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Sample records for hf patients compared

  1. Effect of Peripheral Arterial Disease on Functional and Clinical Outcomes in Patients with Heart Failure From HF-ACTION

    Science.gov (United States)

    Jones, W. Schuyler; Clare, Robert; Ellis, Stephen J.; Mills, James S.; Fischman, David L.; Kraus, William E.; Whellan, David J.; O'Connor, Christopher M.; Patel, Manesh R.

    2011-01-01

    Patients with peripheral arterial disease (PAD) have lower functional capacity and worse clinical outcomes than age and gender matched patients. Few data exist on the relationship of PAD with functional and clinical outcomes in heart failure (HF) patients. We sought to compare HF patients with and without PAD for baseline functional capacity, response to exercise training, and clinical outcomes. HF-ACTION was a randomized controlled trial comparing usual care to structured exercise training plus usual care in HF patients with an ejection fraction ≤ 35% and NYHA class II – IV heart failure symptoms. Cardiopulmonary exercise (CPX) testing occurred at enrollment, 3 months, and 1 year. Clinical follow-up occurred up to 4 years. Of the 2331 HF-ACTION patients, 157 (6.8%) had PAD. At baseline, HF patients with PAD had a lower exercise duration (8.0 vs. 9.8 minutes, p<0.001), lower peak oxygen consumption (VO2) (12.5 vs. 14.6 mL/kg/min, p<0.001), and shorter six minute walking distance (306 vs. 371 meters, p<0.001) compared to HF patients without PAD. At three months, HF patients with PAD had less improvement on CPX testing [exercise duration (0.5 vs. 1.1 minutes; p=0.002) and peak VO2 (mean change; 0.1 vs. 0.6 mL/kg/min; p=0.04)] compared to HF patients without PAD. PAD was an independent predictor of all-cause death or hospitalization [hazard ratio (95% CI); 1.31 (1.06 – 1.62), p=0.011]. PAD patients with HF have depressed baseline exercise capacity and decreased response to exercise training. In conclusion, PAD is an independent predictor of all-cause death or hospitalization in HF patients. PMID:21565325

  2. Early Postdischarge STOP-HF-Clinic Reduces 30-day Readmissions in Old and Frail Patients With Heart Failure.

    Science.gov (United States)

    Pacho, Cristina; Domingo, Mar; Núñez, Raquel; Lupón, Josep; Moliner, Pedro; de Antonio, Marta; González, Beatriz; Santesmases, Javier; Vela, Emili; Tor, Jordi; Bayes-Genis, Antoni

    2017-08-01

    Heart failure (HF) is associated with a high rate of readmissions within 30 days postdischarge. Strategies to lower readmission rates generally show modest results. To reduce readmission rates, we developed a STructured multidisciplinary outpatient clinic for Old and frail Postdischarge patients hospitalized for HF (STOP-HF-Clinic). This prospective all-comers study enrolled patients discharged from internal medicine or geriatric wards after HF hospitalization. The intervention involved a face-to-face early visit (within 7 days), HF nurse education, treatment titration, and intravenous medication when needed. Thirty-day readmission risk was calculated using the CORE-HF risk score. We also studied the impact of 30-day readmission burden on regional health care by comparing the readmission rate in the STOP-HF-Clinic Referral Area (∼250000 people) with that of the rest of the Catalan Health Service (CatSalut) (∼7.5 million people) during the pre-STOP-HF-Clinic (2012-2013) and post-STOP-HF-Clinic (2014-2015) time periods. From February 2014 to June 2016, 518 consecutive patients were included (age, 82 years; Barthel score, 70; Charlson index, 5.6, CORE-HF 30-day readmission risk, 26.5%). The observed all-cause 30-day readmission rate was 13.9% (47.5% relative risk reduction) and the observed HF-related 30-day readmission rate was 7.5%. The CatSalut registry included 65131 index HF admissions, with 9267 all-cause and 6686 HF-related 30-day readmissions. The 30-day readmission rate was significantly reduced in the STOP-HF-Clinic Referral Area in 2014-2015 compared with 2012-2013 (P < .001), mainly driven by fewer HF-related readmissions. The STOP-HF-Clinic, an approach that could be promptly implemented elsewhere, is a valuable intervention for reducing the global burden of early readmissions among elder and vulnerable patients with HF. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF)

    Science.gov (United States)

    McMurray, John J.V.; Anand, Inder S.; Diaz, Rafael; Maggioni, Aldo P.; O'Connor, Christopher; Pfeffer, Marc A.; Solomon, Scott D.; Tendera, Michal; van Veldhuisen, Dirk J.; Albizem, Moetaz; Cheng, Sunfa; Scarlata, Debra; Swedberg, Karl; Young, James B.; Amuchastegui, M.; Belziti, C.; Bluguermann, J.; Caccavo, M.; Cartasegna, L.; Colque, R.; Cuneo, C.; Fernandez, A.; Gabito, A.; Goicochea, R.; Gonzalez, M.; Gorosito, V.; Grinfeld, L.; Hominal, M.; Kevorkian, R.; Litvak Bruno, M.; Llanos, J.; Mackinnon, I.; Manuale, O.; Marzetti, E.; Nul, D.; Perna, E.; Riccitelli, M.; Sanchez, A.; Santos, D.; Schygiel, P.; Toblli, J.; Vogel, D.; Aggarwal, A.; Amerena, J.; De Looze, F.; Fletcher, P.; Hare, D.; Ireland, M.; Krum, H.; Lattimore, J.; Marwick, T.; Sindone, A.; Thompson, P.; Waites, J.; Altenberger, J.; Ebner, C.; Lenz, K.; Pacher, R.; Poelzl, G.; Charlier, F.; de Ceuninck, M.; De Keulenaer, G.; Dendale, P.; Maréchal, P.; Mullens, W.; Thoeng, J.; Vanderheyden, M.; Vanhaecke, J.; Weytjens, C.; Wollaert, B.; Albuquerque, D.; Almeida, D.; Aspe y Rosas, J.; Bocchi, E.; Bordignon, S.; Clausell, N.; Kaiser, S.; Leaes, P.; Martins Alves, S.; Montera, M.; Moura, L.; Pereira de Castro, R.; Rassi, S.; Reis, A.; Saraiva, J.; Simões, M.; Souza Neto, J.; Teixeira, M.; Benov, H.; Chompalova, B.; Donova, T.; Georgiev, P.; Gotchev, D.; Goudev, A.; Grigorov, M.; Guenova, D.; Hergeldjieva, V.; Ivanov, D.; Kostova, E.; Manolova, A.; Marchev, S.; Nikolov, F.; Popov, A.; Raev, D.; Tzekova, M.; Czarnecki, W.; Giannetti, N.; Haddad, H.; Heath, J.; Huynh, T.; Lepage, S.; Liu, P.; Lonn, E.; Ma, P.; Manyari, D.; Moe, G.; Parker, J.; Pesant, Y.; Rajda, M.; Ricci, J.; Roth, S.; Sestier, F.; Sluzar, V.; Sussex, B.; Vizel, S.; Antezana, G.; Bugueno, C.; Castro, P.; Conejeros, C.; Manriquez, L.; Martinez, D.; Potthoff, S.; Stockins, B.; Vukasovic, J.; Gregor, P.; Herold, M.; Jerabek, O.; Jirmar, R.; Kuchar, R.; Linhart, A.; Podzemska, B.; Soucek, M.; Spac, J.; Spacek, R.; Vodnansky, P.; Bronnum-Schou, J.; Clemmensen, K.; Egstrup, K.; Jensen, G.; Kjoller-Hansen, L.; Kober, L.; Markenvard, J.; Rokkedal, J.; Skagen, K.; Torp-Pedersen, C.; Tuxen, C.; Videbak, L.; Laks, T.; Vahula, V.; Harjola, V.; Kettunen, R.; Kotila, M.; Bauer, F.; Cohen Solal, A.; Coisne, D.; Davy, J.; De Groote, P.; Dos Santos, P.; Funck, F.; Galinier, M.; Gibelin, P.; Isnard, R.; Neuder, Y.; Roul, G.; Sabatier, R.; Trochu, J.; Anker, S.; Denny, S.; Dreykluft, T.; Flesch, M.; Genth-Zotz, S.; Hambrecht, R.; Hein, J.; Jeserich, M.; John, M.; Kreider-Stempfle, H.; Laufs, U.; Muellerleile, K.; Natour, M.; Sandri, M.; Schäufele, T.; von Hodenberg, E.; Weyland, K.; Winkelmann, B.; Tse, H.; Yan, B.; Barsi, B.; Csikasz, J.; Dezsi, C.; Edes, I.; Forster, T.; Karpati, P.; Kerekes, C.; Kis, E.; Kosa, I.; Lupkovics, G.; Nagy, A.; Preda, I.; Ronaszeki, A.; Tomcsanyi, J.; Zamolyi, K.; Agarwal, D.; Bahl, V.; Bordoloi, A.; Chockalingam, K.; Chopda, M.; Chopra, V.; Dugal, J.; Ghaisas, N.; Ghosh, S.; Grant, P.; Hiremath, S.; Iyengar, S.; Jagadeesa Subramania, B.; Jain, P.; Joshi, A.; Khan, A.; Mullasari, A.; Naik, S.; Oomman, A.; Pai, V.; Pareppally Gopal, R.; Parikh, K.; Patel, T.; Prakash, V.; Sastry, B.; Sathe, S.; Sinha, N.; Srikanthan, V.; Subburamakrishnan, P.; Thacker, H.; Wander, G.; Admon, D.; Katz, A.; Klainman, E.; Lewis, B.; Marmor, A.; Moriel, M.; Mosseri, M.; Shotan, A.; Weinstein, J.; Zimlichman, R.; Agostoni, P.; Albanese, M.; Alunni, G.; Bini, R.; Boccanelli, A.; Bolognese, L.; Campana, C.; Carbonieri, E.; Carpino, C.; Checco, L.; Cosmi, F.; D'Angelo, G.; De Cristofaro, M.; Floresta, A.; Fucili, A.; Galvani, M.; Ivleva, A.; Marra, S.; Musca, G.; Peccerillo, N.; Perrone Filardi, P.; Picchio, E.; Russo, T.; Scelsi, L.; Senni, M.; Tavazzi, L.; Erglis, A.; Jasinkevica, I.; Kakurina, N.; Veze, I.; Volans, E.; Bagdonas, A.; Berukstis, E.; Celutkiene, J.; Dambrauskaite, A.; Jarasuniene, D.; Luksiene, D.; Rudys, A.; Sakalyte, G.; Sliaziene, S.; Aguilar-Romero, R.; Cardona-Muñoz, E.; Castro-Jimenez, J.; Chavez-Herrera, J.; Chuquiure Valenzuela, E.; De la Pena, G.; Herrera, E.; Leiva-Pons, J.; Lopez Alvarado, A.; Mendez Machado, G.; Ramos-Lopez, G.; Basart, D.; Buijs, E.; Cornel, J.; de Leeuw, M.; Dijkgraaf, R.; Dunselman, P.; Freericks, M.; Hamraoui, K.; Lenderlink, T.; Linssen, G.; Lodewick, P.; Lodewijks, C.; Lok, D.; Nierop, P.; Ronner, E.; Somsen, A.; van Dantzig, J.; van der Burgh, P.; van Kempen, L.; van Vlies, B.; Voors, A.; Wardeh, A.; Willems, F.; Dickstein, K.; Gundersen, T.; Hole, T.; Thalamus, J.; Westheim, A.; Dabrowski, M.; Gorski, J.; Korewicki, J.; Kuc, K.; Miekus, P.; Musial, W.; Niegowska, J.; Piotrowski, W.; Podolec, P.; Polonski, L.; Ponikowski, P.; Rynkiewicz, A.; Szelemej, R.; Trusz-Gluza, M.; Ujda, M.; Wojciechowski, D; Wysokinski, A.; Camacho, A.; Fonseca, C.; Monteiro, P.; Apetrei, E.; Bruckner, I.; Carasca, E.; Coman, I.; Datcu, M.; Dragulescu, S.; Ionescu, P.; Iordachescu-Petica, D.; Manitiu, I.; Popa, V.; Pop-Moldovan, A.; Radoi, M.; Stamate, S.; Tomescu, M.; Vita, I.; Aroutiounov, G.; Ballyuzek, M.; Bart, B.; Churina, S.; Glezer, M.; Goloshchekin, B.; Ivleva, A.; Kobalava, Z.; Kostenko, V.; Lopatin, Y.; Martynov, A.; Orlov, V.; Semernin, E.; Shogenov, Z.; Sidorenko, B.; Skvortsov, A.; Storzhakov, G.; Sulimov, V.; Talibov, O.; Tereshenko, S.; Tsyrline, V.; Zadionchenko, V.; Zateyshchikov, D.; Dzupina, A.; Hranai, M.; Kmec, J.; Micko, K.; Murin, J.; Pella, D.; Sojka, G.; Spisak, V.; Vahala, P.; Vinanska, D.; Badat, A.; Bayat, J.; Dawood, S.; Delport, E.; Ellis, G.; Garda, R.; Klug, E.; Mabin, T.; Naidoo, D.; Pretorius, M.; Ranjith, N.; Van Zyl, L.; Weich, H.; Anguita, M.; Berrazueta, J.; Bruguera i Cortada, J.; de Teresa, E.; Gómez Sánchez, M.; González Juanatey, J.; Gonzalez-Maqueda, I.; Jordana, R.; Lupon, J.; Manzano, L.; Pascual Figal, D.; Pulpón, L.; Recio, J.; Ridocci Soriano, F.; Rodríguez Lambert, J.; Roig Minguell, E.; Roig Minguell, E.; Romero, J.; Valdovinos, P.; Klintberg, L.; Kronvall, T.; Lycksell, M.; Morner, S.; Rydberg, E.; Swedberg, K.; Timberg, I.; Wikstrom, G.; Moccetti, T.4; Ashok, J.; Banerjee, P.; Carr-White, G.; Cleland, J.; Connolly, E.; Francis, M.; Greenbaum, R.; Kadr, H.; Lindsay, S.; McMurray, J.; Megarry, S.; Memon, A.; Murdoch, D.; Senior, R.; Squire, I.; Tan, L.; Witte, K.; Adams, K.; Adamson, P.; Adler, A.; Altschul, L.; Altschuller, A.; Amirani, H.; Anand, I.; Andreou, C.; Ansari, M.; Antonishen, M.; Banchs, H.; Banerjee, S.; Banish, D.; Bank, A.; Barbagelata, A.; Barnard, D.; Bellinger, R.; Benn, A.; Berk, M.; Berry, B.; Bethala, V.; Bilazarian, S.; Bisognano, J.; Bleyer, F.; Blum, M.; Boehmer, J.; Bouchard, A.; Boyle, A.; Bozkurt, B.; Brown, C.; Burlew, B.; Burnham, K.; Butler, J.; Call, J.; Cambier, P.; Cappola, T.; Carlson, R.; Chandler, B.; Chandra, R.; Chandraratna, P.; Chernick, R.; Colan, D.; Colfer, H.; Colucci, W.; Connelly, T.; Costantini, O.; Dadkhah, S.; Dauber, I.; Davis, J.; Davis, S.; Denning, S.; Drazner, M.; Dunlap, S.; Egbujiobi, L.; Elkayam, U.; Elliott, J.; El-Shahawy, M.; Essandoh, L.; Ewald, G.; Fang, J.; Farhoud, H.; Felker, G.; Fernandez, J.; Festin, R.; Fishbein, G.; Florea, V.; Flores, E.; Floro, J.; Gabris, M.; Garg, M.; Gatewood, R.; Geller, M.; Ghali, J.; Ghumman, W.; Gibbs, G.; Gillespie, E.; Gilmore, R.; Gogia, H.; Goldberg, L.; Gradus-Pizlo, I.; Grainger, T.; Gudmundsson, G.; Gunawardena, D.; Gupta, D.; Hack, T.; Hall, S.; Hamroff, G.; Hankins, S.; Hanna, M.; Hargrove, J.; Haught, W.; Hauptman, P.; Hazelrigg, M.; Herzog, C.; Heywood, J.; Hill, T.; Hilton, T.; Hirsch, H.; Hunter, J.; Ibrahim, H.; Imburgia, M.; Iteld, B.; Jackson, B.; Jaffrani, N.; Jain, D.; Jain, A.; James, M.; Jimenez, J.; Johnson, E.; Kale, P.; Kaneshige, A.; Kapadia, S.; Karia, D.; Karlsberg, R.; Katholi, R.; Kerut, E.; Khoury, W.; Kipperman, R.; Klapholz, M.; Kosinski, E.; Kozinn, M.; Kraus, D.; Krueger, S.; Krum, H.; Kumar, S.; Lader, E.; Lee, C.; Levy, W.; Lewis, E.; Light-McGroary, K.; Loh, I.; Lombardi, W.; Machado, C.; Maislos, F.; Mancini, D.; Markus, T.; Mather, P.; McCants, K.; McGrew, F.; McLaurin, B.; McMillan, E.; McNamara, D.; Meyer, T.; Meymandi, S.; Miller, A.; Minami, E.; Modi, M.; Mody, F.; Mohanty, P.; Moscoso, R.; Moskowitz, R.; Moustafa, M.; Mullen, M.; Naz, T.; Noonan, T.; O'Brien, T.; Oellerich, W.; Oren, R.; Pamboukian, S.; Pereira, N.; Pitt, W.; Porter, C.; Prabhu, S.; Promisloff, S.; Ratkovec, R.; Richardson, R.; Ross, A.; Saleh, N.; Saltzberg, M.; Sarkar, S.; Schmedtje, J.; Schneider, R.; Schuyler, G.; Shanes, J.; Sharma, A.; Siegel, C.; Siegel, R.; Silber, D.; Singh, V.; Singh, N.; Singh, J.; Sklar, J.; Small, R.; Smith, A.; Smith, E.; Smith, E.; Smull, D.; Sotolongo, R.; Staniloae, C.; Stapleton, D.; Steele, P.; Stehlik, J.; Stein, M.; Tang, W.; Thadani, U.; Torre-Amoine, G.; Trichon, B.; Tsai, C.; Tummala, R.; Van Bakel, A.; Vicari, R.; Vijay, N.; Vijayaraghavan, K.; Vittorio, T.; Vossler, M.; Wagoner, L.; Wallis, D.; Ward, N.; Widmer, M.; Wight, J.; Wilkins, C.; Williams, C.; Williams, G.; Winchester, M.; Winkel, E.; Wittmer, B.; Wood, D.; Wormer, D.; Wright, R.; Xu, Z.; Yasin, M.; Zolty, R.

    2013-01-01

    Aims This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes. Methods and results Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate <60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L. Conclusion The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity. PMID:23329651

  4. Telemonitoring Adherence to Medications in Heart Failure Patients (TEAM-HF): A Pilot Randomized Clinical Trial.

    Science.gov (United States)

    Gallagher, Benjamin D; Moise, Nathalie; Haerizadeh, Mytra; Ye, Siqin; Medina, Vivian; Kronish, Ian M

    2017-04-01

    Medication nonadherence contributes to hospitalizations in recently discharged patients with heart failure (HF). We aimed to test the feasibility of telemonitoring medication adherence in patients with HF. We randomized 40 patients (1:1) hospitalized for HF to 30 days of loop diuretic adherence monitoring with telephonic support or to passive adherence monitoring alone. Eighty-three percent of eligible patients agreed to participate. The median age of patients was 64 years, 25% were female, and 45% were Hispanic. Overall, 67% of patients were nonadherent (percentage of days that the correct number of doses were taken telemonitoring was acceptable to most patients with HF. Diuretic nonadherence was common even when patients knew they were being monitored. Future studies should assess whether adherence telemonitoring can improve adherence and reduce readmissions among patients with HF. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Treatment of atrial fibrillation with a dual defibrillator in heart failure patients (TRADE HF: protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Grandinetti Giuseppe

    2011-02-01

    Full Text Available Abstract Background Heart failure(HF and atrial fibrillation(AF frequently coexist in the same patient and are associated with increased mortality and frequent hospitalizations. As the concomitance of AF and HF is often associated with a poor prognosis, the prompt treatment of AF in HF patients may significantly improve outcome. Methods/design Recent implantable cardiac resynchronization (CRT devices allow electrical therapies to treat AF automatically. TRADE-HF (trial registration: NCT00345592; http://www.clinicaltrials.gov is a prospective, randomized, double arm study aimed at demonstrating the efficacy of an automatic, device-based therapy for treatment of atrial tachycardia and fibrillation(AT/AF in patients indicated for CRT. The study compares automatic electrical therapy to a traditional more usual treatment of AT/AF: the goal is to demonstrate a reduction in a combined endpoint of unplanned hospitalizations for cardiac reasons, death from cardiovascular causes or permanent AF when using automatic atrial therapy as compared to the traditional approach involving hospitalization for symptoms and in-hospital treatment of AT/AF. Discussion CRT pacemaker with the additional ability to convert AF as well as ventricular arrhythmias may play a simultaneous role in rhythm control and HF treatment. The value of the systematic implantation of CRT ICDs with the capacity to deliver atrial therapy in HF patients at risk of AF has not yet been explored. The TRADE-HF study will assess in CRT patients whether a strategy based on automatic management of atrial arrhythmias might be a valuable option to reduce the number of hospital admission and to reduce the progression the arrhythmia to a permanent form. Trial registration NCT00345592

  6. Computed tomographic coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE HF Project 1-C).

    Science.gov (United States)

    Chow, Benjamin J W; Green, Rachel E; Coyle, Doug; Laine, Mika; Hanninen, Helena; Leskinen, Hanna; Rajda, Miroslav; Larose, Eric; Hartikainen, Juha; Hedman, Marja; Mielniczuk, Lisa; O'Meara, Eileen; deKemp, Robert A; Klein, Ran; Paterson, Ian; White, James A; Yla-Herttuala, Seppo; Leber, Alex; Tandon, Vikas; Lee, Ting; Al-Hesayen, Abdul; Hessian, Renee; Dowsley, Taylor; Kass, Malek; Kelly, Cathy; Garrard, Linda; Tardif, Jean-Claude; Knuuti, Juhani; Beanlands, Rob S; Wells, George A

    2013-12-26

    The prevalence of heart failure (HF) is rising in industrialized and developing countries. Though invasive coronary angiography (ICA) remains the gold standard for anatomical assessment of coronary artery disease in HF patients, alternatives are being sought. Computed tomographic coronary angiography (CTA) has emerged as an accurate non-invasive diagnostic tool for coronary artery disease (CAD) and has been demonstrated to have prognostic value. Whether or not CTA can be used in HF patients is unknown. Acknowledging the aging population, the growing prevalence of HF and the increasing financial burden of healthcare, we need to identify non-invasive diagnostic tests that are available, safe, accurate and cost-effective. The proposed study aims to provide insight into the efficacy of CTA in HF patients. A multicenter randomized controlled trial will enroll 250 HF patients requiring coronary anatomical definition. Enrolled patients will be randomized to either CTA or ICA (n = 125 per group) as the first test to define coronary anatomy. The primary outcomes will be collected to determine downstream resource utilization. Secondary outcomes will include the composite clinical events and major adverse cardiac events. In addition, the accuracy of CTA for detecting coronary anatomy and obstruction will be assessed in patients who subsequently undergo both CTA and ICA. It is expected that CTA will be a more cost-effective strategy for diagnosis: yielding similar outcomes with fewer procedural risks and improved resource utilization. ClinicalTrials.gov, NCT01283659. Team grant #CIF 99470.

  7. Clinical Characteristics, Response to Exercise Training and Outcomes in Heart Failure Patients with Chronic Obstructive Pulmonary Disease: Findings from HF-ACTION

    Science.gov (United States)

    Mentz, Robert J.; Schulte, Phillip J.; Fleg, Jerome L.; Fiuzat, Mona; Kraus, William E.; Piña, Ileana L.; Keteyian, Steven J.; Kitzman, Dalane W.; Whellan, David J.; Ellis, Stephen J.; O’Connor, Christopher M.

    2013-01-01

    Background To investigate the clinical characteristics, exercise training response, beta-blocker selectivity and outcomes in heart failure (HF) patients with chronic obstructive pulmonary disease (COPD). Methods We performed an analysis of HF-ACTION, which randomized 2,331 HF patients with ejection fraction ≤35% to usual care with or without aerobic exercise training. We examined clinical characteristics and outcomes [mortality/hospitalization, mortality, cardiovascular (CV) mortality/CV hospitalization, and CV mortality/HF hospitalization] by physician-reported COPD status using adjusted Cox models and explored an interaction with exercise training. The interaction between beta-blocker cardioselectivity and outcomes was investigated. Results Of patients with COPD status documented (N=2311), 11% (N=249) had COPD. COPD patients were older, had more comorbidities, and lower use of beta-blockers compared to those without COPD. At baseline, COPD patients had lower peak VO2 and higher VE/VCO2 slope. During a median follow-up of 2.5 years, COPD was associated with increased mortality/hospitalization, mortality, and CV mortality/HF hospitalization. After multivariable adjustment, the risk of CV mortality/HF hospitalization remained increased (Hazard Ratio [HR] 1.46, 95% Confidence Interval [CI]: 1.14–1.87), while mortality/hospitalization (HR 1.15, 95% CI: 0.96–1.37) and mortality (HR 1.33, 95% CI: 0.99–1.76) were not significantly increased. There was no interaction between COPD and exercise training on outcomes or between COPD and beta-blocker selectivity on mortality/hospitalization (all P>0.1). Conclusions COPD in HF patients was associated with older age, more comorbidities, reduced exercise capacity, and increased CV mortality/HF hospitalization, but not a differential response to exercise training. Beta-blocker selectivity was not associated with differences in outcome for patients with versus without COPD. PMID:23351822

  8. A comparative study of the palliative care needs of heart failure and cancer patients.

    LENUS (Irish Health Repository)

    O'Leary, Norma

    2012-02-01

    AIMS: Studies suggest that patients with advanced heart failure (HF) have unmet palliative care (PC) needs. However, many of these studies have been retrospective or based on patients receiving poorly coordinated ad hoc care. We aimed to demonstrate whether the PC needs of patients with advanced HF receiving specialist multidisciplinary coordinated care are similar to cancer patients deemed to have specialist PC needs; thereby justifying the extension of specialist PC services to HF patients. METHODS AND RESULTS: This was a cross-sectional comparative cohort study of 50 HF patients and 50 cancer patients, using quantitative and qualitative methods. Both patient cohorts were statistically indistinguishable in terms of symptom burden, emotional wellbeing, and quality-of-life scores. HF patients had good access to community and social support. HF patients particularly valued the close supervision, medication monitoring, ease of access to service, telephone support, and key worker provided at the HF unit. A small subset of patients had unmet PC needs. A palliative transition point is described. CONCLUSION: HF patients should not be excluded from specialist PC services. However, the majority of their needs can be met at a HF unit. Recognition of the palliative transition point may be key to ensuring that end-of-life issues are addressed. The palliative transition point needs further evaluation.

  9. Predictors of arrhythmic sudden cardiac death in heart failure patients in the CARE-HF study

    DEFF Research Database (Denmark)

    Uretsky, B.; Cleland, J.G.F.; Freemantle, N.

    2006-01-01

    Topic(s):Rsynchronisation therapy   Cardiac resynchronization therapy (CRT) has become an important modality to improve symptoms, exercise performance, and survival in patients with severe heart failure and left ventricular dyssynchrony. The CARE-HF study showed that CRT reduced mortality in syst...

  10. Comparative behavior of Sr, Nd and Hf isotopic systems during fluid-related deformation at middle crust levels

    Science.gov (United States)

    Luais, Béatrice; Le Carlier de Veslud, Christian; Géraud, Yves; Gauthier-Lafaye, François

    2009-05-01

    We have carried out a comparative Rb-Sr, Sm-Nd and Lu-Hf isotopic study of a progressively deformed hercynian leucogranite from the French Massif Central, belonging to the La Marche ductile shear zone, in order to investigate the respective perturbation of these geochronometers with fluid induced deformation. The one-meter wide outcrop presents a strongly deformed and mylonitized zone at the center, and an asymmetric deformation pattern with a higher deformation gradient on the northern side of the zone. Ten samples have been carefully collected every 10 cm North and South away from the strongest deformed mylonitic zone. They have been analyzed for a complete major, trace element data set, oxygen isotopes, Rb-Sr, Sm-Nd and Lu-Hf isotopic systematics. We show that most of major and trace elements except SiO 2, alkaline elements (K 2O, Rb), and some metal transition elements (Cu), are progressively depleted with increasing deformation. This depletion includes REE + Y, but also HFS elements (Ti, Hf, Zr, Nb) which are commonly considered as immobile elements during upper level processes. Variations in elemental ratios with deformation, e.g. decrease in LREE/MREE- HREE, Nd/Hf, Th/Sr, increase in Rb/Sr, U/Th and constant Sr/Nd, lead to propose the following order of element mobility: U ≫ Th > Sr = Nd ≫ Hf + HREE. We conclude in agreement with previous tectonic and metallogenic studies that trace element patterns across the shear zone result from circulation of oxidizing F-rich hydrothermal fluids associated with deformation. A temperature of the fluid of 470-480 °C can be deduced from the δ 18O equilibrium between quartz-muscovite pairs. Elemental fractionation induces perturbation of the Rb-Sr geochronometer. The well-defined 87Rb/ 86Sr- 87Sr/ 86Sr correlation gives an apparent age of 294 ± 19 Ma, slightly younger than the 323 ± 4 Ma age of leucogranites in this area. This apparent age is interpreted as dating event of intense deformation and fluid circulation

  11. Challenges in comparing the acute cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) vs. electroconvulsive therapy (ECT) in major depression: A systematic review.

    Science.gov (United States)

    Kedzior, Karina Karolina; Schuchinsky, Maria; Gerkensmeier, Imke; Loo, Colleen

    2017-03-02

    The present study aimed to systematically compare the cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and electroconvulsive therapy (ECT) in head-to-head studies with major depression (MDD) patients. A systematic literature search identified six studies with 219 MDD patients that were too heterogeneous to reliably detect meaningful differences in acute cognitive outcomes after ECT vs. HF-rTMS. Cognitive effects of brain stimulation vary depending on the timeframe and methods of assessment, stimulation parameters, and maintenance treatment. Thus, acute and longer-term differences in cognitive outcomes both need to be investigated at precisely defined timeframes and with similar instruments assessing comparable functions.

  12. Home telemonitoring study for Japanese patients with heart failure (HOMES-HF): protocol for a multicentre randomised controlled trial.

    Science.gov (United States)

    Kotooka, Norihiko; Asaka, Machiko; Sato, Yasunori; Kinugasa, Yoshiharu; Nochioka, Kotaro; Mizuno, Atsushi; Nagatomo, Daisuke; Mine, Daigo; Yamada, Yoko; Eguchi, Kazuo; Hanaoka, Hideki; Inomata, Takayuki; Fukumoto, Yoshihiro; Yamamoto, Kazuhiro; Tsutsui, Hiroyuki; Masuyama, Tohru; Kitakaze, Masafumi; Inoue, Teruo; Shimokawa, Hiroaki; Momomura, Shin-Ichi; Seino, Yoshihiko; Node, Koichi

    2013-06-20

    Despite the encouraging results from several randomised controlled trials (RCTs) and meta-analyses, the ability of home telemonitoring for heart failure (HF) to improve patient outcomes remains controversial as a consequence of the two recent large-scale RCTs. However, it has been suggested that there is a subgroup of patients with HF who may benefit from telemonitoring. The aim of the present study was to investigate whether an HF management programme using telemonitoring could improve outcomes in patients with HF under the Japanese healthcare system. The Home Telemonitoring Study for Japanese Patients with Heart Failure (HOMES-HF) study is a prospective, multicentre RCT to investigate the effectiveness of home telemonitoring on the primary composite endpoint of all-cause death and rehospitalisation due to worsening HF in recently admitted HF patients (aged 20 and older, New York Heart Association classes II-III). The telemonitoring system is an automated physiological monitoring system including body weight, blood pressure and pulse rate by full-time nurses 7 days a week. Additionally, the system was designed to make it a high priority to support patient's self-care instead of an early detection of HF decompensation. A total sample size of 420 patients is planned according to the Schoenfeld and Richter method. Eligible patients are randomly assigned via a website to either the telemonitoring group or the usual care group by using a minimisation method with biased-coin assignment balancing on age, left ventricular ejection fraction and a history of ischaemic heart disease. Participants will be enrolled until August 2013 and followed until August 2014. Time to events will be estimated using the Kaplan-Meier method, and HRs and 95% CIs will be calculated using the Cox proportional hazards models with stratification factors. The study is registered at UMIN Clinical Trials Registry (UMIN000006839).

  13. A comparative analysis of the results from 4 trials of beta-blocker therapy for heart failure: BEST, CIBIS-II, MERIT-HF, and COPERNICUS.

    Science.gov (United States)

    Domanski, Michael J; Krause-Steinrauf, Heidi; Massie, Barry M; Deedwania, Prakash; Follmann, Dean; Kovar, David; Murray, David; Oren, Ron; Rosenberg, Yves; Young, James; Zile, Michael; Eichhorn, Eric

    2003-10-01

    Recent large randomized, controlled trials (BEST [Beta-blocker Evaluation of Survival Trial], CIBIS-II [Cardiac Insufficiency Bisoprolol Trial II], COPERNICUS [Carvedilol Prospective Randomized Cumulative Survival Study], and MERIT-HF [Metoprolol Randomized Intervention Trial in Congestive Heart Failure]) have addressed the usefulness of beta-blockade in the treatment of advanced heart failure. CIBIS-II, COPERNICUS, and MERIT-HF have shown that beta-blocker treatment with bisoprolol, carvedilol, and metoprolol XL, respectively, reduce mortality in advanced heart failure patients, whereas BEST found a statistically nonsignificant trend toward reduced mortality with bucindolol. We conducted a post hoc analysis to determine whether the response to beta-blockade in BEST could be related to differences in the clinical and demographic characteristics of the study populations. We generated a sample from BEST to resemble the patient cohorts studied in CIBIS-II and MERIT-HF to find out whether the response to beta-blocker therapy was similar to that reported in the other trials. These findings are further compared with COPERNICUS, which entered patients with more severe heart failure. To achieve conformity with the entry criteria for CIBIS-II and MERIT-HF, the BEST study population was adjusted to exclude patients with systolic blood pressure 80 years (exclusion criteria employed in those trials). The BEST comparison subgroup (BCG) was further modified to more closely reflect the racial demographics reported for patients enrolled in CIBIS-II and MERIT-HF. The association of beta-blocker therapy with overall survival and survival free of cardiac death, sudden cardiac death, and progressive pump failure in the BCG was assessed. In the BCG subgroup, bucindolol treatment was associated with significantly lower risk of death from all causes (hazard ratio (HR)=0.77 [95% CI=0.65, 0.92]), cardiovascular death (HR=0.71 [0.58, 0.86]), sudden death (HR=0.77 [0.59, 0.999]), and pump

  14. Comparative study of atomic-layer-deposited HfO2/Al2O3, Hf0.8Al0.2Ox and Hf0.5Al0.5Ox on N-GaAs

    Science.gov (United States)

    Yu, Xinjiang; Lv, Hongliang; Zhang, Yuming; Zhang, Yimen; Qin, Zaiyang

    2016-11-01

    Interfacial properties of n-GaAs metal-oxide-semiconductor (MOSCAPs) with the gate dielectrics of HfO2/Al2O3, Hf0.8Al0.2Ox and Hf0.5Al0.5Ox are investigated. The results reveal that Hf0.5Al0.5Ox has larger permittivity and lower interface trap density than that of HfO2/Al2O3. In order to explain the result from the physical perspective, the XPS tests of all three samples are performed. It is found that the main reason to form interface trap of three samples treated with 500 °C post-deposition annealing, is attributed to the interfacial component of Ga2O3 and The Hf0.5Al0.5Ox dielectric is beneficial to reducing the formation of Ga2O3.

  15. Usefulness of Iron Deficiency Correction in Management of Patients With Heart Failure [from the Registry Analysis of Iron Deficiency-Heart Failure (RAID-HF) Registry].

    Science.gov (United States)

    Wienbergen, Harm; Pfister, Otmar; Hochadel, Matthias; Michel, Stephan; Bruder, Oliver; Remppis, Björn Andrew; Maeder, Micha Tobias; Strasser, Ruth; von Scheidt, Wolfgang; Pauschinger, Matthias; Senges, Jochen; Hambrecht, Rainer

    2016-12-15

    Iron deficiency (ID) has been identified as an important co-morbidity in patients with heart failure (HF). Intravenous iron therapy reduced symptoms and rehospitalizations of iron-deficient patients with HF in randomized trials. The present multicenter study investigated the "real-world" management of iron status in patients with HF. Consecutive patients with HF and ejection fraction ≤40% were recruited and analyzed from December 2010 to October 2015 by 11 centers in Germany and Switzerland. Of 1,484 patients with HF, iron status was determined in only 923 patients (62.2%), despite participation of the centers in a registry focusing on ID and despite guideline recommendation to determine iron status. In patients with determined iron status, a prevalence of 54.7% (505 patients) for ID was observed. Iron therapy was performed in only 8.5% of the iron-deficient patients with HF; 2.6% were treated with intravenous iron therapy. The patients with iron therapy were characterized by a high rate of symptomatic HF and anemia. In conclusion, despite strong evidence of beneficial effects of iron therapy on symptoms and rehospitalizations, diagnostic and therapeutic efforts on ID in HF are low in the actual clinical practice, and the awareness to diagnose and treat ID in HF should be strongly enforced.

  16. ExtraHF survey

    DEFF Research Database (Denmark)

    Piepoli, Massimo F; Binno, Simone; Corrà, Ugo

    2015-01-01

    AIMS: In heart failure (HF), exercise training programmes (ETPs) are a well-recognized intervention to improve symptoms, but are still poorly implemented. The Heart Failure Association promoted a survey to investigate whether and how cardiac centres in Europe are using ETPs in their HF patients...... of evidence on safety or benefit was cited. When implemented, an ETP was proposed to all HF patients in only 55% of the centres, with restriction according to severity or aetiology. CONCLUSIONS: With respect to previous surveys, there is evidence of increased availability of ETPs in HF in Europe, although too...

  17. Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics

    Directory of Open Access Journals (Sweden)

    Casado Jose

    2011-08-01

    Full Text Available Abstract Background Disease management programmes (DMPs have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF, but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity. Methods/Design Clinical trial in 700 patients aged ≥ 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ≥ 3, dependence in ≥ 2 activities of daily living, treatment with ≥ 5 drugs, active treatment for ≥ 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD, anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations, diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care and depression (knowledge of the disease, diagnosis and treatment. It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up. Discussion The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study

  18. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF).

    Science.gov (United States)

    McMurray, John J V; Packer, Milton; Desai, Akshay S; Gong, Jianjian; Lefkowitz, Martin; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R

    2014-07-01

    To describe the baseline characteristics and treatment of the patients randomized in the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and morbidity in Heart Failure) trial, testing the hypothesis that the strategy of simultaneously blocking the renin-angiotensin-aldosterone system and augmenting natriuretic peptides with LCZ696 200 mg b.i.d. is superior to enalapril 10 mg b.i.d. in reducing mortality and morbidity in patients with heart failure and reduced ejection fraction. Key demographic, clinical and laboratory findings, along with baseline treatment, are reported and compared with those of patients in the treatment arm of the Studies Of Left Ventricular Dysfunction (SOLVD-T) and more contemporary drug and device trials in heart failure and reduced ejection fraction. The mean age of the 8442 patients in PARADIGM-HF is 64 (SD 11) years and 78% are male, which is similar to SOLVD-T and more recent trials. Despite extensive background therapy with beta-blockers (93% patients) and mineralocorticoid receptor antagonists (60%), patients in PARADIGM-HF have persisting symptoms and signs, reduced health related quality of life, a low LVEF (mean 29 ± SD 6%) and elevated N-terminal-proB type-natriuretic peptide levels (median 1608 inter-quartile range 886-3221 pg/mL). PARADIGM-HF will determine whether LCZ696 is more beneficial than enalapril when added to other disease-modifying therapies and if further augmentation of endogenous natriuretic peptides will reduce morbidity and mortality in heart failure and reduced ejection fraction. © 2014 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

  19. Effectiveness of Haemodiafiltration with Heat Sterilized High-Flux Polyphenylene HF Dialyzer in Reducing Free Light Chains in Patients with Myeloma Cast Nephropathy.

    Directory of Open Access Journals (Sweden)

    Mathieu Rousseau-Gagnon

    Full Text Available In cases of myeloma cast nephropathy in need of haemodialysis (HD, reduction of free light chains using HD with High-Cut-Off filters (HCO-HD, in combination with chemotherapy, may be associated with better renal recovery. The aim of the present study is to evaluate the effectiveness of haemodiafiltration (HDF in reducing free light chain levels using a less expensive heat sterilized high-flux polyphenylene HF dialyzer (HF-HDF.In a single-centre prospective cohort study, 327 dialysis sessions were performed using a 2.2 m2 heat sterilized high-flux polyphenylene HF dialyzer (Phylther HF22SD, a small (1.1m2 or large (2.1 m2 high-cut-off (HCO dialyzer (HCOS and HCOL in a cohort of 16 patients presenting with dialysis-dependent acute cast nephropathy and elevated free light chains (10 kappa, 6 lambda. The outcomes of the study were the mean reduction ratio (RR of kappa and lambda, the proportion of treatments with an RR of at least 0.65, albumin loss and the description of patient outcomes. Statistical analysis was performed using linear and logistic regression through generalized estimating equation analysis so as to take into account repeated observation within subjects and adjust for session duration.There were no significant differences in the estimated marginal mean of kappa RR, which were respectively 0.67, 0.69 and 0.70 with HCOL-HD, HCOS-HDF and HF-HDF (P = 0.950. The estimated marginal mean of the proportions of treatments with a kappa RR ≥0.65 were 68%, 63% and 71% with HCOL-HD, HCOS-HDF and HF-HDF, respectively (P = 0.913. The estimated marginal mean of lambda RR were higher with HCOL-HDF (0.78, compared to HCOL-HD and HF-HDF (0.62, and 0.61 respectively. The estimated marginal mean proportion of treatments with a lambda RR ≥0.65 were higher with HCOL-HDF (81%, compared to 57% in HF-HDF (P = 0.042. The median albumin loss were 7, 21 and 63 g/session with HF-HDF, HCOL-HD and HCOL-HDF respectively (P = 0.044. Among survivors, 9 out of 10

  20. Baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF)

    NARCIS (Netherlands)

    McMurray, John J. V.; Anand, Inder S.; Diaz, Rafael; Maggioni, Aldo P.; O'Connor, Christopher; Pfeffer, Marc A.; Solomon, Scott D.; Tendera, Michal; van Veldhuisen, Dirk J.; Albizem, Moetaz; Cheng, Sunfa; Scarlata, Debra; Swedberg, Karl; Young, James B.

    2013-01-01

    Aims This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital ad

  1. A Comparative Time Differential Perturbed Angular Correlation Study of the Nuclear Quadrupole Interaction in HfF4·HF·2H2O Using 180mHf and 181Hf(β-)181Ta as Nuclear Probes: Is Ta an Innocent Spy?

    Science.gov (United States)

    Butz, Tilman; Das, Satyendra K.; Manzhur, Yurij

    2009-02-01

    We report on a comparative study of the nuclear quadrupole interaction of the nuclear probes 180mHf and 181Hf(β -)181Ta in HfF4・HF・2H2O using time differential perturbed angular correlations (TDPAC) at 300 K. For the first probe, assuming a Lorentzian frequency distribution, we obtained ωQ= 103(4) Mrad/s, an asymmetry parameter η = 0.68(3), a linewidth δ = 7.3(3.9)%, and full anisotropy within experimental accuracy. For the second probe, assuming a Lorentzian frequency distribution, we obtained three fractions: (1) with 56.5(7)%, ωQ= 126.64(4) Mrad/s and η = 0.9241(4) with a rather small distribution δ = 0.40(8)% which is attributed to HfF4・HF・2H2O; (2) with 4.6(4)%, ωQ = 161.7(3) Mrad/s and η = 0.761(4) assuming no line broadening which is tentatively attributed to a small admixture of Hf2OF6・H2O; (3) the remainder of 39.0(7)% accounts for a rapid loss of anisotropy and is modelled by a perturbation function with a sharp frequency multiplied by an exponential factor exp(-λ t) with λ = 0.55(2) ns-1. Whereas the small admixture of Hf2OF6・H2O escapes detection by the 180mHf probe, there is no rapid loss of roughly half the anisotropy as is the case with 181Hf(β -)181Ta. This loss could in principle be due to fluctuating electric field gradients originating from movements of nearest neighbour HF adducts and/or H2O molecules after nuclear transmutation to the foreign atom Ta which are absent for the isomeric probe. Alternatively, paramagnetic Ta ions could lead to fluctuating magnetic dipole fields which, when combined with fluctuating electric field gradients, could also lead to a rapid loss of anisotropy. In any case, Ta is not an "innocent spy" in this compound. Although 180mHf is not a convenient probe for conventional spectrometers, the use of fast digitizers and software coincidences would allow to use all γ -quanta in the stretched cascade which would greatly improve the efficiency of the spectrometer. 180mHf could also serve as a Pu

  2. n-3PUFA and Holter-derived autonomic variables in patients with heart failure: data from the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca (GISSI-HF) Holter substudy.

    Science.gov (United States)

    La Rovere, Maria Teresa; Staszewsky, Lidia; Barlera, Simona; Maestri, Roberto; Mezzani, Alessandro; Midi, Paolo; Marchioli, Roberto; Maggioni, Aldo P; Tognoni, Gianni; Tavazzi, Luigi; Latini, Roberto

    2013-02-01

    n-3 Polyunsaturated fatty acid (n-3PUFA) supplementation in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca (GISSI-HF) study reduced total mortality in patients with heart failure (HF), but the mechanism of action is still debated. The hypothesis of the present GISSI-HF substudy was that n-3PUFA may have beneficial effects on cardiac autonomic control. To evaluate the effect of 1 g/day of n-3PUFA vs placebo on heart rate variability variables, deceleration capacity, and turbulence slope. The GISSI-HF study enrolled patients with HF of any cause and severity. Twenty-four-hour (range 16-24 hours) Holter recordings were performed and analyzed in 388 patients at baseline, 3 months, and 12 months. Baseline characteristics were compared by using the χ(2) test, t test, or nonparametric Wilcoxon 2-sample test. Changes over time were tested by using the analysis of covariance adjusted by baseline values. At baseline, 36% of the patients were older than 70 years, 82% were men, 92% presented a left ventricular ejection fraction<40%, and 80% were in New York Heart Association class II. An increase in mean RR interval, standard deviation of all normal-to-normal RR intervals, very low frequency power (all P<.05), and turbulence slope (P = .05) was observed after 3 months in the n-3PUFA group compared to the placebo group, independently of the frequency of dietary fish consumption or beta-blocker treatment. These differences between study groups were no longer statistically significant at 12 months. A per-protocol analysis in patients compliant with study treatment showed similar results. n-3PUFA supplementation partially restored autonomic modulation in patients with chronic HF; this effect was maximal after 3 months of treatment. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  3. Comparative effectiveness of different forms of telemedicine for individuals with heart failure (HF: a systematic review and network meta-analysis.

    Directory of Open Access Journals (Sweden)

    Ahmed Kotb

    Full Text Available Previous studies on telemedicine have either focused on its role in the management of chronic diseases in general or examined its effectiveness in comparison to standard post-discharge care. Little has been done to determine the comparative impact of different telemedicine options for a specific population such as individuals with heart failure (HF.Systematic reviews (SR of randomized controlled trials (RCTs that examined telephone support, telemonitoring, video monitoring or electrocardiographic monitoring for HF patients were identified using a comprehensive search of the following databases: MEDLINE, EMBASE, CINAHL and The Cochrane Library. Studies were included if they reported the primary outcome of mortality or any of the following secondary outcomes: all-cause hospitalization and heart failure hospitalization. Thirty RCTs (N = 10,193 patients were included. Compared to usual care, structured telephone support was found to reduce the odds of mortality(Odds Ratio 0.80; 95% Credible Intervals [0.66 to 0.96] and hospitalizations due to heart failure (0.69; [0.56 to 0.85]. Telemonitoring was also found to reduce the odds of mortality(0.53; [0.36 to 0.80] and reduce hospitalizations related to heart failure (0.64; [0.39 to 0.95] compared to usual post-discharge care. Interventions that involved ECG monitoring also reduced the odds of hospitalization due to heart failure (0.71; [0.52 to 0.98].Much of the evidence currently available has focused on the comparing either telephone support or telemonitoring with usual care. This has therefore limited our current understanding of how some of the less common forms of telemedicine compare to one another.Compared to usual care, structured telephone support and telemonitoring significantly reduced the odds of deaths and hospitalization due to heart failure. Despite being the most widely studied forms of telemedicine, little has been done to directly compare these two interventions against one another

  4. The large-scale placebo-controlled beta-blocker studies in systolic heart failure revisited: results from CIBIS-II, COPERNICUS and SENIORS-SHF compared with stratified subsets from MERIT-HF.

    Science.gov (United States)

    Wikstrand, J; Wedel, H; Castagno, D; McMurray, J J V

    2014-02-01

    The four pivotal beta-blocker trials in heart failure (HF) had different inclusion criteria, making comparison difficult without patient stratifying. The aim of this study was to compare, in similar patients, the effects of bisoprolol, metoprolol controlled release/extended release (CR/XL), carvedilol and nebivolol on (i) total mortality, (ii) all-cause mortality or hospitalization due to cardiovascular causes (time to first event), (iii) all-cause mortality or hospitalization because of HF and (iv) tolerability, defined as discontinuation of randomized treatment. We compared stratified (s ) subsets in MERIT-HF with patients in CIBIS-II [New York Heart Association (NYHA) class III/IV and ejection fraction (EF) ≤ 35%] and COPERNICUS (NYHA III/IV and EF COPERNICUS (n = 2289), 19.7% vs. 12.8% (relative risk reduction 35%, 95% CI: 19-48, P = 0.0014) and MERIT-HFs (n = 795), 19.1% vs. 11.7% (relative risk reduction 39%; 95% CI: 11-58, P = 0.0086); (iii) SENIORS-SHF (n = 1359), 11.3% vs. 9.7% (relative risk reduction 16%, NS) and MERIT-HFs (n = 985), 14.8% vs. 10.1% (relative risk reduction 32%, 95% CI: 2-53, P = 0.038). The effects on the other outcomes assessed were similar. Analyses indicated fewer discontinuations from randomized treatment on beta-blockers compared with placebo in COPERNICUS and the MERIT-HFs subsets. The efficacy and tolerability of bisoprolol, carvedilol and metoprolol CR/XL are similar in patients with systolic HF, irrespective of NYHA class or ejection fraction. Nebivolol is less effective and not better tolerated. © 2013 The Association for the Publication of the Journal of Internal Medicine.

  5. Rationale and Design of the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (Reduce LAP-HF) Trial

    DEFF Research Database (Denmark)

    Hasenfuss, Gerd; Gustafsson, Finn; Kaye, David

    2015-01-01

    OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatrial...... include exercise tolerance, quality of life, and the incidence of heart failure hospitalization. CONCLUSION: Reduce LAP-HF is the first trial intended to lower left atrial pressure in HFpEF by means of creating a permanent shunt through the atrial septum with the use of a device. Although the trial...... patients with ejection fraction ≥40% and New York Heart Association functional class III or IV heart failure with a pulmonary capillary wedge pressure (PCWP) ≥15 mm Hg at rest or ≥25 mm Hg during supine bike exercise will be implanted with an IASD System II, and followed for 6 months to assess the primary...

  6. Safety and Efficacy of Eplerenone in Patients at High Risk for Hyperkalemia and/or Worsening Renal Function Analyses of the EMPHASIS-HF Study Subgroups (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure)

    NARCIS (Netherlands)

    Eschalier, Romain; McMurray, John J. V.; Swedberg, Karl; van Veldhuisen, Dirk J.; Krum, Henry; Pocock, Stuart J.; Shi, Harry; Vincent, John; Rossignol, Patrick; Zannad, Faiez; Pitt, Bertram

    2013-01-01

    Objectives The study sought to investigate the safety and efficacy of eplerenone in patients at high risk for hyperkalemia or worsening renal function (WRF) in EMPHASIS-HF, a trial that enrolled patients at least 55 years old with heart failure and reduced ejection fraction (HF-REF), in New York Hea

  7. An investigation of CYP2D6 genotype and response to metoprolol CR/XL during dose titration in patients with heart failure: a MERIT-HF substudy.

    Science.gov (United States)

    Batty, J A; Hall, A S; White, H L; Wikstrand, J; de Boer, R A; van Veldhuisen, D J; van der Harst, P; Waagstein, F; Hjalmarson, Å; Kjekshus, J; Balmforth, A J

    2014-03-01

    To explore the pharmacogenetic effects of the cytochrome P450 (CYP)2D6 genotype in patients with systolic heart failure treated using controlled/extended-release (CR/XL) metoprolol, this study assessed the CYP2D6 locus for the nonfunctional *4 allele (1846G>A; rs3892097) in the Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF; n = 605). Participants were characterized as extensive, intermediate, or poor metabolizers (EMs, IMs, or PMs, respectively), based on the presence of the CYP2D6*4 allele (EM: *1*1, 60.4%; IM: *1*4, 35.8%; and PM: *4*4, 3.8%). Plasma metoprolol concentrations were 2.1-/4.6-fold greater in the IM/PM groups as compared with the EM group (P Metoprolol induced significantly lower heart rates and diastolic blood pressures during early titration, indicating a CYP2D6*4 allele dose-response effect (P metoprolol pharmacokinetics/pharmacodynamics during early titration; however, the MERIT-HF-defined titration schedule remains recommended for all patients, regardless of genotype.

  8. Sarcopenia and Endothelial Function in Patients With Chronic Heart Failure: Results From the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF).

    Science.gov (United States)

    Dos Santos, Marcelo R; Saitoh, Masakazu; Ebner, Nicole; Valentova, Miroslava; Konishi, Masaaki; Ishida, Junichi; Emami, Amir; Springer, Jochen; Sandek, Anja; Doehner, Wolfram; Anker, Stefan D; von Haehling, Stephan

    2017-03-01

    Skeletal muscle wasting, also known as sarcopenia, has recently been identified as a serious comorbidity in patients with heart failure (HF). We aimed to assess the impact of sarcopenia on endothelial dysfunction in patients with HF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Cross-sectional study. Ambulatory patients with HF were recruited at Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. We assessed peripheral blood flow (arm and leg) in 228 patients with HF and 32 controls who participated in the Studies Investigating Comorbidities Aggravating HF (SICA-HF). The appendicular skeletal muscle mass of the arms and the legs combined was assessed by dual energy x-ray absorptiometry (DEXA). Sarcopenia was defined as the appendicular muscle mass two standard deviations below the mean of a healthy reference group of adults aged 18 to 40 years, as suggested for the diagnosis of muscle wasting in healthy aging. All patients underwent a 6-minute walk test and spiroergometry testing. Forearm and leg blood flow were measured by venous occlusion plethysmography. Peak blood flow was assessed after a period of ischemia in the limbs to test endothelial function. Sarcopenia was identified in 37 patients (19.5%). Patients with sarcopenia presented with lower baseline forearm blood flow (2.30 ± 1.21 vs. 3.06 ± 1.49 vs. 4.00 ± 1.66 mL min(-1) 100 mL(-1); P = .02) than those without sarcopenia or controls. The group of patients with sarcopenia showed similar baseline leg blood flow (2.06 ± 1.62 vs. 2.39 ± 1.39 mL min(-1) 100 mL(-1); P = .11) to those without but lower values when compared to controls (2.06 ± 1.62 vs. 2.99 ± 1.28 mL min(-1) 100 mL(-1); P = .03). In addition, patients with and without sarcopenia presented with lower peak flow in the forearm when compared to controls (18.37 ± 7.07 vs. 22.19 ± 8.64 vs. 33.63 ± 8.57 mL min(-1) 100 mL(-1); P < .001). A similar result was

  9. Noise Filter Performance studies for CMS HF by comparing new and old PMTs using Collection of data taken in 2012

    CERN Multimedia

    2016-01-01

    During the data taking before 2012 some abnormal events which have higher signals than expected were observed. Most of these were due to muons. When a muon hits the glass window of photomultiplier tubes (PMTs), it creates a huge signal. To eliminate this kind of events 24 old HF PMTs (Hamamatsu R7525) in HF Minus at iphi 43 (corresponds to one sector) were replaced with new multi anode PMTs (Hamamatsu multi anode R7600) which have thin glass windows. These new PMTs were installed and tested in H2 test beam area in 2009 [1]. To check whether these new PMTs perform better than the old ones, data taken in 2012 were analyzed using various predefined noise filters. The percentage of the noisy rechits was found to be around 6-7 % for the new PMTs while it varies between 29-66 % for the old PMTs for various trigger selections and for HFLongShortFilter after an energy cut of 500 GeV [2]. Presented at 6th Internationally Participated Congress on Particle Accelerators and Applications

  10. Clinical trials update from the Heart Failure Society of America Meeting 2009: FAST, IMPROVE-HF, COACH galectin-3 substudy, HF-ACTION nuclear substudy, DAD-HF, and MARVEL-1.

    Science.gov (United States)

    Lainscak, Mitja; Coletta, Alison P; Sherwi, Nasser; Cleland, John G F

    2010-02-01

    This article presents findings and a commentary on late-breaking trials presented during the meeting of the Heart Failure Society of America in September 2009. Unpublished reports should be considered as preliminary, since analyses may change in the final publication. The FAST trial showed somewhat better performance of intrathoracic impedance for prediction of deterioration in patients with heart failure (HF) when compared with daily weighing. The IMPROVE-HF study reported the benefits of education on the management of patients with systolic HF. Galectin-3 appeared a useful method for improving risk stratification of patients with chronic HF in a substudy of the COACH trial. A nuclear substudy of the HF-ACTION trial failed to demonstrate that resting myocardial perfusion imaging, a measure of myocardial scar and viability, was clinically useful. A small randomized controlled trial (DAD-HF) suggested that the use of low-dose dopamine in patients with acutely decompensated HF was associated with less deterioration in renal function and less hypokalaemia. The MARVEL-1 trial raises further concerns about the safety of myoblast transplantation in ischaemic HF.

  11. Clinical benefits of eplerenone in patients with systolic heart failure and mild symptoms when initiated shortly after hospital discharge : analysis from the EMPHASIS-HF trial

    NARCIS (Netherlands)

    Girerd, Nicolas; Collier, Tim; Pocock, Stuart; Krum, Henry; McMurray, John J.; Swedberg, Karl; Van Veldhuisen, Dirk J.; Vincent, John; Pitt, Bertram; Zannad, Faiez

    2015-01-01

    Aims Cardiovascular hospitalization (CVH) in patients with heart failure (HF) is associated with a high post-discharge rate of early re-admission and CV death. Eplerenone might be effective in reducing the incidence of these adverse clinical outcomes during this period. Methods and results The EMPHA

  12. Atomic-layer-deposited Al2O3 and HfO2 on InAlAs: A comparative study of interfacial and electrical characteristics

    Science.gov (United States)

    Wu, Li-Fan; Zhang, Yu-Ming; Lv, Hong-Liang; Zhang, Yi-Men

    2016-10-01

    Al2O3 and HfO2 thin films are separately deposited on n-type InAlAs epitaxial layers by using atomic layer deposition (ALD). The interfacial properties are revealed by angle-resolved x-ray photoelectron spectroscopy (AR-XPS). It is demonstrated that the Al2O3 layer can reduce interfacial oxidation and trap charge formation. The gate leakage current densities are 1.37 × 10-6 A/cm2 and 3.22 × 10-6 A/cm2 at +1 V for the Al2O3/InAlAs and HfO2/InAlAs MOS capacitors respectively. Compared with the HfO2/InAlAs metal-oxide-semiconductor (MOS) capacitor, the Al2O3/InAlAs MOS capacitor exhibits good electrical properties in reducing gate leakage current, narrowing down the hysteresis loop, shrinking stretch-out of the C-V characteristics, and significantly reducing the oxide trapped charge (Q ot) value and the interface state density (D it). Project supported by the National Basic Research Program of China (Grant No. 2010CB327505), the Advanced Research Foundation of China (Grant No. 914xxx803-051xxx111), the National Defense Advance Research Project, China (Grant No. 513xxxxx306), the National Natural Science Foundation of China (Grant No. 51302215), the Scientific Research Program Funded by Shaanxi Provincial Education Department, China (Grant No. 14JK1656), and the Science and Technology Project of Shaanxi Province, China (Grant No. 2016KRM029).

  13. Comparative Evaluation of Health-Related Quality of Life Questionnaires in Patients With Heart Failure Undergoing Cardiac Rehabilitation: A Psychometric Study.

    Science.gov (United States)

    Rajati, Fatemeh; Feizi, Awat; Tavakol, Kamran; Mostafavi, Firoozeh; Sadeghi, Masoumeh; Sharifirad, Gholamreza

    2016-11-01

    To compare the psychometric properties of 2 heart failure (HF)-specific quality of life questionnaires and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) in patients with HF. A methodological study based on 3-month follow-up data for evaluating psychometric properties of health-related quality of life (HRQOL) questionnaires. Cardiac rehabilitation center at a cardiovascular research institute. Eligible patients with HF (N=60). Exercise training in cardiac rehabilitation. The SF-36, the MacNew Heart Disease questionnaire, and the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and New York Heart Association functional classification. Items from the MLHFQ and the MacNew questionnaire had acceptable correlations (r>.30, Pquestionnaire over time in patients with HF. The MacNew questionnaire was more responsive to changes than the SF-36. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. SAFETY AND EFFICACY OF EPLERENONE IN PATIENTS AT HIGH RISK FOR HYPERKALEMIA AND/OR WORSENING RENAL FUNCTION. ANALYSES OF THE EMPHASIS-HF STUDY SUBGROUPS (EPLERENONE IN MILD PATIENTS HOSPITALIZATION AND SURVIVAL STUDY IN HEART FAILURE

    Directory of Open Access Journals (Sweden)

    R. Eschalier

    2014-01-01

    Full Text Available Translation articles:R. Eschalier, J.J.V. McMurray, K. Swedberg, D.J. van Veldhuisen, H. Krum, S.J. Pocock, H. Shi, J. Vincent, P. Rossignol, F. Zannad, B. Pitt, for the EMPHASIS-HF Investigators “Safety and Efficacy of Eplerenone in Patients at High Risk for Hyperkalemia and/or Worsening Renal Function. Analyses of the EMPHASIS-HF Study Subgroups (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure”  J Am Coll Cardiol 2013;62(17:1585-93; http://dx.doi.org/10.1016/j.jacc.2013.04.086

  15. Design of the Reduction of Events with Darbepoetin alfa in Heart Failure (RED-HF) : a Phase III, anaemia correction, morbidity-mortality trial

    NARCIS (Netherlands)

    McMurray, John J. V.; Anand, Inder S.; Diaz, Rafael; Maggioni, Aldo P.; O'Connor, Christopher; Pfeffer, Marc A.; Polu, Krishna R.; Solomon, Scott D.; Sun, Yan; Swedberg, Karl; Tendera, Michal; van Veldhuisen, Dirk J.; Wasserman, Scott M.; Young, James B.

    2009-01-01

    Patients with heart failure (HF) and anaemia have greater functional impairment, worse symptoms, increased rates of hospital admission, and a higher risk of death, compared with non-anaemic HF patients. Whether correcting anaemia can improve outcomes is unknown. The Reduction of Events with Darbepoe

  16. A comparative study via Monte Carlo simulation of new inorganic scintillator Cs2HfCl6 for applications in nuclear medicine, security and defense, and astrophysics

    Science.gov (United States)

    Chen, Henry; Raby, Paul

    2016-09-01

    Cs2HfCl6 (CHC) is one of the most promising recently discovered new inorganic single crystal scintillator that has high light output, non-hygroscopic, no self-activity, having energy resolution significantly better than NaI(Tl), even approaching that of LaBr3 yet can also potentially be at a much lower cost than LaBr3. This study attempts to use Monte Carlo simulation to examine the great potential offered by this new scintillator. CHC's detector performance is compared via simulation with that of 4 typical existing scintillators of the same size and same PMT readout. Two halide-scintillators: NaI(Tl) and LaBr3 and two oxide-scintillators: GSO and LSO were used in this simulation to compare their 122 keV and 511 keV gamma responses with that of CHC with both spectroscopy application and imaging applications in mind. Initial simulation results are very promising and consistent with reported experimental measurements. Beside detector energy resolution, image-quality measurement parameters commonly used to characterize imaging detectors as in nuclear medicine such as Light Response Function (LRF) which goes in parallel with spatial resolution and simulated position spectra will also be presented and discussed.

  17. Hybrid HF-DFT comparative study of SrZrO{sub 3} and SrTiO{sub 3}(001) surface properties

    Energy Technology Data Exchange (ETDEWEB)

    Evarestov, R.A.; Bandura, A.V.; Alexandrov, V.E. [Department of Quantum Chemistry, St. Petersburg State University, 26 Universitetskii Prospekt, Stary Petergof, 198504 St. Petersburg (Russian Federation)

    2006-10-15

    Hybrid HF-DFT LCAO simulations of SrZrO{sub 3} and SrTiO{sub 3}(001) surface properties are performed in a single-slab model framework. The SrZrO{sub 3}(001) surface was studied by an ab initio method for the first time. Three slab models with different surface terminations including up to 8 atomic planes were used for calculation of the various surface characteristics (surface energies, atomic charges, density of electronic states). The dependence of the results on the chosen model and on the kind of d-element is analyzed. The dissimilarity in the surface oxygen atom contributions to the total density of states of two crystals is attributed to the more ionic nature of Zr-O bonds compared to Ti-O bonds. It is found that in the case of SrZrO{sub 3} the electronic density is biased towards the SrO-terminated surface and this surface should be more basic in nature than the SrO surface of SrTiO{sub 3} crystal. (copyright 2006 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  18. Dysbiosis and compositional alterations with aging in the gut microbiota of patients with heart failure.

    Science.gov (United States)

    Kamo, Takehiro; Akazawa, Hiroshi; Suda, Wataru; Saga-Kamo, Akiko; Shimizu, Yu; Yagi, Hiroki; Liu, Qing; Nomura, Seitaro; Naito, Atsuhiko T; Takeda, Norifumi; Harada, Mutsuo; Toko, Haruhiro; Kumagai, Hidetoshi; Ikeda, Yuichi; Takimoto, Eiki; Suzuki, Jun-Ichi; Honda, Kenya; Morita, Hidetoshi; Hattori, Masahira; Komuro, Issei

    2017-01-01

    Emerging evidence has suggested a potential impact of gut microbiota on the pathophysiology of heart failure (HF). However, it is still unknown whether HF is associated with dysbiosis in gut microbiota. We investigated the composition of gut microbiota in patients with HF to elucidate whether gut microbial dysbiosis is associated with HF. We performed 16S ribosomal RNA gene sequencing of fecal samples obtained from 12 HF patients and 12 age-matched healthy control (HC) subjects, and analyzed the differences in gut microbiota. We further compared the composition of gut microbiota of 12 HF patients younger than 60 years of age with that of 10 HF patients 60 years of age or older. The composition of gut microbial communities of HF patients was distinct from that of HC subjects in both unweighted and weighted UniFrac analyses. Eubacterium rectale and Dorea longicatena were less abundant in the gut microbiota of HF patients than in that of HC subjects. Compared to younger HF patients, older HF patients had diminished proportions of Bacteroidetes and larger quantities of Proteobacteria. The genus Faecalibacterium was depleted, while Lactobacillus was enriched in the gut microbiota of older HF patients. These results suggest that patients with HF harbor significantly altered gut microbiota, which varies further according to age. New concept of heart-gut axis has a great potential for breakthroughs in the development of novel diagnostic and therapeutic approach for HF.

  19. Ultrastructural morphometric findings of cardiomyocytes in patients with impaired ventricular function--a comparative clinicopathological study

    DEFF Research Database (Denmark)

    Wassilew, Katharina; Terziev, Denis; Wassilew, Georgi

    2015-01-01

    AIM: The present study aims to analyze the differences in ultrastructural changes between right ventricular myocardium in clinically determined grades of heart failure (HF) [New York Heart Association (NYHA) classes I-IV] and their value in the routine diagnostic setting. METHODS: We investigated...... ratio (Pperoxide acid shift. CONCLUSION: In this present study, right ventricular myocardial ultrastructure differed between patients diagnosed with HF...

