participation absolute and relative frequencies of impairments/limitations in the study population were reported. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. The mean age in the sample was 56.6 years with a median age of 60 years. Forty percent of the patients were female. In 292 neurological patients 125 categories (51%) had a prevalence of 30% and above: 39 categories (49%) of Body Functions, 11 categories (28%) of Body Structures, 64 categories (88%) of Activities and Participation and 10 (20%) categories of Environmental Factors. This study is a first step towards the development of ICF Core Sets for of patients with neurological conditions in early post-acute rehabilitation facilities.

Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis.

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Han, Shi-You; Hong, Zhi-You; Xie, Yu-Hua; Zhao, Yong; Xu, Xiao

2017-12-01

Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P herbal medicines most likely to improve stroke recovery when combined with acupuncture. Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.

Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes.

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Benson, Ariel A; Rowe, Mina; Eid, Ahmad; Bluth, Keren; Merhav, Hadar; Khalaileh, Abed; Safadi, Rifaat

2018-08-01

Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

[In vivo evaluation of carbon fiber posts].

Science.gov (United States)

Lai, V; Lugliè, P F; Chessa, G

2002-05-01

The use of carbon fiber posts allows morpho-functional restoration of endodontically treated teeth with an assembly of materials of a modulus of elasticity similar to that of dentin. The study clinically evaluated the percentage of survival of dental elements treated and reconstructed with endocanal carbon fiber posts. At the Dentistry Clinic of the University of Sassari 60 dental elements were selected from 46 subjects. The teeth, which had been treated endodontically with success for at least six months, were classified by parameters taken from the international literature and reconstructed using Tech 2000 carbon fiber posts and adhesive resinous systems recommended by the post manufacturer. The success rate was 98.4%. Almost half (49%) of the samples were single-rooted elements, 37.4% of the posts were 1.2 mm in diameter; in 78.3% the opposing contact was with a natural tooth; 100% of the elements had a type A dental structure. Third generation posts are a valid alternative to metallic posts and improve the prognosis of the treated element. The carbon fiber posts fixed with the composite, forming a single unit with the dental element, thus improving mid-term RESULTS. The technique is easy to use under clinical conditions and can be performed in a single session. So far, the method has provided promising clinical results, as this study demonstrated.

Influence of early stress on memory reconsolidation: Implications for post-traumatic stress disorder treatment.

Science.gov (United States)

Villain, Hélène; Benkahoul, Aïcha; Birmes, Philippe; Ferry, Barbara; Roullet, Pascal

2018-01-01

Post-traumatic stress disorder (PTSD) is a common consequence of exposure to a life-threatening event. Currently, pharmacological treatments are limited by high rates of relapse, and novel treatment approaches are needed. We have recently demonstrated that propranolol, a β-adrenergic antagonist, inhibited aversive memory reconsolidation in animals. Following this, in an open-label study 70% of patients with PTSD treated with propranolol during reactivation of traumatic memory exhibited full remission. However, the reason why 30% of these patients did not respond positively to propranolol treatment is still unclear. One of the major candidates as factor of treatment resistance is the patient's early-life traumatic history. To test the role of this factor, mice with pre- or postnatal stress are being tested in fear conditioning and in a new behavioral task, the "city-like", specifically designed as a mouse model of PTSD. After reactivation of the traumatic event, mice received propranolol injection to block the noradrenergic system during memory reconsolidation. Results show that, in the "city-like" test, control mice strongly avoided the shock compartment but also the compartments containing cues associated with the electric shocks. Injection of propranolol after reactivation greatly reduced the memory of the traumatic event, but this effect was not present when mice had received pre- or postnatal stress. Moreover, propranolol produced only a very weak effect in the fear conditioning test, and never changed the corticosterone level whatever the behavioral experiment. Taken together our results suggest that our new behavioural paradigm is well adapted to PTSD study in mice, and that early stress exposure may have an impact on propranolol PTSD treatment outcome. These data are critical to understanding the effect of propranolol treatment, in order to improve the therapeutic protocol currently used in humans.

Understanding Factors Associated with Early Therapeutic Alliance in PTSD Treatment: Adherence, Childhood Sexual Abuse History, and Social Support

Science.gov (United States)

Keller, Stephanie M.; Zoellner, Lori A.; Feeny, Norah C.

2010-01-01

Objective: Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as…

Early post-treatment FDG PET predicts survival after {sup 90}Y microsphere radioembolization in liver-dominant metastatic colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Sabet, Amir; Aouf, Anas; Sabet, Amin; Ghamari, Shahab; Biersack, Hans-Juergen [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Meyer, Carsten; Pieper, Claus C. [University Hospital, Department of Radiology, Bonn (Germany); Mayer, Karin [University Hospital, Department of Medicine and Oncology, Bonn (Germany); Ezziddin, Samer [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Saarland University, Department of Nuclear Medicine, Homburg (Germany)

2014-10-29

The aim of this study was to evaluate the predictive value of early metabolic response 4 weeks post-treatment using {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in patients with unresectable hepatic metastases of colorectal cancer (CRC) undergoing radioembolization (RE) with {sup 90}Y-labelled microspheres. A total of 51 consecutive patients with liver-dominant metastases of CRC were treated with RE and underwent {sup 18}F-FDG PET/CT at baseline and 4 weeks after RE. In each patient, three hepatic metastases with the highest maximum standardized uptake value (SUV{sub max}) were selected as target lesions. Metabolic response was defined as >50 % reduction of tumour to liver ratios. Survival analyses using Kaplan-Meier and multivariate analyses were performed to identify prognostic factors for overall survival (OS). Investigated baseline characteristics included age (>60 years), performance status (Eastern Cooperative Oncology Group >1), bilirubin (>1.0 mg/dl), hepatic tumour burden (>25 %) and presence of extrahepatic disease. The median OS after RE was 7 months [95 % confidence interval (CI) 5-8]; early metabolic responders (n = 33) survived longer than non-responders (p < 0.001) with a median OS of 10 months (95 % CI 3-16) versus 4 months (95 % CI 2-6). Hepatic tumour burden also had significant impact on treatment outcome (p < 0.001) with a median OS of 5 months (95 % CI, 3-7) for patients with >25 % metastatic liver replacement vs 14 months (95 % CI 6-22) for the less advanced patients. Both factors (early metabolic response and low hepatic tumour burden) remained as independent predictors of improved survival on multivariate analysis. These are the first findings to show that molecular response assessment in CRC using {sup 18}F-FDG PET/CT appears feasible as early as 4 weeks post-RE, allowing risk stratification and potentially facilitating early response-adapted treatment strategies. (orig.)

An augmented reality game to support therapeutic education for children with diabetes.

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Andrés-Marcelo Calle-Bustos

Full Text Available Therapeutic education in diabetes helps patients take responsibility for self-control of their disease, and providing technological support systems facilitates this education. In this paper, we present an augmented reality game to support therapeutic education for patients with diabetes. Our game helps children (aged 5-14 years to learn carbohydrate (carb content of different foods. The game shows virtual foods on a real dish. The number of carb choices corresponding to the visualized food is also shown (1 carb choice = 10 grams of carbs. A study to determine the effectiveness of the game in terms of learning and perceived satisfaction and usability was carried out. A total of seventy children with diabetes participated in the study. From the results, we observed that the initial knowledge about carb choices of the children who participated in the study was low (a mean of 2 on a scale from 0 to 9. This indicates that therapeutic education for patients with diabetes is needed. When the results for the pre-knowledge questionnaire and the post-knowledge questionnaire were compared, it was shown that the children learned about carb choices by playing our game. We used two post-knowledge questionnaires (one post-knowledge questionnaire that contained the same foods as the pre-knowledge questionnaire and a second post-knowledge questionnaire that contained foods that were different from the ones on the pre-knowledge questionnaire. There were no statistically significant differences between these two different post-knowledge questionnaires. Moreover, the knowledge acquired was independent of gender and age. We also evaluated usability and perceived satisfaction. The children were satisfied with the game and considered that the game offers a high degree of usability. This game could be a valuable therapeutic education tool for patients with diabetes.

Therapeutic efficacy of Chymotrypsin in acute bovine mastitis

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Marco Leal G

2016-05-01

Full Text Available Objective. To evaluate the therapeutic efficacy of a proteolytic drug “chymotrypsin” combined with beta-lactam antibiotics in cows with acute mastitis. Material and Methods. Fourteen cows with acute mastitis. Three cows were treated with a beta-latam antibiotic (BLA and the other eleven cows were treated with chymotrypsin plus beta-lactam antibiotic (C+BLA. The response was evaluated according to the semiological findings, somatic cell count (SCC and a microbiological culture. Results. There was a therapeutic efficacy comparing the pre and post treatment period (SCC reduction, p<0.01 and a reduction of clinical signs in 84.7% of treated quarters in the first day of treatment (C+BLA compared with (BLA. Conclusions. Chymotrypsin improves the treatment of acute mastitis when is combined with BLA, controlling the infected mammary glands, compared with the group treated only with amoxicilina and clavulanic acid.

Targeted theranostic platinum(IV) prodrug with a built-in aggregation-induced emission light-up apoptosis sensor for noninvasive early evaluation of its therapeutic responses in situ.

Science.gov (United States)

Yuan, Youyong; Kwok, Ryan T K; Tang, Ben Zhong; Liu, Bin

2014-02-12

Targeted drug delivery to tumor cells with minimized side effects and real-time in situ monitoring of drug efficacy is highly desirable for personalized medicine. In this work, we report the synthesis and biological evaluation of a chemotherapeutic Pt(IV) prodrug whose two axial positions are functionalized with a cyclic arginine-glycine-aspartic acid (cRGD) tripeptide for targeting integrin αvβ3 overexpressed cancer cells and an apoptosis sensor which is composed of tetraphenylsilole (TPS) fluorophore with aggregation-induced emission (AIE) characteristics and a caspase-3 enzyme specific Asp-Glu-Val-Asp (DEVD) peptide. The targeted Pt(IV) prodrug can selectively bind to αvβ3 integrin overexpressed cancer cells to facilitate cellular uptake. In addition, the Pt(IV) prodrug can be reduced to active Pt(II) drug in cells and release the apoptosis sensor TPS-DEVD simultaneously. The reduced Pt(II) drug can induce the cell apoptosis and activate caspase-3 enzyme to cleave the DEVD peptide sequence. Due to free rotation of the phenylene rings, TPS-DEVD is nonemissive in aqueous media. The specific cleavage of DEVD by caspase-3 generates the hydrophobic TPS residue, which tends to aggregate, resulting in restriction of intramolecular rotations of the phenyl rings and ultimately leading to fluorescence enhancement. Such noninvasive and real-time imaging of drug-induced apoptosis in situ can be used as an indicator for early evaluation of the therapeutic responses of a specific anticancer drug.

The Psychosocial and Independent Living Donor Advocate Evaluation and Post-surgery Care of Living Donors.

Science.gov (United States)

Rudow, Dianne LaPointe; Swartz, Kathleen; Phillips, Chelsea; Hollenberger, Jennifer; Smith, Taylor; Steel, Jennifer L

2015-09-01

Solid organ transplantation as a treatment for end stage organ failure has been an accepted treatment option for decades. Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. Living donation has been an option that has increased the number of transplants despite the continued shortage of deceased organs. In the early 2000s live donor transplantation reached an all-time high in the United States. As a result, a consensus meeting was convened in 2000 to increase the oversight of living donor transplantation. Both the Centers for Medicare and Medicaid Services and the United Network for Organ Sharing developed regulations that transplant programs performing live donor transplantation. These regulations and guidelines involve the education, evaluation, informed consent process and living donor follow-up care. Two areas in which had significant changes included the psychosocial and the independent living donor advocate (ILDA) evaluation. The purpose of this paper was to outline the current regulations and guidelines associated with the psychosocial and ILDA evaluation as well as provide further recommendations for the administration of a high quality evaluation of living donors. The goals and timing of the evaluation and education of donors; qualifications of the health care providers performing the evaluation; components of the evaluation; education provided to donors; documentation of the evaluation; participation in the selection committee meeting; post-decline and post-donation care of donors is described. Caveats including the paired donor exchange programs and non-directed and directed donation are also considered.

Early Phase Process Evaluation: Industrial Practices

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Zulfan Adi Putra

2016-09-01

Full Text Available Process route evaluation is a part of research and development (R&D works in an industrial chemical project life cycle. In this early phase, good process evaluation, including process synthesis and designs, provide guidance’s on the R&D project. The paper aimed to collect practical methods used in this early phase process route evaluation from author’s 10 years of industrial experiences.  The collected methods range from forward-backward process synthesis, functional process design, use of cost estimation, and applications of Monte Carlo simulation. Led by a good project management (e.g. via a stage-gate approach use of these methods have shown beneficial results. Some important results are strong arguments on whether or not the project will continue, as well as relevant technical and economic issues identified during this early phase process synthesis and design. Later on, these issues become guidance’s to the follow-up project, if it is continued.

Design Alternative Evaluation No. 3: Post-Closure Ventilation

International Nuclear Information System (INIS)

Logan, R.C.

1999-01-01

The objective of this study is to provide input to the Enhanced Design Alternatives (EDA) for License Application Design Selection (LADS). Its purpose is to develop and evaluate conceptual designs for post-closure ventilation alternatives that enhance repository performance. Post-closure ventilation is expected to enhance repository performance by limiting the amount of water contacting the waste packages. Limiting the amount of water contacting the waste packages will reduce corrosion

Improving early cycle economic evaluation of diagnostic technologies.

Science.gov (United States)

Steuten, Lotte M G; Ramsey, Scott D

2014-08-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

Ex-Post Critical Evaluations of Energy Policies in Malaysia from 1970 to 2010: A Historical Institutionalism Perspective

OpenAIRE

Amir F. N. Abdul-Manan; Azizan Baharuddin; Lee Wei Chang

2015-01-01

Ex-post evaluations of energy policies in Malaysia between 1970 and 2010 were conducted. The developments of energy policies in Malaysia were traced from the early 1970s with the introduction of the country’s first energy-related policy all the way to 2010 with the country’s first endeavour towards a biobased energy system. Analyses revealed that many of the policies were either: (1) directly responding to changes in global/domestic socioeconomic and political events, or (2) provided visions ...

Implementation of therapeutic hypothermia guidelines for post-cardiac arrest syndrome at a glacial pace: seeking guidance from the knowledge translation literature.

Science.gov (United States)

Brooks, Steven C; Morrison, Laurie J

2008-06-01

The 2005 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations document represents the most extensive and rigorous systematic review of the resuscitation literature to date and included evidence-based recommendations for post-resuscitation care. A new recommendation for the induction of mild therapeutic hypothermia for comatose cardiac arrest survivors was included in this document. Accordingly, constituent national member associations of ILCOR, including the American Heart Association, incorporated the recommendation for therapeutic hypothermia into their respective guidelines. Despite these endorsements there is a concern that therapeutic hypothermia is not being used in practice. Data from a number of surveys in Europe and the United States suggest that rates of use among physicians may be as low as 30-40%. Despite the cost and effort associated with the production of these guidelines and the potential impact on patient care, current efforts in implementing the guideline have not achieved widespread success. This commentary explores the issue of underutilization of the American Heart Association guidelines for therapeutic hypothermia and looks to the knowledge translation literature to inform a new approach to implementation. We will review the underlying phenomenon of research implementation into practice, specific barriers to guideline implementation and interventions that may improve therapeutic hypothermia uptake.

Prognostic evaluation of primary biliary cirrhosis and its value in guiding therapeutic regimens

Directory of Open Access Journals (Sweden)

HUANG Chunyang

2016-07-01

Full Text Available Prognostic evaluation of patients with primary biliary cirrhosis (PBC and how to improve the prognosis have attracted much attention. Further therapeutic regimens for PBC patients with poor prognosis has become the direction of clinical and scientific studies. This article summarizes the association between baseline indices and prognosis and prognostic evaluation of patients undergoing ursodeoxycholic acid (UDCA treatment, introduces the current status of UDCA combined with budesonide, fibrates, and obeticholic acid for patients with poor response to UDCA and the drugs being developed, and analyzes the influencing factors for prognosis and efficacy of UDCA. It is pointed out that prognosis and efficacy should be evaluated before and during UDCA treatment, and that therapeutic regimens should be adjusted in time to improve prognosis.

Adaptation of adhesive post and cores to dentin after in vitro occlusal loading: evaluation of post material influence.

Science.gov (United States)

Dietschi, Dider; Ardu, Stefano; Rossier-Gerber, Anne; Krejci, Ivo

2006-12-01

Fatigue resistance of post and cores is critical to the long term behavior of restored nonvital teeth. The purpose of this in vitro trial was to evaluate the influence of the post material's physical properties on the adaptation of adhesive post and core restorations after cyclic mechanical loading. Composite post and cores were made on endodontically treated deciduous bovine teeth using 3 anisotropic posts (made of carbon, quartz, or quartz-and-carbon fibers) and 3 isotropic posts (zirconium, stainless steel, titanium). Specimens were submitted to 3 successive loading phases--250,000 cycles at 50 N, 250,000 at 75 N, and 500,000 at 100 N--at a rate of 1.5 Hz. Restoration adaptation was evaluated under SEM, before and during loading (margins) and after test completion (margins and internal interfaces). Six additional samples were fabricated for the characterization of interface micromorphology using confocal microscopy. Mechanical loading increased the proportion of marginal gaps in all groups; carbon fiber posts presented the lowest final gap proportion (7.11%) compared to other stiffer metal-ceramic or softer fiber posts (11.0% to 19.1%). For internal adaptation, proportions of debonding between dentin and core or cement varied from 21.69% (carbon post) to 47.37% (stainless steel post). Debonding at the post-cement interface occurred only with isotropic materials. Confocal microscopy observation revealed that gaps were generally associated with an incomplete hybrid layer and reduced resin tags. Regardless of their rigidity, metal and ceramic isotropic posts proved less effective than fiber posts at stabilizing the post and core structure in the absence of the ferrule effect, due to the development of more interfacial defects with either composite or dentin.

Building an immune-mediated coagulopathy consensus: early recognition and evaluation to enhance post-surgical patient safety

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Voils Stacy A

2009-05-01

Full Text Available Abstract Topical hemostats, fibrin sealants, and surgical adhesives are regularly used in a variety of surgical procedures involving multiple disciplines. Generally, these adjuncts to surgical hemostasis are valuable means for improving wound visualization, reducing blood loss or adding tissue adherence; however, some of these agents are responsible for under-recognized adverse reactions and outcomes. Bovine thrombin, for example, is a topical hemostat with a long history of clinical application that is widely used alone or in combination with other hemostatic agents. Hematologists and coagulation experts are aware that these agents can lead to development of an immune-mediated coagulopathy (IMC. A paucity of data on the incidence of IMC contributes to under-recognition and leaves many surgeons unaware that this clinical entity, originating from normal immune responses to foreign antigen exposure, requires enhanced post-operative vigilance and judicious clinical judgment to achieve best outcomes. Postoperative bleeding may result from issues such as loosened ties or clips or the occurrence of a coagulopathy due to hemodilution, vitamin K deficiency, disseminated intravascular coagulation (DIC or post-transfusion, post-shock coagulopathic states. Other causes, such as liver disease, may be ruled out by a careful patient history and common pre-operative liver function tests. Less common are coagulopathies secondary to pathologic immune responses. Such coagulopathies include those that may result from inherent patient problems such as patients with an immune dysfunction related to systemic lupus erythrematosus (SLE or lymphoma that can invoke antibodies against native coagulation factors. Medical interventions may also provoke antibody formation in the form of self-directed anti-coagulation factor antibodies, that result in problematic bleeding; it is these iatrogenic post-operative coagulopathies, including those associated with bovine thrombin

The effect of implant macro-thread design on implant stability in the early post-operative period: a randomized, controlled pilot study.

Science.gov (United States)

McCullough, Jeffrey J; Klokkevold, Perry R

2017-10-01

Available literature suggests there is a transient drop in implant stability from approximately week 0 to week 3-4 as a result of peri-implant bone remodeling as it transitions from a primary, mechanical stability to a secondary, biological stability. Research investigating the influence of macro-thread design on this process is scant. The specific aim of this study was to evaluate the role of macro-thread design on implant stability in the early post-operative healing period using resonance frequency analysis (RFA). Seven patients, each missing at least two posterior teeth in the same arch, were included in the study. Three patients qualified for four implants resulting in a total of 10 matched pairs. All sites were healed (>6 months), non-grafted sites with sufficient bone to place implants. Each site in a matched pair was randomly assigned to receive either a control (Megagen EZ Plus Internal; EZ) or test (Megagen AnyRidge; AR) implant. The test implant incorporates a novel thread design with a wide thread depth and increased thread pitch. RFA was used to determine implant stability quotient (ISQ) values for each implant at the time of placement and weekly for the first 8 weeks. Implants consistently achieved a relatively high insertion torque (30-45 N/cm) and high initial ISQ value (79.8 ± 1.49). Baseline ISQ values for test (AR; 79.55 ± 1.61) and control (EZ; 80.05 ± 1.37) implants were similar. A general pattern of stability from baseline through all eight follow-up evaluations was observed for the test implants. A pattern of decreasing ISQ values was observed for the control implants across the early follow-up evaluations up to week four, where the value plateaued. There was a statistically significant main effect due to implant type (P implant type and time (P implants performed differently at certain time points. Within the limitations of this study, macro-thread design appears to play a role in implant stability in the early post

Safety and immunogenicity of therapeutic DNA vaccination in individuals treated with antiretroviral therapy during acute/early HIV-1 infection.

Directory of Open Access Journals (Sweden)

Eric S Rosenberg

2010-05-01

Full Text Available An effective therapeutic vaccine that could augment immune control of HIV-1 replication may abrogate or delay the need for antiretroviral therapy. AIDS Clinical Trials Group (ACTG A5187 was a phase I/II, randomized, placebo-controlled, double-blinded trial to evaluate the safety and immunogenicity of an HIV-1 DNA vaccine (VRC-HVDNA 009-00-VP in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. (clinicaltrials.gov NCT00125099Twenty healthy HIV-1 infected subjects who were treated with antiretroviral therapy during acute/early HIV-1 infection and had HIV-1 RNA<50 copies/mL were randomized to receive either vaccine or placebo. The objectives of this study were to evaluate the safety and immunogenicity of the vaccine. Following vaccination, subjects interrupted antiretroviral treatment, and set-point HIV-1 viral loads and CD4 T cell counts were determined 17-23 weeks after treatment discontinuation.Twenty subjects received all scheduled vaccinations and discontinued antiretroviral therapy at week 30. No subject met a primary safety endpoint. No evidence of differences in immunogenicity were detected in subjects receiving vaccine versus placebo. There were also no significant differences in set-point HIV-1 viral loads or CD4 T cell counts following treatment discontinuation. Median set-point HIV-1 viral loads after treatment discontinuation in vaccine and placebo recipients were 3.5 and 3.7 log(10 HIV-1 RNA copies/mL, respectively.The HIV-1 DNA vaccine (VRC-HIVDNA 009-00-VP was safe but poorly immunogenic in subjects treated with antiretroviral therapy during acute/early HIV-1 infection. Viral set-points were similar between vaccine and placebo recipients following treatment interruption. However, median viral load set-points in both groups were lower than in historical controls, suggesting a possible role for antiretroviral therapy in persons with acute or early HIV-1 infection and supporting the safety of

[Post-gastrectomy reconstruction versus enteral alimentation--a one year follow-up study].

Science.gov (United States)

Kostov, D; Balabanova, G; Vasilev, B; Plachkov, I; Ignatov, G

2000-01-01

This is a report on various post-gastrectomy reconstructive procedures, proceeding from personal experience had with 14 patients undergoing gastrectomy for carcinoma of the stomach and five patients with operations of esophagus and stomach for various pathological conditions. An assessment is done of the reconstructive methods used on the ground of objective indicators. All patients are subjected to enteral alimentation through nutritive jejunostomy. In the pre- and postoperatived periods, the trophic state of patients is evaluated on basis of biochemical, anthropometric and immunologic study data. Postoperatively, in those with small-intestinal reservoir a lower degree negative symptomatology is established, along with life style improvement. Post-gastrectomy patients presenting I-II (UICC) stage of the oncological disease are indicated for small-intestinal reservoir formation. In the overall therapeutic approach to post-gastrectomy patients adequate clinical therapeutic feeding proves absolutely indispensable.

Glucocorticoids for the treatment of post-traumatic stress disorder and phobias: a novel therapeutic approach.

Science.gov (United States)

de Quervain, Dominique J-F; Margraf, Jürgen

2008-04-07

Post-traumatic stress disorder (PTSD) and phobias belong to the most common anxiety disorders and to the most common psychiatric illnesses in general. In both disorders, aversive memories are thought to play an important role in the pathogenesis and symptomatology. Previously, we have reported that elevated glucocorticoid levels inhibit memory retrieval in animals and healthy humans. We therefore hypothesized that the administration of glucocorticoids might also inhibit the retrieval of aversive memory, thereby reducing symptoms in patients with PTSD and phobias. In recent clinical studies, we found first evidence to support this hypothesis. In patients with PTSD, low-dose cortisol treatment for one month reduced symptoms of traumatic memories without causing adverse side effects. Furthermore, we found evidence for a prolonged effect of the cortisol treatment. Persistent retrieval and reconsolidation of traumatic memories is a process that keeps these memories vivid and thereby the disorder alive. By inhibiting memory retrieval, cortisol may weaken the traumatic memory trace, and thus reduce symptoms even beyond the treatment period. In patients with social phobia, we found that a single oral administration of cortisone 1 h before a socio-evaluative stressor significantly reduced self-reported fear during the anticipation-, exposure-, and recovery phase of the stressor. In subjects with spider phobia, repeated oral administration of cortisol 1 h before exposure to a spider photograph induced a progressive reduction of stimulus-induced fear. This effect was maintained when subjects were exposed to the stimulus again two days after the last cortisol administration, indicating that cortisol facilitated the extinction of phobic fear. In conclusion, by a common mechanism of reducing the retrieval of aversive memories, glucocorticoids may be suited for the treatment of PTSD as well as phobias. More studies are needed to further evaluate the therapeutic efficacy of

Specific features of early post-stroke seizures

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Tatyana Valeryevna Danilova

2012-01-01

Full Text Available The paper presents the results of examining 101 patients (68 men and 33 women aged 48 to 89 years with seizures in the first 7 days of stroke. A control group comprised 97 patients who had experienced ischemic stroke without seizures. Early seizures more frequently occurred in the cardioembolic subtype of stroke as simple partial seizures. The neuroimaging features of ischemic foci were revealed and the cerebrovascular responsiveness was evaluated in different vascular basins in these patients.

Ex-post evaluation of tax legislation in the Netherlands

NARCIS (Netherlands)

S.J.C. Hemels (Sigrid)

2011-01-01

textabstractIntroduction Since the end of the 20th century, ex-post evaluation of tax legislation has consistently been part of the agenda of the Dutch government. In 2005, the 2001 Income tax Act was evaluated. In addition, several tax expenditures are evaluated each year. Tax expenditures can be a

Anatomy in Cologne--Institutional development and body supply from the Weimar Republic to the early post-war period.

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Kaiser, Stephanie; Gross, Dominik

2015-07-01

The Anatomical Institute of the University of Cologne was founded in 1925. This paper highlights its institutional development and the sources from which it procured bodies for dissection. A comparison is drawn between the first years of the institute's existence during the Weimar Republic (1925-1932) and its rebuilding after war damage in the early post-war period (1947-1954). The institute and its procurement of bodies have not previously been investigated for these two time periods. The Third Reich, for which a detailed study already exists, will be mentioned as well to allow better evaluation of the periods before and after National Socialism. Based on newly evaluated archival material and body journals which will be examined both quantitatively and qualitatively, it becomes apparent that the Cologne institute experienced a chronic shortage of bodies both during the Weimar Republic and the first post-war decade (even though the delivery facilities were mostly the same). However, the situation of the institute in terms of structure, organization and personnel as well as body supply in the aftermath of World War II proved much more challenging than during the time of the Weimar Republic. Copyright © 2015 Elsevier GmbH. All rights reserved.

Post-early cretaceous landform evolution along the western margin of the banca~nnia trough, western nsw

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Gibson, D.L.

2000-01-01

Previously undated post-Devonian sediments outcropping north of Fowlers Gap station near the western margin of the Bancannia Trough are shown by plant macro- and microfossil determinations to be of Early Cretaceous (most likely Neocomian and/or Aptian) age, and thus part of the Eromanga Basin. They are assigned to the previously defined Telephone Creek Formation. Study of the structural configuration of this unit and the unconformably underlying Devonian rocks suggests that the gross landscape architecture of the area results from post-Early Cretaceous monoclinal folding along blind faults at the western margin of the trough, combined with the effects of differential erosion. This study shows that, while landscape evolution in the area has been dynamic, the major changes that have occurred are on a geological rather than human timescale.

Use Case Evaluation (UCE): A Method for Early Usability Evaluation in Software Development

DEFF Research Database (Denmark)

Stage, Jan; Høegh, Rune Thaarup; Hornbæk, K.

2007-01-01

t is often argued that usability problems should be identified as early as possible during software development, but many usability evaluation methods do not fit well in early development activities. We propose a method for usability evaluation of use cases, a widely used representation of design...... ideas produced early in software development processes. The method proceeds by systematic inspection of use cases with reference to a set of guidelines for usable design. To validate the method, four evaluators inspected a set of use cases for a health care application....

Therapeutic effects of FuZhiSan on Alzheimer's disease rat model:evaluation with PET imaging

International Nuclear Information System (INIS)

Guo Zhe; Zhang Jinming; Yao Shulin; Feng Huiru; Li Xuling; Yin Dayi; Tian Jiahe

2010-01-01

Objective: To assess the feasibility of using PET molecular imaging to evaluate the therapeutic effects of traditional Chinese medicine FuZhiSan (FZS) on the model of aging Alzheimer's disease (AD) rats. Methods: Twenty aged AD rats (Sparague-Dawley rats,male) were randomly divided into FZS treated group (n = 10) and control group (n = 10). Another 10 healthy adult rats were as blank controls. Morris water maze record system was used for cognitive function assessment. Before and after FZS treatment 18 F-fluorodeoxyglucose (FDG) and 11 C-2- [4'-(methylamino) phenyl] benzothiazol-6-ol (PIB) PET imaging was undertaken. After post-treatment imaging procedures the brain tissues of all animals were taken for histochemical study, such as staining with HE, congo red, amyloid β (Aβ) immunofluorescence, 5-bromo-2-deoxyuridine (BrdU) immunofluorescence and NeuN immunofluorescence. Paired t-test was performed with SPSS 13.0 software for the data analysis. Results: The cognitive dysfunction of aging AD rats was improved after FZS treatment. The escape latency in FZS treated group was significantly shorter than that of control group ((32.5 ±10.8) s vs (102.6±8.8) s, t =15.7987, P=0. 0001). Diffuse neuronal loss and Aβ deposition were detected in the hippocampus and cortex in the aged AD rats. The imaging data showed that brain glucose metabolism was amended in FZS treated group while the abatement of amyloid deposition was not significant. Immunofluorescence results indicated that the neuronal proliferation was more remarkable in FZS treated group. Conclusions: It may be feasible to use PET imaging as a method to evaluate the therapeutic effect in AD rats. FZS may ameliorate memory dysfunction of aged AD rats. Its mechanism may be partly contributed to the enhancement of the neuronal proliferation and survival. (authors)

Evaluation of Salivary Flow Rate, pH and Buffer in Pre, Post & Post Menopausal Women on HRT.

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D R, Mahesh; G, Komali; K, Jayanthi; D, Dinesh; T V, Saikavitha; Dinesh, Preeti

2014-02-01

Climateric is considered to be a natural phase of life which by definition is the period of life starting from decline in ovarian activity until after the end of ovarian function. It is accompanied by various health consequences that include the changes in saliva too. This study was carried out to evaluate the salivary flow rate, pH, buffering capacity in pre-menopausal, post-menopausal and post-menopausal women on HRT. (1) To evaluate the salivary flow rate, pH of resting saliva and stimulated saliva and buffer capacity of stimulated saliva in pre-menopausal, post-menopausal and post-menopausal women on Hormone Replacement Therapy (HRT). (2) To compare the above salivary findings between pre-menopausal, post-menopausal and post-menopausal women on HRT. The study was carried out on 60 patients. These patients were divided into three groups of 20 patients: Group 1: Pre-menopausal women (control), Group 2: post-menopausal women (case), Group 3: post-menopausal women on HRT (case). The control group consisted of 20 women volunteers, having regular ovulatory menstrual cycles with no known systemic illness and deleterious habits and Group 2 consists of 20 post-menopausal women and Group 3 will consist of 20 post-menopausal women on HRT. After clearing the mouth by swallowing, stimulated saliva was collected after chewing paraffin for 10 mins in to a glass centrifuge tube graded in 0.1 mL increments up to 10mL.in rare cases the collection time will be reduced or extended (5-15 min), salivary flow rate will be determined as ml/min, immediately after collection, pH was determined by dipping pH test paper directly into the sample of oral fluid, salivary buffer capacity was determined by using saliva check buffer kit (GC corporation). The data obtained was statistically evaluated using chi-square test, fisher exact test ANOVA analysis. In our study we found salivary flow rate significantly lower in the post-menopausal women in comparison with the menstruating women and also

Travel websites: Changing visits, evaluations and posts

NARCIS (Netherlands)

Bronner, Fred; de Hoog, Robert

2016-01-01

Many studies concerning the role of web-based information in tourism measure one-time interactions. This paper presents results of a longitudinal study. Data collected in 2014 about website visits, evaluations and posts, are compared with data from 2007. The main finding is the advance of sites

Amino acid transport system - A substrate predicts the therapeutic effects of particle radiotherapy.

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Tomoya Uehara

Full Text Available L-[methyl-11C]Methionine (11C-Met is useful for estimating the therapeutic efficacy of particle radiotherapy at early stages of the treatment. Given the short half-life of 11C, the development of longer-lived 18F- and 123I-labeled probes that afford diagnostic information similar to 11C-Met, are being sought. Tumor uptake of 11C-Met is involved in many cellular functions such as amino acid transport System-L, protein synthesis, and transmethylation. Among these processes, since the energy-dependent intracellular functions involved with 11C-Met are more reflective of the radiotherapeutic effects, we evaluated the activity of the amino acid transport System-A as an another energy-dependent cellular function in order to estimate radiotherapeutic effects. In this study, using a carbon-ion beam as the radiation source, the activity of System-A was evaluated by a specific System-A substrate, alpha-[1-14C]-methyl-aminoisobutyric acid (14C-MeAIB. Cellular growth and the accumulation of 14C-MeAIB or 14C-Met were evaluated over time in vitro in cultured human salivary gland (HSG tumor cells (3-Gy or in vivo in murine xenografts of HSG tumors (6- or 25-Gy before and after irradiation with the carbon-ion beam. Post 3-Gy irradiation, in vitro accumulation of 14C-Met and 14C-MeAIB decreased over a 5-day period. In xenografts of HSG tumors in mice, tumor re-growth was observed in vivo on day-10 after a 6-Gy irradiation dose, but no re-growth was detected after the 25-Gy irradiation dose. Consistent with the growth results, the in vivo tumor accumulation of 14C-MeAIB did not decrease after the 6-Gy irradiation dose, whereas a significant decrease was observed after the 25-Gy irradiation dose. These results indicate that the activity of energy dependent System-A transporter may reflect the therapeutic efficacy of carbon-ion radiotherapy and suggests that longer half-life radionuclide-labeled probes for System-A may also provide widely available probes to

Sense of coherence moderates late effects of early childhood Holocaust exposure.

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van der Hal-van Raalte, Elisheva A M; van IJzendoorn, Marinus H; Bakermans-Kranenburg, Marian J

2008-12-01

This study evaluated child Holocaust survivors with an emphasis on potential protective factors facilitating participants' adaptation to post-Holocaust life. We examined Antonovsky's (1979, 1987) salutogenic paradigm, testing the mediating and moderating effect of participants' sense of coherence (SOC) on the association between early childhood deprivation due to Holocaust persecution and posttraumatic stress later in life. The nonclinical sample, composed of 203 child Holocaust survivors born between 1935 and 1944 completed questionnaires on Holocaust survival exposure, inventories on current health, posttraumatic stress, and SOC. The results indicated that SOC moderates the association between traumatic experiences during the war and posttraumatic stress, and SOC acts as a protective factor, buffering the impact of traumatic Holocaust experiences on child survivors in old age. Survivors with a less coherent perspective on the meaning of their life showed greater vulnerability for posttraumatic complaints. The moderating role of the SOC may suggest promising avenues of therapeutic interventions for child Holocaust survivors and other adults with early childhood trauma. (c) 2008 Wiley Periodicals, Inc.

Early medical skull surgery for treatment of post-traumatic osteomyelitis 5,000 years ago.

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Pierpaolo Petrone

Full Text Available Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP. Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death.

Therapeutic effect of acupuncture combining standard swallowing training for post-stroke dysphagia: A prospective cohort study.

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Mao, Li-Ya; Li, Li-Li; Mao, Zhong-Nan; Han, Yan-Ping; Zhang, Xiao-Ling; Yao, Jun-Xiao; Li, Ming

2016-07-01

To assess the therapeutic effect of acupuncture combining standard swallowing training for patients with dysphagia after stroke. A total of 105 consecutively admitted patients with post-stroke dysphagia in the Affiliated Hospital of Gansu University of Chinese Medicine were included: 50 patients from the Department of Neurology and Rehabilitation received standard swallowing training and acupuncture treatment (acupuncture group); 55 patients from the Department of Neurology received standard swallowing training only (control group). Participants in both groups received 5-day therapy per week for a 4-week period. The primary outcome measures included the scores of Videofluoroscopic Swallow Study (VFSS) and the Standardized Swallowing Assessment (SSA); the secondary outcome measure was the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), all of which were assessed before and after the 4-week treatment. A total of 98 subjects completed the study (45 in the acupuncture group and 53 in the control group). Significant differences were seen in VFSS, SSA and RBHOMS scores in each group after 4-week treatment as compared with before treatment (Pdysphagia, and acupuncture therapy is worth further investigation in the treatment of post-stroke dysphagia.

[Identification of novel therapeutically effective antibiotics using silkworm infection model].

Science.gov (United States)

Hamamoto, Hiroshi; Urai, Makoto; Paudel, Atmika; Horie, Ryo; Murakami, Kazuhisa; Sekimizu, Kazuhisa

2012-01-01

Most antibiotics obtained by in vitro screening with antibacterial activity have inappropriate properties as medicines due to their toxicity and pharmacodynamics in animal bodies. Thus, evaluation of the therapeutic effects of these samples using animal models is essential in the crude stage. Mammals are not suitable for therapeutic evaluation of a large number of samples due to high costs and ethical issues. We propose the use of silkworms (Bombyx mori) as model animals for screening therapeutically effective antibiotics. Silkworms are infected by various pathogenic bacteria and are effectively treated with similar ED(50) values of clinically used antibiotics. Furthermore, the drug metabolism pathways, such as cytochrome P450 and conjugation systems, are similar between silkworms and mammals. Silkworms have many advantages compared with other infection models, such as their 1) low cost, 2) few associated ethical problems, 3) adequate body size for easily handling, and 4) easier separation of organs and hemolymph. These features of the silkworm allow for efficient screening of therapeutically effective antibiotics. In this review, we discuss the advantages of the silkworm model in the early stages of drug development and the screening results of some antibiotics using the silkworm infection model.

Clinical evaluation of post-extraction site wound healing.

Science.gov (United States)

Adeyemo, Wasiu Lanre; Ladeinde, Akinola Ladipo; Ogunlewe, Mobolanle Olugbemiga

2006-07-01

The aim of this prospective study was to evaluate the clinical pattern of post-extraction wound healing with a view to identify the types, incidence, and pattern of healing complications following non-surgical tooth extraction. A total of 311 patients, who were referred for non-surgical (intra-alveolar) extractions, were included in the study. The relevant pre-operative information recorded for each patient included age and gender of the patient, indications for extraction, and tooth/teeth removed. Extractions were performed under local anesthesia with dental forceps, elevators, or both. Patients were evaluated on the third and seventh postoperative days for alveolus healing assessment. Data recorded were: biodata, day of presentation for alveolus healing assessment, day of onset of any symptoms, body temperature (degrees C) in cases of alveolus infection, and presence or absence of pain. Two hundred eighty-two patients (282) with 318 extraction sites were evaluated for alveolus healing. Healing was uneventful in 283 alveoli (89%), while 35 alveoli (11%) developed healing complications. These complications were: localized osteitis 26 (8.2%); acutely infected alveolus 5 (1.6%); and an acutely inflamed alveolus 4 (1.2%). Females developed more complications than males (p=0.003). Most complications were found in molars (60%) and premolars (37.1%). Localized osteitis caused severe pain in all cases, while infected and inflamed alveolus caused mild or no pain. Thirty patients (12%) among those without healing complications experienced mild pain. Most of the post-extraction alveoli healed uneventfully. Apart from alveolar osteitis (AO), post-extraction alveolus healing was also complicated by acutely infected alveoli and acutely inflamed alveoli. This study also demonstrated a painful alveolus is not necessarily a disturbance of post-extraction site wound healing; a thorough clinical examination must, therefore, be made to exclude any of the complications.

Evaluation of the pattern dimensions of cast-metal posts in uniradicular teeth

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Rafael de Assunção Vital

Full Text Available Introduction Accurate dimensions of cast-metal posts are relevant to the survival of dental prostheses. Objective The aim of this study was to verify if the dimensions of cast-metal posts accord with ideal clinical criteria. Material and method For the evaluation, 285 periapical radiographs, from a total of 80 teeth, were taken from the charts of patients that attended the clinics at the Dental School of the Federal University of Goiás, from March 2008 to October 2012. Only periapical radiographs of single-rooted teeth with post and core were included in the study. The radiographic evaluation was conducted with the assistance of a magnifying glass and a view box, in a room with low luminosity. The dimensions of the post and core were established with the help of a digital caliper, and the following measurements were considered: a LR (Length Remnant; b LP (Length Post; c BS (Bone Support; d DR (Diameter Root; e DP (mesiodistal diameter post. The post and core were classified as acceptable or deficient by reference values with a margin of error of 0.2 mm. For descriptive analysis, the data were cataloged using SPSS software (version 17.0. Result With regard to the length of the post and core, only 26.25% and 43.75% of the post and core were classified as acceptable according to the two-thirds rule and fulcrum dental rule, respectively. With regard to the mesiodistal diameter of the post and core, 55% were classified as acceptable. Conclusion Within the limits of this study, it can be concluded that the cast-metal posts evaluated do not accord with the ideal clinical criteria.

The gga-let-7 family post-transcriptionally regulates TGFBR1 and LIN28B during the differentiation process in early chick development.

Science.gov (United States)

Lee, Sang In; Jeon, Mi-Hyang; Kim, Jeom Sun; Jeon, Ik-Soo; Byun, Sung June

2015-12-01

Early chick embryogenesis is governed by a complex mechanism involving transcriptional and post-transcriptional regulation, although how post-transcriptional processes influence the balance between pluripotency and differentiation during early chick development have not been previously investigated. Here, we characterized the microRNA (miRNA) signature associated with differentiation in the chick embryo, and found that as expression of the gga-let-7 family increases through early development, expression of their direct targets, TGFBR1 and LIN28B, decreases; indeed, gga-let-7a-5p and gga-let-7b miRNAs directly bind to TGFBR1 and LIN28B transcripts. Our data further indicate that TGFBR1 and LIN28B maintain pluripotency by regulating POUV, NANOG, and CRIPTO. Therefore, gga-let-7 miRNAs act as post-transcriptional regulators of differentiation in blastodermal cells by repressing the expression of the TGFBR1 and LIN28B, which intrinsically controls blastodermal cell differentiation in early chick development. © 2015 Wiley Periodicals, Inc.

Evaluating the Effects of Interactivity in a Post-Editing Workbench

DEFF Research Database (Denmark)

Underwood, Nancy; Mesa-Lao, Bartolomé; Martinez, Mercedes Garcia

2014-01-01

This paper describes the field trial and subsequent evaluation of a post-editing workbench which is currently under development in the EU-funded CasMaCat project. Based on user evaluations of the initial prototype of the workbench, this second prototype of the workbench includes a number of inter...... on productivity, quality, user satisfaction and cognitive load as reflected in the post-editors’ gaze activity. These quantitative results are combined with the qualitative results derived from user questionnaires and interviews conducted with all the participants....