  20. A Propensity-Matched Study of the Comparative Effectiveness of Angiotensin Receptor Blockers versus Angiotensin-Converting Enzyme Inhibitors in Heart Failure Patients Age ≥65 Years

    Science.gov (United States)

    Zhang, Yan; Fonarow, Gregg C.; Sanders, Paul W.; Farahmand, Firoozeh; Allman, Richard M.; Aban, Inmaculada B.; Love, Thomas E.; Levesque, Raynald; Kilgore, Meredith L.; Ahmed, Ali

    2011-01-01

    The comparative effectiveness of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) in real-world older heart failure (HF) patients remains unclear. Of the 8049 hospitalized HF patients ≥65 years discharged alive from 106 Alabama hospitals, 4044 received discharge prescriptions of either ACEIs (n=3383) or ARBs (n=661). Propensity scores for ARB use, calculated for each of 4044 patients, were used to match 655 (99% of 661) patients receiving ARBs with 661 patients receiving ACEIs. The assembled cohort of 655 pairs of patients was well-balanced on 56 baseline characteristics. During over 8 years of follow-up, all-cause mortality occurred in 63% and 68% of matched patients receiving ARBs and ACEIs respectively (hazard ratio {HR} associated with ARB use, 0.86; 95% confidence interval {CI}, 0.75–0.99; p=0.031). Among the 956 matched patients with data on left ventricular ejection fraction (LVEF), the association between ARB (versus ACEI) use was significant only in 419 patients with LVEF≥45% (HR, 0.65; 95% CI, 0.51–0.84; p=0.001) but not in the 537 patients with LVEF ACEI) was associated with lower mortality and a trend toward lower HF hospitalization, findings which need replication in other HF populations. PMID:21890091

  1. Impact of dopamine infusion on renal function in hospitalized heart failure patients: results of the Dopamine in Acute Decompensated Heart Failure (DAD-HF) Trial.

    Science.gov (United States)

    Giamouzis, Gregory; Butler, Javed; Starling, Randall C; Karayannis, George; Nastas, John; Parisis, Charalambos; Rovithis, Dimitrios; Economou, Dimitrios; Savvatis, Konstantinos; Kirlidis, Themistoklis; Tsaknakis, Themistoklis; Skoularigis, John; Westermann, Dirk; Tschöpe, Carsten; Triposkiadis, Filippos

    2010-12-01

    Worsening renal function (WRF) and hypokalemia related to diuretic use for acute decompensated heart failure (ADHF) are common and associated with poor prognosis. Low-dose dopamine infusion improves renal perfusion; its effect on diuresis or renal function specifically in ADHF is not known. Sixty consecutive ADHF patients (age 75.7 ± 11.2 years; 51.7% female; left ventricular ejection fraction 35.3 ± 12.1%) were randomized, after receiving a 40 mg intravenous furosemide bolus, to either high-dose furosemide (HDF, 20 mg/h continuous infusion for 8 hours) or low-dose furosemide combined with low-dose dopamine (LDFD, furosemide 5 mg/h plus dopamine 5 μg kg(-1) min(-1) continuous infusion for 8 hours). Both strategies were compared for total diuresis, WRF (defined as a rise in serum creatinine of >0.3 mg/dL from baseline to 24 hours), electrolyte balance, and 60-day postdischarge outcomes. Mean hourly excreted urine volume (272 ± 149 mL in HDF vs 278 ± 186 mL in LDFD group; P = .965) and changes in dyspnea score (Borg index: -4.4 ± 2.1 in HDF group vs -4.7 ± 2.0 in LDFD group; P = .575) during the 8 hours of protocol treatment were similar in the two groups. WRF was more frequent in the HDF (n = 9; 30%) than in the LDFD group (n = 2; 6.7%; P = .042). Serum potassium changed from 4.3 ± 0.5 to 3.9 ± 0.4 mEq/L at 24 hours (P = .003) in the HDF group and from 4.4 ± 0.5 to 4.2 ± 0.5 mEq/L at 24 hours (P = .07) in the LDFD group. Length of stay and 60-day mortality or rehospitalization rates (all-cause, cardiovascular, and worsening HF) were similar in the two groups. In ADHF patients, the combination of low-dose furosemide and low-dose dopamine is equally effective as high-dose furosemide but associated with improved renal function profile and potassium homeostasis. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Prevalence and inter-relationship of different Doppler measures of dyssynchrony in patients with heart failure and prolonged QRS: a report from CARE-HF

    Directory of Open Access Journals (Sweden)

    Maru Fikru

    2009-01-01

    Full Text Available Abstract Background Cardiac resynchronisation therapy (CRT improves mortality and morbidity in heart failure patients with wide QRS. Observational studies suggest that patients having more left ventricular dyssynchrony pre-implantation obtain greater benefit on ventricular function and symptoms with CRT. Aim To provide an analysis of the prevalence and type of dyssynchrony in patients included in the CARE-HF trial. Methods 100 patients 67 (58 to 71 years were examined with echocardiography including tissue doppler imaging before receiving a CRT-pacemaker. Atrio-ventricular dyssynchrony (LVFT/RR was defined as left ventricular filling time 40 ms. Intra-ventricular (regional dyssynchrony in a 16-segment model was expressed either as a delayed longitudinal contraction (DLC during the postsystolic phase or by tissue synchronisation imaging (TSI with a predefined time-difference in systolic maximal velocities >85 ms. Results LVFT/RR was present in 34% and IVMD in 60% of patients while intra-ventricular dyssynchrony was present in 85% (DLC and 86% (TSI with a high agreement between the measures (Kappascore 0.86–1.00, indicating the methods being interchangeable. Patients with cardiomyopathy (53% were more likely to have LVFT/RR Conclusion The prevalence of intra-ventricular dyssynchrony is high in patients with heart failure, wide QRS and depressed systolic function. Most important, TSI appears to be a fast and reliable method to identify patients with intra-ventricular dyssynchrony likely to benefit from CRT.

  3. RV Myocardial Strain During Pre-Load Augmentation Is Associated With Exercise Capacity in Patients With Chronic HF.

    Science.gov (United States)

    Kusunose, Kenya; Yamada, Hirotsugu; Nishio, Susumu; Ishii, Ayumi; Hirata, Yukina; Seno, Hiromitsu; Saijo, Yoshihito; Ise, Takayuki; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

    2017-07-13

    The aim of this study was to assess the relationship between right ventricular (RV) function during pre-load augmentation and exercise tolerance. Peak oxygen uptake (VO2) is a strong predictor of mortality in chronic heart failure. Cardiac function during pre-load augmentation is an important part of the phenomenon in the evaluation of exercise capacity. We prospectively performed echocardiographic studies in 68 chronic heart failure patients with cardiopulmonary exercise testing (mean age 60 ± 12 years; 69% male). After resting evaluations, echocardiographic parameters were repeated during leg positive pressure (LPP). Exercise capacity was assessed by peak VO2 in all patients (left ventricular ejection fraction: 43 ± 15%). Patients with severely reduced exercise capacity (peak VO2 <14 ml/kg/min) had significantly lower stroke volume index, left ventricular global longitudinal strain and RV strain and higher filling pressure (E/e' and pulmonary arterial systolic pressure) than the remainder. Stroke volume index (β = 0.49), global longitudinal strain (β = -0.61), E/e' (β = -0.32), pulmonary arterial systolic pressure (β = -0.57), and RV strain (β = -0.66) during LPP were independently correlated to peak VO2 (all p < 0.01). RV strain during LPP was the most powerful predictor in identifying patients with severely reduced exercise capacity (cut off value: -17%; sensitivity: 81%; specificity: 88%; areas under the curve: 0.88, p < 0.001) compared with other variables including resting parameters. RV strain during pre-load augmentation correlated independently to peak VO2 and was a powerful predictor in identifying patients with severely reduced exercise capacity. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. Prognostic Impact of In-Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction

    DEFF Research Database (Denmark)

    Sulo, Gerhard; Igland, Jannicke; Nygård, Ottar

    2017-01-01

    . Logistic and Cox regression models were used to explore the excess mortality associated with HF categories. Changes over time in the excess mortality were assessed by testing the interaction between HF status and study year. In-hospital HF increased in-hospital mortality 1.79 times (odds ratio [OR], 1...... or late complication of AMI-has a negative impact on patients' survival. Changes in the excess mortality associated with HF are driven by modest improvements in survival among AMI patients with HF as compared to those without HF....

  5. A study to evaluate the prevalence and determinants of stress coping strategies in heart failure patients in Poland (CAPS-LOCK-HF sub-study).

    Science.gov (United States)

    Krzych, Łukasz J; Wybraniec, Maciej T; Siennicka, Agnieszka; Lees, Belinda; Gościńska-Bis, Kinga; Wójcik, Maciej; Błaszczyk, Robert; Szymański, Filip M; Orszulak, Michał; Michalski, Błażej; Kamiński, Karol; Kopeć, Grzegorz; Hrynkiewicz-Szymańska, Anna; Jankowska, Ewa A

    2016-01-01

    We aimed to evaluate the prevalence and determinants of different stress coping strategies in Polish patients suffering from heart failure with reduced ejection fraction (HFREF). This manuscript is a sub-study of the CAPS-LOCK-HF multicentre psychological status assessment of patients with HFREF. Patients with > six-month history of HFREF and clinical stability for ≥ three months and left ventricular ejection fraction (LVEF) study. Demographic and clinical variables were obtained from medical records, while a standardised Coping Inventory for Stressful Situations (CISS) was applied to all subjects. The study comprised 758 patients (599 men; 79%) with a median age of 64 years (IQR 58-71). Median LVEF was 33% (25-40). Subjects most commonly used task-oriented coping strategies (median CISS score 55 points; IQR 49-61), followed by avoidance (45 points; 39-50) and emotion-oriented coping strategies (41 points; 34-48). Distraction-based avoidance coping strategies (20 points; 16-23) were more pronounced than social diversion strategies (16 points; 14-19). Multiple regression analysis showed that higher New York Heart Association (NYHA) class and lower systolic blood pressure were independent predictors of task-oriented style. Emotion-oriented coping was more common among females and higher NYHA classes, and in patients who did not take angiotensin-converting enzyme inhibitors. Patients who used avoidance-oriented strategies were more frequently those in sinus rhythm on assessment and those who had less history of neoplastic disease. Patients with HFREF most commonly use favourable task-oriented coping strategies. However, female patients and those with higher NYHA classes tend to use potentially detrimental emotion-oriented coping strategies.

  6. The clinical course of health status and association with outcomes in patients hospitalized for heart failure : insights from ASCEND-HF

    NARCIS (Netherlands)

    Ambrosy, Andrew P; Hernandez, Adrian F; Armstrong, Paul W; Butler, Javed; Dunning, Allison; Ezekowitz, Justin A; Felker, G Michael; Greene, Stephen J; Kaul, Padma; McMurray, John J; Metra, Marco; O'Connor, Christopher M; Reed, Shelby D; Schulte, Phillip J; Starling, Randall C; Wilson Tang, W H; Voors, Adriaan A; Mentz, Robert J

    2015-01-01

    AIMS: A longitudinal and comprehensive analysis of health-related quality of life (HRQOL) was performed during hospitalization for heart failure (HF) or soon after discharge. METHODS AND RESULTS: A post-hoc analysis was performed of the ASCEND-HF trial. The EuroQOL five dimensions questionnaire (EQ-

  7. Environmentally friendly HF (DF) lasers

    Science.gov (United States)

    Apollonov, V. V.

    2016-08-01

    Dedicated to the 100th anniversary of the birth of Academician A M Prokhorov, this paper reviews the physics of self-sustained volume discharge without preionization—self-initiated volume discharge (SIVD)—in the working mixtures of non-chain hydrofluoride HF (deuterofluoride (DF)) lasers. The dynamics of SIVD in discharge gaps with different geometries is thoroughly described. The mechanisms for the restriction of current density in a diffuse channel in electric discharges in SF6 and SF6 based mixtures (which determines whether SIVD is possible) are proposed and analyzed using simple models. The most probable mechanisms are the electron impact dissociation of SF6 and other mixture components, electron-ion recombination and electron attachment to vibrationally excited SF6 molecules. Starting from a comparative analysis of the rate coefficients of these processes, it is shown that electron-ion recombination is capable of compensating for electron detachment from negative ions via electron impact. It is also established that SIVD is not only observed in SF6, but also in other strongly electronegative gases. The factors that determine the uniformity of the active medium in non-chain HF (DF) lasers are analyzed. Some special features of non-chain HF (DF) lasers with different apertures operating are carefully examined. Consideration is given to the problem of increasing the aperture and discharge volume of non-chain HF (DF) lasers. Based on our experimental results, the possibility of increasing the energy of such lasers to ~1 kJ and above is shown.

  8. Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark.

    Science.gov (United States)

    Jørgensen, Mette; Mainz, Jan; Egstrup, Kenneth; Johnsen, Søren P

    2017-09-15

    Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia, using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined as hospital departments and clinics yearly average patient-volume of patients with incident HF). Clinical outcomes included 4-week all-cause readmission and 1-year all-cause mortality after a first-time hospital contact with incident HF. Results showed that compared with patients with incident HF who have no schizophrenia, patients with incident HF who have schizophrenia had a lower chance of receiving high-quality HF care (relative risk 0.66, 95% confidence interval 0.48 to 0.91). A high GAF score was associated with a higher chance of receiving high-quality HF care among patients with incident HF who have schizophrenia. Patients with incident HF who have schizophrenia had a higher risk of 1-year mortality (adjusted hazard ratio 2.83, 95% confidence interval 1.59 to 5.04), but not a higher risk of readmission than patients with incident HF who have no schizophrenia. In conclusion, efforts are warranted to reduce the high mortality among patients with incident HF who have schizophrenia. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post-Hoc Analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) Trial.

    Science.gov (United States)

    Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro

    2017-07-05

    The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01-1.29, respectively). Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00336336. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  10. Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Gislason, Gunnar H; Jørgensen, Casper H

    2011-01-01

    The aim was to investigate the outcomes of individual sulfonylureas in patients with heart failure (HF). Methods All patients hospitalized with HF for the first time in 1997–2006, alive 30 days after discharge, and who received anti-diabetic monotherapy with glimepiride (n = 1097), glibenclamide...... was not dependent on prior acute myocardial infarction or ischemic heart disease (p for interactions >0.3). Conclusions In current clinical practice, it is unlikely that there are considerable differences in risk of mortality associated with individual sulfonylureas in patients with heart failure....

  11. Heterogenous haemodynamic effects of adaptive servoventilation therapy in sleeping patients with heart failure and Cheyne-Stokes respiration compared to healthy volunteers.

    Science.gov (United States)

    Spießhöfer, Jens; Fox, Henrik; Lehmann, Roman; Efken, Christina; Heinrich, Jessica; Bitter, Thomas; Körber, Britta; Horstkotte, Dieter; Oldenburg, Olaf

    2016-07-01

    This study investigated the haemodynamic effects of adaptive servoventilation (ASV) in heart failure (HF) patients with Cheyne-Stokes respiration (CSR) versus healthy controls. Twenty-seven HF patients with CSR and 15 volunteers were ventilated for 1 h using a new ASV device (PaceWave™). Haemodynamics were continuously and non-invasively recorded at baseline, during ASV and after ventilation. Prior to the actual study, a small validation study was performed to validate non-invasive measurement of Stroke volume index (SVI). Non-invasive measurement of SVI showed a marginal overall difference of -0.03 ± 0.41 L/min/m(2) compared to the current gold standard (Thermodilution-based measurement). Stroke volume index (SVI) increased during ASV in HF patients (29.7 ± 5 to 30.4 ± 6 to 28.7 ± 5 mL/m(2), p < 0.05) and decreased slightly in volunteers (50.7 ± 12 to 48.6 ± 11 to 47.9 ± 12 mL/m(2)). Simultaneously, 1 h of ASV was associated with a trend towards an increase in parasympathetic nervous activity (PNA) in HF patients and a trend towards an increase in sympathetic nervous activity (SNA) in healthy volunteers. Blood pressure (BP) and total peripheral resistance response increased significantly in both groups, despite marked inter-individual variation. Effects were independent of vigilance. Predictors of increased SVI during ASV in HF patients included preserved right ventricular function, normal resting BP, non-ischaemic HF aetiology, mitral regurgitation and increased left ventricular filling pressures. This study confirms favourable haemodynamic effects of ASV in HF patients with CSR presenting with mitral regurgitation and/or increased left ventricular filling pressures, but also identified a number of new predictors. This might be mediated by a shift towards more parasympathetic nervous activity in those patients.

  12. Frederiksberg HF kursus

    DEFF Research Database (Denmark)

    Lindstrøm, Maria Duclos

    2008-01-01

    Notatet bygger på et interviewmateriale med dimitterede HF-kursister 3 måneder efter endt eksamen. Notatet undersøger dels, hvad der har hjulpet til at gennemføre, dels hvad der har været negativt og vanskeligt ved uddannelsen. Endvidere belyser notatet hvad kursisterne oplever at tage med fra de...

  13. On Transition Structures for Hydride Transfer Step in Enzyme Catalysis. A Comparative Study on Models of Glutathione Reductase Derived from Semiempirical, HF, and DFT Methods.

    Science.gov (United States)

    Andrés, Juan; Moliner, Vicente; Safont, Vicent S.; Domingo, Luís R.; Picher, María T.

    1996-11-01

    As a model of the chemical reactions that take place in the active site of gluthatione reductase, the nature of the molecular mechanism for the hydride transfer step has been characterized by means of accurate quantum chemical characterizations of transition structures. The calculations have been carried out with analytical gradients at AM1 and PM3 semiempirical procedures, ab initio at HF level with 3-21G, 4-31G, 6-31G, and 6-31G basis sets and BP86 and BLYP as density functional methods. The results of this study suggest that the endo relative orientation on the substrate imposed by the active site is optimal in polarizing the C4-Ht bond and situating the system in the neighborhood of the quadratic region of the transition structure associated to the hydride transfer step on potential energy surface. The endo arrangement of the transition structure results in optimal frontier HOMO orbital interaction between NADH and FAD partners. The geometries of the transition structures and the corresponding transition vectors, that contain the fundamental information relating reactive fluctuation patterns, are model independent and weakly dependent on the level of theory used to determine them. A comparison between simple and complex molecular models shows that there is a minimal set of coordinates describing the essentials of hydride transfer step. The analysis of transition vector components suggests that the primary and secondary kinetic isotope effects can be strongly coupled, and this prompted the calculation of deuterium and tritium primary, secondary, and primary and secondary kinetic isotope effects. The results obtained agree well with experimental data and demonstrate this coupling.

  14. The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF.

    Science.gov (United States)

    Mogensen, Ulrik M; Køber, Lars; Kristensen, Søren L; Jhund, Pardeep S; Gong, Jianjian; Lefkowitz, Martin P; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Swedberg, Karl; Zile, Michael R; Solomon, Scott D; Packer, Milton; McMurray, John J V

    2017-06-01

    Angiotensin converting enzyme inhibitors (ACE-I), are beneficial both in heart failure with reduced ejection fraction (HF-REF) and after myocardial infarction (MI). We examined the effects of the angiotensin-receptor neprilysin inhibitor sacubitril/valsartan, compared with the ACE-I enalapril, on coronary outcomes in PARADIGM-HF. We examined the effect of sacubitril/valsartan compared with enalapril on the following outcomes: i) the primary composite endpoint of cardiovascular (CV) death or HF hospitalization, ii) a pre-defined broader composite including, in addition, MI, stroke, and resuscitated sudden death, and iii) a post hoc coronary composite of CV-death, non-fatal MI, angina hospitalization or coronary revascularization. At baseline, of 8399 patients, 3634 (43.3%) had a prior MI and 4796 (57.1%) had a history of any coronary artery disease. Among all patients, compared with enalapril, sacubitril/valsartan reduced the risk of the primary outcome (HR 0.80 [0.73-0.87], PPARADIGM-HF. Additional studies on the effect of sacubitril/valsartan on atherothrombotic outcomes in high-risk patients are merited. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. A DFT study of temperature dependent dissociation mechanism of HF in HF(H2O)7 cluster

    Indian Academy of Sciences (India)

    Swatantra K Yadav; Hirdyesh Mishra; Ashwani K Tiwari

    2015-10-01

    We report a Density Functional Theoretical (DFT) study of dissociation of Hydrogen Fluoride (HF) in HF(H2O)7 cluster, using B3LYP functional and empirical exchange correlation functional M06-2X along with 6-31+G(d,p) basis set. Dissociation constant, KRP, of HF dissociation and pKa values of HF in cluster at various temperatures have been reported. It has been found that both KRP and pKa are highly dependent on temperature. The variation of pKa with temperature suggests that HF is strong acid at lower temperatures. Our study also reveals that HF is a stronger acid in water cluster than in bulk water. Further, the results obtained by DFT calculations have been compared with the earlier reported results obtained from Monte Carlo (MC) simulation. It is found that DFT results are qualitatively consistent with the results of MC simulation but quantitatively different.

  16. Peripheral vascular insufficiency impairs functional capacity in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Renato Murayama

    2014-04-01

    Full Text Available INTRODUCTION: Heart failure (HF is a complex syndrome in which effort limitation is associated with deterioration of peripheral musculature. Improving survival rates among these patients have led to the appearance of cases in which other pathologies are associated with HF, such as peripheral vascular insufficiency (PVI. The combination of these two pathologies is common, with significant repercussions for affected patients. OBJECTIVE: To compare functional limitations and quality of life between patients with HF in isolation or HF + PVI. METHOD: Twelve patients with HF+PVI were paired to 12 patients with HF in isolation. All had ejection fraction 0.05. CONCLUSIONS: The study participants who had mixed disease exhibited a greater degree of functional impairment than the group with HF, without reporting worsened quality of life.

  17. A Mobile Health Intervention Supporting Heart Failure Patients and Their Informal Caregivers: A Randomized Comparative Effectiveness Trial.

    Science.gov (United States)

    Piette, John D; Striplin, Dana; Marinec, Nicolle; Chen, Jenny; Trivedi, Ranak B; Aron, David C; Fisher, Lawrence; Aikens, James E

    2015-06-10

    interactions at both endpoints (both PmHealth+CP were more likely than standard mHealth patients to report excellent or very good general health during weekly IVR calls. Compared to a relatively intensive model of IVR monitoring, self-management assistance, and clinician alerts, a model including automated feedback to an informal caregiver outside the household improved HF patients' medication adherence and caregiver communication. mHealth+CP may also decrease patients' risk of HF exacerbations related to shortness of breath and sudden weight gains. mHealth+CP may improve quality of life among patients with greater depressive symptoms. Weekly health and self-care monitoring via mHealth tools may identify intervention effects in mHealth trials that go undetected using typical, infrequent retrospective surveys. ClinicalTrials.gov NCT00555360; https://clinicaltrials.gov/ct2/show/NCT00555360 (Archived by WebCite at http://www.webcitation.org/6Z4Tsk78B).

  18. A prospective comparison of alginate-hydrogel with standard medical therapy to determine impact on functional capacity and clinical outcomes in patients with advanced heart failure (AUGMENT-HF trial).

    Science.gov (United States)

    Anker, Stefan D; Coats, Andrew J S; Cristian, Gabriel; Dragomir, Dinu; Pusineri, Enrico; Piredda, Massimo; Bettari, Luca; Dowling, Robert; Volterrani, Maurizio; Kirwan, Bridget-Anne; Filippatos, Gerasimos; Mas, Jean-Louis; Danchin, Nicolas; Solomon, Scott D; Lee, Randall J; Ahmann, Frank; Hinson, Andy; Sabbah, Hani N; Mann, Douglas L

    2015-09-07

    AUGMENT-HF was an international, multi-centre, prospective, randomized, controlled trial to evaluate the benefits and safety of a novel method of left ventricular (LV) modification with alginate-hydrogel. Alginate-hydrogel is an inert permanent implant that is directly injected into LV heart muscle and serves as a prosthetic scaffold to modify the shape and size of the dilated LV. Patients with advanced chronic heart failure (HF) were randomized (1 : 1) to alginate-hydrogel (n = 40) in combination with standard medical therapy or standard medical therapy alone (Control, n = 38). The primary endpoint of AUGMENT-HF was the change in peak VO2 from baseline to 6 months. Secondary endpoints included changes in 6-min walk test (6MWT) distance and New York Heart Association (NYHA) functional class, as well as assessments of procedural safety. Enrolled patients were 63 ± 10 years old, 74% in NYHA functional class III, had a LV ejection fraction of 26 ± 5% and a mean peak VO2 of 12.2 ± 1.8 mL/kg/min. Thirty-five patients were successfully treated with alginate-hydrogel injections through a limited left thoracotomy approach without device-related complications; the 30-day surgical mortality was 8.6% (3 deaths). Alginate-hydrogel treatment was associated with improved peak VO2 at 6 months-treatment effect vs. +1.24 mL/kg/min (95% confidence interval 0.26-2.23, P = 0.014). Also 6MWT distance and NYHA functional class improved in alginate-hydrogel-treated patients vs. Control (both P Alginate-hydrogel in addition to standard medical therapy for patients with advanced chronic HF was more effective than standard medical therapy alone for improving exercise capacity and symptoms. The results of AUGMENT-HF provide proof of concept for a pivotal trial. NCT01311791. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  19. Patients' satisfaction with healthcare: comparing general practice ...

    African Journals Online (AJOL)

    daprim ogaji

    Non-parametric analyses such as median satisfaction scores, Chi-square, Kruskal-Wallis and. Mann-Whitney U test were conducted using SPSS version 20 statistical ... of health care.1, 2 The research on patient satisfaction is affected by a lack of ... multi-specialist teaching hospital that offers tertiary, secondary and primary ...

  20. QT variability index on 24-hour Holter independently predicts mortality in patients with heart failure: analysis of Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca (GISSI-HF) trial.

    Science.gov (United States)

    Dobson, Craig P; La Rovere, Maria Teresa; Pinna, Gian Domenico; Goldstein, Robert; Olsen, Cara; Bernardinangeli, Marino; Veniani, Marco; Midi, Paolo; Tavazzi, Luigi; Haigney, Mark

    2011-08-01

    Increased temporal variability of repolarization, as reflected by QT interval variability measured over 10-15 minutes, predicted spontaneous ventricular arrhythmias and death in implantable cardioverter-defibrillator patients in mild to moderate heart failure (HF). The purpose of this study was to test our hypothesis that increased mean QT variability over 24 hours would be associated with increased cardiovascular (CV) mortality in a heterogeneous HF population. The Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure trial prospectively enrolled subjects with HF of any cause. Twenty-four-hour Holter recordings from 268 subjects were analyzed using a template-matching, semiautomatic algorithm to measure QT and heart rate time series in sequential 5-minute epochs over 24 hours. The QT variability index (QTVI) was expressed as the log ratio of the normalized QT variance over normalized heart rate variance. Total and CV mortality were assessed as a function of continuous and dichotomous QTVI (>-0.84) in univariate and multivariable Cox proportional hazards models, adjusting for significant clinical predictors. After a median of 47 months, there were 53 deaths, of which 44 were from CV causes. A significant association with the outcome was found for QTVI both as continuous and dichotomous variables after adjustment for clinical covariates (age >70, New York Heart Association class III-IV, left ventricular ejection fraction, nonsustained ventricular tachycardia, creatinine): QTVI hazard ratio (HR) 4.0 (confidence interval [CI] 1.8-88; P = .008) for total and 4.4 (CI 1.9-10.1; P = .0006) for CV mortality; QTVI >-0.84 HR 2.0 (CI 1.1-3.6; P = .02) for total and 2.1 (CI 1.1-3.8; P = .02) for CV mortality. Increased repolarization lability, as reflected in QTVI measured over 24 hours, is associated with increased risk for total and CV mortality in a heterogeneous population with chronic HF. Published by Elsevier Inc.

  1. Pulsed inductive HF laser

    Energy Technology Data Exchange (ETDEWEB)

    Razhev, A M; Kargapol' tsev, E S [Institute of Laser Physics, Siberian Branch, Russian Academy of Sciences, Novosibirsk (Russian Federation); Churkin, D S; Demchuk, S V [Novosibirsk State University, Novosibirsk (Russian Federation)

    2016-03-31

    We report the results of experimentally investigated dependences of temporal, spectral and spatial characteristics of an inductive HF-laser generation on the pump conditions. Gas mixtures H{sub 2} – F{sub 2}(NF{sub 3} or SF6{sub 6}) and He(Ne) – H{sub 2} – F{sub 2}(NF{sub 3} or SF{sub 6}) were used as active media. The FWHM pulse duration reached 0.42 μs. This value corresponded to a pulsed power of 45 kW. For the first time, the emission spectrum of an inductive HF laser was investigated, which consisted of seven groups of bands with centres around the wavelengths of 2732, 2736, 2739, 2835, 2837, 2893 and 2913 nm. The cross section profile of the laser beam was a ring with a diameter of about 20 mm and width of about 5 mm. Parameters of laser operation in the repetitively pulsed regime were sufficiently stable. The amplitude instability of light pulses was no greater than 5% – 6%. (lasers)

  2. Photon strength function in the Hf-181 nucleus by method of two-step cascade

    CERN Document Server

    Le Hong Khiem

    2003-01-01

    The applicability of sum-coincidence measurements of two-step cascade gamma ray spectra determining Photon Strength Function (PSF) of Hf-181 induced from Hf-180 (n,2 gamma) Hf-181 reaction is presented. Up to 80% intensity of the primary gamma ray transitions in a wide energy range have been deduced and compared to model calculation.

  3. Diffusion of Hf and Nb in Zr-19%Nb

    Energy Technology Data Exchange (ETDEWEB)

    Zou, H. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Hood, G.M. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Schultz, R.J. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Matsuura, N. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Roy, J.A. [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Jackman, J.A. [CANMET, Ottawa, Ont. (Canada). Met. Sci. and Technol.

    1996-05-01

    Diffusion of Hf and Nb in large-grained bcc Zr-19%Nb has been studied. Diffusion coefficients of Hf, D(Hf), were measured in the range 620-1173 K and D(Nb) was measured at 920 and 1167 K. The Hf diffusion profiles were determined by SIMS and the Nb profiles by microtome sectioning and radio-tracer counting. The Hf data show a smooth, temperature-dependent behaviour through the monotectoid temperature, 875 K, and may be characterised by D{approx}10{sup -9}.exp-1.4 (eV/kT) m{sup 2}/s. D(Nb) tends to be lower than the corresponding values for D(Hf). Overall, diffusion of Hf and Nb are characteristic of diffusion in bcc Zr. Surface hold-up (oxide film) at low temperatures was overcome by using ion-implanted Hf diffusion sources. The results are compared with earlier work and discussed in terms of diffusion mechanisms and the {beta}-phase transformation of commercial Zr-2.5Nb. (orig.).

  4. HF Interference, Procedures and Tools (Interferences HF, procedures et outils)

    Science.gov (United States)

    2007-06-01

    such sources. The existing HF background noise possibly may be increased via ground wave and/or sky wave propagation. Increase of the existing HF...télécommunications filaires à large bande. Les télécommunications via le réseau électrique courant, dites PowerLine Communications (PLT ou PLC) et diverses...cumulative de nombreuses sources de même type. Le bruit de fond HF existant risque d’être augmenté par propagation de l’onde terrestre et/ou aérienne

  5. Comparative Study of Surface Chemical Composition and Oxide Layer Modification upon Oxygen Plasma Cleaning and Piranha Etching on a Novel Low Elastic Modulus Ti25Nb21Hf Alloy

    Science.gov (United States)

    Paredes, Virginia; Salvagni, Emiliano; Rodríguez-Castellón, Enrique; Manero, José María

    2017-08-01

    Metals are widely employed for many biological artificial replacements, and it is known that the quality and the physical/chemical properties of the surface are crucial for the success of the implant. Therefore, control over surface implant materials and their elastic moduli may be crucial to avoid undesired effects. In this study, surface modification upon cleaning and activation of a low elastic modulus Ti alloy (Ti25Hf21Nb) was investigated. Two different methods, oxygen plasma (OP) cleaning and piranha (PI) solution, were studied and compared. Both surface treatments were effective for organic contaminant removal and to increase the Ti-oxide layer thickness rather than other metal-oxides present at the surface, which is beneficial for biocompatibility of the material. Furthermore, both techniques drastically increased hydrophilicity and introduced oxidation and hydroxylation (OH)-functional groups at the surface that may be beneficial for further chemical modifications. However, these treatments did not alter the surface roughness and bulk material properties. The surfaces were fully characterized in terms of surface roughness, wettability, oxide layer composition, and hydroxyl surface density through analytical techniques (interferometry, X-ray photoelectron spectroscopy (XPS), contact angle, and zinc complexation). These findings provide essential information when planning surface modifications for cleanliness, oxide layer thickness, and surface hydroxyl density, as control over these factors is essential for many applications, especially in biomaterials.

  6. Power-Stepped HF Cross Modulation Experiments at HAARP

    Science.gov (United States)

    Greene, S.; Moore, R. C.; Langston, J. S.

    2013-12-01

    High frequency (HF) cross modulation experiments are a well established means for probing the HF-modified characteristics of the D-region ionosphere. In this paper, we apply experimental observations of HF cross-modulation to the related problem of ELF/VLF wave generation. HF cross-modulation measurements are used to evaluate the efficiency of ionospheric conductivity modulation during power-stepped modulated HF heating experiments. The results are compared to previously published dependencies of ELF/VLF wave amplitude on HF peak power. The experiments were performed during the March 2013 campaign at the High Frequency Active Auroral Research Program (HAARP) Observatory. HAARP was operated in a dual-beam transmission format: the first beam heated the ionosphere using sinusoidal amplitude modulation while the second beam broadcast a series of low-power probe pulses. The peak power of the modulating beam was incremented in 1-dB steps. We compare the minimum and maximum cross-modulation effect and the amplitude of the resulting cross-modulation waveform to the expected power-law dependence of ELF/VLF wave amplitude on HF power.

  7. Infarct size, left ventricular function, and prognosis in women compared to men after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: results from an individual patient-level pooled analysis of 10 randomized trials.

    Science.gov (United States)

    Kosmidou, Ioanna; Redfors, Björn; Selker, Harry P; Thiele, Holger; Patel, Manesh R; Udelson, James E; Magnus Ohman, E; Eitel, Ingo; Granger, Christopher B; Maehara, Akiko; Kirtane, Ajay; Généreux, Philippe; Jenkins, Paul L; Ben-Yehuda, Ori; Mintz, Gary S; Stone, Gregg W

    2017-06-01

    Studies have reported less favourable outcomes in women compared with men after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Whether sex-specific differences in the magnitude or prognostic impact of infarct size or post-infarction cardiac function explain this finding is unknown. We pooled patient-level data from 10 randomized primary PCI trials in which infarct size was measured within 1 month (median 4 days) by either cardiac magnetic resonance imaging or technetium-99m sestamibi single-photon emission computed tomography. We assessed the association between sex, infarct size, and left ventricular ejection fraction (LVEF) and the composite rate of death or heart failure (HF) hospitalization within 1 year. Of 2632 patients with STEMI undergoing primary PCI, 587 (22.3%) were women. Women were older than men and had a longer delay between symptom onset and reperfusion. Infarct size did not significantly differ between women and men, and women had higher LVEF. Nonetheless, women had a higher 1-year rate of death or HF hospitalization compared to men, and while infarct size was a strong independent predictor of 1-year death or HF hospitalization (P size or LVEF on the risk of death or HF hospitalization. In this large-scale, individual patient-level pooled analysis of patients with STEMI undergoing primary PCI, women had a higher 1-year rate of death or HF hospitalization compared to men, a finding not explained by sex-specific differences in the magnitude or prognostic impact of infarct size or by differences in post-infarction cardiac function.

  8. Rationale and Design of the ATHENA-HF Trial: Aldosterone Targeted Neurohormonal Combined With Natriuresis Therapy in Heart Failure.

    Science.gov (United States)

    Butler, Javed; Hernandez, Adrian F; Anstrom, Kevin J; Kalogeropoulos, Andreas; Redfield, Margaret M; Konstam, Marvin A; Tang, W H Wilson; Felker, G Michael; Shah, Monica R; Braunwald, Eugene

    2016-09-01

    Although therapy with mineralocorticoid receptor antagonists (MRAs) is recommended for patients with chronic heart failure (HF) with reduced ejection fraction and in post-infarction HF, it has not been studied well in acute HF (AHF) despite being commonly used in this setting. At high doses, MRA therapy in AHF may relieve congestion through its natriuretic properties and mitigate the effects of adverse neurohormonal activation associated with intravenous loop diuretics. The ATHENA-HF (Aldosterone Targeted Neurohormonal Combined with Natriuresis Therapy in Heart Failure) trial is a randomized, double-blind, placebo-controlled study of the safety and efficacy of 100 mg/day spironolactone versus placebo (or continued low-dose spironolactone use in participants who are already receiving spironolactone at baseline) in 360 patients hospitalized for AHF. Patients are randomized within 24 h of receiving the first dose of intravenous diuretics. The primary objective is to determine if high-dose spironolactone, compared with standard care, will lead to greater reductions in N-terminal pro-B-type natriuretic peptide levels from randomization to 96 h. The secondary endpoints include changes in the clinical congestion score, dyspnea relief, urine output, weight change, loop diuretic dose, and in-hospital worsening HF. Index hospital length of stay and 30-day clinical outcomes will be assessed. Safety endpoints include risk of hyperkalemia and renal function. Differences among patients with reduced versus preserved ejection fraction will be determined. (Study of High-dose Spironolactone vs. Placebo Therapy in Acute Heart Failure [ATHENA-HF]; NCT02235077).

  9. RFID UHF i HF w bibliotekach

    Directory of Open Access Journals (Sweden)

    Gładysz Bartłomiej

    2015-06-01

    Full Text Available The potential of the innovative Radio Frequency Identification (RFID technology to be applied for support, acceleration and automation of the circulation process of library collection is presented. Technology basics, and hardware and software components are described. Two different radio standards used in libraries are compared. The goal is to present the potential of RFID technology for libraries, to highlight the differences and to build a basis for further consideration of UHF and HF alternatives.

  10. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  11. Hf Transition Probabilities and Abundances

    CERN Document Server

    Lawler, J E; Labby, Z E; Sneden, C; Cowan, J J; Ivans, I I

    2006-01-01

    Radiative lifetimes from laser-induced fluorescence measurements, accurate to about +/- 5 percent, are reported for 41 odd-parity levels of Hf II. The lifetimes are combined with branching fractions measured using Fourier transform spectrometry to determine transition probabilities for 150 lines of Hf II. Approximately half of these new transition probabilities overlap with recent independent measurements using a similar approach. The two sets of measurements are found to be in good agreement for measurements in common. Our new laboratory data are applied to refine the hafnium photospheric solar abundance and to determine hafnium abundances in 10 metal-poor giant stars with enhanced r-process abundances. For the Sun we derive log epsilon (Hf) = 0.88 +/- 0.08 from four lines; the uncertainty is dominated by the weakness of the lines and their blending by other spectral features. Within the uncertainties of our analysis, the r-process-rich stars possess constant Hf/La and Hf/Eu abundance ratios, log epsilon (Hf...

  12. Influence of heart failure on the prognosis of patients with acute myocardial infarction in southwestern China

    Science.gov (United States)

    DENG, FUXUE; XIA, YONG; FU, MICHAEL; HU, YUNFENG; JIA, FANG; RAHARDJO, YEFFRY; DUAN, YINGYI; HE, LINJING; CHANG, JING

    2016-01-01

    The impact of heart failure (HF) on acute myocardial infarction (AMI) in patients from southwestern China remains unclear. The present study aimed to compare in-hospital cardiovascular events, mortality and clinical therapies in AMI patients with or without HF in southwestern China. In total, 591 patients with AMI hospitalized between February 2009 and December 2012 were examined; those with a history of HF were excluded. The patients were divided into four groups according to AMI type (ST-elevated or non-ST-elevated AMI) and the presence of HF during hospitalization. Clinical characteristics, in-hospital cardiovascular events, mortality, coronary angiography and treatment were compared. Clinical therapies, specifically evidence-based drug use were analyzed in patients with HF during hospitalization, including angiotensin converting enzyme inhibitors (ACEIs) and β-blockers (BBs). AMI patients with HF had a higher frequency of co-morbidities, lower left ventricular ejection fraction, longer length of hospital stay and a greater risk of in-hospital mortality compared with AMI patients without HF. AMI patients with HF were less likely to be examined by cardiac angiography or treated with reperfusion therapy or recommended medications. AMI patients with HF co-treated with ACEIs and BBs had a significantly higher survival rate (94.4 vs. 67.5%; PACEIs or BBs alone. Logistic regression analysis revealed that HF and cardiogenic shock in patients with AMI were the strongest predictors of in-hospital mortality. AMI patients with HF were at a higher risk of adverse outcomes. Cardiac angiography and timely standard recommended medications were associated with improved clinical outcomes. PMID:27284294

  13. Two-dimensional semiconductor HfSe{sub 2} and MoSe{sub 2}/HfSe{sub 2} van der Waals heterostructures by molecular beam epitaxy

    Energy Technology Data Exchange (ETDEWEB)

    Aretouli, K. E.; Tsipas, P.; Tsoutsou, D.; Marquez-Velasco, J.; Xenogiannopoulou, E.; Giamini, S. A.; Vassalou, E.; Kelaidis, N.; Dimoulas, A., E-mail: a.dimoulas@inn.demokritos.gr [Institute of Nanoscience and Nanotechnology, National Center for Scientific Research “Demokritos,” 15310, Aghia Paraskevi, Athens (Greece)

    2015-04-06

    Using molecular beam epitaxy, atomically thin 2D semiconductor HfSe{sub 2} and MoSe{sub 2}/HfSe{sub 2} van der Waals heterostructures are grown on AlN(0001)/Si(111) substrates. Details of the electronic band structure of HfSe{sub 2} are imaged by in-situ angle resolved photoelectron spectroscopy indicating a high quality epitaxial layer. High-resolution surface tunneling microscopy supported by first principles calculations provides evidence of an ordered Se adlayer, which may be responsible for a reduction of the measured workfunction of HfSe{sub 2} compared to theoretical predictions. The latter reduction minimizes the workfunction difference between the HfSe{sub 2} and MoSe{sub 2} layers resulting in a small valence band offset of only 0.13 eV at the MoSe{sub 2}/HfSe{sub 2} heterointerface and a weak type II band alignment.

  14. Hardness and Second Phase Percentage of Ni-Ti-Hf Compounds After Heat Treatment at 700C

    Science.gov (United States)

    Stanford, Malcolm K.

    2017-01-01

    The Vickers hardness and second phase precipitation of three ternary intermetallic Ni-Ti-Hf compounds containing either 1, 3 or 5 at.% Hf were compared to 60-Nitinol (55 at.% Ni - 45 at.% Ti). Heat treatment either at 700 C or with a subsequent aging step, hardened the 3 and 5 at.% Hf-containing ternaries to approximately 620 HV (56 HRC). Heat treatment increased the hardness of the 1 at.% Hf compound by more than 25 percent. Average hardness of the 3 and 5 at.% Hf ternaries, though higher than that of the binary Ni-Ti or the Ni-Ti-Hf compound containing 1 at.% Hf, appeared to be fairly insensitive to the different heat treatments. There was a drastic reduction of fatigue-enhancing second phase precipitates for the 5 at.% Hf ternaries compared to the other compounds. These results should guide materials selection for development of aerospace componentry.

  15. Neuromuscular electrical stimulation for muscle wasting in heart failure patients.

    Science.gov (United States)

    Saitoh, Masakazu; Dos Santos, Marcelo Rodrigues; Anker, Markus; Anker, Stefan D; von Haehling, Stephan; Springer, Jochen

    2016-12-15

    Neuromuscular electrical stimulation (NMES) seems to be safe and beneficial in improvement in functional capacity, muscle strength, and quality of life when compared with conventional aerobic exercise, while the change in muscle fiber composition and muscle size was conflicting in patients with heart failure (HF). Moreover, NMES studies seem to have beneficial effects on pro-inflammatory cytokine, oxidative enzyme activity, and protein anabolic and catabolic metabolism that are the key molecular mechanism of muscle wasting in patients with HF. We review specific issues related to the effects of NMES on muscle wasting in patients with HF, whether NMES seems to be an alternative exercise modality preventing or improving in muscle wasting for HF patients who are unable or unwilling to engage in conventional exercise training; however no established strategies currently exist to focus on the patients with HF accompanied by muscle wasting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Exploring Patient, Caregiver, and Healthcare Provider Perceptions of Caring for Patients With Heart Failure: What Are the Implications?

    Science.gov (United States)

    Kennedy, Betty M.; Jaligam, Vijayendra; Conish, Beverly K.; Johnson, William D.; Melancon, Brian; Katzmarzyk, Peter T.

    2017-01-01

    Background: Heart failure (HF) is an incurable and frequently progressive disease. Symptoms of HF may impair the ability of patients to perform daily living activities. As HF progresses, patients typically increase their reliance on caregivers. The purpose of this study was to determine what roles patients and caregivers perceive and desire for themselves in managing HF and to compare and contrast these roles with those perceived by healthcare providers. Methods: A purposive sample (60 patients, 22 caregivers, and 11 healthcare providers) was enrolled in the study. Patients and caregivers individually participated in semistructured interviews, and healthcare providers participated in 1 of 2 focus groups. Results: Four key themes evolved from interviews with patients and caregivers—education on disease specifics, guidance to enhance quality of life, learning to cope with HF, and future outlook and care decisions—that may guide the development of caregiver interventions in HF. Healthcare providers in both structured focus groups regardless of rank order selected knowledge is powerful, adherence to treatment plan, and compliance with medication as the top 3 issues likely to have the greatest impact, and they identified education on the disease (knowledge is powerful) as the easiest strategy to implement for patients and caregivers in the management of HF. Conclusion: Interventions among caregivers of patients with HF are needed and should focus on education in family structures, family functioning, and skills training in family assessment and engagement. PMID:28331455

  17. Characteristics of patients initiating raloxifene compared to those initiating bisphosphonates

    Directory of Open Access Journals (Sweden)

    Wang Sara

    2008-12-01

    Full Text Available Abstract Background Both raloxifene and bisphosphonates are indicated for the prevention and treatment of postmenopausal osteoporosis, however these medications have different efficacy and safety profiles. It is plausible that physicians would prescribe these agents to optimize the benefit/risk profile for individual patients. The objective of this study was to compare demographic and clinical characteristics of patients initiating raloxifene with those of patients initiating bisphosphonates for the prevention and treatment of osteoporosis. Methods This study was conducted using a retrospective cohort design. Female beneficiaries (45 years and older with at least one claim for raloxifene or a bisphosphonate in 2003 through 2005 and continuous enrollment in the previous 12 months and subsequent 6 months were identified using a collection of large national commercial, Medicare supplemental, and Medicaid administrative claims databases (MarketScan®. Patients were divided into two cohorts, a combined commercial/Medicare cohort and a Medicaid cohort. Within each cohort, characteristics (demographic, clinical, and resource utilization of patients initiating raloxifene were compared to those of patients initiating bisphosphonate therapy. Group comparisons were made using chi-square tests for proportions of categorical measures and Wilcoxon rank-sum tests for continuous variables. Logistic regression was used to simultaneously examine factors independently associated with initiation of raloxifene versus a bisphosphonate. Results Within both the commercial/Medicare and Medicaid cohorts, raloxifene patients were younger, had fewer comorbid conditions, and fewer pre-existing fractures than bisphosphonate patients. Raloxifene patients in both cohorts were less likely to have had a bone mineral density (BMD screening in the previous year than were bisphosphonate patients, and were also more likely to have used estrogen or estrogen/progestin therapy in the

  18. The impact of ulcerative colitis on patients' lives compared to other chronic diseases: a patient survey.

    Science.gov (United States)

    Rubin, David T; Dubinsky, Marla C; Panaccione, Remo; Siegel, Corey A; Binion, David G; Kane, Sunanda V; Hopper, Joseph

    2010-04-01

    This study was designed to identify the impact chronic ulcerative colitis (UC) has on the lives of patients compared to other chronic conditions. Overall, 451 patients with UC, 309 with rheumatoid arthritis, 305 with asthma, and 305 with migraine headaches were recruited in an Internet survey designed to assess a variety of disease-impact indices. Patients with UC reported a mean of eight (self-defined) flare-ups in the previous 12 months. Significantly more patients with UC (81%) believed that the quantity of flare-ups they experienced was 'normal', compared to patients with migraine headaches (64%) or asthma (75%). Patients with UC also reported significantly more worry about disease complications (84%), depression (62%), and embarrassment (70%) than patients with the other chronic conditions. Compared to patients with other chronic conditions, patients with UC perceive substantially more negative impact upon their lives, especially with regard to the psychological burden.

  19. A Comparative Study Of Psychiatric Morbidity In Dermatological Patients

    Directory of Open Access Journals (Sweden)

    Sharma Neelu

    2003-01-01

    Full Text Available The psychiatric morbidity in five chronic and disfiguring diseases, namely psoriasis, chronic urticaria, leprosy, vitiligo and lichen simplex chronicus (LSC was assessed and compared using the standardized Hindi (Vernacular languages version of General Health Questionnaire (GHQ-H. Thirty new untreated patients of each of the above skin diseases between the age group of 18-60 years were included in the study. The overall prevalence of the psychiatric morbidity was found to be 39%, depression and anxiety were present in 13% and 10.66% of the patients and suicidal ideations and somatisation in 16% and 13% of the patients respectively. Prevalence of interpersonal conflict and suicidal attempt were 10% and 2.6% respectively. On comparative analysis of psychiatric morbidity, significant difference was observed between vitiligo and other disorders (p=0.0028, i.e., chronic urticaria (p=0.0242 and psoriasis and other disorders (p=0.0028, however no significant difference could be elicited between psoriasis and leprosy or leprosy and vitiligo. Comparative analysis of anxiety revealed statistically significant difference between the patients of LSC and vitiligo (p=0.02 or vitiligo and chronic urticaria (p=0.04 but no significant difference was observed for vitiligo and leprosy of psoriasis and leprosy. The prevalence of somatic complaints showed significant difference between the patients of LSC and Leprosy.

  20. Self-Cutting: Patient Characteristics Compared with Self-Poisoners

    Science.gov (United States)

    Hawton, Keith; Harriss, Louise; Simkin, Sue; Bale, Elizabeth; Bond, Alison

    2004-01-01

    A large (n = 14,892) consecutive sample of deliberate self-harm (attempted suicide) patients who presented to a general hospital in the United Kingdom during a 23-year study period was examined (over two consecutive time periods) in order to compare the characteristics of those who used self-cutting (n = 428) and those who self-poisoned (n =…

  1. Racial Differences in the Prevalence and Outcomes of Atrial Fibrillation in Patients Hospitalized With Heart Failure

    Science.gov (United States)

    Bhatia, Subir; Qazi, Mohammad; Erande, Ashwini; Shah, Kunjan; Amin, Alpesh; Patel, Pranav; Malik, Shaista

    2017-01-01

    Previous research has shown that roughly 15% to 30% of those with heart failure (HF) develop atrial fibrillation (AF). Although studies have shown variations in the incidence of AF in patients with HF, there has been no evidence of mortality differences by race. The purpose of this study was to assess AF prevalence and inhospital mortality in patients with HF among different racial groups in the United States. Using the National Inpatient Sample registry, the largest publicly available all-payer inpatient care database representing >95% of the US inpatient population, we analyzed subjects hospitalized with a primary diagnosis of HF from 2001 to 2011 (n = 11,485,673) using the International Classification of Diseases, Ninth Edition (ICD 9) codes 428.0-0.1, 428.20-0.23, 428.30-0.33, 428.40-0.43, and 428.9; patients with AF were identified using the ICD 9 code 427.31. We assessed prevalence and mortality among racial groups. Using logistic regression, we examined odds of mortality adjusted for demographics and co-morbidity using Elixhauser co-morbidity index. We also examined utilization of procedures by race. Of the 11,485,673 patients hospitalized with HF in our study, 3,939,129 (34%) had AF. Patients with HF and AF had greater inhospital mortality compared with those without AF (4.6% vs 3.3% respectively, p <0.0001). Additionally, black, Hispanic, Asian, and white patients with HF and AF had a 24%, 17%, 13%, and 6% higher mortality, respectively, than if they did not have AF. Among patients with HF and AF, minority racial groups had underutilization of catheter ablation and cardioversion compared with white patients. In conclusion, minority patients with HF and AF had a disproportionately higher risk of inpatient death compared with white patients with HF. We also found a significant underutilization of cardioversion and catheter ablation in minority racial groups compared with white patients. PMID:26970814

  2. Prevalence and importance of comorbidities in patients with heart failure.

    Science.gov (United States)

    Triposkiadis, Filippos K; Skoularigis, John

    2012-12-01

    Heart failure (HF), being a disease of the elderly, is associated with several noncardiac comorbidities, defined as chronic conditions coexisting with HF that play an integral role in its development, progression, and response to treatment. These include pulmonary dysfunction, sleep-disordered breathing, renal dysfunction, liver dysfunction, anaemia, thyroid disorders, diabetes mellitus, skeletal myopathy, depression, and cognitive impairment. The noncardiac comorbidity burden is higher and associated with higher non-HF hospitalizations in patients with HF and preserved, as compared with those with HF and reduced, left-ventricular ejection fraction. Since chronic inflammation is a characteristic feature of both HF and the coexisting morbidities, it may play a pivotal role in their development, progression, and interactions.

  3. Serpentinization Changes Nd, but not Hf Isotopes of Abyssal Peridotites

    Science.gov (United States)

    Bizimis, M.; Frisby, C. P.; Mallick, S.

    2015-12-01

    Serpentinization of the oceanic lithosphere is a known sink for fluid mobile elements (B, Cl, Li, Sr, etc.), while high field strength elements (HFSE: e.g., Hf, Zr, Ti, Nb) are thought to be unaffected by it. In contrast, the fate of REE during serpentinization is equivocal. Correlations between REE and HFSE concentrations in abyssal peridotites suggest control by magmatic processes (Niu, 2004, J. Pet), while some LREE enrichments in serpentinized peridotites compared to their clinopyroxene (cpx) and Nd, Sr isotope data (Delacour et al., 2008, Chem. Geol.) imply seawater-derived REE addition to the mantle protolith (Paulick et al., 2006, Chem. Geol). To further constrain peridotite-seawater interaction during serpentinization we compare bulk rock and cpx Hf and Nd isotope data in partially (up to ~70%) serpentinized abyssal peridotites (9-16°E South West Indian Ridge). We also present a new method that improves yields in Hf, Nd and Pb separations from depleted (90% of Hf, Zr, Ti are retained in the residue. LA-ICPMS data shows that serpentine after olivine typically has higher LREE/HREE ratios than cpx, pronounced negative Ce anomalies, high U, Sr concentrations and low HFSE, unlike the coexisting cpx. These data are consistent with some seawater-derived LREE addition to peridotite during serpentinization, localized in the serpentine and other secondary phases, while cpx retains the magmatic value. This process will lower the Sm/Nd relative to Lu/Hf ratio in the peridotite and can lead to decoupled radiogenic Hf and unradiogenic Nd isotopes upon recycling and aging. Our data further testifies to the fidelity of Hf isotopes in tracing mantle processes, even in serpentinized rocks.

  4. Social outcome compared in psychotic and nonpsychotic bipolar I patients.

    Science.gov (United States)

    Rosen, L N; Rosenthal, N E; Dunner, D L; Fieve, R R

    1983-05-01

    Eighty-nine bipolar I patients were given a structured interview, the Schedule for Affective Disorders and Schizophrenia. Those who had experienced delusions or hallucinations at some time during the course of their illness were designated "psychotic," and those who had not were designated "nonpsychotic." The two groups were compared with regard to a number of outcome variables as well as age, age at first treatment, and duration of illness. The psychotic group had significantly poorer outcome in terms of social functioning. Although age, age at first treatment, and duration of illness distinguished between the two groups of patients, statistical analyses indicated that these variables did not account for differences in social outcome.

  5. Higher education is associated with reduced risk of heart failure among patients with acute myocardial infarction: A nationwide analysis using data from the CVDNOR project.

    Science.gov (United States)

    Sulo, Gerhard; Nygård, Ottar; Vollset, Stein Emil; Igland, Jannicke; Ebbing, Marta; Sulo, Enxhela; Egeland, Grace M; Tell, Grethe S

    2016-11-01

    Coronary heart disease (CHD) outcomes are characterised by socioeconomic gradients. Although heart failure (HF) is a severe complication of CHD, sparse evidence exists on the association between socioeconomic status and HF among coronary patients. This study aimed to explore potential educational differences in the risk of HF among acute myocardial infarction (AMI) patients in Norway during 2001-2009. A total of 70,506 patients hospitalised for an incident (first) AMI and without history of HF were included in the analyses. Information on education was obtained from the Norwegian Education Database and categorised into primary, secondary or tertiary. In 12,487 (17.7%) patients, HF was present at admission or developed during the AMI hospitalisation (early-onset HF). Compared to patients with primary education, patients with secondary or tertiary education had 9% [incidence rate ratio (IRR) = 0.91; 95% confidence interval (CI): 0.87-0.94] and 20% (IRR = 0.80; 95% CI: 0.75-0.86) lower risks of early-onset HF, respectively. Of the 54,095 AMI patients discharged alive without concurrent HF, 6375 (11.8%) were subsequently hospitalised with or died from late-onset HF during a median follow-up period of 3.4 years. Compared to patients with primary education, those with secondary or tertiary education had 14% [hazard ratio (HR = 0.86; 95% CI: 0.82-0.91] and 27% (HR = 0.73; 95% CI: 0.66-0.80) lower risks of HF, respectively. Educational differences in the risk of HF were not influenced by gender. We observed an inverse association between educational level and risk of HF. More efforts in preventing this severe complication of AMI among less educated patients may help to reduce the socioeconomic gap in survival following coronary events. © The European Society of Cardiology 2016.

  6. Ozone Treatment Improved the Resistive Switching Uniformity of HfAlO2 Based RRAM Devices

    Directory of Open Access Journals (Sweden)

    Lifeng Liu

    2015-01-01

    Full Text Available HfAlO2 based resistive random access memory (RRAM devices were fabricated using atomic layer deposition by modulating deposition cycles for HfO2 and Al2O3. Effect of ozone treatment on the resistive switching uniformity of HfAlO2 based RRAM devices was investigated. Compared to the as-fabricated devices, the resistive switching uniformity of HfAlO2 based RRAM devices with the ozone treatment is significantly improved. The uniformity improvement of HfAlO2 based RRAM devices is related to changes in compositional and structural properties of the HfAlO2 resistive switching film with the ozone treatment.

  7. A comparative study of ICU patient diaries vs. hospital charts.

    Science.gov (United States)

    Egerod, Ingrid; Christensen, Doris

    2010-10-01

    Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after discharge. The central question we posed in this study was: Why do nurses write diaries in addition to conventional charting in the medical record? To answer this question, we compared intensive care diaries and hospital charts using textual analysis and narrative theory. The aims of our study were to compare patient diaries and hospital charts to explore (a) what each documentation instrument has to offer patients in their quest to make sense of their illness, and (b) why it is worthwhile for nurses to sustain the practice of writing diaries. The study findings show that the diary is coherent, personal, and supportive, whereas the hospital chart is fragmented, impersonal, and technical. The diary tells a comprehensive story that might help the patient to construct or reconstruct his or her own illness narrative.

  8. Comparing the Recognition of Emotional Facial Expressions in Patients with

    Directory of Open Access Journals (Sweden)

    Abdollah Ghasempour

    2014-05-01

    Full Text Available Background: Recognition of emotional facial expressions is one of the psychological factors which involve in obsessive-compulsive disorder (OCD and major depressive disorder (MDD. The aim of present study was to compare the ability of recognizing emotional facial expressions in patients with Obsessive-Compulsive Disorder and major depressive disorder. Materials and Methods: The present study is a cross-sectional and ex-post facto investigation (causal-comparative method. Forty participants (20 patients with OCD, 20 patients with MDD were selected through available sampling method from the clients referred to Tabriz Bozorgmehr clinic. Data were collected through Structured Clinical Interview and Recognition of Emotional Facial States test. The data were analyzed utilizing MANOVA. Results: The obtained results showed that there is no significant difference between groups in the mean score of recognition emotional states of surprise, sadness, happiness and fear; but groups had a significant difference in the mean score of diagnosing disgust and anger states (p<0.05. Conclusion: Patients suffering from both OCD and MDD show equal ability to recognize surprise, sadness, happiness and fear. However, the former are less competent in recognizing disgust and anger than the latter.

  9. Adherence to optimal heart rate control in heart failure with reduced ejection fraction: insight from a survey of heart rate in heart failure in Sweden (HR-HF study).

    Science.gov (United States)

    Fu, M; Ahrenmark, U; Berglund, S; Lindholm, C J; Lehto, A; Broberg, A Månsson; Tasevska-Dinevska, G; Wikstrom, G; Ågard, A; Andersson, B

    2017-08-09

    Despite that heart rate (HR) control is one of the guideline-recommended treatment goals for heart failure (HF) patients, implementation has been painstakingly slow. Therefore, it would be important to identify patients who have not yet achieved their target heart rates and assess possible underlying reasons as to why the target rates are not met. The survey of HR in patients with HF in Sweden (HR-HF survey) is an investigator-initiated, prospective, multicenter, observational longitudinal study designed to investigate the state of the art in the control of HR in HF and to explore potential underlying mechanisms for suboptimal HR control with focus on awareness of and adherence to guidelines for HR control among physicians who focus on the contributing role of beta-blockers (BBs). In 734 HF patients the mean HR was 68 ± 12 beats per minute (bpm) (37.2% of the patients had a HR >70 bpm). Patients with HF with reduced ejection fraction (HFrEF) (n = 425) had the highest HR (70 ± 13 bpm, with 42% >70 bpm), followed by HF with preserved ejection fraction and HF with mid-range ejection fraction. Atrial fibrillation, irrespective of HF type, had higher HR than sinus rhythm. A similar pattern was observed with BB treatment. Moreover, non-achievement of the recommended target HR (bpm) in HFrEF and sinus rhythm was unrelated to age, sex, cardiovascular risk factors, cardiovascular diseases, and comorbidities, but was related to EF and the clinical decision of the physician. Approximately 50% of the physicians considered a HR of >70 bpm optimal and an equal number considered a HR of >70 bpm too high, but without recommending further action. Furthermore, suboptimal HR control cannot be attributed to the use of BBs because there was neither a difference in use of BBs nor an interaction with BBs for HR >70 bpm compared with HR bpm. Suboptimal control of HR was noted in HFrEF with sinus rhythm, which appeared to be attributable to physician decision making rather

  10. Characterising the difference in electrophysiological substrate and outcomes between heart failure and non-heart failure patients with persistent atrial fibrillation.

    Science.gov (United States)

    Haldar, Shouvik K; Jones, David G; Khan, Habib; Panikker, Sandeep; Jarman, Julian W E; Butcher, Charlie; Lim, Eric; Wynn, Gareth; Gupta, Dhiraj; Hussain, Wajid; Markides, Vias; Wong, Tom

    2017-01-20

    Characterizing the differences in substrate and clinical outcome between heart failure (HF) and non-heart failure (non-HF) patients undergoing persistent atrial fibrillation (AF) ablation. Using complex fractionated electrograms (CFE) as a surrogate marker of substrate complexity, we compared the bi-atrial substrate in patients with persistent AF with and without HF, at baseline and after ablation, to determine its impact on clinical outcome. In this retrospective analysis of two prospective studies, 60 patients underwent de-novo step-wise left atrial (LA) ablation, 30 with normal left ventricular ejection fraction (LVEF) ≥ 50% (non-HF group) and 30 with LVEF ≤ 35% (HF group). Multiple high-density bi-atrial CFE maps were acquired along with AF cycle length (AFCL) at each procedural stage. Change in bi-atrial CFE areas, AFCL and outcome data were then compared. In the non-HF group, higher CFE-areas were found at baseline and at each step of the procedure in the LA. In both LA and the right atrium (RA), baseline and final CFE area were also higher in the non-HF group. Single procedure, arrhythmia-free survival at 1 year was higher in the HF group compared with the non-HF group (72% vs. 43%, log rank P = 0.04). Final total bi-atrial CFE area was an independent predictor of arrhythmia recurrence. CFE represents an important surrogate marker of atrial substrate complexity. The atrial substrate in persistent AF differs between HF and non-HF with the latter representing a more complex 'primary' bi-atrial myopathy. LA focussed ablation results in more extensive substrate modification in HF and better clinical outcomes as compared with non-HF. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  11. The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry.

    Science.gov (United States)

    Park, Jin Joo; Choi, Dong-Ju; Yoon, Chang-Hwan; Oh, Il-Young; Lee, Ju Hyun; Ahn, Soyeon; Yoo, Byung-Su; Kang, Seok-Min; Kim, Jae-Joong; Baek, Sang-Hong; Cho, Myeong-Chan; Jeon, Eun-Seok; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee

    2015-06-01

    In acute heart failure (AHF) patients, pulmonary oedema and low tissue perfusion may lead to changes in the acid-base balance, which may be associated with worse outcomes. In this prospective nationwide cohort study from 24 academic hospitals, arterial blood gas (ABG) was measured in 1982 AHF patients at hospital admission. Acidosis was defined as pH 7.44. Mortality was stratified according to ABG results. Overall, 19% had acidosis, 37% had normal pH, and 44% had alkalosis. The most common type of acidosis was the mixed type (42%) followed by metabolic acidosis (40%), and the most common type of alkalosis was respiratory alkalosis (58%). At 12 months' follow-up 304 patients (15%) died. Patients with acidosis had higher mortality (acidosis 19.5%, neutral pH 13.7%, alkalosis 14.9%; P = 0.007). In the Cox proportional-hazards regression model, acidosis was a significant predictor of mortality (hazard ratio 1.93; 95% confidence intervals 1.27-2.93) along with N-terminal pro-brain type natriuretic peptide (NT-proBNP), among others. In contrast, alkalosis was not associated with increased mortality. pH had an incremental prognostic value over NT-proBNP (net reclassification improvement 30%; P analysis identified extra patients at increased risk for mortality among patients with an NT-proBNP level less than the median (12-month mortality 17.5% vs. 9.9%; P = 0.009). In high-risk AHF patients, the most common acid-base imbalance is respiratory alkalosis. Acidosis is observed in every fifth patient and is a significant predictor of mortality. pH provides an additional prognostic value and may be used to optimize risk stratification in high-risk AHF patients. © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.

  12. Structural degradation of thin HfO2 film on Ge during the postdeposition annealing

    Science.gov (United States)

    Miyata, Noriyuki; Yasuda, Tetsuji; Abe, Yasuhiro

    2010-05-01

    Securing the thermal robustness of thin hafnium oxide (HfO2) film on the semiconductor surface is an important technical issue in the fabrication of the metal-oxide-semiconductor field-effect transistor devices, as the HfO2-based high-k gate stacks usually undergo high-temperature processes. In this study, the structural development of thin HfO2 film on a Ge surface during postdeposition annealing in an ultrahigh vacuum was examined to explore the origin for the initial degradation of thin HfO2 film. Void nucleation and subsequent two-dimensional void growth take place at 780-840 °C, while the chemical composition of the remaining Hf oxide is virtually stable. Both the void nucleation and growth processes show similar larger activation energy of about 10 eV. Based on the observed manner of void growth and the estimated activation energies, the authors propose that mass transport on the HfO2 surface is responsible for void nucleation in the HfO2 films on Ge. The authors also compare the present results with the previous studies on HfO2/Si structures, and suggest that similar surface process leads to the local Hf silicidation.

  13. Virtual glaucoma clinics: patient acceptance and quality of patient education compared to standard clinics

    Directory of Open Access Journals (Sweden)

    Court JH

    2015-04-01

    Full Text Available Jennifer H Court,1 Michael W Austin1,21Department of Ophthalmology, Singleton Hospital, Swansea, Wales, UK; 2Department of Ophthalmology, Neath Port Talbot Hospital, Swansea, Wales, UKPurpose: Virtual glaucoma clinics allow rapid, reliable patient assessment but the service should be acceptable to patients and concordance with treatment needs to be maintained with adequate patient education. This study compares experiences and understanding of patients reviewed via the virtual clinic versus the standard clinic by way of an extended patient satisfaction questionnaire (PSQ.Patients and methods: One hundred PSQs were given to consecutive patients attending glaucoma clinics in October 2013. All 135 patients reviewed via the virtual clinic from April 2013 until August 2013 were sent postal PSQs in September 2013. Data were obtained for demographics, understanding of glaucoma, their condition, satisfaction with their experience, and quality of information. Responses were analyzed in conjunction with the clinical records.Results: Eighty-five percent of clinic patients and 63% of virtual clinic patients responded to the PSQ. The mean satisfaction score was over 4.3/5 in all areas surveyed. Virtual clinic patients’ understanding of their condition was very good, with 95% correctly identifying their diagnosis as glaucoma, 83% as ocular hypertension and 78% as suspects. There was no evidence to support inferior knowledge or self-perceived understanding compared to standard clinic patients. Follow-up patients knew more about glaucoma than new patients. Over 95% of patients found our information leaflet useful. Forty percent of patients sought additional information but less than 20% used the internet for this.Conclusion: A substantial proportion of glaucoma pathway patients may be seen by non-medical staff supervised by glaucoma specialists via virtual clinics. Patients are accepting of this format, reporting high levels of satisfaction and non

  14. Geographic variations in the PARADIGM-HF heart failure trial.

    Science.gov (United States)

    Kristensen, Søren Lund; Martinez, Felipe; Jhund, Pardeep S; Arango, Juan Luis; Bĕlohlávek, Jan; Boytsov, Sergey; Cabrera, Walter; Gomez, Efrain; Hagège, Albert A; Huang, Jun; Kiatchoosakun, Songsak; Kim, Kee-Sik; Mendoza, Iván; Senni, Michele; Squire, Iain B; Vinereanu, Dragos; Wong, Raymond Ching-Chiew; Gong, Jianjian; Lefkowitz, Martin P; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R; Packer, Milton; McMurray, John J V

    2016-11-01

    The globalization of clinical trials has highlighted geographic variations in patient characteristics, event rates, and treatment effects. We investigated these further in PARADIGM-HF, the largest and most globally representative trial in heart failure (HF) to date. We looked at five regions: North America (NA) 602 (8%), Western Europe (WE) 1680 (20%), Central/Eastern Europe/Russia (CEER) 2762 (33%), Latin America (LA) 1433 (17%), and Asia-Pacific (AP) 1487 (18%). Notable differences included: WE patients (mean age 68 years) and NA (65 years) were older than AP (58 years) and LA (63 years) and had more coronary disease; NA and CEER patients had the worst signs, symptoms, and functional status. North American patients were the most likely to have a defibrillating-device (54 vs. 2% AP) and least likely prescribed a mineralocorticoid receptor antagonist (36 vs. 65% LA). Other evidence-based therapies were used most frequently in NA and WE. Rates of the primary composite outcome of cardiovascular (CV) death or HF hospitalization (per 100 patient-years) varied among regions: NA 13.6 (95% CI 11.7-15.7) WE 9.6 (8.6-10.6), CEER 12.3 (11.4-13.2), LA 11.2 (10.0-12.5), and AP 12.5 (11.3-13.8). After adjustment for prognostic variables, relative to NA, the risk of CV death was higher in LA and AP and the risk of HF hospitalization lower in WE. The benefit of sacubitril/valsartan was consistent across regions. There were many regional differences in PARADIGM-HF, including in age, symptoms, comorbidity, background therapy, and event-rates, although these did not modify the benefit of sacubitril/valsartan. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  15. Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients.

    NARCIS (Netherlands)

    Westerveld, L.A.; van Bemmel, J.C.; Dhert, W.J.A.; Öner, F.C.; Verlaan, J.J.

    2014-01-01

    Background context The clinical outcome of patients with ankylosing spinal disorders (ASDs) sustaining a spinal fracture has been described to be worse compared with the general trauma population. Purpose To investigate clinical outcome (neurologic deficits, complications, and mortality) after spina

  16. Worsening renal function and outcome in heart failure patients with reduced and preserved ejection fraction and the impact of angiotensin receptor blocker treatment : data from the CHARM-study programme

    NARCIS (Netherlands)

    Damman, Kevin; Solomon, Scott D.; Pfeffer, Marc A.; Swedberg, Karl; Yusuf, Salim; Young, James B.; Rouleau, Jean L.; Granger, Christopher B.; McMurray, John J. V.

    2016-01-01

    Aims We investigated the association between worsening renal function (WRF) that occurs during renin-angiotensin-aldosterone system inhibition initation and outcome in heart failure (HF) patients with preserved ejection fraction (HFPEF) and compared this with HF patients with reduced ejection fracti

  17. Effects of n-3 polyunsaturated fatty acids on malignant ventricular arrhythmias in patients with chronic heart failure and implantable cardioverter-defibrillators: A substudy of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca (GISSI-HF) trial.

    Science.gov (United States)

    Finzi, Andrea A; Latini, Roberto; Barlera, Simona; Rossi, Maria G; Ruggeri, Albarosa; Mezzani, Alessandro; Favero, Chiara; Franzosi, Maria G; Serra, Domenico; Lucci, Donata; Bianchini, Francesca; Bernasconi, Roberto; Maggioni, Aldo P; Nicolosi, Gianluigi; Porcu, Maurizio; Tognoni, Gianni; Tavazzi, Luigi; Marchioli, Roberto

    2011-02-01

    The antiarrhythmic effects of n-3 polyunsaturated fatty acids (n-3PUFA) in ischemic heart disease have been demonstrated; however, studies in patients surviving malignant ventricular arrhythmias of different etiologies treated with an implantable cardioverter-defibrillator (ICD) have given conflicting results. The purpose of this study was to assess the antiarrhythmic effect of n-3PUFA versus placebo in 566 patients with heart failure enrolled in the GISSI-HF trial who received an ICD for secondary or primary prevention of ventricular fibrillation (VF) or tachycardia (VT). Clinical data and arrhythmic event recordings extracted from the device memory were obtained. We tested the treatment effect by a multivariate Cox model adjusting for all clinical parameters associated with the primary end point defined as time to first appropriate ICD discharge for VT/VF. In the 566 patients with at least one recorded follow-up visit, 1363 VT and 316 VF episodes were terminated by ICD pacing or shock over a median follow-up of 928 days. The incidence of the primary end point event was 27.3% in the n-3PUFA group and 34.0% in the placebo group (adjusted hazard rate = 0.80, 95% CI 0.59-1.09, P = .152). Patients who received 1, 2 to 3, or >3 ICD discharges were 8.9%, 7.1%, and 11.1% in the n-3PUFA group, compared with slightly higher rates of 11.1%, 10.7%, and 12.1% in the placebo group (overall P = .30). Patients with the highest 3-month increase in plasma n-3PUFA had a somewhat lower incidence of arrhythmic events. The results of this study, though not statistically significant, support prior evidences of an antiarrhythmic effect of n-3PUFA in patients with ICD, although they leave open the issue of whether this effect leads to a survival benefit. Copyright © 2011 Mosby, Inc. All rights reserved.

  18. Cardiovascular risk factor management in patients with RA compared to matched non-RA patients

    NARCIS (Netherlands)

    E. Alemao (Evo); H. Cawston (Helene); F. Bourhis (Francois); M.J. Al (Maiwenn); M.P.M.H. Rutten-van Mölken (Maureen); K. Liao (Katherine); D.H. Solomon (Daniel)

    2015-01-01

    markdownabstractObjective. RA is associated with a 50-60% increase in risk of cardiovascular (CV) death. This study aimed to compare management of CV risk factors in RA and matched non-RA patients. Methods. A retrospective cohort study was conducted using UK clinical practice data. Patients presen

  19. Changed adipocytokine concentrations in colorectal tumor patients and morbidly obese patients compared to healthy controls

    Directory of Open Access Journals (Sweden)

    Hillenbrand Andreas

    2012-11-01

    Full Text Available Abstract Background Obesity has been associated with increased incidence of colorectal cancer. Adipose tissue dysfunction accompanied with alterations in the release of adipocytokines has been proposed to contribute to cancer pathogenesis and progression. The aim of this study was to analyze plasma concentrations of several adipose tissue expressed hormones in colorectal cancer patients (CRC and morbidly obese (MO patients and to compare these concentrations to clinicopathological parameters. Methods Plasma concentrations of adiponectin, resistin, leptin, active plasminogen activator inhibitor (PAI-1, monocyte chemotactic protein (MCP-1, interleukin (IL-1 alpha, and tumor necrosis factor (TNF-alpha were determined in 67 patients operated on for CRC (31 rectal cancers, 36 colon cancers, 37 patients operated on for morbid obesity and 60 healthy blood donors (BD. Results Compared to BD, leptin concentrations were lowered in CRC patients whereas those of MO patients were elevated. Adiponectin concentrations were only lowered in MO patients. Concentrations of MCP-1, PAI-1, and IL-1 alpha were elevated in both CRC and MO patients, while resistin and TNF-alpha were similarly expressed in MO and CRC patients compared to BD. Resistin concentrations positively correlated with tumor staging (p Conclusions The results suggest that both MO and CRC have low-grade inflammation as part of their etiology.

  20. Comparative proteomic analysis of whole saliva from chronic periodontitis patients.

    Science.gov (United States)

    Gonçalves, Lorena Da Rós; Soares, Márcia Regina; Nogueira, Fábio C S; Garcia, Carlos; Camisasca, Danielle Resende; Domont, Gilberto; Feitosa, Alfredo C R; Pereira, Denise de Abreu; Zingali, Russolina B; Alves, Gilda

    2010-05-07

    Chronic periodontal disease is a chronic inflammatory process affecting tooth supporting tissues in the presence of pathogenic bacterial biofilm. There is some evidence for changes in the protein composition of whole saliva from chronic periodontitis patients, but there have been no studies using a proteomic approach. Hence, the aim of this study was to compare the protein profiles of unstimulated whole saliva from patients with periodontitis and healthy subjects by two complementary approaches (2D-gel electrophoresis and liquid chromatography). Protein spots of interest were analyzed by MALDI-TOF-TOF, and the data was complemented by an ESI-Q-TOF experiment. The analyses revealed that subjects with periodontal disease have increased amounts of blood proteins (serum albumin and hemoglobin) and immunoglobulin, and they have a lower abundance of cystatin compared to the control group. A higher number of protein spots were observed in the periodontitis group, of which most were identified as alpha-amylase. This higher number of alpha-amylase variants seems to be caused by hydrolysis by cysteine proteases under such inflammatory conditions. This approach gives novel insights into alterations of salivary protein in presence of periodontal inflammation and may contribute to the improvement of periodontal diagnosis.

  1. Prevalence and inter-relationship of different Doppler measures of dyssynchrony in patients with heart failure and prolonged QRS: a report from CARE-HF

    DEFF Research Database (Denmark)

    Edner, Magnus; Kim, Yong; Hansen, Knud Norregaard

    2009-01-01

    as a delayed longitudinal contraction (DLC) during the postsystolic phase or by tissue synchronisation imaging (TSI) with a predefined time-difference in systolic maximal velocities >85 ms. RESULTS: LVFT/RR was present in 34% and IVMD in 60% of patients while intra-ventricular dyssynchrony was present in 85......% (DLC) and 86% (TSI) with a high agreement between the measures (Kappascore 0.86-1.00), indicating the methods being interchangeable. Patients with cardiomyopathy (53%) were more likely to have LVFT/RR

  2. Detection of muscle wasting in patients with chronic heart failure using C-terminal agrin fragment: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF).

    Science.gov (United States)

    Steinbeck, Lisa; Ebner, Nicole; Valentova, Miroslava; Bekfani, Tarek; Elsner, Sebastian; Dahinden, Pius; Hettwer, Stefan; Scherbakov, Nadja; Schefold, Jörg C; Sandek, Anja; Springer, Jochen; Doehner, Wolfram; Anker, Stefan D; von Haehling, Stephan

    2015-12-01

    Skeletal muscle wasting affects 20% of patients with chronic heart failure and has serious implications for their activities of daily living. Assessment of muscle wasting is technically challenging. C-terminal agrin-fragment (CAF), a breakdown product of the synaptically located protein agrin, has shown early promise as biomarker of muscle wasting. We sought to investigate the diagnostic properties of CAF in muscle wasting among patients with heart failure. We assessed serum CAF levels in 196 patients who participated in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Muscle wasting was identified using dual-energy X-ray absorptiometry (DEXA) in 38 patients (19.4%). Patients with muscle wasting demonstrated higher CAF values than those without (125.1 ± 59.5 pmol/L vs. 103.8 ± 42.9 pmol/L, P = 0.01). Using receiver operating characteristics (ROC), we calculated the optimal CAF value to identify patients with muscle wasting as >87.5 pmol/L, which had a sensitivity of 78.9% and a specificity of 43.7%. The area under the ROC curve was 0.63 (95% confidence interval 0.56-0.70). Using simple regression, we found that serum CAF was associated with handgrip (R = - 0.17, P = 0.03) and quadriceps strength (R = - 0.31, P < 0.0001), peak oxygen consumption (R = - 0.5, P < 0.0001), 6-min walk distance (R = - 0.32, P < 0.0001), and gait speed (R = - 0.2, P = 0.001), as well as with parameters of kidney and liver function, iron metabolism and storage. CAF shows good sensitivity for the detection of skeletal muscle wasting in patients with heart failure. Its assessment may be useful to identify patients who should undergo additional testing, such as detailed body composition analysis. As no other biomarker is currently available, further investigation is warranted. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  3. Comparative clinic research of dysthymia patients used drugs and patients with drug addiction

    Directory of Open Access Journals (Sweden)

    Iliya Gubin

    2012-10-01

    Full Text Available The paper presents comparative research on the clinical picture and distinctive features of the therapy in dysthymia patients who used opiate drugs and drug addiction. 26 patients with dysthymia complicated by addiction to opiate drugs and 22 heroin addicts were examined.The received results will allow doctors to pay attention to the necessary details for the detection of relevant affective disorders, reduce the period of detecting affective disorders that significantly influence the choice of a rational therapy in the status of patients and also to build specific projections regarding patients.

  4. A thirty second isomer in Hf-171

    NARCIS (Netherlands)

    Campbell, P; Billowes, J; Cochrane, ECA; Cooke, JL; Cooper, TG; Dendooven, P; Evans, DE; Grant, IS; Griffith, JAR; Honkanen, A; Huhta, M; Oinonen, M; Pearson, MR; Penttila, H; Persson, B.L.; Richardson, DS; Tungate, G; Wheeler, PD; Zybert, L; Aysto, J

    1997-01-01

    An isomer has been detected in Hf-171 with a half-life of T-1/2 = 29.5(9) s. The state was populated in the Yb-170(alpha,3n)Hf-171m reaction at a beam energy of E-alpha = 50 MeV in an on-line ion guide isotope separator. The isomeric Hf-17lm(+) beam was extracted from the ion guide, mass-analysed an

  5. Hf-W chronometry of primitive achondrites

    Science.gov (United States)

    Schulz, T.; Münker, C.; Mezger, K.; Palme, H.

    2010-03-01

    Metal segregation and silicate melting on asteroids are the most incisive differentiation events in the early evolution of planetary bodies. The timing of these events can be constrained using the short-lived 182Hf- 182W radionuclide system. Here we present new 182Hf- 182W data for major types of primitive achondrites including acapulcoites, winonaites and one lodranite. These meteorites are of particular interest because they show only limited evidence for partial melting of silicates and are therefore intermediate between chondrites and achondrites. For acapulcoites we derived a 182Hf- 182W age of Δ tCAI = 4.1 +1.2/ -1.1 Ma. A model age for winonaite separates calculated from the intercept of the isochron defines an age of Δ tCAI = 4.8 +3.1/ -2.6 Ma (assuming a bulk Hf/W ratio of ˜1.2). Both ages most likely define primary magmatic events on the respective parent bodies, such as melting of metal, although metal stayed in place and did not segregate to form a core. A later thermal event is responsible for resetting of the winonaite isochron, yielding an age of Δ tCAI = 14.3 +2.7/ -2.2 Ma, significantly younger than the model age. Assuming a co-genetic relationship between winonaites and silicates present in IAB iron meteorites (based on oxygen isotope composition) and including data by Schulz et al. (2009), a common parent body chronology can be established. Magmatic activity occurred between ˜1.5 and 5 Ma after CAIs. More than 5 Ma later, intensive thermal metamorphism has redistributed Hf-W. Average cooling rates calculated for the winonaite/IAB parent asteroid range between ˜35 and ˜4 K/Ma, most likely reflecting different burial depths. Cooling rates obtained for acapulcoites were ˜40 K/Ma to ˜720 K and then ˜3 K/Ma to ˜550 K. Accretion and subsequent magmatism on the acapulcoite parent body occurred slightly later if compared to most achondrite parent bodies (e.g., angrites, ureilites and eucrites), in this case supporting the concept of an inverse

  6. Prognostic effect of carbohydrate antigen 125-guided therapy in patients recently discharged for acute heart failure (CHANCE-HF). Study design.

    Science.gov (United States)

    Núñez, Julio; Merlos, Pilar; Fácila, Lorenzo; Llàcer, Pau; Bosch, Maria José; Bertomeu-Martínez, Vicente; García-Blas, Sergio; Montagud, Vicente; Pedrosa, Valle; Mendizábal, Andrea; Cordero, Alberto; Miñana, Gema; Sanchis, Juan; Bertomeu-González, Vicente

    2015-02-01

    Morbidity and mortality after admission for acute heart failure remain prohibitively high. In that setting, plasma levels of antigen carbohydrate 125 have shown to correlate with the severity of fluid overload and the risk of mortality and readmission. Preliminary data suggests a potential role of antigen carbohydrate 125 to guide therapy. The objective of this study is to evaluate the prognostic effect of an antigen carbohydrate 125-guided management strategy vs standard therapy in patients recently discharged for acute heart failure. This is a multicenter, randomized, single-blind, efficacy trial study of patients recently discharged from acute heart failure ( 35 U/ml. A randomization scheme was used to allocate participants (in a 1:1 ratio) to receive therapy guided by antigen carbohydrate 125 (aiming to keep normal values) or standard treatment. Mainly, antigen carbohydrate 125-guided therapy is focused on the frequency of monitoring and titration of decongestive therapies and statins. As of December 10, 2013, there were 383 patients enrolled. The primary outcome was the composite of 1-year all-cause mortality or rehospitalization for acute heart failure. Analysis was planned to be intention-to-treat. Discovering novel therapeutic strategies or finding better ways of optimizing established treatments have become a health care priority in heart failure. This study will add important knowledge about the potential of antigen carbohydrate 125 as a management tool for monitoring and titration of therapies where optimal utilization has not been well defined, such as diuretics and statins. ClinicalTrials.gov number: NCT02008110. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Comparing postural balance among older adults and Parkinson's disease patients

    Directory of Open Access Journals (Sweden)

    Isabela Andrelino de Almeida

    Full Text Available ABSTRACT The objective of this study was to compare postural balance among healthy older adults and Parkinson's disease (PD patients during one-legged stance balance. We recruited 36 individuals of both sexes and divided them into two groups: healthy older adults (HG, and individuals with PD (PG. All the participants were assessed through a single-leg balance test, with eyes open, during 30 seconds (30 seconds of rest across trials on a force platform. Balance parameters were computed from mean across trials to quantify postural control: center of pressure (COP area and mean velocity in both directions of movement, anterior-posterior and medial-lateral. Significant differences between-group were reported for area of COP (P=0.002 and mean velocity in anterior-posterior direction (P=0.037, where poor postural control was related to PD patients rather than to healthy individuals. One-legged stance balance was a sensitive task used to discriminate poor postural control in Parkinson individuals.

  8. What Hf isotopes in zircon tell us about crust-mantle evolution

    Science.gov (United States)

    Iizuka, Tsuyoshi; Yamaguchi, Takao; Itano, Keita; Hibiya, Yuki; Suzuki, Kazue

    2017-03-01

    The 176Lu-176Hf radioactive decay system has been widely used to study planetary crust-mantle differentiation. Of considerable utility in this regard is zircon, a resistant mineral that can be precisely dated by the U-Pb chronometer and record its initial Hf isotope composition due to having low Lu/Hf. Here we review zircon U-Pb age and Hf isotopic data mainly obtained over the last two decades and discuss their contributions to our current understanding of crust-mantle evolution, with emphasis on the Lu-Hf isotope composition of the bulk silicate Earth (BSE), early differentiation of the silicate Earth, and the evolution of the continental crust over geologic history. Meteorite zircon encapsulates the most primitive Hf isotope composition of our solar system, which was used to identify chondritic meteorites best representative of the BSE (176Hf/177Hf = 0.282793 ± 0.000011; 176Lu/177Hf = 0.0338 ± 0.0001). Hadean-Eoarchean detrital zircons yield highly unradiogenic Hf isotope compositions relative to the BSE, providing evidence for the development of a geochemically enriched silicate reservoir as early as 4.5 Ga. By combining the Hf and O isotope systematics, we propose that the early enriched silicate reservoir has resided at depth within the Earth rather than near the surface and may represent a fractionated residuum of a magma ocean underlying the proto-crust, like urKREEP beneath the anorthositic crust on the Moon. Detrital zircons from world major rivers potentially provide the most robust Hf isotope record of the preserved granitoid crust on a continental scale, whereas mafic rocks with various emplacement ages offer an opportunity to trace the Hf isotope evolution of juvenile continental crust (from εHf[4.5 Ga] = 0 to εHf[present] = + 13). The river zircon data as compared to the juvenile crust composition highlight that the supercontinent cycle has controlled the evolution of the continental crust by regulating the rates of crustal generation and intra

  9. Audiology patient fall statistics and risk factors compared to non-audiology patients.

    Science.gov (United States)

    Criter, Robin E; Honaker, Julie A

    2016-10-01

    To compare fall statistics (e.g. incidence, prevalence), fall risks, and characteristics of patients who seek hearing healthcare from an audiologist to individuals who have not sought such services. Case-control study. Two groups of community-dwelling older adult patients: 25 audiology patients aged 60 years or older (M age: 69.2 years, SD: 4.5, range: 61-77) and a control group (gender- and age-matched ±2 years) of 25 non-audiology patients (M age: 69.6, SD: 4.7, range: 60-77). Annual incidence of falls (most recent 12 months) was higher in audiology patients (68.0%) than non-audiology patients (28.0%; p = .005). Audiology patients reported a higher incidence of multiple recent falls (p =.025) and more chronic health conditions (p = .028) than non-audiology patients. Significantly more audiology patients fall on an annual basis than non-audiology patients, suggesting that falls are a pervasive issue in general hearing clinics. Further action on the part of healthcare professionals providing audiologic services may be necessary to identify individuals at risk for falling.

  10. Electrical and structural characterization of PLD grown CeO2–HfO2 laminated high-k gate dielectrics

    NARCIS (Netherlands)

    Karakaya, K.; Barcones, B.; Rittersma, Z.M.; Berkum, van J.G.M.; Verheijen, M.A.; Rijnders, G.; Blank, D.H.A.

    2006-01-01

    The electrical and physical properties of CeO2–HfO2 nanolaminates deposited by pulsed laser deposition (PLD) are investigated. The properties of the nanolaminates are compared with binary CeO2 and HfO2 thin films. Layers were deposited using CeO2 and HfO2 targets at substrate temperatures between 22

  11. The study of multilayers Fe/Hf and Ni/Hf by slow positron beam technique

    Science.gov (United States)

    Tashiro, Mutsumi; Nakajyo, Terunobu; Murashige, Yusuke; Koizumi, Tomoya; Kanazawa, Ikuzo; Komori, Fumio; Soe, We-Hyo; Yamamoto, Ryoichi; Ito, Yasuo

    1997-05-01

    The S-parameters versus the incident positron energy are measured in the Ni/Hf multilayer, thin Hf film, thin Fe film and the bilayer Fe/Hf. We have analyzed the change in vacancy-type defects in these multilayers and thin films with the deposition temperature in the MBE system.

  12. Effect of hydrofluoric acid (HF) concentration to pores size diameter of silicon membrane.

    Science.gov (United States)

    Burham, Norhafizah; Hamzah, Azrul Azlan; Majlis, Burhanuddin Yeop

    2014-01-01

    This paper studies parameters which affect the pore size diameter of a silicon membrane. Electrochemical etching is performed in characterise the parameter involved in this process. The parameter has been studied is volume ratio of hydrofluoric acid (HF) and ethanol as an electrolyte aqueous for electrochemical etch. This electrolyte aqueous solution has been mixed between HF and ethanol with volume ratio 3:7, 5:5, 7:3 and 9:1. As a result, the higher volume of HF in this electrolyte gives the smallest pore size diameter compared to the lower volume of HF. These samples have been dipped into HF and ethanol electrolyte aqueous with supplied 25 mA/cm2 current density for 20, 30, 40, and 50 minutes. The samples will inspect under Scanning Electron Microscope (SEM) to execute the pore formations on silicon membrane surface.

  13. New obesity indices and adipokines in normotensive patients and patients with hypertension: comparative pilot analysis.

    Science.gov (United States)

    Stepien, Mariusz; Stepien, Anna; Banach, Maciej; Wlazel, Rafal N; Paradowski, Marek; Rizzo, Manfredi; Toth, Peter P; Rysz, Jacek

    2014-04-01

    We compared the obesity parameters and selected adipokines-leptin, adiponectin, and resistin-in obese patients with hypertension and normotensive patients. A total of 67 nondiabetic obese outpatients were divided into 2 groups: A-hypertensive and B-normotensive. Serum levels of leptin, adiponectin, resistin, and insulin were measured. Weight, height, waist circumference, and hip circumference were measured to calculate waist-to-hip ratio (WHR), weight-to-height ratio, visceral adiposity index, and body adiposity index (BAI). Among patients with hypertension, significant positive correlations were observed between leptin and body mass index and BAI (r = .31 and r = .63, respectively). In normotensive patients, leptin positively correlated with BAI (r = .73, P obesity and leptin are associated with hypertension in obese patients.

  14. HfO{sub 2} dielectric thickness dependence of electrical properties in graphene field effect transistors with double conductance minima

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Cheng; Xie, Dan, E-mail: xiedan@mail.tsinghua.edu.cn; Xu, Jian-Long; Sun, Yi-Lin; Dai, Rui-Xuan; Li, Xian [Institute of Microelectronics, Tsinghua National Laboratory for Information Science and Technology (TNList), Tsinghua University, Beijing 100084 (China); Li, Xin-Ming [National Center for Nanoscience and Technology, Zhongguancun, Beijing 100190 (China); Zhu, Hong-Wei [School of Materials Science and Engineering, State Key Laboratory of New Ceramics and Fine Processing, Key Laboratory of Materials Processing Technology of MOE, Tsinghua University, Beijing 100084 (China); Center for Nano and Micro Mechanics, Tsinghua University, Beijing 100084 (China)

    2015-10-14

    We investigate the electrical properties in back-gated graphene field effect transistors (GFETs) with SiO{sub 2} dielectric and different thickness of high-k HfO{sub 2} dielectric. The results show that transform characteristic (I{sub ds}–V{sub gs}) curves of GFETs are uniquely W-shaped with two charge neutrality point (left and right) in both SiO{sub 2} and HfO{sub 2} dielectric (SiO{sub 2}-GFETs and HfO{sub 2}-GFETs). The gate voltage reduces drastically in HfO{sub 2}-GFETs compared with that in SiO{sub 2}-GFETs, and it becomes much smaller with the decline of HfO{sub 2} thickness. The left charge neutrality point in I{sub d}–V{sub g} curves of all HfO{sub 2}-GFETs is negative, compared to the positive ones in SiO{sub 2}-GFETs, which means that there exists n-doping in graphene with HfO{sub 2} as bottom dielectric. We speculate that this n-doping comes from the HfO{sub 2} layer, which brings fixed charged impurities in close proximity to graphene. The carrier mobility is also researched, demonstrating a decreasing trend of hole mobility in HfO{sub 2}-GFETs contrast to that in SiO{sub 2}-GFETs. In a series of HfO{sub 2}-GFETs with different HfO{sub 2} dielectric thickness, the hole mobility shows a tendency of rise when the thickness decreases to 7 nm. The possible reason might be due to the introduced impurities into HfO{sub 2} film from atomic layer deposition process, the concentration of which varies from the thickness of HfO{sub 2} layer.

  15. HF radiation emitted by chaotic leader processes

    Science.gov (United States)

    Mäkelä, J. S.; Edirisinghe, M.; Fernando, M.; Montaño, R.; Cooray, V.

    2007-04-01

    This paper presents direct measurements of narrowband 10 MHz HF radiation from so-called “chaotic leaders” associated with subsequent return strokes. Although the term is controversial and poorly defined, we find that more than 30% of subsequent strokes in close lightning flashes contain electric field characteristics that are best described as “chaotic”. In earlier studies, return strokes have consistently been observed to be the strongest sources of HF radiation, but the results for leader processes are less consistent. We also observe return strokes to be the main HF emitter, and the leaders before the first return stroke in a flash sequence also emit HF though somewhat less intensely. The leaders preceding subsequent strokes typically emit little or no HF radiation, whether they are dart or dart-stepped leaders. However, it was observed that the presence of a chaotic component increases the leader HF intensity dramatically Defining the HF intensity unequivocally can be problematic for processes like chaotic leaders which have a combination of continuous and impulsive phenomena. Two time-domain methods were used to measure the HF intensity, the peak energy and the RMS energy. In the frequency domain these correspond to the energy spectral density (ESD) and power spectral density (PSD), respectively. It was found that the methods are not necessarily compatible. Thus, it is suggested that to clarify future work, leader processes should be characterized by the PSD rather than the ESD.

  16. Heart failure patients demonstrate impaired changes in brachial artery blood flow and shear rate pattern during moderate-intensity cycle exercise.

    NARCIS (Netherlands)

    Benda, N.M.M.; Seeger, J.P.; Lier, D.P. van; Bellersen, L.; Dijk, A.P.J. van; Hopman, M.T.E.; Thijssen, D.H.

    2015-01-01

    NEW FINDINGS: What is the central question of this study? We explored whether heart failure (HF) patients demonstrate different exercise-induced brachial artery shear rate patterns compared with control subjects. What is the main finding and its importance? Moderate-intensity cycle exercise in HF

  17. Association Between Valvular Surgery and Mortality Among Patients With Infective Endocarditis Complicated by Heart Failure

    Science.gov (United States)

    Kiefer, Todd; Park, Lawrence; Tribouilloy, Christophe; Cortes, Claudia; Casillo, Roberta; Chu, Vivian; Delahaye, Francois; Durante-Mangoni, Emanuele; Edathodu, Jameela; Falces, Carlos; Logar, Mateja; Miró, José M.; Naber, Christophe; Tripodi, Marie Françoise; Murdoch, David R.; Moreillon, Philippe; Utili, Riccardo; Wang, Andrew

    2016-01-01

    Context Heart failure (HF) is the most common complication of infective endocarditis. However, clinical characteristics of HF in patients with infective endocarditis, use of surgical therapy, and their associations with patient outcome are not well described. Objectives To determine the clinical, echocardiographic, and microbiological variables associated with HF in patients with definite infective endocarditis and to examine variables independently associated with in-hospital and 1-year mortality for patients with infective endocarditis and HF, including the use and association of surgery with outcome. Design, Setting, and Patients The International Collaboration on Endocarditis–Prospective Cohort Study, a prospective, multicenter study enrolling 4166 patients with definite native- or prosthetic-valve infective endocarditis from 61 centers in 28 countries between June 2000 and December 2006. Main Outcome Measures In-hospital and 1-year mortality. Results Of 4075 patients with infective endocarditis and known HF status enrolled, 1359 (33.4% [95% CI, 31.9%–34.8%]) had HF, and 906 (66.7% [95% CI, 64.2%–69.2%]) were classified as having New York Heart Association class III or IV symptom status. Within the subset with HF, 839 (61.7% [95% CI, 59.2%–64.3%]) underwent valvular surgery during the index hospitalization. In-hospital mortality was 29.7% (95% CI, 27.2%–32.1%) for the entire HF cohort, with lower mortality observed in patients undergoing valvular surgery compared with medical therapy alone (20.6% [95% CI, 17.9%–23.4%] vs 44.8% [95% CI, 40.4%–49.0%], respectively; Pendocarditis complicated by HF, severity of HF was strongly associated with surgical therapy and subsequent mortality, whereas valvular surgery was associated with lower in-hospital and 1-year mortality. PMID:22110106

  18. Relative Risk of Deep Vein Thrombosis in Very Elderly Patients Compared With Elderly Patients.

    Science.gov (United States)

    Yayan, Josef; Bals, Robert

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism are major causes of morbidity and mortality in patients during hospitalization; previous studies have proposed that an advanced age of more than 60 years is a risk factor for these conditions. This study analyzes the relative risk of DVT in very elderly patients older than 90 years of age compared with elderly patients aged 80 to 89 years. The study was performed at the Department of Internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany, between 2004 and 2012. After completing ultrasound examinations, 20 (64.52%, 12 [60%] female patients, mean age 91.8 ± 1.83 years) of the 31 patients in the study group and 132 (62.26%, 87 [65.91%] female patients, mean age 83.84 ± 2.66 years) of the 212 patients in the control group were diagnosed with DVT. An increased relative risk of DVT was not discovered in the very elderly patients (relative risk, 1.04; P = .80).

  19. HfS, Hyperfine Structure Fitting Tool

    CERN Document Server

    Estalella, Robert

    2016-01-01

    HfS is a tool to fit the hyperfine structure of spectral lines, with multiple velocity components. The HfS_nh3 procedures included in HfS fit simultaneously the hyperfine structure of the NH$_3$ (J,K)= (1,1) and (2,2) transitions, and perform a standard analysis to derive $T_\\mathrm{ex}$, NH$_3$ column density, $T_\\mathrm{rot}$, and $T_\\mathrm{k}$. HfS uses a Monte Carlo approach for fitting the line parameters. Especial attention is paid to the derivation of the parameter uncertainties. HfS includes procedures that make use of parallel computing for fitting spectra from a data cube.

  20. Cardiovascular risk factor management in patients with RA compared to matched non-RA patients

    Science.gov (United States)

    Cawston, Helene; Bourhis, Francois; Al, Maiwenn; Rutten-van Mölken, Maureen P. M. H.; Liao, Katherine P.; Solomon, Daniel H.

    2016-01-01

    Objective. RA is associated with a 50–60% increase in risk of cardiovascular (CV) death. This study aimed to compare management of CV risk factors in RA and matched non-RA patients. Methods. A retrospective cohort study was conducted using UK clinical practice data. Patients presenting with an incident RA diagnosis were matched 1:4 to non-RA patients based on a propensity score for RA, entry year, CV risk category and treatment received at index date (date of RA diagnosis). Patients tested and treated for CV risk factors as well as those attaining CV risk factor management goals were evaluated in both groups. Results. Between 1987 and 2010, 24 859 RA patients were identified and matched to 87 304 non-RA patients. At index date, groups had similar baseline characteristics. Annual blood pressure, lipids and diabetes-related testing were similar in both groups, although CRP and ESR were higher in RA patients at diagnosis and decreased over time. RA patients prescribed antihypertensives increased from 38.2% at diagnosis to 45.7% at 5 years, from 14.0 to 20.6% for lipid-lowering treatments and from 5.1 to 6.4% for antidiabetics. Similar treatment percentages were observed in non-RA patients, although slightly lower for antihypertensives. Modest (2%) but significantly lower attainment of lipid and diabetes goals at 1 year was observed in RA patients. Conclusion. There were no differences between groups in the frequency of testing and treatment of CV risk factors. Higher CV risk in RA patients seems unlikely to be driven by differences in traditional CV risk factor management. PMID:26705329

  1. Psychopathology of EDNOS Patients: To Whom Do They Compare?

    Science.gov (United States)

    Moor, Sasha; Vartanian, Lenny R.; Touyz, Stephen W.; Beumont, P. J. V.

    2004-01-01

    Do the levels of psychopathology displayed by patients with an eating disorder not otherwise specified (EDNOS) more closely resemble those displayed by full-criteria anorexia and bulimia nervosa patients than they do those of non-eating-disorder controls? Three groups of eating disorder patients (anorexia nervosa, n = 27; bulimia nervosa, n = 23;…

  2. Electrophysiological Neuroimaging using sLORETA Comparing 100 Schizophrenia Patients to 48 Patients with Major Depression

    Directory of Open Access Journals (Sweden)

    Andy R. Eugene

    2015-07-01

    Full Text Available In this retrospective of electroencephalograms were to identify a surrogate biomarker for the Dopamine D2 receptors in the brain by comparing patients diagnosed with Schizophrenia taking Atypical Antipsychotics to Depressive patients medicated with Selective Serotonin Reuptake Inhibitors. To achieve this, thirty-seconds of resting EEG were spectrally transformed in sLORETA. Three-dimensional statistical non-paramentric maps (SnPM for the sLORETA Global Field Power within each band were then computed. Our results illustrated that the Right Superior Frontal Gyrus (t=2.049, p=0.007, along the dopamine mesolimbic pathway, had higher neuronal oscillations in the delta frequency band in the 100 Schizophrenia patients as compared to the 32-depressive female patients. The comparisons with both the 48 depressive patient cohort or the sixteen male depressive patient cohort did not yield any statistically significant findings. We conclude that the Superior Frontal Gyrus should be investigated as a possible surrogate biomarker for preclinical and clinical drug discovery in neuropharmacology.

  3. RISK OF DEMENTIA IN PERITONEAL DIALYSIS PATIENTS COMPARED WITH HEMODIALYSIS PATIENTS

    Science.gov (United States)

    Wolfgram, Dawn F.; Szabo, Aniko; Murray, Anne M.; Whittle, Jeff

    2016-01-01

    Background Compared with similarly aged controls, patients with end-stage renal disease (ESRD) have a higher prevalence of cognitive impairment and more rapid cognitive decline, which is not explained by traditional risk factors alone. Since previous small studies suggest an association of cognitive impairment with dialysis modality, we compared incident dementia among patients initiating hemodialysis (HD) versus peritoneal dialysis (PD) in a large national cohort. Methods This is a retrospective cohort study of incident dialysis patients in the United States from 2006 to 2008 with no diagnosis of dementia prior to beginning dialysis. We evaluated the effect of initial dialysis modality on incidence of dementia, diagnosed by Medicare claims data, adjusted for baseline demographic and clinical data from USRDS registry. Results Our analysis included 121,623 patients, of whom 8,663 initiated dialysis on PD. The mean age of our cohort was 69.2 years. Patients who initiated on PD had a lower cumulative incidence of dementia than those who initiated HD (1.0% versus 2.7%, 2.5% versus 5.3%, and 3.9% versus 7.3% at 1, 2, and 3 years, respectively). The risk of dementia for patients who started on PD was lower compared with those who started on HD, with a hazard ratio (HR) = 0.46 [0.41, 0.53], in an unadjusted model and HR 0.74 [0.64, 0.86] in a matched model. Conclusions Dialysis modality is associated with incident dementia in a cohort of older ESRD patients. This finding warrants further investigation of the effect of dialysis modality on cognitive function and evaluation for possible mechanisms. PMID:25742686

  4. Fibromyalgia patients have reduced hippocampal volume compared with healthy controls

    Directory of Open Access Journals (Sweden)

    McCrae CS

    2015-01-01

    Full Text Available Christina S McCrae,1 Andrew M O’Shea,1 Jeff Boissoneault,2 Karlyn E Vatthauer,1 Michael E Robinson,1,2 Roland Staud,2,3 William M Perlstein,4–7 Jason G Craggs1 1Department of Clinical and Health Psychology, 2Pain Research and Intervention Center of Excellence, 3College of Medicine, University of Florida, Gainesville, FL, USA; 4McKnight Brain Institute, University of Florida, Gainesville, FL, USA; 5Department of Psychiatry, University of Florida, Gainesville, FL, 6Malcom Randall Veterans Administration Medical Center, Gainesville, FL, 7Rehabilitation Research and Development Brain Research Center of Excellence, Veterans Administration Medical Center, Gainesville, FL, USA Objective: Fibromyalgia patients frequently report cognitive abnormalities. As the hippocampus plays an important role in learning and memory, we determined whether individuals with fibromyalgia had smaller hippocampal volume compared with healthy control participants.Methods: T1-weighted structural magnetic resonance imaging (MRI scans were acquired from 40 female participants with fibromyalgia and 22 female healthy controls. The volume of the hippocampus was estimated using the software FreeSurfer. An analysis of covariance model controlling for potentially confounding factors of age, whole brain size, MRI signal quality, and Beck Depression Inventory scores were used to determine significant group differences.Results: Fibromyalgia participants had significantly smaller hippocampi in both left (F[1,56]=4.55, P=0.037, η2p=0.08 and right hemispheres (F[1,56]=5.89, P=0.019, η2p =0.10. No significant effect of depression was observed in either left or right hemisphere hippocampal volume (P=0.813 and P=0.811, respectively.Discussion: Potential mechanisms for reduced hippocampal volume in fibromyalgia include abnormal glutamate excitatory neurotransmission and glucocorticoid dysfunction; these factors can lead to neuronal atrophy, through excitotoxicity, and disrupt

  5. Similar patient survival following kidney allograft failure compared with non-transplanted patients.

    Science.gov (United States)

    Mourad, Georges; Minguet, Johanna; Pernin, Vincent; Garrigue, Valérie; Peraldi, Marie-Noelle; Kessler, Michèle; Jacquelinet, Christian; Couchoud, Cécile; Duny, Yohan; Daurès, Jean-Pierre

    2014-07-01

    Data from the national French Renal Epidemiology and Information Network (REIN) registry were used to compare survival between transplant recipients under age 65 who resumed dialysis after graft failure during 2007-2009 and transplant-naïve incident dialysis patients matched for age, gender, diabetes mellitus, and year of starting dialysis. Among 911 transplant patients who returned to dialysis, 103 had died by 1 January 2011. Multivariate analysis showed that age over 48 years, coronary artery disease, peripheral artery disease, and inability to walk unassisted were significant predictors of death. In the case-control analysis, the observed mortality rates in 778 transplant failure and 778 transplant-naïve dialysis patients were 11.8 and 10.8%, respectively. Kaplan-Meier estimates of survival after transplant failure vs. the transplant-naïve controls were 95.2 vs. 94.1% at 1 year, 90.3 vs. 88.8% at 2 years, and 84.2 vs. 80.2% at 3 years (log rank P=0.197 overall). Dialysis in transplant failure vs. transplant-naïve patients was not associated with significantly increased mortality. At the start of dialysis, the serum creatinine levels and the rate of unplanned dialysis were significantly lower in transplant failure patients compared with transplant-naïve controls. Thus, in patients under 65 years of age in France, survival of dialysis patients after graft loss is similar to that of incident dialysis patients who have not undergone transplantation.

  6. Quality of care: compared perceptions of patient and prosthodontist.

    Science.gov (United States)

    Chamberlain, B B; Razzoog, M E; Robinson, E

    1984-11-01

    The results suggest that, with the exception of retention, differences between patients' and prosthodontists' perceptions of treatment with complete dentures display greater variability with regard to function than to either esthetics or comfort. Although the literature has suggested that satisfying the esthetic concerns of the patient is likely to be a major hurdle in denture treatment success, this study suggests that occlusion, retention, and vertical dimension may be of more importance to effective communication. Misconceptions and unreal expectations should be dealt with early in the treatment program to avoid patient dissatisfaction. During the 1972 International Prosthodontic Workshop held in Ann Arbor, Michigan, the statement was made that patients were generally an unreliable guide as to the adequacy of their dentures, especially after wearing them for a period of time, and that further research to document the patient's reliability seemed unnecessary. This study has demonstrated that patients are quite reliable judges of many criteria related to dentures, provided channels for two-way communication are opened. With the ever greater economic stresses that force dentists to consider patients' concerns, perhaps it is increasingly the dentist's responsibility to better educate patients to evaluate all aspects of the quality of care they receive and encourage extensive two-way communication early in the treatment process. The adjusted quality assessment criteria used in the present study may be a useful instrument to use with patients prior to the initial interview in an effort to establish a better dentist-patient relationship.

  7. Influence of Hf contents on interface state properties in a-HfInZnO thin-film transistors with SiNx/SiOx gate dielectrics

    Science.gov (United States)

    Choi, Hyun-Sik; Jeon, Sanghun; Kim, Hojung; Shin, Jaikwang; Kim, Changjung; Chung, U.-In

    2011-10-01

    We evaluated the interface properties of amorphous hafnium-indium-zinc-oxide (a-HIZO) thin-film transistors (TFTs) with respect to various Hf contents. To this end, the subthreshold swing and the low-frequency noise (LFN) of the a-HIZO TFTs were measured and compared. From LFNs providing more accurate information, we quantitatively analyzed the interface trap densities and found that they decrease with increasing Hf contents. Although the acceptor-like tail state densities in bulk channel increase with Hf contents, higher Hf contents show lower threshold voltage shift under bias stress, implying that reliability characteristics of a-HIZO TFTs are more sensitive to interface quality rather than bulk property.

  8. Aspects of HF radio propagation

    Directory of Open Access Journals (Sweden)

    Stephane Saillant

    2009-06-01

    Full Text Available

    radio systems. From the point of view Working Group 2 of the COST 296 Action, interest lies with effects associated

    with propagation via the ionosphere of signals within the HF band. Several aspects are covered in this paper:

    a The directions of arrival and times of flight of signals received over a path oriented along the trough have

    been examined and several types of propagation effects identified. Of particular note, combining the HF observations

    with satellite measurements has identified the presence of irregularities within the floor of the trough that

    result in propagation displaced from the great circle direction. An understanding of the propagation effects that

    result in deviations of the signal path from the great circle direction are of particular relevance to the operation

    of HF radiolocation systems.

    b Inclusion of the results from the above mentioned measurements into a propagation model of the northerly

    ionosphere (i.e. those regions of the ionosphere located poleward of, and including, the mid-latitude trough

    and the use of this model to predict the coverage expected from transmitters where the signals impinge on the

    northerly ionosphere

  9. The atomic structure and chemical composition of HfOx (x < 2) films prepared by ion-beam sputtering deposition

    Science.gov (United States)

    Aliev, V. S.; Gerasimova, A. K.; Kruchinin, V. N.; Gritsenko, V. A.; Prosvirin, I. P.; Badmaeva, I. A.

    2016-08-01

    Non-stoichiometric HfOx films of different chemical composition (x partial pressure in a chamber. An effect of chemical composition on the atomic structure of the films was studied by reflection high-energy electron diffraction, x-ray photoelectron spectroscopy and field emission scanning electron microscopy methods. The films were found to be amorphous, consisting only of three components: Hf-metal clusters, Hf4O7 suboxide and stoichiometric HfO2. The relative concentration of these components varies with changing x. The surface of the films contains the increased oxygen content compared to the bulk. It was found that the Hf4O7 suboxide concentration is maximal at x = 1.8. The concept of hafnium oxide film growth by the IBSD method is proposed to explain the lack of suboxides variety in the films and the instability of HfO2, when annealed at high temperature.

  10. The study of single station inverting the sea surface current by HF ground wave radar based on adjoint assimilation technology

    Science.gov (United States)

    Han, Shuzong; Yang, Hua; Xue, Wenhu; Wang, Xingchi

    2017-06-01

    This paper introduces the assimilation technology in an ocean dynamics model and discusses the feasibility of inverting the sea surface current in the detection zone by assimilating the sea current radial velocity detected by single station HF ground wave radar in ocean dynamics model. Based on the adjoint assimilation and POM model, the paper successfully inverts the sea surface current through single station HF ground wave radar in the Zhoushan sea area. The single station HF radar inversion results are also compared with the bistatic HF radar composite results and the fixed point measured results by Annderaa current meter. The error analysis shows that acquisition of flow velocity and flow direction data from the single station HF radar based on adjoint assimilation and POM model is viable and the data obtained have a high correlation and consistency with the flow field observed by HF radar.

  11. Isolating the Norepinephrine Pathway Comparing Lithium in Bipolar Patients to SSRIs in Depressive Patients

    Directory of Open Access Journals (Sweden)

    Andy R. Eugene

    2015-07-01

    Full Text Available Introduction: The purpose of this investigatory neuroimaging analysis was done to better understand the pharmacodynamics of Lithium by isolating the norepinephrine pathway in the brain. To accomplish this, we compared patients with Bipolar Disorder treated with Lithium to patients diagnosed with Major Depression or Depressive Disorder who are treated with Selective Serotonin Reuptake Inhibitors (SSRIs.Methodology: We used Standardized Low Resolution Brain Electrotomography to calculate the whole brain, voxel-by-voxel, unpaired t-tests Statistical non-Parametric Maps. For our first electrophysiological neuroimaging investigation, we compared 46 patients (average age = 34 ± 16.5 diagnosed with Bipolar Affective Disorder to three patient groups all diagnosed with Major Depression or Depressive Episode. The first is with 48 patients diagnosed with Major Depression or Depressive Episode (average age = 49 ± 12.9, the second to 16 male depressive patients (average age = 45 ± 15.1, and the final comparison to 32 depressive females (average age = 50 ± 11.7.Results: The results of sLORETA three-dimensional statistical non-parametric maps illustrated that Lithium influenced an increase in neurotransmission in the right Superior TemporalGyrus (t=1.403, p=0.00780, Fusiform Gyrus (t=1.26, and Parahippocampal Gyrus (t=1.29.Moreover, an increased in neuronal function was found was also identified at the Cingulate Gyrus(t=1.06, p=0.01200.Conclusion: We are proposing a translational clinical biological marker for patients diagnosed with Bipolar Disorder to guide physicians during the course of Lithium therapy and have identified neuroanatomical structures influenced by norepinephrine.

  12. Hf impurity and defect interactions in helium-implanted NiHf

    Energy Technology Data Exchange (ETDEWEB)

    Govindaraj, R. E-mail: govind@igcar.ernet.in; Gopinathan, K.P.; Viswanathan, B

    2001-07-01

    TDPAC measurements on the reference and untreated sample indicate a loss in anisotropy which is attributed mainly to the association of probe atoms with defects produced by (n,{gamma}) reactions with isotopes of Ni and experiencing combined magnetic and quadrupole interactions of comparable strengths. Evolution of defect free and substitutional fraction of probe atoms experiencing Larmor frequency characteristic of Ni matrix has been studied as a function of isochronal annealing temperature in helium free {alpha}-irradiated and homogeneously helium-implanted samples. No defect associated Larmor precession frequency and/or quadrupole frequency could be deduced in these uncorrelated damage studies. Comparison of recovery stages in {alpha}-irradiated and helium-implanted samples indicates the binding of helium associated defects by Hf impurities. Segregation of Hf atoms is observed in the helium free {alpha}-irradiated sample for annealing treatment at 973 K, while no such effect is observed in the helium-implanted sample for isochronal annealing treatments up to 1273 K.

  13. Ketamine Patient Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active Comparator Controlled, Blinded, Pilot Trial

    Science.gov (United States)

    2017-01-11

    AFRL-SA-WP-SR-2017-0003 Ketamine Patient-Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active Comparator...June 2013 – December 2016 4. TITLE AND SUBTITLE Ketamine Patient-Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active...in trauma patients while reducing opioid consumption in the traumatically injured patient. The objective of this study was to compare differences in

  14. Adapting comparative effectiveness research summaries for delivery to patients and providers through a patient portal.

    Science.gov (United States)

    McDougald Scott, Amanda M; Jackson, Gretchen Purcell; Ho, Yun-Xian; Yan, Zhou; Davison, Coda; Rosenbloom, S Trent

    2013-01-01

    Despite increases in the scientific evidence for a variety of medical treatments, a gap remains in the adoption of best medical practices. This manuscript describes a process for adapting published summary guides from comparative effectiveness research to render them concise, targeted to audience, and easily actionable; and a strategy for disseminating such evidence to patients and their physicians through a web-based portal and linked electronic health record. This project adapted summary guides about oral medications for adults with type 2 diabetes to a fifth-grade literacy level and modified the resulting materials based on evaluations with the Suitability Assessment of Materials instrument. Focus groups and individual interviews with patients, diabetes providers, and health literacy experts were employed to evaluate and enhance the adapted summary guide. We present the lessons learned as general guidelines for the creation of concise, targeted, and actionable evidence and its delivery to both patients and providers through increasingly prevalent health information technologies.

  15. Comparative effects of amlodipine monotherapy and combination therapy with betaxolol on cardiac autonomic nervous activity and health-related quality of life in patients with poorly controlled hypertension.

    Science.gov (United States)

    Takase, Bonpei; Takeishi, Yasuchika; Hirai, Tadakazu; Lee, Jong-Dae; Uzui, Hiroyasu; Senda, Shoichi; Miwa, Kunihisa; Hiraoka, Yuji; Kinugawa, Toru; Hosokawa, Ryohei; Fujita, Masatoshi

    2008-05-01

    The aim of the study was to evaluate whether the combined treatment of calcium channel blocker, amlodipine and beta-blocker, betaxolol, favorably affects cardiac autonomic nervous activity (CANA) and health-related quality of life (HRQL). A total of 65 patients with a poor blood pressure (BP) control with a low dose amlodipine therapy were randomly assigned to the amlodipine dose-up group (n=21) and betaxolol adding group (n=44). Before and after a 6-month treatment, BP, heart rate variability (HRV), HRQL and blood chemistries were evaluated. Low frequency (LF) spectra/high frequency (HF) spectra and HF/total power spectra (TP) were calculated as indexes of CANA, and HRQL was assessed by the questionnaire sheets. BP was well controlled in all patients of the present study. In the betaxolol adding group, LF/HF decreased (2.1+/-1.9 to 1.3+/-0.9, pCANA and HRQL.

  16. Comparative psychosocial analysis of patients on maintenance hemodialysis and transplanted patients.

    Science.gov (United States)

    Shaheen, Faissal A M; Kurpad, Ramprasad; Al-Attar, Besher A; Muna, Bangash; Al-Khader, Abdullah A

    2005-01-01

    Many previous studies have shown that renal transplantation is associated with superior psychosocial rehabilitation than patients on dialysis. Our objective was to test if the same findings apply in Saudi patients. Questionnaires probing demographic data, income, mental status, literacy and unemployment rates, family support, home ownership, satisfaction with previous transplantation and views and preferences about different types of transplantation were distributed to transplanted patients (n= 150) and patients on maintenance hemodialysis (HD) (n=210) at the Jeddah Kidney Center, King Fahd Hospital, Jeddah, Saudi Arabia. Illiterate patients were helped in completing the questionnaires by the social worker. We found that the male to female ratio in the transplanted group was 1.7:1 whereas it was 1:1 in the HD group. It was also found that more people in the transplant group owned houses than in the HD group (52% vs. 36.7%). Twice as many transplanted patients earned more than 7000 Saudi Riyals monthly. The unemployment rates were equal in the two groups (25-26%). Interestingly, the rate of illiteracy in the transplant group was almost half the rate in the HD group. More transplanted patients were assessed as being mentally balanced and, rational (92%) as compared to 66.2% in the HD group. Gratifyingly, however, both groups reported solid family support in the majority of patients (>80%). Of particular interest was the finding that well over one third (37%) of the patients on dialysis preferred to have live-unrelated transplants. This is far higher than those wishing for live-related (16.7%) or cadaveric (17.1%). Many of our findings coincide with what has been reported earlier. More patients with higher income were transplanted and there was no detected improvement in the employment rate associated with transplantation. Moreover, the vast majority of patients (92.7%) had no objection to receiving a living unrelated kidney and, in fact, as many as 37.6% actually

  17. Subclinical atherosclerosis in gouty arthritis patients: a comparative study.

    Science.gov (United States)

    Çukurova, Selçuk; Pamuk, Ömer Nuri; Ünlü, Ercüment; Pamuk, Gülsüm Emel; Çakir, Necati

    2012-06-01

    We evaluated the incidence of subclinical atherosclerosis and associated factors in our gouty arthritis patients. We included 55 gouty arthritis patients diagnosed at our center within the last 4 years. The control group included 41 patients with rheumatoid arthritis (RA) and 34 patients with asymptomatic hyperuricemia (AHU). Atherosclerotic risk factors were determined in all subjects. Carotid intima-media thickness (IMT) and the presence of plaques were evaluated by B-mode ultrasonography. The carotid IMT in gouty arthritis patients (0.730 ± 0.19) was significantly higher than in AHU subjects (0.616 ± 0.12) (P = 0.004) and tended to be higher than the RA group (0.669 ± 0.17) (P = 0.1). Atheromatous plaques were significantly more frequent in gouty arthritis patients (16 cases, 29.1%) than in RA patients (5 cases, 12.2%) and AHU subjects (3 cases, 8.8%) (P values, 0.05 and 0.023). Gout patients with plaques were older (P = 0.006) and tended to have tophi more frequently (P = 0.06). Logistic regression analysis showed that age (OR: 1.3, 95% CI: 1.02-1.54) and the presence of tophi (OR: 12.5, 95% CI: 1.2-140) were independent risk factors for the presence of plaques. Gouty arthritis bears a higher risk of atherosclerosis than both RA and AHU.

  18. Evolution of E2 transition strength in deformed hafnium isotopes from new measurements on $^{172}$Hf, $^{174}$Hf, and $^{176}$Hf

    CERN Document Server

    Rudigier, M; Dannhoff, M; Gerst, R-B; Jolie, J; Saed-Samii, N; Stegemann, S; Régis, J-M; Robledo, L M; Rodríguez-Guzmán, R; Blazhev, A; Fransen, Ch; Warr, N; Zell, K O

    2015-01-01

    The available data for E2 transition strengths in the region between neutron-deficient Hf and Pt isotopes are far from complete. More and precise data are needed to enhance the picture of structure evolution in this region and to test state-of-the-art nuclear models. In a simple model, the maximum collectivity is expected at the middle of the major shell. However, for actual nuclei, this picture may no longer be the case, and one should use a more realistic nuclear-structure model. We address this point by studying the spectroscopy of Hf. We remeasure the 2^+_1 half-lives of 172,174,176Hf, for which there is some disagreement in the literature. The main goal is to measure, for the first time, the half-lives of higher-lying states of the rotational band. The new results are compared to a theoretical calculation for absolute transition strengths. The half-lives were measured using \\gamma-\\gamma and conversion-electron-\\gamma delayed coincidences with the fast timing method. For the determination of half-lives i...

  19. Incidence of Postoperative Deep Venous Thrombosis Is Higher among Cardiac and Vascular Surgery Patients as Compared with General Surgery Patients.

    Science.gov (United States)

    Aziz, Faisal; Patel, Mayank; Ortenzi, Gail; Reed, Amy B

    2015-01-01

    Unlike general surgery patients, most of vascular and cardiac surgery patients receive therapeutic anticoagulation during operations. The purpose of this study was to report the incidence of deep venous thrombosis (DVT) among cardiac and vascular surgery patients, compared with general surgery. The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent surgical procedures from 2005 to 2010. Patients who developed DVT within 30 days of an operation were identified. The incidence of DVT was compared among vascular, general, and cardiac surgery patients. Risk factors for developing postoperative DVT were identified and compared among these patients. Of total 2,669,772 patients underwent surgical operations in the period between 2005 and 2010. Of all the patients, 18,670 patients (0.69%) developed DVT. The incidence of DVT among different surgical specialties was cardiac surgery (2%), vascular surgery (0.99%), and general surgery (0.66%). The odds ratio for developing DVT was 1.5 for vascular surgery patients and 3 for cardiac surgery patients, when compared with general surgery patients (P cardiac surgery was 2, when compared with vascular surgery (P cardiac surgery patients as compared with that of general surgery patients. Intraoperative anticoagulation does not prevent the occurrence of DVT in the postoperative period. These patients should receive DVT prophylaxis in the perioperative period, similar to other surgical patients according to evidence-based guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Centrifugal stretching of 170Hf in the interacting boson model

    Directory of Open Access Journals (Sweden)

    Werner V.

    2014-03-01

    Full Text Available We present the results of a recent experiment to deduce lifetimes of members of the ground state rotational band of 170Hf, which show the effect of centrifugal stretching in this deformed isotope. Results are compared to the geometrical confined beta-soft(CBS rotor model, as well as to the interacting boson model (IBM. Two methods to correct for effects due to the finite valence space within the IBM are proposed.

  1. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel M; Sørensen, Lars T

    2012-01-01

    : To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery.......: To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery....

  2. Air sensitivity of MoS2, MoSe2, MoTe2, HfS2, and HfSe2

    Science.gov (United States)

    Mirabelli, Gioele; McGeough, Conor; Schmidt, Michael; McCarthy, Eoin K.; Monaghan, Scott; Povey, Ian M.; McCarthy, Melissa; Gity, Farzan; Nagle, Roger; Hughes, Greg; Cafolla, Attilio; Hurley, Paul K.; Duffy, Ray

    2016-09-01

    A surface sensitivity study was performed on different transition-metal dichalcogenides (TMDs) under ambient conditions in order to understand which material is the most suitable for future device applications. Initially, Atomic Force Microscopy and Scanning Electron Microscopy studies were carried out over a period of 27 days on mechanically exfoliated flakes of 5 different TMDs, namely, MoS2, MoSe2, MoTe2, HfS2, and HfSe2. The most reactive were MoTe2 and HfSe2. HfSe2, in particular, showed surface protrusions after ambient exposure, reaching a height and width of approximately 60 nm after a single day. This study was later supplemented by Transmission Electron Microscopy (TEM) cross-sectional analysis, which showed hemispherical-shaped surface blisters that are amorphous in nature, approximately 180-240 nm tall and 420-540 nm wide, after 5 months of air exposure, as well as surface deformation in regions between these structures, related to surface oxidation. An X-ray photoelectron spectroscopy study of atmosphere exposed HfSe2 was conducted over various time scales, which indicated that the Hf undergoes a preferential reaction with oxygen as compared to the Se. Energy-Dispersive X-Ray Spectroscopy showed that the blisters are Se-rich; thus, it is theorised that HfO2 forms when the HfSe2 reacts in ambient, which in turn causes the Se atoms to be aggregated at the surface in the form of blisters. Overall, it is evident that air contact drastically affects the structural properties of TMD materials. This issue poses one of the biggest challenges for future TMD-based devices and technologies.

  3. Effects of insulin therapy on weight gain and fat distribution in the HF/HS-STZ rat model of type 2 diabetes.

    Science.gov (United States)

    Skovsø, S; Damgaard, J; Fels, J J; Olsen, G S; Wolf, X A; Rolin, B; Holst, J J

    2015-10-01

    Insulin therapy is required for many patients with the obesity-related disorder type 2 diabetes, but is also associated with weight gain. The specific location of adipose tissue location matters to cardiovascular disease (CVD) risk. We investigated effects of exogenous insulin on fat distribution in the high-fat/high-sucrose fed rat treated with streptozotocin (HF/HS-STZ) rat model of type 2 diabetes. We also examined effects of insulin therapy on circulating CVD markers, including adiponectin, triglycerides (TGs), total cholesterol and high-density lipoprotein. Male SD rats were HF/HS fed for 5 weeks followed by STZ treatment to mimic the hallmarks of human obesity-associated insulin resistance followed by hyperglycemia. Magnetic resonance imaging and computed tomography were used to determine total fat, abdominal fat distribution and liver fat before and after insulin therapy in HF/HS-STZ rats. HbA1c%, TGs, cholesterol, high-density lipoprotein and adiponectin were analyzed by conventional methods adapted for rats. Insulin therapy lowered HbA1c (Pfat mass (Ptissue as compared with visceral adipose tissue (Pfat were observed after insulin therapy, whereas plasma TG and cholesterol levels were decreased (Pinsulin therapy modulates fat distribution. Specifically, our data show that insulin has a relatively positive effect on CVD-associated parameters, including abdominal fat distribution, lean body mass, adiponectin, TGs and HDL in HF/HS-STZ rats, despite a modest gain in weight.

  4. HF Transverse Segmentation and Tagging Jet Capability

    CERN Document Server

    Doroshkevich, E A; Kuleshov, Sergey

    1998-01-01

    So called tagging jets and pile-up were simulated for the optimisation of the HF segmentation. The energy resolution, angular resolution and efficiency of jet reconstruction are defined for different calorimeter segmentation.

  5. Collisional quenching of highly rotationally excited HF

    CERN Document Server

    Yang, Benhui; Forrey, R C; Stancil, P C; Balakrishnan, N

    2015-01-01

    Collisional excitation rate coefficients play an important role in the dynamics of energy transfer in the interstellar medium. In particular, accurate rotational excitation rates are needed to interpret microwave and infrared observations of the interstellar gas for nonlocal thermodynamic equilibrium line formation. Theoretical cross sections and rate coefficients for collisional deexcitation of rotationally excited HF in the vibrational ground state are reported. The quantum-mechanical close-coupling approach implemented in the nonreactive scattering code MOLSCAT was applied in the cross section and rate coefficient calculations on an accurate 2D HF-He potential energy surface. Estimates of rate coefficients for H and H$_2$ colliders were obtained from the HF-He collisional data with a reduced-potential scaling approach. The calculation of state-to-state rotational quenching cross sections for HF due to He with initial rotational levels up to $j=20$ were performed for kinetic energies from 10$^{-5}$ to 15000...

  6. Microhardness evaluation alloys Hf-Si-B; Avaliacao de microdureza de ligas Hf-Si-B

    Energy Technology Data Exchange (ETDEWEB)

    Gigolotti, Joao Carlos Janio; Costa, Eliane Fernandes Brasil [Centro Universitario de Volta Redonda (UNIFOA), Volta Redonda, RJ (Brazil); Nunes, Carlos Angelo; Rocha, Elisa Gombio; Coelho, Gilberto Carvalho, E-mail: carlosjanio@uol.com.br, E-mail: eliane-costabrasi@hotmail.com, E-mail: cnunes@demar.eel.usp.br, E-mail: elisarocha@alunos.eel.usp.br, E-mail: coelho@demar.eel.usp.br [Universidade de Sao Paulo (USP), Lorena, SP (Brazil)

    2014-08-15

    The technological advance has generated increasing demand for materials that can be used under high temperature, what includes intermetallic MR-Si-B (MR = refractory metal) alloys with multiphase structures, that can also be applied in oxide environments. Thus, this work had for objective the micro hardness study of the Hf-Si-B system alloys, heat treated at 1600 deg C, in the Hf rich region. Hf-Si-B alloys had been produced with blades of Hf (min. 99.8%), Si (min. 99.998%) and B (min. 99.5%), in the voltaic arc furnace and heat treated at 1600 deg C under argon atmosphere. The relationship of the phases had been previously identified by X-ray diffraction and contrast in backscattered electron imaging mode. The alloys had their hardness analyzed by method Vickers (micro hardness) with load of 0.05 kgf and 0.2 kgf and application time of 20 s. The results, obtained from the arithmetic mean of measurements for each alloy on the heterogeneous region, showed a mean hardness of 11.08 GPA, with small coefficient of variation of 3.8%. The borides HfB2 (19.34 GPa) e HfB - 11.76 GPa, showed the hardness higher than the silicides Hf2Si (8.57 GPa), Hf5Si3 (9.63 GPa), Hf3Si2 (11.66 GPa), Hf5Si4 (10.00 GPa), HfSi (10.02 GPa) e HfSi2 (8.61 GPa). (author)

  7. Rights of patients: comparative perspectives from five countries.

    Science.gov (United States)

    Blum, John D; Talib, Norchaya; Carstens, Pieter; Nasser, Muhammad; Tomkin, David; McAuley, Adam

    2003-01-01

    Recognition and articulation of patient rights are core issues in the medical jurisprudence of most nations. While the nature of rights in medical care may vary from country to country, reflecting the idiosyncrasies of domestic law and health delivery, there are commonalities in this area of law that cut across borders. This paper presents five case studies in the patient rights area from Malaysia, Ireland, South Africa, Indonesia and the United States, respectively. The case discussions range from ongoing and fundamental concerns over broad patient rights issues, such as access to health care and informed consent, to rights concerns of those suffering from HIV/AIDS, to a novel consideration over ethical and legal issues concerning ownership of infant organs. It is the hope of the authors that individually, and collectively, the cases will provide helpful insights into this core area of medical law.

  8. Recent Patient Characteristics and Medications at Admission and Discharge in Hospitalized Patients With Heart Failure.

    Science.gov (United States)

    Arimura, Tadaaki; Miura, Shin-Ichiro; Morito, Natsumi; Shiga, Yuhei; Kitajima, Ken; Morii, Joji; Iwata, Atsushi; Fujimi, Kanta; Yahiro, Eiji; Saku, Keijiro

    2016-02-01

    To improve the clinical outcome of heart failure (HF), it is important to evaluate the etiology and comorbidities of HF. We previously reported the baseline clinical characteristics and medications in hospitalized patients with HF in years 2000 - 2002 (group 2000) and 2007 - 2009 (group 2008). We conducted a retrospective study of 158 patients who were hospitalized due to HF between 2012 and 2014 (group 2013) in the Department of Cardiology, Fukuoka University Hospital. We analyzed the clinical characteristics and medications at admission and discharge, and compared the findings in group 2013 to those in group 2000 and group 2008. The major causes of HF were ischemic heart disease, hypertensive cardiomyopathy, valvular heart disease, and dilated cardiomyopathy. The New York Heart Association classification in group 2013 was significantly higher than those in group 2000 and group 2008. There was no difference in the level of brain natriuretic peptide at admission between group 2008 and group 2013. Tolvaptan began to be administered in group 2013. The median dose of furosemide just before the use of tolvaptan was 40 mg/day. At discharge, group 2013 showed higher rates of β-blocker and aldosterone antagonist. There was no difference in the frequency of loop diuretics. The dose of carvedilol at discharge was only 6.2 ± 4.0 mg/day. Antiarrhythmic drugs and β-blocker were used more frequently in HF with reduced ejection fraction (EF) than in HF with preserved EF. We may be able to improve the clinical outcome of HF by examining the differences in the clinical characteristics and medications at admission and discharge in hospitalized patients with HF.