Evaluation of anatomical and visual function for early detection of ethambutol toxicity among tuberculosis patients

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Jessica Mani Penny Tevaraj

2017-11-01

Full Text Available AIM: To evaluate if early ethambutol toxicity can be detected by comparing pre-and post-treatment anatomical and visual function using retinal nerve fiber thickness, pattern visual evoked potentials and conventional optic nerve function tests.METHODS:This was a prospective study involving 72 eyes of 36 patients treated with ethambutol according to directly observed treatment short-course(DOTSstrategy in Hospital Universiti Sains Malaysia, Kelantan, Malaysia. The visual acuity and optic nerve function tests were performed by a single investigator. Likewise, Humphrey automated perimetry, optical coherence tomography(OCTmeasurement of the retinal nerve fibre layer(RNFLand pattern visual evoked potential(PVEPwere performed by a single technician. The examinations were performed before initiating ethambutol treatment and 3mo after that.RESULTS: There was no change in visual acuity, colour vision, light brightness, red saturation and fundus findings pre and post ethambutol. However, there was a statistically significant deterioration in the mean deviation of the visual field post treatment(P=0.010. There were also significant changes on OCT and PVEP, with increased RNFL thickness in all quadrants(PPCONCLUSION: Ethambutol toxicity is a known complication of tuberculosis treatment. Early detection of this toxicity may prevent severe irreversible visual loss. The use of OCT to detect RNFL thickness and PVEP to assess P100 latency and amplitude can assist in the detection of subclinical anatomical and visual function changes prior to development of abnormalities on conventional optic nerve function tests.

Radiation induced early delayed changes in mice brain: a 1h MRS and behavioral evaluation study

International Nuclear Information System (INIS)

Gupta, Mamta; Rana, Poonam; Haridas, Seenu; Manda, Kailash; Hemanth Kumar, B.S.; Khushu, Subash

2014-01-01

Radiation induced CNS injury can be classified as acute, early delayed and late delayed. Most of the studies suggest that acute injury is reversible whereas early delayed and late delayed injury is irreversible leading to metabolic and cognitive impairment. Extensive research has been carried out on cranial radiation induced early and late delayed changes, there are no reports on whole body radiation induced early and delayed changes. The present study was designed to observe early delayed effects of radiation during whole body radiation exposure. A total of 20 C57 male mice were divided in two groups of 10 animals each. One group was exposed to a dose of 5 Gy whole body radiation through Tele 60 Co irradiation facility with source operating at 2.496 Gy/min, while other group served as sham irradiated control. Behavioral and MR spectroscopy was carried out 3 months post irradiation. Behavioral parameters such as locomotor activity and working memory were evaluated first then followed by MR spectroscopy at 7T animal MRI system. For MRS, voxel was localised in the cortex-hippocampus region of mouse brain. MR spectra were acquired using PRESS sequence, FID was processed using LC model for quantitation. The data showed impaired cognitive functions and altered metabolite levels during early delayed phase of whole body radiation induced injury. In behavioural experiments, there was a significant impairment in the cognitive as well as exploratory functions at 3 months post irradiation in irradiated group as compared to controls. MRS results explained changes in mI, glutamine and glx levels in irradiated animals compared to controls. Altered mI level has been found to be associated with reduced cognitive abilities in many brain disorders including MCI and Alzheimer's disease. The findings of this study suggest that whole body radiation exposure may have long lasting effect on the cognitive performance. (author)

Heuristic Evaluation of Ehealth Interventions: Establishing Standards That Relate to the Therapeutic Process Perspective.

Science.gov (United States)

Baumel, Amit; Muench, Fred

2016-01-13

In recent years, the number of available eHealth interventions aimed at treating behavioral and mental health challenges has been growing. From the perspective of health care providers, there is a need for eHealth interventions to be evaluated prior to clinical trials and for the limited resources allocated to empirical research to be invested in the most promising products. Following a literature review, a gap was found in the availability of eHealth interventions evaluation principles related to the patient experience of the therapeutic process. This paper introduces principles and concepts for the evaluation of eHealth interventions developed as a first step in a process to outline general evaluation guidelines that relate to the clinical context from health care providers' perspective. Our approach was to conduct a review of literature that relates to the examination of eHealth interventions. We identified the literature that was most relevant to our study and used it to define guidelines that relate to the clinical context. We then compiled a list of heuristics we found to be useful for the evaluation of eHealth intervention products' suitability for empirical examination. Four heuristics were identified with respect to the therapeutic process: (1) the product's ease of use (ie, usability), (2) the eHealth intervention's compatibility with the clinical setting, (3) the presence of tools that make it easier for the user to engage in therapeutic activities, and (4) the provision of a feasible therapeutic pathway to growth. We then used this set of heuristics to conduct a detailed examination of MyFitnessPal. This line of work could help to set the bar higher for product developers and to inform health care providers about preferred eHealth intervention designs.

Early hypopharyngeal cancer treated with different therapeutic approaches: a single-institution cohort analysis

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Kim, Nalee; Lee, Jeong Shin; Kim, Kyung Hwan; Park, Jong Eon; Lee, Chang Geol; Keum, Ki Chang [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

Estimation of efficiency of new local rehabilitation method at the early post-operative period after dental implantation

Directory of Open Access Journals (Sweden)

A. V. Pasechnik

2017-01-01

  Summary Despite of success of dental implantation, there are often complications at the early post-operative period of implant placing associated with wound damage and aseptic inflammation. Purpose of the work is studying clinical efficiency of combined local application of new mucosal gel “Apior” and magnetotherapy at the early post-operative period after dental implantation. Combined local application of the mucosal gel “Apior” and pulsating low-frequency electromagnetic field in the complex medical treatment of patients after conducting an operation of setting dental implants favourably affects the common state of patients and clinical symptoms of inflammation in the area of operating wound. As compared with patients who had traditional anti-inflammatory therapy, the patients treated with local application of apigel and magnetoterapy had decline of edema incidence, of gingival mucosa hyperemia, of discomfort in the area of conducted operation. There occurred more rapid improvement of inflammation painfulness, which correlated with the improvement of hygienic state of oral cavity and promoted to prevention of bacterial content of damaged mucous surfaces. Estimation of microvasculatory blood stream by the method of ultrasonic doppler flowmetry revealed more rapid normalization of volume and linear high systole speed of blood stream in the periimplant tissues in case of use of new complex local rehabilitation method, that testified to the less pronounced inflammation of oral mucosa after the operation. The authors came to conclusion that the local application of the offered method of medical treatment of early post-operative complications of dental implantation reduces terms of renewal of structural-functional integrity of oral mucosa, helps in preventing development of inflammatory complications and strengthening endosseus implant. The inclusion in the treatment management of a new combined method of application of mucosal gel “Apior” and

A More-than-Social Movement: The Post-Human Condition of Quality in the Early Years

Science.gov (United States)

Arndt, Sonja; Tesar, Marek

2016-01-01

This article explores quality in early childhood education by de-elevating the importance of the human subject and experience, and heightening instead a focus on and tensions with the post-human. The argument traces the intricate web of "qualities" woven throughout entanglements of subjects, objects and things that constitute what is…

Therapeutic drug monitoring of infliximab : performance evaluation of three commercial ELISA kits

NARCIS (Netherlands)

Schmitz, E.M.H.; van de Kerkhof, D.; Hamann, D.; van Dongen, J.L.J.; Kuijper, P.H.M.; Brunsveld, L.; Scharnhorst, V.; Broeren, M.A.C.

2016-01-01

BACKGROUND: Therapeutic drug monitoring (TDM) of infliximab (IFX, Remicade®) can aid to optimize therapy efficacy. Many assays are available for this purpose. However, a reference standard is lacking. Therefore, we evaluated the analytical performance, agreement and clinically relevant differences

[Sample size calculation in clinical post-marketing evaluation of traditional Chinese medicine].

Science.gov (United States)

Fu, Yingkun; Xie, Yanming

2011-10-01

In recent years, as the Chinese government and people pay more attention on the post-marketing research of Chinese Medicine, part of traditional Chinese medicine breed has or is about to begin after the listing of post-marketing evaluation study. In the post-marketing evaluation design, sample size calculation plays a decisive role. It not only ensures the accuracy and reliability of post-marketing evaluation. but also assures that the intended trials will have a desired power for correctly detecting a clinically meaningful difference of different medicine under study if such a difference truly exists. Up to now, there is no systemic method of sample size calculation in view of the traditional Chinese medicine. In this paper, according to the basic method of sample size calculation and the characteristic of the traditional Chinese medicine clinical evaluation, the sample size calculation methods of the Chinese medicine efficacy and safety are discussed respectively. We hope the paper would be beneficial to medical researchers, and pharmaceutical scientists who are engaged in the areas of Chinese medicine research.

Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI

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Alina Tudorica

2016-02-01

Full Text Available The purpose is to compare quantitative dynamic contrast-enhanced (DCE magnetic resonance imaging (MRI metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT and evaluation of residual cancer burden (RCB. Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD was measured according to the RECIST (Response Evaluation Criteria In Solid Tumors guidelines. Pharmacokinetic analyses of DCE-MRI data were performed with the standard Tofts and Shutter-Speed models (TM and SSM. After one NACT cycle the percent changes of DCE-MRI parameters Ktrans (contrast agent plasma/interstitium transfer rate constant, ve (extravascular and extracellular volume fraction, kep (intravasation rate constant, and SSM-unique τi (mean intracellular water lifetime are good to excellent early predictors of pathologic complete response (pCR vs. non-pCR, with univariate logistic regression C statistics value in the range of 0.804 to 0.967. ve values after one cycle and at NACT midpoint are also good predictors of response, with C ranging 0.845 to 0.897. However, RECIST LD changes are poor predictors with C = 0.609 and 0.673, respectively. Post-NACT Ktrans, τi, and RECIST LD show statistically significant (P < .05 correlations with RCB. The performances of TM and SSM analyses for early prediction of response and RCB evaluation are comparable. In conclusion, quantitative DCE-MRI parameters are superior to imaging tumor size for early prediction of therapy response. Both TM and SSM analyses are effective for therapy response evaluation. However, the τi parameter derived only with SSM analysis allows the unique opportunity to potentially quantify therapy-induced changes in tumor energetic metabolism.

MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

International Nuclear Information System (INIS)

Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon

1997-01-01

For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change

MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

Energy Technology Data Exchange (ETDEWEB)

Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

1997-10-01

For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

MR imaging of the early rheumatoid arthritis: usefulness of contrast enhanced fat suppressed SPGR imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Mi; Joo, Kyung Bin; Kim, Seong Tae; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1995-06-15

To evaluate value of post-contrast 3-Dimensional fat suppressed Spoiled GRASS (FS SPGR) in detecting subtle bony erosion and tenosynovitis of hands and wrists due to early rheumatoid arthritis. Fourteen MR imagings of the hands and wrists were performed in 7 early rheumatoid arthritis without any abnormalities in plain radiography and in 7 healthy volunteers. All subjects underwent MR sequence of coronal 3D FS SPGR with and without contrast enhancement in 1.5T MR unit. We evaluated the number of the bony erosion and tenosynovitis respectively in pre-and post-contrast FS SPGR images. The abnormal enhancing areas were not demonstrated in 7 healthy volunteers. Seven patients had 25 bony erosions in pre-contrast FS SPGR and 52 bony erosions with tenosynovitis (n = 10) in post-contrast FS SPGR. Enhancing joint spaces were shown in 8 cases. Post-contrast FS SPGR was better than pre-contrast FS SPGR in the evaluation of early rheumatoid arthritis and is valuable as a baseline study.

MR imaging of the early rheumatoid arthritis: usefulness of contrast enhanced fat suppressed SPGR imaging

International Nuclear Information System (INIS)

Kim, Sun Mi; Joo, Kyung Bin; Kim, Seong Tae; Hahm, Chang Kok

1995-01-01

To evaluate value of post-contrast 3-Dimensional fat suppressed Spoiled GRASS (FS SPGR) in detecting subtle bony erosion and tenosynovitis of hands and wrists due to early rheumatoid arthritis. Fourteen MR imagings of the hands and wrists were performed in 7 early rheumatoid arthritis without any abnormalities in plain radiography and in 7 healthy volunteers. All subjects underwent MR sequence of coronal 3D FS SPGR with and without contrast enhancement in 1.5T MR unit. We evaluated the number of the bony erosion and tenosynovitis respectively in pre-and post-contrast FS SPGR images. The abnormal enhancing areas were not demonstrated in 7 healthy volunteers. Seven patients had 25 bony erosions in pre-contrast FS SPGR and 52 bony erosions with tenosynovitis (n = 10) in post-contrast FS SPGR. Enhancing joint spaces were shown in 8 cases. Post-contrast FS SPGR was better than pre-contrast FS SPGR in the evaluation of early rheumatoid arthritis and is valuable as a baseline study

Effects of therapeutic irradiation delivered in early childhood upon subsequent lung function

International Nuclear Information System (INIS)

Wohl, M.E.B.; Griscom, N.T.; Graggis, D.G.; Jaffe, N.

1975-01-01

To determine the long-term effects of therapeutic pulmonary irradiation and treatment with actinomycin D during a period of lung growth, 12 patients treated for Wilms' tumor metastatic to the lung and 8 patients treated for Wilms' tumor with no evidence of pulmonary metastases were studied 7 to 14 years after their initial tumor therapy. All patients had received irradiation to the tumor bed and treatment with actinomycin D. Group 1 had received a single course of bilateral pulmonary irradiation; group 2 had received additional pulmonary irradiation and/or thoracic surgery; group 3 had received no therapeutic irradiation directed primarily to the chest. Total lung capacity (TLC) averaged 71 percent of predicted value in group 1, 58 percent in group 2, and 94 percent in group 3. Diffusing capacity in groups 1 and 2 was reduced to the same extent as lung volume. Quasi-static pressure-volume relationships, studied in three of six patients in group 1, were within the normal range when lung volume was expressed as percentage of observed TLC. Airway resistance, evaluated by spirometry, maximum expiratory flow-volume curves, and resistance of the total respiratory system, was normal or reduced. The data support the hypothesis that therapeutic irradiation during a period of lung growth primarily affects the lung parenchyma and produces a decrease in subsequent size of both the lung and chest wall. No effect of actinomycin D alone upon the lung could be demonstrated

The effect of local and landscape-level characteristics on the abundance of forest birds in early-successional habitats during the post-fledging season in western Massachusetts.

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Michelle A Labbe

Full Text Available Many species of mature forest-nesting birds ("forest birds" undergo a pronounced shift in habitat use during the post-fledging period and move from their forest nesting sites into areas of early-successional vegetation. Mortality is high during this period, thus understanding the resource requirements of post-fledging birds has implications for conservation. Efforts to identify predictors of abundance of forest birds in patches of early-successional habitats have so far been equivocal, yet these previous studies have primarily focused on contiguously forested landscapes and the potential for landscape-scale influences in more fragmented and modified landscapes is largely unknown. Landscape composition can have a strong influence on the abundance and productivity of forest birds during the nesting period, and could therefore affect the number of forest birds in the landscape available to colonize early-successional habitats during the post-fledging period. Therefore, the inclusion of landscape characteristics should increase the explanatory power of models of forest bird abundance in early-successional habitat patches during the post-fledging period. We examined forest bird abundance and body condition in relation to landscape and habitat characteristics of 15 early-successional sites during the post-fledging season in Massachusetts. The abundance of forest birds was influenced by within-patch habitat characteristics, however the explanatory power of these models was significantly increased by the inclusion of landscape fragmentation and the abundance of forest birds in adjacent forest during the nesting period for some species and age groups. Our findings show that including factors beyond the patch scale can explain additional variation in the abundance of forest birds in early-successional habitats during the post-fledging period. We conclude that landscape composition should be considered when siting early-successional habitat to maximize its

The Effect of Local and Landscape-Level Characteristics on the Abundance of Forest Birds in Early-Successional Habitats during the Post-Fledging Season in Western Massachusetts

Science.gov (United States)

Labbe, Michelle A.; King, David I.

2014-01-01

Many species of mature forest-nesting birds (“forest birds”) undergo a pronounced shift in habitat use during the post-fledging period and move from their forest nesting sites into areas of early-successional vegetation. Mortality is high during this period, thus understanding the resource requirements of post-fledging birds has implications for conservation. Efforts to identify predictors of abundance of forest birds in patches of early-successional habitats have so far been equivocal, yet these previous studies have primarily focused on contiguously forested landscapes and the potential for landscape-scale influences in more fragmented and modified landscapes is largely unknown. Landscape composition can have a strong influence on the abundance and productivity of forest birds during the nesting period, and could therefore affect the number of forest birds in the landscape available to colonize early-successional habitats during the post-fledging period. Therefore, the inclusion of landscape characteristics should increase the explanatory power of models of forest bird abundance in early-successional habitat patches during the post-fledging period. We examined forest bird abundance and body condition in relation to landscape and habitat characteristics of 15 early-successional sites during the post-fledging season in Massachusetts. The abundance of forest birds was influenced by within-patch habitat characteristics, however the explanatory power of these models was significantly increased by the inclusion of landscape fragmentation and the abundance of forest birds in adjacent forest during the nesting period for some species and age groups. Our findings show that including factors beyond the patch scale can explain additional variation in the abundance of forest birds in early-successional habitats during the post-fledging period. We conclude that landscape composition should be considered when siting early-successional habitat to maximize its benefit to

Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland.

Science.gov (United States)

Kołtowski, Łukasz; Malesa, Karolina; Tomaniak, Mariusz; Stępińska, Janina; Średniawa, Beata; Karolczyk, Paulina; Puchta, Dominika; Kowalik, Robert; Kremis, Elżbieta; Filipiak, Krzysztof J; Banaszewski, Marek; Opolski, Grzegorz; Bagińska, Marta

2017-11-01

The post-cardiac arrest (CA) period is often associated with secondary damage of the brain that leads to severe neurological deficits. The current practice guidelines recommend the use of therapeutic hypothermia (TH) to prevent neurological deficit and improve survival. The aim of the study was to investigate the implementation of medical guidelines in clinical practice and to evaluate the barriers for implementation of TH in cardiology units in Poland. A telephone survey, fax and online inquiry form were used to assess the implementation of TH in cardiology units in the management of unconscious patients after cardiac arrest (CA). The questions addressed the local practice, TH protocol, reasons for not using TH and outcomes of CA patients. We obtained information from 79 units out of 150 asked (53%). At the time of the survey, 24 units (30.8%) were using TH as part of their post-CA management. Of all CA patients, 45% underwent TH in cardiac intensive care units (CICU), 37.5% in the coronary care unit (CCU) and 12.5% in the intensive care unit (ICU). The major barrier for the implementation of TH declared by the non-cooling centers was lack of sufficient knowledge regarding the technique and protocol, as well as experience (37%); access to dedicated equipment was not perceived as an obstacle. The number of cardiology units that provide TH for comatose CA patients is low. The main limiting factor for wider use of TH is lack of knowledge and experience. There is a clear need for urgent educational activities for cardiology units. The benefits of TH still have not reached their potential in cardiology units.

Intra Articular Therapeutic Delivery for Post Traumatic Osteoarthritis

Science.gov (United States)

2016-10-01

size distribution therapeutic timepoints EPIC-µCT Articular cartilage Subchondral bone Osteophytes Proteoglycans 3. OVERALL PROJECT SUMMARY: In...joint degeneration induced by MMT. Previously documented in Year 1 annual report: Changes in articular cartilage and subchondral bone morphology...and resulted in increased cartilage thickness at 3 weeks. The majority of alterations to subchondral bone (density, thickness) were detected at 3

Therapeutical evaluation of bevacizumab application in relapsed pterygium

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Mayara Martins Abrahão

Full Text Available Abstract Objective: Therapeutic evaluation of Bevacizumab application in relapsed pterygium concerning visual acuity, keratometry, refraction, symptomatology. Methods: Group 1 (4 patients received 0.1 ml of Bevacizumab (avastin, being evaluated posteriorly on the tenth and thirtieth days after the application, seeking to compare with the exam previously made, being it realized with the other two groups, in which Group 2 (4 patients received 0.2 ml of Bevacizumab and the Group 3 (3 patients received 1 ml of the placebo injection. Results: In this study, eleven eyes of eleven patients were evaluated. Among these patients, 7 were women (63.6% and 4 men (36.4%. There was a variation in the cylindrical diopter after the treatment with a dose of 0.1 ml of bevaciumab during the evaluation on the thirtieth day. Whereas the cylindrical shaft had a significantly larger modification after the application of 0.2 ml. Regarding the spherical diopter variation, there were modifications in the 3 groups. The keratometry varied in the 3 groups, mostly after the thirtieth day of evaluation. In relation to symptomatology, it was observed a reduction in the subjective evaluation of the eye burning sensation, the prurience mentioned by the patient and a reduction of the hyperemia biomicroscopy evaluation. Conclusion: In bevacizumab application in the recurrent pterygium treatment, there is modification of the spherical and cylindrical parameters of refraction, besides the changes in keratometry and the reduction of the symptomatology.

Laboratory methods to evaluate therapeutic radiopharmaceuticals

International Nuclear Information System (INIS)

Arteaga de Murphy, C.; Rodriguez-Cortes, J.; Pedraza-Lopez, M.; Ramirez-Iglesias, MT.; Ferro-Flores, G.

2007-01-01

The overall aim of this coordinated research project was to develop in vivo and in vitro laboratory methods to evaluate therapeutic radiopharmaceuticals. Towards this end, the laboratory methods used in this study are described in detail. Two peptides - an 8 amino acid minigastrin analogue and octreotate - were labelled with 177 Lu. Bombesin was labelled with 99 mTc, and its diagnostic utility was proven. For comparison, 99 mTc-TOC was used. The cell lines used in this study were AR42J cells, which overexpress somatostatin receptors found in neuroendocrine cancers, and PC3 cells, which overexpress gastric releasing peptide receptors (GRP-r) found in human prostate and breast cancers. The animal model chosen was athymic mice with implanted dorsal tumours of pathologically confirmed cell cancers. The methodology described for labelling, quality control, and in vitro and in vivo assays can be easily used with other radionuclides and other peptides of interest. (author)

Evaluation of the early enhancement of coronary atherosclerotic plaque by contrast-enhanced MR angiography

Energy Technology Data Exchange (ETDEWEB)

Li Tao [Department of Radiology, The General Hospital of Chinese People' s Armed Police Forces, Number 69, Yong Ding Road, Hai Dian District, Beijing (China); Department of Radiology, Chinese People' s Liberation Army General Hospital, Number 28, Fu Xing Road, Hai Dian District, Beijing (China); Zhao Xihai [Department of Radiology, Chinese People' s Liberation Army General Hospital, Number 28, Fu Xing Road, Hai Dian District, Beijing (China); Liu Xin [Paul C. Lauterbur Biomedical Imaging Center, Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen 518067 (China); Gao Jianhua [Department of Radiology, The General Hospital of Chinese People' s Armed Police Forces, Number 69, Yong Ding Road, Hai Dian District, Beijing (China); Zhao Shaohong [Department of Radiology, Chinese People' s Liberation Army General Hospital, Number 28, Fu Xing Road, Hai Dian District, Beijing (China); Li Xin; Zhou Weihua [Department of Radiology, The General Hospital of Chinese People' s Armed Police Forces, Number 69, Yong Ding Road, Hai Dian District, Beijing (China); Cai Zulong [Department of Radiology, Chinese People' s Liberation Army General Hospital, Number 28, Fu Xing Road, Hai Dian District, Beijing (China); Zhang Weiguo [Cardiovascular and Neurological Consulting Institute, 6771 San Fernando, Irving, TX 75039 (United States); Yang Li, E-mail: Yangli301@yahoo.com [Department of Radiology, Chinese People' s Liberation Army General Hospital, Number 28, Fu Xing Road, Hai Dian District, Beijing (China)

2011-10-15

Purpose: To evaluate the early enhancement of coronary atherosclerotic plaque using contrast-enhanced MR angiography (CE-MRA) and investigate the association between unstable angina pectoris (UAP) and early enhancement of the plaque. Methods: Forty-one patients presenting with angina pectoris and demonstrating single-vessel disease with non-calcified plaque and significant coronary stenosis ({>=}50%) on CTA were consecutively recruited for coronary CE-MRA. Contrast-to-noise ratio of the culprit plaque guided by CTA was measured on a cross-sectional multi-planar reconstruction image of the plaque on both pre- and post-CE-MRA. A 50% increasing of CNR was defined as plaque enhancement. The association between early enhancement of the plaques and UAP was analyzed. Results: Thirty-seven non-calcified plaques with significant coronary stenosis were detected in the 37 patients on MRA. 4 subjects were excluded because coronary atherosclerotic plaques were inadequate for identification on MRA. Of the 37 patients, 18 patients had UAP and other 19 patients presented stable angina pectoris (SAP). Of the 37 plaques on CE-MRA, 13 and 24 plaques presented early enhancement and no enhancement, respectively. Of the 13 early-enhanced plaques, 11 (85%) and 2 (15%) were found in the patients with UAP and SAP, respectively (p < 0.01). Of the 37 patients, 11 (61%) with UAP and 2 (11%) with SAP had early-enhanced plaques, respectively (p < 0.01). Conclusion: CE-MRA allows detection of early enhancement of coronary atherosclerotic plaque. The early enhancement is common in unstable angina and could be a sign of vulnerability.

Nefopam hydrochloride loaded microspheres for post-operative pain management: synthesis, physicochemical characterization and in-vivo evaluation.

Science.gov (United States)

Sharma, Neelam; Arora, Sandeep; Madan, Jitender

2018-02-01

Once-daily oral dosage of nefopam hydrochloride loaded sustained release microspheres (NPH-MS) was investigated as novel therapeutic strategy for post-operative pain management. Microspheres were synthesized using poly-3-hydroxybutyrate and poly-(ɛ-caprolactone) by double emulsion solvent evaporation technique. NPH-MS were characterized through FTIR, PXRD and SEM. In-vitro drug release study revealed sustained behavior till 24 h. Haemolysis was pain model, reversal of mechanical allodynia and thermal hyperalgesia by NPH-MS was statistically significant (p < .001) as compared with NPH till 24 h post-dose.

[Post-herpes simplex encephalitis chorea: Viral replication or immunological mechanism?].

Science.gov (United States)

Benrhouma, H; Nasri, A; Kraoua, I; Klaa, H; Turki, I; Gouider-Khouja, N

2015-09-01

Herpes simplex encephalitis is a severe neurological condition, whose outcome is improved if treated early with acyclovir. Post-herpes simplex encephalitis with acute chorea has rarely been reported. We report on two observations of children presenting with post-herpes simplex encephalitis with acute chorea, related to two different pathophysiological mechanisms. The first one is an 11-month-old girl developing relapsing herpes simplex encephalitis with chorea due to resumption of viral replication. The second one is a 2-year-old boy with relapsing post-herpes simplex encephalitis acute chorea caused by an immunoinflammatory mechanism. We discuss the different neurological presentations of herpetic relapses, notably those presenting with movement disorders, as well as their clinical, paraclinical, physiopathological, and therapeutic aspects. Post-herpes simplex encephalitis with acute chorea may involve two mechanisms: resumption of viral replication or an immunoinflammatory mechanism. Treatment of post-herpes simplex encephalitis with acute chorea depends on the underlying mechanism, while prevention is based on antiviral treatment of herpes simplex encephalitis with acyclovir at the dose of 20mg/kg/8h for 21 days. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome

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Y.A. Briskin

2015-12-01

Full Text Available Purpose: to determine purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome. Material: in the research 135 women with post mastectomies syndrome, who endured radical mastectomy by Madden, participated. Women of main groups were trained in compliance with appropriate programs during one year. Effectiveness of trainings was controlled after half of year. Admission to trainings was given by oncologist. Patients of these groups belonged to third clinical group. At the beginning of dispensary period the groups were equal by all indicators of external system function. Results: it was found that early rehabilitation is more effective exclusively for indicators of bronchial patency. Complex, personality oriented program included: aqua-fitness; conditional swimming; health related aerobic and Pilates. It was found that after half year training advantages of early physical rehabilitation were noticed only in indicators of forced exhale volume at first second. Conclusions: we stated importance of early rehabilitation trainings of women with post mastectomies syndrome.

An evaluation of Neuro-Physiological Psychotherapy: An integrative therapeutic approach to working with adopted children who have experienced early life trauma.

Science.gov (United States)

McCullough, Elaine; Gordon-Jones, Susi; Last, Anna; Vaughan, Jay; Burnell, Alan

2016-10-01

Research into the effectiveness of therapeutic interventions for older children who have experienced multiple forms of trauma within the context of their early development is scant. This article explores the effectiveness of Neuro-Physiological Psychotherapy (NPP): a wrap-around multi-disciplinary, neuro-sequential, attachment-focussed intervention for children and families who present with multiple, clinically significant, emotional and behavioural difficulties. In total, 31 young people and their adoptive parents took part in the study. Baseline measures were repeated and parents and children interviewed. An assessment of the parent/child relationship and child attachment was undertaken but not analysed for this article. Analysis of the repeated measures received statistically significant changes in behavioural regulation, metacognitive executive functioning and externalising and internalising difficulties, alongside an improvement in thought and social problems. An analysis of the parent interviews provided positive results in terms of the children's engagement in education, an absence of further mental health diagnosis or involvement in the criminal justice system. Further hypotheses are posited regarding the impact of the treatment and further research into the effectiveness of the model outlined. © The Author(s) 2016.

Evaluation of Pharmacists' Participation in Post-Admission Ward ...

African Journals Online (AJOL)

Objective: The study evaluates pharmacist's perception of and participation in post-admission ward rounds, at the Lagos University Teaching Hospital (LUTH). Method: All the 60 pharmacists covering various units of pharmaceutical services were administered a forty-two element structured questionnaire. Fifty (83.3%) ...

The Conservation of Early Post-Medieval Period Coins Found in Estonia

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Aive Viljus

2013-02-01

Full Text Available This article deals with archaeological find material with a low silver content and the problems of conserving such material. The aim of the research was to find the most suitable method for the conservation of poorly preserved early post-medieval period coins with varying composition. For this, first, the composition of both the metal and the corrosion products of the archaeological coins were analysed, after which comparative experiments of different cleaning methods were carried out in order to find out the least harmful and most efficient method. A test was also performed to determine the necessity and efficiency of stabilizing the surface of the coins after cleaning.

THE EFFECTS OF AN EARLY RETURN TO TRAINING ON THE BONE-TENDON JUNCTION POST-ACUTE MICRO-INJURY HEALING

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Lin Wang

2012-06-01

Full Text Available Bone-tendon junction (BTJ overuse injuries are common athletic and occupational problems. BTJ injuries may sometimes be caused by resuming training too early after injury. To study the effects of post-injury resuming training within 48 hours on the acute injury healing process, as it is often the case for athletes. Twelve mature female rabbits were assigned to one of the following groups: acute injury (AI, n = 6, post-injury early return to training (PIERT, n = 6 and normal control (CON, n = 6. Tissue specimens were harvested at week 4. The radiological and histological characteristics of the AI and PIERT groups were compared among the groups. The trabecular thickness of the PIERT group was significantly different from those of the AI and CON group. A histological evaluation revealed poor collagen fibre alignment, extensive scar tissue and lowered cell density in the AI and PIERT groups compared with the CON group, but no significant differences were observed between the AI group and the PIERT group. The fibrocartilage zone and proteoglycan area in the PIERT group were significantly different from those in AI group. No differences were observed in the Total VOI volume (TV, Object volume (OBV, Percent object volume (BV/TV and trabecular number (Tb.N among the AI, PIERT and CON groups. In conclusion, a repeatable animal model of bone-tendon junction acute micro-damage by puncture was established. Resuming training in 48 hours did not significantly deteriorate the BTJ injury healing, but improved bone remodelling and increased fibrocartilage zone thickness

Bacteriological And Clinical Evaluation Of Twelve Cases Of Post ...

African Journals Online (AJOL)

Bacteriological And Clinical Evaluation Of Twelve Cases Of Post-Surgical Sepsis Of Odontogenic Tumours At A ... East African Medical Journal ... Intervention: Adequate review of patient\\'s medical history, bacteriological investigations and

Histopathological study of ocular erythema nodosum leprosum and post-therapeutic scleral perforation: A case report

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Rathinam S

2008-01-01

Full Text Available Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.

Therapeutic cloning: The ethical limits

International Nuclear Information System (INIS)

Whittaker, Peter A.

2005-01-01

A brief outline of stem cells, stem cell therapy and therapeutic cloning is given. The position of therapeutic cloning with regard to other embryonic manipulations - IVF-based reproduction, embryonic stem formation from IVF embryos and reproductive cloning - is indicated. The main ethically challenging stages in therapeutic cloning are considered to be the nuclear transfer process including the source of eggs for this and the destruction of an embryo to provide stem cells for therapeutic use. The extremely polarised nature of the debate regarding the status of an early human embryo is noted, and some potential alternative strategies for preparing immunocompatible pluripotent stem cells are indicated

Early post transplantation renal allograft perfusion failure due to intimal dissection of the renal artery

Directory of Open Access Journals (Sweden)

Khattab Omar

2009-01-01

Full Text Available Transplant renal artery stenosis (TRAS is a recognized and potentially curable cause of post transplant arterial hypertension, allograft dysfunction, and graft loss. It usually occurs 3 months to 2 years after transplantation, but early or later presentations are not uncommon. We present a case of renal artery narrowing due to intimal dissection that was managed medically.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

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Laughlin, M. S.; Murray, J. D.; Wear, M. L.; Van Baalen, M.

2016-01-01

INTRODUCTION Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors. Thus, the purpose of this project was to perform an initial evaluation of reported post-flight back pain and injury cases to relevant spaceflight risk factors in United States astronauts that have completed an ISS mission. METHODS All US astronauts who completed an ISS mission between Expeditions (EXP) 1 and 41 (2000-2015) were included in this evaluation. Forty-five astronauts (36 males and 9 females) completed 50 ISS missions during the study time period, as 5 astronauts completed 2 ISS missions. Researchers queried medical records of the 45 astronauts for occurrences of back pain and injury. A case was defined as any reported event of back pain or injury to the cervical, thoracic, lumbar, sacral, or coccyx spine regions. Data sources for the cases included the Flight Medicine Clinic's electronic medical record; Astronaut Strength, Conditioning and Rehabilitation electronic documentation; the Private Medical Conference tool; and the Space Medicine Operations Team records. Post-flight cases were classified as an early case if reported within 45 days of landing (R + 45) or a late case if reported from R + 46 to R + 365 days after landing (R + 1y). Risk factors in the astronaut population for back pain include age, sex, prior military service, and prior history of back pain. Additionally, spaceflight specific risk factors such as type of landing vehicle and onboard exercise countermeasures were included to evaluate their

The significance of early post-exercise ST segment normalization.

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Chow, Rudy; Fordyce, Christopher B; Gao, Min; Chan, Sammy; Gin, Kenneth; Bennett, Matthew

2015-01-01

The persistence of ST segment depression in recovery signifies a strongly positive exercise treadmill test (ETT). However, it is unclear if early recovery of ST segments portends a similar prognosis. We sought to determine if persistence of ST depression into recovery correlates with ischemic burden based on myocardial perfusion imaging (MPI). This was a retrospective analysis of 853 consecutive patients referred for exercise MPI at a tertiary academic center over a 24-month period. Patients were stratified into three groups based on the results of the ETT: normal (negative ETT), persistence (positive ETT with >1mm ST segment depression at 1minute in recovery) and early normalization (positive ETT with normalization, while 105 patients met criteria for persistence. The persistence group had a significantly greater SSS (8.48±7.77) than both the early normalization (4.34±4.98, pnormal (4.47±5.31, pnormalization and normal groups were not statistically different and met the prespecified non-inferiority margin (mean difference 0.12, -0.66=lower 95% CI, pnormal and 7.4% of early normalization groups. Among patients with an electrically positive ETT, recovery of ST segment depression within 1minute was associated with a lower SSS than patients with persistence of ST depression beyond 1minute. Furthermore, early ST segment recovery conferred a similar SSS to patients with a negative ETT. These results suggest that among patients evaluated for chest pain with a positive ETT, early recovery of the ST segment during recovery is associated with a significantly less ischemic burden on subsequent MPI and thus may represent a false positive finding in exercise treadmill testing. Copyright © 2015 Elsevier Inc. All rights reserved.

Glucose balance and muscle glycogen during TPN in the early post-operative phase

DEFF Research Database (Denmark)

Henneberg, S; Stjernström, H; Essén-Gustavsson, B

1985-01-01

In order to study how muscle glycogen is influenced by different nutritional regimens in the early post-operative period we took muscle biopsies from 20 patients preoperatively and on the fourth post-operative day after abdominal aortic surgery. Ten patients received 93% of non-protein energy......-production) were performed and from these data glucose balance was calculated as the difference between glucose intake and glucose expenditure. Muscle biopsies were analysed for glycogen, adenosine triphosphate, glucose-6-phosphate, lactate and citrate. We found that it was possible to maintain muscle...... glycogen stores at pre-operative levels with a glucose-insulin regimen. With the fat regimen there was a 31% decrease in muscle glycogen and two patients had a negative glucose balance despite the fact that 150 g of glucose were given. Average glucose balance throughout the study correlated positively...

[Activating therapeutic care in geriatrics : Evaluation of a practice concept].

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Acklau, Stefanie; Gödecker, Lisa; Kaden, Andrea; Jahn, Patrick

2016-10-01

The special feature of the concept of activating therapeutic care in geriatrics (ATP-G) is based on the focus of nursing and therapeutic elements specifically related to the elderly. Further significance lies in the bottom-up development of this concept, which shows a close proximity to the nursing practice. The research project targeted the characteristics of ATP-G from a nursing point of view. Furthermore, the resulting elements of professional nursing care understanding for inpatient geriatric rehabilitation were used to build a scientific and theoretical foundation of the ATP-G concept. In this study 12 semi-structured interviews with professional caregivers were realized. The data collection was undertaken in three different facilities of inpatient geriatric (early) rehabilitation, chosen by lot. The data analysis was based on the methodology of qualitative content analysis according to Mayring. The research project showed that the basic elements described in the ATP-G concept are consistent with the view of nursing practitioners and therefore reflect the characteristic features of routine daily practice; nonetheless, some new aspects were found, primarily the importance of interdisciplinary teamwork in geriatric settings. There were also difficulties related to the ATP-G concept which were experienced as restraints by the questioned professionals. Further research should therefore investigate the structures for optimal implementation of the ATP-G concept into standard practice.

Renal impairment and heart failure with preserved ejection fraction early post-myocardial infarction

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Jorapur, Vinod; Lamas, Gervasio A; Sadowski, Zygmunt P; Reynolds, Harmony R; Carvalho, Antonio C; Buller, Christopher E; Rankin, James M; Renkin, Jean; Steg, Philippe Gabriel; White, Harvey D; Vozzi, Carlos; Balcells, Eduardo; Ragosta, Michael; Martin, C Edwin; Srinivas, Vankeepuram S; Wharton III, William W; Abramsky, Staci; Mon, Ana C; Kronsberg, Shari S; Hochman, Judith S

2010-01-01

AIM: To study if impaired renal function is associated with increased risk of peri-infarct heart failure (HF) in patients with preserved ejection fraction (EF). METHODS: Patients with occluded infarct-related arteries (IRAs) between 1 to 28 d after myocardial infarction (MI) were grouped into chronic kidney disease (CKD) stages based on estimated glomerular filtration rate (eGFR). Rates of early post-MI HF were compared among eGFR groups. Logistic regression was used to explore independent predictors of HF. RESULTS: Reduced eGFR was present in 71.1% of 2160 patients, with significant renal impairment (eGFR < 60 mL/min every 1.73 m2) in 14.8%. The prevalence of HF was higher with worsening renal function: 15.5%, 17.8% and 29.4% in patients with CKD stages 1, 2 and 3 or 4, respectively (P < 0.0001), despite a small absolute difference in mean EF across eGFR groups: 48.2 ± 10.0, 47.9 ± 11.3 and 46.2 ± 12.1, respectively (P = 0.02). The prevalence of HF was again higher with worsening renal function among patients with preserved EF: 10.1%, 13.6% and 23.6% (P < 0.0001), but this relationship was not significant among patients with depressed EF: 27.1%, 26.2% and 37.9% (P = 0.071). Moreover, eGFR was an independent correlate of HF in patients with preserved EF (P = 0.003) but not in patients with depressed EF (P = 0.181). CONCLUSION: A significant proportion of post-MI patients with occluded IRAs have impaired renal function. Impaired renal function was associated with an increased rate of early post-MI HF, the association being strongest in patients with preserved EF. These findings have implications for management of peri-infarct HF. PMID:20885993

Early infant diagnosis and post-exposure prophylaxis for HIV- exposed infants.

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Gawde, Nilesh Chandrakant

2016-01-01

Recent scientific evidence suggests that early initiation of antiretroviral therapy (ART) among infants exposed perinatally to HIV has beneficial effects on their health and survival, and may even induce remission. This has led to the roll-out of early infant diagnosis (EID) of HIV and early treatment. Also, there is talk of using ART as post-exposure prophylaxis (PEP) to prevent mother-to-child transmission. EID involves carrying out diagnostic tests before initiating ART. In India, current programme design of centralised diagnosis has been resulting in poor access to diagnosis and treatment. To save the lives of HIV-infected infants, it is important to prevent delay. Another issue to be kept in mind is that the results of HIV tests may turn negative after the initiation of ART. This could be due to viral remission induced by ART or false positive initial results. Differentiating between the two is difficult. To deal with such cases, we need to develop a clinical algorithm and tools for capacity-building in counselling. The use of ART as PEP is expected to encounter further challenges. Between ART as PEP and EID, the later has advantages from an ethical perspective. There is a need to address the ethical issues within the EID programme by strengthening the current mechanisms for protecting the rights of HIV-exposed infants.

Therapeutic monoclonal antibody N-glycosylation - Structure, function and therapeutic potential.

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Cymer, Florian; Beck, Hermann; Rohde, Adelheid; Reusch, Dietmar

2018-03-01

Therapeutic antibodies (IgG-type) contain several post-translational modifications (PTMs) whereby introducing a large heterogeneity, both structural and functional, into this class of therapeutics. Of these modifications, glycosylation in the fragment crystallizable (Fc) region is the most heterogeneous PTM, which can affect the stability of the molecule and interactions with Fc-receptors in vivo. Hence, the glycoform distribution can affect the mode of action and have implications for bioactivity, safety and efficacy of the drug. Main topics of the manuscript include: What factors influence the (Fc) glycan pattern in therapeutic antibodies and how can these glycans be characterized? How does structure of the Fc-glycan relate to function and what methods are available to characterize those functions? Although heterogeneous in their scope, the different sections are intended to combine current knowledge on structure-function correlations of IgG glycan structures with regard to Fc (effector) functions, as well as basic aspects and methodologies for their assessment. Copyright © 2017. Published by Elsevier Ltd.

Evaluation of point-of-care test for elevated tear matrix metalloproteinase 9 in post-LASIK dry eyes.

Science.gov (United States)

Chan, Tommy C Y; Ye, Cong; Chan, Kwok Ping; Chu, Kai On; Jhanji, Vishal

2016-09-01

To evaluate the performance of a point-of-care test for detection of matrix metalloproteinase 9 (MMP-9) levels in post-laser-assisted in situ keratomileusis (LASIK) dry eyes. A comparative study between patients with mild to moderate post-LASIK dry eyes and age-matched normal subjects was conducted. Ocular surface disease index (OSDI), tear break-up time (TBUT), and tear film MMP-9 and total protein levels were compared between the two groups. A point-of-care test device (RPS InflammaDry, Sarasota, Florida, USA) was utilised to confirm elevated MMP-9 levels in tear film. Fourteen post-LASIK dry eyes and 34 normal eyes were included. There was no significant difference in age and gender between both groups (p>0.175). The OSDI was significantly higher (25.5±7.7 vs 7.4±2.5; pdry eye compared with normal subjects. The tear film MMP-9 levels were 52.7±32.5 ng/mL in dry eyes and 4.1±2.1 ng/mL in normal eyes (p40 ng/mL in 7/14 (50.0%) post-LASIK dry eyes. The InflammaDry was positive in 8/14 (57.1%) post-LASIK eyes. All positive cases had tear film MMP-9 levels ≥38.03 ng/mL. Agreement between InflammaDry and MMP-9 was excellent with Cohen κ value of 0.857 in post-LASIK dry eyes. Only half of post-LASIK dry eyes were found to have significant inflammation associated with elevated MMP-9. The OSDI is useful to non-specifically identify patients with symptomatic dry eye while the InflammaDry determined which patients with dry eye were associated with significant inflammation that may guide therapeutic management decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluation of the healing activity of therapeutic clay in rat skin wounds.

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Dário, Giordana Maciel; da Silva, Geovana Gomes; Gonçalves, Davi Ludvig; Silveira, Paulo; Junior, Adilson Teixeira; Angioletto, Elidio; Bernardin, Adriano Michael

2014-10-01

The use of clays for therapeutic practice is widespread in almost all regions of the world. In this study the physicochemical and microbiological healing characteristics of a clay from Ocara, Brazil, popularly used for therapeutic uses, were analyzed. The presence of Ca, Mg, Al, Fe, and Si was observed, which initially indicated that the clay had potential for therapeutic use. The average particle size of the clay (26.3 μm) can induce the microcirculation of the skin and the XRD analysis shows that the clay is formed by kaolinite and illite, a swelling clay. During the microbiological evaluation there was the need to sterilize the clay for later incorporation into the pharmaceutical formula. The accelerated stability test at 50°C for 3 months has showed that the pharmaceutical formula remained stable with a shelf life of two years. After the stability test the wound-healing capacity of the formulation in rats was evaluated. It was observed that the treatment made with the formulation containing the Ocara clay showed the best results since the formula allowed greater formation of collagen fibers and consequent regeneration of the deep dermis after seven days of treatment and reepithelialization and continuous formation of granulation tissue at the 14th day. Copyright © 2014 Elsevier B.V. All rights reserved.

[Application of Markov model in post-marketing pharmacoeconomic evaluation of traditional Chinese medicine].

Science.gov (United States)

Wang, Xin; Su, Xia; Sun, Wentao; Xie, Yanming; Wang, Yongyan

2011-10-01

In post-marketing study of traditional Chinese medicine (TCM), pharmacoeconomic evaluation has an important applied significance. However, the economic literatures of TCM have been unable to fully and accurately reflect the unique overall outcomes of treatment with TCM. For the special nature of TCM itself, we recommend that Markov model could be introduced into post-marketing pharmacoeconomic evaluation of TCM, and also explore the feasibility of model application. Markov model can extrapolate the study time horizon, suit with effectiveness indicators of TCM, and provide measurable comprehensive outcome. In addition, Markov model can promote the development of TCM quality of life scale and the methodology of post-marketing pharmacoeconomic evaluation.

Post-irradiation regeneration of early B-lymphocyte precursor cells in mouse bone marrow

International Nuclear Information System (INIS)

Park, Y.-H.; Osmond, D.G.

1989-01-01

To examine the sequential development of early B-cell precursors in mouse bone marrow, B-lineage cells have been examined during a wave of post-irradiation regeneration. Cell phenotypes have been defined for (i) terminal deoxynucleotidyl transferase (TdT); (ii) B220 glycoprotein, (iii) μ heavy chains in the cytoplasm (cμ) and at the cell surface (sμ). Three populations of μ - cells (TdT + 14.8 - ; TdT + 14.8 + ; TdT - 14.8 + ) have been proposed to be early B-cell precursors which would give rise to cμ + sμ - pre-B cells and to sμ + B lymphocytes. The timing, cell-size shifts and progressive amplification of the waves of regeneration accord with a dynamic model in which the TdT + 14.8 - , TdT + 14.8 + and TdT - 14.8 + cells form three successive stages in B-cell differentiation before the expression of μ chains, presumptively including the stage of μ chain gene rearrangement. In addition, the results provide an experimental system for the enrichment of early B-cell precursors in mouse bone marrow. (author)

Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

Science.gov (United States)

Weitzner, Erica; McKenna, Donna; Nowakowski, John; Scavarda, Carol; Dornbush, Rhea; Bittker, Susan; Cooper, Denise; Nadelman, Robert B; Visintainer, Paul; Schwartz, Ira; Wormser, Gary P

2015-12-15

Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years. Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS. One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi. PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

New Therapeutic Possibilities of the Post-Irradiation Haemorrhagic Syndrome

Energy Technology Data Exchange (ETDEWEB)

Pospisil, J.; Dienstbier, Z. [Institute of Biophysics and Nuclear Medicine, Faculty of General Medicine, Charles University, Prague, Czechoslovak Socialist Republic (Czech Republic); Skala, E. [Central Military Hospital, Prague-Stresovice, Czechoslovak Socialist Republic (Czech Republic)

1969-10-15

Haemorrhagic diathesis is one of the dominant symptoms of acute post-irradiation lesion. Haemorrhagic syndrome is caused by the disturbance of haemocoagulation during simultaneous lesion of the vascular system. In our study we have tried to affect the post-irradiation haemocoagulation disturbance. Epsilon- amino-caproic acid (EACA) administered between the 8{sup th} and the 18{sup th} day (0.4 g/kg per day) to whole- body irradiated dogs (600 R) partially regulated the post-irradiation disturbance of haemocoagulation. The favourable effect of EACA was verified by in vitro experiments in which the blood of irradiated dogs was used. A repeated administration of EACA in the dose of 0.4 g/kg per day to whole-body irradiated rats (600 R) did not substantially affect the post-irradiation changes in the number of white blood elements; however, its administration to healthy animals caused lymphocytosis. In whole-body irradiated dogs (600 R) we have found lower levels of EACA in the blood up to the 8 day following irradiation as compared with healthy dogs after oral application of EACA. The whole-body irradiation of mice did not increase the acute toxicity of EACA. The daily administration of 0.4 g EACA/kg to whole-body irradiated mice (600 and 700 R) did not change the mortality induced by irradiation. The authors consider EACA to be a suitable compound for a complex therapy of radiation sickness. The administration of para-amino-methyl-benzoic acid (PAMBA), in spite of a certain improvement of postirradiation haemocoagulation disturbance, is less efficient. Our recent experiments with ellagic acid which significantly affects the post-traumatic haemorrhage in whole-body irradiated rats seem to be very promising. (author)

[Early therapeutic trials for retinitis pigmentosa].

Science.gov (United States)

Dufier, Jean-Louis

2003-01-01

Non syndromic forms of Retinitis Pigmentosa (RP) constitute a collection of clinically and genetically heterogeneous inherited retinal degenerative diseases. They are characterized by a bilateral progressive visual loss susceptible to cause blindness. These diseases are transmitted through pedigrees according to all known modes of inheritance. They are bilateral and usually start during infancy. However, very early clinical presentations exist, such as those observed in children affected by Leber Congenital Amaurosis, as well as late onset autosomal dominant forms of retinitis pigmentosa. The characteristic clinical aspect of the rod-cone RP dystrophies is marked by alterations of the peripheral retina associated with a night blindness and a progressive narrowing of the visual field. The ophthalmoscopic examination of RP patients commonly reveals thin retinal arteries and scattered pigmentary accumulations. In contrast, there are cone rod retinal dystrophies whose onset is marked by a decreased visual acuity before the appearance of any visual field alteration. Some forms of RPs display an ocular fundus devoid of any pigmentary alteration. Syndromic forms of RPs are not uncommon. The association of deafness with RP is detected in nearly 30% of the patients. Other associations with RP can include mental deficiency, facial dysmorphy, microcephaly, obesity, kidney deficiency, immune deficiencies, metabolic disorders. The existence of such syndromic forms of RP localizes RPs at the crossroad of several medical specialties. A long lasting collaboration between our department of ophthalmology and the department of medical genetics of the Necker-Sick Children Hospital has allowed us to establish numerous genotype-phenotype correlations, especially in LCA and Stargardt's disease. ABCR gene mutations cause Stargardt disease. ABCR mutations may also cause some types of Ages Related Macular Degenerations (AMD). Nowadays, there is no known efficient therapy available for

The effect of dietary fatty acids on post-operative inflammatory response in a porcine model

DEFF Research Database (Denmark)

Langerhuus, Sine Nygaard; Jensen, Karin Hjelholt; Tønnesen, Else Kirstine

2012-01-01

), sunflower oil (SO, n 28), or animal fat (AF, n 28) was evaluated with respect to post-operative responses in inflammatory markers in a porcine model on aortic vascular prosthetic graft infection. In the early post-operative period (0 necrosis factor...

Improving early cycle economic evaluation of diagnostic technologies

NARCIS (Netherlands)

Steuten, Lotte Maria Gertruda; Ramsey, Scott D.

2014-01-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to

Preliminary approach on early post mortem stress and quality indexes changes in large size bluefin tuna (Thunnus thynnus

Directory of Open Access Journals (Sweden)

R. Ugolini

2010-01-01

Full Text Available Bluefin tuna (Thunnus thynnus is very appreciated on Japan and USA market for the preparation of sushi and sahimi. The market price of the fresh product can vary from 8 to 33 Euro/kg (gate farm/producers prices according to size, shape, fat level, meat colour, consistency and freshness (absence of “hyake”, all parameters strictly connected to feeding quality and quantity, rearing and killing stress factors and refrigeration times and conditions after death. Excessive levels of stress during the slaughtering can affect meat quality, contributing to significantly decrease of tuna’s price. The present trial was carried out to evaluate the possible harvesting/slaughtering stress effect on reared bluefin tuna meat quality, starting from the examination of the most important stress and quality parameters changes during the early post mortem period.

Evaluation of the therapeutic effect of potassium permanganate at early stages of an experimental acute infection of Flavobacterium columnare in channel catfish (Ictalurus punctatus)

Science.gov (United States)

The efficacy of potassium permanganate (KMnO4) against early stages of an experimental acute infection of Flavobacterium columnare in channel catfish (Ictalurus punctatus) was evaluated. Fish were experimentally challenged, by waterborne exposure for 2 h to F. columnare after cutaneous abrasion, an...

Perfusion MDCT enables early detection of therapeutic response to antiangiogenic therapy.

Science.gov (United States)

Sabir, Adeel; Schor-Bardach, Rachel; Wilcox, Carol J; Rahmanuddin, Syed; Atkins, Michael B; Kruskal, Jonathan B; Signoretti, Sabina; Raptopoulos, Vassilios D; Goldberg, S Nahum

2008-07-01

The objective of our study was to determine whether perfusion CT can be used to detect early changes in therapeutic response to antiangiogenic therapy in an animal tumor model. Twenty-five rats implanted with R3230 mammary adenocarcinoma (diameter, 1.2-2.0 cm) randomly received 7.5 or 30 mg/kg of an antiangiogenic agent, sorafenib, by daily gavage for 4 (n = 4), 9 (n = 9), or 14 (n = 5) days. Seven untreated animals served as a control group. Perfusion MDCT was performed at days 0, 4, 9, and 14 with 0.4 mL of ioversol (350 mg/mL) and included four 5-mm slices covering the entire tumor volume. Changes in tumor growth were determined by volumetric analysis of CT data. Serial changes in tumor volume and blood flow were assessed and correlated with pathology findings. All control tumors grew larger (from 2.0 +/- 0.7 cm(3) at day 0 to 5.9 +/- 1.0 cm(3) at day 14), whereas all treated tumors shrank (from 2.5 +/- 1.1 to 2.1 +/- 1.0 cm(3)), with a statistically significant rate of growth or shrinkage in both groups (p histopathologic viability despite the fact that these tumors were shrinking in size from day 4 onward (day 4, 2.18 +/- 0.8 cm(3); day 9, 1.98 +/- 0.8 cm(3)). Perfusion MDCT can detect focal blood flow changes even when the tumor is shrinking, possibly indicating early reversal of tumor responsiveness to antiangiogenic therapy. Given that changes in tumor volume after antiangiogenic therapy do not necessarily correlate with true treatment response, physiologic imaging of tumor perfusion may be necessary.

Loading regimen required to rapidly achieve therapeutic trough plasma concentration of teicoplanin and evaluation of clinical features

Directory of Open Access Journals (Sweden)

Seki M

2012-11-01

Full Text Available Masafumi Seki,1,* Kaori Yabuno,1,2,* Koji Miyawaki,1,2 Yoshihiro Miwa,2 Kazunori Tomono11Division of Infection Control and Prevention, 2Department of Pharmacy, Osaka University Hospital, Suita, Osaka, Japan*These authors contributed equally to this workBackground: A trough concentration of >20 mg/L is considered the optimal dosage of teicoplanin required to ensure early therapeutic effects against methicillin-resistant Staphylococcus aureus (MRSA infections including those in patients who develop febrile neutropenia after chemotherapy. This study determines appropriate initial doses during the first 2 days of administration and evaluates the therapeutic target teicoplanin trough concentration.Method: A 2-day regimen was evaluated in patients treated with 600 mg and 1200 mg or 1200 mg and 600 mg (total 1800 mg, Group 1, 800 mg and 800 mg (total 1600 mg, Group 2, and 800 mg and 400 mg (total 1200 mg, Group 3 of teicoplanin on Days 1 and 2, respectively. We also compared the efficiency and adverse effects at trough concentrations of 15–20 mg/L (Group A, n = 28 with >20 mg/L (Group B, n = 27 of teicoplanin, and also compared them with those on the similar concentrations of vancomycin (Groups C and D, n = 50 and 34, respectively.Results: The mean trough concentrations of teicoplanin on Days 4 or 5 were 22.2, 17.5, and 16.2 mg/L in Groups 1, 2, and 3, respectively. The clinical efficiency was 85.7%, 81.5%, 92.0%, and 91.5%, in Groups A, B, C, and D, respectively. The rates of adverse effects were not high in teicoplanin (nephrotoxicity, 7.1% and 3.7%, and hepatotoxicity, 14.3% and 11.1% in Groups A and B, respectively. However, more adverse effects tended to arise in patients who received vancomycin in nephrotoxicity (14.0% and 11.8%, in Groups C and D, respectively.Conclusion: These results suggest that the 2-day regimens with total 1800 mg achieved the most effective therapeutic trough plasma concentration of teicoplanin (20 mg/L. However, 15–20

Dynamic MRI evaluation of urethral hypermobility post-radical prostatectomy.

Science.gov (United States)

Suskind, Anne M; DeLancey, John O L; Hussain, Hero K; Montgomery, Jeffrey S; Latini, Jerilyn M; Cameron, Anne P

2014-03-01

One postulated cause of post-prostatectomy incontinence is urethral and bladder neck hypermobility. The objective of this study was to determine the magnitude of anatomical differences of urethral and bladder neck position at rest and with valsalva in continent and incontinent men post-prostatectomy based on dynamic MRI. All subjects underwent a dynamic MRI protocol with valsalva and non-valsalva images and a standard urodynamic evaluation. MRI measurements were taken at rest and with valsalva, including (1) bladder neck to sacrococcygeal inferior pubic point line (SCIPP), (2) urethra to pubis, and (3) bulbar urethra to SCIPP. Data were analyzed in SAS using two-tailed t tests. A total of 21 subjects (13 incontinent and 8 continent) had complete data and were included in the final analysis. The two groups had similar demographic characteristics. On MRI, there were no statistically significant differences in anatomic position of the bladder neck or urethra either at rest or with valsalva. The amount of hypermobility ranged from 0.8 to 2 mm in all measures. There were also no differences in the amount of hypermobility (position at rest minus position at valsalva) between groups. We found no statistically significant differences in bladder neck and urethral position or mobility on dynamic MRI evaluation between continent and incontinent men status post-radical prostatectomy. A more complex mechanism for post-prostatectomy incontinence needs to be modeled in order to better understand the continence mechanism in this select group of men. © 2013 Wiley Periodicals, Inc.

Alterations in Circulating miRNA Levels following Early-Stage Estrogen Receptor-Positive Breast Cancer Resection in Post-Menopausal Women

DEFF Research Database (Denmark)

Kodahl, Annette R; Zeuthen, Pernille; Binder, Harald

2014-01-01

INTRODUCTION: Circulating microRNAs (miRNAs) exhibit remarkable stability and may serve as biomarkers in several clinical cancer settings. The aim of this study was to investigate changes in the levels of specific circulating miRNA following breast cancer surgery and evaluate whether these altera...... and could potentially be used to monitor whether all cancer cells have been removed at surgery and/or, subsequently, whether the patients develop recurrence.......INTRODUCTION: Circulating microRNAs (miRNAs) exhibit remarkable stability and may serve as biomarkers in several clinical cancer settings. The aim of this study was to investigate changes in the levels of specific circulating miRNA following breast cancer surgery and evaluate whether...... these alterations were also observed in an independent data set. METHODS: Global miRNA analysis was performed on prospectively collected serum samples from 24 post-menopausal women with estrogen receptor-positive early-stage breast cancer before surgery and 3 weeks after tumor resection using global LNA...

A new tool to evaluate postgraduate training posts: the Job Evaluation Survey Tool (JEST).

Science.gov (United States)

Wall, David; Goodyear, Helen; Singh, Baldev; Whitehouse, Andrew; Hughes, Elizabeth; Howes, Jonathan

2014-10-02

Three reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors' views about their training experience to be heard. In the UK, the General Medical Council (GMC) quality assures medical training programmes and requires postgraduate deaneries to undertake quality management and monitoring of all training posts in their area. The aim of this study was to develop a simple trainee questionnaire for evaluation of postgraduate training posts based on the GMC, UK standards and to look at the reliability and validity including comparison with a well-established and internationally validated tool, the Postgraduate Hospital Educational Environment Measure (PHEEM). The Job Evaluation Survey Tool (JEST), a fifteen item job evaluation questionnaire was drawn up in 2006, piloted with Foundation doctors (2007), field tested with specialist paediatric registrars (2008) and used over a three year period (2008-11) by Foundation Doctors. Statistical analyses including descriptives, reliability, correlation and factor analysis were undertaken and JEST compared with PHEEM. The JEST had a reliability of 0.91 in the pilot study of 76 Foundation doctors, 0.88 in field testing of 173 Paediatric specialist registrars and 0.91 in three years of general use in foundation training with 3367 doctors completing JEST. Correlation of JEST with PHEEM was 0.80 (p training posts.

Detection and differentiation of early acute and following age stages of myocardial infarction with quantitative post-mortem cardiac 1.5T MR.

Science.gov (United States)

Schwendener, Nicole; Jackowski, Christian; Persson, Anders; Warntjes, Marcel J; Schuster, Frederick; Riva, Fabiano; Zech, Wolf-Dieter

2017-01-01

Recently, quantitative MR sequences have started being used in post-mortem imaging. The goal of the present study was to evaluate if early acute and following age stages of myocardial infarction can be detected and discerned by quantitative 1.5T post-mortem cardiac magnetic resonance (PMCMR) based on quantitative T1, T2 and PD values. In 80 deceased individuals (25 female, 55 male), a cardiac MR quantification sequence was performed prior to cardiac dissection at autopsy in a prospective study. Focal myocardial signal alterations detected in synthetically generated MR images were MR quantified for their T1, T2 and PD values. The locations of signal alteration measurements in PMCMR were targeted at autopsy heart dissection and cardiac tissue specimens were taken for histologic examinations. Quantified signal alterations in PMCMR were correlated to their according histologic age stage of myocardial infarction. In PMCMR seventy-three focal myocardial signal alterations were detected in 49 of 80 investigated hearts. These signal alterations were diagnosed histologically as early acute (n=39), acute (n=14), subacute (n=10) and chronic (n=10) age stages of myocardial infarction. Statistical analysis revealed that based on their quantitative T1, T2 and PD values, a significant difference between all defined age groups of myocardial infarction can be determined. It can be concluded that quantitative 1.5T PMCMR quantification based on quantitative T1, T2 and PD values is feasible for characterization and differentiation of early acute and following age stages of myocardial infarction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stress exposure in early post-natal life reduces telomere length: an experimental demonstration in a long-lived seabird

OpenAIRE

Herborn, Katherine A.; Heidinger, Britt J.; Boner, Winnie; Noguera, Jose C.; Adam, Aileen; Daunt, Francis; Monaghan, Pat

2014-01-01

Exposure to stressors early in life is associated with faster ageing and reduced longevity. One important mechanism that could underlie these late life effects is increased telomere loss. Telomere length in early post-natal life is an important predictor of subsequent lifespan, but the factors underpinning its variability are poorly understood. Recent human studies have linked stress exposure to increased telomere loss. These studies have of necessity been non-experimental and are consequentl...

Early post-operative magnetic resonance imaging in glioblastoma: correlation among radiological findings and overall survival in 60 patients

International Nuclear Information System (INIS)

Majos, Carles; Cos, Monica; Castaner, Sara; Gil, Miguel; Plans, Gerard; Lucas, Anna; Bruna, Jordi; Aguilera, Carles

2016-01-01

To evaluate early post-operative magnetic resonance (EPMR) as a prognostic tool after resection of glioblastoma. Sixty EPMR examinations were evaluated for perioperative infarct, tumour growth between diagnosis and EPMR, contrast enhancement pattern, and extent of resection (EOR). The EOR was approached with the subjective evaluation of radiologists and by quantifying volumes. These parameters were tested as predictors of survival using the Kaplan-Meier method. Contrast enhancement was found in 59 patients (59/60; 98 %). Showing a thin-linear pattern of enhancement was the most favourable finding. Patients with this pattern survived longer than patients with thick-linear (median overall survival (OS) thin-linear=609 days; thick-linear=432 days; P =.023) or nodular (median OS = 318 days; P =.001) enhancements. The subjective evaluation of the EOR performed better than its quantification. Patients survived longer when resection was total (median OS total resection=609 days; subtotal=371 days; P =.001). When resection was subtotal, patients survived longer if it was superior to 95 % (median OS resection superior to 95 %=559 days; inferior to 95 %=256 days; P =.034). EPMR provides valuable prognostic information after surgical resection of glioblastomas. A thin-linear pattern of contrast enhancement is the most favourable finding. Further prognostic stratification may be obtained by assessing the EOR. (orig.)

Early post-operative magnetic resonance imaging in glioblastoma: correlation among radiological findings and overall survival in 60 patients

Energy Technology Data Exchange (ETDEWEB)

Majos, Carles [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Centro de Investigacion en Red en Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain); Hospital Duran i Reynals, IDI Centre Bellvitge, Barcelona (Spain); Cos, Monica; Castaner, Sara [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Gil, Miguel [ICO l' Hospitalet, HU de Bellvitge, Department of Medical Onclogy, Barcelona (Spain); Plans, Gerard [HU de Bellvitge, Department of Neurosurgery, Barcelona (Spain); Lucas, Anna [ICO l' Hospitalet, HU de Bellvitge, Department of Radiotherapy Oncology, Barcelona (Spain); Bruna, Jordi [HU de Bellvitge, Department of Neurology, Barcelona (Spain); Aguilera, Carles [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Centro de Investigacion en Red en Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain)

2016-04-15

To evaluate early post-operative magnetic resonance (EPMR) as a prognostic tool after resection of glioblastoma. Sixty EPMR examinations were evaluated for perioperative infarct, tumour growth between diagnosis and EPMR, contrast enhancement pattern, and extent of resection (EOR). The EOR was approached with the subjective evaluation of radiologists and by quantifying volumes. These parameters were tested as predictors of survival using the Kaplan-Meier method. Contrast enhancement was found in 59 patients (59/60; 98 %). Showing a thin-linear pattern of enhancement was the most favourable finding. Patients with this pattern survived longer than patients with thick-linear (median overall survival (OS) thin-linear=609 days; thick-linear=432 days; P =.023) or nodular (median OS = 318 days; P =.001) enhancements. The subjective evaluation of the EOR performed better than its quantification. Patients survived longer when resection was total (median OS total resection=609 days; subtotal=371 days; P =.001). When resection was subtotal, patients survived longer if it was superior to 95 % (median OS resection superior to 95 %=559 days; inferior to 95 %=256 days; P =.034). EPMR provides valuable prognostic information after surgical resection of glioblastomas. A thin-linear pattern of contrast enhancement is the most favourable finding. Further prognostic stratification may be obtained by assessing the EOR. (orig.)

Clinical endoscopic management and outcome of post-endoscopic sphincterotomy bleeding.

Directory of Open Access Journals (Sweden)

Wei-Chen Lin

Full Text Available Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016. The blood biochemistry, comorbidities, indication for sphincterotomy, severity of bleeding, endoscopic features of bleeder, and type of endoscopic therapy were analyzed. Post-endoscopic sphincterotomy bleeding occurred in 65 (12.6% patients. Forty-five patients had immediate bleeding and 20 patients had delayed bleeding. The multivariate analysis of risk factors associated with post-endoscopic sphincterotomy bleeding were liver cirrhosis (P = 0.029, end-stage renal disease (P = 0.038, previous antiplatelet drug use (P<0.001, and duodenal ulcer (P = 0.023. The complications of pancreatitis and cholangitis were higher in the bleeding group, with statistical significance. Delayed bleeding occurred within 1 to 7 days (mean, 2.5 days, and 60% (12/20 of the patients received endoscopic evaluation. In the delayed bleeding group, the successful hemostasis rate was 71.4% (5/7, and 65% (13/20 of the patients had ceased bleeding without endoscopic hemostasis therapy. Comparison of different therapeutic modalities showed that cholangitis was higher in patients who received epinephrine spray (P = 0.042 and pancreatitis was higher in patients who received epinephrine injection and electrocoagulation (P = 0.041 and P = 0.039 respectively. Clinically, post-endoscopic sphincterotomy bleeding and further endoscopic hemostasis therapy increase the complication rate of pancreatitis and cholangitis. Realizing the effectiveness of each

Evaluation of reproductive tract infection during early post-partum period and its relationship with subsequent reproductive performance in high milk producing dairy cows.

Science.gov (United States)

Senosy, W; Uchiza, M; Tameoka, N; Izaike, Y; Osawa, T

2012-04-01

Clinically normal Holstein-Friesian cows (n = 43) were used to establish a relationship between the evaluations of the uterine condition by vaginoscopy, Metricheck, endometrial cytology (EC) and ultrasonography (US) during post-partum period (pp), and subsequent reproductive performance. The uterine status of the selected cows was evaluated by EC, Metricheck, US and vaginoscopy on a weekly basis from the third week (W3) to the seventh week (W7) pp. The animals were bred after a voluntary waiting period of 45-60 days pp and diagnosed for pregnancy status at 45 days after breeding by US. First service conception rate (FSCR) of bred animals was 32.6% (14/43). There was no significant difference in polymorphonuclear leucocyte percentage between conceived and non-conceived cows during different weeks post-partum. First service conception rate in animals with normal vaginal discharge as detected by Metricheck was significantly low when compared to those of abnormal discharge during W3 (2.3% vs 30.3%; p reproductive performance of dairy cattle. © 2011 Blackwell Verlag GmbH.

Early post-fire regeneration of a Pinus halepensis forest on Mount Parnis, Greece

Energy Technology Data Exchange (ETDEWEB)

Thanos, C.A.; Daskalakou, E.N.; Nikolaidou, S. [Athens Univ. (Greece). Dept. of Botany

1996-05-01

The post-fire regeneration of a 45-yr-old Pinus halepensis (Aleppo pine) forest, burned in July 1989, has been studied on Mount Parnis, Attiki, Greece. Four experimental plots at various slopes and exposures were established at altitudes of 400 - 450 m, and monitored for 3 yr at 3-month intervals. Early regeneration took place abundantly, through both resprouting and seed germination of mostly hard-seeded herbs and shrubs; the floristic richness was high with 80 taxa. Pine seedling emergence took place during the winter of the first post-fire year. The mean pine seedling density by the end of the recruitment period (March 1990) was 5-6 seedlings/m{sup 2}. This density decreased slightly during late spring and considerably during summer. During the second post-fire year only a relatively slight decline was observed; thereafter the density was stabilized to 1-2 seedlings/m{sup 2}. Mortality follows a negative exponential curve that levels off at ca. 20%. Height distributions throughout the three post-fire years were all positively skewed as a result of the presence of few very tall saplings. A considerable fraction (20%) of very short (5-15 cm) saplings were still alive 39 months after the fire; these may constitute the sapling bank. Based on the analysis of height distribution curves, it is concluded that the taller seedlings survived significantly better than the shorter ones. 36 refs, 3 figs, 5 tabs

Milrinone therapeutic drug monitoring in a pediatric population: Development and validation of a quantitative liquid chromatography-tandem mass spectrometry method.

Science.gov (United States)

Raizman, Joshua E; Taylor, Katherine; Parshuram, Christopher; Colantonio, David A

2017-05-01

Milrinone is a potent selective phosphodiesterase type III inhibitor which stimulates myocardial function and improves myocardial relaxation. Although therapeutic monitoring is crucial to maintain therapeutic outcome, little data is available. A proof-of-principle study has been initiated in our institution to evaluate the clinical impact of optimizing milrinone dosing through therapeutic drug monitoring (TDM) in children following cardiac surgery. We developed a robust LC-MS/MS method to quantify milrinone in serum from pediatric patients in real-time. A liquid-liquid extraction procedure was used to prepare samples for analysis prior to measurement by LC-MS/MS. Performance characteristics, such as linearity, limit of quantitation (LOQ) and precision, were assessed. Patient samples were acquired post-surgery and analyzed to determine the concentration-time profile of the drug as well as to track turn-around-times. Within day precision was milrinone levels were either sub-therapeutic or in the toxic range, highlighting the importance for milrinone TDM. This simplified and quick method proved to be analytically robust and able to provide therapeutic monitoring of milrinone in real-time in patients post-cardiac surgery. Copyright © 2017. Published by Elsevier B.V.

Project Rulison: post-shot plans and evaluations

Energy Technology Data Exchange (ETDEWEB)

1969-12-01

Project Rulison post-shot plans and evaluations are discussed and include physical characteristics of the Rulison cavity; pressure and temperature expected in the cavity; amount, nature, and distribution of radioactivity in the cavity; reentry plan; radioactive species which may be encountered during reentry; public safety considerations arising from release of radioactivity; procedures to assure public safety; and the radiological safety plan. Maximum hypothetical accidents and ecological considerations are discussed in the appendices.

Fake news and post-truth pronouncements in general and in early human development.

Science.gov (United States)

Grech, Victor

2017-12-01

Fake news and post-truth pronouncements are increasingly common, and are unfortunately also progressively being applied to the sciences, including the medical sciences. This editorial briefly reviews this unsavoury trend and highlights recent debunking of fake truths in early human development. Science is arguably the last metanarrative with any significant cachet in the postmodern period. We, as scientists, must strive to ensure that our work is transparent and of the highest possible standard so as to continue to uphold science's integrity and probity. Copyright © 2017 Elsevier B.V. All rights reserved.

Phospholipase A2 activation as a therapeutic approach for cognitive enhancement in early-stage Alzheimer disease.

Science.gov (United States)

Schaeffer, Evelin L; Forlenza, Orestes V; Gattaz, Wagner F

2009-01-01

Alzheimer disease (AD) is the leading cause of dementia in the elderly and has no known cure. Evidence suggests that reduced activity of specific subtypes of intracellular phospholipases A2 (cPLA2 and iPLA2) is an early event in AD and may contribute to memory impairment and neuropathology in the disease. The objective of this study was to review the literature focusing on the therapeutic role of PLA2 stimulation by cognitive training and positive modulators, or of supplementation with arachidonic acid (PLA2 product) in facilitating memory function and synaptic transmission and plasticity in either research animals or human subjects. MEDLINE database was searched (no date restrictions) for published articles using the keywords Alzheimer disease (mild, moderate, severe), mild cognitive impairment, healthy elderly, rats, mice, phospholipase A(2), phospholipid metabolism, phosphatidylcholine, arachidonic acid, cognitive training, learning, memory, long-term potentiation, protein kinases, dietary lipid compounds, cell proliferation, neurogenesis, and neuritogenesis. Reference lists of the identified articles were checked to select additional studies of interest. Overall, the data suggest that PLA2 activation is induced in the healthy brain during learning and memory. Furthermore, learning seems to regulate endogenous neurogenesis, which has been observed in AD brains. Finally, PLA2 appears to be implicated in homeostatic processes related to neurite outgrowth and differentiation in both neurodevelopmental processes and response to neuronal injury. The use of positive modulators of PLA2 (especially of cPLA2 and iPLA2) or supplementation with dietary lipid compounds (e.g., arachidonic acid) in combination with cognitive training could be a valuable therapeutic strategy for cognitive enhancement in early-stage AD.

COST EVALUATION OF AUTOMATED AND MANUAL POST- CONSUMER PLASTIC BOTTLE SORTING SYSTEMS

Science.gov (United States)

This project evaluates, on the basis of performance and cost, two Automated BottleSort® sorting systems for post-consumer commingled plastic containers developed by Magnetic Separation Systems. This study compares the costs to sort mixed bales of post-consumer plastic at these t...

Report of the consultants' meeting on comparative laboratory evaluation of therapeutic radionuclides and radiopharmaceuticals

International Nuclear Information System (INIS)

1999-12-01

Therapeutic radiopharmaceuticals consist of two components - the radionuclide and the biological carrier. With regard to the radionuclide, an advantage of targeted radiotherapy is that there are a wide variety of radionuclides with different physical half-lives and radiation qualities that can be applied for this purpose. An important task is to select a radionuclide that is compatible with the needs of a particular clinical application. The identification of the ideal targeted radiotherapeutic for each potential clinical application is a difficult task because of the multitude of variables that must be considered, some relating to the radioisotope, and others to the biological carrier. Hence it is recommended that a Co-ordinated Research Programme be established by the Agency to enable participants to acquire and intercompare the methodological expertise to evaluate the relative merit of therapeutic radiopharmaceuticals. These studies will be performed using a model system selected either from those described in this report or a promising agent that has emerged in the time since this meeting. The molecular carrier will be labelled with 131 I, 125 I as well as other therapeutic radionuclides available to the participant (for example, 90 Y, 186 Re, 188 Re, 153 Sm, 166 Ho, 165 Dy). The potential radiopharmaceuticals will then be compared in a progression of studies evaluating biological integrity after labelling, internalisation and residualization of radioactivity in the tumour cell, in vitro cytotoxicity, tissue distribution, normal organ toxicity (determination of the maximum tolerated dose) and finally, therapeutic efficacy

Therapeutic Theory and Social Context: A Social Constructionist Perspective.

Science.gov (United States)

Lynch, Gordon

1997-01-01

Explores the foundation of therapeutic theory from the perspective of social constructionism. Proposes a theoretical description of the interaction between an individual and the social context in the formation of therapeutic theory. Then explores this description in relation to the early life and subsequent therapeutic theory of Carl Rogers. (RJM)

Early Spring Post-Fire Snow Albedo Dynamics in High Latitude Boreal Forests Using Landsat-8 OLI Data

Science.gov (United States)

Wang, Zhuosen; Erb, Angela M.; Schaaf, Crystal B.; Sun, Qingsong; Liu, Yan; Yang, Yun; Shuai, Yanmin; Casey, Kimberly A.; Roman, Miguel O.

2016-01-01

Taking advantage of the improved radiometric resolution of Landsat-8 OLI which, unlike previous Landsat sensors, does not saturate over snow, the progress of fire recovery progress at the landscape scale (less than 100 m) is examined. High quality Landsat-8 albedo retrievals can now capture the true reflective and layered character of snow cover over a full range of land surface conditions and vegetation densities. This new capability particularly improves the assessment of post-fire vegetation dynamics across low- to high-burn severity gradients in Arctic and boreal regions in the early spring, when the albedos during recovery show the greatest variation. We use 30 m resolution Landsat-8 surface reflectances with concurrent coarser resolution (500 m) MODIS high quality full inversion surface Bidirectional Reflectance Distribution Functions (BRDF) products to produce higher resolution values of surface albedo. The high resolution full expression shortwave blue sky albedo product performs well with an overall RMSE of 0.0267 between tower and satellite measures under both snow-free and snow-covered conditions. While the importance of post-fire albedo recovery can be discerned from the MODIS albedo product at regional and global scales, our study addresses the particular importance of early spring post-fire albedo recovery at the landscape scale by considering the significant spatial heterogeneity of burn severity, and the impact of snow on the early spring albedo of various vegetation recovery types. We found that variations in early spring albedo within a single MODIS gridded pixel can be larger than 0.6. Since the frequency and severity of wildfires in Arctic and boreal systems is expected to increase in the coming decades, the dynamics of albedo in response to these rapid surface changes will increasingly impact the energy balance and contribute to other climate processes and physical feedback mechanisms. Surface radiation products derived from Landsat-8 data will

Phenotypic Plasticity Determines Cancer Stem Cell Therapeutic Resistance in Oral Squamous Cell Carcinoma

Directory of Open Access Journals (Sweden)

Adrian Biddle

2016-02-01

Full Text Available Cancer stem cells (CSCs drive tumour spread and therapeutic resistance, and can undergo epithelial-to-mesenchymal transition (EMT and mesenchymal-to-epithelial transition (MET to switch between epithelial and post-EMT sub-populations. Examining oral squamous cell carcinoma (OSCC, we now show that increased phenotypic plasticity, the ability to undergo EMT/MET, underlies increased CSC therapeutic resistance within both the epithelial and post-EMT sub-populations. The post-EMT CSCs that possess plasticity exhibit particularly enhanced therapeutic resistance and are defined by a CD44highEpCAMlow/−CD24+ cell surface marker profile. Treatment with TGFβ and retinoic acid (RA enabled enrichment of this sub-population for therapeutic testing, through which the endoplasmic reticulum (ER stressor and autophagy inhibitor Thapsigargin was shown to selectively target these cells. Demonstration of the link between phenotypic plasticity and therapeutic resistance, and development of an in vitro method for enrichment of a highly resistant CSC sub-population, provides an opportunity for the development of improved chemotherapeutic agents that can eliminate CSCs.

Phenotypic Plasticity Determines Cancer Stem Cell Therapeutic Resistance in Oral Squamous Cell Carcinoma.

Science.gov (United States)

Biddle, Adrian; Gammon, Luke; Liang, Xiao; Costea, Daniela Elena; Mackenzie, Ian C

2016-02-01

Cancer stem cells (CSCs) drive tumour spread and therapeutic resistance, and can undergo epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET) to switch between epithelial and post-EMT sub-populations. Examining oral squamous cell carcinoma (OSCC), we now show that increased phenotypic plasticity, the ability to undergo EMT/MET, underlies increased CSC therapeutic resistance within both the epithelial and post-EMT sub-populations. The post-EMT CSCs that possess plasticity exhibit particularly enhanced therapeutic resistance and are defined by a CD44(high)EpCAM(low/-) CD24(+) cell surface marker profile. Treatment with TGFβ and retinoic acid (RA) enabled enrichment of this sub-population for therapeutic testing, through which the endoplasmic reticulum (ER) stressor and autophagy inhibitor Thapsigargin was shown to selectively target these cells. Demonstration of the link between phenotypic plasticity and therapeutic resistance, and development of an in vitro method for enrichment of a highly resistant CSC sub-population, provides an opportunity for the development of improved chemotherapeutic agents that can eliminate CSCs.

The therapeutic value of glycolic acid peels in dermatology

Directory of Open Access Journals (Sweden)

Grover C

2003-03-01

Full Text Available Chemical peeling or chemexfoliation has become increasingly popular in recent years for treatment of a number of cosmetic skin problems. Topical glycolic acid in the concentration of 10-30% for 3-5 minutes at fortnightly intervals was investigated as a therapeutic peeling agent in 41 patients having acne (39%, melasma (36.5%, post inflammatory hyperpigmentation (12% and superficial scarring of varied etiology (12%. A final evaluation done at 16 weeks revealed that this modality is useful especially in superficial scarring and melasma, moderately successful in acne patients with no response in dermal pigmentation. No significant untoward effects were seen.

Sequential Tc[sup 99m] mercaptoacetyl-triglycine (MAB3) renography as an evaluator of early renal transplant function

Energy Technology Data Exchange (ETDEWEB)

Carmody, E.; Greene, A.; Brennan, P.; Donohue, J.; Carmody, M.; Keeling, F. (Department of Radiology and Nephrology, Beaumont Hospital, Dublin, Ireland (United Kingdom))

1993-01-01

A prospective study was carried out to evaluate the role of sequential Tc[sup 99m] MAG3 renography in assessing transplant function in the early post-operative period. Twenty patients were included in the study. Studies were performed on all patients at intervals of 48-72 hours until discharge. There were 11 clinically diagnosed episodes of rejection, 9 of which were correctly diagnosed using MAG3 renography. Six episodes of rejection were diagnosed prior to the onset of clinical symptoms. Two patients with graft infarction were correctly diagnosed. Six patients had evidence of transient renographic abnormalities in the immediate post-operative phase which were not associated with clinical symptoms, all of these resolved spontaneously on subsequent examinations and were presumed to be related to resolving acute tubular necrosis (ATN). The perfusion index was of no discriminatory value in this study. Sequential Tc[sup 99m] MAG3 renography is highly sensitive but entirely nonspecific in the evaluation of pathology in the transplant kidney. Rejection in an uncomplicated transplant can be readily detected in many cases well in advance of clinical manifestations. This study demonstrates that Tc[sup 99m] MAG3 renography is certainly equal to Tc[sup 99m] DTPA renography or Iodine 131 renography in assessing early transplant function. However, TC[sup 99m] MAG3 exposes the patient to considerably less radiation and the images are of superior quality. (au) (15 refs.).

166Ho-HA evaluation as therapeutic agent for rheumatoid arthritis treatment

International Nuclear Information System (INIS)

Chandia, M.C.; Errazu, X.C.; Pinto, L.N.; Godoy, N.O.; Avila, M.J.; Mendoza, P.; Mendoza, J.; Jofre, J.; Sirraalta, P.

2002-01-01

Aim: Rheumatoid arthritis is a limiting disease having, among its pathological features, the inflammation of synovial tissue with progressive and later destruction of the articulation. This leads to joint deformation and loss of its function, generating pain and reducing the mobility of the affected articulation. The aim was to evaluate 166 Ho-Hydroxyapatite ( 166 Ho-HA) as potential radiopharmaceutical for the symptomatic treatment of chronic and acute arthritis. Materials and Methods: Holmiun-166 was produced by irradiation of Ho 2 O 3 at La Reina Research Reactor, Nuclear Chilean Energy Commission. Hydroxyapatite was in-house synthesized. Its labelling and quality controls follows the internationally accepted procedures. An antigen's arthritis was induced to eight New Zealand rabbits with the 166 Ho-HA radiochemical being administered thereafter in two dosage modalities (single and double). The compound therapeutic efficiency was evaluated based upon clinical improvement and images from the inflamated articulation using 67 Ga citrate before and after 166 Ho-HA injection. Results: The radiochemical purity of the inoculated compound was greater than 98% as measured under sterility conditions. Clinically, an inflammation reduction (2 cm), appetite improvement and general well being was observed. The 166 Ho-HA distribution and localization was monitored using gamma camera images taken at 4 and 24 h. There was no evidence of extra articular leakage. From the 67 Ga citrate imaging, the acute group shows an overall improvement of well being corresponding to a lesser uptake at the inflamated articulation, regarding to the chronic group. The 166 Ho-HA double doses, compared to the single doses, suggest a reduced uptake of 67 Ga citrate at the inflamated tissue, meaning an increased therapeutic effect. Conclusions: 166 Ho-HA is useful as therapeutic agent for the symptomatic treatment of rheumatoid arthritis as shown by imaging and clinical examination

166 Ho-HA Evaluation as therapeutic agent for rheumatoid arthritis treatment

International Nuclear Information System (INIS)

Chandia, M; Errazu, X; Mendoza, P; Troncoso, F; Jofre, J; Sierralta, P

2003-01-01

Aim: Rheumatoid arthritis is a limiting disease having, among its pathological features, the inflammation of synovial tissue with progressive and later destruction of the articulation. This lead to joint deformation and loss of its function, generating pain and reducing the mobility of the affected articulation. The aim was to evaluate 166 Ho-Hydroxyapatite ( 166 Ho-HA) as potential radiopharmaceutical for the syntomatic treatment of chronic and acute arthritis Materials and Methods: 166 Holmiun was produced by irradiation of Ho 2 O 3 at La Reina Research Reactor, Nuclear Chilean Energy Commission. Hydroxyapatite was in-house synthetized. Its labelling and quality controls follows the internationally accepted procedures. An antigen arthritis was induced to eight New Zealand rabbits with the 166 Ho-HA radiochemical being administred thereafter in two dosage modalities (single and double). The compound therapeutic efficiency was evaluated based upon clinical improvement and images from the inflamated articulation using 67 Ga citrate before and after 166 Ho-HA injection. Results: The radiochemical purity of the innoculated compound was greater than 98% as measured under sterility conditions. Clinically, an inflamation reduction (2 cm), appetite improvement and general well being was observed. The 166 Ho-HA distribution and localization was monitored using gamma camera images taken at 4 and 24 h. There was no evidence of extraarticular leakage. From the 67 Ga citrate imaging, the acute group shows an overall improvement of well being corresponding to a lesser uptake at the inflamated articulation, regarding to the chronic group. The 166 Ho-HA double dosis, compared to the single dosis, suggest a reduced uptake of 67 Ga citrate at the inflamated tissue, meaning an increased therapeutic effect. Conclusions: 166 Ho-HA is usefull as therapeutic agent for the syntomatic treatment of rheumatoideal arthritis as shown by imaging and clinical examination (author)

Early motion and directed exercise (EMADE) versus usual care post ankle fracture fixation: study protocol for a pragmatic randomised controlled trial.