  9. Mood induction in depressive patients: a comparative multidimensional approach.

    Directory of Open Access Journals (Sweden)

    Irina Falkenberg

    Full Text Available Anhedonia, reduced positive affect and enhanced negative affect are integral characteristics of major depressive disorder (MDD. Emotion dysregulation, e.g. in terms of different emotion processing deficits, has consistently been reported. The aim of the present study was to investigate mood changes in depressive patients using a multidimensional approach for the measurement of emotional reactivity to mood induction procedures. Experimentally, mood states can be altered using various mood induction procedures. The present study aimed at validating two different positive mood induction procedures in patients with MDD and investigating which procedure is more effective and applicable in detecting dysfunctions in MDD. The first procedure relied on the presentation of happy vs. neutral faces, while the second used funny vs. neutral cartoons. Emotional reactivity was assessed in 16 depressed and 16 healthy subjects using self-report measures, measurements of electrodermal activity and standardized analyses of facial responses. Positive mood induction was successful in both procedures according to subjective ratings in patients and controls. In the cartoon condition, however, a discrepancy between reduced facial activity and concurrently enhanced autonomous reactivity was found in patients. Relying on a multidimensional assessment technique, a more comprehensive estimate of dysfunctions in emotional reactivity in MDD was available than by self-report measures alone and this was unsheathed especially by the mood induction procedure relying on cartoons. The divergent facial and autonomic responses in the presence of unaffected subjective reactivity suggest an underlying deficit in the patients' ability to express the felt arousal to funny cartoons. Our results encourage the application of both procedures in functional imaging studies for investigating the neural substrates of emotion dysregulation in MDD patients. Mood induction via cartoons appears to

  10. Comparing patient access to pharmaceuticals in the UK and US

    NARCIS (Netherlands)

    J.P. Cohen (Joshua); C. Cairns (Catherine); C. Paquette (Cherie); H. Faden

    2006-01-01

    textabstractBackground: The debate on access to new drugs has focused on the time lag between applications for approval and granting of marketing authorisation. This delay was identified as the first barrier with respect to patient access to new drugs, encompassing the hurdles of safety, efficacy an

  11. A comparative study of ICU patient diaries vs. hospital charts

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Christensen, Doris

    2010-01-01

    Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after discha...

  12. The role of phosphates for the Lu-Hf chronology of meteorites

    Science.gov (United States)

    Debaille, Vinciane; Van Orman, James; Yin, Qing-Zhu; Amelin, Yuri

    2017-09-01

    The 176Lu-176Hf isotopic system is widely used for dating and tracing cosmochemical and geological processes, but still suffers from two uncertainties. First, Lu-Hf isochrons for some early Solar System materials have excess slope of unknown origin that should not be expected for meteorites with ages precisely determined with other isotopic chronometers. This observation translates to an apparent Lu decay constant higher than the one calculated by comparing ages obtained with various dating methods on terrestrial samples. Second, unlike the well constrained Sm/Nd value (to within 2%) for the chondritic uniform reservoir (CHUR), the Lu/Hf ratios in chondrites vary up to 18% when considering all chondrites, adding uncertainty to the Lu/Hf CHUR value. In order to better understand the Lu-Hf systematics of chondrites, we analyzed mineral fractions from the Richardton H5 chondrite to construct an internal Lu-Hf isochron, and set up a numerical model to investigate the effect of preferential diffusion of Lu compared to Hf from phosphate, the phase with the highest Lu-Hf ratio in chondrites, to other minerals. The isochron yields an age of 4647 ± 210 million years (Myr) using the accepted 176Lu decay constant of 1.867 ± 0.008 ×10-11yr-1. Combining this study with the phosphate fractions measured in a previous study yields a slope of 0.08855 ± 0.00072, translating to a 176Lu decay constant of 1.862 ± 0.016 ×10-11yr-1 using the Pb-Pb age previously obtained, in agreement with the accepted value. The large variation of the Lu/Hf phosphates combined with observations in the present study identify phosphates as the key in perturbing Lu-Hf dating and generating the isochron slope discrepancy. This is critical as apatite has substantially higher diffusion rates of rare earth elements than most silicate minerals that comprise stony meteorites. Results of numerical modeling depending of temperature peak, size of the grains and duration of the metamorphic event, show that

  13. Comparing Patient Safety in Rural Hospitals by Bed Count

    Science.gov (United States)

    2005-01-01

    tomography; SPECT = single photon emission computed tomography; ESWL = extracorporeal shock - wave lithotripte Patient Safety by Rural Hospital Bed Count...Computed Tomography (SPECT), and Extracorporeal Shockwave Lithotripsy (ESWL). Relatively few rural hospitals provide cardiac services, with large...48) 3.0% (266) SPECT* 9.1% (154) 32.8% (64) 56.3% (48) 23.3% (266) Ultrasound 90.9% (154) 95.3% (64) 95.8% (48) 92.9% (266) Radiation therapy * 5.2

  14. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    De Vecchis, R; Baldi, C; Cioppa, C; Giasi, A; Fusco, A

    2016-02-01

    The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF. Only randomized controlled trials comparing liberal and restricted fluid oral intake in patients with HF were included. Primary outcomes were HF hospitalizations and all-cause mortality. Secondary outcomes were the sensation of thirst, the duration of therapy with intravenous diuretics, and the serum levels of creatinine, sodium, and B-type natriuretic peptide (BNP). Six studies met the inclusion criteria. Significant heterogeneity was detected for the majority of outcomes. In 5 studies, patients with restricted fluid intake compared to patients with free consumption of beverages had similar rehospitalization and mortality rates. There were no differences regarding patients' sense of thirst (4 studies), duration of intravenous diuretic treatment (2 studies), serum creatinine levels (5 studies), and serum sodium levels (5 studies). Serum BNP levels were significantly higher in the group with free fluid intake (4 studies). In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.

  15. Dementia-related adverse events in PARADIGM-HF and other trials in heart failure with reduced ejection fraction.

    Science.gov (United States)

    Cannon, Jane A; Shen, Li; Jhund, Pardeep S; Kristensen, Søren L; Køber, Lars; Chen, Fabian; Gong, Jianjian; Lefkowitz, Martin P; Rouleau, Jean L; Shi, Victor C; Swedberg, Karl; Zile, Michael R; Solomon, Scott D; Packer, Milton; McMurray, John J V

    2017-01-01

    Inhibition of neprilysin, an enzyme degrading natriuretic and other vasoactive peptides, is beneficial in heart failure with reduced ejection fraction (HFrEF), as shown in PARADIGM-HF which compared the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan with enalapril. As neprilysin is also one of many enzymes clearing amyloid-β peptides from the brain, there is a theoretical concern about the long-term effects of sacubitril/valsartan on cognition. Therefore, we have examined dementia-related adverse effects (AEs) in PARADIGM-HF and placed these findings in the context of other recently conducted HFrEF trials. In PARADIGM-HF, patients with symptomatic HFrEF were randomized to sacubitril/valsartan 97/103 mg b.i.d. or enalapril 10 mg b.i.d. in a 1:1 ratio. We systematically searched AE reports, coded using the Medical Dictionary for Regulatory Activities (MedDRA), using Standardized MedDRA Queries (SMQs) with 'broad' and 'narrow' preferred terms related to dementia. In PARADIGM-HF, 8399 patients aged 18-96 years were randomized and followed for a median of 2.25 years (up to 4.3 years). The narrow SMQ search identified 27 dementia-related AEs: 15 (0.36%) on enalapril and 12 (0.29%) on sacubitril/valsartan [hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.33-1.59]. The broad search identified 97 (2.30%) and 104 (2.48%) AEs (HR 1.01, 95% CI 0.75-1.37), respectively. The rates of dementia-related AEs in both treatment groups in PARADIGM-HF were similar to those in three other recent trials in HFrEF. We found no evidence that sacubitril/valsartan, compared with enalapril, increased dementia-related AEs, although longer follow-up may be necessary to detect such a signal and more sensitive tools are needed to detect lesser degrees of cognitive impairment. Further studies to address this question are warranted. © 2016 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of

  16. Intra- and interatrial asynchrony in patients with heart failure.

    Science.gov (United States)

    Van Beeumen, Katarina; Duytschaever, Mattias; Tavernier, Rene; Van de Veire, Nico; De Sutter, Johan

    2007-01-01

    Heart failure (HF) is associated with atrial conduction delay. Color tissue Doppler imaging was used to evaluate intra- and interatrial asynchrony in patients with HF, patients with structural heart disease without HF, and controls. Twenty-three controls (mean age 65 +/- 13 years), 29 patients with structural heart disease without HF (mean age 68 +/- 9 years), and 29 patients with HF (mean age 67 +/- 9 years) were studied. Patients had no histories of atrial fibrillation. Echocardiographic color tissue Doppler imaging of the atria was performed. Measurements below the atrioventricular plane were selected on the right atrial (RA) free wall, interatrial septum (IAS), and left atrial (LA) free wall. The time difference from the onset of the P wave to the onset of the A wave at the right atrium (P-RA), the IAS (P-IAS), and the left atrium (P-LA) was measured. Asynchrony was defined as the differences between P-IAS and P-RA (RA asynchrony), P-LA and P-IAS (LA asynchrony), and P-LA and P-RA (interatrial asynchrony). In patients with HF, a significant increase in RA asynchrony was observed compared with controls and patients without HF (30 +/- 21 vs 12 +/- 13 and 14 +/- 15 ms, p 17 ms, p = 0.04). There were moderate but significant correlations of RA asynchrony with log N-terminal-pro-B-type natriuretic peptide (r = 0.3, p = 0.01) and the ejection fraction (r = -0.4, p <0.001). In conclusion, in patients with HF, significant RA and interatrial asynchrony was documented, evaluated by noninvasive color tissue Doppler imaging. Asynchrony was related to N-terminal-pro-B-type natriuretic peptide and to the ejection fraction.

  17. Grindability of cast Ti-Hf alloys.

    Science.gov (United States)

    Kikuchi, Masafumi; Takahashi, Masatoshi; Sato, Hideki; Okuno, Osamu; Nunn, Martha E; Okabe, Toru

    2006-04-01

    As part of our systematic studies characterizing the properties of titanium alloys, we investigated the grindability of a series of cast Ti-Hf alloys. Alloy buttons with hafnium concentrations up to 40 mass% were made using an argon-arc melting furnace. Each button was cast into a magnesia-based mold using a dental titanium casting machine; three specimens were made for each metal. Prior to testing, the hardened surface layer was removed. The specimens were ground at five different speeds for 1 min at 0.98 N using a carborundum wheel on an electric dental handpiece. Grindability was evaluated as the volume of metal removed per minute (grinding rate) and the volume ratio of metal removed compared to the wheel material lost (grinding ratio). The data were analyzed using ANOVA. A trend of increasing grindability was found with increasing amounts of hafnium, although there was no statistical difference in the grindability with increasing hafnium contents. We also found that hafnium may be used to harden or strengthen titanium without deteriorating the grindability.

  18. Electrical characteristics of MOS capacitor with HfTiON gate dielectric and HfTiSiON interlayer

    Institute of Scientific and Technical Information of China (English)

    Chen Wei-Bing; Xu Jing-Ping; Lai Pui-To; Li Yan-Ping; Xu Sheng-Guo; Chan Chu-Lok

    2006-01-01

    The paper reports that HfTiO dielectric is deposited by reactive co-sputtering of Hf and Ti targets in an Ar/O2 ambience, followed by an annealing in different gas ambiences of N2, NO and NHa at 600°C for 2 min. Capacitance-voltage and gate-leakage properties are characterized and compared. The results indicate that the NO-annealed sample exhibits the lowest interface-state and dielectric-charge densities and best device reliability. This is attributed to the fact that nitridation can create strong Si≡N bonds to passivate dangling Si bonds and replace strained Si- O bonds, thus the sample forms a hardened dielectric/Si interface with high reliability.

  19. Comparative Proteomic Analysis of Peritoneal Dialysate from Chronic Glomerulonephritis Patients

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Wu

    2013-01-01

    Full Text Available Peritoneal dialysis (PD frequently contributes to peritoneal damage which cannot be easily identified without invasive techniques, implying the urgent need for biomarkers and revealing mechanisms. Chronic glomerulonephritis (CGN is one of the leading causes of receiving dialysis treatment. Here, we attempted to analyze the peritoneal dialysate collected from CGN patients when they receive continuous ambulatory peritoneal dialysis (CAPD treatment for the first time and after a year to reveal the protein changes that resulted from PD. Proteins were displayed by two-dimensional gel electrophoresis (2DE. Altered gel spots were digested followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS analysis for protein identification. Eight proteins were found to have differential expression levels between two groups. Their differential expressions were validated by Western blots in other sets of peritoneal dialysates. Proteins identified with higher levels in the first-time dialysate suggested their dominant appearance in CGN patients, while those that showed higher levels in peritoneal dialysate collected after one year may result from initial peritoneal inflammation or changes in the permeability of the peritoneum to middle-sized proteins. All the identified proteins may provide a perceptiveness of peritoneal changes caused by PD and may function as potential biomarkers or drug targets.

  20. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    OpenAIRE

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-01-01

    Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia ...

  1. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    OpenAIRE

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-01-01

    Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia ...

  2. Body Image Disturbance in Acromegaly Patients Compared to Nonfunctioning Pituitary Adenoma Patients and Controls

    Directory of Open Access Journals (Sweden)

    Helen M. Conaglen

    2015-01-01

    Full Text Available Purpose. Excess growth hormone secretion in adults results in acromegaly, a condition in which multiple physical changes occur including bony and soft tissue overgrowth. Over time these changes can markedly alter a person’s appearance. The aim of this study was to compare body image disturbance in patients with acromegaly to those with nonfunctioning pituitary adenomas (NFAs and controls and assess the impact of obesity in these groups. Methods. A cross-sectional survey including quality of life, body image disturbance, anxiety and depression measures, growth hormone, and BMI measurement was carried out. Results. The groups did not differ with respect to body image disturbance. However separate analysis of obese participants demonstrated relationships between mood scales, body image disturbance, and pain issues, particularly for acromegaly patients. Conclusions. While the primary hypothesis that acromegaly might be associated with body image disturbance was not borne out, we have shown that obesity together with acromegaly and NFA can be associated with body image issues, suggesting that BMI rather than primary diagnosis might better indicate whether patients might experience body image disturbance problems.

  3. Myostatin signaling is up-regulated in female patients with advanced heart failure.

    Science.gov (United States)

    Ishida, Junichi; Konishi, Masaaki; Saitoh, Masakazu; Anker, Markus; Anker, Stefan D; Springer, Jochen

    2017-07-01

    Myostatin, a negative regulator of skeletal muscle mass, is up-regulated in the myocardium of heart failure (HF) and increased myostatin is associated with weight loss in animal models with HF. Although there are disparities in pathophysiology and epidemiology between male and female patients with HF, it remains unclear whether there is gender difference in myostatin expression and whether it is associated with weight loss in HF patients. Heart tissue samples were collected from patients with advanced heart failure (n=31, female n=5) as well as healthy control donors (n=14, female n=6). Expression levels of myostatin and its related proteins in the heart were evaluated by western blotting analysis. Body mass index was significantly lower in female HF patients than in male counterparts (20.0±4.2 in female vs 25.2±3.8 in male, p=0.04). In female HF patients, both mature myostatin and pSmad2 were significantly up-regulated by 1.9 fold (p=0.05) and 2.5 fold (p<0.01) respectively compared to female donors, while expression of pSmad2 was increased by 2.8 times in male HF patients compared to male healthy subjects, but that of myostatin was not. There was no significant difference in protein expression related to myostatin signaling between male and female patients. In this study, myostatin and pSmad2 were significantly up-regulated in the failing heart of female patients, but not male patients, and female patients displayed lower body mass index. Enhanced myostatin signaling in female failing heart may causally contribute to pathogenesis of HF and cardiac cachexia. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Arrival by ambulance in acute heart failure: insights into the mode of presentation from Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF).

    Science.gov (United States)

    Ezekowitz, Justin A; Podder, Mohua; Hernandez, Adrian F; Armstrong, Paul W; Starling, Randall C; O'Connor, Christopher M; Califf, Robert M

    2016-03-17

    Limited data exist assessing the relationship between ambulance versus self-presentation and outcomes in patients with acute heart failure (AHF). Clinical trial sites in North America. 1068 patients enrolled in the Acute Studies of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial. The association between ambulance use and dyspnoea improvement, 30-day mortality or HF rehospitalisation and 180-day mortality. Of the 1068 patients in the substudy, 832 (78%) self-presented (SP) and 236 (22%) patients presented via ambulance. Patients presenting via ambulance were older, more likely to be female, have a higher ejection fraction but similar natriuretic peptide levels as patients who SP. Patients presenting by ambulance (compared with SP) trended towards more dyspnoea improvement at 6 (p=0.09) and 24 h (p=0.10). The co-primary end point (30-day mortality or HF rehospitalisation) was similar between groups (ambulance 12.2% vs SP 11.4%, p=0.74). Patients who presented by ambulance had a higher 30-day and 180-day mortality rate than those who SP (30-day: 4.3% vs 2.2%, p=0.08; 180-day: 15.1% vs 10.3%, p=0.04). After adjustment for baseline characteristics, patients arriving by ambulance (compared with SP) had a 2-fold high risk of 30-day mortality (OR 2.12, 95% CI 0.94 to 4.79), but no relationship to the composite of 30-day mortality/HF rehospitalisation (OR 1.01, 95% CI 0.63 to 1.63). Among patients with AHF, 30-day and 180-day mortality is 1.5-2 times higher for those with presenting via ambulance compared with patients who self-present. Understanding patient-related and system-related factors of ambulance use for patients with AHF is important. NCT00475852. 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/

  5. Detection of HCl and HF by TTFMS and WMS.

    Science.gov (United States)

    De Luca, Anna Chiara; Pesce, Giuseppe; Rusciano, Giulia; Sasso, Antonio

    2006-04-01

    In this work we discuss on a compact spectrometer based on DFB diode lasers for detection of chloridric and fluoridric acids. HCl and HF concentrations are determined through optical absorption of the P(4) line (lambda=1.7 microm) and the R(3) line (lambda=1.3 microm), respectively. Both lines belong to first overtone vibrational bands and their line strengths are 7.8 x 10(-21)cm/molecule for HCl and 2.8 x 10(-20)cm/molecule for HF. We chose these lines for their relative high intensities and because they are quite far from water vapour lines which represent the main interfering gas for trace-gases analysis. To detect these species we used two different high frequency modulation techniques: two-tone frequency modulation spectroscopy (f(1)=800 MHz and f(2)=804 MHz) was used for HCl while for HF we followed a simpler approach based on wavelength modulation spectroscopy (f=600 kHz). We demonstrate that the two techniques provide comparable detection limit of about 80 ppbV at atmospheric pressure. Positive testing of our spectrometer makes it suitable for in situ measurements of exhaust gases coming from waste incinerators.

  6. Comparing a tablet computer and paper forms for assessing patient-reported outcomes in edentulous patients

    Science.gov (United States)

    Caetano, Thais Angelina; Ribeiro, Adriana Barbosa; Della Vecchia, Maria Paula; Cunha, Tatiana Ramirez; Chaves, Carolina de Andrade Lima

    2016-01-01

    PURPOSE The aim of this study was to determine whether two methods of documentation, print and electronic forms, for the assessment of patient-reported outcomes (PRO) in complete denture wearers provide comparable results. The study also quantified the time needed for filling the forms by each method. MATERIALS AND METHODS Thirty participants enrolled in a university clinic answered two forms (a questionnaire for denture satisfaction and OHIP-EDENT). They provided answers with two application methods in a random order, with a one-month interval between them: (1) electronic forms on a tablet computer; and (2) print forms. The methods were compared in terms of mean results, correlation/agreement, internal consistency, and spent time. RESULTS Mean results for both methods were similar for each denture satisfaction item (100-mm VAS) and OHIP-EDENT summary score. Both questionnaires presented good internal consistency regardless of the application method (Cronbach's α=0.86 or higher). Correlation and agreement between the methods regarding specific items was at least moderate for the majority of cases. Mean time for the electronic and print forms were 9.2 and 8.5 minutes, respectively (paired t test, P=.06, non-significant). CONCLUSION The electronic method is comparable to print forms for the assessment of important PRO of prosthetic treatment for edentulism, considering the results and time needed. Findings suggest the viability of replacing print forms with a tablet for applying the tested inventories in clinical trials. PMID:28018563

  7. Anemia, renal dysfunction and malnutrition associated with heart failure in patients with valvulopathy.

    Science.gov (United States)

    Souza, Wysllenny Nascimento de; Araújo, Cristiane Maria Sá de; Silva, Silvia Alves da; Petribú, Marina de Moraes Vasconcelos

    2010-06-01

    Valvular disease can course with heart failure (HF), anemia and renal dysfunction (RD), increasing the nutritional risk and worsening patient prognosis. To evaluate the prevalence of anemia and RD in patients with valvulopathy with or without HF, as well as establish a correlation with the nutritional status. A total of 104 patients admitted at the Clinic of Valvulopathy of PROCAPE/UPE, during the period of Aug-Oct/2008. The data were obtained from the nutritional and medical follow-up files. The collected variables were: sex, age, nutritional status according to the body mass index (BMI), presence of HF, anemia and RD. Anemia was considered when hemoglobin values were prevalence of anemia and RD was 71.1% and 68.8%, and 48.1% and 60.0%, in patients with and without HF, respectively, with a statistically significant difference for anemia (p = 0.022). Of the patients, 48.1% were eutrophic, 26.9% had excess weight and 25.0% presented some degree of malnutrition. The patients with HF presented a higher frequency of low weight (p = 0.020). The nutritional status was not associated with anemia (p = 0.117), but it was associated with RD, with renal function being decreased more often in patients with low weight (p = 0.000). When the prevalence of malnutrition, anemia and RD was compared between patients with and without HF, it showed statistical significance.

  8. Usefulness of Serial Measurements of Inferior Vena Cava Diameter by Vscan(TM) to Identify Patients With Heart Failure at High Risk of Hospitalization.

    Science.gov (United States)

    Khandwalla, Raj M; Birkeland, Kade T; Zimmer, Raymond; Henry, Timothy D; Nazarian, Roland; Sudan, Madhuri; Mirocha, James; Cha, Jeena; Kedan, Ilan

    2017-05-15

    Estimation of volume status is integral to heart failure (HF) management. Measurement of inferior vena cava (IVC) diameter (IVCd) by ultrasound provides a noninvasive estimate of right atrial pressures. The GE Vscan is a handheld ultrasound (HHU) device that allows for point-of-care measurements to assess volume status. We hypothesize that IVCd measurements using HHU can predict the risk of HF admission. We retrospectively analyzed a cohort of patients with HF treated in an ambulatory care setting over 17 months. Serial measurements of IVCd were obtained using HHU in the supine position from the subcostal window. Log-binomial regression models were used to compare IVCd measurements between patients with and without HF admissions and to estimate the association between IVCd and risk of HF admission. Of the 355 patients with systolic (38%) and diastolic HF (62%) who were analyzed, 45% were women with a mean age of 73 years at the time of the first IVCd measurement. Overall, 3,488 measurements were obtained, and 32.4% of patients were hospitalized during follow-up. Patients with at least 1 hospital admission had a greater mean IVCd than those who were not admitted (2.0 vs 1.8 cm, p risk of HF admission (risk ratio [RR] 1.38, 95% CI 1.16 to 1.62, p risk of HF admission was also significantly increased in patients with IVCd 2.0 to 2.49 cm (RR 1.79, 95% CI 1.27 to 2.52, p risk of HF admission and may provide clinically useful information at the point-of-care to guide HF management. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  9. Natriuretic Peptide System Activation in Acute Heart Failure Patients with Diabetes

    Directory of Open Access Journals (Sweden)

    Filipe M. Cunha

    2017-01-01

    Full Text Available Background. Elevated B-type natriuretic peptide (BNP is a hallmark in heart failure (HF. Diabetic patients with chronic HF seem to have higher BNP than nondiabetics. We studied, in acute HF, if BNP levels are different between diabetics and nondiabetics. Methods. From a prospectively recruited population of acute HF patients, we selected a convenience sample. In pair-matched analysis, each diabetic patient was matched with a nondiabetic of the same age (±1 year, gender, and according to left ventricular systolic dysfunction. Diabetics and nondiabetics were compared. Cox-regression analysis was used to analyse the prognostic impact of diabetes. Results. We studied 328 patients, mean age: 78 years, 44.5% male. Diabetics were more often hypertensive and had ischemic HF; they had higher body mass index, lower haemoglobin, and worse renal function. Diabetics were more often discharged on ACE inhibitors/ARB, antiplatelet therapy, and statins. Neither admission nor discharge BNP values differed between diabetics and pair-matched nondiabetics. One-year mortality was also nondifferent between pairs of diabetics and nondiabetics: 44 (26.8% and 46 (28.0%, respectively. HR for 1-year mortality in diabetics was 1.00 (95% CI: 0.82–1.24 compared with nondiabetics. Conclusions. HF patients with diabetes have similar neurohumoral activation when compared with nondiabetics. One-year mortality is also nondifferent after matching for age, gender, and systolic function.

  10. Power-Stepped HF Cross-Modulation Experiments: Simulations and Experimental Observations

    Science.gov (United States)

    Greene, S.; Moore, R. C.

    2014-12-01

    High frequency (HF) cross modulation experiments are a well established means for probing the HF-modified characteristics of the D-region ionosphere. The interaction between the heating wave and the probing pulse depends on the ambient and modified conditions of the D-region ionosphere. Cross-modulation observations are employed as a measure of the HF-modified refractive index. We employ an optimized version of Fejer's method that we developed during previous experiments. Experiments were performed in March 2013 at the High Frequency Active Auroral Research Program (HAARP) observatory in Gakona, Alaska. During these experiments, the power of the HF heating signal incrementally increased in order to determine the dependence of cross-modulation on HF power. We found that a simple power law relationship does not hold at high power levels, similar to previous ELF/VLF wave generation experiments. In this paper, we critically compare these experimental observations with the predictions of a numerical ionospheric HF heating model and demonstrate close agreement.

  11. A new wideband HF technique for MHz-bandwidth spread-spectrum radio communications

    Science.gov (United States)

    Perry, B. D.

    1983-09-01

    The one-way results are seen as demonstrating that equalized MHz-bandwidth skywave HF channels can be achieved using long-range one-hop F-layer propagation paths. It has thus become possible to use direct-sequence pseudo-noise or coherent fast-frequency-hop signaling at HF with processing gains of several orders of magnitude for teletype data rates. Possibilities are seen for using the spread spectrum in covert and/or jam-resistant communications. What is more, the equalized wideband HF channel is not subject to the fading caused by multiple propagation modes; as a consequence, it is substantially more reliable than the traditional narrow-band HF channel. Conversely, reliability comparable to traditional HF can be attained at greatly reduced signal margins. Since the time stability of the wideband HF channel is of the order of 10 s, very little channel-transmission time is needed for initializing and maintaining the equalizer. It is noted that probe signals similar to the channel-measuring waveform described here or spread-spectrum training sequences at the beginning of each message are adequate. Results from the 1982 two-way experimentation show that N(omega) is not reciprocal between terminals 2000 km apart.

  12. Troponin I in acute decompensated heart failure : insights from the ASCEND-HF study

    NARCIS (Netherlands)

    Felker, G. Michael; Hasselblad, Vic; Tang, W. H. Wilson; Hernandez, Adrian F.; Armstrong, Paul W.; Fonarow, Gregg C.; Voors, Adriaan A.; Metra, Marco; McMurray, John J. V.; Butler, Javed; Heizer, Gretchen M.; Dickstein, Kenneth; Massie, Barry M.; Atar, Dan; Troughton, Richard W.; Anker, Stefan D.; Califf, Robert M.; Starling, Randall C.; O'Connor, Christopher M.

    2012-01-01

    We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. Contemporary assays with greater sensitivity requ

  13. Influences of different oxidants on the characteristics of HfAlOx films deposited by atomic layer deposition

    Institute of Scientific and Technical Information of China (English)

    Fan Ji-Bin; Liu Hong-Xia; Ma Fei; Zhuo Qing-Qing; Hao Yue

    2013-01-01

    A comparative study of two kinds of oxidants (H2O and O3) with the combinations of two metal precursors [trimethylaluminum (TMA) and tetrakis(ethylmethylamino) hafnium (TEMAH)] for atomic layer deposition (ALD) hafnium aluminum oxide (HfAlOx) films is carried out.The effects of different oxidants on the physical properties and electrical characteristics of HfAlOx films are studied.The preliminary testing results indicate that the impurity level of HfAlOx films grown with both H2O and O3 used as oxidants can be well controlled,which has significant effects on the dielectric constant,valence band,electrical properties,and stability of HfAlOx film.Additional thermal annealing effects on the properties of HfAlOx films grown with different oxidants are also investigated.

  14. HF readmissions drop after initiatives.

    Science.gov (United States)

    2014-06-01

    By analyzing heart failure readmissions and collaborating with post-acute providers and community organizations, Essentia Health-St. Joseph's Medical Center in Brainerd, MN, cut its readmission rate from 18% to a low of 6%. An interdisciplinary team analyzed readmissions, interviewed patients who were readmitted, and developed the program. Initiatives include setting primary care appointments while patients are in the hospital, following up after discharge, and creating order sets that include best practices. The hospital staff meet regularly with post-acute providers and social service agencies to brainstorm ways to create smoother transitions and ensure that patients get what they need after discharge.

  15. General concepts of modern HF communications

    Science.gov (United States)

    Aarons, Jules

    Both conceptual and hardware advancements have led to substantial systems developments in military HF communications; the former encompass coding and error correction techniques for security, in order to minimize propagation and interference, while the latter prominently include digital equipment permitting the selection of a frequency for a particular path and propagation mode, as well as modulation selection. Propagation-related advancements involve better statistical models as well as advancements in short-term forecasting methods responsive to changes in solar-geophysical parameters. Adaptive HF systems have been developed for meteor-scatter radio communications.

  16. Subduction Controls of Hf and Nd Isotopes in Lavas of the Aleutian Island Arc

    Energy Technology Data Exchange (ETDEWEB)

    Yogodzinski, Gene; Vervoort, Jeffery; Brown, Shaun Tyler; Gerseny, Megan

    2010-08-29

    trench east of the Amlia Fracture Zone, which is being subducting beneath the arc at Seguam Island. Mixing trends between mantle wedge and sediment end members become flatter in Hf-Nd isotope space at locations further west along the arc, indicating that the sediment end member in the west has either higher Nd/Hf or is more radiogenic in Hf compared to Nd. This pattern is interpreted to reflect an increase in pelagic clay relative to the terrigenous subducted sedimentary component westward along the arc. Results of this study imply that Hf does not behave as a conservative element in the Aleutian subduction system, as has been proposed for some other arcs.

  17. Research on Multi-Layer Distributed HF Radio Network Structure

    Institute of Scientific and Technical Information of China (English)

    Hui Dai; Chun-Jiang Wang; Quan Yu

    2008-01-01

    High frequency (HF) transmission is an important communication techniques. However, conventional point-to-point transmission can be easily destroyed, which limits its utilization in practice. HF networking communication has the capability against demolishment. The network structure is one of the key factors for HF networking communication. In this paper, a novel analysis method of the network connectedness based on the eigenvalue is derived, and a multi-layer distributed HF radio network structure is proposed. Both the theore tical analysis and the computer simulation results verify that the application of the proposed network structure in the HF radio communication can improve the anti demolishment ability of the HF network efficiently.

  18. Comparing Cognitive and Somatic Symptoms of Depression in Myocardial Infarction Patients and Depressed Patients in Primary and Mental Health Care

    NARCIS (Netherlands)

    Groenewold, Nynke A.; Doornbos, Bennard; Zuidersma, Marij; Vogelzangs, Nicole; Penninx, Brenda W. J. H.; Aleman, Andre; de Jonge, Peter

    2013-01-01

    Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in

  19. Bridging the gap: how traditional healers interact with their patients. A comparative study in Cameroon.

    NARCIS (Netherlands)

    Labhardt, N.D.; Aboa, S.M.; Manga, E.; Bensing, J.M.; Langewitz, W.

    2010-01-01

    Objective: To compare traditional healers (TH) and Cameroonian representatives of Western medicine (Western providers (WP)) in terms of patient characteristics and communication patterns during the consultation in rural Cameroon. Methods: A facility-based comparative study was conducted. Seven TH

  20. Blood gas analysis of the coronary sinus in patients with heart failure.

    Science.gov (United States)

    Zhang, Jianghua; Shan, Chunfang; Zhang, Y U; Zhou, Xianhui; Li, Jinxin; Li, Yaodong; Xing, Qiang; Tang, Baopeng

    2015-05-01

    The difference in cardiac oxygen consumption between individuals with normal cardiac function and those with heart failure (HF), and the association between cardiac oxygen consumption and cardiac ejection fraction (EF) are poorly understood. By establishing a control group composed of individuals with normal cardiac function, the present study aimed to determine the difference in cardiac oxygen consumption between individuals with normal and abnormal cardiac function, as well as the association between cardiac oxygen consumption and cardiac EF. A total of 34 patients with normal cardiac function were enrolled in the control group and 44 patients with HF were enrolled in the experimental group. Blood samples from the aortic root, femoral vein and coronary sinus (CS) were collected from each patient. All the blood samples were subjected to blood gas analysis. The partial pressure of oxygen and oxygen saturation obtained from the peripheral vein and CS of patients with HF were lower than those in patients with normal cardiac function. In each patient with HF, the association between cardiac oxygen consumption and cardiac EF was analyzed using multi-linear correlation and regression analyses. Cardiac oxygen consumption negatively correlated with cardiac EF (R=-0.336, P=0.026). Furthermore, linear regression analysis suggested that cardiac EF had a significant effect on cardiac oxygen consumption (y = 82.906-0.483×, P=0.026). In conclusion, myocardial oxygen consumption is greater in individuals with HF compared to those with normal cardiac function. The cardiac EF affects myocardial oxygen consumption in patients with HF.

  1. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia.

    Science.gov (United States)

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-07-01

    Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

  2. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2011-01-01

    Full Text Available Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

  3. Systematic Comparison of HF CMOS Transconductors

    NARCIS (Netherlands)

    Klumperink, Eric A.M.; Nauta, Bram

    2003-01-01

    Transconductors are commonly used as active elements in high-frequency (HF) filters, amplifiers, mixers, and oscillators. This paper reviews transconductor design by focusing on the V-I kernel that determines the key transconductor properties. Based on bandwidth considerations, simple V-I kernels wi

  4. Electron impact on vibrationally cold {{HF}}^{+}

    Science.gov (United States)

    Cristian Stroe, Marius; Fifirig, Magda

    2016-12-01

    The dissociative recombination and vibrational excitation processes induced by electron impact on vibrationally cold {{HF}}+ are investigated in the framework of the multichannel quantum defect theory for electron energies below 1 eV. The thermal rate coefficients for the electron temperature range from 10 to 5000 K are reported.

  5. ORIGIN OF EXCESS (176)Hf IN METEORITES

    DEFF Research Database (Denmark)

    Thrane, Kristine; Connelly, James Norman; Bizzarro, Martin

    2010-01-01

    After considerable controversy regarding the (176)Lu decay constant (lambda(176)Lu), there is now widespread agreement that (1.867 +/- 0.008) x 10(-11) yr(-1) as confirmed by various terrestrial objects and a 4557 Myr meteorite is correct. This leaves the (176)Hf excesses that are correlated with...

  6. Bipolar Resistive Switching Characteristics of HfO2/TiO2/HfO2 Trilayer-Structure RRAM Devices on Pt and TiN-Coated Substrates Fabricated by Atomic Layer Deposition

    Science.gov (United States)

    Zhang, Wei; Kong, Ji-Zhou; Cao, Zheng-Yi; Li, Ai-Dong; Wang, Lai-Guo; Zhu, Lin; Li, Xin; Cao, Yan-Qiang; Wu, Di

    2017-06-01

    The HfO2/TiO2/HfO2 trilayer-structure resistive random access memory (RRAM) devices have been fabricated on Pt- and TiN-coated Si substrates with Pt top electrodes by atomic layer deposition (ALD). The effect of the bottom electrodes of Pt and TiN on the resistive switching properties of trilayer-structure units has been investigated. Both Pt/HfO2/TiO2/HfO2/Pt and Pt/HfO2/TiO2/HfO2/TiN exhibit typical bipolar resistive switching behavior. The dominant conduction mechanisms in low and high resistance states (LRS and HRS) of both memory cells are Ohmic behavior and space-charge-limited current, respectively. It is found that the bottom electrodes of Pt and TiN have great influence on the electroforming polarity preference, ratio of high and low resistance, and dispersion of the operating voltages of trilayer-structure memory cells. Compared to using symmetric Pt top/bottom electrodes, the RRAM cells using asymmetric Pt top/TiN bottom electrodes show smaller negative forming voltage of -3.7 V, relatively narrow distribution of the set/reset voltages and lower ratio of high and low resistances of 102. The electrode-dependent electroforming polarity can be interpreted by considering electrodes' chemical activity with oxygen, the related reactions at anode, and the nonuniform distribution of oxygen vacancy concentration in trilayer-structure of HfO2/TiO2/HfO2 on Pt- and TiN-coated Si. Moreover, for Pt/HfO2/TiO2/HfO2/TiN devices, the TiN electrode as oxygen reservoir plays an important role in reducing forming voltage and improving uniformity of resistive switching parameters.

  7. Role of WC additive on reaction, solid-solution and densification in HfB2–SiC ceramics

    DEFF Research Database (Denmark)

    Hu, Dong-Li; Zheng, Qiang; Gu, Hui

    2014-01-01

    A comparative study of phase components and compositions was performed for the pressureless sintered HfB2–SiC–WC composites by various analytical methods. The relative decrease of HfB2 phase leads to a new reaction of HfO2 removal by WC to create B2O3. By using SiC instead of Si3N4 as milling med...

  8. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    patients with heart failure from July 1, 2005 to June 30, 2007. Heart failure was defined in accordance with European Society of Cardiology (ESC) guidelines. The recorded diagnoses from the NRP were compared with clinical data from the medical records. RESULTS: We identified 758 patients with a diagnosis......OBJECTIVE: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF. DESIGN: The NRP was used to identify...... of heart failure in the NRP. The PPV of a heart failure discharge diagnosis was 84.0% (95% confidence interval: 81.2-86.6). Patients with a discharge diagnosis of HF in the NRP without fulfilling the ESC criteria for HF had a better survival rate, a lower rate of rehospitalization, none were followed...

  9. Preferred Place of Care and Death in Terminally Ill Patients with Lung and Heart Disease Compared to Cancer Patients

    DEFF Research Database (Denmark)

    Skorstengaard, Marianne H; Neergaard, Mette Asbjørn; Andreassen, Pernille

    2017-01-01

    OBJECTIVES: The dual aim of this study is, first, to describe preferred place of care (PPOC) and preferred place of death (PPOD) in terminally ill patients with lung and heart diseases compared with cancer patients and second, to describe differences in level of anxiety among patients...... to be cared for and to die at home. Patients with cancer and heart diseases chose hospice as their second most common preference for both PPOC and PPOD, whereas patients with lung diseases chose nursing home and hospice equally frequent as their second most common preference. Regardless of their diagnosis......, all patients had a higher level of anxiety than the average Danish population; patients with heart diseases had a much higher level of anxiety than patients with lung diseases and cancer. CONCLUSION: Patient preferences for PPOC and PPOD vary according to their diagnoses; tailoring palliative needs...

  10. Quality of life after prostate cancer treatments in patients comparable at baseline

    NARCIS (Netherlands)

    Tol-Geerdink, J.J. van; Leer, J.W.H.; Oort, I.M. van; Lin, E.J. van; Weijerman, P.C.; Vergunst, H.; Witjes, J.A.; Stalmeier, P.F.M.

    2013-01-01

    Background:Previous studies on the effects of different prostate cancer treatments on quality of life, were confounded because patients were not comparable. This study examined treatment effects in more comparable groups.Methods:From 2008-2011, 240 patients with localised prostate cancer were select

  11. A comparative study of patients and therapists' reports of schema modes

    NARCIS (Netherlands)

    Lobbestael, J.; Arntz, A.R.; Lobbes, A.; Cima, M.

    2009-01-01

    The current study assesses whether patients and therapists report similar levels of schema modes, one of the central features in Schema-Focused Therapy. Patient's self-report and therapists' report on an abbreviated Schema Mode Inventory were compared in a sample of 92 patients with antisocial, bord

  12. Internalized Stigma of Mental Illness among Schizophrenic Patients and Their Families (Comparative Study)

    Science.gov (United States)

    Mahmoud, Sahar; Zaki, Rania A.

    2015-01-01

    This study was a comparative study aiming to assess the extent of internalized stigma of mental illness among patients with schizophrenia & identify stigma as perceived by family members caring schizophrenic patients. The study was conducted in two settings 1st clinic was outpatient clinic for psychiatric patient affiliated to Abbasia…

  13. Web-based Internet telemedicine management of patients with heart failure.

    Science.gov (United States)

    Kashem, Abul; Droogan, Marie T; Santamore, William P; Wald, Joyce W; Marble, Judith F; Cross, Robert C; Bove, Alfred A

    2006-08-01

    An Internet-based store-and-retrieval telemedicine system to communicate between patients and their healthcare provider was tested. The system requires no specialized equipment, is Web-based, and allows frequent surveillance of the health status of the patients with heart failure (HF). Thirty six patients were recruited to evaluate a Web-based telemedicine system for reducing care encounters. Eighteen patients were randomized to the telemedicine arm (group T), and 18 were given usual clinical care (group C) in our HF center. Patients in group T reported three times weekly via a secure Internet site for telemedicine intervention. We studied patients with HF with New York Heart Association (NYHA) class 2 to 4 with hospitalization within past 6 months. Mean age was 56.1 +/- 12.6 years (66.7% male; 66.7% Caucasian, 27.8% African American, and 5.6% Hispanic). Mean ejection fraction (EF) was 23.9% +/- 17.6% in group T and 26.6% +/- 16.4% in group C. Over an 8-month period, unscheduled (group T-3; group C-5), and scheduled clinic visits (group T-11, group C-7) were similar (p = NS); one group T patient was transplanted, one group C patient died. Total hospital days were lower with group T (44 days) compared to group C (133 days), p HF. Surveillance through Internet-based telemedicine resulted in less hospitalization compared to control patients. This system may be helpful in reducing the cost of HF patient care.

  14. Action potential-evoked calcium release is impaired in single skeletal muscle fibers from heart failure patients.

    Directory of Open Access Journals (Sweden)

    Marino DiFranco

    Full Text Available BACKGROUND: Exercise intolerance in chronic heart failure (HF has been attributed to abnormalities of the skeletal muscles. Muscle function depends on intact excitation-contraction coupling (ECC, but ECC studies in HF models have been inconclusive, due to deficiencies in the animal models and tools used to measure calcium (Ca2+ release, mandating investigations in skeletal muscle from HF patients. The purpose of this study was to test the hypothesis that Ca2+ release is significantly impaired in the skeletal muscle of HF patients in whom exercise capacity is severely diminished compared to age-matched healthy volunteers. METHODS AND FINDINGS: Using state-of-the-art electrophysiological and optical techniques in single muscle fibers from biopsies of the locomotive vastus lateralis muscle, we measured the action potential (AP-evoked Ca2+ release in 4 HF patients and 4 age-matched healthy controls. The mean peak Ca2+ release flux in fibers obtained from HF patients (10±1.2 µM/ms was markedly (2.6-fold and significantly (p<0.05 smaller than in fibers from healthy volunteers (28±3.3 µM/ms. This impairment in AP-evoked Ca2+ release was ubiquitous and was not explained by differences in the excitability mechanisms since single APs were indistinguishable between HF patients and healthy volunteers. CONCLUSIONS: These findings prove the feasibility of performing electrophysiological experiments in single fibers from human skeletal muscle, and offer a new approach for investigations of myopathies due to HF and other diseases. Importantly, we have demonstrated that one step in the ECC process, AP-evoked Ca2+ release, is impaired in single muscle fibers in HF patients.

  15. Facile synthesis and enhanced luminescent properties of ZnO/HfO2 core-shell nanowires.

    Science.gov (United States)

    Zhang, Yuan; Lu, Hong-Liang; Wang, Tao; Ren, Qing-Hua; Gu, Yu-Zhu; Li, De-Hui; Zhang, David Wei

    2015-10-07

    The morphological, structural and photoluminescence properties of one-dimensional ZnO/HfO2 core-shell nanowires (NWs) with various thicknesses of HfO2 shell layers are studied in detail in this work. The ZnO NWs have been fabricated by a simple hydrothermal method, which are then coated by thin HfO2 shell layers using atomic layer deposition (ALD). The morphological and structural characterization demonstrates that the HfO2 shells with polycrystalline structures grow on the single-crystalline ZnO NWs conformally. Moreover, the ZnO/HfO2 core/shell NWs show remarkable enhanced ultraviolet (UV) emission with increasing thickness of the HfO2 shell layer compared with bare ZnO NWs. The UV emission intensity for the sample with HfO2 shell thickness of ∼16 nm is about 9 times higher than that of bare ZnO NWs. It mainly results from the decreased surface states by surface passivation of the HfO2 shell layer as well as a typical type-I band alignment in the ZnO/HfO2 core/shell structure. A model is also proposed to explain the evolution of the wide visible emission band with the relatively low intensity of the core/shell structures. Our results suggest that the ZnO/HfO2 core/shell structures have potential applications for high-efficiency optoelectronic devices such as UV light-emitting diodes and lasers.

  16. Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction

    DEFF Research Database (Denmark)

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars

    2015-01-01

    AIMS: To investigate the prognostic significance of hospitalization for worsening heart failure (WHF), myocardial infarction (MI), and stroke in patients with chronic heart failure (HF). METHODS AND RESULTS: We studied 5011 patients with HF and reduced EF (HF-REF) in the CORONA trial and 4128...... patients with HF and preserved EF (HF-PEF) in the I-Preserve trial. Adjusted hazard ratios (HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616.......21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29). CONCLUSIONS: In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk...

  17. The alternative complement pathway is dysregulated in patients with chronic heart failure

    Science.gov (United States)

    Shahini, Negar; Michelsen, Annika E.; Nilsson, Per H.; Ekholt, Karin; Gullestad, Lars; Broch, Kaspar; Dahl, Christen P.; Aukrust, Pål; Ueland, Thor; Mollnes, Tom Eirik; Yndestad, Arne; Louwe, Mieke C.

    2017-01-01

    The complement system, an important arm of the innate immune system, is activated in heart failure (HF). We hypothesized that HF patients are characterized by an imbalance of alternative amplification loop components; including properdin and complement factor D and the alternative pathway inhibitor factor H. These components and the activation product, terminal complement complex (TCC), were measured in plasma from 188 HF patients and 67 age- and sex- matched healthy controls by enzyme immunoassay. Our main findings were: (i) Compared to controls, patients with HF had significantly increased levels of factor D and TCC, and decreased levels of properdin, particularly patients with advanced clinical disorder (i.e., NYHA functional class IV), (ii) Levels of factor D and properdin in HF patients were correlated with measures of systemic inflammation (i.e., C-reactive protein), neurohormonal deterioration (i.e., Nt-proBNP), cardiac function, and deteriorated diastolic function, (iii) Low levels of factor H and properdin were associated with adverse outcome in univariate analysis and for factor H, this was also seen in an adjusted model. Our results indicate that dysregulation of circulating components of the alternative pathway explain the increased degree of complement activation and is related to disease severity in HF patients. PMID:28195242

  18. A comparative study of charge trapping in HfO{sub 2}/Al{sub 2}O{sub 3} and ZrO{sub 2}/Al{sub 2}O{sub 3} based multilayered metal/high-k/oxide/Si structures

    Energy Technology Data Exchange (ETDEWEB)

    Spassov, D., E-mail: d_spassov@abv.bg [Institute of Solid State Physics, Bulgarian Academy of Sciences, Tzarigradsko Chaussee 72, Sofia 1784 (Bulgaria); Skeparovski, A. [Institute of Physics, Faculty of Natural Sciences and Mathematics, University “Ss. Cyril and Methodius”, Arhimedova 3, 1000 Skopje (Macedonia, The Former Yugoslav Republic of); Paskaleva, A. [Institute of Solid State Physics, Bulgarian Academy of Sciences, Tzarigradsko Chaussee 72, Sofia 1784 (Bulgaria); Novkovski, N. [Institute of Physics, Faculty of Natural Sciences and Mathematics, University “Ss. Cyril and Methodius”, Arhimedova 3, 1000 Skopje (Macedonia, The Former Yugoslav Republic of)

    2016-09-01

    The electrical properties of multilayered HfO{sub 2}/Al{sub 2}O{sub 3}/HfO{sub 2}/SiO{sub 2} and ZrO{sub 2}/Al{sub 2}O{sub 3}/ZrO{sub 2}/SiO{sub 2} metal-oxide semiconductor capacitors were investigated in order to evaluate the possibility of their application in charge-trapping non-volatile memory devices. The stacks were deposited by reactive radiofrequency magnetron sputtering on Si substrates with thermal SiO{sub 2} with a thickness ranging from 2 to 5 nm. Both types of stacks show negative initial oxide charge and its density is higher for HfO{sub 2}-based structures. Memory window up to 6V at sweeping voltage range of ± 16V was obtained for HfO{sub 2}-based stacks. The hysteresis in these structures is mainly due to a trapping of electrons injected from the Si substrate. The charge-trapping properties of ZrO{sub 2}-based samples are compromised by the high leakage currents and the dielectric breakdown. The conduction through the capacitors at low applied voltages results from hopping of thermally excited electrons from one isolated state to another. The energy depth of the traps participating in the hopping conduction was determined as ~ 0.7 eV for the HfO{sub 2}-based layers and ~ 0.6 eV for ZrO{sub 2}-based ones, originating from negatively charged oxygen vacancies. At high electric fields, the current voltage characteristics were interpreted in terms of space charge limited currents, Fowler–Nordheim tunneling, Schottky emission, and Poole–Frenkel mechanism. The charge retention characteristics do not depend on the thickness of the tunnel SiO{sub 2}. - Highlights: • Sputtered HfO{sub 2}/Al{sub 2}O{sub 3}/HfO{sub 2} and ZrO{sub 2}/Al{sub 2}O{sub 3}/ZrO{sub 2} charge-trapping layers were studied. • HfO{sub 2}/Al{sub 2}O{sub 3}/HfO{sub 2} stacks show memory window up to 6 V and good retention times. • Negatively charged oxygen vacancies were identified as main defects in the stacks. • Electrical breakdown compromise the charge-trapping properties

  19. Performance enhancement of GaN metal–semiconductor–metal ultraviolet photodetectors by insertion of ultrathin interfacial HfO{sub 2} layer

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Manoj, E-mail: panwarm72@yahoo.com, E-mail: aokyay@ee.bilkent.edu.tr [UNAM-National Nanotechnology Research Center and Institute of Materials Science and Nanotechnology, Bilkent University, 06800 Ankara (Turkey); Tekcan, Burak; Okyay, Ali Kemal, E-mail: panwarm72@yahoo.com, E-mail: aokyay@ee.bilkent.edu.tr [UNAM-National Nanotechnology Research Center and Institute of Materials Science and Nanotechnology, Bilkent University, 06800 Ankara, Turkey and Department of Electrical and Electronics Engineering, Bilkent University, 06800 Ankara (Turkey)

    2015-03-15

    The authors demonstrate improved device performance of GaN metal–semiconductor–metal ultraviolet (UV) photodetectors (PDs) by ultrathin HfO{sub 2} (UT-HfO{sub 2}) layer on GaN. The UT-HfO{sub 2} interfacial layer is grown by atomic layer deposition. The dark current of the PDs with UT-HfO{sub 2} is significantly reduced by more than two orders of magnitude compared to those without HfO{sub 2} insertion. The photoresponsivity at 360 nm is as high as 1.42 A/W biased at 5 V. An excellent improvement in the performance of the devices is ascribed to allowed electron injection through UT-HfO{sub 2} on GaN interface under UV illumination, resulting in the photocurrent gain with fast response time.

  20. Systemic Inflammatory Response Syndrome in End-Stage Heart Failure Patients Following Continuous-Flow Left Ventricular Assist Device Implantation: Differences in Plasma Redox Status and Leukocyte Activation.

    Science.gov (United States)

    Mondal, Nandan K; Sorensen, Erik N; Pham, Si M; Koenig, Steven C; Griffith, Bartley P; Slaughter, Mark S; Wu, Zhongjun J

    2016-05-01

    The role of oxidative stress and leukocyte activation has not been elucidated in developing systemic inflammatory response syndrome (SIRS) in heart failure (HF) patients after continuous-flow left ventricular assist device (CF-LVAD) implantation. The objective of this study was to investigate the change of plasma redox status and leukocyte activation in CF-LVAD implanted HF patients with or without SIRS. We recruited 31 CF-LVAD implanted HF patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers as the control. Pre- and postimplant blood samples were collected from the HF patients. Plasma levels of oxidized low-density lipoprotein (oxLDL), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD) in erythrocyte, myeloperoxidase (MPO), and polymorphonuclear elastase (PMN-elastase) were measured. The HF patients had a preexisting condition of oxidative stress than healthy controls as evident from the higher oxLDL and MDA levels as well as depleted SOD and TAC. Leukocyte activation in terms of higher plasma MPO and PMN-elastase was also prominent in HF patients than controls. Persistent oxidative stress and reduced antioxidant status were found to be more belligerent in HF patients with SIRS after the implantation of CF-LVAD when compared with non-SIRS patients. Similar to oxidative stress, the activation of blood leukocyte was significantly highlighted in SIRS patients after implantation compared with non-SIRS. We identified that the plasma redox status and leukocyte activation became more prominent in CF-LVAD implanted HF patients who developed SIRS. Our findings suggest that plasma biomarkers of oxidative stress and leukocyte activation may be associated with the development of SIRS after CF-LVAD implant surgery.

  1. Health locus of control and the sense of self-efficacy in patients with systolic heart failure: a pilot study.

    Science.gov (United States)

    Rydlewska, Agnieszka; Krzysztofik, Justyna; Libergal, Julia; Rybak, Agata; Banasiak, Waldemar; Ponikowski, Piotr; Jankowska, Ewa A

    2013-01-01

    Treatment of heart failure (HF) requires the lifelong adherence to medical self-care regimes. The objective of this study was to examine health-control beliefs and the sense of self-efficacy (psychological features particularly important for efficient compliance among patients suffering from chronic diseases) in patients with systolic HF in relation to clinical status and depressive symptoms. Sixty-six consecutive patients with chronic systolic HF, hospitalized in the Centre for Heart Diseases, Military Hospital (94% men, age: 61 ± 11 years, ischemic etiology: 63%, left ventricular ejection fraction: 32% ± 12%), filled in (during their hospital stay): (1) the Multidimensional Health Locus of Control Scale measuring three possible localizations of health control: "internality" (ie, the belief that health status depends only on personal decisions and behaviors); "powerful others externality" ([PHLC subscale] ie, the conviction that health depends on "powerful people" such as doctors, family members, close friends), and "chance externality" (ie, belief that health status is determined by chance, fate, or luck), and (2) the Generalized Self-Efficacy Scale. The results obtained by HF patients were compared to those reported by patients with other chronic diseases and healthy subjects. In patients with HF, internality was similar to values obtained by patients with diabetes, men after myocardial infarction, and women after mastectomy; and was lower than in healthy subjects. Powerful others externality was more pronounced in patients with HF as compared to other groups of patients and healthy people. Only women after mastectomy had higher scores of PHLC. In patients with HF, chance externality was similar to values reported in patients with renal failure, men after myocardial infarction, and women after mastectomy; and was less pronounced than in healthy subjects. The majority (77%) of patients with HF were characterized by a high sense of self-efficacy (>the 7th sten

  2. Atomic layer deposition of HfO{sub 2}: Growth initiation study on metallic underlayers

    Energy Technology Data Exchange (ETDEWEB)

    Platt, Christopher L., E-mail: Christopher.L.Platt@seagate.co [Seagate Technology, 47010 Kato Rd, Fremont, CA 94538 (United States); Li Ning; Li Kejing; Klein, Tonya M. [Department of Chemical and Biological Engineering, University of Alabama, A131 Bevill Building, Tuscaloosa, AL 35487-0203 (United States)

    2010-05-31

    The initial stages of HfO{sub 2} film growth by atomic layer deposition (ALD) on Co, Ta, and Pt thin films have been compared by x-ray photoelectron spectroscopy (XPS) and attenuated total reflection Fourier transform infrared spectroscopy. The initial tetrakis-dimethylamido(IV) hafnium (TDMAH) adsorption rate was highest on Co and increased with substrate temperature between 150 {sup o}C and 250 {sup o}C. The initial adsorption rate of TDMAH on Ta was less than on Co or Pt at the same substrate temperatures. The Ta surface also proved to be more stable with regard to TDMAH decomposition as fluctuations of adsorbed Hf and decomposition products were not observed during ALD cycling. Larger amounts of carbon were observed on Pt after TDMAH exposure compared to Co or Ta, suggestive of decomposition products. The XPS Hf(4f) peak measured after initial exposure of TDMAH on Pt showed evidence of two Hf oxidation states at the surface. It is postulated that the reaction of TDMAH and decomposition by-products with available oxygen or hydroxyl molecules at the surface of the various metal underlayers affected the initial growth of HfO{sub 2}.

  3. Curative effect of HF10 on liver and peritoneal metastasis mediated by host antitumor immunity

    Science.gov (United States)

    Hotta, Yoshihiro; Kasuya, Hideki; Bustos, Itzel; Naoe, Yoshinori; Ichinose, Toru; Tanaka, Maki; Kodera, Yasuhiro

    2017-01-01

    Background HF10 is a highly attenuated type 1 herpes simplex virus (HSV) with proven effective oncolytic effect. Previous investigations have demonstrated that colon cancer mice model treated with HF10 not only had better survival but were also resistant to the reimplantation of the antitumor effect mediated by host antitumor immunity. Importantly, it has also been noted that in mice with antitumors implanted on both sides of the back, an injection of HF10 on only one side strongly restrains not only the injected antitumor but also the non-injected ones. Materials and methods MC26 colon cancer cells were injected subcutaneously into the back, spleen, and intraperitoneal region of metastasis model mice. Antitumor volume and survival rate were monitored. To measure cytotoxic T lymphocytes (CTL) cytotoxicity against MC26, lymphocytes were extracted from the spleens of the peritoneal metastasis model mice as well as from the thymus of the liver metastasis model mice. The expression of interferon gamma was examined by enzyme-linked immunospot assay. Samples from the liver metastasis model mice were subjected to polymerase chain reaction to quantify the level of HSV genomes. Results HF10 was injected only on the back antitumor; however, a antitumor-suppressor effect was observed against liver and peritoneal metastases. When HF10 genome was measured, we observed lower genome on liver metastases compared to back antitumor genome quantity. CTL activity against MC26 was also observed. These results indicate that local administration of HF10 exerts a curative effect on systemic disease, mediated by host antitumor immunity. Conclusion HF10 local administration stimulates antitumor immunity to recognize antitumor-specific antigen, which then improves systemic disease. Metastatic antitumors lysis, on the other hand, appears to be mediated by the host immune system, rather than by virus-mediated direct oncolysis. PMID:28331843

  4. Effects of biased irradiation on charge trapping in HfO2 dielectric thin films

    Science.gov (United States)

    Mu, Yifei; Zhao, Ce Zhou; Lu, Qifeng; Zhao, Chun; Qi, Yanfei; Lam, Sang; Mitrovic, Ivona Z.; Taylor, Stephen; Chalker, Paul R.

    2017-09-01

    This paper reports the low-dose-rate radiation response of Al-HfO2/SiO2-Si MOS devices, in which the gate dielectric was formed by atomic layer deposition (ALD) with 5-nm equivalent oxide thickness. The degradation of the devices was characterized by a pulse capacitance-voltage (CV) and on-site radiation response technique under continuous gamma (γ) ray exposure at a relatively low dose rate of 0.116 rad (HfO2)/s. Compared with conventional CV measurements, the proposed measurements extract significant variations of flat-band voltage shift of the hafnium based MOS devices. The large flat-band voltage shift is mainly attributed to the radiation-induced oxide trapped charges, which are not readily compensated by bias-induced charges produced over the measurement timescales (for timescales less than 5 ms). A negative flat-band voltage shift up to -1.02 V was observed under a positive biased irradiation with the total dose up to 40 krad (HfO2) and with the electric field of 0.5 MV/cm. This is attributed to net positive charge generation in the HfO2 oxide layer. The generated charges are transported towards the HfO2/SiO2 interface, and then form effective trapped holes in the HfO2. Similarly, a positive flat-band voltage shift up to 1.1 V was observed from irradiation under negative bias with an electric field of -0.5 MV/cm. The positive shift is mainly due to the accumulation of trapped electrons. Analyses of the experimental results suggest that both hole and electron trapping can dominate the radiation response performance of the HfO2-based MOS devices depending upon the applied bias. It was also found there was no distinct border traps with irradiation in all cases.

  5. A comparative study of patients and therapists' reports of schema modes.

    Science.gov (United States)

    Lobbestael, Jill; Arntz, Arnoud; Löbbes, Annette; Cima, Maaike

    2009-12-01

    The current study assesses whether patients and therapists report similar levels of schema modes, one of the central features in Schema-Focused Therapy. Patient's self-report and therapists' report on an abbreviated Schema Mode Inventory were compared in a sample of 92 patients with antisocial, borderline or cluster C personality disorder. Results indicate a markedly stronger self-therapist discrepancy in mode rating in antisocial patients than in borderline and cluster C patients. Compared to their therapists, ASPD-patients report less presence of most maladaptive modes, whereas there was no difference in adaptive modes. These findings underscore the importance for the use of alternative assessment methods of cognitive concepts in antisocial patients.

  6. REMPI Spectroscopy of HfF

    CERN Document Server

    Loh, Huanqian; Yahn, Tyler S; Looser, Herbert; Field, Robert W; Cornell, Eric A

    2012-01-01

    The spectrum of electronic states at 30000--33000 cm$^{-1}$ in hafnium fluoride has been studied using (1+1) resonance-enhanced multi-photon ionization (REMPI) and (1+1$'$) REMPI. Six $\\Omega' = 3/2$ and ten $\\Pi_{1/2}$ vibronic bands have been characterized. We report the molecular constants for these bands and estimate the electronic energies of the excited states using a correction derived from the observed isotope shifts. When either of two closely spaced $\\Pi_{1/2}$ electronic states is used as an intermediate state to access autoionizing Rydberg levels, qualitatively distinct autoionization spectra are observed. The intermediate state-specificity of the autoionization spectra bodes well for the possibility of using a selected $\\Pi_{1/2}$ state as an intermediate state to create ionic HfF$^+$ in various selected quantum states, an important requirement for our electron electric dipole moment (eEDM) search in HfF$^+$.

  7. Single-patient (n-of-1) trials: a pragmatic clinical decision methodology for patient-centered comparative effectiveness research.

    Science.gov (United States)

    Duan, Naihua; Kravitz, Richard L; Schmid, Christopher H

    2013-08-01

    To raise awareness among clinicians and epidemiologists that single-patient (n-of-1) trials are potentially useful for informing personalized treatment decisions for patients with chronic conditions. We reviewed the clinical and statistical literature on methods and applications of single-patient trials and then critically evaluated the needs for further methodological developments. Existing literature reports application of 2,154 single-patient trials in 108 studies for diverse clinical conditions; various recent commentaries advocate for wider application of such trials in clinical decision making. Preliminary evidence from several recent pilot acceptability studies suggests that single-patient trials have the potential for widespread acceptance by patients and clinicians as an effective modality for increasing the therapeutic precision. Bayesian and adaptive statistical methods hold promise for increasing the informational yield of single-patient trials while reducing participant burden, but are not widely used. Personalized applications of single-patient trials can be enhanced through further development and application of methodologies on adaptive trial design, stopping rules, network meta-analysis, washout methods, and methods for communicating trial findings to patients and clinicians. Single-patient trials may be poised to emerge as an important part of the methodological armamentarium for comparative effectiveness research and patient-centered outcomes research. By permitting direct estimation of individual treatment effects, they can facilitate finely graded individualized care, enhance therapeutic precision, improve patient outcomes, and reduce costs. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Electrolyte changes and urinalysis pattern in patients with vesicovaginal fistula compared to their healthy controls

    Directory of Open Access Journals (Sweden)

    Chinwe O. Ewenighi

    2014-12-01

    Full Text Available Objective: The present work aimed to determine the electrolyte and urinalysis pattern among vesicovaginal fistula (VVF patients admitted into the National Obstetric Fistula Center (NOFC, Abakaliki, Ebonyi State, Nigeria. Method: Twenty VVF patients (mean age 27.65 +/- 5.44 from the VVF Unit of NOFC and twenty apparently healthy controls (mean age 25.85 +/- 1.66 from the Medical Laboratory Science Department, Ebonyi State University, were recruited for the study. Serum concentrations of sodium (Na+, potassium (K+, chloride (Cl and bicarbonate (HCO3 were analyzed by the ion-selective electrode method while urine analysis was done using urinalysis strips. Results: VVF patients indicated significantly higher K+ and Cl levels but lower Na+ level when compared with their controls. Bicarbonate level was found to be insignificantly higher in VVF patients when compared with controls. Urine analysis showed higher but insignificant differences in the frequencies of hematuria, urobilinogenuria, bilirubinuria, proteinuria, nitrite, ascorbic acid and glucosuria between the control group and VVF patients. The presence of cloudy urine was significantly higher in the VVF patients compared to the controls. Conclusion: The present study indicated significantly higher levels of K+, Cl and lower level of Na+ in VVF patients when compared with the healthy controls. Furthermore, there were greater presence of protein, ascorbic acid, blood and glucose in VVF patients when compared with the control but these differences were statistically insignificant. [J Exp Integr Med 2014; 4(4.000: 232-236

  9. Digitally Driven Antenna for HF Transmission

    Science.gov (United States)

    2010-09-01

    the 1-MHz carrier signal. This signal is then fed into the base terminals of an NPN/ PNP transistor pair arranged in a push–pull configura- tion. A dual...negative voltage connected to the collector terminal of the PNP transistor . Since it was not possible to explicitly simulate the radia- tion of the time...complementary pair of switching transistors is driven with a pulsewidth modulated HF signal, eliminating the requirement for a frequency-dependent

  10. Post-Cleaning Effect on a HfO2 Gate Stack Using a NF3/NH3 Plasma.

    Science.gov (United States)

    Lee, Min-Seon; Oh, Hoon-Jung; Lee, Joo-Hee; Lee, In-Geun; Shin, Woo-Gon; Kim, Kyu-Dong; Park, Jin-Gu; Ko, Dae-Hong

    2016-05-01

    The effects of dry cleaning of a HfO2 gate stack using NF3 only and a NF3/NH3 gas mixture plasma were investigated. The plasma dry cleaning process was carried out after HfO2 deposition using an indirect down-flow capacitively coupled plasma (CCP) system. An analysis of the chemical composition of the HfO2 gate stacks by XPS indicated that fluorine was incorporated into the HfO2 films during the plasma dry cleaning. Significant changes in the HfO2 chemical composition were observed as a result of the NF3 dry cleaning, while they were not observed in this case of NF3/NH3 dry cleaning. TEM results showed that the interfacial layer (IL) between the HfO2 and Si thickness was increased by the plasma dry cleaning. However, in the case of NF3/NH3 dry cleaning using 150 W, the IL thickness was suppressed significantly compared to the sample that had not been dry cleaned. Its electrical properties were also improved, including the low gate leakage currents, and reduced EOT. Finally, the finding show that the IL thickness of the HfO2 gate stack can be controlled by using the novel NF3/NH3 dry cleaning process technique without any the significant changes in chemical composition and metal-oxide-semiconductor (MOS) capacitor characteristics.