Science.gov (United States)

Matthews, Paul A; Scammell, Brigitte E; Ali, Arfan; Coughlin, Timothy; Nightingale, Jessica; Khan, Tanvir; Ollivere, Ben J

2018-05-31

Following surgical fixation of ankle fractures, the traditional management has included immobilisation for 6 weeks in a below-knee cast. However, this can lead to disuse atrophy of the affected leg and joint stiffness. While early rehabilitation from 2 weeks post surgery is viewed as safe, controversy remains regarding its benefits. We will compare the effectiveness of early motion and directed exercise (EMADE) ankle rehabilitation, against usual care, i.e. 6 weeks' immobilisation in a below-knee cast. We have designed a pragmatic randomised controlled trial (p-RCT) to compare the EMADE intervention against usual care. We will recruit 144 independently living adult participants, absent of tissue-healing comorbidities, who have undergone surgical stabilisation of isolated Weber B ankle fractures. The EMADE intervention consists of a non-weight-bearing progressive home exercise programme, complemented with manual therapy and education. Usual care consists of immobilisation in a non-weight-bearing below-knee cast. The intervention period is between week 2 and week 6 post surgery. The primary outcome is the Olerud and Molander Ankle Score (OMAS) patient-reported outcome measure (PROM) at 12 weeks post surgery. Secondary PROMs include the EQ-5D-5 L questionnaire, return to work and return to driving, with objective outcomes including ankle range of motion. Analysis will be on an intention-to-treat basis. An economic evaluation will be included. The EMADE intervention is a package of care designed to address the detrimental effects of disuse atrophy and joint stiffness. An advantage of the OMAS is the potential of meta-analysis with other designs. Within the economic evaluation, the cost-utility analysis, may be used by commissioners, while the use of patient-relevant outcomes, such as return to work and driving, will ensure that the study remains pertinent to patients and their families. As it is being conducted in the clinical environment, this p-RCT has high external

Recovery of the cardiac frequency to the minute post effort as early indicator of myocardial ischemia

International Nuclear Information System (INIS)

Jimenez M, L.

2007-01-01

The objective of the work was to evaluate the recovery cardiac frequency like ischemia indicator, due to the immediate reactivity of the parasympathetic nervous system in the post-effort. It is obtained as conclusion that a slow descent of the cardiac frequency to the first minute of the post-effort is a predictor ischemia index when correlating it with the risk evaluated by cardiac SPECT with a high specificity; being this a marker of simple calculating in the daily practice. (Author)

Early Non-Immunological Post Transplant complications: A Single Center Experience

Directory of Open Access Journals (Sweden)

Jabur Wael

2008-01-01

Full Text Available To assess non-immunological complications affecting renal transplant patients in the first six months after transplantation in Al-Karama hospital, Baghdad, Iraq, we studied 68 patients (49 males, 19 females attending the clinic during the year 2006. Forty six (67% patients received kidneys from related and 22 (33% from unrelated donors. The patients revealed the following complications: post transplant hypertension in 28 (41% patient, infection (mostly bacterial in 27 (37%, new onset diabetes in 11 (16%, calcineurin inhibitor toxicity in 10 (14%, anemia in 8 (12%, surgical complications in 7 (10%, slow graft recovery in 4 (6%, cardiovascular complications in 3 (4%, and Kaposi sarcoma in 2 (2.9%.Transient hyperglycemia, hypertension, infection and diabetes mel-litus were the commonest early complications of renal transplantation. The incidence of complications is comparable to the average reported in the literature, especially in this region of the world.

Evaluation of human health risk from in situ recovery uranium mining, pre-and post-mining, and post-restoration

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Ruedig, E.; Bhattacharyya, A.; Borch, T.; Johnson, T. [Colorado State University (United States); Till, J. [Risk Assessment Corporation (United States)

2014-07-01

In the United States, the restoration of in situ recovery (ISR) uranium mines is aimed at returning sites to pre-mining conditions. While this may seem an appropriate goal, little or no scientific information is available to justify utilizing baseline conditions for regulatory compliance. The chemical and radiological contaminants monitored for restoration compliance have not been evaluated to ensure they are proper indicators of the mitigation of risk. Pre-mining aquifers do not meet minimum United States drinking water standards, and must have an aquifer exemption in place prior to mining. Under these conditions, returning groundwater to near the original concentrations of contaminants may be unnecessary. Post-mining groundwater is also unlikely to meet standards for drinking water, but may be depleted in at least some toxic species as a result of the mining process. Here, we examine the risk to representative person from the personal use of groundwater sourced from an Uranium ISR mine. Water samples were collected from Cameco Resource's Smith Ranch-Highlands ISR Uranium mine near Casper, Wyoming, USA. Samples were acquired pre-mining, post-mining, and post-restoration. Concentrations of heavy metals and radionuclides were assessed by appropriate analytical techniques (e.g., mass spectroscopy or alpha spectroscopy) and these concentrations were used to estimate human health risk for three exposure scenarios: a scenario with high exposure, a scenario with medium exposure, and a scenario with low exposure. A simple biosphere transport model was constructed for each scenario to estimate the risk to humans from the use of contaminated waters for subsistence-related activities. Chemical and radiological risks were harmonized according to the United States Environmental Protection Agency's guidance for superfund sites. Each exposure scenario and its subsequent risk were evaluated individually for pre-mining, post-mining, and post-restoration aquifer waters

The role of therapeutic leukapheresis in hyperleukocytotic AML.

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Friederike Pastore

Full Text Available Hyperleukocytosis in AML with leukostasis is a serious life-threatening condition leading to a high early mortality which requires immediate cytoreductive therapy. Therapeutic leukapheresis is currently recommended by the American Society of Apheresis in patients with a WBC>100 G/l with signs of leukostasis, but the role of prophylactic leukapheresis before clinical signs of leukostasis occur is unclear.We retrospectively analyzed the role of leukapheresis in 52 patients (median age 60 years with hyperleukocytotic AML with and without clinical signs of leukostasis. Since leukapheresis was performed more frequently in patients with signs of leukostasis due to the therapeutic policy in our hospital, we developed a risk score for early death within seven days after start of therapy (EDd7 to account for this selection bias and to independently measure the effect of leukapheresis on EDd7.20 patients received leukapheresis in combination to chemotherapy compared to 32 patients who received chemotherapy only. In a multivariate logistic regression model for the estimation of the probability of EDd7 thromboplastin time and creatinine remained as independent significant parameters and were combined to create an EDd7 risk score. The effect of leukapheresis on EDd7 was evaluated in a bivariate logistic regression together with the risk score. Leukapheresis did not significantly change early mortality in all patients with a WBC≥100 G/l.Prophylactic leukapheresis in hyperleukocytotic patients with and without leukostasis did not improve early mortality in our retrospective study. Larger and prospective clinical trials are needed to validate the risk score and to further explore the role of leukapheresis in AML with hyperleukocytosis.

Effects of a screening and treatment protocol with haloperidol on post-cardiotomy delirium

DEFF Research Database (Denmark)

Schrøder Pedersen, Sofie; Kirkegaard, Thomas; Balslev Jørgensen, Martin

2014-01-01

OBJECTIVES: Post-cardiotomy delirium is common and associated with increased morbidity and mortality. No gold standard exists for detecting delirium, and evidence to support the choice of treatment is needed. Haloperidol is widely used for treating delirium, but indication, doses and therapeutic...... targets vary. Moreover, doubt has been raised regarding overall efficacy. The purpose of this study was to assess the effect of a combination of early detection and standardized treatment with haloperidol on post-cardiotomy delirium, with the hypothesis that the proportion of delirium- and coma-free days...... could be increased. Length of stay (LOS), complications and 180-day mortality are reported. METHODS: Prospective interventional cohort study. One hundred and seventeen adult patients undergoing cardiac surgery were included before introduction of a screening and treatment protocol with haloperidol...

Early applications of granulocyte colony-stimulating factor (G-CSF) can stabilize the blood-optic-nerve barrier and ameliorate inflammation in a rat model of anterior ischemic optic neuropathy (rAION).

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Wen, Yao-Tseng; Huang, Tzu-Lun; Huang, Sung-Ping; Chang, Chung-Hsing; Tsai, Rong-Kung

2016-10-01

Granulocyte colony-stimulating factor (G-CSF) was reported to have a neuroprotective effect in a rat model of anterior ischemic optic neuropathy (rAION model). However, the therapeutic window and anti-inflammatory effects of G-CSF in a rAION model have yet to be elucidated. Thus, this study aimed to determine the therapeutic window of G-CSF and investigate the mechanisms of G-CSF via regulation of optic nerve (ON) inflammation in a rAION model. Rats were treated with G-CSF on day 0, 1, 2 or 7 post-rAION induction for 5 consecutive days, and a control group were treated with phosphate-buffered saline (PBS). Visual function was assessed by flash visual evoked potentials at 4 weeks post-rAION induction. The survival rate and apoptosis of retinal ganglion cells were determined by FluoroGold labeling and TUNEL assay, respectively. ON inflammation was evaluated by staining of ED1 and Iba1, and ON vascular permeability was determined by Evans Blue extravasation. The type of macrophage polarization was evaluated using quantitative real-time PCR (qRT-PCR). The protein levels of TNF-α and IL-1β were analyzed by western blotting. A therapeutic window during which G-CSF could rescue visual function and retinal ganglion cell survival was demonstrated at day 0 and day 1 post-infarct. Macrophage infiltration was reduced by 3.1- and 1.6-fold by G-CSF treatment starting on day 0 and 1 post-rAION induction, respectively, compared with the PBS-treated group (P<0.05). This was compatible with 3.3- and 1.7-fold reductions in ON vascular permeability after G-CSF treatment compared with PBS treatment (P<0.05). Microglial activation was increased by 3.8- and 3.2-fold in the early (beginning treatment at day 0 or 1) G-CSF-treated group compared with the PBS-treated group (P<0.05). Immediate (within 30 mins of infarct) treatment with G-CSF also induced M2 microglia/macrophage activation. The cytokine levels were lower in the group that received immediate G-CSF treatment compared to

Protein malnutrition during gestation and early life decreases neuronal size in the medial prefrontal cortex of post-pubertal rats

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Roelf J. Cruz-Rizzolo

2017-12-01

Full Text Available Retrospective studies in human populations indicate that protein deprivation during pregnancy and early life (early protein malnutrition, EPM is associated with cognitive impairments, learning disabilities and may represent a risk factor for the late onset of some psychiatric disorders, fundamentally schizophrenia, a condition where the prefrontal cortex plays an important role. The purpose of this study was to analyze whether EPM affects structural aspects of the rat medial prefrontal cortex (mPFC, such as cortical volume, neuronal density and neuronal soma size, which seem altered in patients with schizophrenia. For this, a rat model of EPM (5% casein from conception to postnatal day 60 was adopted and the rat mPFC volume, total number of neurons and average neuronal volume were evaluated on postnatal day 60 (post-pubertal animals by histo- and immunohistochemical techniques using unbiased stereological analysis. EPM did not alter the number of NeuN+ neurons in the rat mPFC. However, a very significant decrease in mPFC volume and average neuronal size was observed in malnourished rats. Although the present study does not establish causal relationships between malnutrition and schizophrenia, our results may indicate a similar structural phenomenon in these two situations.

Pilot prospective study of post-surgery sleep and EEG predictors of post-operative delirium.

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Evans, Joanna L; Nadler, Jacob W; Preud'homme, Xavier A; Fang, Eric; Daughtry, Rommie L; Chapman, Joseph B; Attarian, David; Wellman, Samuel; Krystal, Andrew D

2017-08-01

Delirium is a common post-operative complication associated with significant costs, morbidity, and mortality. We sought sleep/EEG predictors of delirium present prior to delirium symptoms to facilitate developing and targeting therapies. Continuous EEG data were obtained in 12 patients post-orthopedic surgery from the day of surgery until delirium assessment on post-operative day 2 (POD2). Diminished total sleep time (r=-0.68; pdelirium severity. Patients experiencing delirium slept 2.4h less and took 2h longer to fall asleep. Greater waking EEG delta power (r=0.84; pdelirium severity. Loss of sleep on night1 post-surgery is an early predictor of subsequent delirium. EEG Delta Power alterations in waking and sleep appear to be later indicators of impending delirium. Further work is needed to evaluate reproducibility/generalizability and assess whether sleep loss contributes to causing delirium. This first study to prospectively collect continuous EEG data for an extended period prior to delirium onset identified EEG-derived indices that predict subsequent delirium that could aid in developing and targeting therapies. Copyright © 2017. Published by Elsevier B.V.

Confirmatory factor analysis of Post-Occupancy Evaluation Model (POEM) for sustainable neighborhood development

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Yaman, R.; Thadaniti, S.; Abdullah, J.; Ahmad, N.; Ishak, N. M.

2018-02-01

The sustainable urban development growth in the ASEAN region has accelerated tremendously. More demand on the sustainable development has led to bigger market driven certified green neighborhood and buildings. However, there is a lack of post-occupancy evaluation study conducted in assessing the end-users perspective on the certified sustainable neighborhood development. This paper aims to investigate the end-users point of view on sustainable dimension pillar (SDP) adaptation based on environment dimension, social dimension and economic dimension using Post-Occupancy Evaluation Model (POEM) framework. The research methodology employed stakeholders-Inclusion Approach survey questionnaires in order to obtained the sustainable dimensional adaptation score. The results show that there is sustainable dimension gap in POEM evaluation, hence, suggested the pre- occupancy criteria did not fulfill the SDP adaptation and pre-occupancy criteria and variables if differ from post-occupancy criteria and variables.

Early Pseudoprogression following Chemoradiotherapy in Glioblastoma Patients: The Value of RANO Evaluation

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Paulo Linhares

2013-01-01

Full Text Available Introduction. The aim of this study was to determine the frequency of pseudoprogression in a cohort of glioblastoma (GBM patients following radiotherapy/temozolomide (RT/TMZ by comparing Macdonald criterial to Response Assessment in Neuro-Oncology (RANO criteria. The impact on prognosis and survival analysis was also studied. Materials and Methods. All patients receiving RT/TMZ for newly diagnosed GBM from January 2005 to December 2009 were retrospectively evaluated, and demographic, clinical, radiographic, treatment, and survival data were reviewed. Updated RANO criteria were used for the evaluation of the pre-RT and post-RT MRI and compared to classic Macdonald criteria. Survival data was evaluated using the Kaplan-Meier and log-rank analysis. Results and Discussion. 70 patients were available for full radiological response assessment. Early progression was confirmed in 42 patients (60% according to Macdonald criteria and 15 patients (21% according to RANO criteria. Pseudoprogression was identified in 10 (23.8% or 2 (13.3% patients in Macdonald and RANO groups, respectively. Cumulative survival of pseudoprogression group was higher than that of true progression group and not statistically different from the non-progressive disease group. Conclusion. In this cohort, the frequency of pseudoprogression varied between 13% and 24%, being overdiagnosed by older Macdonald criteria, which emphasizes the importance of RANO criteria and new radiological biomarkers for correct response evaluation.

Evaluation of Histopathological Changes in Control Biopsies Which Taken 48 Sessions after NBUVB Phototherapy for Early-Stage Mycosis Fungoides

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Ebru Zemheri

2012-01-01

Full Text Available Background. There are not many studies investigating histomorphological changes in 48 sessions in patients with early-stage MF after narrowband UVB (NBUVB treatment. Our purpose is to evaluate histological features of phototherapy after 48 sessions and determine which parameters are more reliable for controlling skin biopsies. Methods. Biopsies of 32 patients with early stage of MF, who were treated with NBUVB phototherapy, were histologically evaluated before and after the treatments, including epidermotropism, stratum corneum, epidermal thickness, dermal infiltration, papillary dermal fibrosis, vascular alterations, and other dermal changes. We discuss the histomorphological effects of NBUVB phototherapy on skin biopsies by comparing the responders with nonresponders, with before and after the treatment. Results. 9 patients (28% did not give any response to treatment. Alleviation in epidermotropism, increases in parakeratosis and normal keratosis, perivascular infiltration, and melanophages, decrease in the lichenoid/patchy lichenoid infiltration pattern after the treatment was statistically significant. Comparing by response, normalization of stratum corneum and epidermis, orthohyperkeratosis, decrease in linearly arranged cells, the lichenoid/patchy lichenoid infiltration, the loss of inflammation were statistically significant in responders group. Conclusion. We detected a significant decrease in linearly arranged cells after phototherapy, indicating that it is an “important diagnostic parameter" in evaluation of therapeutic response.

Animal Robot Assisted-therapy for Rehabilitation of Patient with Post-Stroke Depression

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Zikril Zulkifli, Winal; Shamsuddin, Syamimi; Hwee, Lim Thiam

2017-06-01

Recently, the utilization of therapeutic animal robots has expanded. This research aims to explore robotics application for mental healthcare in Malaysia through human-robot interaction (HRI). PARO, the robotic seal PARO was developed to give psychological effects on humans. Major Depressive Disorder (MDD) is a common but severe mood disorder. This study focuses on the interaction protocol between PARO and patients with MDD. Initially, twelve rehabilitation patients gave subjective evaluation on their first interaction with PARO. Next, therapeutic interaction environment was set-up with PARO in it to act as an augmentation strategy with other psychological interventions for post-stroke depression. Patient was exposed to PARO for 20 minutes. The results of behavioural analysis complemented with information from HRI survey question. The analysis also observed that the individual interactors engaged with the robot in diverse ways based on their needs Results show positive reaction toward the acceptance of an animal robot. Next, therapeutic interaction is set-up for PARO to contribute as an augmentation strategy with other psychological interventions for post-stroke depression. The outcome is to reduce the stress level among patients through facilitated therapy session with PARO

Family group interventions in an early psychosis program: A re-evaluation of practice after 10 years of service delivery.

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Day, Kate; Starbuck, Rachael; Petrakis, Melissa

2017-08-01

The role of family in supporting service users in coping with illness and engaging in relapse prevention in early psychosis is important. Taking on this caring though is stressful and challenging, and it has been found that support and information for carers assists in their coping and reduces isolation. To evaluate the current utility of a psychoeducation group program in a public adult mental health service, for the families of people experiencing early psychosis. A purpose-designed pre- and post-intervention questionnaire was administered to quantitatively measure group participants' changes in perceptions of their understanding of mental illness and its treatment through attending the group. Additional qualitative items were used to determine other knowledge, benefits and any critical feedback. The group program continues to result in highly significant improvements in family members' understanding of psychosis, recovery, medications, relapse prevention and substance co-morbidities. Additional feedback reaffirmed previous findings that family members find group peer support valuable and that this reduces isolation and the experience of stigma. The current evaluation, conducted following 10 years of early psychosis group work, found there to be efficacy in family peer support groups and that it is important to provide family interventions in public early psychosis mental health services.

Comparison of Quantitative Characteristics of Early Post-resuscitation EEG Between Asphyxial and Ventricular Fibrillation Cardiac Arrest in Rats.

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Chen, Bihua; Chen, Gang; Dai, Chenxi; Wang, Pei; Zhang, Lei; Huang, Yuanyuan; Li, Yongqin

2018-04-01

Quantitative electroencephalogram (EEG) analysis has shown promising results in studying brain injury and functional recovery after cardiac arrest (CA). However, whether the quantitative characteristics of EEG, as potential indicators of neurological prognosis, are influenced by CA causes is unknown. The purpose of this study was designed to compare the quantitative characteristics of early post-resuscitation EEG between asphyxial CA (ACA) and ventricular fibrillation CA (VFCA) in rats. Thirty-two Sprague-Dawley rats of both sexes were randomized into either ACA or VFCA group. Cardiopulmonary resuscitation was initiated after 5-min untreated CA. Characteristics of early post-resuscitation EEG were compared, and the relationships between quantitative EEG features and neurological outcomes were investigated. Compared with VFCA, serum level of S100B, neurological deficit score and brain histopathologic damage score were dramatically higher in the ACA group. Quantitative measures of EEG, including onset time of EEG burst, time to normal trace, burst suppression ratio, and information quantity, were significantly lower for CA caused by asphyxia and correlated with the 96-h neurological outcome and survival. Characteristics of earlier post-resuscitation EEG differed between cardiac and respiratory causes. Quantitative measures of EEG not only predicted neurological outcome and survival, but also have the potential to stratify CA with different causes.

Post-Colonial Urban Development and Planning in Cyprus: Shifting Visions and Realities of Early Suburbia

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Byron Ioannou

2016-12-01

Full Text Available The paper studies the evolution of early suburban neighbourhoods in the context of the post-colonial urban development and planning. The Planning Report of the colonial Government of Cyprus in 1959 examines the foundations of urban development in Cyprus and at the same time implies a surprisingly sustainable vision for the future of planning. Despite this early intentions and guidance, the urban districts developed far from being sustainable under widely accepted criteria and indicators (participation, effectiveness of planning and development control, sprawl, character and identity, green. The basic hypothesis is that planning has proved insufficient in providing rational urban development. The paper outlines the roots of the planning shortcomings during the last fifty years. British perceptions on planning of the first half of the 20th century influenced the 1959 Report, which affected, in turns, the legislation which followed. It is explained why development constrains and land market restrictions prevented the implementation of rational key ideas, and sustainable visions throughout the years. The paper concludes in attempting to visualize these dynamic processes at the early suburban neighbourhoods and measure distortions on densities, green spaces and layouts by taking an early suburban district as a case study.

Post Landsat-D advanced concept evaluation /PLACE/

Science.gov (United States)

Alexander, L. D.; Alvarado, U. R.; Flatow, F. S.

1979-01-01

The aim of the Post Landsat-D Advanced Concept Evaluation (PLACE) program was to identify the key technology requirements of earth resources satellite systems for the 1985-2000 period. The program involved four efforts: (1) examination of future needs in the earth resources area, (2) creation of a space systems technology model capable of satisfying these needs, (3) identification of key technology requirements posed by this model, and (4) development of a methodology (PRISM) to assist in the priority structuring of the resulting technologies.

Early intervention for post-traumatic stress disorder.

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Bryant, Richard A

2007-02-01

The potentially debilitating effect of posttraumatic stress disorder (PTSD) has created much interest in early intervention strategies that can reduce PTSD. This review critiques the evidence for psychological debriefing approaches and alternate early intervention strategies. The review critiques the randomized controlled trials of psychological debriefing, and early provision of cognitive behavior therapy. The latter approach involves therapy attention on acutely traumatized individuals who are high risk for PTSD development, and particularly in people with acute stress disorder (ASD). Psychological debriefing does not prevent PTSD. Cognitive behaviour therapy strategies have proven efficacy in reducing subsequent PTSD in ASD populations. Despite the promising evidence for early provision of CBT, many people do not benefit from CBT. This review concludes with consideration of major challenges facing early intervention approaches in the context of terrorist attacks and mass disasters.

Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors.

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Cespedes Feliciano, Elizabeth M; Kwan, Marilyn L; Kushi, Lawrence H; Weltzien, Erin K; Castillo, Adrienne L; Caan, Bette J

2017-04-01

Little research examines whether adiposity or post-diagnosis weight changes influence Cardiovascular disease (CVD) among breast cancer patients for whom effects may differ due to treatment and recovery. We studied Stage I-III breast cancer survivors 18 to  diagnosis and weight and waist circumference (WC) around 24 months post diagnosis. Using Cox models for time to incident coronary artery disease, heart failure, valve abnormality, arrhythmia, stroke, or CVD death, we examined at-diagnosis body mass index (BMI, n = 3109) and post-diagnosis WC (n = 1898) and weight change (n = 1903, stable, ±5 to  diagnosis, 25% of women gained and 14% lost ≥10-lbs; mean (SD) WC was 90 (15) cm. Over a median of 8.28 years, 915 women developed CVD. BMI 25-30-kg/m 2 (vs. BMI diagnosis weight change had no association with CVD. Extreme adiposity and any elevation in WC increased risk of CVD among breast cancer survivors; however, changes in weight in the early post-diagnosis period were not associated with CVD. Survivors with high WC and existing CVD risk factors should be monitored.

Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.

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Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; Bonani, Marco; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J

2018-01-01

Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; Ptransplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.

Evaluating post-wildfire hydrologic recovery using ParFlow in southern California

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Lopez, S. R.; Kinoshita, A. M.; Atchley, A. L.

2016-12-01

Wildfires are naturally occurring hazards that can have catastrophic impacts. They can alter the natural processes within a watershed, such as surface runoff and subsurface water storage. Generally, post-fire hydrologic models are either one-dimensional, empirically-based models, or two-dimensional, conceptually-based models with lumped parameter distributions. These models are useful in providing runoff measurements at the watershed outlet; however, do not provide distributed hydrologic simulation at each point within the watershed. This research demonstrates how ParFlow, a three-dimensional, distributed hydrologic model can simulate post-fire hydrologic processes by representing soil burn severity (via hydrophobicity) and vegetation recovery as they vary both spatially and temporally. Using this approach, we are able to evaluate the change in post-fire water components (surface flow, lateral flow, baseflow, and evapotranspiration). This model is initially developed for a hillslope in Devil Canyon, burned in 2003 by the Old Fire in southern California (USA). The domain uses a 2m-cell size resolution over a 25 m by 25 m lateral extent. The subsurface reaches 2 m and is assigned a variable cell thickness, allowing an explicit consideration of the soil burn severity throughout the stages of recovery and vegetation regrowth. Vegetation regrowth is incorporated represented by satellite-based Enhanced Vegetation Index (EVI) products. The pre- and post-fire surface runoff, subsurface storage, and surface storage interactions are evaluated and will be used as a basis for developing a watershed-scale model. Long-term continuous simulations will advance our understanding of post-fire hydrological partitioning between water balance components and the spatial variability of watershed processes, providing improved guidance for post-fire watershed management.

Serum protein profile at remission can accurately assess therapeutic outcomes and survival for serous ovarian cancer.

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Jinhua Wang

Full Text Available BACKGROUND: Biomarkers play critical roles in early detection, diagnosis and monitoring of therapeutic outcome and recurrence of cancer. Previous biomarker research on ovarian cancer (OC has mostly focused on the discovery and validation of diagnostic biomarkers. The primary purpose of this study is to identify serum biomarkers for prognosis and therapeutic outcomes of ovarian cancer. EXPERIMENTAL DESIGN: Forty serum proteins were analyzed in 70 serum samples from healthy controls (HC and 101 serum samples from serous OC patients at three different disease phases: post diagnosis (PD, remission (RM and recurrence (RC. The utility of serum proteins as OC biomarkers was evaluated using a variety of statistical methods including survival analysis. RESULTS: Ten serum proteins (PDGF-AB/BB, PDGF-AA, CRP, sFas, CA125, SAA, sTNFRII, sIL-6R, IGFBP6 and MDC have individually good area-under-the-curve (AUC values (AUC = 0.69-0.86 and more than 10 three-marker combinations have excellent AUC values (0.91-0.93 in distinguishing active cancer samples (PD & RC from HC. The mean serum protein levels for RM samples are usually intermediate between HC and OC patients with active cancer (PD & RC. Most importantly, five proteins (sICAM1, RANTES, sgp130, sTNFR-II and sVCAM1 measured at remission can classify, individually and in combination, serous OC patients into two subsets with significantly different overall survival (best HR = 17, p<10(-3. CONCLUSION: We identified five serum proteins which, when measured at remission, can accurately predict the overall survival of serous OC patients, suggesting that they may be useful for monitoring the therapeutic outcomes for ovarian cancer.

PD-1hiTIM-3+ T cells associate with and predict leukemia relapse in AML patients post allogeneic stem cell transplantation

International Nuclear Information System (INIS)

Kong, Y; Zhang, J; Claxton, D F; Ehmann, W C; Rybka, W B; Zhu, L; Zeng, H; Schell, T D; Zheng, H

2015-01-01

Prognosis of leukemia relapse post allogeneic stem cell transplantation (alloSCT) is poor and effective new treatments are urgently needed. T cells are pivotal in eradicating leukemia through a graft versus leukemia (GVL) effect and leukemia relapse is considered a failure of GVL. T-cell exhaustion is a state of T-cell dysfunction mediated by inhibitory molecules including programmed cell death protein 1 (PD-1) and T-cell immunoglobulin domain and mucin domain 3 (TIM-3). To evaluate whether T-cell exhaustion and inhibitory pathways are involved in leukemia relapse post alloSCT, we performed phenotypic and functional studies on T cells from peripheral blood of acute myeloid leukemia patients receiving alloSCT. Here we report that PD-1 hi TIM-3 + cells are strongly associated with leukemia relapse post transplantation. Consistent with exhaustion, PD-1 hi TIM-3 + T cells are functionally deficient manifested by reduced production of interleukin 2 (IL-2), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ). In addition, these cells demonstrate a phenotype consistent with exhausted antigen-experienced T cells by losing T N and T EMRA subsets. Importantly, increase of PD-1 hi TIM-3 + cells occurs before clinical diagnosis of leukemia relapse, suggesting their predictive value. Results of our study provide an early diagnostic approach and a therapeutic target for leukemia relapse post transplantation

Clinical characteristics, risk factors and pre-surgical evaluation of post-infectious epilepsy.

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Sellner, J; Trinka, E

2013-03-01

Epilepsy is a frequent complication of central nervous system (CNS) infections. Post-infectious epilepsy is commonly refractory to medical treatment and plays a pivotal role for the poor long-term outcome of CNS infections. To provide an overview of clinical characteristics and risk factors of seizures associated with CNS infections. In addition, to summarize the state of the art of anticonvulsive treatment and the pre-surgical evaluation process in refractory cases. A comprehensive literature search for articles published between January 1970 and December 2011 was carried out. The occurrence of seizures during the acute course of meningitis, encephalitis and brain abscess is the main risk factor for the development of post-infectious epilepsy. There is a shortage of trials evaluating the efficacy of prophylactic and symptomatic treatment during the course of acute infection. Moreover, there are no randomized-controlled trials studying anticonvulsive drugs and their combinations for the management of post-infectious epilepsy. In a selected group of patients, however, medically refractory focal epilepsy is potentially curable by surgery. Further studies are required to improve the pathogenetic understanding of post-infectious epilepsy in order to develop preventive measures as well as to evaluate additional medical and surgical treatment strategies for the patients currently not considered for surgery. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: one year follow-up.

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Berti, L; Vannini, F; Lullini, G; Caravaggi, P; Leardini, A; Giannini, S

2013-09-01

Severe post-traumatic ankle arthritis poses a reconstructive challenge in active patients. Whereas traditional surgical treatments, i.e. arthrodesis and arthroplasty, provide good pain relief, arthrodesis is associated to functional and psychological limitations, and arthroplasty is prone to failure in the active patient. More recently the use of bipolar fresh osteochondral allografts transplantation has been proposed as a promising alternative to the traditional treatments. Preliminary short- and long-term clinical outcomes for this procedure have been reported, but no functional evaluations have been performed to date. The clinical and functional outcomes of a series of 10 patients who underwent allograft transplantation at a mean follow-up of 14 months are reported. Clinical evaluation was performed with the AOFAS score, functional assessment by state-of-the-art gait analysis. The clinical score significantly improved from a median of 54 (range 12-65) pre-op to 76.5 (range 61-86) post-op (p=0.002). No significant changes were observed for the spatial-temporal parameters, but motion at the hip and knee joints during early stance, and the range of motion of the ankle joint in the frontal plane (control: 13.8°±2.9°; pre-op: 10.4°±3.1°, post-op: 12.9°±4.2°; p=0.02) showed significant improvements. EMG signals revealed a good recovery in activation of the biceps femoris. This study showed that osteochondral allograft transplantation improves gait patterns. Although re-evaluation at longer follow-ups is required, this technique may represent the right choice for patients who want to delay the need for more invasive joint reconstruction procedures. Copyright © 2013 Elsevier B.V. All rights reserved.

3H-TdR autoradiography in vitro incubation for the evaluation of the therapeutic effect in chronic atrophic gastritis

International Nuclear Information System (INIS)

Ding Jie

1988-01-01

This paper discussed with the feasibility of using 3 H-TdR autoraoiography in vitro incubation to evaluate the therapeutic effect of atrophic gastritis. The results showed that gastric mucosa labelling indices measured by autoradiography can reflect the property, severity and clincal conditions of chronic gastritis quantitatively. The methodology is raliable and reproducible. It was suggested that labelling indices may serve as a cytokinetic parameter to evaluate the therapeutic effect of atrophic gastritis

Early economic evaluation of emerging health technologies: protocol of a systematic review

Science.gov (United States)

2014-01-01

Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

MicroRNA-4639 Is a Regulator of DJ-1 Expression and a Potential Early Diagnostic Marker for Parkinson’s Disease

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Yimeng Chen

2017-07-01

Full Text Available Parkinson’s disease (PD is the second most common neurodegenerative disorder and has profound impacts on the daily lives of patients. However, there is a lack of effective biomarkers for early diagnosis, and the mechanisms of PD pathogenesis remain obscure. microRNAs (miRNAs are post-transcriptional gene regulators and can be easily detected in plasma, which suggests a promising role as diagnostic markers. Here, we aimed to explore a peripheral biomarker, which not only can be applied for early diagnosis of PD but also has the potential to be a therapeutic target. Through miRNA microarray screening and further validation in plasma from 169 sporadic PD patients, 170 healthy controls, and 60 essential tremor (ET patients, hsa-miR-4639-5p level was identified to be significantly up-regulated in PD patients. Also, it was able to discriminate between early PD patients (disease duration ≤2 years or Hoehn and Yahr stage 1–2.5 and healthy controls. Furthermore, hsa-miR-4639-5p was shown to negatively regulate DJ-1 (PARK7, a well-known PD-related gene, in the post-transcriptional level. Abnormal up-regulation of hsa-miR-4639-5p caused down-regulation of DJ-1 protein level, leading to severe oxidative stress and neuronal death. In conclusion, hsa-miR-4639-5p has the potential to be a peripheral diagnostic biomarker and therapeutic target for early PD.

Comparative evaluation of therapeutic efficacy of sulfadiazine-trimethoprim, oxytetracycline, enrofloxacin and florfenicol on Staphylococcus aureus-induced arthritis in broilers.

Science.gov (United States)

Mosleh, N; Shomali, T; Namazi, F; Marzban, M; Mohammadi, M; Boroojeni, A Motamedi

2016-04-01

Staphylococcus aureus is an important human and veterinary pathogen that causes economic loss in the poultry industry. This study aimed to compare therapeutic efficacy of 4 commonly used antibiotics in poultry on S. aureus-induced arthritis in broilers. Sixty broilers, 8 weeks of age, were assigned at random into 7 groups as follows: (1) negative control (n = 5); (2) vehicle control (n = 5); (3) sulfadiazine-trimethoprim, 250 ml/1000 l drinking water (n = 10); (4) oxytetracycline 20%, 1 mg/l drinking water (n = 10); (5) florfenicol 10%, 1/1000 v/v in drinking water (n = 10); (6) enrofloxacin 10%, 1/1000 v/v in drinking water (n = 10) and (7) positive control (n = 10). Birds in group 2 were injected with 1 ml of sterile TSB medium into the right tibiotarsal joint on d 0 while other birds (except group 1) were challenged with 1 ml of 1.2 × 10(10) CFU/ml suspension of S. aureus bacteria. Antibiotic therapy was started from d 4 post challenge and continued for 5 d. At the end, birds were weighed and clinical severity of arthritis was determined. After blood collection, birds were slaughtered and tibiotarsal and hip joints were evaluated grossly. The content of inflammatory exudates of tibiotarsal joint and the degree of femoral head necrosis were recorded. Mucin clot test and histopathological evaluation were performed on right tibiotarsal joint. Serum interleukin 6 was also assayed. Sulfadiazine-trimethoprim had higher therapeutic efficiency with regard to most of the assayed criteria, whereas none of the antibiotics significantly affected femoral head necrosis and body weight. These data will help clinicians to have better antibiotic choice in field conditions.

Early Detection of Brain Pathology Suggestive of Early AD Using Objective Evaluation of FDG-PET Scans

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James C. Patterson

2011-01-01

Full Text Available The need for early detection of AD becomes critical as disease-modifying agents near the marketplace. Here, we present results from a study focused on improvement in detection of metabolic deficits related to neurodegenerative changes consistent with possible early AD with statistical evaluation of FDG-PET brain images. We followed 31 subjects at high risk or diagnosed with MCI/AD for 3 years. 15 met criteria for diagnosis of MCI, and five met criteria for AD. FDG-PET scans were completed at initiation and termination of the study. PET scans were read clinically and also evaluated objectively using Statistical Parametric Mapping (SPM. Using standard clinical evaluation of the FDG-PET scans, 11 subjects were detected, while 18 were detected using SPM evaluation. These preliminary results indicate that objective analyses may improve detection; however, early detection in at-risk normal subjects remains tentative. Several FDA-approved software packages are available that use objective analyses, thus the capacity exists for wider use of this method for MCI/AD.

Understanding Early Post-Mortem Biochemical Processes Underlying Meat Color and pH Decline in the Longissimus thoracis Muscle of Young Blond d'Aquitaine Bulls Using Protein Biomarkers.

Science.gov (United States)

Gagaoua, Mohammed; Terlouw, E M Claudia; Micol, Didier; Boudjellal, Abdelghani; Hocquette, Jean-François; Picard, Brigitte

2015-08-05

Many studies on color biochemistry and protein biomarkers were undertaken in post-mortem beef muscles after ≥24 hours. The present study was conducted on Longissimus thoracis muscles of 21 Blond d'Aquitaine young bulls to evaluate the relationships between protein biomarkers present during the early post-mortem and known to be related to tenderness and pH decline and color development. pH values at 45 min, 3 h, and 30 h post-mortem were correlated with three, seven, and six biomarkers, respectively. L*a*b* color coordinates 24 h post-mortem were correlated with nine, five, and eight protein biomarkers, respectively. Regression models included Hsp proteins and explained between 47 and 59% of the variability between individuals in pH and between 47 and 65% of the variability in L*a*b* color coordinates. Proteins correlated with pH and/or color coordinates were involved in apoptosis or had antioxidative or chaperone activities. The main results include the negative correlations between pH45 min, pH3 h, and pHu and Prdx6, which may be explained by the antioxidative and phospholipase activities of this biomarker. Similarly, inducible Hsp70-1A/B and μ-calpain were correlated with L*a*b* coordinates, due to the protective action of Hsp70-1A/B on the proteolytic activities of μ-calpain on structural proteins. Correlations existed further between MDH1, ENO3, and LDH-B and pH decline and color stability probably due to the involvement of these enzymes in the glycolytic pathway and, thus, the energy status of the cell. The present results show that research using protein indicators may increase the understanding of early post-mortem biological mechanisms involved in pH and beef color development.

Evaluation of malignant solid tumor in childhood with FDG-PET

International Nuclear Information System (INIS)

Ishida, Amane; Goto, Hiroaki; Kuroki, Fumiko

2006-01-01

Usefulness of FDG-PET (18F-deoxyglucose PET) was examined in evaluation of diagnosis and therapeutic efficacy of childhood malignant solid tumors. Subjects were 32 patients (16 males) of the median age of 7 y (1 - 27 y), involving those with neuroblastoma (9 cases), hepatoblastoma (4), chronic granulomatous disorder (4) and others (each ≤2). They underwent 75 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from May 2001 to December 2003. Standard uptake value (SUV), 1 x 1 cm region of interest (ROI) of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt., was used for evaluation: SUV>1.5 was defined positive. In neuroblastoma, FDG was found to be highly distributed and kinetics of SUV, to be useful for evaluation of therapeutic efficacy and early metastasis detection. In some cases of hepatoblastoma, the therapeutic effectiveness and recurrence were not satisfactorily evaluative. The distribution of FDG was not satisfactory in Wilms' tumor relative to other tumors. The PET was thought to be useful, despite their small case number examined, for those evaluations of Ewing's tumor, dysgerminoma and Langerhans cell histiocytosis. Thus FDG-PET was found useful for detection, evaluation of therapeutic efficacy and early metastasis detection of pediatric malignant solid tumors. (T.I.)

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions.

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Baumel, Amit; Faber, Keren; Mathur, Nandita; Kane, John M; Muench, Fred

2017-03-21

Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects. As a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims). A total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary

Multicenter evaluation of rectal cancer reimaging post neoadjuvant (MERRION) therapy.

LENUS (Irish Health Repository)

Hanly, Ann M

2014-04-01

The aim of this study was to evaluate the utility of reimaging rectal cancer post-CRT (chemoradiotherapy) with magnetic resonance (MR) imaging of the pelvis for local staging and computed tomography of thorax, abdomen, and pelvis (CT TAP) to identify distant metastases.

Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

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Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

2013-03-01

Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

Early Seizures Prematurely Unsilence Auditory Synapses to Disrupt Thalamocortical Critical Period Plasticity

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Hongyu Sun

2018-05-01

Full Text Available Heightened neural excitability in infancy and childhood results in increased susceptibility to seizures. Such early-life seizures are associated with language deficits and autism that can result from aberrant development of the auditory cortex. Here, we show that early-life seizures disrupt a critical period (CP for tonotopic map plasticity in primary auditory cortex (A1. We show that this CP is characterized by a prevalence of “silent,” NMDA-receptor (NMDAR-only, glutamate receptor synapses in auditory cortex that become “unsilenced” due to activity-dependent AMPA receptor (AMPAR insertion. Induction of seizures prior to this CP occludes tonotopic map plasticity by prematurely unsilencing NMDAR-only synapses. Further, brief treatment with the AMPAR antagonist NBQX following seizures, prior to the CP, prevents synapse unsilencing and permits subsequent A1 plasticity. These findings reveal that early-life seizures modify CP regulators and suggest that therapeutic targets for early post-seizure treatment can rescue CP plasticity.

Post-therapeutic recovery of serum interleukin-35 level might predict positive response to immunosuppressive therapy in pediatric aplastic anemia.

Science.gov (United States)

Huang, Zhen; Tong, Hongfei; Li, Yuan; Zhou, Haixia; Qian, Jiangchao; Wang, Juxiang; Ruan, Jichen

2017-08-01

The predictive value of interleukin-35 (IL-35) on efficacy of immunosuppressive therapy (IST) in aplastic anemia (AA) has not been well investigated. The aim of the study was to evaluate the association between serum IL-35 level and response to IST in pediatric AA. A total of 154 children with AA and 154 controls were included between January 2012 and December 2013. Blood and bone marrow fluid specimens were collected. Serum level of IL-35 was determined by enzyme-linked immunosorbent assay. Patients were treated with IST, and response to therapy was evaluated during 180-day follow-up period after starting therapy. Serum levels of IL-35 at admission decreased significantly in patients compared with that in controls (10.9 ± 5.5 pg ml -1 and 45.3 ± 8.8 pg ml -1 , p < 0.001). After starting IST, serum levels of IL-35 in patients recovered 30.7 ± 9.7 pg ml -1 in the first 28 days (p < 0.001). During the follow-up period, increased range of serum IL-35 level ≥30.7 pg ml -1 in the first 28 days was associated with effective response to therapy (odds ratio 7.97, 95% confidence interval 3.82-16.79). In addition, Fas/FasL protein expression in bone marrow mononuclear cells dropped significantly in the same group of patients in the first 28 days (p < 0.05). The study revealed that post-therapeutic recovery of circulating IL-35 concentration might be an independent predictor for effective response to IST in pediatric AA. Moreover, apoptosis might be involved in such a forecasting process.

Renal Sympathetic Denervation System via Intraluminal Ultrasonic Ablation: Therapeutic Intravascular Ultrasound Design and Preclinical Evaluation.

Science.gov (United States)

Chernin, Gil; Szwarcfiter, Iris; Bausback, Yvonne; Jonas, Michael

2017-05-01

To assess the safety and performance of a nonfocused and nonballooned ultrasonic (US) catheter-based renal sympathetic denervation (RDN) system in normotensive swine. RDN with the therapeutic intravascular US catheter was evaluated in 3 experiments: (i) therapeutic intravascular US RDN vs a control group of untreated animals with follow-up of 30, 45, and 90 days (n = 6; n = 12 renal arteries for each group); (ii) therapeutic intravascular US RDN vs radiofrequency (RF) RDN in the contralateral artery in the same animal (n = 2; n = 4 renal arteries); and (iii) therapeutic intravascular US RDN in a recently stent-implanted renal artery (n = 2; n = 4 renal arteries). In the first experiment, therapeutic intravascular US RDN was safe, without angiographic evidence of dissection or renal artery stenosis. Neuronal tissue vacuolization, nuclei pyknosis, and perineuronal inflammation were evident after RDN, without renal artery wall damage. Norepinephrine levels were significantly lower after therapeutic intravascular US RDN after 30, 45, and 90 days compared with the control group (200.17 pg/mg ± 63.35, 184.75 pg/mg ± 44.51, and 203.43 pg/mg ± 58.54, respectively, vs 342.42 pg/mg ± 79.97). In the second experiment, deeper neuronal ablation penetrance was found with therapeutic intravascular US RDN vs RF RDN (maximal penetrance from endothelium of 7.0 mm vs 3.5 mm, respectively). There was less damage to the artery wall after therapeutic intravascular US RDN than with RF RDN, after which edema and injured endothelium were seen. In the third experiment, denervation inside the stent-implanted segments was feasible without damage to the renal artery wall or stent. The therapeutic intravascular US system performed safely and reduced norepinephrine levels. Deeper penetrance and better preservation of vessel wall were observed with therapeutic intravascular US RDN vs RF RDN. Neuronal ablations were observed in stent-implanted renal arteries. Copyright © 2017 SIR. Published

Therapeutic Vaccines and Antibodies for Treatment of Orthopoxvirus Infections

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Stuart N. Isaacs

2010-10-01

Full Text Available Despite the eradication of smallpox several decades ago, variola and monkeypox viruses still have the potential to become significant threats to public health. The current licensed live vaccinia virus-based smallpox vaccine is extremely effective as a prophylactic vaccine to prevent orthopoxvirus infections, but because of safety issues, it is no longer given as a routine vaccine to the general population. In the event of serious human orthopoxvirus infections, it is important to have treatments available for individual patients as well as their close contacts. The smallpox vaccine and vaccinia immune globulin (VIG were used in the past as therapeutics for patients exposed to smallpox. VIG was also used in patients who were at high risk of developing complications from smallpox vaccination. Thus post-exposure vaccination and VIG treatments may again become important therapeutic modalities. This paper summarizes some of the historic use of the smallpox vaccine and immunoglobulins in the post-exposure setting in humans and reviews in detail the newer animal studies that address the use of therapeutic vaccines and immunoglobulins in orthopoxvirus infections as well as the development of new therapeutic monoclonal antibodies.

Therapeutic effect of Arctium lappa in Schistosoma haematobium associated kidney disturbance: biochemical and molecular effects.

Science.gov (United States)

Koriem, Khaled M M; Idris, Zulzamri H; Haron, Hasniza F; Omar, Nurulhuda A; Lazain, Halita S

2016-12-01

Schistosoma haematobium ( S. haematobium ) infection has been found to be strongly associated with bladder cancer, which necessitates for discover of a natural new therapeutic agent. The aim of this study was to evaluate the therapeutic effect of Arctium lappa seed extract in S. haematobium associated kidney disturbance. Forty male albino mice were used and divided into four equal groups; group 1 control includes non-infected healthy mice, groups 2, 3 and 4 subcutaneous infected with S. haematobium cercariae. Groups 3 co-treated daily with oral dose of A. lappa seed extract (300 mg/kg, bwt) for 15 days in the same time of S. haematobium infection. Groups 4 post-treated daily for 15 days with oral dose of A. lappa seed extract (300 mg/kg, bwt) after 15 days of S. haematobium infection. The results obtained revealed that S. haematobium significantly decreased kidney weight and serum sodium, potassium and chloride, but increased urinary volume, urinary excretion of sodium, potassium and chloride, serum urea, creatinine and uric acid. Schistosoma haematobium also significantly decreased kidney superoxide dismutase, glutathione peroxidase and reduced glutathione levels while increased kidney lipid peroxidation level. Co- and post-treatment with A. lappa seed extract restore all the above parameters to approach the normal values. These results were supported with histopathological examinations. In conclusion, A. lappa seed extract has therapeutic effect in kidney disturbance caused by S. haematobium where co-treatment of A. lappa seed extract was more effective than post-treatment of the extract.

Benefits of PEGylation in the early post-transplant period of intraportal islet transplantation as assessed by magnetic resonance imaging of labeled islets.

Science.gov (United States)

Jin, Sang-Man; Oh, Seung-Hoon; Oh, Bae Jun; Suh, Sunghwan; Bae, Ji Cheol; Lee, Jung Hee; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Kwang-Won; Kim, Jae Hyeon

2014-01-01

While a few studies have demonstrated the benefit of PEGylation in islet transplantation, most have employed renal subcapsular models and none have performed direct comparisons of islet mass in intraportal islet transplantation using islet magnetic resonance imaging (MRI). In this study, our aim was to demonstrate the benefit of PEGylation in the early post-transplant period of intraportal islet transplantation with a novel algorithm for islet MRI. Islets were PEGylated after ferucarbotran labeling in a rat syngeneic intraportal islet transplantation model followed by comparisons of post-transplant glycemic levels in recipient rats infused with PEGylated (n = 12) and non-PEGylated (n = 13) islets. The total area of hypointense spots and the number of hypointense spots larger than 1.758 mm(2) of PEGylated and non-PEGylated islets were quantitatively compared. The total area of hypointense spots (P islet group 7 and 14 days post translation (DPT). These results translated into better post-transplant outcomes in the PEGylated islet group 28 DPT. In validation experiments, MRI parameters obtained 1, 7, and 14 DPT predicted normoglycemia 4 wk post-transplantation. We directly demonstrated the benefit of islet PEGylation in protection against nonspecific islet destruction in the early post-transplant period of intraportal islet transplantation using a novel algorithm for islet MRI. This novel algorithm could serve as a useful tool to demonstrate such benefit in future clinical trials of islet transplantation using PEGylated islets.

Effect of ultraviolet light irradiation on bond strength of fiber post: Evaluation of surface characteristic and bonded area of fiber post with resin cement

OpenAIRE

Reza, Fazal; Ibrahim, Nur Sukainah

2015-01-01

Objective: Fiber post is cemented to a root canal to restore coronal tooth structure. This research aims to evaluate the effect of ultraviolet (UV) irradiation on bond strength of fiber post with resin cement. Materials and Methods: A total of 40 of the two types of fiber posts, namely, FRC Prostec (FRC) and Fiber KOR (KOR), were used for the experiment. UV irradiation was applied on top of the fiber post surface for 0, 15, 20, and 30 min. The irradiated surface of the fiber posts (n = 5) wer...

A Comparison of Therapeutic Modalities for Septated Tuberculous PleuraI Effusion on US

Energy Technology Data Exchange (ETDEWEB)

Cho, In Hwan; Kim, Kyeong Ah; Kim, Chul Joong; Kang, Eun Young; Cha, In Ho [Dae Rim St. Mary' s Hospital, Seoul (Korea, Republic of); Sim, Jae Jung [Korea University College of Medicine, Seoul (Korea, Republic of)

1995-12-15

To evaluate the utility of ultrasonography as a guide of determination of therapeutic modality an dto compare the therapeutic effects of modalities in patients with tuberculous pleural effusion. This study included 47 patients who had multiple septations on ultrasonography. We classified ultrasonographic pattern of pleural effusion into three groups according to pattern of septation : linear(n=6),moderate(n=19), honeycombing(n=22). We also classified therapeutic modalities into three groups : thoracentesis group(n=13), percutaneous catheter drainage group(n=11), intrapleural urokinase instillation group(n=23). We assessed the early and late therapeutic effects of these groups prospectively with follow-up chest radiographs. There was statistically no significant difference in therapeutic effect among the groups that had linear and moderate septa on ultrasonography(p<0.01). In patients with honeycombing septa, the therapeutic effects of catheter group and urokinase group were superior to conservative thoracentesis group(p<0.01). In urokinase group,mean duration of drainage(6.6 days) was significantly shorter than catheter group's(12.4 days) (p<0.01). Pattern of septation on ultrasonography could be an useful factor for determination of the therapeutic modality in patients with tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation is a good therapeutic modality with shortened duration of drainage in treatment of pleural effusion with honeycombing septae

A Comparison of Therapeutic Modalities for Septated Tuberculous PleuraI Effusion on US

International Nuclear Information System (INIS)

Cho, In Hwan; Kim, Kyeong Ah; Kim, Chul Joong; Kang, Eun Young; Cha, In Ho; Sim, Jae Jung

1995-01-01

To evaluate the utility of ultrasonography as a guide of determination of therapeutic modality an dto compare the therapeutic effects of modalities in patients with tuberculous pleural effusion. This study included 47 patients who had multiple septations on ultrasonography. We classified ultrasonographic pattern of pleural effusion into three groups according to pattern of septation : linear(n=6),moderate(n=19), honeycombing(n=22). We also classified therapeutic modalities into three groups : thoracentesis group(n=13), percutaneous catheter drainage group(n=11), intrapleural urokinase instillation group(n=23). We assessed the early and late therapeutic effects of these groups prospectively with follow-up chest radiographs. There was statistically no significant difference in therapeutic effect among the groups that had linear and moderate septa on ultrasonography(p<0.01). In patients with honeycombing septa, the therapeutic effects of catheter group and urokinase group were superior to conservative thoracentesis group(p<0.01). In urokinase group,mean duration of drainage(6.6 days) was significantly shorter than catheter group's(12.4 days) (p<0.01). Pattern of septation on ultrasonography could be an useful factor for determination of the therapeutic modality in patients with tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation is a good therapeutic modality with shortened duration of drainage in treatment of pleural effusion with honeycombing septae

Gross and histological evaluation of early lesions of navicular bone and deep digital flexor tendon in horses

Directory of Open Access Journals (Sweden)

Komosa Marcin

2014-03-01

Full Text Available The study aimed at evaluation of pathological lesions on flexor surface of navicular bone and deep digital flexor tendon in horses graded in standard X-ray examination as 2 (fair. The evaluation was performed on fifteen horses (6-9 years of age. Analysis procedure involved examining navicular bones on X-ray pictures, post-slaughter preparation of navicular bones from the hoof capsule, macroscopic evaluation of fibrocartilage on flexor surface, and analysis of histologic preparations. In horses with navicular bones graded as 2, early pathological changes have already developed, even if such horses were not lame. The pathological changes included fibrillation and disruption of deep digital flexor tendon surface, loss of fibrocartillage in sagittal ridge area of navicular bone, thinning of subchondral bone on its flexor surface, and fibromyxoid changes in chondroid matrix. In terms of clinical relevance, more studies are needed to understand the sequence of changes in a better way.

Therapeutic effects of hydrogen on chronic graft-versus-host disease.

Science.gov (United States)

Qian, Liren; Liu, Xiaopeng; Shen, Jianliang; Zhao, Defeng; Yin, Wenjie

2017-10-01

The incidence of chronic graft-versus-host disease (cGVHD) is rising recent years, which has been the leading cause of non-transplantation mortality post allogenetic hematopoietic stem cell transplantation (HSCT). Imbalance of inflammatory cytokines and fibrosis plays critical roles in the pathogenesis of cGVHD. Recent studies showed that molecular hydrogen has anti-inflammatory, antioxidant, anti-fibrosis effects. Therefore, we hypothesized that molecular hydrogen may have therapeutic effects on cGVHD. To determine whether hydrogen could protect mice from cGVHD in an MHC-incompatible murine bone marrow transplantation (BMT) model, survival rates of mice were calculated, and skin lesions were also evaluated after BMT. This article demonstrated that administration of hydrogen-rich saline increased survival rate of cGVHD mice. Administration of hydrogen-rich saline after transplantation also reduced skin lesions of cGVHD mice. Previously, we reported the therapeutic effects of hydrogen on acute GVHD. However, there was no report on the therapeutic effects of hydrogen on cGVHD mice. It is suggested that hydrogen has a potential as an effective and safe therapeutic agent on cGVHD. This study will provide new ideas on the treatment of cGVHD and has important theoretical values. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Kompleksowe postępowanie fizjoterapeutyczne w skręceniu stawu skokowego

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Paulina Brzezińska

2015-09-01

e-mail: brzezinskapp@gmail.com   Streszczenie Wstęp: Skręcenia stawu skokowego zaliczane są do jednych z najczęściej spotykanych urazów kończyn dolnych. Pomimo częstości występowania, nadal wielokrotnie są one lekceważone, zarówno w aspekcie wczesnej i prawidłowej diagnostyki medycznej jak i zastosowania szybkiego i optymalnego postępowania leczniczego. Cel pracy: Usystematyzowanie wiedzy na temat postępowania terapeutycznego, u osób po urazie stawu skokowego. Wnioski: W postępowaniu terapeutycznym u  osób po urazie stawu skokowego najważniejszą rolę odgrywa diagnostyka radiologiczna oraz kliniczna pozwalająca                    na postawienie właściwej diagnozy oraz na kreślenie celów terapii. Kompleksowe postępowanie fizjoterapeutyczne wpływa istotnie na skrócenie czasu koniecznego                          do przywrócenia możliwego do osiągnięcia poziomu funkcjonalnego pacjentów i zwiększa skuteczność stosowanych terapii.   Summary Introduction: Ankle sprains are classified as one of the most common injuries of the lower extremities.  This type of inquiry is still frequently underestimated, both in terms of early and proper medical diagnosis and the use of fast and optimal therapeutic management. Aim: Systematization of knowledge relating to the treatment of the ankle injuries, and analyze the therapeutic treatment and its effectiveness in the ankle sprains. Conclusions: Radiological and clinical diagnosis plays a key role in a normal therapeutic procedure for a person after ankle injury. It allows for diagnose and sets a objectives hierarchy for the optimized therapy. Comprehensive physiotherapy have a significant impact on the functional state of patients with ankle sprains significantly. increasing effectiveness of therapy.

Observational therapeutics: Scope, challenges, and organization.

Science.gov (United States)

Vaidya, Rama

2011-10-01

The importance of Observational Therapeutics in the progress of medicine has been neglected in the current era of the hierarchal position imparted to Randomized Controlled Trials (RCTs) for new drug discovery and practice of evidence-based medicine. There is a need to reflect on the reason for many new drugs being withdrawn during post marketing surveillance. There are several examples in literature where drug-discovery has originated initially from keen clinical and / or laboratory observations. The roots of these discoveries have often been from observations made by practitioners of traditional medicine including Ayurveda. The present article draws attention to the scope and challenges for observational therapeutics. There is an urgent need for the meticulous planning for a systematic organization of developing observational therapeutics, with a full understanding of its strengths and limitations.

Observational therapeutics: Scope, challenges, and organization

Directory of Open Access Journals (Sweden)

Rama Vaidya

2011-01-01

Full Text Available The importance of Observational Therapeutics in the progress of medicine has been neglected in the current era of the hierarchal position imparted to Randomized Controlled Trials (RCTs for new drug discovery and practice of evidence-based medicine. There is a need to reflect on the reason for many new drugs being withdrawn during post marketing surveillance. There are several examples in literature where drug-discovery has originated initially from keen clinical and / or laboratory observations. The roots of these discoveries have often been from observations made by practitioners of traditional medicine including Ayurveda. The present article draws attention to the scope and challenges for observational therapeutics. There is an urgent need for the meticulous planning for a systematic organization of developing observational therapeutics, with a full understanding of its strengths and limitations.

Therapeutic Nanodevices

Science.gov (United States)

Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

Post-injury stretch promotes recovery in a rat model of muscle damage induced by lengthening contractions.

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Mori, Tomohiro; Agata, Nobuhide; Itoh, Yuta; Inoue-Miyazu, Masumi; Mizumura, Kazue; Sokabe, Masahiro; Taguchi, Toru; Kawakami, Keisuke

2017-06-30

We investigated the cellular mechanisms and therapeutic effect of post-injury stretch on the recovery process from muscle injury induced by lengthening contractions (LC). One day after LC, a single 15-min bout of muscle stretch was applied at an intensity of 3 mNm. The maximal isometric torque was measured before and at 2-21 days after LC. The myofiber size was analyzed at 21 days after LC. Developmental myosin heavy chain-immunoreactive (dMHC-ir) cells, a marker of regenerating myofibers, were observed in the early recovery stage (2-5 days after LC). We observed that LC-induced injury markedly decreased isometric torque and myofiber size, which recovered faster in rats that underwent stretch than in rats that did not. Regenerating myofiber with dMHC-ir cells was observed earlier in rats that underwent stretch. These results indicate that post-injury stretch may facilitate the regeneration and early formation of new myofibers, thereby promoting structural and functional recovery from LC-induced muscle injury.

[Process and key points of clinical literature evaluation of post-marketing traditional Chinese medicine].

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Liu, Huan; Xie, Yanming

2011-10-01

The clinical literature evaluation of the post-marketing traditional Chinese medicine is a comprehensive evaluation by the comprehensive gain, analysis of the drug, literature of drug efficacy, safety, economy, based on the literature evidence and is part of the evaluation of evidence-based medicine. The literature evaluation in the post-marketing Chinese medicine clinical evaluation is in the foundation and the key position. Through the literature evaluation, it can fully grasp the information, grasp listed drug variety of traditional Chinese medicines second development orientation, make clear further clinical indications, perfect the medicines, etc. This paper discusses the main steps and emphasis of the clinical literature evaluation. Emphasizing security literature evaluation should attach importance to the security of a comprehensive collection drug information. Safety assessment should notice traditional Chinese medicine validity evaluation in improving syndrome, improveing the living quality of patients with special advantage. The economics literature evaluation should pay attention to reliability, sensitivity and practicability of the conclusion.

Evaluating prestressing strands and post-tensioning cables in concrete structures using nondestructive methods.

Science.gov (United States)

2015-11-01

The objectives were to evaluate the ability of different NDE methods to detect and quantify : defects associated with corrosion of steel reinforcement and grout defects in post-tensioning : applications; and to evaluate the effectiveness of selected ...

Outcome of early pars plana vitrectomy in exogenous endophthalmitis

International Nuclear Information System (INIS)

Dar, A.J.; Islam, Q.U.; Hanif, M.K.

2013-01-01

Objective: To evaluate the role of early pars plana vitrectomy (PPV) in cases of exogenous endophthalmitis in terms of final visual outcome and to determine association between various study variables and final visual outcome. Study Design: Quasi experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from Aug 2010 to May 2012. Patients and Methods: Eleven cases of exogenous endophthalmitis (post surgical/post traumatic) were managed surgically through 20 G or 23/25 G complete and early PPV. Vitreous aspirate/explanted intraocular lens (IOL) were sent for culture and sensitivity in all cases. Intra and post operative complications were recorded and best corrected visual acuity (BCVA) at 3 months post operative interval was taken as final visual acuity. Results: Median age of study population was 55 years with male preponderance (64%). Approximately 2/3 rd of study population developed endophthalmitis within 6 weeks of surgery/trauma and 55% of patients were operated within 2 weeks of presentation. Positive culture from vitreous aspirate/IOL explant was obtained in 27% of cases. All the patients had initial BCVA in the range of counting finger (CF) at 2 meter to perception of light (PL+). However, 18% of the patients achieved final BCVA of 6/12 or better and 64% achieved final BCVA of 6/36 or better. Maculopathy (macular scar, macular pucker), corneal decompensation, corneal opacity and raised intraocular pressure were the major complications associated with compromised visual outcome. Conclusion: With the advancement in vitreoretinal surgical techniques and availability of more sophisticated viewing and illumination systems, early and complete vitrectomy for post operative or post traumatic endophthalmitis results in favorable visual outcome and early rehabilitation. (author)

A Preclinical Assessment of Early Continuous Passive Motion and Treadmill Therapeutic Exercises for Generating Chondroprotective Effects After Anterior Cruciate Ligament Rupture.

Science.gov (United States)

Chang, Nai-Jen; Lee, Kuan-Wei; Chu, Chih-Jou; Shie, Ming-You; Chou, Pei-Hsi; Lin, Chih-Chan; Liang, Peir-In

2017-08-01

Anterior cruciate ligament (ACL) injury is a well-known risk factor for the development of posttraumatic osteoarthritis (PTOA). However, whether using continuous passive motion (CPM) with or without additional treadmill exercise (TRE) in early ACL injury might provide chondroprotective effects and further decrease the risk of PTOA has yet to be determined. CPM may offer an enhanced chondroprotective effect, but TRE may attenuate that effect due to the mechanical stress on the joint and inflammatory cytokines in the joint. Controlled laboratory study. Thirty adult New Zealand White male rabbits were randomly allocated to sedentary (SED), CPM, TRE, or CPM+TRE groups. Each rabbit underwent an ACL transection (ACLT) on the right knee, with the contralateral knee used as an internal control (sham). The 4 joint surfaces (ie, medial and lateral femoral condyles and tibial plateaus) were evaluated 4 weeks after surgery for gross appearance, histological characteristics, and quantitative osteoarthritis (OA) scores. Overall, at the end of testing, the CPM group experienced the best protective therapeutic effects in all compartments. In gross appearance, CPM resulted in normal articular surfaces, while the TRE and SED groups exhibited surface abrasion. Histological analysis showed significant differences in articular cartilage status. The CPM group had significantly better histological OA scores ( P CPM+TRE group displayed visible pathological changes in the superficial cartilage, indicating that early loading exercise may contribute to osteoarthritis. The sham treatment showed no difference in the changes in all compartments between groups. Immediate CPM therapy produces a superior in situ microenvironment for reducing the occurrence of PTOA after ACL injury without reconstruction in rabbits. These data suggest that immediate application of CPM therapy may be necessary to create a sound microenvironment in joints and possibly to decrease the risk of PTOA without or while

Prevention and early intervention of anxiety problems in young children: A pilot evaluation of Cool Little Kids Online

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Amy J. Morgan

2016-05-01

Full Text Available Anxiety disorders are common, debilitating, and begin early in life. Early intervention to prevent anxiety disorders in children who are at risk could have long-term impact. The ‘Cool Little Kids’ parenting group program has previously been shown to be efficacious in preventing anxiety disorders in temperamentally inhibited young children. Wider dissemination of the program could be achieved with an internet-based delivery platform, affording greater accessibility and convenience for parents. The aim of this study was to evaluate ‘Cool Little Kids Online’, a newly developed online version of the existing parenting group program. Fifty-one parents of children aged 3–6 years were recruited to evaluate the online program's acceptability and preliminary efficacy in reducing inhibited young children's anxiety problems. Parents were randomized to receive either a clinician-supported version or an unsupported version of the program. Parents had 10 weeks to access the program and completed questionnaires at baseline and post-intervention. Both groups showed medium-to-large reductions in children's anxiety symptoms, emotional symptoms, number of child anxiety diagnoses, and improvements in life interference from anxiety. The effect of clinician support was inconsistent and difficult to interpret. Parents reported high levels of satisfaction with the program. These encouraging results indicate that the online version is acceptable and useful for parents with temperamentally inhibited young children. Cool Little Kids Online may be a promising direction for improving access to an evidence-based prevention and early intervention program for child anxiety problems. A large randomized trial is warranted to further evaluate efficacy.

Evaluation of post-operative prophylactic irradiation for carcinoma of the esophagus

International Nuclear Information System (INIS)

Mafune, Ken-ichi; Tanaka, Yoichi; Fujita, Kichishiro; Sakura, Mizuyoshi

1987-01-01

Of 147 patients with carcinoma of the esophagus resected at Saitama Cancer Center Hospital for 10 years, 98 cases were studied to evaluate post-operative prophylactic irradiation. The total dose of irradiation was up to 4,000 ∼ 5,000 rads of Linac X-ray and the irradiated field was T-shaped covering the upper mediastinal and bilateral cervical regions. The prognosis of the post-operative irradiated group (56 cases) was significantly better than that of the control group (42 cases) (p < 0.01). This study resulted in a five-year survival rate of 34.2 percent for patients in the post-operative irradiated group, compared to 16.7 percent for those in the control group. Further detailed comparative studies revealed similar results. Cancer recurrence occurred at the irradiated fields in 8 cases (14.3 %), though in 15 cases (35.7 %) of the control group. This suggested the local suppressive effect of the post-operative irradiation to the cancer recurrence. (author)

Accuracy of a pediatric early warning score in the recognition of clinical deterioration

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Juliana de Oliveira Freitas Miranda

Full Text Available ABSTRACT Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and VassarStats.net programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likelihood ratios and post-test probability. Results: the Brighton Pediatric Early Warning Score for the Brazilian context showed sensitivity of 73.9%, specificity of 95.5%, positive predictive value of 73.3%, negative predictive value of 94.7%, area under Receiver Operating Characteristic Curve of 91.9% and the positive post-test probability was 80%. Conclusion: the Brighton Pediatric Early Warning Score for the Brazilian context, presented good performance, considered valid for the recognition of clinical deterioration warning signs of the children studied.

The short mean length of stay of post-emergency geriatric units is associated with the rate of early readmission in frail elderly.

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Traissac, Thalie; Videau, Marie-Neige; Bourdil, Marie-José; Bourdel-Marchasson, Isabelle; Salles, Nathalie

2011-06-01

Specific postemergency short-stay geriatric units may decrease length of hospital stay, functional decline, and early readmission rates. The aim of this study was to evaluate risk factors of early rehospitalization in a shortstay geriatric unit. This study was a prospective observational study comprising over one year patients aged over 75 years, admitted to the post-emergency short-stay geriatric unit (Hôpital Saint André, Bordeaux, France) and discharged home. Socio-demographic data, length of hospital stay, and a standardized geriatric assessment were collected for all patients. One month after home discharge, patients were followed-up by phone, and the hospital readmission rate was calculated. descriptive, unvaried and multivariate analyses were carried out. A total of 476 patients were included in this study (mean age 86.5±6 yrs; 154 men, 322 women). Mean length of stay in the post-emergency short-stay geriatric unit was 6.3±2.7 days, and a total of 68 (14.3%) patients were readmitted within one month after home discharge. The readmission rate was associated with a diagnosis of delirium (Odds Ratio (OR) 1.9; 95% CI 1.1-3.3; p=0.02), mean length of stay exceeding 6 days (OR 1.9, 95% CI 1.1-3.5; p=0.02), and decision of home discharge (OR 2.4; 95% CI 1.4-4.1; p=0.002). Short mean lengths of stay were not considered as a risk factor for readmissions within one month, even in frail, dependent, hospitalized elderly persons.

Evaluation of Two Dry Commercial Therapeutic Diets for the Management of Feline Chronic Gastroenteropathy

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Sally C. Perea

2017-05-01

Full Text Available Management of feline chronic gastroenteropathies has included intervention with both veterinary therapeutic formulas designed to manage non-specific gastrointestinal disorders and those designed with limited novel or hydrolyzed ingredients for management of food-responsive enteropathies and steroid-responsive enteropathies (inflammatory bowel disease. There have been few studies evaluating the use of dietary intervention for the management of feline chronic gastroenteropathy. This prospective, multi-center study evaluated the use of two commercially available feline veterinary therapeutic dry diets designed to manage non-specific gastrointestinal disorders in 28 cats with a history of chronic vomiting and/or diarrhea. The majority of cats enrolled in the study had a history of vomiting (n = 25, with a smaller number having a history of concurrent diarrhea (n = 2 or diarrhea alone (n = 3. Cats were excluded if diagnostic tests identified any systemic or infectious disease that could be associated with the clinical signs of vomiting or diarrhea, and if they were panhypoproteinemic, hypoalbuminemic, hypocobalaminemic, or had a Spec fPL ≥5.4 µg/L. Cats were randomized to one of two veterinary therapeutic diets for 4 weeks. Feeding of both therapeutic diets resulted in a numeric reduction in the number of vomiting episodes over the 4-week period, but no significant differences were seen between dietary interventions. When looking within dietary groups, significant differences were seen in cats fed Diet A with reductions of 69.1, 73.3, and 63.2% (p values of 0.008, 0.003, and 0.029 in weeks 2, 3, and 4, respectively, when compared to week 0. The probability of vomiting also showed significant reductions in cats fed Diet A between weeks 0 and 2, 3, and 4, with odds ratios of 0.008, 0.005, and 0.005, respectively (p values of 0.038, 0.23, and 0.23. Results of this study demonstrate that a veterinary therapeutic gastrointestinal

Clinical, Epidemiological and Therapeutic Evaluation in 14 Cases of Inflammatory Breast Cancer in Canines

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Celina Gomes da Silva

2014-06-01

Full Text Available With the aim of evaluating clinical aspects, age, breed, presence of metastasis, chemotherapeutical protocol, use of COX-2 inhibitors and survival rate in female dogs diagnosed with inflammatory carcinoma at the Hospital Veterinario de Uberaba (HVU, a retrospective analysis was performed on the medical records of 14 female dogs seen at HVU between July, 2011 and July, 2012 and diagnosed with inflammatory breast cancer. The breeds included were crossbred, poodle, Brazilian terrier, teckel and Belgian shepherd. Average age: 11.1 years. Outbreaks of distant metastasis were detected in 7 animals, out of which 5 patients received COX-2 inhibitors as sole treatment and only 4 received chemotherapeutical treatment. The protocol, constituted by piroxicam, cyclophosphamide, carboplatin and doxorubicin showed the highest survival time (210 days. In conclusion, inflammatory carcinoma is a disease of bad prognosis, short survival time and produces systemic alterations that reduce therapeutic response. Apparently, the most accurate therapeutic form is the association of COX-2 inhibitors and chemotherapeutics; however, controlled clinical studies are needed in order to evaluate these suggestions.

The Evaluation of Yellow vs. Blue Color Contrast Sensitivity pre and Post LASIK

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S. Heydarian

2007-06-01

Full Text Available Introduction: contrast sensitivity is one of the most important psychophysical tests that may be used for the evaluation of refractive state of eye and retinal image quality. Yellow vs. blue color contrast sensitivity may be more suitable in this regard. Materials and Methods: thirty myopic eyes were considered in this study. Yellow vs. blue color contrast sensitivity was evaluated under the same environment and conditions in these individuals pre and post LASIK. Results: The comparison of yellow vs. blue color contrast sensitivity with glasses pr e and post LASIK shows a significant improvement (p

KRAS early testing: consensus initiative and cost-effectiveness evaluation for metastatic colorectal patients in an Italian setting.

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Carlo Barone

Full Text Available KRAS testing is relevant for the choice of the most appropriate first-line therapy of metastatic colorectal cancer (CRC. Strategies for preventing unequal access to the test should be implemented, but their relevance in the practice is related to economic sustainability. The study adopted the Delphi technique to reach a consensus on several topics. Issues related to execution of KRAS testing were identified by an expert's board and proposed to 108 Italian oncologists and pathologists through two subsequent questionnaires. The emerging proposal was evaluated by decision analyses models employed by technology assessment agencies in order to assess cost-effectiveness. Alternative therapeutic strategies included most commonly used chemotherapy regimens alone or in combination with cetuximab or bevacizumab. The survey indicated that time interval for obtaining KRAS test should not exceed 15 days, 10 days being an optimal interval. To assure the access to proper treatment, a useful strategy should be to anticipate the test after radical resection in patients at high risk of relapse. Early KRAS testing in high risk CRC patients generates incremental cost-effectiveness ratios between 6,000 and 13,000 Euro per quality adjusted life year (QALY gained. In extensive sensitivity analyses ICER's were always below 15,000 Euro per QALY gained, far within the threshold of 60,000 Euro/QALY gained accepted by regulatory institutions in Italy. In metastatic CRC a time interval higher than 15 days for result of KRAS testing limits access to therapeutic choices. Anticipating KRAS testing before the onset of metastatic disease in patients at high risk does not affect the sustainability and cost-effectiveness profile of cetuximab in first-line mCRC. Early KRAS testing may prevent this inequality in high-risk patients, whether they develop metastases, and is a cost-effective strategy. Based on these results, present joined recommendations of Italian societies of

RNAi Therapeutics in Autoimmune Disease

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Seunghee Cha

2013-03-01

Full Text Available Since the discovery of RNA interference (RNAi, excitement has grown over its potential therapeutic uses. Targeting RNAi pathways provides a powerful tool to change biological processes post-transcriptionally in various health conditions such as cancer or autoimmune diseases. Optimum design of shRNA, siRNA, and miRNA enhances stability and specificity of RNAi-based approaches whereas it has to reduce or prevent undesirable immune responses or off-target effects. Recent advances in understanding pathogenesis of autoimmune diseases have allowed application of these tools in vitro as well as in vivo with some degree of success. Further research on the design and delivery of effectors of RNAi pathway and underlying molecular basis of RNAi would warrant practical use of RNAi-based therapeutics in human applications. This review will focus on the approaches used for current therapeutics and their applications in autoimmune diseases, including rheumatoid arthritis and Sjögren’s syndrome.

Therapeutic and post-lesional aspects of enzootic pneumonia in pigs

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Adrian C. Stancu

2013-01-01

The mycoplasmas are causing significant economic damage, these conditions being constant attention of farmers and veterinary services. Economic losses may be due to mortality, veterinary restrictions, a decrease in meat production, increased feed consumption and expenditure specific therapeutic and control measures. The conducted reaserches aimed at methods of disease treatment and diagnosis of enzootic pneumonia based on morphopathological lesions (macroscopic and histopathological)in dead p...

Recommendations for measurement of tumour vascularity with positron emission tomography in early phase clinical trials

International Nuclear Information System (INIS)

Aboagye, Eric O.; Kenny, Laura M.; Myers, Melvyn; Gilbert, Fiona J.; Fleming, Ian N.; Beer, Ambros J.; Cunningham, Vincent J.; Marsden, Paul K.; Visvikis, Dimitris; Gee, Antony D.; Groves, Ashley M.; Cook, Gary J.; Kinahan, Paul E.; Clarke, Larry

2012-01-01

The evaluation of drug pharmacodynamics and early tumour response are integral to current clinical trials of novel cancer therapeutics to explain or predict long term clinical benefit or to confirm dose selection. Tumour vascularity assessment by positron emission tomography could be viewed as a generic pharmacodynamic endpoint or tool for monitoring response to treatment. This review discusses methods for semi-quantitative and quantitative assessment of tumour vascularity. The radioligands and radiotracers range from direct physiological functional tracers like [ 15 O]-water to macromolecular probes targeting integrin receptors expressed on neovasculature. Finally we make recommendations on ways to incorporate such measurements of tumour vascularity into early clinical trials of novel therapeutics. (orig.)

Evaluation of the therapeutic effect of hydroxyapatite particles labeled with Ho166 in rats with acute and chronic arthritis

International Nuclear Information System (INIS)

Mendoza Lopez, Patricia

2002-01-01

The therapeutic effect of an intraarticular injection of hydroxyapatite particles labeled with Holmium-166 ( Ho 166 HA) was evaluated. For this evaluation 72 antigen-induced arthritis rats; the arthritis was induced by an intraarticular injection of a suspension of ovoalbumin and Freund's adjuvant complete. The 72 rats were divided in three groups: control group, acute arthritis group and chronic arthritis group. The evaluation of the therapeutic effect was achieved by the measuring of the perimeter of the arthritic knee joint in different days after the intraarticular injection of 0,5 μCi of Ho 166 -HA (day 0, 4, 9, 14, 19, 30). Also a biological distribution study was done at 4, 24 and 48 hours in different organs, through the counting of its radiation. The results of the biological distribution showed that a very high percent of the injected activity remains inside the joint, with minimal activity in other organs, which indicates that the extra articular leakage is very low. The evaluation of the articular perimeter, demonstrated that Ho 166 -HA has a therapeutic effect , which was shown by comparing the control group (6.42 ±0.43 cm right knee; 6.14 ±0.31 cm left knee) with the acute arthritis group (5.11 ±0.3 cm right knee; 4.95 ±0.39 cm left knee) with significantly statistical values (p≤0,01); also the control group was compared with the chronic arthritis group (5.6 ±0.56 cm right knee; 5.47 ±0.51 cm left knee), with significantly statistical values (p≤0,01). This therapeutic effect was evident too when evaluating the measure of the articular perimeter in acute and chronic arthritis groups through the time with significantly statistical values (p≤0,01). In conclusion the hydroxyapatite particles labeled with Holmium-166 are biologically stable in vivo and have a therapeutic effect in the treatment of acute and chronic arthritis in rats [es

[Early post-partum discharges: benefits, disadvantages and implementation methodology].

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Berkane, N

2015-02-01

Early post-partum discharges (EPD) are a hot topic. Already widely practised in many European countries this procedure, was promoted by the government for a decade, requested by representatives of Midwive organisations, desired by some patients, but also criticized by the Academy of Medicine. Well organized and with an obligatory control and follow-up, EPD could help with the management of the shortage of maternity beds and hence increase the satisfaction of the patients. The procedure could even be a way to effectively implement a town-hospital network, something, which has many other benefits. However this procedure is not without potential dangers: lower quality of care, financial risks for the department, and especially a significant increase of the workload of the hospital staff. The main objective of this paper is to detail the benefits and disadvantages of EPD for maternities and to propose an organizational basis if EPD is the procedure of choice. A participatory methodology is essential when using this procedure, due to the important participation of different categories of staff involved in hospital discharge (administrative, medical and paramedical staff) and to exclude complications when certain specifications are not followed or misunderstood. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Poly(2-oxazoline)s as Polymer Therapeutics

OpenAIRE

Luxenhofer, Robert; Han, Yingchao; Schulz, Anita; Tong, Jing; He, Zhijian; Kabanov, Alexander V.; Jordan, Rainer

2012-01-01

Poly(2-oxazoline)s (POx) are currently discussed as an upcoming platform for biomaterials design and especially for polymer therapeutics. POx meets several requirements needed for the development of next-generation polymer therapeutics such as biocompatibility, high modulation of solubility, variation of size, architecture as well as chemical functionality. Although in the early 1990s first and promising POx-based systems were presented but the field lay dormant for almost two decades. Only v...

Diffusion MRI: A New Strategy for Assessment of Cancer Therapeutic Efficacy

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Thomas L. Chenevert

2002-10-01

Full Text Available The use of anatomical imaging in clinical oncology practice traditionally relies on comparison of patient scans acquired before and following completion of therapeutic intervention. Therapeutic success is typically determined from inspection of gross anatomical images to assess changes in tumor size. Imaging could provide significant additional insight into therapeutic impact if a specific parameter or combination of parameters could be identified which reflect tissue changes at the cellular or physiologic level. This would provide an early indicator of treatment response/outcome in an individual patient before completion of therapy. Moreover, response of a tumor to therapeutic intervention may be heterogeneous. The use of imaging could assist in delineating therapeutic-induced spatial heterogeneity within a tumor mass by providing information related to specific regions that are resistant or responsive to treatment. Largely untapped potential resides in exploratory methods such as diffusion MRI, which is a non-volumetric intravoxel measure of tumor response based upon water molecular mobility. Alterations in water mobility reflect changes in tissue structure at the cellular level. While the clinical utility of diffusion MRI for oncologic practice is still under active investigation, this overview on the use of diffusion MRI for the evaluation of brain tumors will serve to introduce how this approach may be applied in the future for the management of patients with solid tumors.

Multimodal imaging evaluation in staging of rectal cancer

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Heo, Suk Hee; Kim, Jin Woong; Shin, Sang Soo; Jeong, Yong Yeon; Kang, Heoung-Keun

2014-01-01

Rectal cancer is a common cancer and a major cause of mortality in Western countries. Accurate staging is essential for determining the optimal treatment strategies and planning appropriate surgical procedures to control rectal cancer. Endorectal ultrasonography (EUS) is suitable for assessing the extent of tumor invasion, particularly in early-stage or superficial rectal cancer cases. In advanced cases with distant metastases, computed tomography (CT) is the primary approach used to evaluate the disease. Magnetic resonance imaging (MRI) is often used to assess preoperative staging and the circumferential resection margin involvement, which assists in evaluating a patient’s risk of recurrence and their optimal therapeutic strategy. Positron emission tomography (PET)-CT may be useful in detecting occult synchronous tumors or metastases at the time of initial presentation. Restaging after neoadjuvant chemoradiotherapy (CRT) remains a challenge with all modalities because it is difficult to reliably differentiate between the tumor mass and other radiation-induced changes in the images. EUS does not appear to have a useful role in post-therapeutic response assessments. Although CT is most commonly used to evaluate treatment responses, its utility for identifying and following-up metastatic lesions is limited. Preoperative high-resolution MRI in combination with diffusion-weighted imaging, and/or PET-CT could provide valuable prognostic information for rectal cancer patients with locally advanced disease receiving preoperative CRT. Based on these results, we conclude that a combination of multimodal imaging methods should be used to precisely assess the restaging of rectal cancer following CRT. PMID:24764662

Long-term use of amiodarone before heart transplantation significantly reduces early post-transplant atrial fibrillation and is not associated with increased mortality after heart transplantation

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Rivinius R

2016-02-01

Full Text Available Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Bastian Schmack,2 Christian Erbel,1 Christian A Gleissner,1 Mohammadreza Akhavanpoor,1 Lutz Frankenstein,1 Fabrice F Darche,1 Patrick A Schweizer,1 Dierk Thomas,1 Philipp Ehlermann,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: Amiodarone is a frequently used antiarrhythmic drug in patients with end-stage heart failure. Given its long half-life, pre-transplant use of amiodarone has been controversially discussed, with divergent results regarding morbidity and mortality after heart transplantation (HTX.Aim: The aim of this study was to investigate the effects of long-term use of amiodarone before HTX on early post-transplant atrial fibrillation (AF and mortality after HTX.Methods: Five hundred and thirty patients (age ≥18 years receiving HTX between June 1989 and December 2012 were included in this retrospective single-center study. Patients with long-term use of amiodarone before HTX (≥1 year were compared to those without long-term use (none or <1 year of amiodarone. Primary outcomes were early post-transplant AF and mortality after HTX. The Kaplan–Meier estimator using log-rank tests was applied for freedom from early post-transplant AF and survival.Results: Of the 530 patients, 74 (14.0% received long-term amiodarone therapy, with a mean duration of 32.3±26.3 months. Mean daily dose was 223.0±75.0 mg. Indications included AF, Wolff–Parkinson–White syndrome, ventricular tachycardia, and ventricular fibrillation. Patients with long-term use of amiodarone before HTX had significantly lower rates of early post-transplant AF (P=0.0105. Further, Kaplan–Meier analysis of freedom from early post-transplant AF showed significantly lower rates of AF in this

Therapeutic and post-lesional aspects of enzootic pneumonia in pigs

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Adrian C. Stancu

2013-05-01

Full Text Available The mycoplasmas are causing significant economic damage, these conditions being constant attention of farmers and veterinary services. Economic losses may be due to mortality, veterinary restrictions, a decrease in meat production, increased feed consumption and expenditure specific therapeutic and control measures. The conducted reaserches aimed at methods of disease treatment and diagnosis of enzootic pneumonia based on morphopathological lesions (macroscopic and histopathologicalin dead pigs cases.

Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections

Science.gov (United States)

2011-05-01

cystoid macular oedema in uveitis . Clin. Exp. Ophthalmol. 29, 2–6 (2001). 36 Campochiaro PA, Lim JI. Aminoglycoside toxicity in the treatment of...TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18 Improved Therapeutic Regimens for Treatment of...injury and adequate treatment . This proposal was designed to analyze the effectiveness of antibiotics, anti-inflammatory drugs, and non-conventional

[Research about re-evaluation of screening of traditonal Chinese medicine symptoms item of post-marketing medicine Xuezhikang].