  11. A Herschel/HIFI Legacy Survey of HF and H2O in the Galaxy: Probing Diffuse Molecular Cloud Chemistry

    CERN Document Server

    Sonnentrucker, P; Neufeld, D A; Flagey, N; Gerin, M; Goldsmith, P; Lis, D; Monje, R

    2015-01-01

    We combine Herschel observations of a total of 12 sources to construct the most uniform survey of HF and H2O in our Galactic disk. Both molecules are detected in absorption along all sight lines. The high spectral resolution of the Heterodyne Instrument for the Far-Infrared (HIFI) allows us to compare the HF and H2O distributions in 47 diffuse cloud components sampling the disk. We find that the HF and H2O velocity distributions follow each other almost perfectly and establish that HF and H2O probe the same gas-phase volume. Our observations corroborate theoretical predictions that HF is a sensitive tracer of H2 in diffuse clouds, down to molecular fractions of only a few percent. Using HF to trace H2 in our sample, we find that the N(H2O)-to-N(HF) ratio shows a narrow distribution with a median value of 1.51. Our results further suggest that H2O might be used as a tracer of H2 -within a factor 2.5- in the diffuse interstellar medium. We show that the measured factor of ~2.5 variation around the median is dri...

  12. Nosocomial candidemia in patients admitted to medicine wards compared to other wards: a multicentre study.

    Science.gov (United States)

    Luzzati, Roberto; Merelli, Maria; Ansaldi, Filippo; Rosin, Chiara; Azzini, Annamaria; Cavinato, Silvia; Brugnaro, Pierluigi; Vedovelli, Claudio; Cattelan, Annamaria; Marina, Busetti; Gatti, Giuseppe; Concia, Ercole; Bassetti, Matteo

    2016-12-01

    Risk factors for nosocomial candidemia, severity of sepsis, treatment, and outcome were compared between patients admitted to medicine wards and those to surgical and intensive care units (ICUs). Data were retrospectively collected from patients belonging to six referral hospitals in Italy between January 2011 and December 2013. Risk factors for 30-day mortality were evaluated in the whole patient population. A total of 686 patients (mean age 70 ± 15 years) with candidemia were included. 367 (53.5 %) patients were in medicine wards, and 319 in surgery and ICUs. Host-related risk factors for candidemia were more common in medicine patients whereas healthcare-related factors in surgery/ICU patients. These patients showed severe sepsis and septic shock more commonly (71.7 %) than medicine patients (59.9 %) (p 0.003). The latter underwent central venous catheter (CVC) removal and adequate antifungal therapy less frequently than surgery/ICU patients. 149 (40.6 %) patients died with candidemia in medicine wards and 69 (21.6 %) in other wards (p candidemia was different between medicine patients and those in other wards. Despite the lower severity of candidemia in medicine patients, their mortality turned out to be higher than in surgery or ICU patients. Awareness of the best management of candidemia should be pursued, especially in medicine wards.

  13. Investigating a TELEmedicine solution to improve MEDication adherence in chronic Heart Failure (TELEMED-HF: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Widdershoven Jos

    2011-10-01

    Full Text Available Abstract Background Frequent rehospitalisations and poorer survival chances in heart failure (HF patients may partly be explained by poor medication adherence. There are multiple medication-related reasons for suboptimal adherence, but psychological reasons may also be important. A novel TELEmonitoring device may improve MEDication adherence in HF patients (TELEMED-HF. TELEMED-HF is a randomized, controlled clinical intervention trial designed to examine (1 the efficacy and cost-efficiency of an electronic medication adherence support system in improving and monitoring HF patients' medication adherence; (2 the effect of medication adherence on hospitalizations and health care consumption; as well as on (3 clinical characteristics, and Quality of Life (QoL; and (4 clinical, sociodemographic, and psychological determinants of medication adherence. Methods/Design Consecutive patients with chronic, systolic HF presenting to the outpatient clinic of the TweeSteden Hospital, The Netherlands, will be approached for study participation and randomly assigned (1:1 following blocked randomization procedures to the intervention (n = 200 or usual care arm (n = 200. Patients in the intervention arm use the medication support device for six months in addition to usual care. Post-intervention, patients return to usual care only and all patients participate in four follow-up occasions over 12 months. Primary endpoints comprise objective and subjective medication adherence, healthcare consumption, number of hospitalizations, and cost-effectiveness. Secondary endpoints include disease severity, physical functioning, and QoL. Discussion The TELEMED-HF study will provide us a comprehensive understanding of medication adherence in HF patients, and will show whether telemonitoring is effective and cost-efficient in improving adherence and preventing hospitalization in HF patients. Trial registration number NCT01347528.

  14. Effect of fluid and dietary sodium restriction in the management of patients with heart failure and preserved ejection fraction: study protocol for a randomized controlled trial.

    Science.gov (United States)

    d'Almeida, Karina S M; Rabelo-Silva, Eneida R; Souza, Gabriela C; Trojahn, Melina M; Barilli, Sofia L S; Mansson, Jessica V; Biolo, Andreia; Rohde, Luis E P; Clausell, Nadine; Beck-da-Silva, Luís

    2014-09-04

    Although half of all patients with heart failure (HF) have a normal or near-normal ejection fraction and their prognosis differs little from that of patients with a reduced ejection fraction, the pathophysiology of HF with preserved ejection fraction (HF-PEF) is still poorly understood, and its management poorly supported by clinical trials. Sodium and fluid restriction is the most common self-care measure prescribed to HF patients for management of congestive episodes. However, its role in the treatment of HF-PEF remains unclear. This trial seeks to compare the effects of a sodium- and fluid-restricted diet versus an unrestricted diet on weight loss, neurohormonal activation, and clinical stability in patients admitted for decompensated HF-PEF. This is a randomized, parallel trial with blinded outcome assessment. The sample will include adult patients (aged ≥18 years) with a diagnosis of HF-PEF admitted for HF decompensation. The patients will be randomized to receive a diet with sodium and fluid intake restricted to 0.8 g/day and 800 mL/day respectively (intervention group) or an unrestricted diet, with 4 g/day sodium and unlimited fluid intake (control group), and followed for 7 days or until hospital discharge. The primary outcome shall consist of weight loss at 7 days or discharge. The secondary outcome includes assessment of clinical stability, neurohormonal activation, daily perception of thirst and readmission rate at 30 days. Assessment of the effects of sodium and fluid restriction on neurohormonal activation and clinical course of HF-PEF can promote a deeper understanding of the pathophysiology and progression of this complex syndrome. ClinicalTrials.gov identifier: NCT01896908 (date of registration: 8 August 2013).

  15. Correlation of nanochemistry and electrical properties in HfO2 films grown by metalorganic molecular-beam epitaxy

    Science.gov (United States)

    Moon, Tae-Hyoung; Ham, Moon-Ho; Myoung, Jae-Min

    2005-03-01

    We present the annealing effects on nanochemistry and electrical properties in HfO2 dielectrics grown by metalorganic molecular-beam epitaxy. After the postannealing treatment of HfO2 films in the temperature range of 600-800°C, the thicknesses and chemical states of the films were examined by high-resolution transmission electron microscopy and angle-resolved x-ray photoelectron spectroscopy. By comparing the line shapes of core-level spectra for the samples with different annealing temperatures, the concentrations of SiO and Hf-silicate with high dielectric constant are found to be highest for HfO2 film annealed at 700°C. This result supports that the accumulation capacitance of the sample annealed at 700°C is not deteriorated in spite of a steep increase in interfacial layer thickness compared with that of the sample annealed at 600°C.

  16. Height dependence of the observed spectrum of radar backscatter from HF-induced ionospheric Langmuir turbulence

    Science.gov (United States)

    Fejer, J. A.; Sulzer, M. P.; Djuth, F. T.

    1991-09-01

    Results are presented of observations of the spectrum of the 430-MHz radar backscatter from HF-induced Langmuir turbulence with height discrimination. During very stable ionospheric conditions under which the height of the below-threshold backscatter spectrum changed by less than 300 m during a 7-min period, a 20-s-long temporary increase in the HF power from 3 MW ERP to 38-MW-equivalent-radiated HF power is found to result in subsequent strong above-threshold spectra extending to heights up to 1200 m greater than the height of the below-threshold spectrum for more than a minute. The generation of irregularities in the plasma density during the 20 s of enhanced HF power is suggested as a possible cause of this persistence of strong above-threshold spectra at greater heights. The initial temporal evolution of the backscatter spectrum from Langmuir turbulence after the start of HF transmissions is observed for different heights. The observational results are compared with the predictions of existing theories of Langmuir turbulence.

  17. Efficacy of Experimental Hydrofluoric Acid (HF on Bond Strength and Microleakage of Composite-Porcelain Interface

    Directory of Open Access Journals (Sweden)

    Samaneh Mahvidyzadeh

    2012-09-01

    Full Text Available Background and Aims: The aim of this study was to evaluate the quality of an experimental hydrofluoric acid (HF for preparation of porcelain and to compare it with two commercial hydrofluoric acids in Iranian trademark. Materials and Methods: A- Evaluation of etch pattern of experimental HF using scanning electron microscope (SEM: 6 feldespathic discs were divided into 3 groups. Each group was etched with related HF (experimental, Ultradent and Kimia for 1 minute. SEM images were recorded at 3 magnifications. B- Bond strength test: 18 feldespathic discs were considered for each acidic group. Then the porcelain surfaces were etched and bonded to composite with unfilled resin. Consequently, the microshear test was done. C- Microleakage test: 54 discs were divided into 3 groups (n=18. Then the porcelain surfaces were etched and bonded to composite with unfilled resin and finally observed under stereomicroscope. The data were analyzed with one-way ANOVA and Smirnov tests. Results: SEM analysis showed no difference between groups in terms of etch pattern. Microshear bond strength values for experimental, Kimia, and Ultradent HF were 28.53 (±4.92, 28.21 (±6.61, and 26.14 (±7.61 MPa, respectively. There was no significant difference between the bond strength of test groups (P0.05. Conclusion: Quality of experimental HF in terms of etch pattern, microshear bond strength and microleakage of composite/porcelain interface was similar to that of two commercial hydrofluoric acids.

  18. Elevation of Platelet and Monocyte Activity Markers of Atherosclerosis in Haemodialysis Patients Compared to Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Ksenija Stach

    2017-01-01

    Full Text Available Purpose. The predominant cause of mortality in dialysis patients are cardiovascular events. Platelet and monocyte activity markers play an important role in cardiovascular mortality and were assessed and related to dialysis quality criteria in haemodialysis (HD and peritoneal dialysis (PD patients. Methods. For this prospective comparative study, HD patients (n=41 and PD patients (n=10 were included. In whole blood samples, surface expression of CD62P and CD40L on platelets, tissue factor binding on monocytes, and platelet-monocyte aggregates were measured by flow cytometry. Plasma levels of MCP-1, IL-6, TNFα, and soluble CD40L were analysed by enzyme-linked immunosorbent assay. Results. Haemodialysis patients showed a significantly higher CD62P expression on platelets (p=0.017, significantly higher amount of platelet-monocyte aggregates (p<0.0001, and significantly more tissue factor binding on monocytes (p<0.0001 compared to PD patients. In PD patients, a significant correlation between Kt/V and platelet CD40L expression (r=0.867; 0.001 and between Kt/V and platelet CD62P expression (r=0.686; p=0.028 was observed, while there was no significant correlation between Kt/V and tissue factor binding on monocytes and platelet-monocyte aggregates, respectively. Conclusion. Platelet and monocyte activity markers are higher in HD patients in comparison with those in PD patients, possibly suggesting a higher risk of cardiovascular morbidity and mortality.

  19. Elevation of Platelet and Monocyte Activity Markers of Atherosclerosis in Haemodialysis Patients Compared to Peritoneal Dialysis Patients.

    Science.gov (United States)

    Stach, Ksenija; Karb, Susanne; Akin, Ibrahim; Borggrefe, Martin; Krämer, Bernhard; Kälsch, Thorsten; Kälsch, Anna-Isabelle

    2017-01-01

    The predominant cause of mortality in dialysis patients are cardiovascular events. Platelet and monocyte activity markers play an important role in cardiovascular mortality and were assessed and related to dialysis quality criteria in haemodialysis (HD) and peritoneal dialysis (PD) patients. For this prospective comparative study, HD patients (n = 41) and PD patients (n = 10) were included. In whole blood samples, surface expression of CD62P and CD40L on platelets, tissue factor binding on monocytes, and platelet-monocyte aggregates were measured by flow cytometry. Plasma levels of MCP-1, IL-6, TNFα, and soluble CD40L were analysed by enzyme-linked immunosorbent assay. Haemodialysis patients showed a significantly higher CD62P expression on platelets (p = 0.017), significantly higher amount of platelet-monocyte aggregates (p < 0.0001), and significantly more tissue factor binding on monocytes (p < 0.0001) compared to PD patients. In PD patients, a significant correlation between Kt/V and platelet CD40L expression (r = 0.867; 0.001) and between Kt/V and platelet CD62P expression (r = 0.686; p = 0.028) was observed, while there was no significant correlation between Kt/V and tissue factor binding on monocytes and platelet-monocyte aggregates, respectively. Platelet and monocyte activity markers are higher in HD patients in comparison with those in PD patients, possibly suggesting a higher risk of cardiovascular morbidity and mortality.

  20. [Potentially inappropriate prescribing in hospitalized patients with comparative study between prescription by internist and geriatricians].

    Science.gov (United States)

    Pardo-Cabello, A J; Bermudo-Conde, S; Manzano-Gamero, V

    2014-01-01

    To analyze potentially inappropriate prescribing in hospitalized patients and compare the prescription by internists and geriatricians. Cross-sectional study in hospitalized patients older than 65 years. We recorded prevalence of potentially inappropriate prescriptions according to the criteria of "Screening Tool of Older Person's Prescriptions". We included 95 hospitalized patients over 65 years with a median age of 79 years (interquartile range: 73-82 years) and 50.5% female. One hundred eighty-three potentially inappropriate prescriptions were detected in 81 patients (85.2% of patients). The most frequent potentially inappropriate prescription were the prolonged use of inhibitors of proton pump high dose (32.6% of patients), the use of benzodiazepines in patients prone to falling (23.2% of patients), the prolonged use of long-acting benzodiazepines (21.1% of patients) and prolonged use of neuroleptic as hypnotics (21.1% of patients). In comparative study between medical specialties, significant differences were found in mean number of drugs (P = 0.0001) and in prolonged use of neuroleptics as hypnotics (P = 0.015). A high percentage of hospitalized patients older than 65 years receive potentially inappropriate prescribing. Prolonged use of inhibitors of the proton pump at high doses was the most frequent potentially inappropriate prescribing criterion.

  1. Active Despite Pain: Patient Experiences With Guided Imagery With Relaxation Compared to Planned Rest.

    Science.gov (United States)

    Adeola, Mope T; Baird, Carol L; Sands, Laura; Longoria, Nancy; Henry, Una; Nielsen, Jacqueline; Shields, Cleveland G

    2015-12-01

    Inadequate pain control remains a threat to the quality of life of patients with cancer. Guided imagery with relaxation (GIR) is a mind-body therapy that has shown promise in reducing chronic pain. This article discusses a qualitative, descriptive study for which the objective was to compare the experiences of patients with cancer with reported pain using GIR compared to planned rest.
.

  2. Risk of Stroke in Chronic Heart Failure Patients Without Atrial Fibrillation: Analysis of the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) Trials.

    Science.gov (United States)

    Abdul-Rahim, Azmil H; Perez, Ana-Cristina; Fulton, Rachael L; Jhund, Pardeep S; Latini, Roberto; Tognoni, Gianni; Wikstrand, John; Kjekshus, John; Lip, Gregory Y H; Maggioni, Aldo P; Tavazzi, Luigi; Lees, Kennedy R; McMurray, John J V

    2015-04-28

    Our aim was to describe the incidence and predictors of stroke in patients who have heart failure without atrial fibrillation (AF). We pooled 2 contemporary heart failure trials, the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza cardiaca-Heart Failure trial (GISSI-HF). Of the 9585 total patients, 6054 did not have AF. Stroke occurred in 165 patients (4.7%) with AF and in 206 patients (3.4%) without AF (rates 16.8/1000 patient-years and 11.1/1000 patient-years, respectively). Using Cox proportional-hazards models, we identified the following independent predictors of stroke in patients without AF (ranked by χ(2) value): age (hazard ratio, 1.34; 95% confidence interval, 1.18-1.63 per 10 years), New York Heart Association class (1.60, 1.21-2.12 class III/IV versus II), diabetes mellitus treated with insulin (1.87, 1.22-2.88), body mass index (0.74, 0.60-0.91 per 5 kg/m(2) up to 30), and previous stroke (1.81, 1.19-2.74). N-terminal pro B-type natriuretic peptide (available in 2632 patients) was also an independent predictor of stroke (hazard ratio, 1.31; 1.11-1.57 per log unit) when added to this model. With the use of a risk score formulated from these predictors, we found that patients in the upper third of risk had a rate of stroke that approximated the risk in patients with AF. A small number of demographic and clinical variables identified a subset of patients who have heart failure without AF at a high risk of stroke. © 2015 American Heart Association, Inc.

  3. A Comparative Study of Nonopiate and Clinical Patients: Implications for Education and Prevention

    Science.gov (United States)

    Kinsey, Barry A.; And Others

    1975-01-01

    This study examines the appropriateness of the preventive mental health model by comparing a sample of non-opiate drug abusers with a sample of psychiatric patients. Data indicate non-opiate drug abusers and psychiatric patients are similar, although the drug abuse sample shows small, but consistent evidence of greater psychosocial adjustment…

  4. Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack

    DEFF Research Database (Denmark)

    Hankey, Graeme J; Patel, Manesh R; Stevens, Susanna R

    2012-01-01

    In ROCKET AF, rivaroxaban was non-inferior to adjusted-dose warfarin in preventing stroke or systemic embolism among patients with atrial fibrillation (AF). We aimed to investigate whether the efficacy and safety of rivaroxaban compared with warfarin is consistent among the subgroups of patients ...

  5. Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack

    DEFF Research Database (Denmark)

    Easton, J Donald; Lopes, Renato D; Bahit, M Cecilia

    2012-01-01

    In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy ...

  6. Superior Vena Cava Obstruction in Hemodialysis Patients: Symptoms, Clinical Presentation and Outcomes Compared to Other Etiologies.

    Science.gov (United States)

    Siegel, Yoel; Kuker, Russ

    2016-08-01

    The incidence of superior vena cava (SVC) obstruction associated with non-malignant diseases is on the rise, and a large percentage of these patients are on hemodialysis (HD). The objective was to characterize the presentation, symptoms and outcomes of HD patients with SVC obstruction identified on computerized tomography (CT) compared to patients with other etiologies such as neoplasm. A search was performed through the PACS system using key words to identify patients with SVC obstruction. The CT scans and charts were reviewed for degree of obstruction, signs, symptoms and outcomes. Thirty-six patients were included in the study. Thirteen were on HD and of these, five had symptoms associated with SVC obstruction and one had concordant findings on physical exam. In comparison, thirteen patients with a chest neoplasm had symptoms and four had concordant findings on physical exam. On follow up, 31% of the HD patients died and of these 60% were symptomatic and died within 2 years. 29% of lung cancer patients died within 16 months. The majority of the HD patients had complete SVC obstruction (85%) as opposed to those with a chest neoplasm who mostly had partial SVC occlusion (67%). In conclusion, patients on HD with SVC obstruction are less often symptomatic than those with a neoplasm. However, these HD patients had a death rate similar to the patients with cancer. This risk seems to increase in those who are symptomatic. Diagnosis of SVC obstruction by CT in HD patients may help identify those with less favorable prognosis.

  7. Practice based evidence: incorporating clinical heterogeneity and patient-reported outcomes for comparative effectiveness research.

    Science.gov (United States)

    Horn, Susan D; Gassaway, Julie

    2010-06-01

    Comparative effectiveness research analyzes groups of patients and looks for associations between medical treatments and patient outcomes. To make meaningful comparisons of medical interventions, one must consider clinical heterogeneity of patient populations, intervention combinations, and outcomes. To explain how practice-based evidence (PBE) study methodology measures and controls for heterogeneity of patients, treatments, and outcomes seen in real-world clinical settings. Overview of PBE methodology. PBE study designs address comparative effectiveness by creating a comprehensive set of patient, treatment, and outcome variables, and analyzing them to identify treatments associated with better outcomes for specific types of patients. PBE studies are an alternative to randomized controlled trials, well suited to determine what works best for specific patient types, and provide clinicians with a rational basis for treatment recommendations for individual patients. They provide a holistic picture of patients, treatments, and outcomes, with no preset limits to the number of variables that can be included. Such an approach is needed for high quality comparative effectiveness research.

  8. Comparative Study of Carcinoembryonic Antigen Tumor Marker in Stomach and Colon Cancer Patients in Khyber Pakhtunkhwa.

    Science.gov (United States)

    Ahmad, Bashir; Gul, Bushra; Ali, Sajid; Bashir, Shumaila; Mahmood, Nourin; Ahmad, Jamshed; Nawaz, Seema

    2015-01-01

    Due to the increase in morbidity and mortality rate, cancer has become an alarming threat to the human population worldwide. Since cancer is a progressive disorder, timely diagnosis would be helpful to prevent/stop cancer from progressing to severe stage. In Khyber Pakhtunkhwa, Pakistan, most of the time, tumors are diagnosed with endoscopy and biopsy; therefore rare studies exist regarding the diagnosis of gastrointestinal (GIT) carcinomas based on tumor markers, especially CEA. This study made a comparative analysis of CEA in admitted hospitalized stomach and colon cancer patients diagnosed as GIT with biopsy. In this study, a total of 66 cases were included. The level of CEA was determined in the blood of these patients using ELISA technique. Out of 66 patients, the level of CEA was high in 59.1% of the total, 60.7% in colon cancer patients and 57.9 % in stomach cancer patients. Moreover, the incidence of colorectal and stomach cancer was greater in males as compared to females. Patients were more of the age group of 40- 60 and the level of CEA was comparatively higher in patients (51.5%) with histology which was moderately differentiated, than patients with well differentiated and poorly differentiated tumor histology. CEA level was high in more than 50% of the total patients. Moreover, CEA exhibited higher sensitivity for colon than stomach cancer.

  9. Study on absorbance and laser damage threshold of HfO2 films prepared by ion-assisted reaction deposition

    Institute of Scientific and Technical Information of China (English)

    Dawei Zhang(张大伟); Shuhai Fan(范树海); Weidong Gao(高卫东); Hongbo He(贺洪波); Yingjian Wang(王英剑); Jianda Shao(邵建达); Zhengxiu Fan(范正修); Haojie Sun(孙浩杰)

    2004-01-01

    Using a new kind of EH1000 ion source, hafnium dioxide (HfO2) films are deposited with different deposition techniques and different conditions. The absorbance and the laser damage threshold of these films have been measured and studied. By comparing these characteristics, one can conclude that under right conditions, such as high partial pressure of oxygen and right kind of ion source, the ion-assisted reaction deposition can prepare HfO2 films with higher laser induced damage threshold.

  10. Rationale and design of MinerAlocorticoid Receptor antagonist Tolerability Study-Heart Failure (ARTS-HF)

    DEFF Research Database (Denmark)

    Pitt, Bertram; Anker, Stefan D; Böhm, Michael

    2015-01-01

    2 diabetes mellitus and/or chronic kidney disease (CKD) will be randomized within 7 days of emergency presentation to hospital for worsening chronic HF to receive finerenone (one of five doses in the range 2.5-20.0 mg once daily) or eplerenone (25 mg every second day to 50 mg once daily for 90 days...... with eplerenone. Other objectives are to assess the effects of finerenone on a composite clinical endpoint (death from any cause, cardiovascular hospitalizations, or emergency presentations for worsening chronic HF), and on changes in health-related quality of life from baseline. CONCLUSIONS: ARTS-HF is the first...... phase 2b clinical trial to investigate the effects of finerenone on plasma NT-proBNP in a high-risk population of patients who have worsening chronic HF with type 2 diabetes mellitus and/or CKD presenting at the emergency department....

  11. How Physicians, Patients, and Observers Compare on the Use of Qualitative and Quantitative Measures of Physician-Patient Communication.

    Science.gov (United States)

    Gordon, Howard S; Street, Richard L

    2016-12-01

    The purpose of this study was to compare several different measures of physician-patient communication. We compared data derived from different measures of three communication behaviors, patient participation, physician information giving, and physician participatory decision-making (PDM) style, from 83 outpatient visits to oncology or thoracic surgery clinics for pulmonary nodules or lung cancer. Communication was measured with rating scales completed by patients and physicians after the consultation and by two different groups of external observers who used rating scales or coded the frequency of communication behaviors, respectively, after listening to an audio recording of the consultation. Measures were compared using Pearson's correlations. Correlations of patients' and physicians' ratings of patient participation (r = .04) and physician PDM style (r = .03) were low and not significant (p > .0083, Bonferroni-adjusted). Correlations of observers' ratings with patients' or physicians' ratings for patient participation and physician PDM style were moderate or low (r = .15, .27, .07, and .01, respectively) but were not statistically significant (p > .0083, Bonferroni-adjusted). Correlations between observers' ratings and frequency measures were .31, .52, and .63 and were statistically significant with p values .005, observers' ratings as an alternate measure of communication to more labor intensive frequency measures.

  12. High-temperature grain size stabilization of nanocrystalline Fe–Cr alloys with Hf additions

    Energy Technology Data Exchange (ETDEWEB)

    Li, Lulu, E-mail: lli18@ncsu.edu; Saber, Mostafa; Xu, Weizong; Zhu, Yuntian; Koch, Carl C.; Scattergood, Ronald O.

    2014-09-08

    The influence of 1–4 at% Hf additions on the thermal stability of mechanically alloyed nanocrystalline Fe–14Cr alloys was studied in this work. XRD-calculated grain size and microhardness results were reported versus isochronal annealing treatments up to 1100 °C. Microstructural evolution was investigated using channeling contrast FIB imaging and TEM. Grain size of samples with 4 at% Hf was found to be maintained in the nanoscale range at temperatures up to 1000 °C. Zener pinning was considered as a major source of high temperature grain size stabilization. By comparing the Orowan strengthening contribution to the total hardness, the deviation of grain size predictions from the actual grain size in Fe–14Cr–4Hf suggests the presence of thermodynamic stabilization by the solute segregation to grain boundaries (GBs). A predictive thermodynamic model indicates that the thermodynamic stabilization can be expected.

  13. PNO-CEPA and MCSCF-SCEP calculations of transition probabilities in OH, HF + , and HCl +

    Science.gov (United States)

    Werner, Hans-Joachim; Rosmus, Pavel; Schätzl, Wolfgang; Meyer, Wilfried

    1984-01-01

    Electronic transition moment functions for the A 2Σ+-X2Π transitions in OH, HF+, and HCl+ have been calculated using RHF, PNO-CI, PNO-CEPA, MCSCF, and MCSCF-SCEP wave functions. The vibrational band transition probabilities are obtained, and the resulting radiative lifetimes are compared with measured values. For OH and HCl+ the deviations are smaller than 10%, but the theoretical lifetimes for HF+ are larger by about 300% than the experimental values. For the electronic ground states of HF+ and HCl+ vibrational transition probabilities have been calculated from MCSCF-SCEP dipole moment functions. Both ions are predicted to be excellent absorbers and emitters in the infrared spectral region.

  14. Structural and dielectric properties of amorphous ZrO2 and HfO2

    Science.gov (United States)

    Ceresoli, Davide; Vanderbilt, David

    2006-09-01

    Zirconia (ZrO2) and hafnia (HfO2) are leading candidates for replacing SiO2 as the gate insulator in complementary metal-oxide semiconductor technology. Amorphous versions of these materials ( a-ZrO2 and a-HfO2 ) can be grown as metastable phases on top of a silicon buffer; while they tend to recrystallize during subsequent annealing steps, they would otherwise be of considerable interest because of the promise they hold for improved uniformity and electrical passivity. In this work, we report our theoretical studies of a-ZrO2 and a-HfO2 by first-principles density-functional methods. We construct realistic amorphous models using the “activation-relaxation” technique of Barkema and Mousseau. The structural, vibrational, and dielectric properties of the resulting models are analyzed in detail. The overall average dielectric constant is computed and found to be comparable to that of the monoclinic phase.

  15. Numerical modeling of HF skywave radiation from antennas in irregular terrain

    Energy Technology Data Exchange (ETDEWEB)

    Burke, G.J.

    1990-11-01

    The problem of computing the radiation pattern of an HF antenna sited in irregular terrain was investigated. The primary interest is in antennas for skywave communication, however ionospheric models were not considered. Several methods for modeling terrain effects are briefly reviewed. A geometrical optics model for arbitrary terrain is developed and results are compared with published results from solution of a Volterra integral equation for scattering by a Gaussian ridge. This report covers work on the first phase of a project for the US Navy to develop and apply models for terrain effects in HF communications involving skywave. 45 refs., 16 figs.

  16. Vacancy induced metallicity at the CaHfO3/SrTiO3 interface

    KAUST Repository

    Nazir, Safdar

    2011-03-31

    Density functional theory is used to study the electronic properties of the oxide heterointerfaceCaHfO3/SrTiO3. Structural relaxation is carried out with and without O vacancies. As compared to related interfaces, strongly reduced octahedral distortions are found. Stoichiometric interfaces between the wide band gap insulatorsCaHfO3 and SrTiO3 turn out to exhibit an insulating state. However, interface metallicity is introduced by O vacancies, in agreement with experiment. The reduced octahedral distortions and necessity of O deficiency indicate a less complicated mechanism for the creation of the interfacial electron gas.

  17. Hydrogen doping in HfO{sub 2} resistance change random access memory

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, D.; Magyari-Köpe, B.; Nishi, Y. [Department of Electrical Engineering, Stanford University, Stanford, California 94305 (United States)

    2016-01-25

    The structures and energies of hydrogen-doped monoclinic hafnium dioxide were calculated using density-functional theory. The electronic interactions are described within the LDA + U formalism, where on-site Coulomb corrections are applied to the 5d orbital electrons of Hf atoms and 2p orbital electrons of the O atoms. The effects of charge state, defect-defect interactions, and hydrogenation are investigated and compared with experiment. It is found that hydrogenation of HfO{sub 2} resistance-change random access memory devices energetically stabilizes the formation of oxygen vacancies and conductive vacancy filaments through multiple mechanisms, leading to improved switching characteristic and device yield.

  18. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    DEFF Research Database (Denmark)

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    : To investigate whether uterine artery embolization generates a reduced inflammatory response as compared with conventional hysterectomy. MATERIAL AND METHODS: 40 women, 20 in each group, entered this prospective, non-randomized study. The two groups were comparable concerning age, comorbidity, and body......-mass index (BMI). RESULTS: We found a significant difference between the inflammatory responses in women undergoing embolization compared with the inflammatory response in women having an abdominal hysterectomy. Women undergoing embolization were subjected to a much smaller inflammatory burden, their total...... morphine consumption was lower, and their return to work was faster than women subjected to conventional hysterectomy. CONCLUSION: Uterine artery embolization generates a reduced inflammatory response compared with conventional hysterectomy....

  19. Cognitive emotion regulation strategies in patients with functional dyspepsia and healthy controls - A comparative study.

    Science.gov (United States)

    Mazaheri, Mina; Afshar, Hamid; Nikneshan, Shekoufeh; Adibi, Peyman

    2016-01-01

    Patients with functional dyspepsia (FD) may use specific coping strategies. Hence, the aim of the present study was to compare cognitive emotion regulation strategies in FD patients and healthy controls. This was a descriptive observational study. The sample consisted of 86 individuals, 43 of whom were patients diagnosed with FD. The patients referred to the psychosomatic disorders clinic, Isfahan, Iran. The comparative sample included 43 healthy controls (without digestive diagnoses) matched with the patients by age and gender. Subjects completed data on demographic factors and cognitive emotion regulation questionnaire. The results indicated that there are significant differences between patients with FD and healthy controls according to using cognitive strategies. Scores of healthy controls in positive reappraisal and acceptance were significantly more than FD patients, and inversely, scores of FD patients in rumination and other-blame were meaningfully more than healthy controls. FD patients apply less adaptive strategies and more maladaptive strategies. It is seemed psychological interventions that focus on reducing maladaptive strategies and increasing adaptive strategies could be effective for FD patients.

  20. Pilot program to improve self-management of patients with heart failure by redesigning care coordination.

    Science.gov (United States)

    Shaw, Jessica D; O'Neal, Daniel J; Siddharthan, Kris; Neugaard, Britta I

    2014-01-01

    Objectives. We tested both an educational and a care coordination element of health care to examine if better disease-specific knowledge leads to successful self-management of heart failure (HF). Background. The high utilization of health care resources and poor patient outcomes associated with HF justify tests of change to improve self-management of HF. Methods. This prospective study tested two components of the Chronic Care Model (clinical information systems and self-management support) to improve outcomes in the self-management of HF among patients who received intensive education and care coordination during their acute care stay. A postdischarge follow-up phone call assessed their knowledge of HF self-management compared to usual care patients. Results. There were 20 patients each in the intervention and usual care groups. Intervention patients were more likely to have a scale at home, write down their weight, and practice new or different health behaviors. Conclusion. Patients receiving more intensive education knew more about their disease and were better able to self-manage their weight compared to patients receiving standard care.

  1. Benefits of monitoring patients with mobile cardiac telemetry (MCT) compared with the Event or Holter monitors.

    Science.gov (United States)

    Tsang, Jean-Patrick; Mohan, Shunmugam

    2013-01-01

    This research is meant to establish if a patient monitored with mobile cardiac telemetry (MCT) sees different outcomes regarding diagnostic yield of arrhythmia, therapeutic management through the use of antiarrhythmic drugs, and cardiovascular costs incurred in the hospital setting when compared with more traditional monitoring devices, such as the Holter or the Event monitor. We conducted a retrospective analysis spanning 57 months of claims data from January 2007 to September 2011 pertaining to 200,000+ patients, of whom 14,000 used MCT only, 54,000 an Event monitor only, and 163,000 a Holter monitor only. Those claims came from the Truven database, an employer database that counts 2.8 million cardiovascular patients from an insured population of about 10 million members. We employed a pair-wise pre/post test-control methodology, and ensured that control patients were similar to test patients along the following dimensions: age, geographic location, type of cardiovascular diagnosis both in the inpatient and outpatient settings, and the cardiovascular drug class the patient uses. First, the diagnostic yield of patients monitored with MCT is 61%, that is significantly higher than that of patients that use the Event monitor (23%) or the Holter monitor (24%). Second, patients naive to antiarrhythmic drugs initiate drug therapy after monitoring at the following rates: 61% for patients that use MCT compared with 39% for patients that use the Event and 43% for patients that use the Holter. Third, there are very significant inpatient cardiovascular savings (in the tens of thousands of dollars) for patients that undergo ablation, coronary artery bypass graft (CABG) and valve septa. Savings are more modest but nonetheless significant when it comes to the heart/pericardium procedure. Given the superior outcome of MCT regarding both patient care and hospital savings, hospitals only stand to gain by enforcing protocols that favor the MCT system over the Event or the Holter

  2. Increased p-cresyl sulfate level is independently associated with poor outcomes in patients with heart failure.

    Science.gov (United States)

    Wang, Chao-Hung; Cheng, Mei-Ling; Liu, Min-Hui; Shiao, Ming-Shi; Hsu, Kuang-Hung; Huang, Yu-Yen; Lin, Cheng-Cheng; Lin, Jui-Fen

    2016-07-01

    Amino acid-derived metabolites, including protein-bound uremic toxins, may have prognostic value for patients with heart failure (HF). The aim of this study was to investigate whether p-cresyl sulfate (PCS), indoxyl sulfate (IS), and arginine metabolites provided prognostic values in addition to the traditional biomarker, B-type natriuretic peptide (BNP), in patients with HF. Chromatography mass spectrometry was performed to measure tyrosine, tryptophan, arginine, PCS, IS, and asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in the plasma from 51 normal controls and 136 HF patients. Compared to the normal controls, PCS levels significantly increased in HF patients (p = 0.003). During the follow-up (2.3 ± 1.1 years), 35 (25.7 %) patients experienced a composite event of death or HF-related re-hospitalization. In univariable analysis, PCS, estimated glomerular filtration rate (eGFR), BNP, DMA/arginine ratio, and ADMA/arginine ratio were associated with a higher rate of composite events. In the multivariable analysis, PCS was the only independent predictor of composite events [hazard ratio (HR) 1.06 (per 10 μM), 95 % confidence interval (CI) 1.01-1.11, p = 0.02]. Kaplan-Meier curves showed that a PCS level of ≥50 μM was significantly associated with a higher composite event rate than those with a PCS level of <50 μM (Log rank = 5.11, p = 0.024; HR 2.13, 95 % CI 1.09-4.16, p = 0.02). In conclusion, among protein-bound uremic toxins, eGFR, and DMA metabolites, increased PCS is the only independent predictor of HF-related events in patients with HF. A combination of PCS and BNP should better risk-stratify patients with HF.

  3. Comparative characteristics of primary hyperparathyroidism in pediatric and young adult patients.

    Science.gov (United States)

    Nicholson, Kristina J; McCoy, Kelly L; Witchel, Selma F; Stang, Michael T; Carty, Sally E; Yip, Linwah

    2016-10-01

    Primary hyperparathyroidism is rare in pediatric patients. Our study aim was to compare primary hyperparathyroidism in pediatric (pediatric and 87 young adult patients. Presenting symptoms, operative data, and postoperative course were compared for patients age 0-19 years and 20-29 years. Sporadic primary hyperparathyroidism was present in 81.7% and occurred less often in pediatric patients than young adult patients (74.4% vs 86.2%, P = .12). Among patients with hereditary primary hyperparathyroidism, multiple endocrine neoplasia type 1 was the most common type. Multiglandular disease was common in both pediatric (30.7%) and young adult (21.8%) patients. Following parathyroidectomy, 3 (2.3%) patients had permanent hypoparathyroidism and none had permanent recurrent laryngeal nerve paralysis. Biochemical cure at 6 months was equally likely in pediatric and young adult patients (97.1% vs 93.6%, P = .44) with comparable follow-up (78.4 months vs 69.1 months, P = .66) and rates of recurrent disease (5.9% vs 10.3%, P = .46). Recurrence was due to multiple endocrine neoplasia 1-related primary hyperparathyroidism in all cases. Although primary hyperparathyroidism is sporadic in most patients multiple endocrine neoplasia type 1-associated primary hyperparathyroidism (23%). Parathyroidectomy for primary hyperparathyroidism can be performed safely in pediatric patients with a high rate of cure. Follow-up for patients with hereditary disease is necessary. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Bridging the gap: how traditional healers interact with their patients. A comparative study in Cameroon.

    NARCIS (Netherlands)

    Labhardt, N.D.; Aboa, S.M.; Manga, E.; Bensing, J.M.; Langewitz, W.

    2010-01-01

    Objective: To compare traditional healers (TH) and Cameroonian representatives of Western medicine (Western providers (WP)) in terms of patient characteristics and communication patterns during the consultation in rural Cameroon. Methods: A facility-based comparative study was conducted. Seven TH we

  5. Relationship between disease activity and hearing impairment in patients with rheumatoid arthritis compared with controls.

    Science.gov (United States)

    Yildirim, Adem; Surucu, Gulseren; Dogan, Sedat; Karabiber, Mehmet

    2016-02-01

    The characteristics of hearing impairment (HI) in rheumatoid arthritis (RA) are still poorly understood, and their association with disease activity is based on conflicting information. This study compared HI between RA patients and controls and between active and remission RA groups using multi-frequency audiometry. This study enrolled 88 RA patients and 50 controls. The pure-tone hearing thresholds at 500 to 4000 Hz for air (AC) and bone (BC) conduction were compared between RA and controls as well as between active and remission RA patients using DAS28-CRP scores. The pure-tone hearing thresholds for AC and BC were significantly higher at high frequencies (2000 and 4000 Hz) in the RA group for both ears compared with controls. In addition, the BC threshold at 1000 Hz for the right ear was higher in the RA group than controls. When active and remission RA patients were compared, the thresholds were higher only at 4000 Hz for both ears for AC and BC in patients with active RA. The air-bone gap differed significantly at 2000 and 4000 Hz in both ears. This study demonstrated that patients with RA have a heightened risk of HI, and disease activity increases this risk, particularly at high frequencies. Clinicians who manage RA should be aware of HI and consider performing audiological evaluations in RA patients with active disease in particular.

  6. Comparing cognitive and somatic symptoms of depression in myocardial infarction patients and depressed patients in primary and mental health care.

    Directory of Open Access Journals (Sweden)

    Nynke A Groenewold

    Full Text Available Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in myocardial infarction patients. We hypothesized that myocardial infarction patients with first depression onset at a late age would experience fewer cognitive/affective symptoms than depressed patients without cardiovascular disease. Combined data from two large multicenter depression studies resulted in a sample of 734 depressed individuals (194 myocardial infarction, 214 primary care, and 326 mental health care patients. A structured clinical interview provided information about depression diagnosis. Summed cognitive/affective and somatic symptom levels were compared between groups using analysis of covariance, with and without adjusting for the effects of recurrence and age of onset. Depressed myocardial infarction and primary care patients reported significantly lower cognitive/affective symptom levels than mental health care patients (F (2,682 = 6.043, p = 0.003. Additional analyses showed that the difference between myocardial infarction and mental health care patients disappeared after adjusting for age of onset but not recurrence of depression. These group differences were also supported by data-driven latent class analyses. There were no significant group differences in somatic symptom levels. Depression after myocardial infarction appears to have a different phenomenology than depression observed in mental health care. Future studies should investigate the etiological factors predictive of symptom dimensions in myocardial infarction and late-onset depression patients.

  7. Impact of Dual Task on Parkinson's Disease, Stroke and Ataxia Patients' Gait: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Michelly Arjona Maciel

    2014-01-01

    Full Text Available Introduction: Performing dual task for neurological patients is complex and it can be influenced by the localization of the neurological lesion. Objective: Comparing the impact of dual task on gait in patients with Parkinson's disease, stroke and ataxia. Method: Subjects with Parkinson's disease (PD in initial phase, stroke and ataxia, with independent gait, were evaluated while doing simple gait, with cognitive, motor and cognitive-motor gait demand, assessing average speed and number of steps. Results: Ataxia and stroke patients, compared with PD, showed an increase in the number of steps and decrease the average speed on the march with cognitive demand. Subjects with PD performed better on tasks when compared to others. Conclusion: In this study the impact of dual task was lower in Parkinson's disease patients.

  8. Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis:A comparative study

    Institute of Scientific and Technical Information of China (English)

    Ioan; Sporea; Roxana; Sirli; Alexandra; Deleanu; Adriana; Tudora; Alina; Popescu; Manuela; Curescu; Simona; Bota

    2010-01-01

    AIM:To assess the values of liver stiffness (LS) in pa-tients with hepatitis B virus (HBV) chronic hepatitis and to compare them with those in patients with hepatitis C virus (HCV) chronic hepatitis. METHODS: The study included 140 patients with HBV chronic hepatitis, and 317 patients with HCV chronic hepatitis, in which LS was measured (FibroScan-Echo-sens) and liver biopsy was performed in the same session (assessed according to the Metavir score). RESULTS:According to the Metavir score of the 140 HBV p...

  9. Detection heart failures (HF) biomarkers by proton transfer reaction - mass spectrometry and ion mobility spectrometry

    Science.gov (United States)

    Shaltaeva, Y. R.; Vasilev, V. K.; Yakovlev, D. Y.; Kopylov, F. Iu; Syrkin, A. L.; Chomakhidze, P. Sh; Bykova, A. A.; Malinovskaya, L. K.; Skorokhod, A. I.

    2016-10-01

    Exhaled breath contains 1% of volatile organic compounds. The concentration of individual biomarkers in hundreds of volatile organic compounds lies within the range ppm- ppb. In compare with control group the concentrations of acetone, acetic acid, ethanol, propylene biomarkers is significantly higher in HF-PEF group.

  10. Quality of life in elderly heart failure patients

    Institute of Scientific and Technical Information of China (English)

    Kathleen L. Grady; Kathleen Halvey

    2006-01-01

    Quality of life (QOL), as a relevant area of research in the understanding of heart failure (HF) patient outcomes, has been increasingly studied during the last two decades. The purposes of this review article are to (1) describe QOL in older adults with HF, (2)identify and critique research designed to test interventions to improve QOL, (3) identify gaps in the literature, and (4) provide recommendations for future research. Seventeen studies describing QOL in older adults with HF were identified. Elderly HF patient QOL has been reported to be fair to poor and is worse as compared to a healthy control group. Furthermore, there is some evidence that suggests that QOL is better in older adults than younger adults and worse in women (both older and younger) than in men, although these findings are not consistent across studies. Predictors of QOL and its dimensions in older HF patients included demographic, clinical, and psychosocial variables. Sixteen interventional studies were identified that reported QOL as an outcome in older adults. Findings among randomized clinical trials (RCTs) to improve QOL outcomes in elderly HF patients do not allow strong conclusions about the benefits of the interventions. It must be noted, though, that while not all studies reported improvements in QOL (either significant or as a trend),no studies reported deterioration in QOL with randomization to an intervention versus control. These studies were limited by several methodological issues. While there has been some research of QOL in this elderly cohort, it is paramount that we address methodological issues and thereby improve the scientific rigor of our research, continue to explore QOL in elderly HF patients, and design intervention trials for elders at risk for poor QOL.

  11. Ten Years of Abstinence in Former Opiate Addicts: Medication-Free Non-Patients Compared to Methadone Maintenance Patients.

    Science.gov (United States)

    Peles, Einat; Sason, Anat; Tene, Oren; Domany, Yoav; Schreiber, Shaul; Adelson, Miriam

    2015-01-01

    Fifty-five former opioid addicts who have been methadone maintained patients for 10 or more years and whose urine has tested negative for drugs for 2 or more years were compared to 99 former opioid addicts who have been medication-free for 10 or more years. Groups were comparable in age and education, but the medication-free subjects were younger when having started opioids with more severe addiction scores. Methadone maintained patients presented with a higher proportion of psychiatric comorbidity and chronic pain. Their scores of perceived sleep quality and cognitive state were poorer than the medication-free individuals. Possible explanations of the differences are discussed in this article.

  12. Subjective symptoms in euthymic bipolar disorder and remitted schizophrenia patients: A comparative study

    Directory of Open Access Journals (Sweden)

    Manish Kumar

    2016-01-01

    Full Text Available Background: Subjective experience means subtle, not yet psychotic abnormalities of experience that might be present during remitted phase and also in prodromal phase of schizophrenia and might be accurately efficient in identifying individuals at risk of eminent psychosis (Parnas et al., 2003. Apart from schizophrenic patients, bipolar patients also experience certain subjective symptoms in their euthymic state. They often experience subtle cognitive impairment and functional disturbances during their euthymic states. These subjective experiences may be related to distorted cognitive functions in these patients. These experiences include a great variety of cognitive dysfunction complaints about attention, perception, memory, thinking, language, movement, and emotion. Objective: To measure the experience of subjective symptoms and compare them between euthymic bipolar and remitted schizophrenia patients. Materials and Methods: Thirty euthymic bipolar patients and 30 remitted schizophrenia patients as per International Classification of Diseases Tenth Revision were selected for the purpose of the study. At first, sociodemographic data were collected. And then, the patients were assessed using the scales; positive and negative syndrome scale, Young Mania Rating Scale, Hamilton Depression Rating Scale, Symptom Checklist-90-Revised, and Frankfurt Complaint Questionnaire-24. Results: Both the groups showed significant differences in terms of subjective symptoms. However, no significant correlation has been found between the objective psychopathology and subjective experience in the two groups. Conclusion: It can be suggested that the patients with schizophrenia show significantly higher subjective experience when compared with the patients of bipolar disorder.

  13. Comparative study of impact of hemodialysis and renal transplantation on cognitive functions in ESRD patients.

    Science.gov (United States)

    Anwar, Waleed; Ezzat, Haitham; Mohab, Amr

    2015-01-01

    Cognitive impairment is defined as a newly appeared deficit in at least two areas of cognitive functions, including disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. Cognitive impairment is highly prevalent in ESRD patients when compared with the general population. It has also been associated with a decreased quality of life. Cognitive functions in patients with ESRD showed improvement with dialysis and renal transplantation. These findings illustrate the potential importance of evaluating and comparing the effects of hemodialysis and transplantation regarding cognitive performance and thus quality of life in ESRD patients and normal subjects. This study was carried out in 100 patients (50 ESRD patients on regular hemodialysis for at least 6 months and 50 post-transplant patients who had maintained successful kidney graft for at least 3 months). All patients underwent laboratory and psychometric scoring tests, including trail making test part A, trail making test part B, digit span, and mini-mental state examination. Thirty healthy adults matched by age and sex served as a control group. The results showed significant differences in cognitive function tests results between transplant and hemodialysis patients (P0.05). Renal transplantation as a modality of treatment, in ESRD patients, is superior to hemodialysis in terms of cognitive performance improvement. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  14. Role of Soluble ST2 as a Prognostic Marker in Patients with Acute Heart Failure and Renal Insufficiency.

    Science.gov (United States)

    Kim, Min-Seok; Jeong, Tae-Dong; Han, Seung-Bong; Min, Won-Ki; Kim, Jae-Joong

    2015-05-01

    This study sought to assess the relationship between serum concentrations of the soluble ST2 (sST2) and B-type natriuretic peptide (BNP) and investigate the role of sST2 as a prognosticator in patients hospitalized with acute heart failure (HF) and renal insufficiency. sST2 was measured at admission and discharge in 66 patients hospitalized with acute decompensated HF and renal insufficiency (estimated glomerular filtration rate [eGFR] renal insufficiency (eGFR renal function, even though BNP level was much higher in patients with severe renal insufficiency. During 3 month follow-up, 9 (13.6%) died and 16 (24.2%) were readmitted due to HF aggravation.On multivariate analysis, sST2 at discharge was independently associated with death or HF readmission during 3 months after discharge (hazard ratio, 1.038; 95% confidence interval, 1.011-1.066, P = 0.006). In conclusion, sST2 is not affected by renal function compared with BNP in acute HF patients. The measurement of predischarge sST2 can be helpful in predicting short-term outcomes in acute decompensated HF patients with renal insufficiency.

  15. Heart failure patients demonstrate impaired changes in brachial artery blood flow and shear rate pattern during moderate-intensity cycle exercise.

    Science.gov (United States)

    Benda, Nathalie M M; Seeger, Joost P H; van Lier, Dirk P T; Bellersen, Louise; van Dijk, Arie P J; Hopman, Maria T E; Thijssen, Dick H J

    2015-04-01

    What is the central question of this study? We explored whether heart failure (HF) patients demonstrate different exercise-induced brachial artery shear rate patterns compared with control subjects. What is the main finding and its importance? Moderate-intensity cycle exercise in HF patients is associated with an attenuated increase in brachial artery anterograde and mean shear rate and skin temperature. Differences between HF patients and control subjects cannot be explained fully by differences in workload. HF patients demonstrate a less favourable shear rate pattern during cycle exercise compared with control subjects. Repeated elevations in shear rate (SR) in conduit arteries, which occur during exercise, represent a key stimulus to improve vascular function. We explored whether heart failure (HF) patients demonstrate distinct changes in SR in response to moderate-intensity cycle exercise compared with healthy control subjects. We examined brachial artery SR during 40 min of cycle exercise at a work rate equivalent to 65% peak oxygen uptake in 14 HF patients (65 ± 7 years old, 13 men and one woman) and 14 control subjects (61 ± 5 years old, 12 men and two women). Brachial artery diameter, SR and oscillatory shear index (OSI) were assessed using ultrasound at baseline and during exercise. The HF patients demonstrated an attenuated increase in mean and anterograde brachial artery SR during exercise compared with control subjects (time × group interaction, P = 0.003 and P exercise and remained increased throughout the exercise period in both groups (time × group interaction, P = 0.11). In control subjects, the immediate increase in OSI during exercise (time, P exercise did not normalize in HF patients (time × group interaction, P = 0.029). Subgroup analysis of five HF patients and five control subjects with comparable workload (97 ± 13 versus 90 ± 22 W, P = 0.59) confirmed the presence of distinct changes in mean SR during exercise (time × group

  16. Welfare costs in patients with rheumatoid arthritis and their partners compared with matched controls

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2017-01-01

    subjects, i.e., treatment (€346 vs. €211), hospitalization (€1261 vs. €778), and medication use (€654 vs. €393). The costs associated with the patients were present 11 years before diagnosis of RA (€1592) compared with control subjects (€1172). Furthermore, income from employment was lower for patients...... (€14,023) than for control subjects (€17,196). Being a partner to a patient with RA was associated with high total welfare costs. This register-based study shows that RA has significant welfare costs for patients, their partners, and society. The differences in total health costs exist up to 11 years......Rheumatoid arthritis (RA) is a chronic autoimmune disease with significant morbidity, mortality, and costs for the individual patient and for society. The purpose of this study was to examine welfare costs in patients with RA including their partners before and after initial diagnosis. Data were...

  17. HF-enhanced 4278-Å airglow: evidence of accelerated ionosphere electrons?

    Science.gov (United States)

    Fallen, C. T.; Watkins, B. J.

    2013-12-01

    We report calculations from a one-dimensional physics-based self-consistent ionosphere model (SCIM) demonstrating that HF-heating of F-region electrons can produce 4278-Å airglow enhancements comparable in magnitude to those reported during ionosphere HF modification experiments at the High-frequency Active Auroral Research Program (HAARP) observatory in Alaska. These artificial 'blue-line' emissions, also observed at the EISCAT ionosphere heating facility in Norway, have been attributed to arise solely from additional production of N2+ ions through impact ionization of N2 molecules by HF-accelerated electrons. Each N2+ ion produced by impact ionization or photoionization has a probability of being created in the N2+(1N) excited state, resulting in a blue-line emission from the allowed transition to its ground state. The ionization potential of N2 exceeds 18 eV, so enhanced impact ionization of N2 implies that significant electron acceleration processes occur in the HF-modified ionosphere. Further, because of the fast N2+ emission time, measurements of 4278-Å intensity during ionosphere HF modification experiments at HAARP have also been used to estimate artificial ionization rates. To the best of our knowledge, all observations of HF-enhanced blue-line emissions have been made during twilight conditions when resonant scattering of sunlight by N2+ ions is a significant source of 4278-Å airglow. Our model calculations show that F-region electron heating by powerful O-mode HF waves transmitted from HAARP is sufficient to increase N2+ ion densities above the shadow height through temperature-enhanced ambipolar diffusion and temperature-suppressed ion recombination. Resonant scattering from the modified sunlit region can cause a 10-20 R increase in 4278-Å airglow intensity, comparable in magnitude to artificial emissions measured during ionosphere HF-modification experiments. This thermally-induced artificial 4278-Å aurora occurs independently of any artificial

  18. Neurological soft signs in euthymic bipolar I patients: A comparative study with healthy siblings and controls.

    Science.gov (United States)

    Mrad, Amel; Wassim Krir, Mohamed; Ajmi, Inès; Gaha, Lotfi; Mechri, Anwar

    2016-02-28

    Neurological Soft Signs (NSS) are endophenotypic markers widely studied in schizophrenia and remain poorly evaluated in bipolar disorder. The aims of this paper were to determine the prevalence and scores of NSS in bipolar I patients, compared to healthy siblings and controls and to explore correlations with socio-demographic and clinical features of patients. This was a case-control study comparing 92 euthymic bipolar I patients, 44 of their healthy siblings and 60 control subjects. The neurological assessment was performed through the NSS scale validated by Krebs et al. (2000). Bipolar I patients were also assessed with the Bech-Rafaelsen Mania Scale (MAS), the Hamilton Depression Rating Scale (HDRS) and the Global Assessment of Functioning (GAF). The raters were not blinded to groups. The prevalence and the total score of NSS were significantly higher in bipolar I patients compared to their healthy siblings and controls. The sibling group had significantly higher NSS prevalence and total score than controls. No correlation was found between NSS total score and socio-demographic and clinical features of patients, except a negative correlation with the school level and the GAF score. In conclusion, bipolar I patients have motor and sensory signs, which are unrelated to their clinical features.

  19. Improvements on Signal Processing for HF Radar

    Institute of Scientific and Technical Information of China (English)

    LIU Yongtan; SHEN Yiying

    2001-01-01

    In this paper improvements on signalprocessing are achieved to enhance the performancesof H-F radar system, being unobtainable by the con-ventional signal processing. Using the improved sig-nal processing both high range resolution and longcoherent integration time may be obtained for goodbenefit to the target resolution and weak signal de-tection. Modification to the unmatched correspon-dence between range delay samples and range resolu-tion ceils saves an additional accumulation loss in therange processing. Finally, comparisons between theimproved and the conventional signal processing aregiven by numerical simulation.

  20. Empowerment in intensive care: patient experiences compared to next of kin and staff beliefs.

    Science.gov (United States)

    Wåhlin, Ingrid; Ek, Anna-Christina; Idvall, Ewa

    2009-12-01

    Experiences of critically ill patients are an important aspect of the quality of care in intensive care units. If next of kin and staff try to empower the patient, this is probably performed in accordance with their beliefs about what patients experience as empowering. As intensive care patients often have difficulties communicating, staff and next of kin need to interpret their wishes, but there is limited knowledge about how correct picture next of kin and staff have of the intensive care patient's experiences. The aim of this study was to compare intensive care patients' experiences of empowerment with next of kin and staff beliefs. Interviews with 11 intensive care patients, 12 next of kin and 12 staff were conducted and analysed using a content analysis method. The findings showed that the main content is quite similar between patient experiences, next of kin beliefs and staff beliefs, but a number of important differences were identified. Some of these differences were regarding how joy of life and the will to fight were generated, the character of relationships, teamwork, humour, hope and spiritual experiences. Staff and next of kin seemed to regard the patient as more unconscious than the patient him/herself did.

  1. Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

    Directory of Open Access Journals (Sweden)

    Bodlaj Gert

    2012-03-01

    Full Text Available Abstract In rare cases (1-8% diabetic patients with end-stage renal disease (ESRD suffer from diabetic nephropathy (dNP due to pancreatic diabetes mellitus (PDM. Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD in our dialysis centre (1997-2005. In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m2 was lower (22 + 3 versus 25 + 3, and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

  2. Burn, freeze, or photo-ablate?: comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation

    Science.gov (United States)

    Gill, Kanwar Rupinder S.; Gross, Seth A.; Greenwald, Bruce D.; Hemminger, Lois L.; Wolfsen, Herbert C.

    2009-06-01

    Background: There are few data available comparing endoscopic ablation methods for Barrett's esophagus with high-grade dysplasia (BE-HGD). Objective: To determine differences in symptoms and complications associated with endoscopic ablation. Design: Prospective observational study. Setting: Two tertiary care centers in USA. Patients: Consecutive patients with BE-HGD Interventions: In this pilot study, symptoms profile data were collected for BE-HGD patients among 3 endoscopic ablation methods: porfimer sodium photodynamic therapy, radiofrequency ablation and low-pressure liquid nitrogen spray cryotherapy. Main Outcome Measurements: Symptom profiles and complications from the procedures were assessed 1-8 weeks after treatment. Results: Ten BE-HGD patients were treated with each ablation modality (30 patients total; 25 men, median age: 69 years (range 53-81). All procedures were performed in the clinic setting and none required subsequent hospitalization. The most common symptoms among all therapies were chest pain, dysphagia and odynophagia. More patients (n=8) in the porfimer sodium photodynamic therapy group reported weight loss compared to radio-frequency ablactation (n=2) and cryotherapy (n=0). Four patients in the porfimer sodium photodynamic therapy group developed phototoxicity requiring medical treatment. Strictures, each requiring a single dilation, were found in radiofrequency ablactation (n=1) and porfimer sodium photodynamic therapy (n=2) patients. Limitations: Small sample size, non-randomized study. Conclusions: These three endoscopic therapies are associated with different types and severity of post-ablation symptoms and complications.

  3. A Comparative Study of Stressful Life Events and Stress Coping Strategies in Coronary Heart Disease Patients and Non-Patients

    Directory of Open Access Journals (Sweden)

    A. Heidari Pahlavian

    2010-10-01

    Full Text Available Introduction & Objective: Etiological researches suggest that biopsychosocial dimensions are responsible for coronary heart disease (CHD. The main goal of the present research was to compare stressful life events and stress coping strategies in coronary heart patients (Acute Myocardial Infarction and non-patients. Materials & Methods: In this cross sectional research 102 patients (all males suffering from acute myocardial infarction and 162 non-patient individuals after matching were studied and compared with regard to psychosocial life events and stress coping strategies through coping response inventory (Moos, 1993 , scaling of life Events (paykel , 1971 and researcher made questionnaire. Results: The result established that myocardial infarction patients experienced more stress than the control group during one year before heart- attack and they used more inadequate stress coping strategies comparing with the control individuals. Conclusion: This study showed that stress and inadequate coping strategies are important variables for the development of coronary heart diseases. (Sci J Hamadan Univ Med Sci 2010;17(3:33-38

  4. Systematic Study on Triaxial Superdeformed Bands of Hf Isotopes

    Institute of Scientific and Technical Information of China (English)

    ZHANG Da-Li; DING Bin-Gang

    2009-01-01

    Properties of the triaxial superdeformed (TSD) bands of Hf isotopes are investigated systematically within the supersymmetry scheme including many-body interactions and a perturbation possessing the SO(5) (or SU(5)) symmetry on the rotational symmetry. Quantitatively good results of the γ-ray energies, the dynamical moments of inertia,and the spin of the TSD bands in Hf isotopes are obtained. It shows that this approach is quite powerful in describing the properties of the triaxial superdeformation in Hf isotopes.

  5. Determining Energy Distributions of HF-Accelerated Electrons at HAARP

    Science.gov (United States)

    2015-11-18

    AFRL-AFOSR-VA-TR-2015-0383 Determining energy distributions of HF-accelerated electrons at HAARP Christopher Fallen University of Alaska Fairbanks...2012 - 11/14/2015 4. TITLE AND SUBTITLE Determining energy distributions of HF-accelerated electrons at HAARP 5a. CONTRACT NUMBER FA9550-12-1-0424...transmitted from the High-frequency Active Auroral Research Program ( HAARP ) transmitter in Alaska. For a given fixed HF-plasma interaction altitude

  6. Physics of the Geospace Response to Powerful HF Radio Waves

    Science.gov (United States)

    2012-10-31

    studies of the response of the Earth’s space plasma to high-power HF radio waves from the High-frequency Active Auroral Research Program ( HAARP ...of HF heating and explored to simulate artificial ducts. DMSP- HAARP experiments revealed that HF-created ion outflows and artificial density ducts...in the topside ionosphere appeared faster than predicted by the models, pointing to kinetic (suprathermal) effects. CHAMP/GRACE- HAARP experiments

  7. Episodic memory and executive functioning in currently depressed patients compared to healthy controls.

    Science.gov (United States)

    Pauls, Franz; Petermann, Franz; Lepach, Anja Christina

    2015-01-01

    At present, little is still known about the link between depression, memory and executive functioning. This study examined whether there are memory-related impairments in depressed patients and whether the size of such deficits depends on the age group and on specific types of cognitive measures. Memory performances of 215 clinically depressed patients were compared to the data of a matched control sample. Regression analyses were performed to determine the extent to which executive dysfunctions contributed to episodic memory impairments. When compared with healthy controls, significantly lower episodic memory and executive functioning performances were found for depressed patients of all age groups. Effect sizes appeared to vary across different memory and executive functioning measures. The extent to which executive dysfunctions could explain episodic memory impairments varied depending on the type of measure examined. These findings emphasise the need to consider memory-related functioning of depressed patients in the context of therapeutic treatments.

  8. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction

    DEFF Research Database (Denmark)

    Jackson, Colette E.; Castagno, Davide; Maggioni, Aldo P.

    2015-01-01

    AIMS: Low pulse pressure is a marker of adverse outcome in patients with heart failure (HF) and reduced ejection fraction (HF-REF) but the prognostic value of pulse pressure in patients with HF and preserved ejection fraction (HF-PEF) is unknown. We examined the prognostic value of pulse pressure...

  9. Family burden in patient with schizophrenia and depressive disorder: A comparative study

    Directory of Open Access Journals (Sweden)

    Sateesh R Koujalgi

    2013-01-01

    Full Text Available Background: Family care burden among schizophrenia and depressive disorders has not been addressed in the research. Family burden was significantly high in patient with schizophrenia except the effect on physical health of other family member. Comparing burden in these two groups may help in the psychosocial management. Aim: The aim of the study was to examine family care burden in families of schizophrenia patient and compare them with patients having depressive disorders. Materials and Methods: One hundred family caregivers of patient with schizophrenia and 100 family caregivers of patient with depressive disorders were recruited for the study. It was cross sectional study. The patients were diagnosed as having schizophrenia (all types and depressive disorders using International Classification of Disease-10, Classification of Mental and Behavioral Disorders, Diagnostic Criteria for Research ICD-10 DCR criteria. Pollack and Perlick scale was used to identify the key family caregivers. Patient with 2 or more than 2 years duration of illness were included in the study groups. Family burden was assessed in the both groups by using the Family Burden Interview Schedule (FBIS of Pai and Kapur. Data was analyzed using the descriptive statistics, Chi-square test. Results: Caregivers of patients with schizophrenia in comparison to depressive disorder has significantly increased mean FBIS score (P<0.001. The family burden was significantly high in family caregivers of patients with the schizophrenia except the effect on physical health of other family members. Conclusion: To conclude caregivers of patient with schizophrenia experience high-level of burden than the caregivers of patients with the depressive disorders.

  10. Primary care COPD patients compared with large pharmaceutically-sponsored COPD studies: an UNLOCK validation study.

    Directory of Open Access Journals (Sweden)

    Annemarije L Kruis

    Full Text Available BACKGROUND: Guideline recommendations for chronic obstructive pulmonary disease (COPD are based on the results of large pharmaceutically-sponsored COPD studies (LPCS. There is a paucity of data on disease characteristics at the primary care level, while the majority of COPD patients are treated in primary care. OBJECTIVE: We aimed to evaluate the external validity of six LPCS (ISOLDE, TRISTAN, TORCH, UPLIFT, ECLIPSE, POET-COPD on which current guidelines are based, in relation to primary care COPD patients, in order to inform future clinical practice guidelines and trials. METHODS: Baseline data of seven primary care databases (n=3508 from Europe were compared to baseline data of the LPCS. In addition, we examined the proportion of primary care patients eligible to participate in the LPCS, based on inclusion criteria. RESULTS: Overall, patients included in the LPCS were younger (mean difference (MD-2.4; p=0.03, predominantly male (MD 12.4; p=0.1 with worse lung function (FEV1% MD -16.4; p<0.01 and worse quality of life scores (SGRQ MD 15.8; p=0.01. There were large differences in GOLD stage distribution compared to primary care patients. Mean exacerbation rates were higher in LPCS, with an overrepresentation of patients with ≥ 1 and ≥ 2 exacerbations, although results were not statistically significant. Our findings add to the literature, as we revealed hitherto unknown GOLD I exacerbation characteristics, showing 34% of mild patients had ≥ 1 exacerbations per year and 12% had ≥ 2 exacerbations per year. The proportion of primary care patients eligible for inclusion in LPCS ranged from 17% (TRISTAN to 42% (ECLIPSE, UPLIFT. CONCLUSION: Primary care COPD patients stand out from patients enrolled in LPCS in terms of gender, lung function, quality of life and exacerbations. More research is needed to determine the effect of pharmacological treatment in mild to moderate patients. We encourage future guideline makers to involve primary care

  11. Actigraphy combined with EEG compared to polysomnography in sleep apnea patients.

    Science.gov (United States)

    Fietze, Ingo; Penzel, Thomas; Partinen, Markku; Sauter, Jochen; Küchler, Gert; Suvoro, Alexander; Hein, Holger

    2015-03-01

    An actigraph extended with electroencephalography (EEG), electroocculography (EOG) and electromyography (EMG) was compared to polysomnography in two studies on patients suffering from sleep disordered breathing. Study A with 30 subjects used a single lead EEG, and study B with 20 subjects used EOG and EMG in addition. Sleep was scored according to Rechtschaffen and Kales rules. Total sleep time (TST), sleep period time (SPT), sleep efficiency (SE), sustained sleep efficiency (SSE), sleep-onset latency (SL), and sleep stages were compared. For study A an epoch-by-epoch comparison of sleep stages revealed an overall agreement of 74.2%. Correlations were high for SE (0.98, p polysomnography and single lead EEG in sleep apnea patients. Deviations for REM were slightly higher for the single lead EEG compared to single lead EEG plus EOG/EMG. Both simplified systems proved to be reliable for comfortable out-patient sleep recording.