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He, Wei; Xie, Yanming; Wang, Yongyan

2011-10-01

The purpose of post-marketing Chinese medicine re-evaluation is to identify Chinese medicine clinical indications, while designing scientific and rational of Chinese medicine symptoms items are important to the result of symptoms re-evaluation. This study give screening of traditional Chinese medicine(TCM) symptoms item of post-marketing medicine Xuezhikang re-evaluation as example that reference to principle dyslipidemia clinical research, academic dissertations, Xuezhikang directions, clinical expert practice experience etc. while standardization those symptom names and screening 41 dyslipidemia common symptoms. Furthermore, this paper discuss about the accoerdance and announcements when screening symptoms item, so as to providing a research thread to manufacture PRO chart for post-marketing medicine re-evaluation.

Evaluation of Early-Age Concrete Compressive Strength with Ultrasonic Sensors.

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Yoon, Hyejin; Kim, Young Jin; Kim, Hee Seok; Kang, Jun Won; Koh, Hyun-Moo

2017-08-07

Surface wave velocity measurement of concrete using ultrasonic sensors requires testing on only one side of a member. Thus, it is applicable to concrete cast inside a form and is often used to detect flaws and evaluate the compressive strength of hardened concrete. Predicting the in situ concrete strength at a very early stage inside the form helps with determining the appropriate form removal time and reducing construction time and costs. In this paper, the feasibility of using surface wave velocities to predict the strength of in situ concrete inside the form at a very early stage was evaluated. Ultrasonic sensors were used to measure a series of surface waves for concrete inside a form in the first 24 h after placement. A continuous wavelet transform was used to compute the travel time of the propagating surface waves. The cylindrical compressive strength and penetration resistance tests were also performed during the test period. Four mixtures and five curing temperatures were used for the specimens. The surface wave velocity was confirmed to be applicable to estimating the concrete strength at a very early age in wall-like elements. An empirical formula is proposed for evaluating the early-age compressive strength of concrete considering the 95% prediction intervals.

Post-transcriptional regulation of macrophage ABCA1, an early response gene to IFN-γ

International Nuclear Information System (INIS)

Alfaro Leon, Martha Leticia; Evans, Glenn F.; Farmen, Mark W.; Zuckerman, Steven H.

2005-01-01

Interferon-γ (IFN-γ) down-regulates receptors associated with reverse cholesterol transport including ABCA1. In the present study, the kinetics and mechanism of ABCA1 down-regulation were determined in mouse peritoneal macrophages. IFN-γ decreased ABCA1 mRNA 1 h following IFN-γ addition and was maximally reduced by 3 h. Down-regulation was protein synthesis dependent and involved post-transcriptional processes. ABCA1 message had a T 1/2 of 115 min in actinomycin treated cells that was reduced to a T 1/2 of 37 min by IFN-γ. The decrease in message stability was also associated with a rapid loss of ABCA1 protein, significant 3 h following IFN-γ addition. The kinetics of ABCA1 message and protein decrease was consistent with the early IFN-γ-induced changes in Stat1 phosphorylation and nuclear translocation observed in these cells. Therefore, ABCA1 can be considered as an early response gene to macrophage activation by IFN-γ with down-regulation occurring by message destabilization

[Strategy of constructing post-market integral evaluation system of traditional Chinese medicine injection].

Science.gov (United States)

Zhang, Xiao-Yu; Wang, Yan-Ping; Lin, Li-Kai; Shang, Hong-Cai; Wang, Yong-Yan

2017-08-01

As an important representative of modern Chinese medicine, traditional Chinese medicine (TCM) injzection has become an indispensable part of the Chinese medicine industry. However, its development is now restricted by the bottleneck of insufficient core competitiveness, low-level research and production, even injection quality and the safe use are not guaranteed. Thus, it is urgent to reevaluate post-marketing TCM injection generally and to make secondary development. Under current circumstances, taking major brands which have good clinical and market foundation, as well as research value, as the main subject of cultivation and evaluation is an important approach to innovative development of TCM injection industry. Unlike oral proprietary Chinese medicine, the cultivatation of major brands of TCM injection needs higher technical support, quality standards and more timely feedback. Therefore, a post-market integral evaluation system adaptive to TCM injection is required. This article discussed some key points on the construction of a post-market integral evaluation system of TCM injection in three levels： optimizing evaluation methods, building synergistic innovation platforms which combine the medical research institutions and pharmaceutical enterprises, and finally constructing the integral evaluation system. A "five to one" structure has been proposed to enhance TCM injection effectiveness, safety and adaptability on the whole, which are from the following aspects： mechanism research, clinical evidence validation, literature information mining, sustainable development of resources and industrialization operation. Copyright© by the Chinese Pharmaceutical Association.

Therapeutic Effect of Caffeine Treatment Immediately Following Neonatal Hypoxic-Ischemic Injury on Spatial Memory in Male Rats

Directory of Open Access Journals (Sweden)

R. Holly Fitch

2013-03-01

Full Text Available Hypoxia Ischemia (HI refers to the disruption of blood and/or oxygen delivery to the brain. Term infants suffering perinatal complications that result in decreased blood flow and/or oxygen delivery to the brain are at risk for HI. Among a variety of developmental delays in this population, HI injured infants demonstrate subsequent memory deficits. The Rice-Vannucci rodent HI model can be used to explore behavioral deficits following early HI events, as well as possible therapeutic agents to help reduce deleterious outcomes. Caffeine is an adenosine receptor antagonist that has recently shown promising results as a therapeutic agent following HI injury. The current study sought to investigate the therapeutic benefit of caffeine following early HI injury in male rats. On post-natal day (P 7, HI injury was induced (cauterization of the right common carotid artery, followed by two hours of 8% oxygen. Male sham animals received only a midline incision with no manipulation of the artery followed by room air exposure for two hours. Subsets of HI and sham animals then received either an intraperitoneal (i.p. injection of caffeine (10 mg/kg, or vehicle (sterile saline immediately following hypoxia. All animals later underwent testing on the Morris Water Maze (MWM from P90 to P95. Results show that HI injured animals (with no caffeine treatment displayed significant deficits on the MWM task relative to shams. These deficits were attenuated by caffeine treatment when given immediately following the induction of HI. We also found a reduction in right cortical volume (ipsilateral to injury in HI saline animals as compared to shams, while right cortical volume in the HI caffeine treated animals was intermediate. These findings suggest that caffeine is a potential therapeutic agent that could be used in HI injured infants to reduce brain injury and preserve subsequent cognitive function.

Study on post-earthquake plant evaluation and communication (Annual safety research report, JFY 2010)

International Nuclear Information System (INIS)

Iijima, Toru; Taoka, Hideto; Yamada, Hiroyuki; Sano, Kyoko

2011-01-01

The aims of this study are to establish a post-earthquake plant evaluation method and to develop a communication system for the improving seismic safety regulations as well as encouraging public communication. The Miyagiken-oki earthquake in 2005, Onagawa Nuclear Power Plant shut down automatically. Subsequently, JNES started development of post-earthquake plant evaluation and communication system based on the experience of the cross-check analysis for Onagawa Nuclear Power Plant. The Niigata-ken Chuetsu-oki Earthquake in 2007, the plant situation was not transmitted promptly. The loss of information sharing between local community and related organizations caused the public anxiety. The importance of plant information transmission as well as seismic information gathering were recognized. The proposal for the solution of the information issues were performed by government committee. In this study, the evaluation method for soundness of the main structure and equipment after earthquake event were updated. Moreover, procedure of the post-earthquake plant soundness evaluation and multi-functional seismic information system were developed. In addition, the implementation strategy of the easy-to -understand information dissemination to the public and transparent communication methodology was examined by the Industry-Academia-Government cooperation in the Kashiwazaki-Kariwa region. (author)

Stressful Life Events and Predictors of Post-traumatic Growth among High-Risk Early Emerging Adults.

Science.gov (United States)

Arpawong, Thalida E; Rohrbach, Louise A; Milam, Joel E; Unger, Jennifer B; Land, Helen; Sun, Ping; Spruijt-Metz, Donna; Sussman, Steve

2016-01-01

Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools ( n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.

Effects of enoxaparin and unfractionated heparin in prophylactic and therapeutic doses on the fertility of female Wistar rats.

Science.gov (United States)

Figueiró-Filho, Ernesto Antonio; Aydos, Ricardo Dutra; Senefonte, Flávio Renato de Almeida; Ferreira, Cristiane Munaretto; Pereira, Erica Freire de Vasconcelos; Oliveira, Vanessa Marcon de; Menezes, Giovanna Pádoa de; Bósio, Marco Antonio Costa

2014-07-01

To evaluate the effects of exposure of enoxaparin and unfractionated heparin (UFH) in prophylactic and therapeutic doses on the fertility rates of pregnant healthy Wistar rats. Enoxaparin and UFH were administered in prophylactic doses 1 mg/Kg/day 72 UI/Kg/day, and in therapeutic doses at 2 mg/kg/day 400UI/Kg/day. The rats were divided into five groups. The number of live and dead foetuses was quantified. The uterine horns were dissected and the presence of early and late reabsorptions (abortions) was determined. A peffect on fertility with the use of anticoagulant drugs in pregnant healthy Wistar rats.

Early genetic evaluation of open-pollinated Douglas-fir families

Science.gov (United States)

Kurt H. Riitters; David A. Perry

1987-01-01

In a test of early genetic evaluation of the growth potential of 14 families of open-pollinated Douglas-fir (Pseudotsuga menziesii) [Mirb.] Franco), measures of growth and phenology of seedligns grown in a coldframe were correlated with height of saplings in evaluation plantations at 9, 12, and 15 years. fifteen-year height was most strongly...

Investigating the key indicators for evaluating post-disaster shelter.

Science.gov (United States)

Nath, Ronita; Shannon, Harry; Kabali, Conrad; Oremus, Mark

2017-07-01

This study sought to identify the primary indicators for evaluating shelter assistance following natural disasters and then to develop a shelter evaluation instrument based on these indicators. Electronic databases and the 'grey' literature were scoured for publications with a relation to post-disaster shelter assistance. Indicators for evaluating such assistance were extracted from these publications. In total, 1,525 indicators were extracted from 181 publications. A preliminary evaluation instrument was designed from these 1,525 indicators. Shelter experts checked the instrument for face and content validity, and it was revised subsequently based on their input. The revised instrument comprises a version for use by shelter agencies (48 questions that assess 23 indicators) and a version for use by beneficiaries (52 questions that assess 22 indicators). The instrument can serve as a standardised tool to enable groups to gauge whether or not the shelter assistance that they supply meets the needs of disaster-affected populations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Post-targeting strategy for ready-to-use targeted nanodelivery post cargo loading.

Science.gov (United States)

Zhu, J Y; Hu, J J; Zhang, M K; Yu, W Y; Zheng, D W; Wang, X Q; Feng, J; Zhang, X Z

2017-12-14

Based on boronate formation, this study reports a post-targeting methodology capable of readily installing versatile targeting modules onto a cargo-loaded nanoplatform in aqueous mediums. This permits the targeted nanodelivery of broad-spectrum therapeutics (drug/gene) in a ready-to-use manner while overcoming the PEGylation-dilemma that frequently occurs in conventional targeting approaches.

Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

International Nuclear Information System (INIS)

Zhou Xiaodong; Ren Xiaolong; Zhang Jun; He Guangbin; Zheng Minjuan; Tian Xue; Li Li; Zhu Ting; Zhang Min; Wang Lei; Luo Wen

2007-01-01

Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 ± 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids

Development and evaluation of an electronic drug and therapeutics bulletin.

Science.gov (United States)

Alderman, Christopher P

2002-10-01

To describe the development, implementation, and initial evaluation of a paperless drug and therapeutics bulletin that is distributed by electronic mail from the pharmacy department of an Australian teaching hospital. A standardized format for the bulletin was designed and approved in February 2001. The aim of the bulletin is to facilitate the timely dissemination of concise, factual information about issues of current interest in therapeutics, drug safety, and the cost-effective use of medicines. A simple and attractive graphic design was chosen, and the hospital's clinical pharmacists and drug information staff developed an initial bank of content during the period immediately preceding the launch. The bulletin is presented as a 1-page, read-only file in Word for Windows format and was initially distributed by electronic mail to all users of the hospital's computerized communication network. As the popularity of the bulletin increased, healthcare practitioners from outside of the hospital began to request permission for inclusion on the circulation list, and the content was frequently forwarded by E-mail to workers in other hospitals and community-based settings. The bulletin is now distributed to pharmacists around Australia via 2 separate moderated discussion lists, one of which provides an archive site for previous editions. Healthcare workers in Singapore, the US, Canada, and New Zealand also receive the bulletin, which is now also abstracted by a major Australian pharmacy journal. A readership survey (also electronically distributed) was used to seek feedback after the publication of the first 12 editions. Readers indicated a high level of satisfaction with the content, format, and frequency of distribution of the materials. Although the concept and execution of this project was relatively simple, an extensive literature review did not reveal any previously published reports describing this type of approach to the distribution of a pharmacy bulletin. The

Recommendations for measurement of tumour vascularity with positron emission tomography in early phase clinical trials

Energy Technology Data Exchange (ETDEWEB)

Aboagye, Eric O.; Kenny, Laura M.; Myers, Melvyn [Imperial College London, Department of Surgery and Cancer, Faculty of Medicine, London (United Kingdom); Gilbert, Fiona J. [University of Cambridge, Radiology Department, Cambridge (United Kingdom); Fleming, Ian N. [University of Aberdeen, NCRI PET Research Network, Aberdeen Bioimaging Centre, Aberdeen (United Kingdom); Beer, Ambros J. [Technische Universitaet Munchen, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich (Germany); Cunningham, Vincent J. [University of Aberdeen, Institute of Medical Sciences, Aberdeen (United Kingdom); Marsden, Paul K. [St. Thomas' Hospital, Division of Imaging Sciences, PET Imaging Centre, London (United Kingdom); Visvikis, Dimitris [INSERM National Institute of Health and Clinical Sciences LaTIM, CHU Morvan, Brest (France); Gee, Antony D. [St. Thomas' Hospital, Division of Imaging Sciences, The Rayne Institute, London (United Kingdom); Groves, Ashley M. [University College London, University College Hospital, Institute of Nuclear Medicine, London (United Kingdom); Cook, Gary J. [St. Thomas' Hospital, KCL Division of Imaging, Sciences and Biomedical Engineering, PET Imaging Centre, London (United Kingdom); Kinahan, Paul E. [University of Washington, 222 Old Fisheries Center (FIS), Box 357987, Seattle, WA (United States); Clarke, Larry [Cancer Imaging Program, Imaging Technology Development Branch, Rockville, MD (United States)

2012-07-15

The evaluation of drug pharmacodynamics and early tumour response are integral to current clinical trials of novel cancer therapeutics to explain or predict long term clinical benefit or to confirm dose selection. Tumour vascularity assessment by positron emission tomography could be viewed as a generic pharmacodynamic endpoint or tool for monitoring response to treatment. This review discusses methods for semi-quantitative and quantitative assessment of tumour vascularity. The radioligands and radiotracers range from direct physiological functional tracers like [{sup 15}O]-water to macromolecular probes targeting integrin receptors expressed on neovasculature. Finally we make recommendations on ways to incorporate such measurements of tumour vascularity into early clinical trials of novel therapeutics. (orig.)

Effect of pre- and post-marination aging on meat quality attributes of early deboned (2 h postmortem) broiler breast fillets.

Science.gov (United States)

Kuttappan, V A; Gunsaulis, V B; Mauromoustakos, A; Meullenet, J F; Owens, C M

2016-11-01

Marination is an effective method that can be used to improve the tenderness of early deboned breast fillets. The present study was designed to evaluate the effect of pre- and post-marination aging of 2 h postmortem (PM) deboned chicken fillets to get optimum meat quality. In this study, a total of 300 broilers (43 to 46 d of age) were processed using an in-line system and deboned at 2 h PM. Fillets were marinated, at either 2.5, 4, 6, 8 or 24 h PM, using vacuum tumbling (20 min) with a 15% marinade (final concentration of 0.5% salt and 0.45% phosphate). A non-marinated control (CON) was included. The left (HOLD) fillets were aged (held at 4°C for 24 h) prior to freezing post-marination while the right (NO HOLD) fillets were frozen immediately after marination to simulate various commercial practices. Marination pickup (MPU), total marinade retained after thawing (TMR), total purge loss after thawing (TPL), cook loss (CL), and Meullenet-Owens Razor Shear energy (MORSE) values were measured. Both in HOLD and NO HOLD fillets, there was an increase (P water holding capacity. However, both in HOLD and NO HOLD groups, the MORSE values for the marinated fillets decreased (P retention as well as tenderness (or lower shear values). © 2016 Poultry Science Association Inc.

[Predictors of the therapeutic discharge in patients with dual pathology admitted to a therapeutic community with a psychiatric unit].

Science.gov (United States)

Madoz-Gúrpide, Agustín; García Vicent, Vicente; Luque Fuentes, Encarnación; Ochoa Mangado, Enriqueta

2013-01-01

This study aims to analyze the variables on which depends therapeutic discharge, in patients with a severe dual diagnosis admitted to a professional therapeutic community where their pathology is treated. 325 patients admitted between June 2000 and June 2009 to the therapeutic community. This is a retrospective, cross-sectional study with no control group, based on the detailed analysis of the information collected in a model of semi-structured clinical interview designed in the therapeutic community. The 29.5% of the individuals included in the sample were therapeutically discharged. Of all the variables introduced in this analysis the most significant ones were gender, age at the beginning of treatment, education level, opiate dependence, polidrug abuse, and the presence of psychotic disorders and borderline personality disorder. In our study, gender determines the type of discharge, being therapeutic discharge more frequent among women. A higher educational also increases a better prognosis with a higher rate of therapeutic discharge among individuals with higher education level. A later age at the beginning of the treatment reduces the likelihood of therapeutic discharge. Likewise, polidrug abuse, diagnosis of psychotic disorders and borderline personality disorder are associated to a lower rate of therapeutic discharge. Recognizing these characteristics will allow the early identification of those patients more at risk of dropping treatment hastily, while trying to prevent it by increasing the therapeutic intensity.

Post isolation modification of exosomes for nanomedicine applications.

Science.gov (United States)

Hood, Joshua L

2016-07-01

Exosomes are extracellular nanovesicles. They innately possess ideal structural and biocompatible nanocarrier properties. Exosome components can be engineered at the cellular level. Alternatively, when exosome source cells are unavailable for customized exosome production, exosomes derived from a variety of biological origins can be modified post isolation which is the focus of this article. Modification of exosome surface structures allows for exosome imaging and tracking in vivo. Exosome membranes can be loaded with hydrophobic therapeutics to increase drug stability and efficacy. Hydrophilic therapeutics such as RNA can be encapsulated in exosomes to improve cellular delivery. Despite advances in post isolation exosome modification strategies, many challenges to effectively harnessing their therapeutic potential remain. Future topics of exploration include: matching exosome subtypes with nanomedicine applications, optimizing exosomal nanocarrier formulation and investigating how modified exosomes interface with the immune system. Research into these areas will greatly facilitate personalized exosome-based nanomedicine endeavors.

Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?

Science.gov (United States)

Morreale, Manuela; Marchione, Pasquale; Pili, Antonio; Lauta, Antonella; Castiglia, Stefano F; Spallone, Aldo; Pierelli, Francesco; Giacomini, Patrizia

2016-02-01

Early/intensive mobilization may improve functional recovery after stroke but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and cognitive therapeutic exercise (CTE) are widespread applied in post-stroke rehabilitation but their efficacy and safety have not been systematically investigated. To compare PNF and CTE methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute ischemic stroke. We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and CTE. A discrete stroke-dedicated area for out-of-thrombolysis patients, connected with two different comprehensive stroke centres in two different catchment areas. Three hundred and forty consecutive stroke patient with first ever sub-cortical ischemic stroke in the mean cerebral artery (MCA) territory and contralateral hemiplegia admitted within 6 and 24 hours from symptoms onset. All patients were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. Patients in both delayed group underwent to a standard protocol in the acute phase. disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck Depression Inventory. Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. A

An improved interim therapeutic restoration technique for management of anterior early childhood caries: report of two cases.

Science.gov (United States)

Nelson, Travis

2013-01-01

Early childhood caries presents unique treatment challenges that often require advanced behavior management techniques, such as general anesthesia or procedural sedation. In some cases, use of these pharmacologic adjuncts is undesirable or not possible. The interim therapeutic restoration is a treatment method that, while sometimes employed in such cases, can often produce unsatisfactory results in primary anterior teeth. This is often due to insufficient bulk of material and lack of retention. The purpose of this report was to describe a simple alternative technique (resin modified glass ionomer strip crowns) that may be employed to deliver esthetic anterior restorations to marginally cooperative children in the dental clinic setting and to report on two cases in which it was successfully used. \\\\\\Department of Pediatric Dentistry, University of Washington, Seattle, Wash., USA. tmnelson@uw.edu

Pre-operative assessment and post-operative care in elective shoulder surgery.

Science.gov (United States)

Akhtar, Ahsan; Macfarlane, Robert J; Waseem, Mohammad

2013-01-01

Pre-operative assessment is required prior to the majority of elective surgical procedures, primarily to ensure that the patient is fit to undergo surgery, whilst identifying issues that may need to be dealt with by the surgical or anaesthetic teams. The post-operative management of elective surgical patients begins during the peri-operative period and involves several health professionals. Appropriate monitoring and repeated clinical assessments are required in order for the signs of surgical complications to be recognised swiftly and adequately. This article examines the literature regarding pre-operative assessment in elective orthopaedic surgery and shoulder surgery, whilst also reviewing the essentials of peri- and post-operative care. The need to recognise common post-operative complications early and promptly is also evaluated, along with discussing thromboprophylaxis and post-operative analgesia following shoulder surgery.

Sex Differences in Brain Thyroid Hormone Levels during Early Post-Hatching Development in Zebra Finch (Taeniopygia guttata.

Directory of Open Access Journals (Sweden)

Shinji Yamaguchi

Full Text Available Thyroid hormones are closely linked to the hatching process in precocial birds. Previously, we showed that thyroid hormones in brain had a strong impact on filial imprinting, an early learning behavior in newly hatched chicks; brain 3,5,3'-triiodothyronine (T3 peaks around hatching and imprinting training induces additional T3 release, thus, extending the sensitive period for imprinting and enabling subsequent other learning. On the other hand, blood thyroid hormone levels have been reported to increase gradually after hatching in altricial species, but it remains unknown how the brain thyroid hormone levels change during post-hatching development of altricial birds. Here, we determined the changes in serum and brain thyroid hormone levels of a passerine songbird species, the zebra finch using radioimmunoassay. In the serum, we found a gradual increase in thyroid hormone levels during post-hatching development, as well as differences between male and female finches. In the brain, there was clear surge in the hormone levels during development in males and females coinciding with the time of fledging, but the onset of the surge of thyroxine (T4 in males preceded that of females, whereas the onset of the surge of T3 in males succeeded that of females. These findings provide a basis for understanding the functions of thyroid hormones during early development and learning in altricial birds.

Sex Differences in Brain Thyroid Hormone Levels during Early Post-Hatching Development in Zebra Finch (Taeniopygia guttata).

Science.gov (United States)

Yamaguchi, Shinji; Hayase, Shin; Aoki, Naoya; Takehara, Akihiko; Ishigohoka, Jun; Matsushima, Toshiya; Wada, Kazuhiro; Homma, Koichi J

2017-01-01

Thyroid hormones are closely linked to the hatching process in precocial birds. Previously, we showed that thyroid hormones in brain had a strong impact on filial imprinting, an early learning behavior in newly hatched chicks; brain 3,5,3'-triiodothyronine (T3) peaks around hatching and imprinting training induces additional T3 release, thus, extending the sensitive period for imprinting and enabling subsequent other learning. On the other hand, blood thyroid hormone levels have been reported to increase gradually after hatching in altricial species, but it remains unknown how the brain thyroid hormone levels change during post-hatching development of altricial birds. Here, we determined the changes in serum and brain thyroid hormone levels of a passerine songbird species, the zebra finch using radioimmunoassay. In the serum, we found a gradual increase in thyroid hormone levels during post-hatching development, as well as differences between male and female finches. In the brain, there was clear surge in the hormone levels during development in males and females coinciding with the time of fledging, but the onset of the surge of thyroxine (T4) in males preceded that of females, whereas the onset of the surge of T3 in males succeeded that of females. These findings provide a basis for understanding the functions of thyroid hormones during early development and learning in altricial birds.

Evaluation of various therapeutic measures in striae rubra

Directory of Open Access Journals (Sweden)

Umesh Karsandas Karia

2016-01-01

Full Text Available Background: Striae are linear atrophic depressions that form in areas of dermal damage in the skin. As on date, no consensus or protocol exists for the treatment of stria rubra. Topical retinoids, chemical peels, microdermabrasion, radiofrequency, photothermolysis, intense pulsed light and lasers are some of the modalities used. Aims and Objective: To compare the efficacy of various therapeutic modalities in striae rubra. Methods: This prospective cohort study comprised of a total of fifty patients from August-2012 to October-2013 in a tertiary care center in Western India, Gujarat having striae rubra. They were randomly divided into five groups of ten patients each. Patients were evaluated on the basis of visual assessment, both by doctor as well as the patient. Group I was given topical tretinoin (0.1% w/w gel applied once at night, Group II-microdermabrasion (MDA combined with trichloroacetic acid (TCA (30% peel, Group III-mesotherapy, Group IV-Q-switched Nd: YAG laser, and Group V-combination treatment of microdermabrasion, salicylic acid peel and retinol (yellow peel. Patients were treated at an interval of 15 days for 2 months and then at monthly intervals. Objective assessment was done at 2nd month, 6th month, and at the end of 1st year. Results: Patients in Group I treated with topical tretinoin showed the least response with 80% (8 of them showing minimal clinical improvement (0–25% as compared to patients in Group V in which 60% (6 patients showed moderate clinical improvement (50–75%. While majority of the patients in Group II, III, and IV showed mild clinical improvement (25–50%. Conclusions: Striae rubra is a common cause of concern for adolescent population. Combination treatment with microdermabrasion, salicylic acid and retinol yellow peel gave superior results as compared to other therapeutic options. Mild to moderate improvement was seen with Nd: YAG laser, mesotherapy and MDA + TCA whereas minimal improvement were seen

Evaluation of Various Therapeutic Measures in Striae Rubra

Science.gov (United States)

Karia, Umesh Karsandas; Padhiar, Bela Bhemabhai; Shah, Bela Jaswantbhai

2016-01-01

Background: Striae are linear atrophic depressions that form in areas of dermal damage in the skin. As on date, no consensus or protocol exists for the treatment of stria rubra. Topical retinoids, chemical peels, microdermabrasion, radiofrequency, photothermolysis, intense pulsed light and lasers are some of the modalities used. Aims and Objective: To compare the efficacy of various therapeutic modalities in striae rubra. Methods: This prospective cohort study comprised of a total of fifty patients from August-2012 to October-2013 in a tertiary care center in Western India, Gujarat having striae rubra. They were randomly divided into five groups of ten patients each. Patients were evaluated on the basis of visual assessment, both by doctor as well as the patient. Group I was given topical tretinoin (0.1% w/w) gel applied once at night, Group II-microdermabrasion (MDA) combined with trichloroacetic acid (TCA) (30%) peel, Group III-mesotherapy, Group IV-Q-switched Nd: YAG laser, and Group V-combination treatment of microdermabrasion, salicylic acid peel and retinol (yellow) peel. Patients were treated at an interval of 15 days for 2 months and then at monthly intervals. Objective assessment was done at 2nd month, 6th month, and at the end of 1st year. Results: Patients in Group I treated with topical tretinoin showed the least response with 80% (8) of them showing minimal clinical improvement (0–25%) as compared to patients in Group V in which 60% (6) patients showed moderate clinical improvement (50–75%). While majority of the patients in Group II, III, and IV showed mild clinical improvement (25–50%). Conclusions: Striae rubra is a common cause of concern for adolescent population. Combination treatment with microdermabrasion, salicylic acid and retinol yellow peel gave superior results as compared to other therapeutic options. Mild to moderate improvement was seen with Nd: YAG laser, mesotherapy and MDA + TCA whereas minimal improvement were seen with

Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors

Energy Technology Data Exchange (ETDEWEB)

Kim, Yeo Ju [Inha University Hospital, Department of Radiology, Incheon (Korea); Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeongi-do (Korea); Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-do (Korea); Park, Jeong Mi [The Catholic University of Korea, Department of Radiology, St. Mary' s Hospital, College of Medicine, Seoul (Korea)

2010-08-15

To investigate the short-term therapeutic effect of percutaneous vertebroplasty (PVP) for intravertebral cleft (IVC) and to analyze possible outcome predictors. After retrospective review of spot radiographs during PVP, 23 patients were included in this study. Age, sex, symptom duration, functional status, injected cement volume, and type of approach were evaluated using patients' medical and operative records. The following factors were analyzed on radiographs, MRI, dual bone densitometry, spot radiographs during PVP, and CT: anatomical location of the fracture, bone mineral density, morphology of the fracture, IVC morphology, presence of surrounding non-enhanced area and bone marrow edema, degeneration of adjacent discs, co-existing old compression fractures, patterns of cement opacification, pre-procedural kyphosis, and post-procedural kyphosis correction. Effectiveness was defined as a much-improved state or no pain after 1 week, 1 month, and 2 months. Statistical analyses were conducted to evaluate the relationship between those factors and therapeutic outcome using Fisher's exact test, Chi-squared test, and the Mann-Whitney U test. Percutaneous vertebroplasty of IVC was effective in 16 out of 23 (69.6%) patients after 1 week and 1 month and 15 out of 23 (65.2%) patients after 2 months. Post-procedural kyphosis correction {>=}5 and poor functional status (full dependency) were more common in the ineffective group after 1 week and 2 months respectively (P = 0.047, P = 0.02). Kyphotic correction {>=}5 was related to pre-procedural kyphosis {>=}15 (P = 0.018). Functional status was related to subsequent fracture (P = 0.005). Other factors were not statistically significant (P > 0.05). Percutaneous vertebroplasty on osteoporotic vertebral compression fractures (VCF) with IVC was effective in only about 69.6% of patients after the first week and month and in 65.2% of patients after 2 months. Post-procedural kyphosis correction {>=}5 was associated with

Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors

International Nuclear Information System (INIS)

Kim, Yeo Ju; Lee, Joon Woo; Kang, Heung Sik; Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib; Park, Jeong Mi

2010-01-01

To investigate the short-term therapeutic effect of percutaneous vertebroplasty (PVP) for intravertebral cleft (IVC) and to analyze possible outcome predictors. After retrospective review of spot radiographs during PVP, 23 patients were included in this study. Age, sex, symptom duration, functional status, injected cement volume, and type of approach were evaluated using patients' medical and operative records. The following factors were analyzed on radiographs, MRI, dual bone densitometry, spot radiographs during PVP, and CT: anatomical location of the fracture, bone mineral density, morphology of the fracture, IVC morphology, presence of surrounding non-enhanced area and bone marrow edema, degeneration of adjacent discs, co-existing old compression fractures, patterns of cement opacification, pre-procedural kyphosis, and post-procedural kyphosis correction. Effectiveness was defined as a much-improved state or no pain after 1 week, 1 month, and 2 months. Statistical analyses were conducted to evaluate the relationship between those factors and therapeutic outcome using Fisher's exact test, Chi-squared test, and the Mann-Whitney U test. Percutaneous vertebroplasty of IVC was effective in 16 out of 23 (69.6%) patients after 1 week and 1 month and 15 out of 23 (65.2%) patients after 2 months. Post-procedural kyphosis correction ≥5 and poor functional status (full dependency) were more common in the ineffective group after 1 week and 2 months respectively (P = 0.047, P = 0.02). Kyphotic correction ≥5 was related to pre-procedural kyphosis ≥15 (P = 0.018). Functional status was related to subsequent fracture (P = 0.005). Other factors were not statistically significant (P > 0.05). Percutaneous vertebroplasty on osteoporotic vertebral compression fractures (VCF) with IVC was effective in only about 69.6% of patients after the first week and month and in 65.2% of patients after 2 months. Post-procedural kyphosis correction ≥5 was associated with poor outcomes

The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial.

Science.gov (United States)

Huang, Jia; Lin, Zhengkun; Wang, Qin; Liu, Feiwen; Liu, Jiao; Fang, Yunhua; Chen, Shanjia; Zhou, Xiaoxuan; Hong, Wenjun; Wu, Jinsong; Madrigal-Mora, Natalia; Zheng, Guohua; Yang, Shanli; Tao, Jing; Chen, Lidian

2015-06-16

Post-stroke cognitive impairment (PSCI) lessens quality of life, restricts the rehabilitation of stroke, and increases the social and economic burden stroke imposes on patients and their families. Therefore effective treatment is of paramount importance. However, the treatment of PSCI is very limited. The primary aim of this protocol is to propose a lower cost and more effective therapy, and to confirm the long-term effectiveness of a therapeutic regimen of Traditional Chinese Medicine (TCM) rehabilitation for PSCI. A prospective, multicenter, large sample, randomized controlled trial will be conducted. A total of 416 eligible patients will be recruited from seven inpatient and outpatient stroke rehabilitation units and randomly allocated into a therapeutic regimen of TCM rehabilitation group or cognitive training (CT) control group. The intervention period of both groups will last 12 weeks (30 minutes per day, five days per week). Primary and secondary outcomes will be measured at baseline, 12 weeks (at the end of the intervention), and 36 weeks (after the 24-week follow-up period). This protocol presents an objective design of a multicenter, large sample, randomized controlled trial that aims to put forward a lower cost and more effective therapy, and confirm the long-term effectiveness of a therapeutic regimen of TCM rehabilitation for PSCI through subjective and objective assessments, as well as highlight its economic advantages. This trial was registered with the Chinese Clinical Trial Registry (identifier: ChiCTR-TRC-14004872 ) on 23 June 2014.

Post-Transcriptional Control of Gene Expression in Mouse Early Embryo Development: A View from the Tip of the Iceberg

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Claudio Sette

2011-04-01

Full Text Available Fertilization is a very complex biological process that requires the perfect cooperation between two highly specialized cells: the male and female gametes. The oocyte provides the physical space where this process takes place, most of the energetic need, and half of the genetic contribution. The spermatozoon mostly contributes the other half of the chromosomes and it is specialized to reach and to penetrate the oocyte. Notably, the mouse oocyte and early embryo are transcriptionally inactive. Hence, they fully depend on the maternal mRNAs and proteins stored during oocyte maturation to drive the onset of development. The new embryo develops autonomously around the four-cell stage, when maternal supplies are exhausted and the zygotic genome is activated in mice. This oocyte-to-embryo transition needs an efficient and tightly regulated translation of the maternally-inherited mRNAs, which likely contributes to embryonic genome activation. Full understanding of post-transcriptional regulation of gene expression in early embryos is crucial to understand the reprogramming of the embryonic genome, it might help driving reprogramming of stem cells in vitro and will likely improve in vitro culturing of mammalian embryos for assisted reproduction. Nevertheless, the knowledge of the mechanism(s underlying this fundamental step in embryogenesis is still scarce, especially if compared to other model organisms. We will review here the current knowledge on the post-transcriptional control of gene expression in mouse early embryos and discuss some of the unanswered questions concerning this fascinating field of biology.

Low-frequency rTMS with language therapy over a 3-month period for sensory-dominant aphasia: case series of two post-stroke Japanese patients.

Science.gov (United States)

Kakuda, Wataru; Abo, Masahiro; Uruma, Go; Kaito, Nobuyoshi; Watanabe, Motoi

2010-01-01

To examine the safety and feasibility of therapeutic application of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with language therapy for post-stroke patients with sensory-dominant aphasia. Two post-stroke Japanese patients with sensory-dominant aphasia were studied. In both patients, 10 sessions of 20-minute low-frequency rTMS with 1 Hz to the Wernicke's area were provided throughout 6-day hospitalization, followed by weekly outpatient rTMS treatment for 3 months. The language therapy was also provided through the period of in- and out-patient treatment. Language function was evaluated using the Token test and the Standard Language Test of Aphasia (SLTA) at the start and end of the in-patient treatment and the end of the outpatient treatment. The therapeutic protocol was well tolerated throughout the in- and out-patient treatments, without any adverse effects. The scores of the Token test and certain sub-categories of SLTA increased in both patients after the in-patient rTMS treatment. Persistent improvement of the score was noted over the 3-month post-discharge period. The proposed protocol of long-term application of low-frequency rTMS to the Wernicke's area and language therapy is considered a safe and feasible therapeutic approach for post-stroke patients with sensory-dominant aphasia.

SUPPLEMENTAL CARDIOPLEGIA IMMEDIATELY BEFORE GRAFT IMPLANTATION MAY IMPROVE EARLY POST-TRANSPLANTATION OUTCOME

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Hendrik eTevaearai Stahel

2014-11-01

Full Text Available Background: Preservation of cardiac grafts for transplantation is not standardized and most centers use a single administration of crystalloid solution at the time of harvesting. We investigated possible benefits of an additional dose of cardioplegia dispensed immediately before implantation.Methods: Consecutive adult cardiac transplantations (2005-2012 were reviewed. Hearts were harvested following a standard protocol (Celsior 2L, 4-8oC. In 2008, 100mL crystalloid cardioplegic solution was added and administered immediately before implantation. Univariate and logistic regression analyses were used to investigate risk factors for post-operative graft failure and mid-term outcome. Results: A total of 81 patients, 44 standard (Cardio - versus 37 with additional cardioplegia (Cardio + were analyzed. Recipients and donors were comparable in both groups. Cardio + patients demonstrated a reduced need for defibrillation (24% vs. 48%, p=0.03, post-operative ratio of CK-MB/CK (10.1±3.9% vs. 13.3±4.2%, p=0.001, intubation time (2.0±1.6 vs. 7.2±11.5 days, p=0.05 and ICU stay (3.9±2.1 vs. 8.5±7.8 days, p=0.001. Actuarial survival was reduced when graft ischemic time was >180 minutes in Cardio – but not in Cardio + patients (p=0.033. Organ ischemic time >180 minutes (OR:5.48, CI:1.08-27.75, donor female gender (OR:5.84, CI:1.13-33.01 and recipient/donor age >60 (OR:6.33, CI:0.86-46.75, but not the additional cardioplegia nor the observation period appeared independent predictors of post-operative acute graft failure.Conclusion: An additional dose of cardioplegia administered immediately before implantation may be a simple way to improve early and late outcome of cardiac transplantation, especially in situations of prolonged graft ischemia. A large, ideally multicentric, randomized study is desirable to verify this preliminary observation.

Diabetes insípida post-parotiditis

OpenAIRE

Pila Pérez, Rafael; Rivero Sánchez, Miguel; Peralta Ventura, Ricardo; Carbonell Perdomo, Diego; Pila Peláez, Rafael; Guerra Rodríguez, Carmen

2001-01-01

Se describe un caso de diabetes insípida post parotiditis, entidad sumamente rara en nuestro medio. Se destaca el diagnóstico y la terapéutica de esta entidad, así como la causa etiológico y forma de presentación. A case of diabetes insipidus post-parotiditis is described entity totally rare in our midicu. Diagnostics and therapeutics are stressed a well as the ethiologic antecedent and way of presentation.

Post-disaster health impact of natural hazards in the Philippines in 2013

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Miguel Antonio Salazar

2016-05-01

Full Text Available Background: In 2011, the Health Emergency Management Bureau (HEMB created the Surveillance for Post Extreme Emergencies and Disasters (SPEED, a real-time syndromic surveillance system that allows the early detection and monitoring of post-disaster disease trends. SPEED can assist health leaders in making informed decisions on health systems affected by disasters. There is a need for further validation of current concepts in post-disaster disease patterns in respect to actual field data. This study aims to evaluate the temporal post-disaster patterns of selected diseases after a flood, an earthquake, and a typhoon in the Philippines in 2013. Methodology: We analyzed the 21 syndromes provided by SPEED both separately and grouped into injuries, communicable diseases, and non-communicable diseases (NCDs by calculating daily post-disaster consultation rates for up to 150 days post-disaster. These were compared over time and juxtaposed according to the type of disaster. Results: Communicable diseases were found to be the predominant syndrome group in all three disaster types. The top six syndromes found were: acute respiratory infections, open wounds, bruises and burns, high blood pressure, skin disease, fever, and acute watery diarrhea. Discussion: Overall, the results aligned with the country's morbidity profile. Within 2 months, the clear gradation of increasing syndrome rates reflected the severity (floodpost-disaster syndromes may be addressed by prevention, early diagnosis, and early treatment. Health needs differ in response and recovery phases.

Xenon ventilation-perfusion lung scans. The early diagnosis of inhalation injury

International Nuclear Information System (INIS)

Schall, G.L.; McDonald, H.D.; Carr, L.B.; Capozzi, A.

1978-01-01

The use of xenon Xe-133 ventilation-perfusion lung scans for the early diagnosis of inhalation injury was evaluated in 67 patients with acute thermal burns. Study results were interpreted as normal if there was complete pulmonary clearance of the radioactive gas by 150 seconds. Thirty-two scans were normal, 32 abnormal, and three technically inadequate. There were three true false-positive study results and one false-negative study result. Good correlation was found between the scan results and various historical, physical, and laboratory values currently used to evaluate inhalation injury. The scans appeared to be the most sensitive method for the detection of early involvement, often being abnormal several days before the chest roentgenogram. Xenon lung scanning is a safe, easy, accurate, and sensitive method for the early diagnosis of inhalation injury and has important therapeutic and prognostic implications as well

Galantamine is a novel post-exposure therapeutic against lethal VX challenge

International Nuclear Information System (INIS)

Hilmas, Corey J.; Poole, Melissa J.; Finneran, Kathryn; Clark, Matthew G.; Williams, Patrick T.

2009-01-01

The ability of galantamine hydrobromide (GAL HBr) treatment to antagonize O-ethyl-S-(2-diisopropylaminoethyl) methylphosphonothiolate (VX)-induced lethality, impairment of muscle tension, and electroencephalographic (EEG) changes was assessed in guinea pigs. Guinea pigs were challenged with 16.8 μg/kg VX (2LD50). One min after challenge, animals were administered 0.5 mg/kg atropine sulfate (ATR) and 25 mg/kg pyridine-2-aldoxime methochloride (2-PAM). In addition, guinea pigs were given 0, 1, 2, 4, 8 or 10 mg/kg GAL as a post-exposure treatment immediately prior to ATR and 2-PAM. Animals were either monitored for 24-h survival, scheduled for electroencephalography (EEG) recording, or euthanized 60 min later for measurement of indirectly-elicited muscle tension in the hemidiaphragm. Post-exposure GAL therapy produced a dose-dependent increase in survival from lethal VX challenge. Optimal clinical benefits were observed in the presence of 10 mg/kg GAL, which led to 100% survival of VX-challenged guinea pigs. Based on muscle physiology studies, GAL post-exposure treatment protected the guinea pig diaphragm, the major effector muscle of respiration, from fatigue, tetanic fade, and muscular paralysis. Protection against the paralyzing effects of VX was dose-dependent. In EEG studies, GAL did not alter seizure onset for all doses tested. At the highest dose tested (10 mg/kg), GAL decreased seizure duration when administered as a post-exposure treatment 1 min after VX. GAL also reduced the high correlation associated between seizure activity and lethality after 2LD50 VX challenge. GAL may have additional benefits both centrally and peripherally that are unrelated to its established mechanism as a reversible acetylcholinesterase inhibitor (AChEI).

Early intranasal insulin therapy halts progression of neurodegeneration: progress in Alzheimer's disease therapeutics.

Science.gov (United States)

de la Monte, Suzanne M

Evaluation of Craft S, Baker LD, Montine TJ, Minoshima S, Watson GS, Claxton A, et al. Intranasal Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive Impairment: A Pilot Clinical Trial. Arch Neurol . 2011 Sep 12. Alzheimer's disease is associated with brain insulin deficiency and insulin resistance, similar to the problems in diabetes. If insulin could be supplied to the brain in the early stages of Alzheimer's, subsequent neurodegeneration might be prevented. Administering systemic insulin to elderly non-diabetics poses unacceptable risks of inadvertant hypoglycemia. However, intranasal delivery directs the insulin into the brain, avoiding systemic side-effects. This pilot study demonstrates both efficacy and safety of using intranasal insulin to treat early Alzheimer's and mild cognitive impairment, i.e. the precursor to Alzheimer's. Significant improvements in learning, memory, and cognition occured within a few months, but without intranasal insulin, brain function continued to deteriorate in measurable degrees. Intranasal insulin therapy holds promise for halting progression of Alzheimer's disease.