  12. Clinical outcome among HIV-infected patients starting saquinavir hard gel compared to ritonavir or indinavir

    DEFF Research Database (Denmark)

    Kirk, O; Mocroft, A; Pradier, C

    2001-01-01

    -up within the EuroSIDA study. METHODS: Changes in plasma viral load (pVL) and CD4 cell count from baseline were compared between treatment groups. Time to new AIDS-defining events and death were compared in Kaplan--Meier models, and Cox models were established to further assess differences in clinical...... progression (new AIDS/death). Adjustment was made for differences in baseline parameters, in particular pVL, CD4 cell count, and region of Europe. RESULTS: A total of 2708 patients (median follow-up: 30 months) were included, of which 556 started ritonavir (21%), 1342 indinavir (50%), and 810 saquinavir hgc......OBJECTIVE: To compare the clinical response among patients who initiate protease inhibitor therapies with different virological potency. DESIGN: We analysed patients who started indinavir, ritonavir or saquinavir hard gel capsule (hgc) as part of at least triple therapy during prospective follow...

  13. Comparative analysis of psychological adaptation in patients with paranoid schizophrenia and shizotypal disorder

    Directory of Open Access Journals (Sweden)

    A. V. Stepanova

    2015-01-01

    Full Text Available The purpose of this research was the comparing of psychological adaptation characteristics (type of attitude to a disease, psychological defense mechanisms, special aspects of coping-strategy as exemplified by 2 groups of schizophrenia disorder patients: 1 schizotypal disorders (F-21 according to ICD-10; 2 paranoid schizophrenia (F-20 according to ICD-10. The authors arrived at the conclusion of the same nature if special aspects of psychological adaptation in the groups compared. At the same time, both groups compared showed imbalance of «the level of success» between individual characteristics constituting the module of psychological adaptation. This circumstance testifies to the fact that psychological adaptation in the patients with schizophrenic disorders should be evaluated on a case- bycase basis. In conclusion, the study revealed the necessity to take into consideration of these characteristics during rehabilitation of these patients.

  14. PEMISAHAN Zr – Hf SECARA SINAMBUNG MENGGUNAKAN MIXER SETTLER

    Directory of Open Access Journals (Sweden)

    Dwi Biyantoro

    2017-01-01

    Full Text Available ABSTRAK PEMISAHAN Zr – Hf SECARA SINAMBUNG MENGGUNAKANMIXER SETTLER. Telah dilakukan pemisahanZr – Hf secara sinambung menggunakan pengaduk pengenap (mixer settler 16 stage. Larutan umpan adalah zirkon nitrat dengan kadar Zr = 30786 ppm dan Hf = 499 ppm. Ekstraktan dipakai adalah solven 60 % TBP dalam kerosen dan larutan scrubbingyang dipakai adalah asam nitrat 1 M. Umpan masuk pada stageke 5 dikontakkan secara berlawanan arah dengan solven masuk pada stage ke 16 dan larutan scrubbing masuk pada stage ke 1. Tujuan penelitian ini adalah memisahkan unsur Zr dan Hf dari hasil olah pasir zirkon menggunakan solven TBP dengan alat mixer settler16 stage. Analisis umpan dan hasil proses pemisahan untuk zirkonium (Zr dilakukan dengan menggunakan alat pendar sinar-X, sedangkananalisis unsur hafnium (Hf menggunakan Analisis Pengaktifan Neutron (APN. Parameter penelitian dilakukan dengan variasi keasaman asam nitrat dalam umpan dan variasi waktu pada berbagai laju pengadukan. Hasil penelitian pemisahan unsur Zr dengan Hf diperolehkondisi optimum pada keasaman umpan 4 N HNO3, keseimbangan dicapai setelah 3jam dan laju pengadukan 3300 rpm. Hasil ekstrak  unsur zirkon (Zr diperoleh kadar sebesar 28577 ppm dengan efisiensi 92,76 % serta kadar pengotor hafnium (Hf sebesar 95 ppm. Kata Kunci: pemisahan Zr, Hf, ekstraksi, mixer settler, alat pendar sinar-X, APN. ABSTRACT SEPARATION of Zr - Hf CONTINUOUSLY USE THE MIXER SETTLER. Separation of Zr - Hf continuously using mixer settler 16 stage has been done. The feed solution is zircon nitrate concentration of Zr = 30786 ppm  and Hf = 499 ppm. As the solvent used extractant 60 % TBP in 40 % kerosene. Nitric acid solution used srubbing 1 M. The feed entered into stage to 5 is contacted with solvents direction on the stage to 16 and the scrubbing solution enter the stage to 1. The purpose of this study is to separate Zr and Hf of the results from the process of zircon sand using solvent TBP using 16 stage

  15. Mitigating Doppler shift effect in HF multitone data modem

    Science.gov (United States)

    Sonlu, Yasar

    1989-09-01

    Digital communications over High Frequency (HF) radio channels are getting important in recent years. Current HF requirements are for data transmission at rates 2.4 kbps or more to accommodate computer data links and digital secure voice. HF modems which were produced to meet these speeds are, serial modems and parallel modems. On the other hand, the HF sky-wave communication medium, the ionosphere, has some propagation problems such as multipath and Doppler shift. The effect of Doppler shift in a parallel modem which employs Differential Quadrature Phase Shift Keying (DQPSK) modulation is considered and a correction method to mitigate the Doppler Shift effect is introduced.

  16. Epitaxial Thin Films of Y doped HfO2

    Science.gov (United States)

    Serrao, Claudy; Khan, Asif; Ramamoorthy, Ramesh; Salahuddin, Sayeef

    Hafnium oxide (HfO2) is one of a few metal oxides that is thermodynamically stable on silicon and silicon oxide. There has been renewed interest in HfO2 due to the recent discovery of ferroelectricity and antiferroelectricity in doped HfO2. Typical ferroelectrics - such as strontium bismuth tantalate (SBT) and lead zirconium titanate (PZT) - contain elements that easily react with silicon and silicon oxide at elevated temperatures; therefore, such ferroelectrics are not suited for device applications. Meanwhile, ferroelectric HfO2 offers promise regarding integration with silicon. The stable phase of HfO2 at room temperature is monoclinic, but HfO2 can be stabilized in the tetragonal, orthorhombic or even cubic phase by suitable doping. We stabilized Y-doped HfO2 thin films using pulsed laser deposition. The strain state can be controlled using various perovskite substrates and controlled growth conditions. We report on Y-doped HfO2 domain structures from piezo-response force microscopy (PFM) and structural parameters via X-ray reciprocal space maps (RSM). We hope this work spurs further interest in strain-tuned ferroelectricity in doped HfO2.

  17. Microstructural characterization of as-cast hf-b alloys

    Directory of Open Access Journals (Sweden)

    João Carlos Jânio Gigolotti

    2012-04-01

    Full Text Available An accurate knowledge of several metal-boron phase diagrams is important to evaluation of higher order systems such as metal-silicon-boron ternaries. The refinement and reassessment of phase diagram data is a continuous work, thus the reevaluation of metal-boron systems provides the possibility to confirm previous data from an investigation using higher purity materials and better analytical techniques. This work presents results of rigorous microstructural characterization of as-cast hafnium-boron alloys which are significant to assess the liquid composition associated to most of the invariant reactions of this system. Alloys were prepared by arc melting high purity hafnium (minimum 99.8% and boron (minimum 99.5% slices under argon atmosphere in water-cooled copper crucible with non consumable tungsten electrode and titanium getter. The phases were identified by scanning electron microscopy, using back-scattered electron image mode and X-ray diffraction. In general, a good agreement was found between our data and those from the currently accepted Hafnium-Boron phase diagram. The phases identified are αHfSS and B-RhomSS, the intermediate compounds HfB and HfB2 and the liquide L. The reactions are the eutectic L ⇔ αHfSS + HfB and L ⇔ HfB2 + B-Rhom, the peritectic L + HfB2 ⇔ HfB and the congruent formation of HfB2.

  18. Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls

    DEFF Research Database (Denmark)

    Christensen, Steffan Wittrup; Hirata, Rogerio Pessoto; Graven-Nielsen, Thomas

    2017-01-01

    from eight bilateral muscles. The first and last three series were separated by 8 min and 42 s, respectively. Each series consisted of three slow and three fast movements. Pressure pain thresholds (PPTs) were recorded bilaterally from neck, head and arm at baseline, after the third and sixth movement...... series. Pain intensity was recorded on an electronic visual analogue scale (VAS). RESULTS: Larger pain areas and higher VAS scores were found in patients compared with controls (p PPTs were lower in patients...

  19. EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression

    OpenAIRE

    Capezzani, L; Ostacoli, L; Cavallo, M; Carletto, S; Fernendez, I; Solomon, R; Pagani, M.; Cantelmi, T

    2013-01-01

    This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the followup stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR...

  20. Diabetes mellitus, cachexia and obesity in heart failure: rationale and design of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)

    National Research Council Canada - National Science Library

    von Haehling, Stephan; Lainscak, Mitja; Doehner, Wolfram; Ponikowski, Piotr; Rosano, Giuseppe; Jordan, Jens; Rozentryt, Piotr; Rauchhaus, Mathias; Karpov, Rostislav; Tkachuk, Vsevolod; Parfyonova, Yelena; Zaritskey, Andrey Y; Shlyakhto, Eugeniy V; Cleland, John G; Anker, Stefan D

    2010-01-01

    .... Cachexia is an ominous and often missed sign in patients with CHF.This manuscript describes the rationale and the design of Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF...

  1. Do Professional Practices among Malaysian Private Healthcare Providers Differ? A Comparative Study using Simulated Patients.

    Science.gov (United States)

    Alabid, Alamin Hassan M A; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi

    2013-12-01

    Malaysia, a South East Asian country, legally permits general medical practitioners in private clinics to dispense medicines. This possibly can dilute the pharmacist role in the provision of healthcare and pharmaceutical care and deprive patients to benefit from these services. This study explored, assessed and compared the current status of medicines labeling, patient's counseling, and symptomatic diagnosis by general practitioners and community pharmacists. This study used trained Simulated Patients (SP), who participated in a scenario of common cold symptoms at private clinics and community pharmacies. SPs explored medication labeling, patients counseling and symptomatic diagnosis undertaken by general practitioners and community pharmacists. Later, study authors assessed and compared these practices. The study was conducted during June 2011 in Penang, Malaysia. The study used descriptive statistics and Fisher-exact test to analyze data. Regarding patients counseling standard, among 100 visits by simulated patients, 64 (64%) from community pharmacists provided information about the medicine name, its indication, dosage and route of administration versus 17 (42.5%) general practitioners during 40 visits (p=0.024). Concerning adherence to labeling standard, for instance, only in one pharmacy visit, (1%) the pharmacist wrote the name of the patient on the medication label versus in 32 (80%) of doctors' visits, the doctors adhered to this labeling standard (p<0.001). In all doctors' visits (n=40, 100%), SPs were asked about symptoms, whereas in 87 (87%) CPs' visits, pharmacists fulfilled this counseling standard (p=0.02). Although pharmacists showed less compliance to medicine labeling and symptomatic diagnosis compared to doctors, their counseling of patients was better. Separation will definitely contribute to more concentration of each provider on his/her roles and improve and direct the experiences and skills towards being more patient oriented.

  2. Highly ordered nanotubular film formation on Ti–25Nb–xZr and Ti–25Ta–xHf

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong-Jae; Byeon, In-Seop [Department of Dental Materials, Research Center of Nano-Interface Activation for Biomaterials, & Research Center for Oral Disease Regulation of the Aged, College of Dentistry, Chosun University, Gwangju (Korea, Republic of); Brantley, William A. [Division of Restorative Sciences and Prosthodontics, College of Dentistry, The Ohio State University, Columbus, OH (United States); Choe, Han-Cheol, E-mail: hcchoe@chosun.ac.kr [Department of Dental Materials, Research Center of Nano-Interface Activation for Biomaterials, & Research Center for Oral Disease Regulation of the Aged, College of Dentistry, Chosun University, Gwangju (Korea, Republic of)

    2015-12-01

    The purpose of this study was to investigate the highly ordered nanotubular film formation on Ti–25Nb–xZr and Ti–25Ta–xHf, examining the roles of niobium, zirconium, tantalum and hafnium alloying elements. The Ti–25Nb–xZr and Ti–25Ta–xHf ternary alloys contained 0, 7 and 15 wt.% of these alloying elements and were manufactured using a vacuum arc-melting furnace. Cast ingots of the alloys were homogenized in Ar atmosphere at 1050 °C for 2 h, followed by quenching into ice water. Formation of nanotubular films was achieved by an electrochemical method in 1 M H{sub 3}PO{sub 4} + 0.8 wt.% NaF at 30 V and 1 h for the Ti–25Nb–xZr alloys and 2 h for the Ti–25Ta–xHf alloys. Microstructures of the Ti–25Ta–xHf alloys transformed from α″ phase to β phase, changing from a needle-like structure to an equiaxed structure as the Hf content increased. In a similar manner, the needle-like structure of the Ti–25Nb–xZr alloys transformed to an equiaxed structure as the Zr content increased. Highly ordered nanotubes formed on the Ti–25Ta–15Hf and Ti–25Nb–15Zr alloys compared to the other alloys, and the nanotube layer thickness on Ti–25Ta–15Hf and Ti–25Nb–15Zr was greater than for the other alloys. Nanotubes formed on Ti–25Ta–15Hf and Ti–25Nb–15Zr showed two sizes of highly ordered structures. The diameters of the large nanotubes decreased and the diameters of the small nanotubes increased as Zr and Hf contents increased. It was found that the layer thickness, diameter, surface density and growth rate of nanotubes on the Ti–25Ta–xHf and Ti–25Nb–xZr alloys can be controlled by varying the Hf and Zr contents. X-ray diffraction analyses revealed only weak peaks for crystalline anatase or rutile TiO{sub 2} phases from the nanotubes on the Ti–25Nb–xZr and Ti–25Ta–xHf alloys, indicating a largely amorphous condition. - Highlights: • Nanotubular film formation on anodized Ti-25Nb-xZr and Ti-25Ta-xHf (x = 0, 7 and

  3. Patients' experience compared with physicians' recommendations for treating fecal incontinence: a qualitative approach.

    Science.gov (United States)

    Cichowski, Sara B; Dunivan, Gena C; Rogers, Rebecca G; Komesu, Yuko M

    2014-07-01

    Using qualitative methods, we compared physician-recommended treatment options for fecal incontinence to patient knowledge of treatment options. Our hypothesis was that physician recommendations were not being communicated well to patients and that this impaired patients' ability to cope with fecal incontinence. Cognitive interviews were conducted with physicians who routinely care for women with fecal incontinence. Physicians were asked to describe their typical nonsurgical treatment recommendations and counseling for fecal incontinence. Women with bothersome fecal incontinence were recruited to participate in focus groups and asked about personal experience with fecal incontinence symptoms and treatment options. For both physician interviews and patient focus groups, qualitative data analysis was performed using grounded-theory methodology. Physicians identified several barriers patients face when seeking treatment: lack of physician interest toward fecal incontinence, and patient embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70-80 %) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians, although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms, and encouragement to go on living life fully. Whereas physicians had treatment to offer women with fecal incontinence, women had already found the best treatments through personal research and effort. Women want to hear a message of hope and encouragement and perceive personal effort from providers.

  4. Self-consciousness/Awareness and Bladder Sensations: Comparative Study of Overactive Bladder Patients and Healthy Volunteers.

    Science.gov (United States)

    Vrijens, Desiree; Marcelissen, Tom; Drossaerts, Jamie; Heeringa, Rhea; Degaillier, Sam; Leue, Carsten; van Koeveringe, Gommert

    2017-08-31

    To explore differences in bladder sensations between patients with overactive bladder (OAB) and healthy volunteers by evaluating self-consciousness, self-awareness and affective complaints. A prospective, observational study was performed comparing patients with OAB symptoms and healthy volunteers. During 3 days subjects filled out sensation-related bladder diaries (SR-BD), Self-Consciousness Questionnaires (SCS), Self-Awareness Questionnaire (SSAS) and the Hospital Anxiety and Depression Scale (HADS). The SSAS was filled out at the second void of the first day. In total, 134 participants were included (66 volunteers and 68 patients). Patients had lower voided volumes (193 mL vs 270 mL, P self-awareness than volunteers, indicating that OAB patients may attribute different values to body signals. Future research is required to elaborate our knowledge on the perceived sensations and labeling of emotions in OAB. © 2017 John Wiley & Sons Australia, Ltd.

  5. Comparative evaluation of two different vestibuloplasty surgical procedures in cleft patients: a pilot study.

    Science.gov (United States)

    de Almeida, Ana Lúcia Pompéia Fraga; Pedro, Patrícia Franco; Kogawa, Evelyn Mikaela; Pereira, Tatiana; de Barros Carrilho, Guilherme Paes; Aiello, Carlos Alberto; Freitas, Patrícia Zambonato

    2005-07-01

    Patients with a cleft lip or palate often present alterations in the labial aspect of the ridge, resulting in a shallow vestibule. This study compares the results of two different surgical procedures on deepening of the labial sulcus. Ten patients with a cleft lip and palate were separated into two groups and underwent different vestibuloplasty procedures. An experimental group used a removable retention splint. Preoperative and 4-month postoperative sulcus heights were measured and analyzed statistically. No statistically significant differences could be detected between groups. The results indicated that to reach consistent results, a larger number of patients must be submitted to this evaluation.

  6. A Comparative Study on the Quality of Living for Therapeutic Cancer and Hospice Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kook [Dept. of Radiological Technology, Kwangju Health College, Kwangju (Korea, Republic of); Rhee, Dong Soo; Rou, Jae Man; Kim, Jong Deok [Dept. of Therapeutic Radiology, Chonnam University Hospital, Kwangju (Korea, Republic of)

    2004-03-15

    This study carried a comparative analysis of quality of living perceived by cancer and hospice patients who received radiotherapy, and influential factors in order to provide basic data for nursing goals and establishment of strategy. The subjects of the study were 50 cancer patients who were more than twenty years old and was receiving radiotherapy in therapeutic radiology department of C university hospital, and fourteen hospice patients who were in J hospital in Gwangju. They were conveniently sampled according to the selection standard, and researchers personally interviewed them using questionnaire and patient scripts to obtain necessary data. The results were presented as follows: 1. When cancer and hospice patients were examined demographically, the number of 60 year-old patients were the most. The subjects whose marriage period was more than thirty-one years were the most. In medical expense, more than 70.0% of the patients bore their expenses themselves. 2. When disease-related characteristics of the cancer and pos piece patients were examined, more than 75% of the patients had experience of being in hospital, and more than experienced operation. However, for prevalence period, 57.5% of the cancer patients had less than six months, and 64.3% of the hospice patients had more than two years. 3. For physical symptoms of cancer patients, 77.5% had fatigue, 60.0% had loss of appetite, and 52.5% had loss of weight while for the hospice patients, 100% had loss of weight, and 92.9% had fatigue and loss of appetite. For the cancer patients, 0.0% had swelling, and 7.5% had bleeding, For the hospice patients, 7.1% had change in skin, and 14.3% had diarrhea. 4. Mean score of the cancer subjects were as follows: family support, social support, emotional and spiritual support, physical symptoms, and periods were 3.87, 2.88, 3.10, 2.80, and 2.94 respectively. Those of the hospice patients were 3.80, 1.96, 1.58, 2.64 and 3.24 respectively. 5. Mean score of family support

  7. Comparing Facial Emotional Recognition in Patients with Borderline Personality Disorder and Patients with Schizotypal Personality Disorder with a Normal Group

    Directory of Open Access Journals (Sweden)

    Aida Farsham

    2017-04-01

    Full Text Available Objective: No research has been conducted on facial emotional recognition on patients with borderline personality disorder (BPD and schizotypal personality disorder (SPD. The present study aimed at comparing facial emotion recognition in these patients with the general population. The neurocognitive processing of emotions can show the pathologic style of these 2 disorders. Method:  Twenty BPD patients, 16 SPD patients, and 20 healthy individuals were selected by available sampling method. Structural Clinical Interview for Axis II, Millon Personality Inventory, Beck Depression Inventory and Facial Emotional Recognition Test was were conducted for all participants.Discussion: The results of one way ANOVA and Scheffe’s post hoc test analysis revealed significant differences in neuropsychology assessment of  facial emotional recognition between BPD and  SPD patients with normal group (p = 0/001. A significant difference was found in emotion recognition of fear between the 2 groups of BPD and normal population (p = 0/008. A significant difference was observed between SPD patients and control group in emotion recognition of wonder (p = 0/04(.The obtained results indicated a deficit in negative emotion recognition, especially disgust emotion, thus, it can be concluded that these patients have the same neurocognitive profile in the emotion domain.

  8. Symptom recognition and health care seeking among immigrants and native Swedish patients with heart failure

    Science.gov (United States)

    Hedemalm, Azar; Schaufelberger, Maria; Ekman, Inger

    2008-01-01

    Background It is not known what patient perceptions or beliefs lead to beneficial decisions or response patterns in symptom interpretation among heart failure (HF) patients, especially immigrants. The aim of this study was to explore and compare symptom recognition and health care seeking patterns among immigrants and native Swedes with HF. Methods The study used a qualitative design. Semi-structured interviews were conducted with 42 patients with HF, of whom 21 were consecutively selected immigrants and 21 were randomly selected Swedish patients. The interviews were analysed using content analysis. Results A majority of the immigrant patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. Twice as many immigrants as Swedes were unaware of "what the illness experience entailed" and which symptoms indicated worsening of HF. Conclusion The symptoms that patients sought care for, were similar among immigrants and Swedes. However, when interpreting symptoms more immigrants were unaware of the connection between the symptoms/signs and their HF condition. More tailored educational interventions might improve recognition of worsening symptoms in immigrant patients with chronic heart failure. PMID:18590538

  9. Comparing the demographic factors of patient with limited and diffuse type of alopecia areata

    Directory of Open Access Journals (Sweden)

    Mina Daliri

    2010-09-01

    Full Text Available Background: Alopecia areata is a chronic inflammatory disease that involves the hair follicle. Clinically, patients with alopecia areata may have patchy or confluent hair loss on the scalp or body so we conduct a study to compare the demographic aspects of patient with limited and diffuse type of alopecia areata.Materials and Method: We conducted a descriptive-analyzing study in which 306 patient were chosen. The patients were divided into two groups of diffuse and limited Alopecia. Demographic factors including age, gender, disease onset were compared in two groups. Results: Out of 306 patients, 58.8 % were male and 41.2 % were female. 247 patients (80.7% suffered from limited type and 59 patients (19.2% suffered from diffuse type. The mean age of the onset of involvement in limited group was 21.9±12 yr and 15.8±12 yr in diffuse group. The mean duration of involvement in limited group was 18.7 months and 71 months in diffuse group. Conclusion: Diffuse type alopecia areata starts at lower age and has longer duration. Our study results were similar to the others. Like other studies, thyroid disorders and atopic dermatitis are positively correlative to the severity of disease

  10. Pressure induced novel compounds in the Hf-O system from first-principles calculations

    OpenAIRE

    2015-01-01

    Using first-principles evolutionary simulations, we have systematically investigated phase stability in the Hf-O system at pressure up to 120 GPa. New compounds Hf5O2, Hf3O2, HfO and HfO3 are discovered to be thermodynamically stable at certain pressure ranges and a new stable high-pressure phase is found for Hf2O with space group Pnnm and anti-CaCl2-type structure. Both P62m-HfO and P4m2-Hf2O3 show semimetallic character. Pnnm-HfO3 shows interesting structure, simultaneously containing oxide...

  11. Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea.

    Directory of Open Access Journals (Sweden)

    Luciana Balester Mello de Godoy

    Full Text Available To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS, mild Obstructive Sleep Apnea (OSA and normal individuals.UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale-ESS-≥ 10 and/or fatigue (Modified Fatigue Impact Scale-MFIS-≥ 38 associated to Apnea/hypopnea index (AHI ≤ 5 and Respiratory Disturbance Index (RDI > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10 and/or fatigue (MFIS ≥ 38 associated to AHI ≥ 5 and ≤ 15 events/hour. "Control group" criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in "control group", adjusted for age, gender, body mass index (BMI and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT was performed five times (each two hours from 8 a.m. to 4 p.m.UARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire-FOSQ-and Pittsburgh Sleep Quality Index-PSQI: p < 0.05 and more fatigue than mild OSA patients (p = 0.003 and scored significantly higher in both Beck inventories than "control group" (p < 0.02. UARS patients had more lapses early in the morning (in time 1 compared to the results in the afternoon (time 5 than mild OSA (p = 0.02. Mild OSA patients had more lapses in times 2 than in time 5 compared to "control group" (p = 0.04.UARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls.

  12. Ferroelectricity of nondoped thin HfO2 films in TiN/HfO2/TiN stacks

    Science.gov (United States)

    Nishimura, Tomonori; Xu, Lun; Shibayama, Shigehisa; Yajima, Takeaki; Migita, Shinji; Toriumi, Akira

    2016-08-01

    We report on the impact of TiN interfaces on the ferroelectricity of nondoped HfO2. Ferroelectric properties of nondoped HfO2 in TiN/HfO2/TiN stacks are shown in capacitance-voltage and polarization-voltage characteristics. The Curie temperature is also estimated to be around 500 °C. The ferroelectricity of nondoped HfO2 clearly appears by thinning HfO2 film down to ˜35 nm. We directly revealed in thermal treatments that the ferroelectric HfO2 film on TiN was maintained by covering the top surface of HfO2 with TiN, while it was followed by a phase transition to the paraelectric phase in the case of the open surface of HfO2. Thus, it is concluded that the ferroelectricity in nondoped HfO2 in this study was mainly driven by both of top and bottom TiN interfaces.

  13. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

  14. Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)

    DEFF Research Database (Denmark)

    Lee, Andy Y; Moss, Arthur J; Ruwald, Martin H;

    2015-01-01

    The temporal effect of heart failure (HF) hospitalization occurring at different time periods before implantation has not yet been studied in detail. The aim of the present study was to investigate the potential association between time from last HF hospitalization to device implantation and effe......The temporal effect of heart failure (HF) hospitalization occurring at different time periods before implantation has not yet been studied in detail. The aim of the present study was to investigate the potential association between time from last HF hospitalization to device implantation...... and effects on subsequent outcomes and benefit from cardiac resynchronization therapy with a defibrillator (CRT-D). Multivariate Cox models were used to determine the temporal influence of previous HF hospitalization on the end point of HF or death within all left bundle branch block implantable cardioverter......-defibrillator (ICD) and CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) trial (n = 1,250) and to evaluate the clinical benefit of CRT-D implantation, comparing CRT-D patients with ICD patients within each previous HF hospitalization...

  15. Glycosylation gap in patients with diabetes with chronic kidney disease and healthy participants: A comparative study

    Directory of Open Access Journals (Sweden)

    Km Neelofar

    2017-01-01

    Full Text Available Aim: The aim of this study it to determine the level of glycosylation gap in patients with type 2 diabetes and its relation with kidney dysfunction. Materials and Methods: In this study, 150 individuals were enrolled (aged 20–75 year and divided into three groups. Group 1 included 50 nondiabetic individuals who served as control. Group 2 included 50 patients with type 2 diabetes without chronic kidney disease (CKD, and in Group 3, there were 50 patients with type 2 diabetes with CKD. Glycated hemoglobin (HbA1c and fructosamine (FA were measured in all groups to determine the glycosylation gap (GG, predicted HbA1c, and mean blood glucose (MBG. GG is defined as the difference between measured HbA1c and HbA1c predicted from FA based on the population regression of HbA1c on FA. The variables were compared by correlation analysis. Results: Serum creatinine level was significantly high in patients with CKD (1.93 ± 0.99 as compared to patients with diabetes and control (0.891 ± 0.16; 0.912 ± 0.1, respectively. The study demonstrated a significant elevation in serum FA, measured HbA1c and predicted HbA1c, MBG in patients with diabetes with CKD as compared with those of without CKD, and controls. GG was found in healthy control (0.51 ± 0.78, patients with type 2 diabetes without CKD (0.62 ± 0.45, and patients with diabetes with CKD (1.0 ± 0.91, respectively. Conclusion: It is concluded that GG may be a useful clinical research tool for evaluating pathological source of variation in diabetes complications such as kidney disease.

  16. Comparing outcomes in patients with persistent asthma: a registry of two therapeutic alternatives.

    Science.gov (United States)

    O'Connor, Richard D; Gilmore, Amanda S; Manjunath, Ranjani; Stanford, Richard H; Legorreta, Antonio P; Jhingran, Priti M

    2006-03-01

    Clinical trials have demonstrated improved efficacy of fluticasone propionate/salmeterol (100/50 mcg) in a single device (FSC) compared with montelukast (10 mg) (MON). This study was designed to assess asthma control, asthma-related quality of life, asthma-related emergency department (ED) visit/hospitalization, treatment-related satisfaction, and productivity losses in patients newly started on FSC or MON. Patients who were newly prescribed FSC or MON during a regularly scheduled office visit were enrolled in a prospective observational study by nearly 500 physicians from eight managed care plans. Patient survey data were collected at baseline and at months 1, 3, 6, and 12, to measure study outcomes. ED visits/inpatient stays were reported from commercial claims data. Multivariate analyses assessed 12-month outcomes, controlling for several baseline patient characteristics. A total of 1414 patients >or= 15 years old were enrolled in the registry (FSC, n = 1061; MON, n = 353), 90% of which completed a 12-month survey. FSC patients had significantly greater improvement in both asthma control and quality of life, and reported significantly higher satisfaction with their medication (p = 0.003) and fewer days at work/school with asthma symptoms (p = 0.04) than MON. Other parameters of productivity losses such as missed work/school days due to asthma were not significantly different between the two groups. FSC use was also significantly associated with a lower risk of an asthma-related ED visit/hospitalization compared with MON (odds ratio = 0.35, 95% confidence interval: 0.15-0.92). In a 12-month office-based observational study, patients age 15 and older with persistent asthma, newly started on FSC, improved in symptom, quality of life, treatment, and utilization-related outcomes compared with patients newly started on MON. These results should be interpreted in light of the inherent limitations of non-randomized, uncontrolled studies.

  17. Glycosylation Gap in Patients with Diabetes with Chronic Kidney Disease and Healthy Participants: A Comparative Study.

    Science.gov (United States)

    Neelofar, Km; Ahmad, Jamal

    2017-01-01

    The aim of this study it to determine the level of glycosylation gap in patients with type 2 diabetes and its relation with kidney dysfunction. In this study, 150 individuals were enrolled (aged 20-75 year) and divided into three groups. Group 1 included 50 nondiabetic individuals who served as control. Group 2 included 50 patients with type 2 diabetes without chronic kidney disease (CKD), and in Group 3, there were 50 patients with type 2 diabetes with CKD. Glycated hemoglobin (HbA1c) and fructosamine (FA) were measured in all groups to determine the glycosylation gap (GG), predicted HbA1c, and mean blood glucose (MBG). GG is defined as the difference between measured HbA1c and HbA1c predicted from FA based on the population regression of HbA1c on FA. The variables were compared by correlation analysis. Serum creatinine level was significantly high in patients with CKD (1.93 ± 0.99) as compared to patients with diabetes and control (0.891 ± 0.16; 0.912 ± 0.1), respectively. The study demonstrated a significant elevation in serum FA, measured HbA1c and predicted HbA1c, MBG in patients with diabetes with CKD as compared with those of without CKD, and controls. GG was found in healthy control (0.51 ± 0.78), patients with type 2 diabetes without CKD (0.62 ± 0.45), and patients with diabetes with CKD (1.0 ± 0.91), respectively. It is concluded that GG may be a useful clinical research tool for evaluating pathological source of variation in diabetes complications such as kidney disease.

  18. Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays.

    Science.gov (United States)

    Glance, Laurent G; Osler, Turner; Li, Yue; Lustik, Stewart J; Eaton, Michael P; Dutton, Richard P; Dick, Andrew W

    2016-06-01

    Increasing surgical access to previously underserved populations in the United States may require a major expansion of the use of operating rooms on weekends to take advantage of unused capacity. Although the so-called weekend effect for surgery has been described in other countries, it is unknown whether US patients undergoing moderate-to-high risk surgery on weekends are more likely to experience worse outcomes than patients undergoing surgery on weekdays. The aim of this study was to determine whether patients undergoing surgery on weekends are more likely to die or experience a major complication compared with patients undergoing surgery on a weekday. Using all-payer data, we conducted a retrospective cohort study of 305,853 patients undergoing isolated coronary artery bypass graft surgery, colorectal surgery, open repair of abdominal aortic aneurysm, endovascular repair of abdominal aortic aneurysm, and lower extremity revascularization. We compared in-hospital mortality and major complications for weekday versus weekend surgery using multivariable logistic regression analysis. After controlling for patient risk and surgery type, weekend elective surgery [adjusted odds ratio (AOR)=3.18; 95% confidence interval (CI), 2.26-4.49; Psurgery (AOR=2.11; 95% CI, 1.68-2.66; Psurgery. Weekend elective (AOR=1.58; 95% CI, 1.29-1.93; Psurgery (AOR=1.61; 95% CI, 1.42-1.82; Psurgery. Patients undergoing nonemergent major cardiac and noncardiac surgery on the weekends have a clinically significantly increased risk of death and major complications compared with patients undergoing surgery on weekdays. These findings should prompt decision makers to seek to better understand factors, such physician and nurse staffing, which may contribute to the weekend effect.

  19. Heart Failure Predictors in a Group of Patients with Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Sokol Myftiu

    2016-09-01

    Full Text Available AIM: The present study considers of the prevalence of heart failure (HF in patients suffering from acute myocardial infarction (AMI in the University Hospital Centre of Tirana (UHCT “Mother Theresa”; the demographic and clinical characteristics of the sample during hospitalization; and the main predictors of heart failure occurrence inside the group of patients suffering an AMI. MATERIAL AND METHODS: During a period of study from 2013-2015 we studied demographic and clinical data from 587 consecutive patients presenting with AMI; Framingham criteria were adopted for classifying patients with HF upon admission. RESULTS: A Killip class ≥ 2 was the main diagnostic criterion of HF during hospitalisation. HF was identified in 156 patients (26.6%. The subgroup with HF had significant differences when compared with the other patients with regard to age, sex (male, heart rate upon admission, systolic blood pressure on admission, previous episodes of AMI, glycemia on admission, previous antihypertensive treatment, previous revascularization procedures, peripheral vascular disease, chronic renal disease, ejection fraction (EF, anemia, and atrial fibrillation presence. Independent predictors for HF occurrence in the logistic regression model were EF, previous revascularization, peripheral vascular disease, age, sex, previous AMI, systolic blood pressure upon admission, and anaemia. CONCLUSION: As a conclusion, HF seems to be a common occurrence after AMI, in spite of changes in the epidemiological profile of the acute coronary syndrome. An increase in the incidence is registered as well, parallel to a decrease in the mortality following AMI. Attention must be shown for highly risked subpopulations, aged persons, patients with the previous coronary disease, and concomitant conditions.

  20. Anion exchange behaviour of Zr, Hf, Nb, Ta and Pa as homologues of RF and Db in fluoride medium

    Energy Technology Data Exchange (ETDEWEB)

    Monroy G, F. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Trubert, D.; Brillard, L.; Hussonnois, M.; Constantinescu, O.; Le Naour, C., E-mail: fabiola.monroy@inin.gob.m [Institut de Physique Nucleaire, F-91406 Orsay, France (France)

    2010-07-01

    Studies of the chemical property of trans actinide elements are very difficult due to their short half-lives and extremely small production yields. However it is still possible to obtain considerable information about their chemical properties, such as the most stable oxidation states in aqueous solution, complexing ability, etc., comparing their behaviour with their lighter homologous in the periodic table. In order to obtain a better knowledge of the behaviour of rutherfordium, RF (element 104), dub nium, Db (element 105) in HF medium, the sorption properties of Zr, Hf, Nb, Ta an Pa, homologues of RF and Db, were studied in NH{sub 4}F/HClO{sub 4} medium in this work. Stability constants of the fluoride complexes of these elements were experimentally obtained from K{sub d} obtained at different F{sup -} and H{sup +} concentrations. The anionic complexes: [Zr(Hf)F{sub 5}]{sup -}, [Zr(Hf)F{sub 6}]{sup 2-}, [Zr(Hf)F{sub 7}]{sup 3-}, [Ta(Pa)F{sub 6}]{sup -}, [Ta(Pa)F{sub 7}]{sup 2-}, [Ta(Pa)F{sub 8}]{sup 3-}, [NbOF{sub 4}]{sup -} and [NbOF{sub 5}]{sup 2-} are present as predominant species in the HF range over investigation. (Author)

  1. Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.

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    Ian Louis Ross

    Full Text Available BACKGROUND: Patients with Addison's disease (AD in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD. Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. METHODS: In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP and adiponectin were studied. RESULTS: All patients were Caucasian and the majority were women N = 36 (65.5%. Mean (standard deviation; SD ages of the Swedish and South African patients were 52.9 (13.0 and 52.6 (14.4 years and BMI 25.3 (3.2 and 25.8 (4.1 kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1 versus 24.3 (8.0 mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR triglycerides (TG [1.59 (1.1-2.46 versus 0.96 (0.74-1.6 mmol/l; p<0.001], total cholesterol (TC [6.02(1.50 versus 5.13 (0.87 mmol/l; p<0.001], LDL-C [4.43 (1.44 versus 2.75 (0.80 mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45 versus 0.99 (0.57-2.10 mg/L; p<0.003] and lower HDL-C [0.80 (0.40 versus 1.86 (0.46 mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. CONCLUSIONS: South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.

  2. Cardiovascular Risk Factors in Patients with Addison's Disease: A Comparative Study of South African and Swedish Patients

    Science.gov (United States)

    Ross, Ian Louis; Bergthorsdottir, Ragnhildur; Levitt, Naomi; Dave, Joel Alex; Schatz, Desmond; Marais, David; Johannsson, Gudmundur

    2014-01-01

    Background Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. Methods In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. Results All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1–2.46) versus 0.96 (0.74–1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93–5.45) versus 0.99 (0.57–2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. Conclusions South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors. PMID:24603607

  3. Patient satisfaction and side effects in primary care: An observational study comparing homeopathy and conventional medicine

    Directory of Open Access Journals (Sweden)

    Thurneysen André

    2008-09-01

    Full Text Available Abstract Background This study is part of a nationwide evaluation of complementary medicine in Switzerland (Programme Evaluation of Complementary Medicine PEK and was funded by the Swiss Federal Office of Public Health. The main objective of this study is to investigate patient satisfaction and perception of side effects in homeopathy compared with conventional care in a primary care setting. Methods We examined data from two cross-sectional studies conducted in 2002–2003. The first study was a physician questionnaire assessing structural characteristics of practices. The second study was conducted on four given days during a 12-month period in 2002/2003 using a physician and patient questionnaire at consultation and a patient questionnaire mailed to the patient one month later (including Europep questionnaire. The participating physicians were all trained and licensed in conventional medicine. An additional qualification was required for medical doctors providing homeopathy (membership in the Swiss association of homeopathic physicians SVHA. Results A total of 6778 adult patients received the questionnaire and 3126 responded (46.1%. Statistically significant differences were found with respect to health status (higher percentage of chronic and severe conditions in the homeopathic group, perception of side effects (higher percentage of reported side effects in the conventional group and patient satisfaction (higher percentage of satisfied patients in the homeopathic group. Conclusion Overall patient satisfaction was significantly higher in homeopathic than in conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to three times fewer side effects than conventional care

  4. Patient perceived burden of implant placement compared to surgical tooth removal and apicectomy.

    Science.gov (United States)

    Reissmann, Daniel R; Poulopoulos, Georgios; Durham, Justin

    2015-12-01

    To assess how patients actually perceive implant placement, to evaluate whether patients' perceived burdens are related to specific stages during implant placement, and to compare patients' perceptions during implant placement with other surgical procedures. A sample of 287 patients was consecutively recruited. Only patients with implantations (n=45), surgical tooth removal (n=147), or apicectomies (n=95) were included. Patients' perceptions during oral surgery and implantation were assessed using the Burdens in Oral Surgery Questionnaire (BiOS-Q). Effects of treatment on BiOS-Q total and domain scores were assessed using multivariate linear regression analyses, and effect sizes (Cohen's d) were computed. Overall, patients' perceived burdens during oral surgery were low indicated by a mean BiOS-Q total score of 28.5 points, with lowest scores for Side effects (19.4) and highest scores for Anesthesia (34.1). Among treatment groups, implantation was perceived least unpleasant. This was related to lower burdens during Bone and soft tissue manipulation during implantation than during surgical tooth removal (difference: 14.8 points; d=0.8) or apicectomy (difference: 13.1 points; d=0.7). Implantation has a low overall perceived burden and is significantly less burdensome during bone and soft tissue manipulation than surgical tooth removal or apicectomy. Patients can be informed that implant placement is less unpleasing than other commonly performed oral surgery procedures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Effect of cardiac resynchronization therapy in patients with diabetes randomized in EchoCRT

    DEFF Research Database (Denmark)

    Nägele, Matthias P; Steffel, Jan; Robertson, Michele;

    2017-01-01

    AIMS: As patients with heart failure (HF) and concomitant diabetes carry a poor prognosis, this post-hoc subgroup analysis aimed to compare the outcomes of patients with and without diabetes randomized in the Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study. METHODS AND R...

  6. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  7. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling

    Science.gov (United States)

    Chiang, Yi Zhen; Al-Niaimi, Firas; Madan, Vishal

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA®), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4®)) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice) were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval) pain score of 5 (±2.58; 3.66-6.46) with Ametop™, 4.38 (±2.53; 2.64-4.89) with EMLA® and 3.91 (±1.95; 2.65-4.76) with LMX4®. There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures. PMID:26644737

  8. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

    Directory of Open Access Journals (Sweden)

    Serhat Atilgan

    2010-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70% males and 162 (30% females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65% in young patients and traffic accidents (38% in adults. The most common fracture sites were the symphysis (35% and condyle (36% in young patients, and the symphysis in adults (36%. Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67% and adult (39% patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

  9. Multiple crown size variables of the upper incisors in patients with supernumerary teeth compared with controls

    NARCIS (Netherlands)

    Khalaf, K.; Smith, R. N.; Elcock, C.; Brook, A. H.

    2009-01-01

    Aims: As part of ongoing studies of the aetiology of dental anomalies the aims of this study were to identify multiple components of tooth size of the upper permanent incisors in 34 patients with supernumerary teeth and to compare them with those in a control group to determine whether the presence

  10. Comparing mortality in renal patients on hemodialysis versus peritoneal dialysis using a marginal structural model.

    NARCIS (Netherlands)

    Wal, W.M. van der; Noordzij, M.; Dekker, F.W.; Boeschoten, E.W.; Krediet, R.T.; Korevaar, J.C.; Geskus, R.B.

    2010-01-01

    When comparing the causal effect of peritoneal dialysis (PD) and hemodialysis (HD) treatment on lowering mortality in renal patients, using observational data, it is necessary to adjust for different forms of confounding and informative censoring. Both the type of dialysis treatment that is started

  11. Mortality among patients with cleared hepatitis C virus infection compared to the general population

    DEFF Research Database (Denmark)

    Omland, Lars Haukali; Christensen, Peer Brehm; Krarup, Henrik Bygum;

    2011-01-01

    The increased mortality in HCV-infected individuals partly stems from viral damage to the liver and partly from risk-taking behaviours. We examined mortality in patients who cleared their HCV-infection, comparing it to that of the general population. We also addressed the question whether prognos...... differed according to age, substance abuse (alcohol abuse and injection drug use) and comorbidity....

  12. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  13. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  14. Oral ftorafur versus intravenous 5-fluorouracil. A comparative study in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Andersen, E; Pedersen, H

    1987-01-01

    The toxicities of oral Ftorafur (1 g/m2/day 1-21) and intravenous 5-fluorouracil (5-FU) (500 mg/m2/day 1-5) were compared in a prospective randomized study in patients with colorectal cancer. The treatment courses were repeated every 6th week. Leucopenia was more common after 5-FU. Leucocyte nadir...

  15. Fatty acid concentrations in patients with posttraumatic stress disorder compared to healthy controls

    NARCIS (Netherlands)

    de Vries, G.J.; Mocking, R.; Lok, A.; Assies, J.; Schene, A.H.; Olff, M.

    2016-01-01

    BACKGROUND: Although fatty acid (FA)-supplementation studies are currently being implemented, in fact little is known about FA-profiles in posttraumatic stress disorder (PTSD). Therefore, the present study aimed at comparing FA-concentrations between PTSD-patients and healthy controls. METHODS: A cr

  16. TESE-ICSI in patients with non-mosaic Klinefelter syndrome: a comparative study.

    Science.gov (United States)

    Yarali, Hakan; Polat, Mehtap; Bozdag, Gurkan; Gunel, Mufit; Alpas, Idil; Esinler, Ibrahim; Dogan, Utku; Tiras, Bulent

    2009-06-01

    There are limited data in the literature on the performance of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) treatment in patients with Klinefelter syndrome. The current study compared TESE-ICSI treatment in patients with non-mosaic Klinefelter syndrome with controls having non-obstructive azoospermia and normal karyotype. Thirty-three consecutive patients (39 TESE-ICSI cycles) with Klinefelter syndrome (study group) and 113 consecutive patients (130 TESE-ICSI cycles) with non-obstructive azoospermia and normal karyotype (control group) were recruited in a private IVF setting. In the two groups, the mean ages of the men at the time of TESE were 32.0 +/- 6.4 and 34.3 +/- 5.8 years respectively (P Klinefelter syndrome group, following biopsy and fluorescence in-situ hybridization, a normal karyotype was obtained in 42 of the 71 embryos (59%). The clinical pregnancy and implantation rates in the study and control groups were similar (39, 23 and 33, 26% respectively). In conclusion, patients with non-mosaic Klinefelter syndrome have sperm recovery and pregnancy rates comparable with patients having non-obstructive azoospermia and normal karyotype.

  17. Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Chang, Sei Kyung; Lee, Bo Mi; Shin, Hyun Soo [Dept. of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of); Park, Heily [Dept. of Radiation Oncology, Presbyterian Hospital, Jeonju (Korea, Republic of)

    2012-09-15

    To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

  18. Comparative prognostic value of C-reactive protein & fibrinogen in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Gjin Ndrepepa

    2014-01-01

    Full Text Available Background & objectives: The comparative prognostic value of C-reactive protein (CRP and fibrinogen for cardiovascular events has been inconclusively investigated. t0 his study was carried out to compare the prognostic value of CRP versus fibrinogen in patients with coronary artery disease (CAD. Methods: The study included 13,100 patients with coronary angiography-confirmed CAD. Plasma CRP and fibrinogen levels were measured before angiography in all patients. The levels of CRP>3 mg/l and fibrinogen>350 mg/dl were considered as elevated. The primary outcome was 1-year all-cause mortality. Results: Patients were divided into four groups: patients with CRP≤3 mg/l and fibrinogen ≤350 mg/dl (n=4206; patients with CRP≤3 mg/l and fibrinogen >350 mg/dl (n=3132; patients with CRP>3 mg/l and fibrinogen ≤ 350 mg/dl (n=1273 and CRP >3 mg/l and patients with fibrinogen >350 mg/dl (n=4489. There were 634 deaths: 75 deaths in patients with CRP ≤3 mg/l and fibrinogen ≤350 mg/dl, 91 deaths in patients with CRP ≤3 mg/l and fibrinogen >350 mg/dl, 87 deaths in patients with CRP >3 mg/l and fibrinogen ≤350 mg/dl and 381 deaths in patients with CRP >3 mg/l and fibrinogen >350 mg/dl (Kaplan-Meier estimates of all-cause mortality, 1.8, 3.0, 7.0 and 8.7 %, log-rank test P<0.001. The multivariate analysis showed that CRP [adjusted hazard ratio (HR=1.31, 95% confidence interval (CI 1.18-1.45, for each standard deviation increase in the logarithmic scale] but not fibrinogen [adjusted HR=0.99 (0.90-1.09, for each standard deviation increase in the logarithmic scale] was an independent correlate of mortality. Interpretation & conclusions: The findings indicated that in patients with CAD, CRP was a better predictor of mortality than fibrinogen and offered prognostic information beyond that provided by the conventional cardiovascular risk factors.

  19. Various functions of PBMC from colon cancer patients are not decreased compared to healthy blood donors

    DEFF Research Database (Denmark)

    Afzelius, P; Nielsen, Hans Jørgen

    1997-01-01

    -2 and its receptor proteins in T helper cells. The proliferative responses and IL-2 synthesis of PBMC have earlier been shown to be reduced in patients with colon cancer. Recently immune modulating agents have been demonstrated to increase the proliferative response of PBMC in vitro, probably...... by inhibition of adenylate cyclase activity and induction of IL-2 mRNA expression. We have therefore studied the proliferative responses of PBMC from colon cancer patients to PWM and tested the effect of immune modulating agents, such as Serotonin, Sumatriptan, and Buspirone on these PBMC. We found...... no difference in levels of intracellular cAMP, IL-2 mRNA expression, IL-2R mRNA expression, or proliferative responses of PBMC from colon cancer patients compared to healthy blood donors. There was no effect of the immune modulating agents on PBMC from colon cancer patients....

  20. A comparative, descriptive study of systemic factors and survival in elderly patients with sacral pressure ulcers.

    Science.gov (United States)

    Jaul, Efraim; Menczel, Jacob

    2015-03-01

    Sacral pressure ulcers (PUs) are a serious complication in frail elderly patients. Thin tissue in the sacral area, low body mass index, and anatomical location contribute to the development of sacral PUs. A comparative, descriptive study was conducted to identify patient systemic factors associated with sacral PUs and to compare survival time in patients with and without PU. All consecutive patients with PUs (n = 77) and without sacral PUs (n = 53) admitted to the skilled nursing department of a geriatric hospital in Jerusalem, Israel between July 1, 2008 and December 31, 2011 were eligible to participate. Charts of previously admitted patients were abstracted and patients were prospectively followed until discharge, death, or the end of the study. Patient demographics, comorbidities, nutritional status, physical and cognitive function (measured using the Reisberg's Functional Assessment Staging Tool [FAST], Stages of Dementia of Alzheimer Scale, and the Glasgow Coma Scale), PU status, number of courses of antibiotic treatment during admission, length of hospitalization, and mortality were compared between patients admitted with and without a sacral PU using descriptive and univariate statistics. Logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for sacral PU versus without PU by study covariate. The association between sacral PU and survival time was assessed using Kaplan-Meier models. Patients with a sacral PU were significantly older (average age 81.60 ±10.78 versus 77.06±11.19 years old, P = 0.02) and had a higher prevalence of dementia (70% versus 30%, P = 0.007), Parkinson's disease (92.3% versus 7.7%, P = 0.03), and anemia (67.7% versus 32.3%, P = 0.06) than patients admitted without a PU. Patients with a sacral PU also had a lower body mass index (23.1 versus 25.4, P = 0.04), and lower hemoglobin (10.54 versus 11.11, P = 0.03), albumin (26.2 versus 29.7, P = 0.002), and total protein levels (61.3 versus

  1. Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study.

    Science.gov (United States)

    Pan, Xilong; Dib, Hassan H; Zhu, Minmin; Zhang, Ying; Fan, Yang

    2009-10-01

    Expose the weak loops in the Chinese medical insurance coverage and uncover hospitals' role of over-pricing hospitalized insured patients compared with those non-insured. A multi-linear regression method was used to analyze hospitalization expense for insured and uninsured patients with uncomplicated acute appendicitis, cholecystitis, benign uterine tumors, and normal delivery. Hospitalization cost is higher among insured than uninsured patients due to longer hospitalization lengths of stay, type of disease (highest among cholecystitis patients), type of gender - females, old-aged people, and type of marital status - singles, as well as drugs expenses, surgical expenses, and other medical acts. Require a better government's supervision system over medical insurance expenses such as reforming methods of payments, building up new cost compensation mechanism, and unifying and stabilizing prices for each category of medicines.

  2. Synthesis of Freestanding HfO2 Nanostructures

    Science.gov (United States)

    2011-04-05

    Tang J, Fabbri J, Robinson RD, Zhu Y, Herman IP, Steigerwald ML, Brus LE: Solid-solution nanoparticles:use of a nonhydrolytic sol-gel synthesis to...colloidal HfO2 nanorods. Adv Mater 2007, 19:2608-2612. Page 21 5. Qiu X, Howe JY, Cardoso MB, Polat O, Heller W: Size control of highly ordered HfO2

  3. Parametric excitation of whistler waves by HF heater

    Science.gov (United States)

    Kuo, S. P.; Lee, M. C.

    1989-01-01

    Possible generation of whistler waves by Tromso HF heater is investigated. It is shown that the HF heater wave can parametrically decay into a whistler wave and a Langmuir wave. Since whistler waves may have a broad range of frequency, the simultaneously excited Langmuir waves can have a much broader frequency bandwidth than those excited by the parametric decay instability.

  4. Study of {sup 179}Hf{sup m2} excitation

    Energy Technology Data Exchange (ETDEWEB)

    Vishnevsky, I. N.; Zheltonozhsky, V. A., E-mail: zhelton@kinr.kiev.ua; Savrasov, A. N. [National Academy of Sciences of Ukraine, Institute for Nuclear Research (Ukraine); Mazur, V. M. [National Academy of Sciences of Ukraine, Institute of Electronic Physics (Ukraine)

    2016-12-15

    Isomeric ratios of {sup 179}Hf{sup m2,g} yields in the (γ, n) reaction and the cross section for the {sup 179}Hf{sup m2} population in the (α, p) reaction are measured for the first time at the end-point energies of 15.1 and 17.5 MeV for bremsstrahlung photons and 26 MeV for alpha particles. The results are σ = (1.1 ± 0.11) × 10{sup −27} cm{sup 2} for the {sup 176}Lu(α, p){sup 179}Hf{sup m2} reaction and Y{sub m2}/Y{sub g} = (6.1 ± 0.3) × 10{sup −6} and (3.7 ± 0.2) × 10{sup −6} for the {sup 180}Hf(γ, n){sup 179}Hf{sup m22} reaction at E{sub ep} =15.1 and 17.5 MeV, respectively. The experimental data on the relative {sup 179}Hf{sup m2} yield indicate a single-humped shape of the excitation function for the {sup 180}Hf(γ, n){sup 179}Hf{sup m2} reaction. Simulation is performed using the TALYS-1.4 and EMPIRE-3.2 codes.

  5. Evaluation of the Lipid Profile of Hypertensive Patients Compared to Non- Hypertensive Individuals

    Directory of Open Access Journals (Sweden)

    Golnoosh Ghooshchi

    2014-07-01

    Full Text Available Introduction: This study was designed to compare the lipid profiles of hypertensive and non-hypertensive cases. Materials and Methods:In this case-control study, we assessed 200 hypertensive patients alongside 200 healthy individuals who were referred to our cardiology clinics from 2007 to 2008, in Mashhad, Iran. Blood pressure and serum lipids profile including total cholesterol, triglyceride, High-density lipoprotein (HDL and low-density lipoprotein (LDL were evaluated in both the case and control group. Results: Total cholesterol and the mean of serum LDL level were significantly higher in the hypertensive patients compared to non-hypertensive cases (P=0.001, while the mean of serum triglyceride levels was higher in the case group compared to the control group (P= 0.001. Conclusion: We concluded that only the serum triglyceride levels were significantly different between the hypertensive and non-hypertensive individuals.

  6. Clinical outcome among HIV-infected patients starting saquinavir hard gel compared to ritonavir or indinavir

    DEFF Research Database (Denmark)

    Kirk, O; Mocroft, A; Pradier, C;

    2001-01-01

    OBJECTIVE: To compare the clinical response among patients who initiate protease inhibitor therapies with different virological potency. DESIGN: We analysed patients who started indinavir, ritonavir or saquinavir hard gel capsule (hgc) as part of at least triple therapy during prospective follow.......62--1.11); P = 0.20. CONCLUSIONS: Saquinavir hgc was associated with an inferior long-term clinical response relative to indinavir, which was consistent with the observed differences in virological and immunological responses.......-up within the EuroSIDA study. METHODS: Changes in plasma viral load (pVL) and CD4 cell count from baseline were compared between treatment groups. Time to new AIDS-defining events and death were compared in Kaplan--Meier models, and Cox models were established to further assess differences in clinical...

  7. Comparative study of bacterial infection prevalence between cirrhotic patients with and without upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Delvone Almeida

    Full Text Available Bacterial infection is a frequent complication in patients with chronic liver disease, mainly during the advanced stages. There is evidence that the main factors that contribute to a predisposition to infection in cirrhotic patients are related to hepatic failure with consequent immunodeficiency. Invasive procedures (diagnostic or therapeutic can predispose to bacterial infections, and upper gastrointestinal bleeding (UGB is considered a potentially important risk factor. A group of cirrhotic patients (child B and C Pugh groups were evaluated retrospectively by chart reviews regarding the prevalence of bacterial infection during hospitalization to determine whether UGB was a risk factor. An infection was considered present if a specific organ system was identified or if fever (>38ºC persisted for more than 24 hours with associated leukocytosis. Spontaneous bacterial peritonitis was based on classical criteria. Eighty-nine patients were evaluated. Fourty-six patients presented with UGB, and 43 patients had no UGB (control. There were infections recorded in 25/46 (54% patients with UGB, and 15/43 (35% in those without UGB (p=0.065. The ratio of the number of infections/admitted patients, was significantly larger in the group with UGB (0.78 ± 0.89 vs. 0.39 ± 0.62; p=0.028 since patients had more than one infection. In the UGB group compared to non UGB group, ascites was more frequent (67% vs. 42%; p=0.027; they were more likely to have undergone endoscopic procedures (p<0.001 and the mean ± SD for platelets count was smaller (96,114 ± 57,563 vs. 145,674 ± 104,083; p=0.007. The results show that UGB is an important contribution to bacterial infection among Child B and C cirrhotic patients.

  8. Comparative study of bacterial infection prevalence between cirrhotic patients with and without upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Delvone Almeida

    2001-06-01

    Full Text Available Bacterial infection is a frequent complication in patients with chronic liver disease, mainly during the advanced stages. There is evidence that the main factors that contribute to a predisposition to infection in cirrhotic patients are related to hepatic failure with consequent immunodeficiency. Invasive procedures (diagnostic or therapeutic can predispose to bacterial infections, and upper gastrointestinal bleeding (UGB is considered a potentially important risk factor. A group of cirrhotic patients (child B and C Pugh groups were evaluated retrospectively by chart reviews regarding the prevalence of bacterial infection during hospitalization to determine whether UGB was a risk factor. An infection was considered present if a specific organ system was identified or if fever (>38ºC persisted for more than 24 hours with associated leukocytosis. Spontaneous bacterial peritonitis was based on classical criteria. Eighty-nine patients were evaluated. Fourty-six patients presented with UGB, and 43 patients had no UGB (control. There were infections recorded in 25/46 (54% patients with UGB, and 15/43 (35% in those without UGB (p=0.065. The ratio of the number of infections/admitted patients, was significantly larger in the group with UGB (0.78 ± 0.89 vs. 0.39 ± 0.62; p=0.028 since patients had more than one infection. In the UGB group compared to non UGB group, ascites was more frequent (67% vs. 42%; p=0.027; they were more likely to have undergone endoscopic procedures (p<0.001 and the mean ± SD for platelets count was smaller (96,114 ± 57,563 vs. 145,674 ± 104,083; p=0.007. The results show that UGB is an important contribution to bacterial infection among Child B and C cirrhotic patients.

  9. Comparative Assessment of Quality of Life in Hemodialysis and Kidney Transplant Patients

    Directory of Open Access Journals (Sweden)

    A Abbaszadeh

    2010-12-01

    Full Text Available Introduction: Quality of life(QOL is a state of complete physical, mental, social and spiritual well-being and may be affected by sociodemographic variables, chronic illnesses, psychiatric and physical conditions. End stage renal diseases and treatments lead to many problems in patients including physical, mental and socioeconomic problems thus affecting their overall QOL. This study evaluated and compared QOL in hemodialysis and kidney transplant patients. Methods: In a descriptive analytic study, SF36 questionnaire was used to examine QOL in 120 patients (60 hemodialysis and 60 kidney transplant patients in Kerman. Results: The mean QOL score in hemodialysis patients was 49.83±17.56, while in kidney transplant patients, it was 60.95±16.60. Although difference between the two groups was significant (p≤o.o5, the difference in three dimensions pain, physical and social function was not significant (p≥0.05. In hemodialysis patients, minimum score was in vitality dimension and maximum score in physical function. In kidney transplant patients, minimum score was in general health and maximum score was in role limitation due to physical problem dimension. Conclusion: Although QOL in both groups is lower than public communities, kidney transplantation can improve QOL, especially in role restriction due to physical problems. Based on results, it seems that age, blood creatinine levels and personal perception are the most important factors affecting QOL of hemodialysis patients and only creatinine levels and personal perception can be modified. So, in this group of patients, by maintaining creatinine levels and assuring dialysis quality, QOL can be improved. On the other hand, recognition of patient’s defiance mechanisms can improve adaptation and life satisfaction.

  10. Comparing efficacy of preemptively used dexketoprofen and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Süreyya Özkan

    2015-03-01

    Full Text Available Objective: In our study, we aimed to compare effects of preoperative dexketoprofen and tramadol administered by intravenous route on intraoperative and postoperative analgesic consumption, postoperative pain, durations of hospital stay and patient satisfaction in patients, undergoing laparoscopic cholecystectomy. Methods:After approval of ethic committee and written consent of patients were obtained, 60 patients between 18-70 years old with ASA I-II were included in the study. After routine monitorization and 20 minutes before induction of anesthesia, dexketoprofen 50 mg in 100 cc 0.9% NaCl was administered in Dexketoprofen Group and tramadol 100 mg in 100 cc 0.9% NaCl in Tramadol Group as intravenous infusion during 20 minutes. Intraoperative hemodynamic parameters, analgesic-anesthetic consumptions and complications of patients, on whom standard general anesthesia was applied, were recorded. Pain severity, degree of sedation, morphine consumptions and hemodynamic parameters were recorded at postoperative 30 th minute, and 4 th, 8th, 12th and 24 th hours. Additional analgesia requirement, times for requiring first analgesia, duration of hospital stay, postoperative complications and patient satisfactions were recorded. Results: Intraoperative analgesic-anesthetic consumptions, postoperative visual analogue scale (VAS scores, sedation degrees, intravenous patient controlled analgesia (PCA and morphine consumptions, times for requiring first analgesic, durations of hospital stay, intraoperative-postoperative complications developed and patient satisfactions were similar in both groups. Consequently, postoperative analgesic efficacy of pre-emptive dexketoprofen intravenous 50 mg and tramadol intravenous 100 mg administered was found to be similar in cases, who had laparoscopic cholecystectomy operation. Conclusion:Because VAS scores were low in our patients, morphine consumptions with intravenous PCA were similar in both groups, and there wasn

  11. Psychological characteristics of patients with Ménière's disease compared with patients with vertigo, tinnitus, or hearing loss.

    Science.gov (United States)

    Savastano, Marina; Marioni, Gino; Aita, Maria

    2007-03-01

    An association between Ménière 's disease and psychological distress is frequently reported. Patients who do not have Ménière's disease but who have similar symptoms also experience various kinds of psychological disturbances. We conducted a study to investigate the relationship between Ménière's disease and personality traits, illness behavior, depression, and anxiety. We compared these factors in 77 patients who had Ménière's disease and 133 controls who did not have the disease but had one of its symptoms--either vertigo, tinnitus, or hearing loss. The mental status of study participants was assessed with standard tests. Patients in both groups had higher than normal levels of anxiety and neuroticism. The only significant difference between the two groups was a higher rate of extroversion in the Ménière's disease group. Minor differences emerged when Ménière's patients with tinnitus or vertigo were compared with similar controls. Relationships between psychological observations and otologic symptomatology or an otologic diagnosis were not specific, which illustrates the need to consider the role of illness behavior and personality as targets for psychological support or therapy associated with ENT treatment.

  12. Conscious sedation for patients undergoing enteroclysis: Comparing the safety and patient-reported effectiveness of two protocols

    Energy Technology Data Exchange (ETDEWEB)

    Maglinte, Dean D.T. [Department of Radiology, Indiana University Medical Center, 550 N, University Boulevard, University Hospital Room 0279, Indianapolis, IN 46202-5253 (United States)], E-mail: dmaglint@iupui.edu; Applegate, Kimberly E.; Rajesh, Arumugam; Jennings, S. Gregory; Ford, Jason M. [Department of Radiology, Indiana University Medical Center, 550 N, University Boulevard, University Hospital Room 0279, Indianapolis, IN 46202-5253 (United States); Savabi, Mojgan Sarah [Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, 550 N, University Boulevard, Indianapolis, IN 46202-5253 (United States); Lappas, John C. [Department of Radiology, Indiana University Medical Center, 550 N, University Boulevard, University Hospital Room 0279, Indianapolis, IN 46202-5253 (United States)

    2009-06-15

    Objective: To compare the safety and patient-reported effectiveness of two regimens for conscious sedation during enteroclysis. Materials and methods: We surveyed two groups of outpatients and retrospectively reviewed procedure records for conscious sedation and complications. Patients were divided into Group One (received sedative/amnesic diazepam), and Group Two, (received amnesic/sedative, midazolam and analgesic fentanyl). Results: All enteroclyses were successfully completed; there were no hospital admissions due to complications. In Group One (n = 106), mean dose of diazepam was 12.7 mg. 25% had oxygen desaturation (n = 25), and post-procedure vomiting without aspiration (n = 1). 56% of outpatients completed phone surveys, and 68% recalled procedural discomfort. In Group Two (n = 45), mean doses were 3.9 mg midazolam and 108 mcg fentanyl. 31% had desaturation (n = 13), and post-procedure vomiting without aspiration (n = 1). 87% had only a vague recall of the procedure or of any discomfort. Conclusion: A combination of amnesic and fentanyl prevented the recall of discomfort of nasoenteric intubation and infusion in most patients who had enteroclysis compared to diazepam. Most of the patients would undergo the procedure again, if needed.

  13. Differential expression of plasma miR-146a in sepsis patients compared with non-sepsis-SIRS patients.

    Science.gov (United States)

    Wang, Lina; Wang, Hua-Cheng; Chen, Cha; Zeng, Jianming; Wang, Qian; Zheng, Lei; Yu, Huan-DU

    2013-04-01

    Sepsis is a subtype of systemic inflammatory response syndrome (SIRS), which is characterized by infection. Circulating microRNAs (miRNAs), including miR-150, miR-146a and miR-223, are potential biomarkers of sepsis. In this study, we demonstrated that measuring the relative expression of miR-146a/U6 in plasma, using the 2(-ΔΔCt) method, provides a method for differentiating between sepsis and non-sepsis-SIRS. We observed a significant increase in miR-146a expression in the initial cohort of 6 non-sepsis-SIRS patients compared to the 4 sepsis patients (P=0.01) and in the second cohort of 8 non-sepsis-SIRS patients compared to the 10 sepsis patients (P=0.027). Additionally, we identified that sodium citrate and ethylenediaminetetraacetic acid (EDTA) K2 may be used as anticoagulant reagents. Generation of a standard curve is not necessary in these diagnostic tests, unless the standard of normalization is carefully selected. Thus we provide more detailed guidance for the clinical use of circulating miRNA biomarkers.

  14. [Comparative study of the Candida albicans genotypes isolated from immunocompromised patients and health carriers].

    Science.gov (United States)

    Carnovale, S; Elias Costa, M R; Relloso, S; Negroni, R; Negroni, M B; Iovannitti, C

    2001-01-01

    The aim of this study is to compare Candida albicans strain genotype isolates from oral cavity of immunocompromised patients due to different immunologic impairments with apparently normal carriers. Four populations were studied: 1) HIV positive hospitalized patients, 2) HIV negative immunocompromised patients (leukemia, lymphoma, organ transplant recipients), 3) drug addicts prior to AIDS pandemia in Argentina, 4) apparently normal carriers. DNA extracted was digested with the enzyme Eco RI, electrophoresed, transferred to nitrocellulose membrane and hybridized with the 27A probe labelled with 32P. The comparison between the profiles obtained permitted the differentiation of 16 genotypes. The distribution of the strains led to the conclusion that: a) all the isolated strains from AIDS patients were closely related and distributed in only three genotypes (1, 3, 11); b) a major genetic relationship between the isolates from AIDS patients and HIV negative immunocompromised patients was observed; c) strains from carriers showed a minor genetic similarity with those obtained from AIDS patients; d) characteristic profiles belonging to any of the studied groups were not found; e) significant genomic changes have not been observed during the last twenty years.

  15. Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

    Science.gov (United States)

    Cerqueiro, J M; González-Franco, A; Montero-Pérez-Barquero, M; Llácer, P; Conde, A; Dávila, M F; Carrera, M; Serrado, A; Suárez, I; Pérez-Silvestre, J; Satué, J A; Arévalo-Lorido, J C; Rodríguez, A; Herrero, A; Jordana, R; Manzano, L

    2016-01-01

    Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  16. Oxygen Recovery in Hf Oxide Films Fabricated by Sputtering

    Institute of Scientific and Technical Information of China (English)

    JIANG Ran; LI Zi-Feng

    2009-01-01

    The chemical structure of ultrathin Hf oxide films (< 10 nm) fabricated by a standard sputtering method is investigated using x-ray spectroscopy and Rutherford backscattering spectroscopy. According to the experiments,oxygen species are impacted to the HfO2/Si interface during the initial sputtering, and then released back to the upper Hf02 region driven by the oxygen concentration grads. A vacuum annealing can greatly enhance this recovery process. Additionally, significant SiO2 reduction in the interface is observed after the vacuum annealing for the thick HfO2 films in our experiment. It might be an effective method to confine the interracial layer thickness by sputtering thick HfO2 in no-oxygen ambient.

  17. Crystal structure of Si-doped HfO2

    Science.gov (United States)

    Zhao, Lili; Nelson, Matthew; Aldridge, Henry; Iamsasri, Thanakorn; Fancher, Chris M.; Forrester, Jennifer S.; Nishida, Toshikazu; Moghaddam, Saeed; Jones, Jacob L.

    2014-01-01

    Si-doped HfO2 was prepared by solid state synthesis of the starting oxides. Using Rietveld refinement of high resolution X-ray diffraction patterns, a substitutional limit of Si in HfO2 was determined as less than 9 at. %. A second phase was identified as Cristobalite (SiO2) rather than HfSiO4, the latter of which would be expected from existing SiO2-HfO2 phase diagrams. Crystallographic refinement with increased Si-dopant concentration in monoclinic HfO2 shows that c/b increases, while β decreases. The spontaneous strain, which characterizes the ferroelastic distortion of the unit cell, was calculated and shown to decrease with increasing Si substitution.

  18. The (178m2)Hf Controversy

    Energy Technology Data Exchange (ETDEWEB)

    Becker, J A; Gemmell, D S; Schiffer, J P; Wilhelmy, J B

    2003-07-24

    Since its discovery in the 1960's the {sup 178m2}Hf isomer has garnered high attention from both the basic and applied communities in nuclear science. It's combination of high spin (16+), long half life (31 yrs), and high excitation energy (2.446 MeV) offer unique possibilities as an energy storage medium. Interest in the isomer was rekindled beginning in 1999 when a series of publications began to appear from a group (referred to here as the ''Texas collaboration'') primarily based at the University of Texas, Dallas [1]. They reported observations that some of the stored energy could be released (''triggered'') when the isomer was exposed to a fluence of photons in the energy range {approx}10 to {approx}60 keV. The implications of this observation are profound. Even though the claimed cross section for the process was {approx}7 orders of magnitude greater than would be predicted from the known systematics of photon absorption by nuclei in this mass range [2], such a highly efficient method for triggering the isomeric deexcitation immediately suggested applications utilizing the explosive or the controlled gradual energy release from a very compact source. The prospect of such applications has focused considerable interest on realizing the promise that is implicit in the reported observations. However, two experiments performed by a group from ANL/LANL/LLNL at the Advanced Photon Source at Argonne (the ''APS collaboration'') reported negative results for the observation of any photon-triggered deexcitation of the {sup 178m2}Hf isomer [3]. This has led to a continued controversy, where both sides have adamantly defended their observations. At this point an outsider has difficulty determining whether there is indeed a triggering effect that should be pursued energetically with substantial resources, or whether the phenomenon consists of overly optimistic interpretation of data.

  19. High-k perovskite gate oxide BaHfO3

    Directory of Open Access Journals (Sweden)

    Young Mo Kim

    2017-01-01

    Full Text Available We have investigated epitaxial BaHfO3 as a high-k perovskite dielectric. From x-ray diffraction measurement, we confirmed the epitaxial growth of BaHfO3 on BaSnO3 and MgO. We measured optical and dielectric properties of the BaHfO3 gate insulator; the optical bandgap, the dielectric constant, and the breakdown field. Furthermore, we fabricated a perovskite heterostructure field effect transistor using epitaxial BaHfO3 as a gate insulator and La-doped BaSnO3 as a channel layer on SrTiO3 substrate. To reduce the threading dislocations and enhance the electrical properties of the channel, an undoped BaSnO3 buffer layer was grown on SrTiO3 substrates before the channel layer deposition. The device exhibited a field effect mobility value of 52.7 cm2 V−1 s−1, a Ion/Ioff ratio higher than 107, and a subthreshold swing value of 0.80 V dec−1. We compare the device performances with those of other field effect transistors based on BaSnO3 channels and different gate oxides.

  20. The Performance and Fouling Control of Submerged Hollow Fiber (HF Systems: A Review

    Directory of Open Access Journals (Sweden)

    Ebrahim Akhondi

    2017-07-01

    Full Text Available The submerged membrane filtration concept is well-established for low-pressure microfiltration (MF and ultrafiltration (UF applications in the water industry, and has become a mainstream technology for surface-water treatment, pretreatment prior to reverse osmosis (RO, and membrane bioreactors (MBRs. Compared to submerged flat sheet (FS membranes, submerged hollow fiber (HF membranes are more common due to their advantages of higher packing density, the ability to induce movement by mechanisms such as bubbling, and the feasibility of backwashing. In view of the importance of submerged HF processes, this review aims to provide a comprehensive landscape of the current state-of-the-art systems, to serve as a guide for further improvements in submerged HF membranes and their applications. The topics covered include recent developments in submerged hollow fiber membrane systems, the challenges and developments in fouling-control methods, and treatment protocols for membrane permeability recovery. The highlighted research opportunities include optimizing the various means to manipulate the hydrodynamics for fouling mitigation, developing online monitoring devices, and extending the submerged HF concept beyond filtration.

  1. Cross sections for medium energy He ions scattered from Hf and Au atoms

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Tomoaki, E-mail: t-nishi@hosei.ac.jp [Research Center of Ion Beam Technology and College of Engineering, Hosei University, Koganei, Tokyo 184-8584 (Japan); Mitsuhara, Kei; Visikovskiy, Anton; Kido, Yoshiaki [Department of Physics, Ritsumeikan University, Kusatsu, Shiga-ken 525-8577 (Japan)

    2012-06-01

    The elastic scattering cross sections for medium energy He ions incident on Ni, Hf and Au atoms were measured precisely using a toroidal electrostatic analyzer. We prepared the targets of Ni({approx}1 nm)/HfO{sub 2}(1.5 nm)/Si(0 0 1) and Ni({approx}1 nm)/Au({approx}0.5 nm)/Si(1 1 1) and performed in situ ion scattering measurement under ultrahigh vacuum condition. The absolute amounts of Ni, Hf and Au were determined by Rutherford backscattering using 1.5 MeV He ions at a scattering angle of 150 Degree-Sign . The scattering cross sections for Hf and Au were normalized by those for Ni to avoid the ambiguities of the number of incident particles, solid angle subtended by a detector, detection efficiency and the He{sup +} fractions for the emerging He ions from the surfaces. The results obtained are compared with the simple Lee-Hart formula and the calculated values using the Moliere and ZBL potentials and the potentials derived from the Hartree-Fock-Slater wave functions.

  2. 182Hf- 182W chronometry and early differentiation of the ureilite parent body

    Science.gov (United States)

    Lee, Der-Chuen; Halliday, Alex N.; Singletary, Steven J.; Grove, Timothy L.

    2009-11-01

    Eight samples spanning the bulk chemical range of monomict ureilites, have been analyzed for their W isotopic composition and Hf/W in order to elucidate the differentiation history of the ureilite parent body. The ureilites studied here show sub-chondritic Hf and W concentrations and low Hf/W ratio, and all show clear 182W deficits relative to bulk chondrites. The W isotope data provide evidence that the ureilite parent body differentiated within 1 to 2 million years after the start of the solar system. Such early accretion and differentiation is comparable to the parent bodies of various magmatic iron meteorites, as well as the HED parent body. However, the trace element fractionations and by inference melting processes are very different. An early smelting/partial melting event coupled with metal-silicate segregation, however, can reproduce the observed Hf-W data in ureilites, and is consistent with petrological and other chemical evidence for a missing basaltic component and with primitive oxygen and noble gases compositions.

  3. Tribological and wear behavior of HfN/VN nanomultilayer coated cutting tools

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    Willian Aperador Chaparro

    2014-03-01

    Full Text Available Wear and tribological behavior of [HfN/VN]n multinanolayers deposited via magnetron sputtering has been exhaustively studied in this work. Enhancement of both hardness and elastic modulus up to 37 GPa and 351 GPa, respectively, was observed as bilayer periods in the coatings were decreased. The sample with a bilayer period (Λ of 15 nm and bilayer number n = 80, showed the lowest friction coefficient (∼0.15 and the highest critical load (72 N, corresponding to 2.2 and 1.38 times better than those values for the coating deposited with n = 1, respectively. Taking into account the latest results of tungsten carbide (WC inserts were used as substrates to improve the mechanical and tribological properties of [HfN/VN]n coatings as a function of increased interface number and to manage higher efficiency of these coatings in different industrial applications, like machining and extrusion. Their physical, mechanical, and tribological characteristics were investigated, including cutting tests with AISI 1020 steel (workpiece to assess wear as a function of the bilayer number and bilayer period. A comparison of the tribological properties revealed a decrease of flank wear (approximately 24% for WC inserts coated with [HfN/VN]80 (Λ =15 nm, when compared to uncoated tungsten carbide inserts. These results demonstrate the possibility of using [HfN/VN] multilayers as new coatings for tool machining with excellent industrial performance.

  4. Kinetics of Cerium(IV) Extraction from H(2)SO(4)-HF Medium with Cyanex 923.

    Science.gov (United States)

    Liao, Wuping; Yu, Guihong; Yue, Shantang; Li, Deqian

    2002-03-11

    Studies of the extraction kinetics of cerium(IV) from H(2)SO(4)-HF solutions with Cyanex 923 in n-heptane have been carried out using a constant interfacial area cell with laminar flow. The experimental hydrodynamic conditions were chosen so that the contribution of diffusion to the measured rate of reaction was minimized. The data were analyzed in terms of pseudo-first order constants. The results were compared with those of the system without HF. It was concluded that the addition of HF reduces the activation energy for the forward rate from 46.2 to 36.5 kJ mol(-1) while it has an opposite effect on the activation energy for the reverse process(the activation energy increased from 23.3 to 90.8 kJ mol(-1)). Thus, HF can accelerate the rate of cerium(IV) extraction. At the same time, the extraction rate is controlled by a mixed chemical reaction-diffusion rather than by a chemical reaction alone. A rate equation has also been obtained.

  5. Recent vs Conventional Methods of Caries Removal: A Comparative in vivo Study in Pediatric Patients.

    Science.gov (United States)

    Chowdhry, Swati; Saha, Sonali; Samadi, Firoza; Jaiswal, J N; Garg, Aarti; Chowdhry, Preet

    2015-01-01

    To compare the three different methods of caries removal, conventional method using Airotor and chemomechanical method using Carisolv and Papacarie. The patients with multiple carious teeth were selected either in the deciduous dentition or mixed dentition. Ninety primary molars were selected from 30 children (10 males and 20 females) between the age group 6 and 9 years. After caries excavation, cavities were evaluated for caries removal or clinical efficacy by the tactile and visual criteria, microbiological efficacy, time taken for the procedure. Patient acceptability toward the treatment was also checked with the help of a visual analog scale (VAS). The observations thus obtained were subjected to statistical analysis using analysis of variance (ANOVA), Mann-Whitney U-test and Kruskal-Wallis test. The clinical efficacy of caries removal was highest with Airotor while the microbiological efficacy of caries removal was almost comparable with Airotor, Carisolv and Papacarie caries removal methods. The time taken to remove caries by Airotor method was observed to be least while the patient acceptance was found to be highest with Papacarie method. How to cite this article: Chowdhry S, Saha S, Samadi F, Jaiswal JN, Garg A, Chowdhry P. Recent vs Conventional Methods of Caries Removal: A Comparative in vivo Study in Pediatric Patients. Int J Clin Pediatr Dent 2015;8(1):6-11.

  6. Tsunami Arrival Detection with High Frequency (HF Radar

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    Donald Barrick

    2012-05-01

    Full Text Available Quantitative real-time observations of a tsunami have been limited to deep-water, pressure-sensor observations of changes in the sea surface elevation and observations of sea level fluctuations at the coast, which are essentially point measurements. Constrained by these data, models have been used for predictions and warning of the arrival of a tsunami, but to date no system exists for local detection of an actual incoming wave with a significant warning capability. Networks of coastal high frequency (HF-radars are now routinely observing surface currents in many countries. We report here on an empirical method for the detection of the initial arrival of a tsunami, and demonstrate its use with results from data measured by fourteen HF radar sites in Japan and USA following the magnitude 9.0 earthquake off Sendai, Japan, on 11 March 2011. The distance offshore at which the tsunami can be detected, and hence the warning time provided, depends on the bathymetry: the wider the shallow continental shelf, the greater this time. We compare arrival times at the radars with those measured by neighboring tide gauges. Arrival times measured by the radars preceded those at neighboring tide gauges by an average of 19 min (Japan and 15 min (USA The initial water-height increase due to the tsunami as measured by the tide gauges was moderate, ranging from 0.3 to 2 m. Thus it appears possible to detect even moderate tsunamis using this method. Larger tsunamis could obviously be detected further from the coast. We find that tsunami arrival within the radar coverage area can be announced 8 min (i.e., twice the radar spectral time resolution after its first appearance. This can provide advance warning of the tsunami approach to the coastline locations.

  7. Aviation and healthcare: a comparative review with implications for patient safety

    Science.gov (United States)

    Parand, Anam; Soukup, Tayana; Reader, Tom; Sevdalis, Nick

    2015-01-01

    Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing. PMID:26770817

  8. A comparative study of oxidant-antioxidant status in stable and active vitiligo patients.

    Science.gov (United States)

    Ines, Dammak; Sonia, Boudaya; Riadh, Ben Mansour; Amel, El Gaied; Slaheddine, Marrekchi; Hamida, Turki; Hamadi, Attia; Basma, Hentati

    2006-09-01

    The pathogenetic mechanisms in vitiligo have not been completely clarified. One of the major hypotheses in the pathogenesis of vitiligo is the oxidative stress hypothesis. The active or stable phase of vitiligo is defined on the basis of the progression or appearance of new lesions in the last 3 months and the absence of new lesions or their progression in the last 6 months, respectively. Eighteen patients with active vitiligo, 18 patients with stable vitiligo, and 40 controls were included in this study. We examined serum levels of malondialdehyde, selenium, vitamin E and A, and the erythrocyte activities of glutathione peroxidase, superoxide dismutase, and catalase. Our results revealed a significantly higher level of serum malondialdehyde, selenium in patients with active disease compared with the controls. Significant higher increase in erythrocytes superoxide dismutase activities was observed in active vitiligo group, erythrocyte glutathione peroxidase activity was decreased significantly in active disease, whereas erythrocyte catalase activity and plasma vitamin E and A levels were not different in vitiligo patients as compared with controls. Our study shows that oxidative stress is involved in the pathophysiology of both active and stable vitiligo but increased imbalance of antioxidants was observed in the blood of active vitiligo patients.

  9. Subduction Contributions in the Trans-Mexican Volcanic Belt: Implications from Lava Chemistry and Hf-Nd-Pb Isotopes

    Science.gov (United States)

    Cai, Y.; Goldstein, S. L.; Langmuir, C. H.; Gómez-Tuena, A.; Lagatta, A.; Straub, S. M.; Martín Del Pozzo, A.

    2007-05-01

    Despite thick continental crust, near primitive lavas erupt throughout the Trans-Mexican Volcanic Belt (TMVB). In order to distinguish and better constrain subduction contributions and effects of crustal contamination, we analyzed samples representing subducting sediments from DSDP Site 487, and Quaternary lavas from stratovolcanoes and cinder cones, including alkaline "high-Nb" lavas from the Sierra Chichinautzin Volcanic Field (SCVF) showing negligible subduction signature in its trace element chemistry and representing melts of the mantle wedge. Our primary observations and implications are: (1) The high-Nb SCVF `intraplate' lavas define a linear trend along the "Nd-Hf mantle-crust array", defining the composition of the mantle wedge. (2) Popocatepetl and Nevado de Toluca stratovolcanoes show the highest Nd and Hf isotope ratios, higher than the `intraplate' lavas, indicating their sources are more "depleted mantle-like" than the regional mantle wedge. (3) The Popo and Toluca chemical and isotopic trends sharply contrast with Pico de Orizaba, which shows classic indications of crustal contamination (e.g. high 207Pb/204Pb, low Nd-Hf isotope ratios), consistent with contamination by local Precambrian crust. (4) Higher Nd-Hf isotopes in Popo and Toluca lavas also correlate with lower Pb isotope ratios, and lower Lu/Hf and Zr/Hf. Together, these data indicate contributions from subducted Pacific oceanic crust and hydrothermal sediment. (5) Popo and Toluca are also enriched in Th/LREE compared with `intraplate' lavas, reflecting subducted sediment contributions. (6) Nd-Hf isotope ratios of hydrothermal sediment from DSDP Site 487 lie on the "seawater array", with high Hf isotope ratios compared to the "mantle-crust array". Popo and Toluca Nd-Hf isotopes display a shallower slope than the "intraplate lava Nd-Hf array", reflecting contributions from hydrothermal sediment. Popocatepetl and Toluca lavas therefore avoid substantial crustal contamination of mantle wedge

  10. Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer.

    Science.gov (United States)

    Alawadi, Zeinab; Phatak, Uma R; Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy; Kao, Lillian S; Massarweh, Nader N; Feig, Barry W; Rodriguez-Bigas, Miguel A; Skibber, John M; Chang, George J

    2017-04-01

    Although the safety of combination chemotherapy without primary tumor resection (PTR) in patients with stage IV colon cancer has been established, questions remain regarding a potential survival benefit with PTR. The objective of this study was to compare mortality rates in patients who had colon cancer with unresectable metastases who did and did not undergo PTR. An observational cohort study was conducted among patients with unresectable metastatic colon cancer identified from the National Cancer Data Base (2003-2005). Multivariate Cox regression analyses with and without propensity score weighting (PSW) were performed to compare survival outcomes. Instrumental variable analysis, using the annual hospital-level PTR rate as the instrument, was used to account for treatment selection bias. To account for survivor treatment bias, in situations in which patients might die soon after diagnosis from different reasons, a landmark method was used. In the total cohort, 8641 of 15,154 patients (57%) underwent PTR, and 73.8% of those procedures (4972 of 6735) were at landmark. PTR was associated with a significant reduction in mortality using Cox regression (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.44-0.47) or PSW (HR, 0.46; 95% CI, 0. 44-0.49). However, instrumental variable analysis revealed a much smaller effect (relative mortality rate, 0.91; 95% CI, 0.87-0.96). Although a smaller benefit was observed with the landmark method using Cox regression (HR, 0.6; 95% CI, 0.55-0.64) and PSW (HR, 0.59; 95% CI, 0.54-0.64), instrumental variable analysis revealed no survival benefit (relative mortality rate, 0.97; 95% CI, 0.87-1.06). Among patients with unresectable metastatic colon cancer, after adjustment for confounder effects, PTR was not associated with improved survival compared with systemic chemotherapy; therefore, routine noncurative PTR is not recommended. Cancer 2017;123:1124-1133. © 2016 American Cancer Society. © 2016 American Cancer Society.

  11. Worthing Physiological Score vs Revised Trauma Score in Outcome Prediction of Trauma patients; a Comparative Study

    Science.gov (United States)

    Nakhjavan-Shahraki, Babak; Yousefifard, Mahmoud; Hajighanbari, Mohammad Javad; Karimi, Parviz; Baikpour, Masoud; Mirzay Razaz, Jalaledin; Yaseri, Mehdi; Shahsavari, Kavous; Mahdizadeh, Fatemeh; Hosseini, Mostafa

    2017-01-01

    Introduction: Awareness about the outcome of trauma patients in the emergency department (ED) has become a topic of interest. Accordingly, the present study aimed to compare the rapid trauma score (RTS) and worthing physiological scoring system (WPSS) in predicting in-hospital mortality and poor outcome of trauma patients. Methods: In this comparative study trauma patients brought to five EDs in different cities of Iran during the year 2016 were included. After data collection, discriminatory power and calibration of the models were assessed and compared using STATA 11. Results: 2148 patients with the mean age of 39.50±17.27 years were included (75.56% males). The AUC of RTS and WPSS models for prediction of mortality were 0.86 (95% CI: 0.82-0.90) and 0.91 (95% CI: 0.87-0.94), respectively (p=0.006). RTS had a sensitivity of 71.54 (95% CI: 62.59-79.13) and a specificity of 97.38 (95% CI: 96.56-98.01) in prediction of mortality. These measures for the WPSS were 87.80 (95% CI: 80.38-92.78) and 83.45 (95% CI: 81.75-85.04), respectively. The AUC of RTS and WPSS in predicting poor outcome were 0.81 (95% CI: 0.77-0.85) and 0.89 (95% CI: 0.85-0.92), respectively (p<0.0001). Conclusion: The findings showed a higher prognostic value for the WPSS model in predicting mortality and severe disabilities in trauma patients compared to the RTS model. Both models had good overall performance in prediction of mortality and poor outcome. PMID:28286838

  12. Comparative Analysis of Espa-Carb Efficacy in Patients with Hyperthyroidism

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    V.I. Pankiv

    2014-07-01

    Materials and Methods. We observed 55 patients with DTG, divided into two groups. The first group (n = 30 received carbimazole (Espa-Carb, the second group (n = 25 — thiamazolum (Mercazolil-Zdorovye. The patient groups did not differ in age, sex, size of thyroid gland and duration of thyrotoxicosis. Results. Analysis of the findings shows that the first group of patients has a more significant effect of treatment compared with patients of the second group. Average thyroid volume was significantly reduced only in the first group. At average, thyroid volume decreased from 37.2 ± 3.1 cm3 to 29.3 ± 2.9 cm3 (p 0.05. In patients from the first group with DTG, a significant increase in TSH (from 0.027 ± 0.009 mIU/l to 0.37 ± 0.16 mIU/L; p 0.05. At the same time, the second group of patients reported a significant decrease in the levels fT4 (from 31.4 ± 2.1 nmol/l to 21.7 ± 1.8 nmol/l; p 0.05. Side effects weren’t observed for six months during the treatment of patients in both groups. Normalization of peripheral hormones (fT4 and fT3 in 90 days of observation has been achieved in 96.2 % of patients in the first group and 74.1 % — in the second group. The number of patients who achieved normal TSH levels was significantly higher in the first group (93.3 % vs. 76 %. Conclusions. We determined higher efficiency of carbimazole compared to thiamazolum that manifested by more rapid achievement of clinical effect and compensation thyrotoxicosis, significant decrease of thyroid volume, the level of antibodies to the TSH receptor. Using carbimazole reduces thyreostatics daily dose in patients with DTG, which reduces the risk of complications of therapy. When using carbimazole for six months in patients with DTG, cases of intolerance or other adverse effects weren’t reported.

  13. Comparative study of metacarpophalangeal joint arthroplasty effectiveness in patients with rheumatoid hand

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    L. A. Rodomanova

    2015-01-01

    Full Text Available Objective - to determine the optimal implant for metacarpophalangeal joint arthroplasty in patients with rheumatoid hand. Materials and methods. 24 patients with rheumatoid hand were operated in Vreden Russian Research Institute of Traumatology and Orthopedics (St.-Petersburg, Russia. 37 MCPJ arthroplasties were performed with 129 implants of 3 types. First group consisted of 11 patients with 43 implanted NeuFlex “DePuy International Ltd.” silicone implants on 12 hands. Second group - 6 patients with 26 implants Daphne “TECRES S.p.A.” on 7 hands. Third group - 16 patients with 60 implants RM Finger “MATHYS AG Bettlach” on 17 hands. Criteria for treatment effectiveness were estimated taking into account hand function, complications and also relapse of deformation. We compared movement amplitude in MCP joins, angle of ulnar drift, strength of hand and also subjective assessment by patients with DASH. Results were fixed before surgery and 3, 6 and 12 months after. Results. Complications were recorded in I and II of patient groupsin 50% of cases:fracturesof components, dislocations of construction, relapse of ulnar drift. Complications in III group of patients were not detected. Range of motion and function improvement were increased in all groups (p>0,05, as well as strength of hand. But the most stable growth of hand strength was fixed only in III group (p<0,05. Relapse of ulnar drift occurred in I group of patients. Conclusion. RM Finger “MATHYS AG Bettlach” is more reliable for metacarpophalangeal joint arthroplasty since it provides stable long-term results of treatment.

  14. Comparative Effectiveness of Etanercept and Adalimumab in Patient Reported Outcomes and Injection-Related Tolerability.

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    Iris Navarro-Millán

    Full Text Available To describe patient preferences in selecting specific biologics and compare clinical response using patient reported outcomes (PROs among patients with rheumatoid arthritis (RA started on different anti-tumor necrosis factor (TNF therapies.Participants were enrollees in Kaiser Permanente Northern California. Patients with RA who had at least two provider visits and started a new anti-TNF therapy from 10/2010-8/2011, were eligible for participation in this longitudinal study. Using a telephone survey, patient preferences in biologic selection and RAPID3, MDHAQ, and SF-12 scores were collected at baseline and at 6 months. Patient scores rating injection/infusion-site burning and stinging (ISBS were collected at 6 months.In all, 267 patients with RA responded to the baseline survey, of whom 57% preferred an injectable biologic, 22% preferred an infused biologic, and 21% had no preference. Motivation for injectable biologics was convenience (92% and for infusion therapy was dislike or lack of self-efficacy for self-injection (16%. After 6 months of treatment with anti-TNF, 70% of the 177 patients who answered the ISBS question reported ISBS with the last dose; on a scale of 1 (none to 10 (worst, 41% of these reported a score of 2-5; and 29% reported a score of 6-10. Adalimumab users experienced 3.2 times (95% confidence interval 1.2-8.6 the level of ISBS that etanercept users experienced. There were no significant differences in RAPID3, MDHAQ, or SF-12 scores between etanercept or adalimumab initiators.Convenience and fear of self-injection were important considerations to patients selecting a biologic drug. Although more convenient, adalimumab associated with more ISBS than did etanercept, and this rate was higher than reported in clinical trials. At 6 months, PROs did not differ between etanercept and adalimumab users.

  15. Psychological Distress in Out-Patients Assessed for Chronic Pain Compared to Those with Rheumatoid Arthritis

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    D. Rice

    2016-01-01

    Full Text Available Background. Patients diagnosed with chronic pain (CP and rheumatoid arthritis (RA represent two samples with overlapping symptoms, such as experiencing significant pain. Objectives. To compare the level of psychological distress among patients diagnosed CP attending a specialist pain clinic with those attending a specialist RA clinic. Measures. A cross-sectional study was conducted at an academic specialist chronic pain and rheumatology clinic. Participants. 330 participants included a CP group (n=167 and a RA group (n=163 completed a booklet of questionnaires regarding demographic characteristics, duration, and severity of their pain. Psychological and personality variables were compared between the CP and RA participants using a Multivariate Analysis of Covariance (MANCOVA. Results. Level of psychological distress based on the subscales of the DASS (depression, anxiety, and stress, PASS (escape avoidance, cognitive anxiety, fear of pain, and physiological anxiety, and PCS (rumination, magnification, and helplessness was significantly higher in the CP group compared to the RA group. Categorization of individuals based on DASS severity resulted in significant differences in rates of depression and anxiety symptoms between groups, with a greater number of CP participants displaying more severe depressive and anxiety symptoms. Discussion and Conclusions. This study found greater levels of psychological distress among CP individuals referred to an academic pain clinic when compared to RA patients referred to an academic rheumatology clinic.

  16. Comparative Study of laryngeal mask airway Supreme and laryngeal mask airway Classic in paralyzed patients

    OpenAIRE

    2016-01-01

    Aim and Objectives: The present study was undertaken to compare the LMA Classic with LMA Supreme in assessing the ease of insertion, number of attempts, time for insertion, any unwanted responses, stability of device, peak airway pressure, leak volume and leak fraction and postoperative complications.Methods: A total of 274 patients of ASA grade 1 and 2 were included in the study and divided into two groups with 137 patients in each group: the LMA Classic group (group C) and LMA Supreme group...

  17. Evaluation of Heart Rate Variation Analysis during Rest and Tilting in Patients with Temporal Lobe Epilepsy

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    Hanna Ansakorpi

    2011-01-01

    Full Text Available Objective. To evaluate spectral heart rate (HR variation using short-term ECG recordings at rest and during the tilt table test. Methods. The values of spectral components of total power (TP, high-frequency power (HF, low-frequency power (LF and LF: HF ratio were measured at rest and during the head-up tilt in patients with temporal lobe epilepsy (TLE and their control subjects. Results. Compared to the control subjects, patients with TLE had lower HF (<0.05 and LF : HF ratio (<0.05 at rest and lower TP (<0.001, HF (<0.05, and LF (<0.05 during the head-up tilt. Upon changing from supine to standing position TP (<0.05 and LF (<0.05 were attenuated in patients with TLE compared to the control subjects. Conclusion. These results suggest that spectral analysis of HR variation from ECG recordings of short duration may add value to assessment of autonomic nervous system function using autonomic cardiac tests in patients with TLE.

  18. The effect of adaptive servo ventilation (ASV) on objective and subjective outcomes in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF): A systematic review.

    Science.gov (United States)

    Yang, Hyunju; Sawyer, Amy M

    2016-01-01

    To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF (n = 10). ASV has a beneficial effect on the reduction of central sleep apnea in adult patients with CSR-CSA in HF, but it is not be superior to CPAP, bilevel PPV, or supplemental oxygen in terms of sleep quality defined by polysomnography, cardiovascular outcomes, subjective daytime sleepiness, and quality of life. ASV is not recommended for CSR-CSA in HF. It is important to continue to refer HF patients for sleep evaluation to clearly discern OSA from CSR-CSA. Symptom management research, inclusive of objective and subjective outcomes, in CSR-CSA in HF adults is needed.

  19. [Comparative study of pneumococcal bacteremia in patients with and without HIV infection].

    Science.gov (United States)

    Roca, V; Pérez-Cecilia, E; Santillana, T; Romero, J; Picazo, J J

    1993-01-01

    A retrospective study of bacteriemias due to S. pneumoniae in adults is performed, from all the cases observed in our hospital during the 1989-1990 period. We compare the clinical characteristics of the disease depending if the affected patients were infected or not by the human immunodeficiency virus (HIV). In the considered period bacteriemia due to S. pneumoniae has been diagnosed in 12 patients with HIV infection and 29 without it. Ten of the twelve patients with HIV infection (83.3%) were in Stage IV (CDC) of the disease, staying the rest in a less developed phase of the disease. Age was significantly higher in non-HIV patients (p < 0.001) and a high percentage of patients in this group (75%) showed some disease considered as predisposing to bacteriemia due to S. pneumoniae. When a respiratory foci was present, VIH positive individuals showed more frequently bilateral radiologic infiltrates and less frequently pleural effusion. Leucocyte count when diagnosis was done were significantly higher in non-HIV group. Sensibility of isolated S. pneumoniae was similar in the two groups, being the immediate mortality related with bacteriemia due to S. pneumoniae higher in the non-HIV group. In our center 29.3% of bacteriemias due to S. pneumoniae are diagnosed in patients with HIV infection. This disease in itself could constitute an added risk factor in the development of bacteriemia due to S. pneumoniae.

  20. Comparative effect of telmisartan vs lisinopril on blood pressure in patients of metabolic syndrome.

    Science.gov (United States)

    Gore, Pradip N; Badar, Vandana A; Hardas, Mrunalini M; Bansode, Varsha J

    2015-01-01

    The present study was planned to focus on comparative effects of telmisartan vs lisinopril on blood pressure in patients of metabolic syndrome The study was carried out on 62 patients of metabolic syndrome from Dec 2010 to Oct 2012 in OPD of Institute. There were two groups, A and B. Group A- Telmisartan (31 patients) and Group B- Lisinopril (31 patients) receiving Telmisartan 40 mg and lisinopril 5 mg orally once a day respectively for 12 weeks. The diagnosis of essential hypertension was made by the physician based on two measurements of blood pressure on two different occasions using auscultatory method and was done at initial stage and repeated after 6 weeks and 12 weeks of treatment in Group A and Group B patients. Our study found that telmisartan or lisinopril treatment for 12 weeks leads to statistically significant (ptelmisartan and lisinopril treatment failed to show any statistically significant effect. Treatment of metabolic patients with telmisartan or lisinopril for the management of hypertension reduced both Systolic blood pressure (SBP) as well as Diastolic blood pressure (DBP) statistically significantly during 12 weeks treatment. However, telmisartan and lisinopril treatment were found effective.

  1. Autonomic dysfunction: A comparative study of patients with Alzheimer's and frontotemporal dementia – A pilot study

    Science.gov (United States)

    Issac, Thomas Gregor; Chandra, Sadanandavalli Retnaswami; Gupta, Neelesh; Rukmani, Malligurki Raghurama; Deepika, S.; Sathyaprabha, T. N.

    2017-01-01

    Introduction: In frontotemporal dementia (FTD) and Alzheimer's disease (AD), central autonomic structures get affected early. An insight into autonomic functions in these patients is likely to be of diagnostic importance and thus help in prognosticating and also probably explain unexplained sudden death in some of these patients. Objectives: The objective of this study is to identify autonomic dysfunction prevailing in patients. Then, if there is dysfunction, is the pattern same or different in these two conditions. And if different it will serve as an additional biomarker for specific diagnosis. Patients and Methods: There were 25 patients and 25 controls and six patients and three controls in AD and FTD groups, respectively. The participants who were recruited were assessed for heart rate variability and conventional cardiac autonomic function testing. The parameters were analyzed using LabChart version 7 software and compared with control population using appropriate statistical methods using SPSS version 22 software. Results: The mean overall total power was low in the FTD group (P yoga. The presence of parasympathetic suppression in AD in addition helps differentiate these two conditions. PMID:28149088

  2. Survival of diabetes patients with major amputation is comparable to malignant disease.

    Science.gov (United States)

    Hoffmann, Martin; Kujath, Peter; Flemming, Annette; Proß, Moritz; Begum, Nehara; Zimmermann, Markus; Keck, Tobias; Kleemann, Markus; Schloericke, Erik

    2015-07-01

    Almost all studies on diabetic foot syndrome focused on prevention of amputation and did not investigate long-term prognosis and survival of patients as a primary outcome parameter. We did a retrospective cohort study including 314 patients who had diabetic foot syndrome and underwent amputation between December 1995 and January 2001. A total of 48% of patients received minor amputation (group I), 15% only major amputation (group II) and 36% initially underwent a minor amputation that was followed by a major amputation (group III). Statistically significant differences were observed in comparison of the median survival of group I to group II (51 vs. 40 months; p = 0.016) and of group II to group III (40 vs. 55 months; p = 0.003). The prognosis of patients with major amputation due to diabetic foot syndrome is comparable to patients with malignant diseases. Vascular interventions did not improve the individual prognosis of patients. © The Author(s) 2015.

  3. The influence of aetiology on the benefits of exercise training in patients with heart failure.

    Science.gov (United States)

    Antunes-Correa, Ligia M; Ueno-Pardi, Linda M; Trevizan, Patricia F; Santos, Marcelo R; da Silva, Carlos Henrique P; Franco, Fábio Gm; Alves, Maria Janieire Nn; Rondon, Maria Urbana Pb; Negrao, Carlos E

    2017-03-01

    Background Exercise training improves neurovascular control and functional capacity in heart failure (HF) patients. However, the influence of the aetiology on these benefits is unknown. We compared the effects of exercise training on neurovascular control and functional capacity in idiopathic, ischaemic and hypertensive HF patients. Design Subjects consisted of 45 exercise-trained HF patients from our database (2000-2015), aged 40-70 years old, functional class II/III and ejection fraction ≤40%, and they were divided into three groups: idiopathic ( n = 11), ischaemic ( n = 18) and hypertensive ( n = 16). Methods Functional capacity was determined by cardiopulmonary exercise testing. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Results Four months of exercise training significantly reduced MSNA and significantly increased FBF in all groups. However, the relative reduction in MSNA was greater in hypertensive patients compared with that in idiopathic patients (frequency: -34% vs . -15%, p = 0.01; incidence: -31% vs . -12%, p = 0.02). No differences were found between hypertensive patients and ischaemic patients. The relative increase in FBF was greater in hypertensive patients than in ischaemic and idiopathic patients (42% vs. 15% and 17%, respectively, p = 0.02). The relative increase in forearm vascular conductance was greater in hypertensive patients compared with those in ischaemic and idiopathic patients (57% vs . 13% and 26%, respectively, p = 0.001). Exercise training significantly and similarly increased peak oxygen consumption in all groups. Conclusion The exercise-induced improvement in neurovascular control is more pronounced in hypertensive HF patients than in idiopathic and ischaemic HF patients. The increase in functional capacity is independent of aetiology.

  4. Ferroelectricity-modulated resistive switching in Pt/Si:HfO2/HfO2-x /Pt memory

    Science.gov (United States)

    Ran, Jiang; Xianghao, Du; Zuyin, Han

    2016-08-01

    It is investigated for the effect of a ferroelectric Si:HfO2 thin film on the resistive switching in a stacked Pt/Si:HfO2/highly-oxygen-deficient HfO2-x /Pt structure. Improved resistance performance was observed. It was concluded that the observed resistive switching behavior was related to the modulation of the width and height of a depletion barrier in the HfO2-x layer, which was caused by the Si:HfO2 ferroelectric polarization field effect. Reliable switching reproducibility and long data retention were observed in these memory cells, suggesting their great potential in non-volatile memories applications with full compatibility and simplicity. Project supported by the National Natural Science Foundation of China (No. 11374182), the Natural Science Foundation of Shandong Province (No. ZR2012FQ012), and the Jinan Independent Innovation Projects of Universities (No. 201303019).

  5. Effect of Cardiac Resynchronization Therapy in Patients With Insulin-Treated Diabetes Mellitus

    DEFF Research Database (Denmark)

    Szepietowska, Barbara; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    .74, p = 0.012) in subgroup of diabetic patients treated with insulin only (interaction p = 0.043). Significant risk reduction in HF alone, HF/death, and the VT/VF after CRT-D was observed across investigated groups and similar left ventricular reverse remodeling to CRT-D. In conclusion, patients......Diabetes mellitus (DM) modify outcome in patients with heart failure (HF). We aimed to analyze the risk for death, HF alone, combined end point HF/death, and ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with mild HF without DM and in those with DM, further stratified...... with mild HF with DM treated with insulin derive significant risk reduction in mortality, in HF, and VT/VF after implantation of CRT-D. Diabetic patients not receiving insulin benefit from CRT-D by reduction of HF events....

  6. Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea

    Science.gov (United States)

    de Godoy, Luciana Balester Mello; Luz, Gabriela Pontes; Palombini, Luciana Oliveira; e Silva, Luciana Oliveira; Hoshino, Wilson; Guimarães, Thaís Moura; Tufik, Sergio; Bittencourt, Lia; Togeiro, Sonia Maria

    2016-01-01

    Purpose To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals. Methods UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale—ESS—≥ 10) and/or fatigue (Modified Fatigue Impact Scale—MFIS—≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10) and/or fatigue (MFIS ≥ 38) associated to AHI ≥ 5 and ≤ 15 events/hour. “Control group” criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in “control group”), adjusted for age, gender, body mass index (BMI) and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT) was performed five times (each two hours) from 8 a.m. to 4 p.m. Results UARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire—FOSQ—and Pittsburgh Sleep Quality Index—PSQI: p < 0.05) and more fatigue than mild OSA patients (p = 0.003) and scored significantly higher in both Beck inventories than “control group” (p < 0.02). UARS patients had more lapses early in the morning (in time 1) compared to the results in the afternoon (time 5) than mild OSA (p = 0.02). Mild OSA patients had more lapses in times 2 than in time 5 compared to “control group” (p = 0.04). Conclusions UARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls. PMID:27228081

  7. Neutral sphingomyelinase-2, acid sphingomyelinase, and ceramide levels in COPD patients compared to controls

    Directory of Open Access Journals (Sweden)

    Lea SR

    2016-09-01

    Full Text Available Simon R Lea,1,* Hannah J Metcalfe,1,* Jonathan Plumb,1 Christian Beerli,2 Chris Poll,3 Dave Singh,1 Katharine H Abbott-Banner3 1Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK; 2Novartis Pharma AG, Postfach, Basel, Switzerland; 3Respiratory Diseases, Novartis Institute for Biomedical Research, Horsham, West Sussex, UK *These authors contributed equally to this work Background: Increased pulmonary ceramide levels are suggested to play a causative role in lung diseases including COPD. Neutral sphingomyelinase-2 (nSMase-2 and acid SMase (aSMase, which hydrolyze sphingomyelin to produce ceramide, are activated by a range of cellular stresses, including inflammatory cytokines and pathogens, but notably cigarette smoke appears to only activate nSMase-2. Our primary objective was to investigate nSMase-2 and aSMase protein localization and quantification in lung tissue from nonsmokers (NS, smokers (S, and COPD patients. In addition, various ceramide species (C16, C18, and C20 were measured in alveolar macrophages from COPD patients versus controls. Materials and methods: Patients undergoing surgical resection for suspected or confirmed lung cancer were recruited, and nSMase-2 and aSMase protein was investigated in different areas of lung tissue (small airways, alveolar walls, subepithelium, and alveolar macrophages by immunohistochemistry. Ceramide species were measured in alveolar macrophages from COPD patients and controls by mass spectrometry. Results: nSMase-2 and aSMase were detected in the majority of small airways. There was a significant increase in nSMase-2 immunoreactivity in alveolar macrophages from COPD patients (54% compared with NS (31.7% (P<0.05, and in aSMase immunoreactivity in COPD (68.2% and S (69.5% alveolar macrophages compared with NS (52.4% (P

  8. Learning Patient Safety in Academic Settings: A Comparative Study of Finnish and British Nursing Students' Perceptions.

    Science.gov (United States)

    Tella, Susanna; Smith, Nancy-Jane; Partanen, Pirjo; Turunen, Hannele

    2015-06-01

    Globalization of health care demands nursing education programs that equip students with evidence-based patient safety competences in the global context. Nursing students' entrance into clinical placements requires professional readiness. Thus, evidence-based learning activities about patient safety must be provided in academic settings prior to students' clinical placements. To explore and compare Finnish and British nursing students' perceptions of learning about patient safety in academic settings to inform nursing educators about designing future education curriculum. A purpose-designed instrument, Patient Safety in Nursing Education Questionnaire (PaSNEQ) was used to examine the perceptions of Finnish (n = 195) and British (n = 158) nursing students prior to their final year of registration. Data were collected in two Finnish and two English nursing schools in 2012. Logistic regressions were used to analyze the differences. British students reported more inclusion (p learning than what their programs had provided. Training patient safety skills in the academic settings were the strongest predictors for differences (odds ratio [OR] = 34.69, 95% confidence interval [CI] 7.39-162.83), along with work experience in the healthcare sector (OR = 3.02, 95% CI 1.39-6.58). To prepare nursing students for practical work, training related to clear communication, reporting errors, systems-based approaches, interprofessional teamwork, and use of simulation in academic settings requires comprehensive attention, especially in Finland. Overall, designing patient safety-affirming nursing curricula in collaboration with students may enhance their positive experiences on teaching and learning about patient safety. An international collaboration between educators could help to develop and harmonize patient safety education and to better prepare nurses for practice in the global context. © 2015 Sigma Theta Tau International.

  9. Comparing nursing handover and documentation: forming one set of patient information.

    Science.gov (United States)

    Johnson, M; Sanchez, P; Suominen, H; Basilakis, J; Dawson, L; Kelly, B; Hanlen, L

    2014-03-01

    The aim of this study was to explore the potential for one set of patient information for nursing handover and documentation. Communication of patient information requires two processes in nursing: a verbal summary of the patients' care and another report within the nursing notes, creating duplication. Advances in speech recognition technology have provided an opportunity to consider the practicality of one set of information at the nursing end-of-shift. We used content analysis to compare transcripts from 162 digitally recorded handovers and written nursing notes for similar patients within general medical-surgical wards from two metropolitan hospitals in Sydney Australia. Using the Nursing Handover Minimum Dataset analysis framework similar content [n = 2109 (handover) n = 1902 (nursing notes)] was found within the handovers and notes at the end-of-shift (7:00 am and 2:00 pm). Analysis of the overarching categories demonstrated the emphasis within the differing data sources as: patient identification (31%), care planning or interventions (25%), clinical history (13%), and clinical status (13%) for handover, vs. care planning (47%), clinical status (24%), and outcomes or goals of care (12%) for nursing notes. This study has demonstrated that similar patient information is presented at handover and within documentation. Major categories are consistent with international nursing minimum datasets in use. We can use one set of patient information (within some limitations) for two purposes with system design, practice change and education. Experiments are currently being conducted trialling speech recognition within laboratory and clinical settings. One set of patient information, verbally generated at handover delivering electronic documentation within one process, will transform international nursing policy for nursing handover and documentation. © 2013 International Council of Nurses.

  10. Retrospective study comparing low-dose versus standard dose of bortezomib in patients with multiple myeloma

    Directory of Open Access Journals (Sweden)

    Marcela Espinoza Zelada

    2015-03-01

    Full Text Available INTRODUCTION Bortezomib is a selective inhibitor of the proteosoma that is used in multiple myeloma. In combination with other antineoplastic drugs, it has a well-documented impact in progression-free survival rates and overall survival rates with standard doses (1.3-1.5 mg/m2. However, up to 88% of patients on standard doses have unwanted side effects (neutropenia, neuropathy or anemia. Standard dose (1.3 mg/m2 is used in almost all patients and low dose (0.7-0.8 mg/m2 is reserved for patients with kidney disease and neuropathy. OBJECTIVE We aim to describe clinical, cytological, and cytometric outcomes, as well as overall survival and side effects of low dose versus standard dose of bortezomib in our institution. METHODS Retrospective, descriptive study based on data recovered from clinical charts of 48 multiple myeloma patients treated in our hospital between 2011 and 2013. We included data on age, gender, type of multiple myeloma, serum albumin, serum creatinine, beta 2 microglobulin, calcemia, imaging studies, disease stage, pre-and post-therapy bone marrow studies, adverse events and rate of progression. We also recorded events like date of death or of the last medical appointment. RESULTS Forty-eight multiple myeloma patients were treated with bortezomib-cyclophosphamide-dexamethasone. Twenty-one patients received low dose and 27 patients were treated with the standard dose. No statistical differences between the two groups were found for clinical response (p=0.6, cytological response (p=0.28, flow cytometric response (p= 0.3, rate of adverse effects and overall survival rates. CONCLUSION This retrospective analysis suggests that lower doses of bortezomib have similar effects in disease control measured by flow cytometry and cytology compared to standard doses in multiple myeloma patients.

  11. Autonomic dysfunction: A comparative study of patients with Alzheimer's and frontotemporal dementia – A pilot study

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    Thomas Gregor Issac

    2017-01-01

    Full Text Available Introduction: In frontotemporal dementia (FTD and Alzheimer's disease (AD, central autonomic structures get affected early. An insight into autonomic functions in these patients is likely to be of diagnostic importance and thus help in prognosticating and also probably explain unexplained sudden death in some of these patients. Objectives: The objective of this study is to identify autonomic dysfunction prevailing in patients. Then, if there is dysfunction, is the pattern same or different in these two conditions. And if different it will serve as an additional biomarker for specific diagnosis. Patients and Methods: There were 25 patients and 25 controls and six patients and three controls in AD and FTD groups, respectively. The participants who were recruited were assessed for heart rate variability and conventional cardiac autonomic function testing. The parameters were analyzed using LabChart version 7 software and compared with control population using appropriate statistical methods using SPSS version 22 software. Results: The mean overall total power was low in the FTD group (P < 0.001, and there was significant reduction in the standard deviation of normal-to-normal intervals and root mean square of successive differences (P < 0.001 with elevated sympathovagal balance in the FTD group (P = 0.04. Patients with AD also showed sympathetic dominance, but there was in addition parasympathetic suppression unlike in the FTD group. Conclusion: This study reveals autonomic dysfunction in patients with FTD and AD. Both conditions show sympathetic dominance, probably consecutive to the involvement of central autonomic regulatory structures as a shared domain. It remains to be confirmed if these findings are the cause or effect of neurodegeneration and might open up newer territories of research based on the causal role of neurotransmitters in these regions and thus lead to novel therapeutic options such as yoga. The presence of parasympathetic

  12. A Comparative study of dermatoglyphic patterns in patients with primary glaucoma and control group

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    Sharmila Pal

    2013-08-01

    Full Text Available Dermatoglyphics are the dermal ridge configurations on the digits, palms and soles. They are permanent and inherited. A comparative study of the Dermatoglyphic patterns of patients with primary glaucoma and general healthy population was made to ascertain the value of Dermatoglyphics as a diagnostic tool for primary glaucoma. Fifty-seven primary glaucoma patients (24 males, 33 females and fifty normal healthy persons (25 males, 25 females participated in this study. In the present study primary glaucoma subjects were examined in terms of dermatoglyphic characteristics and compared with that of controls. Frequency of loops was decreased in primary glaucoma but in case of whorls and arch increased numbers.Deviation is also observed in a-b ridge count and atd angle. In general tfrc and afrc also increased. These can be considered as useful as a supportive investigation and to some extent knowing the prediction for primary glaucoma

  13. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

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    Z. A. Kadyrov

    2014-11-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  14. Comparative evaluation of different methods of surgery in patients with benign prostatic hyperplasia large

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2013-01-01

    Full Text Available This paper presents the results of different removal methods of the prostate in 122 patients with benign prostatic hyperplasia in larger sizes (80 ml. The perioperations data of extraperitoneoscopic, traditional simple prostatectomy (EP, TTP and RP and TUR were analyzed. The results of blood loss, time of activation, the uses of analgesics, time of irrigation, Hb dinamic, duration of catheterization and hospital stay after the TP were worse compared to other methods. EP has long operation time however short time duration of catheterization and hospital stay, and the minimal use of analgesics make this method more feasible. TUR and RP demonstrate better results in many parameters. It was revealed that early and late postoperative complications were more common in patients after TUR – 93.2 % and traditional prostatectomy (TTP – 65 %, compared to the RP and EP – 20.5 % and 41.9 %, respectively.

  15. Comparative efficacy of lormetazepam (Noctamid) and diazepam (Valium) in 100 out-patients with insomnia.

    Science.gov (United States)

    Sastre y Hernández, M S; Hentschel, H D; Fichte, K

    1981-01-01

    Lormetazepam (Noctamid) at a dosage of 1 mg was compared with diazepam (Valium) at a dosage of 5 mg in a 7-day double-blind study. The study involved fifty patients in the lormetazepam group and fifty patients in the diazepam group. All the patients were suffering from sleep disorders as a concomitant symptom of general diseases. Lormatazepam was significantly better than diazepam in the: -Reduction of the time taken to fall asleep (p less than 0.05) -Prolongation of the duration of uninterrupted sleep (p less than 0.05) -Reduction of the frequency of awakening (p less than 0.05). Lormetazepam displayed no hang-over effects or other side-effects and, in this respect too, was significantly superior to diazepam (p less than 0.05).

  16. Cardiac involvement in progressive systemic sclerosis and polymyositis: a comparative study in 116 patients.

    Science.gov (United States)

    Purice, S; Luca, R; Vintilă, M; Tănăseanu, S; Bălănescu, E

    1989-01-01

    A comparative study was carried out in 116 patients-51 with progressive systemic sclerosis (PSS) and 65 with polymyositis (PM) to detect the cardiac involvements secondary to these two collagen diseases. Different forms of cardiac involvement could be detected in 51% of the patients with PSS and in 18.5% of those with PM. The most frequent cardiac dysfunctions were disturbances of rhythm and conduction probably due to the coronary vascular changes in PSS and to processes of fibrosis and degenerescence of the specific myocardial fibers in PM. Myocardial lesions expressed by myocarditis and cardiomyopathies are not infrequent and have important prognostic implications. In the group of patients studied the valvular cardiopathies and clinically evident pericardites were rare. Cardiac involvement clearly proved more frequent in PSS - in which the pathogenic mechanism is mainly vascular - than in PM. This emphasizes the great importance of coronary circulation disturbances in the pathogenesis of collagen heart diseases.

  17. Comparative effectiveness research on patients with acute ischemic stroke using Markov decision processes

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    Wu Darong

    2012-03-01

    Full Text Available Abstract Background Several methodological issues with non-randomized comparative clinical studies have been raised, one of which is whether the methods used can adequately identify uncertainties that evolve dynamically with time in real-world systems. The objective of this study is to compare the effectiveness of different combinations of Traditional Chinese Medicine (TCM treatments and combinations of TCM and Western medicine interventions in patients with acute ischemic stroke (AIS by using Markov decision process (MDP theory. MDP theory appears to be a promising new method for use in comparative effectiveness research. Methods The electronic health records (EHR of patients with AIS hospitalized at the 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine between May 2005 and July 2008 were collected. Each record was portioned into two "state-action-reward" stages divided by three time points: the first, third, and last day of hospital stay. We used the well-developed optimality technique in MDP theory with the finite horizon criterion to make the dynamic comparison of different treatment combinations. Results A total of 1504 records with a primary diagnosis of AIS were identified. Only states with more than 10 (including 10 patients' information were included, which gave 960 records to be enrolled in the MDP model. Optimal combinations were obtained for 30 types of patient condition. Conclusion MDP theory makes it possible to dynamically compare the effectiveness of different combinations of treatments. However, the optimal interventions obtained by the MDP theory here require further validation in clinical practice. Further exploratory studies with MDP theory in other areas in which complex interventions are common would be worthwhile.

  18. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    Science.gov (United States)

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P dependency, all P dependency after stroke.

  19. Comparative study between sugammadex and neostigmine in neurosurgical anesthesia in pediatric patients

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    Ayman A Ghoneim

    2015-01-01

    Full Text Available Background: Postoperative recurarization remains a risk following the use of the conventional neuromuscular blocking agents. In addition, none of the commonly used reversal agents, such as neostigmine or edrophonium are capable of reliably reversing profound blockade. The present comparative and randomized study investigated the use of sugammadex for reversing profound neuromuscular blockade (NMB in pediatric neurosurgical patients undergone posterior fossa tumor excision. Patients and Methods: Forty pediatric patients undergoing elective craniotomy for posterior fossa tumor excision were randomly divided into either of neostigmine or sugammadex group in which muscle relaxant was reversed at the end of anesthesia either with neostigmine 0.04 mg/kg added to atropine 0.02 mg/kg or sugammadex 4 mg/kg alone, respectively. The primary endpoint was the time from the administration of sugammadex or neostigmine to recovery of the train of four (TOF ratio to 90% after rocuronium-induced neuromuscular block. Unpaired t-test was used to compare continuous variables between groups. Meanwhile, repeated ANOVA was used to detect intragroup differences. Results: Patients in sugammadex group attained a TOF ratio 90% in statistically shorter time (1.4 ± 1.2 min than those in neostigmine group (25.16 ± 6.49 min for reversal of the rocuronium. Mean arterial pressure and heart rate were significantly higher in neostigmine group at 2, 5 and 10 min after administration of the reversal agents and returned nonsignificantly different after that. With no recurarization in any patient throughout the study period. Conclusion: Sugammadex rapidly and effectively reverses rocuronium-induced NMB in pediatric patients undergoing neurosurgery when administered at reappearance of T2 of TOF at dose 4 mg/kg.

  20. Comparing Voice Self-Assessment with Auditory Perceptual Analysis in Patients with Multiple Sclerosis

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    Bauer, Vladimir

    2015-01-01

    Full Text Available Introduction Disordered voice quality could be a symptom of multiple sclerosis (MS. The impact of MS on voice-related quality of life is still controversial. Objectives The aim of this study was to compare the results of voice self-assessment with the results of expert perceptual assessment in patients with MS. Methods The research included 38 patients with relapse-remitting MS (23 women and 15 men; ages 21 to 83, mean = 44. All participants filled out a Voice Handicap Index (VHI, and their voice sample was analyzed by speech and language professionals using the Grade Roughness Breathiness Asthenia Strain scale (GRBAS. Results The patients with MS had significantly higher VHI than control group participants (mean value 16.68 ± 16.2 compared with 5.29 ± 5.5, p = 0.0001. The study established a notable level of dysphonia in 55%, roughness and breathiness in 66%, asthenia in 34%, and strain in 55% of the vocal samples. A significant correlation was established between VHI and GRBAS scores (r = 0.3693, p = 0.0225, and VHI and asthenia and strain components (r = 0.4037 and 0.3775, p = 0.012 and 0.0195, respectively. The female group showed positive and significant correlation between claims for self-assessing one's voice (pVHI and overall GRBAS scores, and between pVHI and grade, roughness, asthenia, and strain components. No significant correlation was found for male patients (p > 0.05. Conclusion A significant number of patients with MS experienced voice problems. The VHI is a good and effective tool to assess patient self-perception of voice quality, but it may not reflect the severity of dysphonia as perceived by voice and speech professionals.

  1. Comparing Voice Self-Assessment with Auditory Perceptual Analysis in Patients with Multiple Sclerosis

    Science.gov (United States)

    Bauer, Vladimir; Aleric, Zorica; Jancic, Ervin

    2014-01-01

    Introduction Disordered voice quality could be a symptom of multiple sclerosis (MS). The impact of MS on voice-related quality of life is still controversial. Objectives The aim of this study was to compare the results of voice self-assessment with the results of expert perceptual assessment in patients with MS. Methods The research included 38 patients with relapse-remitting MS (23 women and 15 men; ages 21 to 83, mean = 44). All participants filled out a Voice Handicap Index (VHI), and their voice sample was analyzed by speech and language professionals using the Grade Roughness Breathiness Asthenia Strain scale (GRBAS). Results The patients with MS had significantly higher VHI than control group participants (mean value 16.68 ± 16.2 compared with 5.29 ± 5.5, p = 0.0001). The study established a notable level of dysphonia in 55%, roughness and breathiness in 66%, asthenia in 34%, and strain in 55% of the vocal samples. A significant correlation was established between VHI and GRBAS scores (r = 0.3693, p = 0.0225), and VHI and asthenia and strain components (r = 0.4037 and 0.3775, p = 0.012 and 0.0195, respectively). The female group showed positive and significant correlation between claims for self-assessing one's voice (pVHI) and overall GRBAS scores, and between pVHI and grade, roughness, asthenia, and strain components. No significant correlation was found for male patients (p > 0.05). Conclusion A significant number of patients with MS experienced voice problems. The VHI is a good and effective tool to assess patient self-perception of voice quality, but it may not reflect the severity of dysphonia as perceived by voice and speech professionals. PMID:25992162

  2. Intranasal midazolam compared with intravenous diazepam in patients suffering from acute seizure: a randomized clinical trial.

    Science.gov (United States)

    Javadzadeh, Mohsen; Sheibani, Kourosh; Hashemieh, Mozhgan; Saneifard, Hedyeh

    2012-03-01

    Acute seizure attack is a stressful experience both for health care personnel and parents. These attacks might cause morbidity and mortality among patients, so reliable methods to control the seizure preferably at home should be developed. This study was performed to measure the time needed to control seizure attacks using intranasal midazolam compared to the common treatment (intravenous diazepam) and to evaluate its probable side effects. This study was conducted as a not blind randomized clinical trial among 60 patients coming to Imam Ali Hospital, Zahedan, Iran. The patients were 2 months to 15 years old children coming to our emergency department suffering from an acute seizure episode. Intranasal midazolam was administered 0.2 mg/kg equally dropped in both nostrils for case group and intravenous diazepam was administered 0.3mg/kg via IV line for control group. After both treatments the time needed to control the seizure was registered by the practitioner. Pulse rate and O2 saturation were recorded at patients' entrance and in minutes 5 and 10 after drug administration. The time needed to control seizure using intranasal midazolam (3.16±1.24) was statistically shorter than intravenous diazepam (6.42±2.59) if the time needed to establish IV line in patients treated by intravenous diazepam is taken into account (P<0.001). The readings for O2 saturation or heart rate did not indicate a statistically significant difference between two groups of patients either at entrance or 5 and 10 minutes after drug administration. Considering the shorter time needed to control acute seizure episodes compared to intravenous diazepam and its safety record, intranasal midazolam seems to be a good candidate to replace diazepam, as the drug of choice, in controlling this condition.

  3. Single-port laparoscopic surgery in acute appendicitis: retrospective comparative analysis for 618 patients.

    Science.gov (United States)

    Kang, Byung Mo; Hwang, Ji Woong; Ryu, Byoung Yoon

    2016-11-01

    Transumbilical single-port laparoscopic appendectomy (SPLA) is a promising procedure that features less pain, faster recovery of postoperative bowel function and superior cosmetic results. We performed a retrospective comparative analysis of SPLA versus conventional laparoscopic surgery (CLA) to evaluate the safety and efficacy in acute appendicitis. From December 2008 to November 2013, laparoscopic surgery was performed on 636 patients with acute appendicitis at the Department of Surgery, Chuncheon Sacred Heart Hospital. Under approval of Institutional Review Board, data concerning baseline characteristics, operative outcomes, postoperative complications and postoperative functional recovery were compared between both procedures. After exclusion of 18 patients, 618 patients treated for acute appendicitis were included. SPLA was performed in 375 patients and CLA in 243 patients. Complicated appendicitis was more prevalent in the CLA group (26.3 %) than in the SPLA group (17.1 %) (p = 0.005). There was no difference between groups in operation time (p = 0.235), postoperative duration of hospital stay (p = 0.672) and readmission rate (p = 0.688). The rate of postoperative complications was similar in both groups (10.7 % in SPLA vs. 11.1 % in CLA, p = 0.862). In subgroup analysis of complicated appendicitis, more patients needed conversion to open surgery in the SPLA group (15.6 vs. 1.6 %, p = 0.005). In uncomplicated appendicitis, SPLA can be performed safely and efficiently. However, more selective indication for SPLA should be applied in cases of complicated appendicitis because of the greater risk of open conversion.

  4. THE COMPARATIVE STUDY OF EVENT RELATED POTENTIALS IN PATIENTS WITH OBSESSIVE COMPULSIVE DISORDER, DEPRESSION AND ANXIETY

    Institute of Scientific and Technical Information of China (English)

    XIAO Zeping; CHEN Xingshi; ZHANG Mingdao; LOU Feiying; CHEN Jue

    2003-01-01

    Objective: To investigate the variations of contingent negative variations (CNV), P300 and mismatch negativity (MMN) in patients with obsessive compulsive disorder (OCD), depression and anxiety. Methods: Event- related potentials CNV, P300 and MMN were recorded in 31 patients with OCD by Nicolet Spirit Instrument, and were compared with that of 20 depression controls (DC) and 17 anxiety controls (AC) and 28 normal controls (NC). Results: A significant difference of CNV among 4 subject groups was found in both post- imperative negative variation (PINV) and amplitudes (M1) (P < 0.01 ) (emergence of PINV were 45%,60%, 35%, and 4% in OCD, DC, AC and NC groups respectively). Compared with NC group, DC and AC groups showed decreased M1 amplitude ( P < 0.01). A significant difference of P300 among 4 groups was found in both latencies (Cz/N2) and P3 and nontarget - P2 amplitudes (P < 0.05 ~ 0.01). The delayed MMN latencies of OCD and DC were similar to that of P300 changes. Conclusions: CNV, P300 and MMN are useful tools for assessing the brain malfunction of OCD, DC and AC, and its clinical application are suggested. The characteristics ERPs of those patients might be useful indexes in distinguishing OCD from DC and AC patients.

  5. Comparing health locus of control in patients with Spasmodic Dysphonia, Functional Dysphonia and Nonlaryngeal Dystonia.

    Science.gov (United States)

    Haselden, Karen; Powell, Theresa; Drinnan, Mike; Carding, Paul

    2009-11-01

    Locus of Control (LoC) refers to an individuals' perception of whether they are in control of life events. Health Locus of Control refers to whether someone feels they have influence over their health. Health Locus of Control has not been studied in any depth in voice-disordered patients. The objective of this study was to examine Health Locus of Control in three patient groups: (1) Spasmodic Dysphonia, (2) Functional Dysphonia and (3) a nondysphonic group with Nonlaryngeal Dystonia. LoC was measured and compared in a total of 57 patients using the Multidimensional Health Locus of Control Scales (diagnostic specific) Form C. Internal, Chance, and Powerful others LoC were measured and comparisons were made using one-way analysis of variance. Contrary to expectations Internal LoC was found to be significantly higher in the Functional Dysphonia group when compared to the other two groups. There was no significant difference between the groups in Chance or Powerful others LoC. The two organic groups, Spasmodic Dysphonia and Nonlaryngeal Dystonia, were more alike in Internal Health Locus of Control than the Functional Dysphonia group. The diagnostic nature of the groups was reflected in their LoC scores rather than their voice loss. These results contribute to the debate about the etiology of Spasmodic Dysphonia and will be of interest to those involved in the psychology of voice and those managing voice-disordered patients.

  6. Cardiovascular magnetic resonance in patients with pectus excavatum compared with normal controls

    Directory of Open Access Journals (Sweden)

    Abrazado Marlon

    2010-12-01

    Full Text Available Abstract Purpose To assess cardiothoracic structure and function in patients with pectus excavatum compared with control subjects using cardiovascular magnetic resonance imaging (CMR. Method Thirty patients with pectus excavatum deformity (23 men, 7 women, age range: 14-67 years underwent CMR using 1.5-Tesla scanner (Siemens and were compared to 25 healthy controls (18 men, 7 women, age range 18-50 years. The CMR protocol included cardiac cine images, pulmonary artery flow quantification, time resolved 3D contrast enhanced MR angiography (CEMRA and high spatial resolution CEMRA. Chest wall indices including maximum transverse diameter, pectus index (PI, and chest-flatness were measured in all subjects. Left and right ventricular ejection fractions (LVEF, RVEF, ventricular long and short dimensions (LD, SD, mid-ventricle myocardial shortening, pulmonary-systemic circulation time, and pulmonary artery flow were quantified. Results In patients with pectus excavatum, the pectus index was 9.3 ± 5.0 versus 2.8 ± 0.4 in controls (P Conclusion Depression of the sternum in pectus excavatum patients distorts RV geometry. Resting RVEF was reduced by 6% of the control value, suggesting that these geometrical changes may influence myocardial performance. Resting LV function, pulmonary circulation times and pulmonary vascular anatomy and perfusion indices were no different to controls.

  7. Higher platelet P-selectin in male patients with inflammatory bowel disease compared to healthy males

    Institute of Scientific and Technical Information of China (English)

    J Patrik F(a)gerstam; Per A Whiss

    2006-01-01

    AIM: To observe if the total amount of platelet P-selectin (tP-selectin) in patients with inflammatory bowel disease (IBD) was related to disease entity or activity, 5-ami-nosalicylic acid (5-ASA) medication or gender.METHODS: tP-selectin was measured by immunoassay in seventeen IBD patients and twelve healthy controls.RESULTS: Compared to controls, there was no difference of tP-selectin in patients related to disease entity or activity and 5-ASA medication. When the groups were split according to gender the male patient group showed higher levels of tP-selectin compared to male controls (153 ng/mL vs 94 ng/mL, P< 0.05).CONCLUSION: Increased tP-selectin levels may alter the inflammatory response and susceptibility to throm-boembolic disease. As previously shown with soluble P-selectin, tP-selectin shows gender dependent differences important to consider in future studies.