Evaluation of early changes of cartilage biomarkers following ...

African Journals Online (AJOL)

Evaluation of early changes of cartilage biomarkers following arthroscopic meniscectomy in young Egyptian adults. ... Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link above.

[A specific questionnaire to evaluate therapeutic inertia in hypertensive patients: a pilot study].

Science.gov (United States)

Pretorean, T; Claisse, G; Delsart, P; Caudrelier, T; Devos, P; Mounier-Vehier, C

2014-02-01

Therapeutic inertia (TI) is a recent concept still unknown by many physicians. In chronic diseases such as hypertension, it is defined as the tendency of physicians not to increase or change antihypertensive medications when the target blood pressure is not reached. Acting on TI could improve blood pressure control in France. This was a single-center prospective pilot study conducted by hypertension specialist physicians at the University Cardio-Vascular Center in Lille (France). It was conducted between March and June 2011. Data was collected from 161 hypertensive patients (mean age: 61.64±11.18 years; 98 (60.9%) male; 75 secondary prevention patients). Each physician completed a questionnaire on therapeutic inertia. TI was defined as a consultation in which treatment change was indicated (systolic blood pressure [BP]≥140 and/or diastolic BP≥90mmHg in all patients), but did not occur, with absence of an adapted justification of this choice. We considered as an adapted justification: a white coat effect demonstrated by ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring; scheduled reassessment of the BP by ABPM; recent change in antihypertensive treatment (less than 4 weeks); hospitalization needed for complete evaluation of secondary causes of hypertension and a more detailed assessment of potential target organ damage in patients with grade 1 or 2 hypertension. Our study aimed to evaluate rates of TI, to identify factors associated with TI, and to test the TI questionnaire. Therapeutic inertia as defined in this study occurred in 11 consultations (8.3%) of the 133 hypertensive patients having uncontrolled BP above or equal to 140 and/or 90mmHg. Significant factors associated with TI were older age (Z=2.35, PP>0.05) and the number of consultations (Z=1.92, 0.1>P>0.05) exhibited a significant trend to be associated with TI. Although the rate of TI was low in our study conducted in a specialized center, a well-accepted definition of

Significance of performing CT after radiofrequency ablation of hepatocellular carcinoma. Relationship between CT findings in areas other than the tumor site and post therapeutic outcome

International Nuclear Information System (INIS)

Shimokoube, Kouichi; Saito, Kazuhiro; Kotake, Fumio; Nakamura, Hiroshi; Mizokami, Yuji; Mikami, Ryuji; Matsuoka, Takeshi

2004-01-01

The relationships between the CT findings following radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) and the clinical symptoms and laboratory data were examined. The subjects consisted of 31 cases (41 nodules) of HCC that were treated by RFA. The CT findings before and after RFA, particularly the findings in areas other than the treatment site (henceforth, secondary findings), were evaluated by a physician and a radiologist. In addition, the relationships between the CT findings and post-RFA clinical symptoms (fever/pain) and laboratory data were examined. Secondary findings were found in 90.3% (28/31). These findings were broadly classified into changes in the needle tract 51.6% (16/31), retention of effusion 41.9% (13/31), thickening of the gallbladder wall 12.9% (4/31), changes in the retroperitoneal space 9.7% (3/31), and dilatation of the intrahepatic bile duct 3.2% (1/31), in the order of frequency. A relationship was found between changes in the retroperitoneal space and the clinical symptoms (fever: p=0.0366, pain: p=0.0012). Relationships were also found between changes in the needle tract and retention of effusion and aspartate aminotransferase (AST) (p<0.0001), as well as between changes in the needle tract and alanine aminotransferase (ALT) (p=0.0149). The size of the treatment area did not correlate with the presence of clinical symptoms and changes in laboratory data. Diverse classification of CT findings was observed after RFA, and a relationship with clinical symptoms was noted. A relationship was also found between classification of the CT findings following RFA and the post-therapeutic outcome. (authors)

DOES FATHER INVOLVEMENT INFLUENCE THE AFFECT, LANGUAGE ACQUISITION, SOCIAL ENGAGEMENT AND BEHAVIOR IN YOUNG AUTISTIC CHILDREN? AN EARLY INTERVENTION STUDY

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Preeti Tabitha LOUIS

2015-11-01

Full Text Available The present study adopts a randomized experimental design to evaluate the impact of a father-mediated therapy to improve the play skills, affect, language, social skills and behavior among 30 clinically diagnosed autistic children at the age of 3-5 years. Standardized inventories such as, The Play Based Observation (PBO, The Griffiths Mental Developmental Scales (GMDS, The Vineland Social Maturity Scale (VSMS and the Rendel Shorts Questionnaire were administered pre and post intervention. A special program that involved fathers in the caregiving and nurturing processes of these children was designed and implemented for 6 months after which the children were reassessed. Prior to the intervention, deficits in play skills and developmental delays across expressive and receptive language were observed Scores on the Vineland Social Maturity Scale and the Rendel Shorts revealed behavioral markers. Post intervention, we noticed significant differences in the play, language acquisition, social engagement and behavior in the treatment group in comparison to the control group. The results suggested that father-mediated therapeutic involvement significantly has proven to positively foster development in young autistic children and this is an important implication for practitioners in developing early intervention programs.

Repeated tumor pO2 measurements by multi-site EPR oximetry as a prognostic marker for enhanced therapeutic efficacy of fractionated radiotherapy

International Nuclear Information System (INIS)

Hou Huagang; Lariviere, Jean P.; Demidenko, Eugene; Gladstone, David; Swartz, Harold; Khan, Nadeem

2009-01-01

Purpose: To investigate the temporal effects of single or fractionated radiotherapy on subcutaneous RIF-1 tumor pO 2 and to determine the therapeutic outcomes when the timing of fractionations is guided by tumor pO 2 . Methods: The time-course of the tumor pO 2 changes was followed by multi-site electron paramagnetic resonance (EPR) oximetry. The tumors were treated with single 10, 20, and 10 Gy x 2 doses, and the tumor pO 2 was measured repeatedly for six consecutive days. In the 10 Gy x 2 group, the second dose of 10 Gy was delivered at a time when the tumors were either relatively oxygenated or hypoxic. The changes in tumor volumes were followed for nine days to determine the therapeutic outcomes. Results: A significant increase in tumor pO 2 was observed at 24 h post 10 Gy, while 20 Gy resulted in a significant increase in tumor pO 2 at 72-120 h post irradiation. The tumors irradiated with a second dose of 10 Gy at 24 h, when the tumors were oxygenated, had a significant increase in tumor doubling times (DTs), as compared to tumors treated at 48 h when they were hypoxic (p 2 repeatedly during fractionated schemes to optimize radiotherapeutic outcome. This technique could also be used to identify responsive and non-responsive tumors, which will facilitate the design of other therapeutic approaches for non-responsive tumors at early time points during the course of therapy.

Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

Science.gov (United States)

Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

2011-01-01

Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

The implementation and evaluation of therapeutic touch in burn patients: an instructive experience of conducting a scientific study within a non-academic nursing setting.

Science.gov (United States)

Busch, Martine; Visser, Adriaan; Eybrechts, Maggie; van Komen, Rob; Oen, Irma; Olff, Miranda; Dokter, Jan; Boxma, Han

2012-12-01

Evaluation of therapeutic touch (TT) in the nursing of burn patients; post hoc evaluation of the research process in a non-academic nursing setting. 38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on anxiety for pain, salivary cortisol, and pain medication. Interviews with nurses were held concerning research in a non-academic setting. Anxiety for pain was more reduced on day 10 in the TT-group. The TT-group was prescribed less morphine on day 1 and 2. On day 2 cortisol level before dressing changes was higher in the TT-group. The situational challenges of this study led to inconsistencies in data collection and a high patient attrition rate, weakening its statistical power. Conducting an effect study within daily nursing practice should not be done with a nursing staff inexperienced in research. Analysis of the remaining data justifies further research on TT for burn patients with pain, anxiety for pain, and cortisol levels as outcomes. Administering and evaluating TT during daily care requires nurses experienced both in TT and research, thus leading to less attrition and missing data, increasing the power of future studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Effect of system of lamb rearing and season on early post-partum fertility of ewes and growth performance of lambs in Katahdin sheep.

Science.gov (United States)

Rastle-Simpson, S; D'Souza, K; Redhead, A; Singh-Knights, D; Baptiste, Q; Knights, M

2017-10-01

The effect of season (S), lamb rearing system (RT) and grain supplementation (GS) on post-partum fertility in Katahdin ewes and growth in Katahdin lambs was evaluated. Katahdin ewes were bred to lamb in fall (n = 36) or spring (n = 56) and at approximately 2.5 months post-partum were randomly assigned to be permanently separated or to continue to suckle their lambs for an additional 3 months. All ewes were joined with rams following treatment to synchronize oestrus. Weaned (W, n = 84) and continuously suckled lambs (CSK, n = 88) were fed forage only (n = 84; hay and pasture for fall- and spring-born lambs respectively) or were supplemented (n = 88; 18% crude protein ration ad libitum) and all weighed biweekly. Ewes rebred in the fall had a shorter ram introduction to lambing interval (p ewes lambing was not affected by season. The first service lambing rate was lower in ewes continuously suckling lambs in the spring, but not in the fall breeding season (S × RT, p = 0.03). Lambs that continuously suckled their dams and were supplemented grew quicker and gained more (p ewes are capable of early rebreeding post-partum while suckling their lambs, which makes them suited for use in accelerated lambing programmes. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

In-Hospital Risk Prediction for Post-stroke Depression. Development and Validation of the Post-stroke Depression Prediction Scale

NARCIS (Netherlands)

Thóra Hafsteinsdóttir; Roelof G.A. Ettema; Diederick Grobbee; Prof. Dr. Marieke J. Schuurmans; Janneke van Man-van Ginkel; Eline Lindeman

2013-01-01

Background and Purpose—The timely detection of post-stroke depression is complicated by a decreasing length of hospital stay. Therefore, the Post-stroke Depression Prediction Scale was developed and validated. The Post-stroke Depression Prediction Scale is a clinical prediction model for the early

Carcinoma cervicis uteri. Long-term follow-up therapeutic results.

Science.gov (United States)

Ptácková, B; Kucera, F; Caha, A; Tacev, T; Spurný, V; Kabela, M; Konecný, M; Krystof, V

1982-01-01

The principle of the therapy of carcinoma cervicis uteri in the Research Institute of Clinical and Experimental Oncology in Brno is the combination of betatron megavoltage irradiation and cobalt 60 irradiation with intracavital radium irradiation. On the basis of many years' study concerning the therapy and therapeutic results of this tumor accurate directions of total therapy were elaborated. Carcinoma is diagnosed and classified precisely according to valid international directions. In addition to basic examination, limb lymphography was introduced giving the strategy of irradiation when lymphatic system is involved and in early stages of the disease. By preliminary evaluation of the obtained data a certain improvement of therapeutic results is proven. About 15% more patients are alive till 5 years without any signs of the disease than in precedent years. In spite of a high dose summation given by the extent of megavoltage irradiation the number of postirradiation reaction, nor early late, is increased to much. Complex therapy of this tumor is performed by a team of physicians composed of gynecologist, radiologist, rentgendiagnosticist, pathologist, and radiation physicist. By increasing the number of cured patients and their return and enclosure into further working process the savings in state budget are achieved. The effectiveness of the carcinoma cervicis uteri therapy is therefore dependent not only on earlier diagnosis and modern irradiation technique, but also on the cooperation of a team of physicians who plan, perform and follow the therapy.

Mindfulness and the Therapeutic Function of Education

Science.gov (United States)

Hyland, Terry

2009-01-01

Although it has been given qualified approval by a number of philosophers of education, the so-called "therapeutic turn" in education has been the subject of criticism by several commentators on post-compulsory and adult learning over the last few years. A key feature of this alleged development in recent educational policy is said to be the…

Colorectal cancer: diagnostic and therapeutic strategies

International Nuclear Information System (INIS)

Vaillant, J.C.

1996-01-01

Technical advances that has been achieved during the past two decades have not dramatically improved the 35 % five-year rate observed in patients with colorectal cancer. These tumours remain one of the most challenging problems in public health policies in western countries. Screening applies to some subgroups of high-risk individuals and the general population aged over 50. In order to improve their efficacy, such screening programs imply large-scale information campaigns and a strong cooperation with the general physicians. The diagnosis is strongly suggested by any recent modification of bowel habits ad by rectal bleeding. It has to be confirmed by rectal examination and by colonoscopy which allows sampling to the tumour. Loco-regional and distant metastatic tumour spread must be assessed precisely before any therapeutic strategy is decided. Surgery, which resects the tumour en bloc with the corresponding lymphatic territories, is the only treatment that can achieve long term cure. In localized tumours, surgery alone can provide patients with 5-years survival rates close to 95 %. On the other hand, surgery alone is not sufficient to cure patients with advances cancers. In recent years, several adjuvant therapeutic modalities have been shown to improve the results of surgery in these cases (rectal cancer: pre-operative radiotherapy or post-operative radio-chemotherapy, colon cancer with nodal metastases: post-operative chemotherapy). There is a hope that a better use of our diagnostic and therapeutic armementarium would be able to avoid or to cure up to 75 % of the colorectal cancers we are dealing with. (author)

Evaluation of selected aspects of the Nutrition Therapeutic ...

African Journals Online (AJOL)

2015-04-28

Apr 28, 2015 ... Background: The Nutrition Therapeutic Programme (NTP) involves the provision of food supplements .... received adequate information and education regarding .... were as follows: 8 facility managers, 10 professional nurses,.

Evaluating FDG uptake changes between pre and post therapy respiratory gated PET scans

International Nuclear Information System (INIS)

Aristophanous, Michalis; Yong, Yue; Yap, Jeffrey T.; Killoran, Joseph H.; Allen, Aaron M.; Berbeco, Ross I.; Chen, Aileen B.

2012-01-01

Purpose: Whole body (3D) and respiratory gated (4D) FDG-PET/CT scans performed pre-radiotherapy (pre-RT) and post-radiotherapy (post-RT) were analyzed to investigate the impact of 4D PET in evaluating 18F-fluorodeoxyglucose (FDG) uptake changes due to therapy, relative to traditional 3D PET. Methods and materials: 3D and 4D sequential FDG-PET/CT scans were acquired pre-RT and approximately one month post-RT for patients with non-small cell lung cancer (NSCLC). The lesions of high uptake targeted with radiotherapy were identified on the pre-RT scan of each patient. Each lesion on the 3D and each of the five phases of the 4D scan were analyzed using a region of interest (ROI). For each patient the ROIs of the pre-RT scans were used to locate the areas of initial FDG uptake on the post-RT scans following rigid registration. Post-RT ROIs were drawn and the FDG uptake was compared with that of the pre-RT scans. Results: Sixteen distinct lesions from 12 patients were identified and analyzed. Standardized uptake value (SUV) maxima were significantly higher (p-value <0.005) for the lesions as measured on the 4D compared to 3D PET. Comparison of serial pre and post-RT scans showed a mean 62% decrease in SUV with the 3D PET scan (range 36–89%), and a 67% decrease with the 4D PET scan (range 30–89%). The mean absolute difference in SUV change on 3D versus 4D scans was 4.9%, with a range 0–15% (p-value = 0.07). Conclusions: Signal recovery with 4D PET results in higher SUVs when compared to standard 3D PET. Consequently, differences in the evaluation of SUV changes between pre and post-RT plans were observed. Such difference can have a significant impact in PET-based response assessment.

Effectiveness of speech language therapy either alone or with add-on computer-based language therapy software (Malayalam version) for early post stroke aphasia: A feasibility study.

Science.gov (United States)

Kesav, Praveen; Vrinda, S L; Sukumaran, Sajith; Sarma, P S; Sylaja, P N

2017-09-15

This study aimed to assess the feasibility of professional based conventional speech language therapy (SLT) either alone (Group A/less intensive) or assisted by novel computer based local language software (Group B/more intensive) for rehabilitation in early post stroke aphasia. Comprehensive Stroke Care Center of a tertiary health care institute situated in South India, with the study design being prospective open randomised controlled trial with blinded endpoint evaluation. This study recruited 24 right handed first ever acute ischemic stroke patients above 15years of age affecting middle cerebral artery territory within 90days of stroke onset with baseline Western Aphasia Battery (WAB) Aphasia Quotient (AQ) score of aphasia. Copyright © 2017 Elsevier B.V. All rights reserved.

Using the TED Talks to Evaluate Spoken Post-editing of Machine Translation

DEFF Research Database (Denmark)

Liyanapathirana, Jeevanthi; Popescu-Belis, Andrei

2016-01-01

This paper presents a solution to evaluate spoken post-editing of imperfect machine translation output by a human translator. We compare two approaches to the combination of machine translation (MT) and automatic speech recognition (ASR): a heuristic algorithm and a machine learning method...

Conceptual Framework for Therapeutic Training with Biofeedback in Virtual Reality: First Evaluation of a Relaxation Simulator

Science.gov (United States)

Fominykh, Mikhail; Prasolova-Førland, Ekaterina; Stiles, Tore C.; Krogh, Anne Berit; Linde, Mattias

2018-01-01

This paper presents a concept for designing low-cost therapeutic training with biofeedback and virtual reality. We completed the first evaluation of a prototype--a mobile learning application for relaxation training, primarily for adolescents suffering from tension-type headaches. The system delivers visual experience on a head-mounted display. A…

Efficacy of sucralfate for the treatment of post-tonsillectomy symptoms.

Science.gov (United States)

Siupsinskiene, Nora; Žekonienė, Jurgita; Padervinskis, Evaldas; Žekonis, Gediminas; Vaitkus, Saulius

2015-02-01

Pain after tonsillectomy remains the main issue of postoperative morbidity and the search for an effective post-tonsillectomy analgesic is of increasing relevance. The aim of this study was to evaluate the effectiveness of topical sucralfate during an early post-tonsillectomy period. Fifty patients of both genders from 6 to 58 years submitted to tonsillectomy or adenotonsillectomy were randomly included into either a sucralfate treatment group (N = 25) or into a control group (N = 25). Patients of the sucralfate group received topical sucralfate four times a day for 7 days. No topical treatment was applied to patients of the control group. A systemic analgesic was standardized. Post-tonsillectomy symptoms, including throat pain, odynophagia and otalgia, were evaluated during the period of seven postoperative days. Secondary outcomes were analgesic use, well being in general, return to regular daily activities, secondary hemorrhage and side effects of sucralfate. This study revealed that during the period of the second to seventh postoperative days average throat pain scores of the sucralfate using patients were significantly lower than those of the control group patients (p < 0.05); the same could be applied to odynophagia scores during the period of all seven postoperative days (p < 0.01) and otalgia scores from the 4th postoperative day (p < 0.05). The sucralfate group patients also had a significantly smaller need for analgesics, better scores of well being in general and early return to regular daily activities with no side effects of the treatment. Topical sucralfate could be recommended for the everyday clinical practice as a safe, adjuvant medicine of treatment during the period of the first post-tonsillectomy week.

[Relationship experiences and therapeutic outcome in inpatient psychotherapy].

Science.gov (United States)

Sammet, Isa; Staats, Herrmann; Schauenburg, Henning

2004-01-01

Inpatient psychotherapy includes the patient's manifold contacts with different therapists, nurses and fellow patients. The present study investigated the association between these multiple relationships and therapy outcome. Pre-post measures of symptom load (Brief Symptom Inventory), interpersonal problems (IIP) and self-efficacy (SEB) were used to define three groups with positive (N=129), unchanged (N=44) or negative (N=40) outcome. These groups were compared 1) by their alliance with an individual therapist, their relationship to the therapeutic team, their experience of cohesion and climate concerning fellow patients in the ward (measured weekly by the "Stationserfahrungsbogen" SEB), and 2) by their differences in mean correlations between the courses of relationship experiences and symptom load. Cohesion and relationship to the therapeutic team were not associated with therapy outcome. Therapeutic alliance with the individual therapist and climate among fellow patients turned out to be moderate indicators of the therapeutic outcome. It is recommended to include these process parameters systematically into the process diagnostics of inpatient psychotherapy.

ISP 22 OECD/NEA/CSNI International standard problem n. 22. Evaluation of post-test analyses

International Nuclear Information System (INIS)

1992-07-01

The present report deals with the open re-evaluation of the originally double-blind CSNI International Standard Problem 22 based on the test SP-FW-02 performed in the SPES facility. The SPES apparatus is an experimental simulator of the Westinghouse PWR-PUN plant. The test SP-FW-02 (ISP22) simulates a complete loss of feedwater with delayed injection of auxiliary feedwater. The main parts of the report are: outline of the test facility and of the SP-FW-02 experiment; overview of pre-test activities; overview of input models used by post-test participants; evaluation of participant predictions; evaluation of qualitative and quantitative code accuracy of pre-test and post-test calculations

Introduction to current and future protein therapeutics: a protein engineering perspective.

Science.gov (United States)

Carter, Paul J

2011-05-15

Protein therapeutics and its enabling sister discipline, protein engineering, have emerged since the early 1980s. The first protein therapeutics were recombinant versions of natural proteins. Proteins purposefully modified to increase their clinical potential soon followed with enhancements derived from protein or glycoengineering, Fc fusion or conjugation to polyethylene glycol. Antibody-based drugs subsequently arose as the largest and fastest growing class of protein therapeutics. The rationale for developing better protein therapeutics with enhanced efficacy, greater safety, reduced immunogenicity or improved delivery comes from the convergence of clinical, scientific, technological and commercial drivers that have identified unmet needs and provided strategies to address them. Future protein drugs seem likely to be more extensively engineered to improve their performance, e.g., antibodies and Fc fusion proteins with enhanced effector functions or extended half-life. Two old concepts for improving antibodies, namely antibody-drug conjugates and bispecific antibodies, have advanced to the cusp of clinical success. As for newer protein therapeutic platform technologies, several engineered protein scaffolds are in early clinical development and offer differences and some potential advantages over antibodies. Copyright © 2011 Elsevier Inc. All rights reserved.

Acute Sleep Deprivation Enhances Post-Infection Sleep and Promotes Survival during Bacterial Infection in Drosophila

Science.gov (United States)

Kuo, Tzu-Hsing; Williams, Julie A.

2014-01-01

Study Objectives: Sleep is known to increase as an acute response to infection. However, the function of this behavioral response in host defense is not well understood. To address this problem, we evaluated the effect of acute sleep deprivation on post-infection sleep and immune function in Drosophila. Setting: Laboratory. Participants: Drosophila melanogaster. Methods and Results: Flies were subjected to sleep deprivation before (early DEP) or after (late DEP) bacterial infection. Relative to a non-deprived control, flies subjected to early DEP had enhanced sleep after infection as well as increased bacterial clearance and survival outcome. Flies subjected to late DEP experienced enhanced sleep following the deprivation period, and showed a modest improvement in survival outcome. Continuous DEP (early and late DEP) throughout infection also enhanced sleep later during infection and improved survival. However, improved survival in flies subjected to late or continuous DEP did not occur until after flies had experienced sleep. During infection, both early and late DEP enhanced NFκB transcriptional activity as measured by a luciferase reporter (κB-luc) in living flies. Early DEP also increased NFκB activity prior to infection. Flies that were deficient in expression of either the Relish or Dif NFκB transcription factors showed normal responses to early DEP. However, the effect of early DEP on post-infection sleep and survival was abolished in double mutants, which indicates that Relish and Dif have redundant roles in this process. Conclusions: Acute sleep deprivation elevated NFκB-dependent activity, increased post-infection sleep, and improved survival during bacterial infection. Citation: Kuo TH, Williams JA. Acute sleep deprivation enhances post-infection sleep and promotes survival during bacterial infection in Drosophila. SLEEP 2014;37(5):859-869. PMID:24790264

Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial

NARCIS (Netherlands)

Voorn, Eric L.; Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H. L.; Nollet, Frans

2016-01-01

To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued

Early intranasal insulin therapy halts progression of neurodegeneration: progress in Alzheimer’s disease therapeutics

OpenAIRE

de la Monte, Suzanne M.

2012-01-01

Evaluation of Craft S, Baker LD, Montine TJ, Minoshima S, Watson GS, Claxton A, et al. Intranasal Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive Impairment: A Pilot Clinical Trial. Arch Neurol. 2011 Sep 12. Alzheimer’s disease is associated with brain insulin deficiency and insulin resistance, similar to the problems in diabetes. If insulin could be supplied to the brain in the early stages of Alzheimer’s, subsequent neurodegeneration might be prevented. ...

FLT-PET for early response evaluation of colorectal cancer patients with liver metastases

DEFF Research Database (Denmark)

Mogensen, Marie Benzon; Loft, Annika; Aznar, Marianne

2017-01-01

BACKGROUND: Fluoro-L-thymidine (FLT) is a positron emission tomography/computed tomography (PET/CT) tracer which reflects proliferative activity in a cancer lesion. The main objective of this prospective explorative study was to evaluate whether FLT-PET can be used for the early evaluation...... standardised uptake values (SUVmax, SUVmean) were measured. After three cycles of chemotherapy, treatment response was assessed by CT scan based on RECIST 1.1. RESULTS: Thirty-nine consecutive patients were included of which 27 were evaluable. Dropout was mainly due to disease complications. Nineteen patients...... between the response according to RECIST and the early changes in FLT uptake measured as SUVmax(p = 0.24). CONCLUSIONS: No correlation was found between early changes in FLT uptake after the first cycle of treatment and the response evaluated from subsequent CT scans. It seems unlikely that FLT-PET can...

Efficacy of early intervention of motor relearning program on post-stroke hemiplemia:A randomized controlled observation

Institute of Scientific and Technical Information of China (English)

Jia Xue; Liang Bai; Qingrong Guo; Chengrong Yang; Jie Lu

2006-01-01

BACKGROUND: Previous studies believed that the effect of rehabilitation training within 6 months after stroke (early rehabilitation training) is usually unsatisfactory. The rehabilitation training when acute stroke is stabilized may be better for the recovery of limb function.OBJECTIVE: To observe the effects of the rehabilitation training of motor relearning program plus Bobath technique on the motor function of limbs, nerve function and activities of daily life (ADL) in patients with acute stroke hemiplegia.DESIGN: A randomized controlled observation.SETTING: Department of Neurology, Yaan People's Hospital.PARTICrPANTS: A total of 150 patients with acute post-stroke hemiplegia were selected from the Department of Neurology, Yaan People's Hospital from March 2000 to October 2002. The patients were all accorded with the diagnostic standards about stroke set by the Fifth National Academic Meeting for Cerebrovascular Disease (1996), confirmed by CT and MRI, and they were all informed with the interventions and the items of evaluation. The enrolled patients were randomly divided into training group (n=78) and control group (n=72) at admission. METHODS: ① Interventions: All the patients were given routine treatments for stroke, including managin blood pressure, maintaining the balance of hydrolyte and electrolure, reducing intracranial pressure by dehydration,and venous injection of citicoline, besides those in the training group received rehabilitation training by motor relearning program and Bobath technique. The rehabilitation training began after the vital signs became stable within 24 hours to 3 days after attack for the patients with cerebral infarction and 48 hours to 5 days after attack for those with cerebral hemorrhage respectively, three times a day in the morning, at noon and in the evening respectively, 30 minutes for each time, they were trained for 1 month. Lying position: The patients should keep the anti-spasm posture in the supine position

Evaluation of possible associated factors for early childhood caries and severe early childhood caries: a multicenter cross-sectional survey

NARCIS (Netherlands)

Özen, B.; van Strijp, A.J.P.; Özer, L.; Olmus, H.; Genc, A.; Cehreli, S.B.

2016-01-01

Objectives: The present study evaluated associated factors for developing early childhood caries (ECC) and Severe-ECC (S-ECC) in a group of children aged 24–71 months. Potential positive effects of early dental visit on formation of ECC is investigated as well. Study Design: This was a multicenter,

Scandinavian clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest

DEFF Research Database (Denmark)

Castrén, M; Silfvast, T; Rubertsson, S

2009-01-01

BACKGROUND AND AIM: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several...... of Anaesthesiology and Intensive Care Medicine (SSAI). METHODS: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus...

The application of post yield fracture methodology to the evaluation of large structures

International Nuclear Information System (INIS)

Landes, J.D.

1979-01-01

The objective of this work is to determine how to use small specimens test results to measure fracture toughness values for application to the evaluation of large structural components. Linear elastic fracture mechanics concepts based on the crack tip stress intensity factor, K, have been extended into the post yield regime by the use of elastic-plastic characterizing parameters such as J integral and COD. One of the primary applications of this technology is the determination of fracture toughness values from small specimens tests taken primarily in the post yield regime which can be used to evaluate structures operating in an essentially linear elastic regime. The fracture toughness values may be either conservative or unconservative depending on the fracture mode; extreme care must be taken in interpretting these results. (orig.)

Therapeutic equivalence and pharmacokinetics of generic tacrolimus formulation in de novo kidney transplant patients.

Science.gov (United States)

Min, Sang-Il; Ha, Jongwon; Kim, Yon Su; Ahn, Sang Hyun; Park, Taejin; Park, Dae Do; Kim, Suh Min; Min, Seung-Kee; Hong, Hyejin; Ahn, Curie; Kim, Sang Joon

2013-12-01

There is a growing concern about the therapeutic equivalence of the generic tacrolimus formulation (GEN Tacrolimus) to the reference tacrolimus (REF Tacrolimus) in solid organ transplantation. A prospective, randomized study of 126 de novo renal transplant patients was conducted to compare the efficacy, safety and pharmacokinetic (PK) profiles between GEN tacrolimus (n = 63) and REF tacrolimus (n = 63). The PK of tacrolimus was evaluated on Day 10 and 6 months under steady-state condition. Crossover study was carried out in 66 patients at 6 months. On Day 10, 117 patients completed PK profiles (54 GEN tacrolimus and 63 REF tacrolimus) and GEN tacrolimus showed comparable C(0) (9.8 ± 2.5 versus 9.7 ± 3.0 ng/mL, P = 0.80) but significantly higher dose-normalized C(max) (309.1 ± 191.9 versus 192.5 ± 95.2 ng/mL/mg/kg, P PK profiles evaluated at 9 months showed that generic substitution also resulted in an 'early and high C(max)'. Efficacy and safety data were comparable over the 9-month study period. Therapeutic equivalence and the PK of GEN tacrolimus should be evaluated in patients undergoing de novo renal transplantation.

Therapeutic Value of the Periodic Health Examination

Energy Technology Data Exchange (ETDEWEB)

Lincoln, T. A.; Hurt, H. B.

1965-09-01

The Oak Ridge National Laboratory has been conducting periodic health examinations on all of its employees for over 10 years. The original purpose of this program was the early detection of disease to be followed by referral or appropriate counseling. Because of the relatively young age of this group, we expected that this service would be of greatest benefit to only the small percentage who had significant findings. However, over this 10 year period we have been increasingly impressed that those who had no significant findings have expressed almost as much enthusiasm and gratitude as those in whom we found early but potentially serious disease. This response caused us to look more critically at the reasons for this favorable reaction. As a result, we have become convinced that these examinations have an important therapeutic value to the healthy, as well as the sick, and that this fact should be considered in their justification. A health examination can quite properly be considered therapeutic, even though no disease is found or treated, providing it "serves" or meets some of the needs of the person being examined. After all, the literal definition of the word therapeutic is service, since it is derived from the Greek word therapeutikos, which means an attendant or servant.

Evaluation of early healing events around mesenchymal stem cell-seeded collagen-glycosaminoglycan scaffold. An experimental study in Wistar rats.

LENUS (Irish Health Repository)

Alhag, Mohamed

2011-03-01

Tissue engineering using cell-seeded biodegradable scaffolds offers a new bone regenerative approach that might circumvent many of the limitations of current therapeutic modalities. The aim of this experiment was to study the early healing events around mesenchymal stem cell-seeded collagen-glycosaminoglycan scaffolds.

Early post-transplant immune monitoring can predict long-term kidney graft survival: soluble CD30 levels, anti-HLA antibodies and IgA-anti-Fab autoantibodies.

Science.gov (United States)

Amirzargar, Mohammad Ali; Amirzargar, Aliakbar; Basiri, Abbas; Hajilooi, Mehrdad; Roshanaei, Ghodratollah; Rajabi, Gholamreza; Mohammadiazar, Sina; Solgi, Ghasem

2014-01-01

This study aimed to investigate the predictive power of anti-HLA antibodies, sCD30 levels and IgA-anti-Fab autoantibody before and early after transplantation in relation to long-term kidney allograft survival. Pre- and post-transplant sera samples of 59 living-unrelated donor kidney recipients were tested for above risk factors by enzyme-linked immunoabsorbent assay. 15 out of 59 cases experienced rejection episodes (failure group). Pre- and post-transplant high sCD30 levels were significantly associated with graft failure (P=0.02 and P=0.004) and decreased 4 year graft survival (P = 0.009 and P = 0.001). Higher frequency of post-transplant HLA class-II antibody in the absence of class-I antibody was observed in failure group (P=0.007). Patients with post-transplant HLA class-I and class-II antibodies either alone or in combination showed significant lower 4 year graft survival. Recipients with high sCD30 levels in the presence of HLA class-I or class-II antibodies within 2 weeks post-transplant had poor graft survival (P = 0.004 and P = 0.002, respectively). High levels of post-transplant IgA-anti-Fab antibody was more frequent in functioning-graft patients (P = 0.00001), correlated with decreased serum creatinine levels (P = 0.01) and associated with improved graft survival (P = 0.008). Our findings indicate the deleterious effect of early post-transplant HLA antibodies and increased sCD30 levels dependently and protective effect of IgA-anti-Fab antibodies on long-term renal graft outcomes. Copyright © 2013 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

The Effect of Neoadjuvant Therapy on Early Complications of Esophageal Cancer Surgery

Directory of Open Access Journals (Sweden)

Mohammadtaghi Rajabi Mashhadi

2015-07-01

Full Text Available Introduction: Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR.   Materials and Methods: This randomized clinical trial was carried out between 2009 and 2011. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of 50 patients receiving standard chemoradiotherapy (Group A and then undergoing surgery, and the second group consisted of 50 patients undergoing surgery only (Group B. Patients were evaluated with respect to age, gender, clinical symptoms, type of pathology, time of surgery, perioperative blood loss, and number of lymph nodes resected as well as early post-operative complicate including leakage at the anastomosis site, chylothorax and pulmonary complications, hospitalization period, and mortality rate within the first 30 days after surgery.   Results: The mean age of patients was 55 years. Seventy-two patients had squamous cell carcinoma (SCC and 28 patients had adenocarcinoma (ACC. There was no significant difference between the two groups with respect to age, gender, time of surgery, complications including anastomotic leakage, chylothorax, pulmonary complications, cardiac complications, deep venous thrombosis (DVT, or mortality. However, there was a significant difference between the two groups regarding hospital stay, time of surgery, perioperative blood loss, and number of lymph nodes resected.   Conclusion:  The use of NACR did not increase early post-operative complications or mortality among patients with esophageal cancer.

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

International Nuclear Information System (INIS)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K.

2000-01-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

Energy Technology Data Exchange (ETDEWEB)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K

2000-11-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

Evaluation of early imaging response criteria in glioblastoma multiforme

International Nuclear Information System (INIS)

Gladwish, Adam; Koh, Eng-Siew; Hoisak, Jeremy; Lockwood, Gina; Millar, Barbara-Ann; Mason, Warren; Yu, Eugene; Laperriere, Normand J; Ménard, Cynthia

2011-01-01

Early and accurate prediction of response to cancer treatment through imaging criteria is particularly important in rapidly progressive malignancies such as Glioblastoma Multiforme (GBM). We sought to assess the predictive value of structural imaging response criteria one month after concurrent chemotherapy and radiotherapy (RT) in patients with GBM. Thirty patients were enrolled from 2005 to 2007 (median follow-up 22 months). Tumor volumes were delineated at the boundary of abnormal contrast enhancement on T1-weighted images prior to and 1 month after RT. Clinical Progression [CP] occurred when clinical and/or radiological events led to a change in chemotherapy management. Early Radiologic Progression [ERP] was defined as the qualitative interpretation of radiological progression one month post-RT. Patients with ERP were determined pseudoprogressors if clinically stable for ≥6 months. Receiver-operator characteristics were calculated for RECIST and MacDonald criteria, along with alternative thresholds against 1 year CP-free survival and 2 year overall survival (OS). 13 patients (52%) were found to have ERP, of whom 5 (38.5%) were pseudoprogressors. Patients with ERP had a lower median OS (11.2 mo) than those without (not reached) (p < 0.001). True progressors fared worse than pseudoprogressors (median survival 7.2 mo vs. 19.0 mo, p < 0.001). Volume thresholds performed slightly better compared to area and diameter thresholds in ROC analysis. Responses of > 25% in volume or > 15% in area were most predictive of OS. We show that while a subjective interpretation of early radiological progression from baseline is generally associated with poor outcome, true progressors cannot be distinguished from pseudoprogressors. In contrast, the magnitude of early imaging volumetric response may be a predictive and quantitative metric of favorable outcome

THERAPEUTIC EFFECTS OF A COGNITIVE-BEHAVIOURAL TREATMENT WITH JUVENILE OFFENDERS

Directory of Open Access Journals (Sweden)

Antonio Andrés-Pueyo

2012-07-01

Full Text Available Several treatment evaluations have highlighted the effectiveness of cognitive-behavioural programmes with both youth and adult offenders. This paper describes the application and assessment of a cognitive-behavioural treatment (adapted to Spanish from Ross and Fabiano’s Reasoning & Rehabilitation Programme with juvenile offenders serving community orders in an educational measure called in Spanish ‘libertad vigilada’ (similar to parole. The intervention comprised six different therapeutic components: self-control, cognitive restructuring, problem solving, social skills/assertiveness, values/empathy, and relapse prevention. Treatment effectiveness was tested using a quasi-experimental design involving two groups and pre/post evaluation. The results show that the programme was effective (with low to moderate effect sizes in improving participants’ social skills and self-esteem, as well as in reducing their aggressiveness. However, the intervention had no positive influence on empathy, cognitive distortions or impulsiveness. These results are in line with those of many other correctional studies, in which the treatment applied had a significant but partial effect on participants.

Post graduate clinical placements: evaluating benefits and challenges with a mixed methods cross sectional design.

Science.gov (United States)

Yiend, Jenny; Tracy, Derek K; Sreenan, Brian; Cardi, Valentina; Foulkes, Tina; Koutsantoni, Katerina; Kravariti, Eugenia; Tchanturia, Kate; Willmott, Lucy; Shergill, Sukhi; Reedy, Gabriel

2016-02-16

Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course. Data were collected over academic years 2010/11- 2013/14, from participating students (n = 20 to 58) and clinician supervisors (n = 10-12), using a mixed-methods cross-sectional design. Quantitative evaluation captured information on uptake, dropout, resource use, attitudes and experience, using standardized (the Placement Evaluation Questionnaire; the Scale To Assess the Therapeutic Relationship - Clinical version and the University of Toronto Placement Supervisor Evaluation) and bespoke questionnaires and audit data. Qualitative evaluation comprised two focus groups (5 clinicians, 5 students), to investigate attitudes, experience, perceived benefits, disadvantages and desired future developments. Data were analysed using framework analysis to identify a priori and emergent themes. High uptake (around 70 placements per annum), low dropout (2-3 students per annum; 5 %) and positive focus group comments suggested placements successfully provided added value and catered sufficiently to student demand. Students' responses confirmed that placements met expectations and the perception of benefit remained after completion with 70 % (n = 14) reporting an overall positive experience, 75 % (n = 15) reporting a pleasant learning experience, 60 % (n = 12) feeling that their clinical skills were enhanced and 85 % (n = 17) believing that it would benefit other students. Placements contributed the equivalent of seven full time unskilled posts per annum to local health care services. While qualitative data revealed perceived 'mutual benefit' for both students and clinicians, this was qualified by

Retrospective study of 48 cases of post-operative radiotherapy for head and neck cancer

International Nuclear Information System (INIS)

Mnejja, W.; Yahiaoui, S.; Siala, W.; Daoud, J.; Ghorbel, A.; Frikha, M.

2011-01-01

The authors report a study which aimed at assessing therapeutic results after post-operative radiotherapy of 48 patients suffering from head and neck cancers. The analysis is made in terms of cancer control, survival without recurrence and global survival. The post-operative radiotherapy improves the disease control rate. Ganglionary attack and capsular failure are survival prognosis factors. The concomitant association of chemo-therapy and radiotherapy should improve therapeutic results. Short communication

Acute sleep deprivation enhances post-infection sleep and promotes survival during bacterial infection in Drosophila.

Science.gov (United States)

Kuo, Tzu-Hsing; Williams, Julie A

2014-05-01

Sleep is known to increase as an acute response to infection. However, the function of this behavioral response in host defense is not well understood. To address this problem, we evaluated the effect of acute sleep deprivation on post-infection sleep and immune function in Drosophila. Laboratory. Drosophila melanogaster. Flies were subjected to sleep deprivation before (early DEP) or after (late DEP) bacterial infection. Relative to a non-deprived control, flies subjected to early DEP had enhanced sleep after infection as well as increased bacterial clearance and survival outcome. Flies subjected to late DEP experienced enhanced sleep following the deprivation period, and showed a modest improvement in survival outcome. Continuous DEP (early and late DEP) throughout infection also enhanced sleep later during infection and improved survival. However, improved survival in flies subjected to late or continuous DEP did not occur until after flies had experienced sleep. During infection, both early and late DEP enhanced NFκB transcriptional activity as measured by a luciferase reporter (κB-luc) in living flies. Early DEP also increased NFκB activity prior to infection. Flies that were deficient in expression of either the Relish or Dif NFκB transcription factors showed normal responses to early DEP. However, the effect of early DEP on post-infection sleep and survival was abolished in double mutants, which indicates that Relish and Dif have redundant roles in this process. Acute sleep deprivation elevated NFκB-dependent activity, increased post-infection sleep, and improved survival during bacterial infection.

[Establish research model of post-marketing clinical safety evaluation for Chinese patent medicine].

Science.gov (United States)

Zheng, Wen-ke; Liu, Zhi; Lei, Xiang; Tian, Ran; Zheng, Rui; Li, Nan; Ren, Jing-tian; Du, Xiao-xi; Shang, Hong-cai

2015-09-01

The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.

Evaluation of carbohydrate restriction as primary treatment for post-gastric bypass hypoglycemia.

Science.gov (United States)

van Meijeren, Jorick; Timmer, Ilse; Brandts, Hans; Janssen, Ignace; Boer, Hans de

2017-03-01

Up to 15% of patients who have undergone Roux-en-Y gastric bypass (RYGB) surgery may eventually develop symptoms of hypoglycemia. To evaluate the daily life efficacy of a carbohydrate (carb)-restricted dietary advice (CRD) of 6 meals per day with a 30 g carb maximum per meal in patients with documented post-RYGB hypoglycemia. Teaching hospital, the Netherlands. Frequency and severity of hypoglycemic events before and after CRD were assessed retrospectively in 41 patients with documented post-RYGB hypoglycemia, based on medical records and telephone questionnaires. Hypoglycemia was defined as a blood glucose leveltreatment of hypoglycemia, decreased from 23 to 6 (Pmeals per day with up to 30 g carbs each, is an effective treatment of post-RYGB hypoglycemia in the majority of patients. Additional medication is needed in about a third of patients. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Early quantification of the therapeutic efficacy of the vascular disrupting agent, CKD-516, using dynamic contrast-enhanced ultrasonography in rabbit VX2 liver tumors

Energy Technology Data Exchange (ETDEWEB)

Joo, Ijin; Kim, Jung Hoon; Lee, Jeong Min; Choi, Jin Woo; Han, Joon Koo; Choi, Byung Ihn [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

2014-03-15

To evaluate the usefulness of dynamic contrast-enhanced ultrasonography (DCE-US) in the early quantification of hemodynamic change following administration of the vascular disrupting agent (VDA) CKD-516 using a rabbit VX2 liver tumor model. This study was approved by our institutional animal care and use committee. Eight VX2 liver-tumor-bearing rabbits were treated with intravenous CKD-516, and all underwent DCE-US using SonoVue before and again 2, 4, 6, and 24 hours following their treatment. The tumor perfusion parameters were obtained from the time-intensity curve of the DCE-US data. Repeated measures analysis of variance was performed to assess any significant change in tumor perfusion over time. Relative changes in the DCE-US parameters between the baseline and follow-up assessments were correlated with the relative changes in tumor size over the course of seven days using Pearson correlation. CKD-516 treatment resulted in significant changes in the DCE-US parameters, including the peak intensity, total area under the time-intensity curve (AUCtotal), and AUC during wash-out (AUCout) over time (P<0.05). Pairwise comparison tests revealed that the AUCtotal and AUC during wash-in (AUCin) seen on the two-hour follow-up were significantly lower than the baseline values (P<0.05). However, none of early changes in the DCE-US parameters until 24-hour follow-up showed a significant correlation with the relative changes in tumor size during seven days after CKD-516 treatment. Our results suggest that a novel VDA (CKD-516) can cause disruption of tumor perfusion as early as two hours after treatment and that the therapeutic effect of CKD-516 treatment can be effectively quantified using DCE-US.

Therapeutic Perspectives of 8-Prenylnaringenin, a Potent Phytoestrogen from Hops

Directory of Open Access Journals (Sweden)

Kateřina Štulíková

2018-03-01

Full Text Available Hop (Humulus lupulus L., as a key ingredient for beer brewing, is also a source of many biologically active molecules. A notable compound, 8-prenylnaringenin (8-PN, structurally belonging to the group of prenylated flavonoids, was shown to be a potent phytoestrogen, and thus, became the topic of active research. Here, we overview the pharmacological properties of 8-PN and its therapeutic opportunities. Due to its estrogenic effects, administration of 8-PN represents a novel therapeutic approach to the treatment of menopausal and post-menopausal symptoms that occur as a consequence of a progressive decline in hormone levels in women. Application of 8-PN in the treatment of menopause has been clinically examined with promising results. Other activities that have already been assessed include the potential to prevent bone-resorption or inhibition of tumor growth. On the other hand, the use of phytoestrogens is frequently questioned regarding possible adverse effects associated with long-term consumption. In conclusion, we emphasize the implications of using 8-PN in future treatments of menopausal and post-menopausal symptoms, including the need for precise evidence and further investigations to define the safety risks related to its therapeutic use.

Trypanosoma cruzi benznidazole susceptibility in vitro does not predict the therapeutic outcome of human Chagas disease

Directory of Open Access Journals (Sweden)

Margoth Moreno

2010-11-01

Full Text Available Therapeutic failure of benznidazole (BZ is widely documented in Chagas disease and has been primarily associated with variations in the drug susceptibility of Trypanosoma cruzi strains. In humans, therapeutic success has been assessed by the negativation of anti-T. cruzi antibodies, a process that may take up to 10 years. A protocol for early screening of the drug resistance of infective strains would be valuable for orienting physicians towards alternative therapies, with a combination of existing drugs or new anti-T. cruzi agents. We developed a procedure that couples the isolation of parasites by haemoculture with quantification of BZ susceptibility in the resultant epimastigote forms. BZ activity was standardized with reference strains, which showed IC50 to BZ between 7.6-32 µM. The assay was then applied to isolates from seven chronic patients prior to administration of BZ therapy. The IC50 of the strains varied from 15.6 ± 3-51.4 ± 1 µM. Comparison of BZ susceptibility of the pre-treatment isolates of patients considered cured by several criteria and of non-cured patients indicates that the assay does not predict therapeutic outcome. A two-fold increase in BZ resistance in the post-treatment isolates of two patients was verified. Based on the profile of nine microsatellite loci, sub-population selection in non-cured patients was ruled out.

76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Science.gov (United States)

2011-03-09

... and Early Childhood Home Visiting Program Evaluation will meet for its first session on Wednesday... Administration for Children and Families Advisory Committee on the Maternal, Infant and Early Childhood Home...: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. Date and...

A CLINICAL EVALUATION OF POST-PARTUM DEPRESSION IN COASTAL KARNATAKA

Directory of Open Access Journals (Sweden)

Annappa Shetty

2016-09-01

Full Text Available BACKGROUND Psychological mood changes, depression is very common in Post-partum period ranging from mild and transient “baby blues” experienced by 50-80% of women to postpartum Psychosis which affects 1% of women. AIMS AND OBJECTIVE To evaluate the association of different factors with Post-Partum depression in coastal Karnataka region, (Karwar. MATERIAL & METHODS  A Prospective study was conducted in the department of Obstetrics and Gynaecology, KAIMS, Karwar, Karnataka.  A total one thousand patients 4-7 Post-partum days were selected and interrogated using Edinburgh Postnatal depression scale (EPDS. Socio-demographic factors (age, Parity, literacy, socio-economic status, marital status and family structure, history of psychiatric disorders and abuse, mode of delivery and the obstetric outcome were recorded. The results were analysed statistically using Chi-square chart. STATISTICAL ANALYSIS AND RESULTS: The incidence of PPD was 22%. Significant association of PPD was seen with low socio-economic status group (P<005, poor literacy (P<0.001, nuclear family structure (P<0.05, single mother (P<0.001, past history of abuse (P<0.05 and poor obstetric outcome (P<0.001. CONCLUSION This study provides useful information about the prevalence of PPD and the association of socio economic, cultural practices prevalent in coastal Karnataka with PPD.

Performance evaluation of early maize genotypes in far western hills of Nepal

OpenAIRE

Hari Kumar Prasai; Ujjawal Kumar Singh Kushwaha; Bishnu Prasad Joshi; Jiban Shrestha

2015-01-01

Initial evaluation trial of maize (early) genotypes was carried out at Regional Agricultural Research Station, Doti, Nepal in 2013 and 2014. Total fourteen and fifteen genotypes of early maize were included in initial evaluation experiment of the year 2013 and 2014 respectively. The experiment was laid out in randomized complete block design (RCBD) with three replications in each year. Out of the tested genotypes, SO3TEY/LN, ZM 423 and SO3TEY-FM (ER) identified as promising from statistical a...

Conversational evidence in therapeutic dialogue.

Science.gov (United States)

Strong, Tom; Busch, Robbie; Couture, Shari

2008-07-01

Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

MALDI Mass Spectrometry Imaging for Evaluation of Therapeutics in Colorectal Tumor Organoids

Science.gov (United States)

Liu, Xin; Flinders, Colin; Mumenthaler, Shannon M.; Hummon, Amanda B.

2018-03-01

Patient-derived colorectal tumor organoids (CTOs) closely recapitulate the complex morphological, phenotypic, and genetic features observed in in vivo tumors. Therefore, evaluation of drug distribution and metabolism in this model system can provide valuable information to predict the clinical outcome of a therapeutic response in individual patients. In this report, we applied matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) to examine the spatial distribution of the drug irinotecan and its metabolites in CTOs from two patients. Irinotecan is a prodrug and is often prescribed as part of therapeutic regimes for patients with advanced colorectal cancer. Irinotecan shows a time-dependent and concentration-dependent permeability and metabolism in the CTOs. More interestingly, the active metabolite SN-38 does not co-localize well with the parent drug irinotecan and the inactive metabolite SN-38G. The phenotypic effect of irinotecan metabolism was also confirmed by a viability study showing significantly reduced proliferation in the drug treated CTOs. MALDI-MSI can be used to investigate various pharmaceutical compounds in CTOs derived from different patients. By analyzing multiple CTOs from a patient, this method could be used to predict patient-specific drug responses and help to improve personalized dosing regimens. [Figure not available: see fulltext.

Reading Philemon as therapeutic narrative | Jordaan | HTS ...

African Journals Online (AJOL)

This article analysed the different narratives implied in Philemon by utilising the narrative therapeutic approach, as developed by Epston and White (1990). A dominant narrative (the harsh treatment of slaves in the early Christian environment) and a challenging narrative (a more humane conduct of slaves) were clearly ...

Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action.

Science.gov (United States)

Meiser-Stedman, Richard; Smith, Patrick; McKinnon, Anna; Dixon, Clare; Trickey, David; Ehlers, Anke; Clark, David M; Boyle, Adrian; Watson, Peter; Goodyer, Ian; Dalgleish, Tim

2017-05-01

Few efficacious early treatments for post-traumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post-trauma and focused on secondary prevention of later post-traumatic stress; however, considerable natural recovery may still occur up to 6-months post-trauma. No trials have addressed the early treatment of established PTSD (i.e. 2- to 6-months post-trauma). Twenty-nine youth (8-17 years) with PTSD (according to age-appropriate DSM-IV or ICD-10 diagnostic criteria) after a single-event trauma in the previous 2-6 months were randomly allocated to Cognitive Therapy for PTSD (CT-PTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. Significantly more participants were free of PTSD after CT-PTSD (71%) than WL (27%) at posttreatment (intent-to-treat, 95% CI for difference .04-.71). CT-PTSD yielded greater improvement on child-report questionnaire measures of PTSD, depression and anxiety; clinician-rated functioning; and parent-reported outcomes. Recovery after CT-PTSD was maintained at 6- and 12-month posttreatment. Beneficial effects of CT-PTSD were mediated through changes in appraisals and safety-seeking behaviours, as predicted by cognitive models of PTSD. CT-PTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. This trial provides preliminary support for the efficacy and acceptability of CT-PTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of 'watchful waiting' into the 2- to 6-month post-trauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Post-hypothermia fever is associated with increased mortality after out-of-hospital cardiac arres

DEFF Research Database (Denmark)

Bro-Jeppesen, John; Hassager, Christian; Wanscher, Michael

2013-01-01

Post-cardiac arrest fever has been associated with adverse outcome before implementation of therapeutic hypothermia (TH), however the prognostic implications of post-hypothermia fever (PHF) in the era of modern post-resuscitation care including TH has not been thoroughly investigated. The aim...

[Common physiological basis for post-traumatic stress disorder and dependence to drugs of abuse: Implications for new therapeutic approaches].

Science.gov (United States)

Gisquet-Verrier, Pascale; Tolédano, Daniel; Le Dorze, Claire

2017-06-01

Post-traumatic stress disorder (PTSD) and addiction to drugs of abuse are two common diseases, showing high comorbidity rates. This review presents a number of evidence showing similarities between these two pathologies, especially the hyper-responsiveness to environmental cues inducing a reactivation of the target memory leading either to re-experiencing (PTSD), or drug craving. Accordingly, PTSD and addiction to drug of abuse might by considered as memory pathologies, underlined by the same physiological process. We propose that these two pathologies rely on an uncoupling of the monoaminergic systems. According to this hypothesis, exposure to extreme conditions, either negative (trauma) or positive (drugs) induced a loss of the reciprocal control that one system usually exerts on the other monoaminergic system, resulting to an uncoupling between the noradrenergic and the serotonergic systems. Results obtained in our laboratory, using animal models of these pathologies, demonstrate that after a trauma, such as after repeated drug injections, rats developed both a behavioral sensitization (increases of the locomotion in response to a stimulation of the monoaminergic systems) and a pharmacological sensitization (increases of noradrenergic release within the prefrontal cortex). These results support our hypothesis and led us to propose new and innovative therapeutic approaches consisting either to induce a re-coupling of the monoaminergic systems, or to modify the pathological memories by using an emotional memory remodeling. Extremely encouraging results have already been obtained in rats and in humans, opening new and promising therapeutic avenues. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

MRI evaluation of post-mastectomy irradiated breast implants: prevalence and analysis of complications

International Nuclear Information System (INIS)

Rella, L.; Telegrafo, M.; Nardone, A.; Milella, A.; Ianora, A.A. Stabile; Lioce, M.; Angelelli, G.; Moschetta, M.

2015-01-01

Aim: To evaluate the effect of post-mastectomy radiation therapy (RT) on breast implants as detected by magnetic resonance imaging (MRI) searching for short-term complications. Materials and methods: One hundred and forty patients (total of 144 implants) were evaluated by MRI; 80 (group 1) had undergone RT, whereas the remaining 60 patients (group 2) underwent mastectomy with implant reconstruction without RT. Two radiologists evaluated MRI images searching for implant rupture signs, sub-capsular seromas, capsular contracture, soft-tissue oedema, peri-implant fluid collections. Implant ruptures were classified as severe complications; seromas and capsular contractures as moderate complications; oedema and fluid collections as mild complications. The prevalence of MRI findings in the two groups was calculated and compared by unpaired t-test. Cohen's kappa statistics was used to assess interobserver agreement. Results: Sixty-nine out of 144 (48%) implants presented pathological findings at MRI with complication rates of 47.5 and 48.4 for groups 1 and 2, respectively. Two (5%) severe complications, 10 (26%) moderate complications, and 26 (69%) mild complications occurred in group 1 and surgical treatment was performed in 10 cases. Two (6%) severe complications, seven (23%) moderate complications, and 22 (71%) mild complications occurred in group 2 and surgical treatment was performed in eight cases. No significant difference between the two groups was found (p>0.1). Almost perfect agreement between the two radiologists was found for MRI image detection (k=0.86). Conclusion: RT does not seem to cause a significant effect on breast implants in terms of complication rate in patients undergoing implant-based breast reconstruction. One-stage immediate implant-based breast reconstruction performed at the same time as mastectomy could be proposed. -- Highlights: •RT could increase complication rates of implant-based breast reconstruction (IBR). •No general consensus

Marital conflict and early adolescents' self-evaluation: the role of parenting quality and early adolescents' appraisals.

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Siffert, Andrea; Schwarz, Beate; Stutz, Melanie

2012-06-01

Cognitive appraisals and family dynamics have been identified as mediators of the relationship between marital conflict and children's adjustment. Surprisingly little research has investigated both meditational processes in the same study. Guided by the cognitive-contextual framework and the spillover hypothesis, the present study integrated factors from both theories early adolescents' appraisals of threat and self-blame, as well as perceived parenting quality as mediators of the link between early adolescents' perception of marital conflict and their self-evaluations (self-esteem and scholastic competence). Analyses were based on the first two waves of an ongoing longitudinal study. Participants were 176 two-parent families, and their early adolescents (50.5% girls) whose mean age was 10.61 years at Time 1 (SD =0.40) and 11.63 years at Time 2 (SD=0.39). Structural equation modeling analyses indicated that parenting quality and early adolescents' perceived threat provided indirect pathways between marital conflict and early adolescents' self-esteem 1 year later when controlling for their initial level of self-esteem. With respect to scholastic competence, only fathers' parenting was an indirect link. Self-blame did not play a role. Implications for understanding the mechanisms by which exposure to marital conflict predicts early adolescents' maladjustment are discussed.

Preoperative PET/CT in early-stage breast cancer

DEFF Research Database (Denmark)

Bernsdorf, M; Berthelsen, A K; Timmermans-Wielenga, Vera

2012-01-01

The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

Targeting protein neddylation: a novel therapeutic strategy for the treatment of cancer.

Science.gov (United States)

Wang, Meng; Medeiros, Bruno C; Erba, Harry P; DeAngelo, Daniel J; Giles, Francis J; Swords, Ronan T

2011-03-01

The NEDD8 (neural precursor cell-expressed developmentally downregulated 8) conjugation pathway regulates the post-translational modification of oncogenic proteins. This pathway has important potential for cancer therapeutics. Several proteins vital in cancer biology are regulated by protein neddylation. These observations led to the development of a small molecule inhibitor that disrupts protein neddylation and leads to cancer cell death and important activity in early phase clinical trials. This review provides an extensive coverage of cellular protein homeostasis with particular emphasis on the NEDD8 conjugation pathway. Insights into a new investigational drug that specifically disrupts the NEDD8 pathway are discussed. The clinical data for this agent are also updated. Neddylation controls key cellular pathways found to be dysregulated in many cancers. Protein neddylation is a relatively under-explored pathway for pharmacologic inhibition in cancer. Selective disruption of this pathway has demonstrated clinical activity in patients with myeloid neoplasms and is worth exploring further in combination with other anti-leukemia agents.

Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.

Science.gov (United States)

Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M

2016-01-01

Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.

The case for applying an early-lifecycle technology evaluation methodology to comparative evaluation of requirements engineering research

Science.gov (United States)

Feather, Martin S.

2003-01-01

The premise of this paper is taht there is a useful analogy between evaluation of proposed problem solutions and evaluation of requirements engineering research itself. Both of these application areas face the challenges of evaluation early in the lifecycle, of the need to consider a wide variety of factors, and of the need to combine inputs from multiple stakeholders in making thse evaluation and subsequent decisions.

ESCAPS study protocol: a feasibility randomised controlled trial of 'Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm'.

Science.gov (United States)

Fletcher-Smith, Joanna C; Walker, Dawn-Marie; Sprigg, Nikola; James, Marilyn; Walker, Marion F; Allatt, Kate; Mehta, Rajnikant; Pandyan, Anand D

2016-01-04

Approximately 70% of patients with stroke experience impaired arm function, which is persistent and disabling for an estimated 40%. Loss of function reduces independence in daily activities and impacts on quality of life. Muscles in those who do not recover functional movement in the stroke affected arm are at risk of atrophy and contractures, which can be established as early as 6 weeks following stroke. Pain is also common. This study aims to evaluate the feasibility of a randomised controlled trial to test the efficacy and cost-effectiveness of delivering early intensive electrical stimulation (ES) to prevent post-stroke complications in the paretic upper limb. This is a feasibility randomised controlled trial (n=40) with embedded qualitative studies (patient/carer interviews and therapist focus groups) and feasibility economic evaluation. Patients will be recruited from the Stroke Unit at the Nottingham University Hospitals National Health Service (NHS) Trust within 72 h after stroke. Participants will be randomised to receive usual care or usual care and early ES to the wrist flexors and extensors for 30 min twice a day, 5 days a week for 3 months. The initial treatment(s) will be delivered by an occupational therapist or physiotherapist who will then train the patient and/or their nominated carer to self-manage subsequent treatments. This study has been granted ethical approval by the National Research Ethics Service, East Midlands Nottingham1 Research Ethics Committee (ref: 15/EM/0006). To our knowledge, this is the first study of its kind of the early application (within 72 h post-stroke) of ES to both the wrist extensors and wrist flexors of stroke survivors with upper limb impairment. The results will inform the design of a definitive randomised controlled trial. Dissemination will include 2 peer-reviewed journal publications and presentations at national conferences. ISRCTN1648908; Pre-results. Clinicaltrials.gov ID: NCT02324634. Published by the BMJ

Effectiveness of therapeutic barium enema for diverticular hemorrhage.

Science.gov (United States)

Matsuura, Mizue; Inamori, Masahiko; Nakajima, Atsushi; Komiya, Yasuhiko; Inoh, Yumi; Kawasima, Keigo; Naitoh, Mai; Fujita, Yuji; Eduka, Akiko; Kanazawa, Noriyoshi; Uchiyama, Shiori; Tani, Rie; Kawana, Kennichi; Ohtani, Setsuya; Nagase, Hajime

2015-05-14

To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding. We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August 2010 and March 2012 at Yokohama Rosai Hospital. Twenty patients were included in the review, consisting of 14 men and 6 women. The median age of the patients was 73.5 years. The duration of the follow-up period ranged from 1 to 19 mo (median: 9.8 mo). Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization, 6 patients who required it for re-bleeding that developed after the patient left the hospital, and 3 patients who required the procedure for the prevention of re-bleeding. Barium (concentration: 150 w%/v%) was administered per the rectum, and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy. After confirmation that the ascending colon and cecum were filled with barium, the enema tube was withdrawn, and the patient's position was changed every 20 min for 3 h. Twelve patients remained free of re-bleeding during the follow-up period (range: 1-19 mo) after the therapeutic barium enema, including 9 men and 3 women with a median age of 72.0 years. Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years: 4 developed early re-bleeding, defined as re-bleeding that occurs within one week after the procedure, and the remaining 4 developed late re-bleeding. The DFI (disease-free interval) decreased 0.4 for 12 mo. Only one patient developed a complication from therapeutic barium enema (colonic perforation). Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy.

Pre- and post-operative evaluations of eight dogs following right nephrectomy due to Dioctophyma renale.

Science.gov (United States)

Mesquita, L R; Rahal, S C; Faria, L G; Takahira, R K; Rocha, N S; Mamprim, M J; Oliveira, H S

2014-01-01

Dioctophyma renale is a large nematode distributed worldwide that may cause progressive and severe destruction of renal parenchyma. The present study aimed to evaluate pre- and post-operatively dogs submitted to right nephrectomy due to D. renale and to assess the histopathological damage of the removed kidney. Eight crossbred dogs, aged from 12 to 48 months that were unilaterally nephrectomized due to the presence of D. renale were evaluated. Physical examination, urinalysis, complete blood count, serum biochemistry, and abdominal ultrasound were performed immediately before and one month after nephrectomy. The nephrectomized right kidneys were submitted to macroscopic and microscopic evaluations. Urinalysis preoperatively detected occult blood in all dogs and D. renale eggs in five cases. Complete blood count showed all parameters within the reference range, except one dog post-operatively. Serum biochemistry performed before and after surgery verified that urea, creatinine and sodium were within the reference range values in all dogs. Other findings varied among the dogs. The length and arterial resistive index mean values of the left kidney were similar pre- and post-operatively. Thus, the inconsiderable change in laboratory findings pre- and post-operatively was attributable to compensation by left kidney function for the removed abnormal right kidney. Right kidney histology revealed chronic nephropathy due to D. renale. Imaging diagnosis should be performed on dogs suspected as carrying the disease or on those from an enzootic area since the laboratory findings are not specific except eggs in the urine.

ECONOMIC ASPECTS OF THERAPEUTIC EYELID HYGIENE IN MEIBOMIAN GLAND DYSFUNCTION TREATMENT

Directory of Open Access Journals (Sweden)

V. N. Trubilin

2015-01-01

Full Text Available The value of dry eye for general public health increases due to its high occurence in elderly persons and aging population. Non-specific questionnaires are adopted for dry eye. Additionally, 36‑item Medical Outcomes Study-Short Form (MOS-SF-36 and benefit evaluation method were developed. Methods. Information analysis and mathematical methods and public health technology evaluation methods (i.e., modelling, analysis of disease burden, and budget impact analysis were applied to economic aspect study. Decision tree model based on these finding was developed and applied to cost estimating of blepharoconjunctival and exogenous dry eye treatment in computer vision syndrome. Two scenarios of patient management were considered, i.e., typical management and management using therapeutic eyelid hygiene. Similar model was developed for early postoperative period after LASIK. Short-run analysis (1 year was performed, direct medical costs were considered. This analysis implies the calculation of overall cost (economic burden of the disease. Official data on adult population size in 2014 and the occurrence of the disease were used to assess prevalence. Budget impact analysis evaluates the difference in total economic effects due to comparison technology use in money terms. Sensitivity analysis assesses the stability of simulation results. Medical treatment cost was considered the most valuable parameter. Results and conclusions. Direct medical costs of typical management and management using therapeutic eyelid hygiene in demodicosis, computer vision syndrome, and after LASIK were 14,623 RUB and 9,200 RUB (savings of 37 %, 17,630 RUB and 9,200 RUB (savings of 47 %, 4,425.5 RUB and 3,004 RUB (savings of 32 %, respectively. Analysis of economic burden with respect to disease occurrence and typical management costs demonstrated that in 2015 this parameter was estimated as 576,198,416,556 RUB. In terms of direct medical costs, therapeutic eyelid hygiene saves 44

The therapeutic evaluation and mechanism on treating bronchial ...

African Journals Online (AJOL)

... the level of bronchial responsiveness, which proved a better curative effect of Chinese medicine. The mechanism is probably due to relieving the airway inflammation by keeping the balance between Th1 and Th2 cells. Keywords: Ziyinqingre prescription; cough; bronchial hyper-responsiveness; therapeutic mechanism ...

Brief Report: An Evaluation of an Australian Autism-Specific, Early Intervention Programme

Science.gov (United States)

Paynter, Jessica M.; Riley, Emma P.; Beamish, Wendi; Scott, James G.; Heussler, Helen S.

2015-01-01

There is a relative paucity of evidence examining the effectiveness of early intervention for young children with Autism Spectrum Disorder, in particular those delivered through educationally-based programmes. This study aimed to evaluate the real world effectiveness of a community-based autism-specific early learning and intervention programme in…

Evaluation of early tissue reactions after lumbar intertransverse process fusion using CT in a rabbit

International Nuclear Information System (INIS)

Shinbo, Jun; Mainil-Varlet, Pierre; Watanabe, Atsuya; Pippig, Suzanne; Koener, Jens; Anderson, Suzanne E.

2010-01-01

The objective of the study was to evaluate tissue reactions such as bone genesis, cartilage genesis and graft materials in the early phase of lumbar intertransverse process fusion in a rabbit model using computed tomography (CT) imaging with CT intensity (Hounsfield units) measurement, and to compare these data with histological results. Lumbar intertransverse process fusion was performed on 18 rabbits. Four graft materials were used: autograft bone (n=3); collagen membrane soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) (n=5); granular calcium phosphate (n=5); and granular calcium phosphate coated with rhBMP-2 (n=5). All rabbits were euthanized 3 weeks post-operatively and lumbar spines were removed for CT imaging and histological examination. Computed tomography imaging demonstrated that each fusion mass component had the appropriate CT intensity range. CT also showed the different distributions and intensities of bone genesis in the fusion masses between the groups. Each component of tissue reactions was identified successfully on CT images using the CT intensity difference. Using CT color mapping, these observations could be easily visualized, and the results correlated well with histological findings. The use of CT intensity is an effective approach for observing and comparing early tissue reactions such as newly synthesized bone, newly synthesized cartilage, and graft materials after lumbar intertransverse process fusion in a rabbit model. (orig.)

The dynamics of success and failure: how post-behaviour evaluations relate to subsequent exercise intentions and behaviour.

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Kwan, Bethany M; Bryan, Angela D; Sheeran, Paschal

2018-01-25

Exercise behaviour change involves multiple experiences with success and failure. The Model of Action Phases (MAP) offers a dynamic account of how success and failure influence both immediate evaluations and future decisions and actions. However, predictions from the MAP have not been formally tested. A longitudinal daily diary study was used to examine how post-behaviour evaluations of exercise success and failure influence subsequent exercise intentions and behaviour. Participants (N = 104) set exercise goals, and then kept a daily online exercise diary for four weeks. Participants self-reported exercise behaviour, affective response to exercise, self-evaluations after success or failure at following through on intentions to exercise, and intentions to exercise in the next week. Multilevel modelling revealed significant within- and between-participant relationships among post-behaviour evaluations, intentions and subsequent behaviour. Findings supported MAP-derived predictions about how success and failure at exercise are associated with feelings about exercise and the self, and inform subsequent exercise intentions and behaviour. Positive post-behaviour evaluations of success or failure may stabilise positive intentions and aid maintenance of exercise behaviour. Implications of these MAP-based findings for intervention design are discussed.

Study and evaluation of radiometry in photo therapeutic treatment of the neonatal hyperbilirubinaemia

International Nuclear Information System (INIS)

Caly, Jose Pucci

2009-01-01

Phototherapy is a procedure established more than 50 years ago in the treatment of the newborn jaundice. However there is no a standard method to quantify the photo therapeutic dose in published clinical studies, hindering the comparison of previous studies on photo therapeutic effectiveness, as well as the establishment of safe and predictable doses. The photo therapeutic dose depends, among other factors, on the effective mean irradiance produced by the photo therapeutic unit. There are no standard procedures, however, neither to quantify the effective irradiance, nor to estimate the mean effective irradiance. As a consequence, large measurement variations in a same photo therapeutic unit are observed using different commercially available radiometers, as a consequence of the vast diversity of spectral responsivities of the instruments. An objective of this work was to adapt and to apply the bases of the wideband ultraviolet radiometry to quantify the available irradiance from photo therapeutic units, establishing procedures that allow us to compare measured irradiances from different sources, using radiometers presenting different spectral responsivities. Another objective was to characterize samples of photo therapeutic units commonly used, focusing the problem of the estimation of the effective mean irradiance from photo therapeutic units, proposing a method to estimate of the effective irradiance from focused sources. The experimental results allow us to conclude that it is not only necessary to standardize the photo therapeutic radiometry, but also the method of estimation of the effective mean irradiance. (author)

Left ventricular remodeling in the post-infarction heart: a review of cellular, molecular mechanisms, and therapeutic modalities.

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Gajarsa, Jason J; Kloner, Robert A

2011-01-01

As more patients survive myocardial infarctions, the incidence of heart failure increases. After an infarction, the human heart undergoes a series of structural changes, which are governed by cellular and molecular mechanisms in a pathological metamorphosis termed "remodeling." This review will discuss the current developments in our understanding of these molecular and cellular events in remodeling and the various pharmacological, cellular and device therapies used to treat, and potentially retard, this condition. Specifically, this paper will examine the neurohormonal activity of the renin-angiotensin-aldosterone axis and its molecular effects on the heart. The emerging understanding of the extra-cellular matrix and the various active molecules within it, such as the matrix metalloproteinases, elicits new appreciation for their role in cardiac remodeling and as possible future therapeutic targets. Cell therapy with stem cells is another recent therapy with great potential in improving post-infarcted hearts. Lastly, the cellular and molecular effects of left ventricular assist devices on remodeling will be reviewed. Our increasing knowledge of the cellular and molecular mechanisms underlying cardiac remodeling enables us not only to better understand how our more successful therapies, like angiotensin-converting enzyme inhibitors, work, but also to explore new therapies of the future.

Regulating Critical Period Plasticity: Insight from the Visual System to Fear Circuitry for Therapeutic Interventions

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Elisa M. Nabel

2013-11-01

Full Text Available Early temporary windows of heightened brain plasticity called critical periods developmentally sculpt neural circuits and contribute to adult behavior. Regulatory mechanisms of visual cortex development –the preeminent model of experience-dependent critical period plasticity- actively limit adult plasticity and have proved fruitful therapeutic targets to reopen plasticity and rewire faulty visual system connections later in life. Interestingly, these molecular mechanisms have been implicated in the regulation of plasticity in other functions beyond vision. Applying mechanistic understandings of critical period plasticity in the visual cortex to fear circuitry may provide a conceptual framework for developing novel therapeutic tools to mitigate aberrant fear responses in post traumatic stress disorder. In this review, we turn to the model of experience-dependent visual plasticity to provide novel insights for the mechanisms regulating plasticity in the fear system. Fear circuitry, particularly fear memory erasure, also undergoes age-related changes in experience-dependent plasticity. We consider the contributions of molecular brakes that halt visual critical period plasticity to circuitry underlying fear memory erasure. A major molecular brake in the visual cortex, perineuronal net formation, recently has been identified in the development of fear systems that are resilient to fear memory erasure. The roles of other molecular brakes, myelin-related Nogo receptor signaling and Lynx family proteins– endogenous inhibitors for nicotinic acetylcholine receptor, are explored in the context of fear memory plasticity. Such fear plasticity regulators, including epigenetic effects, provide promising targets for therapeutic interventions.

Sodium borocaptate (BSH) for Boron Neutron Capture Therapy (BNCT) in the hamster cheek pouch oral cancer model: boron biodistribution at 9 post administration time-points

International Nuclear Information System (INIS)

Garabalino, M.A.; Heber, E.M.; Monti, Hughes A.; Molinari, A.J.; Pozzi, E.C.C.; Trivillin, V.A.; Schwint, Amanda E.

2011-01-01

The therapeutic success of Boron Neutron Capture Therapy (BNCT) depends centrally on boron concentration in tumor and healthy tissue. We previously demonstrated the therapeutic efficacy of boronophenylalanine (BPA) and sodium decahydrodecaborate (GB-10) as boron carriers for BNCT in the hamster cheek pouch oral cancer model. Given the clinical relevance of sodium mercaptoundecahydro-closo-dodecaborate (BSH) as a boron carrier, the aim of the present study was to expand the ongoing BSH biodistribution studies in the hamster cheek pouch oral cancer model. In particular, we studied 3 additional post-administration time-points and increased the sample size corresponding to the time-points evaluated previously, to select more accurately the post-administration time at which neutron irradiation would potentially confer the greatest therapeutic advantage. BSH was dissolved in saline solution in anaerobic conditions to avoid the formation of the dimer BSSB and its oxides which are toxic. The solution was injected intravenously at a dose of 50 mg 10 B/kg (88 mg BSH / kg). Different groups of animals were killed humanely at 7, 8, and 10 h after administration of BSH. The sample size corresponding to the time-points 3, 4, 6, 9 and 12 h was increased. Samples of blood, tumor, precancerous tissue, normal pouch tissue, cheek mucosa, parotid gland, palate, skin, tongue, spinal cord marrow, brain, liver, kidney, spleen and lung were processed for boron measurement by Optic Emission Spectroscopy (ICP-OES). Boron concentration in tumor peaked to 24-34 ppm, 3-10 h post-administration of BSH, with a spread in values that resembled that previously reported in other experimental models and human subjects. The boron concentration ratios tumor/normal pouch tissue and tumor/blood ranged from 1.3 to 1.8. No selective tumor uptake was observed at any of the time points evaluated. The times post-administration of BSH that would be therapeutically most useful would be 5, 7 and 9 h. The

[Psychological distress and post-traumatic stress disorder (PTSD) in young survivors of L'Aquila earthquake].

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Pollice, Rocco; Bianchini, Valeria; Roncone, Rita; Casacchia, Massimo

2012-01-01

The aim of the study is to evaluate the presence of PTSD diagnosis, psychological distress and post-traumatic symptoms in a population of young earthquake survivors after L'Aquila earthquake. Between April 2009 and January 2010, 187 young people seeking help consecutively at the Service for Monitoring and early Intervention against psychoLogical and mEntal suffering in young people (SMILE) of L'Aquila University Psychiatric Department, underwent clinical interview with the Semi-Structured Clinical Interview DSM-IV-I and-II (SCID-I and SCID-II) and psychometric evaluation with Impact Event Scale-Revised (IES-R) and General Health Questionnaire-12 items (GHQ-12). 44.2% and 37.4% respectively, showed high and moderate levels of psychological distress. 66.7% reported the presence of a significant post-traumatic symptoms (Post-traumatic Syndrome) with an IES-R>28, while a diagnosis of PTSD was made in 13.8% of the sample. The obsessive-compulsive trait, female sex and high level of distress (GHQ ≥20) appear to be the main risk factors for the development of PTSD than those who had a post-traumatic syndrome for which the displacement and social disruption, appear to be more associated with post-traumatic aftermaths. Our findings, in line with recent literature, confirm that a natural disaster produces an high psychological distress with long-term aftermaths. Early intervention for survivors of collective or individual trauma, regardless of the presence of a PTSD diagnosis should be a primary goal in a program of Public Health.

Evaluation of early childhood social-communication difficulties in children born preterm using the Quantitative Checklist for Autism in Toddlers.

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Wong, Hilary S; Huertas-Ceballos, Angela; Cowan, Frances M; Modi, Neena

2014-01-01

To characterize early childhood social-communication skills and autistic traits in children born very preterm using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) and explore neonatal and sociodemographic factors associated with Q-CHAT scores. Parents of children born before 30 weeks gestation and enrolled in a study evaluating routinely collected neurodevelopmental data between the post-menstrual ages of 20 and 28 months were invited to complete the Q-CHAT questionnaire. Children with severe neurosensory disabilities and cerebral palsy were excluded. Participants received neurodevelopmental assessments using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Q-CHAT scores of this preterm cohort were compared with published general population scores. The association between Bayley-III cognitive and language scores and neonatal and sociodemographic factors with Q-CHAT scores were examined. Q-CHAT questionnaires were completed from 141 participants. At a mean post-menstrual age of 24 months, the Q-CHAT scores of the preterm cohort (mean 33.7, SD 8.3) were significantly higher than published general population scores (mean 26.7; SD 7.8), indicating greater social-communication difficulty and autistic behavior. Preterm children received higher scores, particularly in the categories of restricted, repetitive, stereotyped behavior, communication, and sensory abnormalities. Lower Bayley-III language scores and non-white ethnicity were associated with higher Q-CHAT scores. Preterm children display greater social-communication difficulty and autistic behavior than the general population in early childhood as assessed by the Q-CHAT. The implications for longer-term outcome will be important to assess. Copyright © 2014 Mosby, Inc. All rights reserved.

Effect of eccentric exercise program for early tibialis posterior tendinopathy.

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Kulig, Kornelia; Lederhaus, Eric S; Reischl, Steve; Arya, Shruti; Bashford, Greg

2009-09-01

Morphology and vascularization of painful tibialis posterior (TP) tendons before and after an intervention targeting the degenerated tendon were examined. Functional status and pain level were also assessed. A10-week twice daily, progressive eccentric tendon loading, calf stretching program with orthoses was implemented with ten, early stage TP tendinopathy subjects. TP tendons were imaged by grayscale and Doppler ultrasound at INITIAL and POST evaluations to assess the tendon's morphology and signs of neovascularization. The Foot Functional Index (FFI), Physical Activity Scale (PAS), 5-Minute Walk Test, and single heel raise (SHR) test were completed at INITIAL and POST evaluations. The Global Rating Scale (GRS) was completed at 6 months followup. One-way ANOVA was used to compare the FFI at INITIAL, POST, and 6-MONTH time points. Paired t-tests were used to compare means between the remaining variables. The level of significance was p = 0.05. There was a significant difference in FFI total, pain, and disability at the three time-points. Post-hoc paired t-tests revealed that the FFI scores were lower for the total score and pain and disability subcategories when comparing from INITIAL to POST and INITIAL to 6-MONTH evaluations (p Tendon morphology and vascularization remained abnormal following the intervention. A 10-week tendon specific eccentric program resulted in improvements in symptoms and function without changes in tendon morphology or neovascularization.

Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service.

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Devescovi, Raffaella; Monasta, Lorenzo; Mancini, Alice; Bin, Maura; Vellante, Valerio; Carrozzi, Marco; Colombi, Costanza

2016-01-01

Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents' and teachers' active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.

The theory-based policy evaluation method applied to the ex-post evaluation of climate change policies in the built environment in the Netherlands

International Nuclear Information System (INIS)

Harmelink, Mirjam; Joosen, Suzanne; Blok, Kornelis

2005-01-01

The challenge within ex-post policy evaluation research is to unravel the whole policy process and evaluate the effect and effectiveness of the different steps. Through this unravelling of the policy implementation process, insight is gained on where something went wrong in the process of policy design and implementation and where the keys are for improving the effectiveness and efficiency. This article presents the results of an ex-post policy evaluation of the effect and effectiveness of the Energy Premium Regulation scheme and the Long Term Voluntary agreements to reduce CO 2 emissions in the built environment in the Netherlands applying the theory-based policy evaluation method. The article starts with a description of the theory-based policy evaluation method. The method begins with the formulation of a program theory, which describes the 'ideal' operation of a policy instrument, from the viewpoint of the policy makers. Thereupon the theory is checked and adapted through interviews with policy makers and executors, and the cause and effect chain is finally translated to (quantitative) indicators. The article shows that the theory-based evaluation method has benefits over other ex-post evaluation methods that include: The whole policy implementation process is evaluated and the focus is not just on the 'end-result' (i.e. efficiency improvement and CO 2 emission reduction). Through the development of indicators for each step in the implementation process, 'successes and failures' are quantified to the greatest possible extent. By applying this approach we not only learn whether policies are successful or not, but also why they succeeded or failed and how they can be improved

Role of the combination of FA and T2* parameters as a new diagnostic method in therapeutic evaluation of parkinson's disease.

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Fang, Yuan; Zheng, Tao; Liu, Lanxiang; Gao, Dawei; Shi, Qinglei; Dong, Yanchao; Du, Dan

2017-11-17

Simple diffusion delivery (SDD) has attained good effects with only tiny amounts of drugs. Fractional anisotropy (FA) and relaxation time T2* that indicate the integrity of fiber tracts and iron concentration within brain tissue were used to evaluate the therapeutic effect of SDD. To evaluate therapeutic effect of SDD in the Parkinson's disease (PD) rat model with FA and T2* parameters. Prospective case-control animal study. Thirty-two male Sprague Dawley rats (eight normal, eight PD, eight SDD, and eight subcutaneous injection rats). Single-shot spin echo echo-planar imaging and fast low-angle shot T 2 WI sequences at 3.0T. Parameters of FA and T2* on the treated side of the substantia nigra were measured to evaluate the therapeutic effect of SDD in a PD rat model. The effects of time on FA and T2* values were analyzed by repeated measurement tests. A one-way analysis of variance was conducted, followed by individual comparisons of the mean FA and T2* values at different timepoints. The FA values on the treated side of the substantia nigra in the SDD treatment group and subcutaneous injection treatment group were significantly higher at week 1 and lower at week 6 than that of the PD control group (SDD vs. PD, week 1, adjusted P = 0.012; subcutaneous vs. PD, week 1, adjusted P T2* parameter in the SDD treatment group and subcutaneous injection treatment group was significantly higher than that in the PD control group at week 6 (SDD vs. PD, adjusted P = 0.032; subcutaneous vs. PD, adjusted P T2* parameters can potentially serve as a new effective evaluation method of the therapeutic effect of SDD. 1 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Evaluation of post-LOCA long term cooling performance in Korean standard nuclear power plants

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Bang, Young Seok; Jung, Jae Won; Seul, Kwang Won; Kim, Hho Jung

2001-01-01

The post-LOCA long term cooling (LTC) performance of the Korean Standard Nuclear Power Plant (KSNPP) is analyzed for both small break loss-of-coolant accidents (LOCA) and large break LOCA at cold leg. The RELAP5/MOD3.2.2 beta code is used to calculate the LTC sequences based on the LTC plan of the Korean Standard Nuclear Power Plants (KSNPP). A standard input model is developed such that LOCA and the followed LTC sequence can be calculated in a single run for both small break LOCA and large break LOCA. A spectrum of small break LOCA ranging from 0.02 to 0.5 ft 2 of break area and a double-ended guillotine break are analyzed. Through the code calculations, the thermal-hydraulic behavior and the boron behavior are evaluated and the effect of the important action including the safety injection tank (SIT) isolation and the simultaneous injection in LTC procedure is investigated. As a result, it is found that the sufficient margin is available in avoiding the boron precipitation in the core. It is also found that a further specific condition for the SIT isolation action need to be setup and it is recommended that the early initiation of the simultaneous injection be taken for larger break LTC sequences. (author)

Performance evaluation of early maize genotypes in far western hills of Nepal

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Hari Kumar Prasai

2015-12-01

Full Text Available Initial evaluation trial of maize (early genotypes was carried out at Regional Agricultural Research Station, Doti, Nepal in 2013 and 2014. Total fourteen and fifteen genotypes of early maize were included in initial evaluation experiment of the year 2013 and 2014 respectively. The experiment was laid out in randomized complete block design (RCBD with three replications in each year. Out of the tested genotypes, SO3TEY/LN, ZM 423 and SO3TEY-FM (ER identified as promising from statistical analysis over year. All the tested characters were found statistically significant. Similarly, the coordinated varietal trial of maize (early was also carried out in the same station at 2013 and 2014. Total fourteen genotypes in 2013 and fifteen genotypes in 2015 of maize (early were included in the experiment. The RCB design was applied and the experiment was replicated three times in every year. ZM 627 and ZM 621/Pool -15 genotypes identified as superior next to Arun-2 from the analysis of two year data. All the tested traits were found statistically significant in over year analysis.

Evaluation on therapeutic effect of de-compressive craniectomies for patients with diffuse brain swelling

International Nuclear Information System (INIS)

Xiao Sanchao; Zhang Changrong; Zuo Yi; Zhou Xiaowei; Li Jian

2000-01-01

Objective: To evaluate the therapeutic effect of de-compressive craniectomies in acute traumatic patients with diffuse brain swelling. Methods: 23 patients with acute posttraumatic diffuse brain swelling admitted and confirmed by X-CT were randomly treated by surgical de-compressive craniectomies (operative group). Their treated results were compared with those of another 11 patients treated conservatively (non-operative group) at the same period. Results: The mortality rate was similar in both operative and nonoperative groups. Conclusion: The de-compressive craniectomy operation has no value and not valid for treatment of acute posttraumatic diffuse brain swelling