  8. Jugular Venous Flow Abnormalities in Multiple Sclerosis Patients Compared to Normal Controls

    Science.gov (United States)

    Sethi, Sean K.; Utriainen, David T.; Daugherty, Ana M.; Feng, Wei; Hewett, J. Joseph; Raz, Naftali; Haacke, E. Mark

    2014-01-01

    Background To determine if extracranial venous structural and flow abnormalities exist in patients with multiple sclerosis (MS). Methods Magnetic resonance imaging was used to assess the anatomy and function of major veins in the neck in 138 MS patients and 67 healthy controls (HC). Time-of-flight (TOF) MR angiography (MRA) was used to assess stenosis while 2D phase contrast flow quantification (PCFQ) was used to assess flow at the C2/C3 and C5/C6 levels. Venous flow was normalized to the total arterial flow. The MS patients were divided into stenotic and non-stenotic groups based on MRA assessment, and each group was compared to the HC group in anatomy and flow. Results The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (p < 0.001). In the MS group, 72 (52%) evidenced stenosis (ST) while 66 (48%) were non-stenotic (NST). In the HC group, 11 (23%) showed a stenosis while 37 (77%) were non-stenotic. The ST-MS group had lower IJV flow than both HC and NST-MS groups. Conclusion After categorizing the MS population into two groups based upon anatomical stenosis determined from an absolute quantification of IJV cross-section, clear differences in IJV flow between the stenotic MS and HC samples became evident. Despite the unknown etiology of MS, abnormal venous flow was noted in a distinct group of MS patients compared to HC. PMID:25316522

  9. Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO

    Directory of Open Access Journals (Sweden)

    Sophia Horster

    2012-01-01

    Full Text Available USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring. The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (=70. Seventy paired left-sided CO measurements (transaortic access = COUS-A were obtained. The mean COUS-A were 6.55 l/min (±2.19 versus COPiCCO 6.5 l/min (±2.18. The correlation coefficient was =0.89. Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO. It seems to be appropriate in situations where CO measurements are most pertinent to patient management.

  10. E-region decameter-scale plasma waves observed by the dual TIGER HF radars

    Directory of Open Access Journals (Sweden)

    B. A. Carter

    2009-01-01

    Full Text Available The dual Tasman International Geospace Environment Radar (TIGER HF radars regularly observe E-region echoes at sub-auroral magnetic latitudes 58°–60° S including during geomagnetic storms. We present a statistical analysis of E-region backscatter observed in a period of ~2 years (late 2004–2006 by the TIGER Bruny Island and Unwin HF radars, with particular emphasis on storm-time backscatter. It is found that the HF echoes normally form a 300-km-wide band at ranges 225–540 km. In the evening sector during geomagnetic storms, however, the HF echoes form a curved band joining to the F-region band at ~700 km. The curved band lies close to the locations where the geometric aspect angle is zero, implying little to no refraction during geomagnetic storms, which is an opposite result to what has been reported in the past. The echo occurrence, Doppler velocity, and spectral width of the HF echoes are examined in order to determine whether new HF echo types are observed at sub-auroral latitudes, particularly during geomagnetic storms. The datasets of both TIGER radars are found to be dominated by low-velocity echoes. A separate population of storm-time echoes is also identified within the datasets of both radars with most of these echoes showing similar characteristics to the low-velocity echo population. The storm-time backscatter observed by the Bruny Island radar, on the other hand, includes near-range echoes (r<405 km that exhibit some characteristics of what has been previously termed the High Aspect angle Irregularity Region (HAIR echoes. We show that these echoes appear to be a storm-time phenomenon and further investigate this population by comparing their Doppler velocity with the simultaneously measured F- and E-region irregularity velocities. It is suggested that the HAIR-like echoes are observed only by HF radars with relatively poor geometric aspect angles when electron density is low and when the electric field is particularly

  11. Curative effect of HF10 on liver and peritoneal metastasis mediated by host antitumor immunity

    Directory of Open Access Journals (Sweden)

    Hotta Y

    2017-03-01

    Full Text Available Yoshihiro Hotta,1 Hideki Kasuya,2 Itzel Bustos,2 Yoshinori Naoe,2 Toru Ichinose,2 Maki Tanaka,3 Yasuhiro Kodera1 1Department of Surgery II, 2Cancer Immune Therapy Research Center, Nagoya University Graduate School of Medicine, Nagoya, 3Takara Bio Inc., Otsu, Japan Background: HF10 is a highly attenuated type 1 herpes simplex virus (HSV with proven effective oncolytic effect. Previous investigations have demonstrated that colon cancer mice model treated with HF10 not only had better survival but were also resistant to the reimplantation of the antitumor effect mediated by host antitumor immunity. Importantly, it has also been noted that in mice with antitumors implanted on both sides of the back, an injection of HF10 on only one side strongly restrains not only the injected antitumor but also the non-injected ones.Materials and methods: MC26 colon cancer cells were injected subcutaneously into the back, spleen, and intraperitoneal region of metastasis model mice. Antitumor volume and survival rate were monitored. To measure cytotoxic T lymphocytes (CTL cytotoxicity against MC26, lymphocytes were extracted from the spleens of the peritoneal metastasis model mice as well as from the thymus of the liver metastasis model mice. The expression of interferon gamma was examined by enzyme-linked immunospot assay. Samples from the liver metastasis model mice were subjected to polymerase chain reaction to quantify the level of HSV genomes.Results: HF10 was injected only on the back antitumor; however, a antitumor-suppressor effect was observed against liver and peritoneal metastases. When HF10 genome was measured, we observed lower genome on liver metastases compared to back antitumor genome quantity. CTL activity against MC26 was also observed. These results indicate that local administration of HF10 exerts a curative effect on systemic disease, mediated by host antitumor immunity.Conclusion: HF10 local administration stimulates antitumor immunity to

  12. Serelaxin in acute heart failure patients with and without atrial fibrillation : a secondary analysis of the RELAX-AHF trial

    NARCIS (Netherlands)

    Filippatos, Gerasimos; Farmakis, Dimitrios; Metra, Marco; Cotter, Gad; Davison, Beth A.; Felker, G. Michael; Greenberg, Barry H.; Hua, Tsushung A.; Pang, Peter S.; Ponikowski, Piotr; Qian, Min; Severin, Thomas A.; Voors, Adriaan A.; Teerlink, John R.

    2017-01-01

    Atrial fibrillation (AFib) is a common comorbidity in HF and affects patients' outcome. We sought to assess the effects of serelaxin in patients with and without AFib. In a post hoc analysis of the RELAX-AHF trial, we compared the effects of serelaxin on efficacy end points, safety end points and bi

  13. Modeling of anisotropic two-dimensional materials monolayer HfS{sub 2} and phosphorene metal-oxide semiconductor field effect transistors

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jiwon [SEMATECH, 257 Fuller Rd #2200, Albany, New York 12203 (United States)

    2015-06-07

    Ballistic transport characteristics of metal-oxide semiconductor field effect transistors (MOSFETs) based on anisotropic two-dimensional materials monolayer HfS{sub 2} and phosphorene are explored through quantum transport simulations. We focus on the effects of the channel crystal orientation and the channel length scaling on device performances. Especially, the role of degenerate conduction band (CB) valleys in monolayer HfS{sub 2} is comprehensively analyzed. Benchmarking monolayer HfS{sub 2} with phosphorene MOSFETs, we predict that the effect of channel orientation on device performances is much weaker in monolayer HfS{sub 2} than in phosphorene due to the degenerate CB valleys of monolayer HfS{sub 2}. Our simulations also reveal that at 10 nm channel length scale, phosphorene MOSFETs outperform monolayer HfS{sub 2} MOSFETs in terms of the on-state current. However, it is observed that monolayer HfS{sub 2} MOSFETs may offer comparable, but a little bit degraded, device performances as compared with phosphorene MOSFETs at 5 nm channel length.

  14. Comparative analysis of cluster versus conventional immunotherapy in patients with allergic rhinitis.

    Science.gov (United States)

    Fan, Qijun; Liu, Xuejun; Gao, Jinjian; Huang, Saiyu; Ni, Liyan

    2017-02-01

    The present study aimed to compare the efficacy and safety of subcutaneous immunotherapy with Dermatophagoides pteronyssinus standardized extract administered in conventional and cluster immunotherapy regiments for patients with persistent allergic rhinitis. A total of 60 patients with moderate to severe allergic rhinitis caused by dust mites were treated for 1 year with either conventional immunotherapy (n=30) or cluster immunotherapy (n=30). Nasal conjunctival symptoms and signs were assessed to evaluate the clinical efficacy of the two regimens, and the incidence of local and systemic adverse reactions were also evaluated. The findings demonstrated that the cluster regimen reduced the duration between the initial and maintenance dose by >60%, and resulted in a significant improvement, as compared with the conventional regimen, after 6 weeks of observation (Pcluster regimen during the dose accumulation phase and the dose maintenance phase was not significantly different, as compared with the conventional immunotherapy regimen. These results suggest that cluster immunotherapy is efficacious and safe to treat patients who are clinically sensitive to dust mites.

  15. The impact of heart failure clinic in the improvement on quality of life of heart failure patients in Mexico.

    Science.gov (United States)

    Mendez, Gustavo F; Betancourt, Lidia; Galicia-Mora, Guillermo

    2007-02-07

    Heart failure clinic (HFC) has emerged as an innovative strategy to improve prognosis and Quality of Life (QOL) of Heart Failure (HF) patients. Unfortunately, there is no-evidence of such benefit on HF patients by HFC in Latin-America. We undertake a research to investigate the impact of HFC on QOL in HF patients in Mexico. From October 2004 to July 2005 all patients that attended for the first time the HFC of the Specialties Hospital No 14 in Veracruz, Mexico were analysed. The study group included patients with HF and left ventricular systolic dysfunction (LVSD). QOL was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). MLHFQ score was compared between basal vs 6 months follow-up. Every patient served as his/her own control. Forty-five HF patients were included and 34 completed 6 months follow-up. Four patients died within 6 months (mortality rate 12% [95% CI 2-22%]). Of the 30 remaining patients, median age was 61 years (range 37-74 years) and 47% was women with a mean left ventricular ejection fraction of 34%. The MLHFQ had a significant reduction at 6 months compared with basal condition from the first evaluation (Basal vs 6 months: mean [SD], 50 [26] vs 31 [19]; p = 0.0001) with a strong correlation between the MLHFQ score and NYHA functional class (p = 0.001; r = 0.59). HFC improves QOL of HF patients in Mexico. This disease management strategy would be considered for widely use in Latin-America countries.

  16. Unique proteomic signature for radiation sensitive patients; a comparative study between normo-sensitive and radiation sensitive breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Skiöld, Sara [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Azimzadeh, Omid [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Merl-Pham, Juliane [Research Unit Protein Science, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg (Germany); Naslund, Ingemar; Wersall, Peter; Lidbrink, Elisabet [Division of Radiotherapy, Radiumhemmet, Karolinska University Hospital, Stockholm (Sweden); Tapio, Soile [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Harms-Ringdahl, Mats [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Haghdoost, Siamak, E-mail: Siamak.Haghdoost@su.se [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden)

    2015-06-15

    Highlights: • The unique protein expression profiles were found that separate radiosensitive from normal sensitive breast cancer patients. • The oxidative stress response, coagulation properties and acute phase response suggested to be the hallmarks of radiation sensitivity. - Abstract: Radiation therapy is a cornerstone of modern cancer treatment. Understanding the mechanisms behind normal tissue sensitivity is essential in order to minimize adverse side effects and yet to prevent local cancer reoccurrence. The aim of this study was to identify biomarkers of radiation sensitivity to enable personalized cancer treatment. To investigate the mechanisms behind radiation sensitivity a pilot study was made where eight radiation-sensitive and nine normo-sensitive patients were selected from a cohort of 2914 breast cancer patients, based on acute tissue reactions after radiation therapy. Whole blood was sampled and irradiated in vitro with 0, 1, or 150 mGy followed by 3 h incubation at 37 °C. The leukocytes of the two groups were isolated, pooled and protein expression profiles were investigated using isotope-coded protein labeling method (ICPL). First, leukocytes from the in vitro irradiated whole blood from normo-sensitive and extremely sensitive patients were compared to the non-irradiated controls. To validate this first study a second ICPL analysis comparing only the non-irradiated samples was conducted. Both approaches showed unique proteomic signatures separating the two groups at the basal level and after doses of 1 and 150 mGy. Pathway analyses of both proteomic approaches suggest that oxidative stress response, coagulation properties and acute phase response are hallmarks of radiation sensitivity supporting our previous study on oxidative stress response. This investigation provides unique characteristics of radiation sensitivity essential for individualized radiation therapy.

  17. Self-directedness: an indicator for clinical response to the HF-rTMS treatment in refractory melancholic depression.

    Science.gov (United States)

    Baeken, Chris; Desmyter, Stefanie; Duprat, Romain; De Raedt, Rudi; Van Denabbeele, Dirk; Tandt, Hannelore; Lemmens, Gilbert M D; Vervaet, Myriam; van Heeringen, Kees

    2014-12-15

    Although well-defined predictors of response are still unclear, clinicians refer a variety of depressed patients for a repetitive Transcranial Magnetic Stimulation (rTMS) treatment. It has been suggested that personality features such as Harm Avoidance (HA) and self-directedness (SD) might provide some guidance for a classical antidepressant treatment outcome. However, to date no such research has been performed in rTMS treatment paradigms. In this open study, we wanted to examine whether these temperament and character scores in particular would predict clinical outcome in refractory unipolar depressed patients when a typical high-frequency (HF)-rTMS treatment protocol is applied. Thirty six unipolar right-handed antidepressant-free treatment resistant depressed (TRD) patients, all of the melancholic subtype, received 10 HF-rTMS sessions applied to the left dorsolateral prefrontal cortex (DLPFC). All patients were classified as at least stage III TRD and were assessed with the Temperament and Character Inventory (TCI) before a HF-rTMS treatment. Only the individual scores on SD predicted clinical outcome. No other personality scales were found to be a predictor of this kind of application. Our results suggest that refractory MDD patients who score higher on the character scale SD may be more responsive to the HF-rTMS treatment.

  18. A comparative study of Cefixime and Chloramphenicole for treatment of patients with typhoid fever

    Directory of Open Access Journals (Sweden)

    Emadi J

    2001-08-01

    Full Text Available Typhoid fever is an endemic disease in Iran and other developing countries. This disease has gradually become resistant to the first line of drugs, and because of this resistancy we have studied a new alternative drug (cefixime on typhoid fever patients and compared it's effectiveness with chloramphenicol. For this purpose, by a randomized clinical trial in Emam Khomeini hospital between 1995-2000, we allocated 44 uncomplicated patient with established typhoid fever (positive blood or bone marrow culture and by random selection, 24 patient were given cefixime (400 mg PO bid and 20 patient received chloramphenicol (500 mg po Q6h. The duration of therapy were 10 and 14 days for chloramphenicol and cefixime group respectively. Median fever clearance times were 5±1.9 for cefixime recipients and 3.8±1.2 days for chloramphenicol treated patients, but for improvement in other clinical and laboratory findings, there were not any significant difference. Bacteriologic and clinical cure rate for cefixime was 100 and 92 percents respectively. Though, even cefixime like other betalactam drugs is slow in helping the fever disappearance but our study suggests that oral cefixime is effective and can be used as an alternate treatment of typhoid fever.

  19. COMPARATIVE STUDY OF EMOTIONAL DISORDERS STRUCTURE IN PATIENTS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    T. G. Mikhaylichenko

    2011-01-01

    Full Text Available Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases, 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety. 

  20. Performance on a probabilistic inference task in healthy subjects receiving ketamine compared with patients with schizophrenia

    Science.gov (United States)

    Almahdi, Basil; Sultan, Pervez; Sohanpal, Imrat; Brandner, Brigitta; Collier, Tracey; Shergill, Sukhi S; Cregg, Roman; Averbeck, Bruno B

    2012-01-01

    Evidence suggests that some aspects of schizophrenia can be induced in healthy volunteers through acute administration of the non-competitive NMDA-receptor antagonist, ketamine. In probabilistic inference tasks, patients with schizophrenia have been shown to ‘jump to conclusions’ (JTC) when asked to make a decision. We aimed to test whether healthy participants receiving ketamine would adopt a JTC response pattern resembling that of patients. The paradigmatic task used to investigate JTC has been the ‘urn’ task, where participants are shown a sequence of beads drawn from one of two ‘urns’, each containing coloured beads in different proportions. Participants make a decision when they think they know the urn from which beads are being drawn. We compared performance on the urn task between controls receiving acute ketamine or placebo with that of patients with schizophrenia and another group of controls matched to the patient group. Patients were shown to exhibit a JTC response pattern relative to their matched controls, whereas JTC was not evident in controls receiving ketamine relative to placebo. Ketamine does not appear to promote JTC in healthy controls, suggesting that ketamine does not affect probabilistic inferences. PMID:22389244

  1. Comparative study of azathioprine-interferon g dispensing to patients with idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Fotios Drakopanagiotakis

    2009-01-01

    Full Text Available SUMMARY. Introduction: Idiopathic pulmonary fibrosis (IPF is characterized by progressive deterioration of lung function, leading ultimately to death. No pharmacological treatment has been found to stabilize the evolution of the disease, but interferon-g and azathioprine have been used as therapeutic options. Aim: To compare the effectiveness of treatment with interferon-g plus low dose prednisone or azathioprine plus low dose prednisone in patients with IPF. Materials and methods: Patients newly diagnosed with IPF were recruited, 22 in total, of whom 10 received azathioprine plus prednisone and 12 patients received interferon-g plus prednisone for six months. Clinical evaluation, lung function tests, HRCT, bronchoscopy and bronchoalveolar lavage (BAL were performed at baseline and after six months of treatment. Results: All patients were alive after six months of treatment. No statistically significant difference between the two groups was detected regarding clinical deterioration, inflammatory biomarkers such as erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and BAL cell sub-populations. There was a trend, not statistically significant, towards a greater reduction in forced vital capacity and diffusing capacity for carbon monoxide in the interferon-g group. Conclusion: Interferon-g does not offer any therapeutic advantage over azathioprine as regards the clinical course, lung function tests and BAL cell counts of patients with IPF. Pneumon 2009, 22(3:240-253.

  2. Randomized controlled trial comparing ciprofloxacin and cefepime in febrile neutropenic patients with hematological malignancies.

    Science.gov (United States)

    Yasuda, Takahiko; Suzuki, Ritsuro; Ishikawa, Yuichi; Terakura, Seitaro; Inamoto, Yoshihiro; Yanada, Masamitsu; Nagai, Hirokazu; Ozawa, Yukiyasu; Ozeki, Kazutaka; Atsuta, Yoshiko; Emi, Nobuhiko; Naoe, Tomoki

    2013-06-01

    Ciprofloxacin (CPFX) is a potential alternative in patients with febrile neutropenia (FN) because of its activity against Gram-negative organisms. We conducted a non-inferiority, open-label, randomized controlled trial comparing intravenous CPFX and cefepime (CFPM) for FN patients with hematological malignancies. Patients aged from 15 to 79 years with an absolute neutrophil count of response, and early toxicity were evaluated. Fifty-one episodes were included in this trial, and 49 episodes (CPFX vs. CFPM: 24 vs. 25) were evaluated. Treatment efficacy at day 7 was significantly higher in the CFPM group (successful clinical response: nine with CPFX and 19 with CFPM; p=0.007). The response was better in high-risk patients with neutrophil counts of ≤ 0.100 × 10(9/)l (p=0.003). The overall response during the study period was similar between the CPFX and CFPM groups (p=0.64). Adverse events were minimal, and all patients could continue the treatment. We could not prove the non-inferiority of CPFX in comparison with CFPM for the initial treatment of FN. CFPM remains the standard treatment of choice for FN. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. The comparative palliative care needs of those with heart failure and cancer patients.

    LENUS (Irish Health Repository)

    O'Leary, Norma

    2012-02-01

    PURPOSE OF REVIEW: Patients with heart failure seem particularly suited to palliative care having needs that fall within the prototypical palliative care domains. Despite this there is still much debate as to who should respond to these needs and when. RECENT FINDINGS: Since the early 1990s many studies have been published outlining the unmet needs of patients with heart failure. However, there have been limitations to these studies and they have not guided professionals as to how to respond. More recently comparative studies using cancer as the reference have explored similarities and highlighted differences in need between heart failure and cancer patients. These studies are useful for informing future service development. SUMMARY: Patients with heart failure have variable needs and variable disease trajectories. A targeted response to these needs is required. Palliative triggers or transitions should be recognized by professionals caring for patients with heart failure. It is unlikely that either specialist palliative care or medical specialists working in isolation will be sufficiently experienced to respond to these needs. Research is required to determine the effectiveness of different collaborative approaches; heart failure specialist care aligned with palliative care consultancy or heart failure-oriented palliative care services.

  4. Comparing the Levels of Trace Elements in Patients With Diabetic Nephropathy and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Makhlough

    2015-06-01

    Full Text Available Background Diabetic nephropathy is the most common cause of end stage renal disease (ESRD in developed countries. Several trace elements were reported to be changed in diabetic nephropathy. Objectives The aim of this study was to investigate changes in serum levels of zinc, copper and chromium and their association with the incidence of ESRD in patients with diabetes. Patients and Methods This study was performed on 70 patients with type 2 diabetic nephropathy (macro and micro-albuminuria and 70 healthy individuals. Samples were collected to survey metals by atomic absorption spectrophotometer. Data was analyzed by SPSS18 using descriptive and inferential analysis methods. Results Mean ± SD levels of Zn, Cu and Cr were significantly decreased in blood samples of patients compared to healthy subjects (P < 0.01. Also the mean concentrations of Cu, Zn and Cr in drinking water of Sari were lower than the accepted limit. Only in one case, Cu was higher than the accepted limit, which was the possibility of contamination by water supply pipes. Conclusions Cu, Zn and Cr play a specific role in the pathophysiology of diabetic nephropathy. Meanwhile in these patients, low serum levels of Cu, Zn and Cr were not associated with factors such as drinking water. Possible causes should be sought in other factors like urine, intervention factors in absorption and utilization and individual conditions.

  5. Medication use in patients with restless legs syndrome compared with a control population.

    Science.gov (United States)

    Pearson, V E; Gamaldo, C E; Allen, R P; Lesage, S; Hening, W A; Earley, C J

    2008-01-01

    Primary restless legs syndrome (RLS) is a sensorimotor disorder causing chronic sleep deprivation in those with moderate to severe symptoms. It has been associated with other medical conditions, such as high blood pressure, depression and attention deficit hyperactive disorder (ADHD). If these conditions are more prevalent for RLS patients, then it would be expected RLS patients would use relatively more of the medications treating these conditions. Current medication use was obtained from 110 RLS patients and 54 age, race and gender-matched local-community controls. Each subject was diagnosed as primary RLS or having no indications for RLS by a clinician board-certified in sleep medicine. The RLS group used more medications than the control group even when medications used for treating RLS were excluded. Significantly more of the RLS patients than controls used anti-depressants, gastro-intestinal (GI) medications and asthma/allergy medications. RLS patients compared with those without RLS are more likely to use medications not related to treating RLS. Moreover they use medications for conditions that have not previously been considered related to RLS, i.e. GI and asthma/allergy conditions.

  6. A COMPARATIVE STUDY OF POST-CHOLECYSTECTOMY COMPLICATIONS AMONG PATIENTS WITH AND WITHOUT DRAIN

    Directory of Open Access Journals (Sweden)

    Anindita Bhar

    2016-06-01

    Full Text Available BACKGROUND The disease of gallbladder is one of the most common abdominal ailment encountered by the surgeons since ancient times for which cholecystectomy is the most commonly performed operation. In the late 19 th century, first successful open cholecystectomy was performed by Carl Langenbuch using aseptic technique, thereafter in the last 100 years, open cholecystectomy has remained the gold standard for definitive management of symptomatic cholelithiasis. It was a common practice to give a routine drain in each and every case of cholecystectomy, but Spivak and many other authors have advocated operation without drain which has dramatically reduced postoperative morbidity and hospital stay. AIM The aim of the study was to compare the postoperative complications such as pain, wound infection, respiratory complications, and incidence of postoperative thrombophlebitis, subhepatic collection and length of hospital stay in patients who have undergone open cholecystectomy with drain with those without drain. DESIGN This is a prospective longitudinal interventional study. MATERIALS AND METHODS This study was done in 70 patients admitted for cholecystectomy operation in Surgery Department of Midnapore Medical College. 35 of them selected randomly were assigned as Group A who were given a postoperative drain and rest 35 patients assigned Group B were without drain. The presence of postoperative complications such as pain, wound infection, respiratory complications (cough, breathing difficulty, pneumonitis, and pulmonary embolism, thrombophlebitis, subhepatic collection and length of hospital stay were compared between the two groups. RESULT 91.42% patients of Group A had a significant pain compared to 51.42% patients of Group B. Wound infection and respiratory complications were present in 14.28% cases of Group A as against 5.71% cases in Group B. Fever was present in 42.85%, thrombophlebitis in 25.71% and subhepatic collection in 28.57% of patients

  7. Forefoot Surgery in Elderly Compared With Younger Patient Populations: Complications and Type of Procedure.

    Science.gov (United States)

    Vermersch, Thibault; Fessy, Michel Henri; Besse, Jean-Luc

    2015-01-01

    In forefoot surgery, the presenting complaints and expected benefits differ between elderly and younger patients. The present study mapped forefoot procedures recommended to elderly patients compared with those recommended to the general population and assessed the complications according to age group and comorbidity. Consecutive patients were included in a single-center, continuous, retrospective case-control study. Three age groups were defined: <65 years, 65 to 74 years, and ≥ 75 years. All patients, regardless of age, underwent the same procedure; elderly-specific techniques such as the Keller procedure were not used. A total of 321 patients were included, with a mean age of 60.6 (range 16 to 86) years. A similar procedure was used in all 3 groups, but at differing frequencies, with arthrodesis and minor procedures increasing with increasing patient age. In all 3 groups, in the population as a whole, the incidence of delayed healing, deep infection, and nonunion was 9%, 1%, and 2%, respectively. These complications were independent of age group. In the <65-year-old group, just as in the study population as a whole, arthrodesis associated with resection arthroplasty resulted in greater rates of delayed healing and deep infection. The complications rates were equivalent among the 3 age groups. Major surgical procedures should be avoided in elderly patients, if possible. However, no particular procedure is contraindicated in the elderly, although the method of fixation must be robust owing to the frequency of osteoporosis. A first step would be to achieve consensus on the age threshold for "elderliness."

  8. Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study.

    Science.gov (United States)

    Gagne, Joshua J; Choudhry, Niteesh K; Kesselheim, Aaron S; Polinski, Jennifer M; Hutchins, David; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

    2014-09-16

    Statins are effective in preventing cardiovascular events, but patients do not fully adhere to them. To determine whether patients are more adherent to generic statins versus brand-name statins (lovastatin, pravastatin, or simvastatin) and whether greater adherence improves health outcomes. Observational, propensity score-matched, new-user cohort study. Linked electronic data from medical and pharmacy claims. Medicare beneficiaries aged 65 years or older with prescription drug coverage between 2006 and 2008. Initiation of a generic or brand-name statin. Adherence to statin therapy (measured as the proportion of days covered [PDC] up to 1 year) and a composite outcome comprising hospitalization for an acute coronary syndrome or stroke and all-cause mortality. Hazard ratios (HRs) and absolute rate differences were estimated. A total of 90,111 patients who initiated a statin during the study was identified; 83,731 (93%) initiated a generic drug, and 6380 (7%) initiated a brand-name drug. The mean age of patients was 75.6 years, and most (61%) were female. The average PDC was 77% for patients in the generic group and 71% for those in the brand-name group (P<0.001). An 8% reduction in the rate of the clinical outcome was observed among patients in the generic group versus those in the brand-name group (HR, 0.92 [95% CI, 0.86 to 0.99]). The absolute difference was -1.53 events per 100 person-years (CI, -2.69 to -0.19 events per 100 person-years). Results may not be generalizable to other populations with different incomes or drug benefit structures. Compared with those initiating brand-name statins, patients initiating generic statins were more likely to adhere and had a lower rate of a composite clinical outcome. Teva Pharmaceuticals.

  9. Prevalence of Comorbidity in Patients With Young-Onset Alzheimer Disease Compared With Late-Onset: A Comparative Cohort Study

    NARCIS (Netherlands)

    Gerritsen, A.A.J.; Bakker, C.; Verhey, F.R.J.; Vugt, M.E. de; Melis, R.J.; Koopmans, R.T.

    2016-01-01

    OBJECTIVES: With the lack of a cure for Alzheimer disease (AD), the identification of comorbidity is important to reduce the possibility of excess disability. Although comorbidity in patients with late-onset AD (LO-AD) is common, for people with young-onset AD (YO-AD), it is unclear how often

  10. Impact of aging on cardiac sympathetic innervation measured by {sup 123}I-mIBG imaging in patients with systolic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Rengo, Giuseppe; Ferrara, Nicola [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Pagano, Gennaro; Formisano, Roberto; Komici, Klara; Petraglia, Laura; Parisi, Valentina; Femminella, Grazia Daniela; De Lucia, Claudio; Cannavo, Alessandro; Memmi, Alessia; Leosco, Dario [University of Naples Federico II, Division of Geriatrics, Department of Translational Medical Sciences, Naples (Italy); Vitale, Dino Franco [Scientific Institute of Telese Terme, Salvatore Maugeri Foundation, IRCCS, Telese Terme (Italy); Paolillo, Stefania [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Attena, Emilio [Fatebenefratelli Hospital, Department of Cardiology, Naples (Italy); Pellegrino, Teresa [Institute of Biostructures and Bioimages of the National Council of Research, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy); Dellegrottaglie, Santo [Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Division of Cardiology, Acerra, Naples (Italy); Trimarco, Bruno; Filardi, Pasquale Perrone [Federico II University of Naples, Division of Cardiology, Department of Advanced Biomedical Sciences, Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development, SDN Foundation, Naples (Italy); Federico II University of Naples, Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Naples (Italy)

    2016-12-15

    Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine ({sup 123}I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac {sup 123}I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by {sup 123}I-mIBG scintigraphy, in patients with HF. We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac {sup 123}I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62-72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p < 0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age. Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by {sup 123}I-mIBG imaging. This finding suggests that cardiac {sup 123}I-mIBG uptake in patients with HF might be affected by patient age. (orig.)

  11. Qualitative examination of compliance in heart failure patients in The Netherlands

    NARCIS (Netherlands)

    van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients'

  12. Qualitative examination of compliance in heart failure patients in The Netherlands

    NARCIS (Netherlands)

    van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients'

  13. A comparative study of regression of jaundice in patients of malaria and acute viral hepatitis

    Directory of Open Access Journals (Sweden)

    D.K. Kochar, K. Kaswan, S.K. Kochar, P. Sirohi, M. Pala, A. Kochar , R.P. Agrawal , A. Das

    2006-09-01

    Full Text Available Background & objectives: Jaundice is one of the common manifestations of severe malaria in adults.The purpose of this study is to compare the pattern of clinical and biochemical parameters such asserum bilirubin and liver enzyme levels in patients of malaria with jaundice and acute viral hepatitis.Methodology: The present study was conducted on 34 patients of malaria with jaundice and 15patients of acute viral hepatitis. Estimation of serum bilirubin, aspartate amino transferase (AST,alanine amino transferase (ALT and alkaline phosphatase was done daily using standard proceduresin malaria patients and weekly in acute viral hepatitis patients.Results: Mean level of serum bilirubin on first day in malaria and acute viral hepatitis patients was7.07 ± 3.94 and 10.38 ± 7.87 mg%, whereas on Day 8 it was 1.19 ± 1.43 and 7.88 ± 7.02 mg%respectively. Mean level of AST on Day 1 in malaria and acute viral hepatitis patients was 158.47 ±120.35 and 1418.6 ± 834.11 IU/L, whereas on Day 8 it was 41 ± 28.33 and 775.3 ± 399.01IU/L respectively. Mean level of ALT on Day 1 in malaria and acute viral hepatitis patients was220.14 ± 145.61 and 1666.67 ± 1112.77 IU/L, whereas on Day 8 it was 50.85 ± 37.31 and 823.8 ±475.06 IU/L respectively. Mean level of serum alkaline phosphatase on Day 1 in malaria and acuteviral hepatitis patients was 394.74 ± 267.78 and 513.4 ± 324.7 IU/L, whereas on Day 8 it was84.76 ± 68.50 and 369.27 ± 207.75 IU/L respectively.Interpretation & conclusion: We observed that resolution of jaundice in malaria took 1–2 weeks incontrast 6 to 8 weeks in viral hepatitis. This difference in duration was statistically significant. Thus,jaundice not resolving in 1–2 weeks time in a patient of malaria requires serious consideration forpresence of other concomitant diseases including viral hepatitis.

  14. Increased frontal electroencephalogram theta amplitude in patients with anorexia nervosa compared to healthy controls

    Directory of Open Access Journals (Sweden)

    Hestad KA

    2016-09-01

    =0.038 compared to controls. Significant differences were also observed for secondary variables: lower values for relative parietooccipital delta and frontocentral alpha activity among AN patients than among controls.Conclusion: We observed slight excess frontal theta and lower relative alpha and delta amplitudes among AN patients than among controls. This pattern is possibly related to a slight frontal lobe dysfunction in AN, or it may reflect increased attention/vigilance or another state-related change in patients with AN compared to healthy controls. Keywords: anorexia, EEG, frontal theta, alpha, delta, eating disorders

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  16. High performance organic nonvolatile memory transistors based on HfO2 and poly(α-methylstyrene) electret hybrid charge-trapping layers

    Science.gov (United States)

    Xu, W. C.; He, H. X.; Jing, X. S.; Wu, S. J.; Zhang, Z.; Gao, J. W.; Gao, X. S.; Zhou, G. F.; Lu, X. B.; Liu, J.-M.

    2017-08-01

    In this work, we fabricated a high performance flash-type organic nonvolatile memory transistor, which adopted polymer-electret poly(α-methylstyrene) (PαMS) and HfO2 films as hybrid charge trapping layer (CTL). Compared with a single HfO2 or PαMS CTL structure, the hybrid HfO2/PαMS CTL structure can provide enhanced charge trapping efficiency to increase the device operation speed and reduce the leakage current to boost the device reliability. The fabricated nonvolatile organic memory transistors with the hybrid CTL shows excellent electrical properties, including low operation voltage (8 V), high speed (memories.

  17. HF dissociation in water clusters by computer simulations

    OpenAIRE

    Elena, Alin Marin

    2013-01-01

    We perform Restrained hybrid Monte Carlo simulations to compute the equilibrium constant of the dissociation reaction of HF in HF(H2O)7. We find that, like in the bulk, hydrofluoric acid, is a weak acid also in the cubic HF(H2O)7 cluster, and that its acidity is higher at lower T. This latter phenomenon has a (vibrational) entropic origin, namely it is due to the reduction of the (negative) T∆S contribution to the variation of free energy between the reactant and product. We found also ...

  18. Comparing Personality Dimensions and coping Strategies in Healthy Individuals and Heart Patients

    Directory of Open Access Journals (Sweden)

    R Rahimi

    2016-01-01

    Full Text Available Introduction: Heart disease is a psycho-physiological disorder that in addition to physical and biological factors, psychological factors such as stressful events, personality traits and coping strategies play an important role in its occurrence and exacerbation. Therefore, the purpose of this study was to investigate personality dimensions and stress-coping strategies within healthy individuals compared with heart patients. Methods: In this analytical-comparative study, 50 patients with heart disease(26 males and 24 females and 50 healthy subjects (28 males and 22 females were selected. The participants were required to respond to the Eysenck personality questionnaire (EPQ-R and Folkman and Lazarus’s stress-coping strategies questionnaire. In order to analyze the studydata, descriptive indicators and independent t-test were applied using SPSS software(ver, 19 and  the significance level was set at α= 0/01. Findings: The study results revealed a significant defference between heart patients and healthy individuals in terms of personality dimensions, neuroticism, and psychoticism, though no significant difference was observed in regard with emotion-focused coping strategies between the two groups. In the present study, the effect of gender was also examined on personality dimensions and coping strategies. Moreover, extraversion features as well as emotion-focused and problem-focused coping strategies were demonstrated to differ significantly between males and females. Conclusion: The study findings indicated that heart patients seem to be more anxious, fearful, violent, aggressive and fast developing for anxiety, depression and aggression compared to healthy individuals who apply emotion-oriented coping style dealing with the problems.

  19. Dexmedetomidine and propofol for cerebral angiography in non-intubated patients: A comparative study

    Directory of Open Access Journals (Sweden)

    Sujoy Banik

    2015-01-01

    Full Text Available Context: Patients posted for cerebral angiography may be restless and drowsy with high chance of inadvertent movements. Aims: The primary objective was to compare the incidence of inadvertent movements between propofol and dexmedetomidine groups. The secondary objectives include comparison of recovery time and characteristics, Steward′s score, and haemodynamic and respiratory parameters between the two groups. Settings and Design: Prospective, randomised, double-blind, pilot study. Materials and Methods: In all, 20 adult uncooperative, drowsy patients were randomised to dexmedetomidine (1 μg/kg bolus over 10 minutes followed by 0.3-0.7 μg/kg/hour infusion or propofol (100 μg/kg/min for 10 minutes followed by 25-75 μg/kg/min infusion. Rate of movement, success of sedation, haemodynamics, respiratory parameters, Steward′s recovery score and recovery time were recorded. Statistical analysis used: Repeated measures of analysis of variance, Mann-Whitney test, independent and paired t-tests, and Fisher test. Results: The median rate of movement was similar (1, P = 0.206 with success of sedation achieved in 7 (70% patients in Group D and 9 (90% patients in Group P, which was comparable (P = 0.582. The median recovery time in patients in Group D was 150 (37-764 seconds and in Group P was 128 (54-174 seconds (P = 0.519 with similar Steward′s scores (P = 0.363. Haemodynamics and respiratory variables were well-maintained during loading and maintenance dose infusions in both the groups. Conclusions: Dexmedetomidine is a safe alternative for diagnostic cerebral angiography. Its success of sedation, median rate of movement during the imaging procedure, haemodynamics, respiratory parameters, recovery time and Steward′s recovery score were similar to propofol in our study.

  20. Comparative study between sugammadex and neostigmine in neurosurgical anesthesia in pediatric patients.

    Science.gov (United States)

    Ghoneim, Ayman A; El Beltagy, Mohammed A

    2015-01-01

    Postoperative recurarization remains a risk following the use of the conventional neuromuscular blocking agents. In addition, none of the commonly used reversal agents, such as neostigmine or edrophonium are capable of reliably reversing profound blockade. The present comparative and randomized study investigated the use of sugammadex for reversing profound neuromuscular blockade (NMB) in pediatric neurosurgical patients undergone posterior fossa tumor excision. Forty pediatric patients undergoing elective craniotomy for posterior fossa tumor excision were randomly divided into either of neostigmine or sugammadex group in which muscle relaxant was reversed at the end of anesthesia either with neostigmine 0.04 mg/kg added to atropine 0.02 mg/kg or sugammadex 4 mg/kg alone, respectively. The primary endpoint was the time from the administration of sugammadex or neostigmine to recovery of the train of four (TOF) ratio to 90% after rocuronium-induced neuromuscular block. Unpaired t-test was used to compare continuous variables between groups. Meanwhile, repeated ANOVA was used to detect intragroup differences. Patients in sugammadex group attained a TOF ratio 90% in statistically shorter time (1.4 ± 1.2 min) than those in neostigmine group (25.16 ± 6.49 min) for reversal of the rocuronium. Mean arterial pressure and heart rate were significantly higher in neostigmine group at 2, 5 and 10 min after administration of the reversal agents and returned nonsignificantly different after that. With no recurarization in any patient throughout the study period. Sugammadex rapidly and effectively reverses rocuronium-induced NMB in pediatric patients undergoing neurosurgery when administered at reappearance of T2 of TOF at dose 4 mg/kg.

  1. Additive Manufacturing of NiTiHf High Temperature Shape Memory Alloy

    Science.gov (United States)

    Benafan, Othmane; Bigelow, Glen S.; Elahinia, Mohammad; Moghaddam, Narges Shayesteh; Amerinatanzi, Amirhesam; Saedi, Soheil; Toker, Guher Pelin; Karaca, Haluk

    2017-01-01

    Additive manufacturing of a NiTi-20Hf high temperature shape memory alloy (HTSMA) was investigated. A selective laser melting (SLM) process by Phenix3D Systems was used to develop components from NiTiHf powder (of approximately 25-75 m particle fractions), and the thermomechanical response was compared to the conventionally vacuum induction skull melted counterpart. Transformation temperatures of the SLM material were found to be slightly lower due to the additional oxygen pick up from the gas atomization and melting process. The shape memory response in compression was measured for stresses up to 500 MPa, and transformation strains were found to be very comparable (Up to 1.26 for the as-extruded; up to 1.52 for SLM).

  2. Hf-Co and Zr-Co alloys for rare-earth-free permanent magnets.

    Science.gov (United States)

    Balamurugan, B; Das, B; Zhang, W Y; Skomski, R; Sellmyer, D J

    2014-02-12

    The structural and magnetic properties of nanostructured Co-rich transition-metal alloys, Co(100-x)TMx (TM = Hf, Zr and 10 ≤ x ≤ 18), were investigated. The alloys were prepared under non-equilibrium conditions using cluster-deposition and/or melt-spinning methods. The high-anisotropy HfCo7 and Zr2Co11 structures were formed for a rather broad composition region as compared to the equilibrium bulk phase diagrams, and exhibit high Curie temperatures of above 750 K. The composition, crystal structure, particle size, and easy-axis distribution were precisely controlled to achieve a substantial coercivity and magnetization in the nanostructured alloys. This translates into high energy products in the range of about 4.3-12.6 MGOe, which are comparable to those of alnico.

  3. 关于医用高频电刀的使用安全和维护%Security and Maintenance on the Medical HF Electrotome

    Institute of Scientific and Technical Information of China (English)

    李广

    2016-01-01

    HF electrotome has been widely used in surgery by hospital, Compared with the traditional instruments scalpel , it has the advantage of surgery fast relief ,surgical bleeding , alleviate the suffering of the patient’s .however , it require special attention to security issues, because it will cause damage to patient or other security incidents . Therefore, as to avoid make patients suffering due to misuse ,and reduce medical disputes ,it’s necessary to make study on the securityand maintenance of the medical HF Electrotome.%医用高频电刀现在各大医院的外科手术中有着广泛的应用,相对于传统的器械手术刀,它具有手术速度快、减免手术出血、减轻病人痛苦的优点,但在使用过程中要特别注意安全问题,因为稍不注意就会出现高低频灼伤及其他一些难以察觉的安全事故。所以,为了避免使用失误增加患者痛苦,继而引发医患纠纷,就必须要研究探讨高频电刀的安全使用及防护管理工作。

  4. Clinical signs and symptoms of tinnitus in temporomandibular joint disorders: A pilot study comparing patients and non-patients

    Directory of Open Access Journals (Sweden)

    Amisha Kanji

    2013-12-01

    Full Text Available Background: Tinnitus is one of the otologic symptoms commonly reported to be associated with temporomandibular disorder (TMD, and questions regarding its nature and cause continue to plague the clinical and research community.Objectives: The current pilot study aimed to investigate the clinical signs and symptoms of presenting tinnitus in a group of individuals with TMD (group A, and compare them with a group with tinnitus but without TMD (group B. Twenty participants were included in the study, 10 from each group.Methods: All participants underwent basic audiological as well as ear, nose and throat (ENT evaluations to establish group A and group B. For tinnitus assessment, all participants completed a tinnitus survey questionnaire, and their tinnitus was evaluated using tinnitus matching procedures.Results: Findings revealed clinically relevant differences in attributes of tinnitus in patients with and without TMD. Most of the participants in group A matched their tinnitus to a 6 000 Hz tone or noise, at lower intensity levels than participants in group B, although these results were not statistically significant. Participants in group A associated their tinnitus with a single sound whereas some participants in group B associated it with more than one sound. More participants in group B reported the duration of their tinnitus as constant.Conclusions: Tinnitus may occur in patients with TMD, and be of high frequency. This highlights the importance of thorough assessment for patients with tinnitus as this might have implications for diagnosis and management.

  5. Reliability study of Zr and Al incorporated Hf based high-k dielectric deposited by advanced processing

    Science.gov (United States)

    Bhuyian, Md Nasir Uddin

    electron affinity variation in HfO2 and ZrO 2. The trap activation energy levels estimated from the temperature dependent current voltage characteristics also support the observed reliability characteristics for these devices. In another experiment, HfO2 is lightly doped with Al with a variation in Al concentration by depositing intermediate HfAlOx layers. This work has demonstrated a high quality HfO2 based gate stack by depositing atomic layer deposited (ALD) HfAlOx along with HfO2 in a layered structure. In order to get multifold enhancement of the gate stack quality, both Al percentage and the distribution of Al are observed by varying the HfAlOx layer thickness and it is found that < 2% Al/(Al+Hf)% incorporation can result in up to 18% reduction in the average EOT along with up to 41% reduction in the gate leakage current as compared to the dielectric with no Al content. On the other hand, excess Al presence in the interfacial layer moderately increases the interface state density (Dit). When devices are stressed in the gate injection mode at a constant voltage stress, dielectrics with Al/(Hf+Al)% < 2% show resistance to stress induced flat-band voltage shift (DeltaVFB), and stress induced leakage current (SILC). The time dependent dielectric breakdown (TDDB) characteristics show a higher charge to breakdown and an increase in the extracted Weibull slope (beta) that further confirms an enhanced dielectric reliability for devices with < 2% Al/(Al+Hf)%.

  6. Ionospheric heating with oblique HF waves

    Science.gov (United States)

    Field, Edward C., Jr.; Bloom, Ron M.

    1990-10-01

    Calculations of ionospheric electron density perturbations and ground-level signal changes produce by intense oblique high frequency (HF) transmitters are presented. This analysis considers radio field focusing at caustics, the consequent joule-heating of the surrounding plasma, heat conduction, diffusion, and recombination processes: these being the effects of a powerful oblique 'modifying' wave. It neglects whatever plasma instabilities might occur. Then effects on a secondary 'test' wave that is propagated along the same path as the first are investigated. Calculations predict ground-level field-strength reductions of several dB in the test wave for modifying waves having ERP in the 85 to 90 dBW range. These field-strength changes are similar in sign, magnitude, and location to ones measured in Soviet experiments. The results are sensitive to the model ionosphere assumed, so future experiments should employ the widest possible range of frequencies and propagation conditions. An effective power of 90 dBW seems to be a sort of threshold that, if exceeded, results in substantial rather than small signal changes. The conclusions are based solely on joule-heating and subsequent defocusing of waves passing through caustic regions.

  7. Process Simulation Analysis of HF Stripping

    Directory of Open Access Journals (Sweden)

    Thaer A. Abdulla

    2013-05-01

    Full Text Available    HYSYS process simulator is used for the analysis of existing HF stripping column in LAB plant (Arab Detergent Company, Baiji-Iraq. Simulated column performance and profiles curves are constructed. The variables considered are the thermodynamic model option, bottom temperature, feed temperature, and column profiles for the temperature, vapor flow rate, liquid flow rate and composition. The five thermodynamic models options used (Margules, UNIQUAC, van laar, Antoine, and Zudkevitch-Joffee, affecting the results within (0.1-58% variation for the most cases.        The simulated results show that about 4% of paraffin (C10 & C11 presents at the top stream, which may cause a problem in the LAB production plant. The major variations were noticed for the total top vapor flow rate with bottom temperature and with feed composition. The column profiles maintain fairly constants from tray 5 to tray 18. The study gives evidence about a successful simulation with HYSYS because the results correspond with the real plant operation data.

  8. The (178m2) Hf Controversy

    CERN Document Server

    Becker, J A; Schiffer, J P; Wilhelmy, J

    2003-01-01

    Since its discovery in the 1960's the sup 1 sup 7 sup 8 sup m sup 2 Hf isomer has garnered high attention from both the basic and applied communities in nuclear science. It's combination of high spin (16+), long half life (31 yrs), and high excitation energy (2.446 MeV) offer unique possibilities as an energy storage medium. Interest in the isomer was rekindled beginning in 1999 when a series of publications began to appear from a group (referred to here as the ''Texas collaboration'') primarily based at the University of Texas, Dallas [1]. They reported observations that some of the stored energy could be released (''triggered'') when the isomer was exposed to a fluence of photons in the energy range approx 10 to approx 60 keV. The implications of this observation are profound. Even though the claimed cross section for the process was approx 7 orders of magnitude greater than would be predicted from the known systematics of photon absorption by nuclei in this mass range [2], such a highly efficient method fo...

  9. Approximating ambient D-region electron densities using dual-beam HF heating experiments at the high-frequency Active Auroral Research Program (HAARP)

    Science.gov (United States)

    Agrawal, Divya

    Dual-beam ELF/VLF wave generation experiments performed at the High-frequency Active Auroral Research Program (HAARP) HF transmitter in Gakona, Alaska are critically compared with the predictions of a newly developed ionospheric high frequency (HF) heating model that accounts for the simultaneous propagation and absorption of multiple HF beams. The dual-beam HF heating experiments presented herein consist of two HF beams transmitting simultaneously: one amplitude modulated (AM) HF beam modulates the conductivity of the lower ionosphere in the extremely low frequency (ELF, 30 Hz to 3 kHz) and/or very low frequency (VLF, 3 kHz to 30 kHz) band while a second HF beam broadcasts a continuous waveform (CW) signal, modifying the efficiency of ELF/VLF conductivity modulation and thereby the efficiency of ELF/VLF wave generation. Ground-based experimental observations are used together with the predictions of the theoretical model to identify the property of the received ELF/VLF wave that is most sensitive to the effects of multi-beam HF heating, and that property is determined to be the ELF/VLF signal magnitude. The dependence of the generated ELF/VLF wave magnitude on several HF transmission parameters (HF power, HF frequency, and modulation waveform) is then experimentally measured and analyzed within the context of the multi-beam HF heating model. For all cases studied, the received ELF/VLF wave magnitude as a function of transmission parameter is analyzed to identify the dependence on the ambient D-region electron density (Ne) and/or electron temperature ( Te), in turn identifying the HF transmission parameters that provide significant independent information regarding the ambient conditions of the D-region ionosphere. A theoretical analysis is performed to determine the conditions under which the effects of Ne and Te can be decoupled, and the results of this analysis are applied to identify an electron density profile that can reproduce the unusually high level of ELF

  10. Turkish and American Undergraduate Students' Attitudes Toward HIV/AIDS Patients: A Comparative Study.

    Science.gov (United States)

    Atav, A Serdar; Sendir, Merdiye; Darling, Rosa; Acaroglu, Rengin

    2015-01-01

    Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a complex healthcare problem. Research has demonstrated that negative attitudes affect healthcare provision. The purpose of this study was to compare nursing students' attitudes using the AIDS Attitude Scale (AAS). A descriptive, cross-sectional study was conducted in nursing schools in Istanbul, Turkey, and in Upstate New York (NY). Baccalaureate nursing students (n = 613) from both countries completed the questionnaire. Demographic data, overall AAS attitudes, and attitudes within each subscale were compared. Analyses included frequency and percentages of the grouped variables, arithmetic means and standard deviations, t-test for independent samples, and multiple analysis of variance. Upstate NY students' mean total AAS scores were significantly more positive toward HIV+ patients than Turkish students'. Scores for Professional Resistance and Emotions subscales were significantly more positive for the Upstate NY students, but Fear of Contagion was not. Upstate NY students had more negative attitudes in the contexts of job risk and eating in a restaurant where the chef has AIDS; more professional resistance to referring patients and training specialists for HIV/AIDS patients; and lower tender feelings for people with HIV/AIDS (p < .01 for each). Improvement in students' attitudes is beneficial for promoting nonjudgmental, compassionate care for the HIV+ population. © 2014 Wiley Periodicals, Inc.

  11. Tuberculosis and histoplasmosis among human immunodeficiency virus-infected patients: a comparative study.

    Science.gov (United States)

    Adenis, Antoine; Nacher, Mathieu; Hanf, Matthieu; Basurko, Célia; Dufour, Julie; Huber, Florence; Aznar, Christine; Carme, Bernard; Couppie, Pierre

    2014-02-01

    In disease-endemic areas, histoplasmosis is the main differential diagnosis for tuberculosis among human immunodeficiency virus (HIV)-infected patients. However, no study has compared the two diseases. Thus, the objective of this study was to compare tuberculosis and histoplasmosis in HIV-infected patients. A population of 205 HIV-infected patients (99 with tuberculosis and 106 with histoplasmosis) hospitalized in Cayenne, French Guiana during January 1, 1997-December 31, 2008 were selected retrospectively from the French Hospital Database on HIV. Multivariate analysis showed that tuberculosis was associated with cough (adjusted odds ratio [AOR] = 0.20, 95% confidence interval [CI] = 0.05-0.73) and a C-reactive protein level > 70 mg/L (AOR = 0.98, 95% CI = 0.97-0.99). Variables associated with disseminated histoplasmosis were a γ-glutamyl transferase level > 72 IU/L (AOR = 4.99, 95% CI = 1.31-18.99), origin from French Guiana (AOR = 5.20, 95% CI = 1.30-20.73), disseminated localization (AOR = 6.40, 95% CI = 1.44-28.45), a concomitant opportunistic infection (AOR = 6.71, 95% CI = 1.50-29.96), a neutrophil count histoplasmosis have similarities, but some factors show a greater association with one of these diseases. Thus, adapted therapeutic choices can be made by using simple clinical and paraclinical criteria.

  12. A comparative study of conventional physiotherapy versus robotic training combined with physiotherapy in patients with stroke.

    Science.gov (United States)

    Dundar, U; Toktas, H; Solak, O; Ulasli, A M; Eroglu, S

    2014-01-01

    There has been a growing interest in the use of robotic therapy to improve walking ability in individuals following stroke. The aim of this retrospective study was to compare conventional physiotherapy (CP) with robotic training (RT) combined with CP and to measure the effects on gait, balance, functional status, cognitive function, and quality of life in patient with stroke. We retrospectively identified 107 cases of new cerebral stroke. They were allocated into 2 groups. In the RT group (n = 36), patients received RT (Lokomat; 2 times per week) combined with CP (3 times per week) for at least 30 sessions. In the CP group (n = 71), patients received a program at least 30 sessions, 5 times per week. The evaluation parameters included modified Ashworth Spasticity Scale (MASS), Brunnstrom Recovery Scale (BRS), Functional Independence Measure (FIM), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), Mini-Mental State Examination (MMSE), and Short Form-36 (SF-36) Health Survey. Posttreatment results showed significant improvements for all parameters (except lower extremity MASS scores) in both groups. However, when we compared the percentage changes of parameters at discharge relative to pretreatment values, improvements in FIM, MMSE, and all subparts of SF-36 were better in the RT group (P stroke (up to 1 year) than the CP program.

  13. Knee joint laxity and passive stiffness in meniscectomized patients compared with healthy controls.

    Science.gov (United States)

    Thorlund, Jonas B; Creaby, Mark W; Wrigley, Tim V; Metcalf, Ben R; Bennell, Kim L

    2014-10-01

    Passive mechanical behavior of the knee in the frontal plane, measured as angular laxity and mechanical stiffness, may play an important role in the pathogenesis of knee osteoarthritis (OA). Little is known about knee laxity and stiffness prior to knee OA onset. We investigated knee joint angular laxity and passive stiffness in meniscectomized patients at high risk of knee OA compared with healthy controls. Sixty patients meniscectomized for a medial meniscal tear (52 men, 41.4 ± 5.5 years, 175.3 ± 7.9 cm, 83.6 ± 12.8 kg, mean ± SD) and 21 healthy controls (18 men, 42.0 ± 6.7 years, 176.8 ± 5.7 cm, 77.8 ± 13.4 kg) had their knee joint angular laxity and passive stiffness assessed twice ~2.3 years apart. Linear regression models including age, sex, height and body mass as covariates in the adjusted model were used to assess differences between groups. Greater knee joint varus (-10.1 vs. -7.3°, pknee joint angular laxity and reduced passive stiffness ~3 months post surgery compared with controls. In addition, the results indicated that knee joint laxity may increase over time in meniscectomized patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. A comparative study of clinical manifestations caused by tuberculosis in immunocompromised and non-immunocompromised patients

    Institute of Scientific and Technical Information of China (English)

    邵长周; 瞿介明; 何礼贤

    2003-01-01

    Objective To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.Methods Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs.Results Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1% vs 35.5%), pulmonary moist rale (41.0% vs 9.2%), miliary pulmonary tuberculosis (30.8% vs 2.6%), pleural effusion (48.7% vs 25.0%) and lymphadenopathy (18.0% vs 4.0 %). ICPs had less lung cavity (15.4% vs 22.4%) and pleural thickening (15.4% vs 23.7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1% vs 6.6%). Pulmonary tuberculosis was found in the apicoposterior segment (SI+SII) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs.Conclusion The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.

  15. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    Directory of Open Access Journals (Sweden)

    Riechel C

    2016-08-01

    Full Text Available Christina Riechel,1,* Anna Christina Alegiani,1,* Sascha Köpke,2 Jürgen Kasper,3,4 Michael Rosenkranz,1,5 Götz Thomalla,1 Christoph Heesen1,4 1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany; 3Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; 4Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 5Department of Neurology, Albertinen-Krankenhaus, Hamburg, Germany *These authors contributed equally to this work Background: Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods: We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262 and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274. The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results: The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data

  16. Comparative evaluation of several parameters of glycemic homeostasis in patients with functional pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Miroslava Rostislavovna Mikityuk

    2014-03-01

    Full Text Available Aim. To investigate glycemic homeostasis in patients with acromegaly and hyperprolactinaemia due to functional pituitary adenoma.Materials and Methods. We enrolled 48 patients with somatotropinoma (Group 1, 19 patients with somatomammotropinoma (Group 2 and 24 patients with prolactinoma (Group 3 with no history of glycemic disorders. Median age was 48.63±9.98 years; median disease duration was 13.1±6.9 years. The comparison group was composed of overweight or obese patients (n=75. We conducted a comparative analysis of glycemic parameters (Glc0, immunoreactive insulin, HOMA2_S%, HOMA2_B% и HOMA2_IR, Ssum and S under isolated segments of the glycemic curve. We also tested their correlation with plasma levels of growth hormone, prolactin and IGF-1.Results. We detected hyperinsulinemia (>20 μU/mL in 35.1% of participants from Group 1, 33.3% and 25% from groups 2 and 3, respectively. There was no statistically significant difference between glycemic parameters of the study groups, though patients were mildly insulin resistant (HOMA2_IR 1.88 to 2.38 units independantly from tumour secretory activity. Groups 1 and 2 were characterized by significantly higher fasting blood glucose levels vs. comparison group (though still within the reference values, and glucose homeostasis was maintained with lower activity of pancreatic β-cells. Average Ssumanalysis showed lower glucose tolerance in groups 1 and 2 vs. Group 3. Median S values under isolated glycemic curve segments were significantly higher than in comparison group. Plasma levels of growth hormone did not correlate with Ssum and S parameters in groups 1 and 2. There was a linear correlation between Ssum and plasma IGF-1 levels in patients from Group 1 (r=0.45; p=0.006. We also noted that Ssum had a non-linear correlation with plasma prolactin levels in patients from Group 3 (r=0.41; p<0.05.Conclusion. Postprandial area under the glycemic curve has positive linear association with

  17. Quantitative electroencephalogram (QEEG Spectrum Analysis of Patients with Schizoaffective Disorder Compared to Normal Subjects.

    Directory of Open Access Journals (Sweden)

    Mahdi Moeini

    2014-12-01

    Full Text Available The aim of this study was to achieve a better understanding of schizoaffective disorder. Therefore, we obtained electroencephalogram (EEG signals from patients with schizoaffective disorder and analyzed them in comparison to normal subjects.Forty patients with schizoaffective disorder and 40 normal subjects were selected randomly and their electroencephalogram signals were recorded based on 10-20 international system by 23 electrodes in open- and closed-eyes while they were sitting on a chair comfortably. After preprocessing for noise removal and artifact reduction, we took 60- second segments from each recorded signals. Then, the absolute and relative powers of these segments were evaluated in all channels and in 4 frequency bands (i.e., delta, theta, alpha and beta waves. Finally, Data were analyzed by independent t-test using SPSS software.A significant decrease in relative power in the alpha band, a significant decrease in power spectra in the alpha band and a significant increase in power spectra in the beta band were found in patients compared to normal subjects (P < 0.05. The predominant wave in the centro-parietal region was the beta wave in patients, but it was the alpha band in normal subjects (P = 0.048. Also, the predominant wave of the occipital region in patients was the delta wave, while it was the alpha wave in normal subjects (P = 0.038.Considering the findings, particularly based on the significant decrease of the alpha waves in schizoaffective patients, it can be concluded that schizoaffective disorder can be seen in schizophrenia spectrum.

  18. Comparative efficacy of meloxicam and placebo in vasospasm of patients with subarachnoid hemorrhage.

    Science.gov (United States)

    Ghodsi, Seyed Mohammad; Mohebbi, Niayesh; Naderi, Soheil; Anbarloie, Mousareza; Aoude, Ahmad; Habibi Pasdar, Seyed Sohail

    2015-01-01

    Cerebral vasospasm considered to be a serious cause of morbidity and mortality following subarachnoid haemorrhage (SAH).Despite several available therapeutic options, current protocols do not prevent major consequences of vasospasm. Inflammation is believed to play an important role in post-haemorrhagic vasospasm. Meloxicam is a non-steroidal anti-inflammatory drug. The aim of this study was to compare the efficacy of meloxicam versus placebo on vasospasm in patients with SAH. In this randomized, double-blind, placebo-controlled trial, SAH patients randomly received 7.5 mg meloxicam or placebo twice daily for 7 days. End points were, middle cerebral artery velocity obtained with transcranial doppler, in-hospital mortality, hospital stay and discharge Glasgow Outcome Scale. Eighty-one patients enrolled in the study. (40 received meloxicam, 41 received placebo). Baseline characteristics were similar between the groups. There were no differences in length of hospitalization (17.4 ± 3.1 vs 18.6 ± 4.2 days; p = 0.145), in-hospital mortality rate (15 vs 22%; p-value=0.569), or GOS (p = 0.972) between the two groups. MCA velocity were slightly less in patients who had received meloxicam, but not to a significant degree (p-value=0. 564(. No side effect has been detected for meloxicam. This study did not prove meloxicam efficacy in vasospasm of SAH patients. But it demonstrated that clinical trial of meloxicam in these patients is feasible and probably safe. The effectiveness of meloxicam on cerebral vasospasm has to be studied in larger trials.

  19. Bisoprolol compared with carvedilol and metoprolol succinate in the treatment of patients with chronic heart failure.

    Science.gov (United States)

    Fröhlich, Hanna; Torres, Lorella; Täger, Tobias; Schellberg, Dieter; Corletto, Anna; Kazmi, Syed; Goode, Kevin; Grundtvig, Morten; Hole, Torstein; Katus, Hugo A; Cleland, John G F; Atar, Dan; Clark, Andrew L; Agewall, Stefan; Frankenstein, Lutz

    2017-04-22

    Beta-blockers are recommended for the treatment of chronic heart failure (CHF). However, it is disputed whether beta-blockers exert a class effect or whether there are differences in efficacy between agents. 6010 out-patients with stable CHF and a reduced left ventricular ejection fraction prescribed either bisoprolol, carvedilol or metoprolol succinate were identified from three registries in Norway, England, and Germany. In three separate matching procedures, patients were individually matched with respect to both dose equivalents and the respective propensity scores for beta-blocker treatment. During a follow-up of 26,963 patient-years, 302 (29.5%), 637 (37.0%), and 1232 (37.7%) patients died amongst those prescribed bisoprolol, carvedilol, and metoprolol, respectively. In univariable analysis of the general sample, bisoprolol and carvedilol were both associated with lower mortality as compared with metoprolol succinate (HR 0.80, 95% CI 0.71-0.91, p < 0.01, and HR 0.86, 95% CI 0.78-0.94, p < 0.01, respectively). Patients prescribed bisoprolol or carvedilol had similar mortality (HR 0.94, 95% CI 0.82-1.08, p = 0.37). However, there was no significant association between beta-blocker choice and all-cause mortality in any of the matched samples (HR 0.90; 95% CI 0.76-1.06; p = 0.20; HR 1.10, 95% CI 0.93-1.31, p = 0.24; and HR 1.08, 95% CI 0.95-1.22, p = 0.26 for bisoprolol vs. carvedilol, bisoprolol vs. metoprolol succinate, and carvedilol vs. metoprolol succinate, respectively). Results were confirmed in a number of important subgroups. Our results suggest that the three beta-blockers investigated have similar effects on mortality amongst patients with CHF.

  20. Management of Postoperative Hypoxaemia in Patients Following Upper Abdominal Laparoscopic Surgery. - A Comparative Study

    Directory of Open Access Journals (Sweden)

    Sampa Datta Gupta

    2008-01-01

    Full Text Available Noninvasive ventilation has been shown to reduce acute postoperative hypoxaemia, with significant reduction in the incidence of re-intubation, complications and a trend towards lower mortality. The aim of the study was to determine the effectiveness of CPAP vs venturi therapy in early achievement of oxygenation goals and in prevention of re-intubation for management of postoperative hypoxaemia following laparoscopic cholecystectomy. Forty adult patients of ASA physical status I& II, scheduled for elective laparoscopic cholecystectomy, those were unable to maintain SpO2 > 95% breathing room air after extubation, were recruited for a prospective, randomized comparative study. Patients with PaO2 / FiO2 between 250 and 300 were included in the study and were randomly allocated to one of the two groups to receive oxygen therapy either using a CPAP of 10 cm of water and a FiO2 of 0.5 (Group A or using a venturi mask of FiO2 of 0.5 (Group B . All patients were observed postoperatively upto 18 h and were screened by ABG analyses at 6, 12 and 18 h of treatment. SpO2, ECG, heart rate, respiratory rate, temperature and NIBP were monitored throughout the study period. Patients in Group A showed significant improvement in early achievement of adequate oxygenation than those in Group B, although, due to intolerance to CPAP therapy two patients in Group A needed reintubation to maintain adequate oxygenation. To conclude, oxygenation using continuous positive airway pressure is a safe and effective means in improving gas exchange to treat acute postoperative hypoxaemia in conscious and cooperative patients.

  1. Design and Fabrication of Interdigital Nanocapacitors Coated with HfO2

    Directory of Open Access Journals (Sweden)

    Gabriel González

    2015-01-01

    Full Text Available In this article nickel interdigital capacitors were fabricated on top of silicon substrates. The capacitance of the interdigital capacitor was optimized by coating the electrodes with a 60 nm layer of HfO2. An analytical solution of the capacitance was compared to electromagnetic simulations using COMSOL and with experimental measurements. Results show that modeling interdigital capacitors using Finite Element Method software such as COMSOL is effective in the design and electrical characterization of these transducers.

  2. Monitoring of Radiation Damage of Quartz Fibers in the Hf-Cms Detector

    Science.gov (United States)

    Merlo, Jean-Pierre

    2014-06-01

    Two HF calorimeters are in the range 3 monitors this loss and is used to correct energies. Since 2010, 29 fb-1 were accumulated and "Raddam runs" were taken in beam stops. The raddam data are compared to our light transmission measurements of irradiated fibers. A FLUKA simulation of dose at 14 TeV for a luminosity accumulated of 3000 fb-1 is presented.

  3. Design and Fabrication of Interdigital Nanocapacitors Coated with HfO2

    Science.gov (United States)

    González, Gabriel; Kolosovas-Machuca, Eleazar Samuel; López-Luna, Edgar; Hernández-Arriaga, Heber; González, Francisco Javier

    2015-01-01

    In this article nickel interdigital capacitors were fabricated on top of silicon substrates. The capacitance of the interdigital capacitor was optimized by coating the electrodes with a 60 nm layer of HfO2. An analytical solution of the capacitance was compared to electromagnetic simulations using COMSOL and with experimental measurements. Results show that modeling interdigital capacitors using Finite Element Method software such as COMSOL is effective in the design and electrical characterization of these transducers. PMID:25602271

  4. Relative Importance of History of Heart Failure Hospitalization and N-Terminal Pro-B-Type Natriuretic Peptide Level as Predictors of Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

    DEFF Research Database (Denmark)

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars

    2015-01-01

    about the value of a history of HF hospitalization as a predictor of adverse cardiovascular outcomes in patients with HF and HF-PEF. METHODS: We estimated rates and adjusted hazard ratios (HRs) for the composite endpoint of cardiovascular death or HF hospitalization, according to history of recent HF.......49 (95% CI: 4.04 to 4.99) per 100 person-years, respectively (HR: 2.71; 95% CI: 2.33 to 3.16). For patients with NT-proBNP concentrations >360 pg/ml (n = 1,299), the event rate was 11.51 (95% CI: 10.54 to 12.58) compared to 3.04 (95% CI: 2.63 to 3.52) per 100 person-years in those with a lower level...... of NT-proBNP (n = 1468) (HR: 3.19; 95% CI: 2.68 to 3.80). In patients with no recent HF hospitalization and NT-proBNP ≤360 pg/ml (n = 1,187), the event rate was 2.43 (95% CI: 2.03 to 2.90) compared with 17.79 (95% CI: 15.77 to 20.07) per 100 person-years when both risk predictors were present (n = 523...

  5. Presence and development of atrial fibrillation in chronic heart failure - Experiences from the MERIT-HF Study

    NARCIS (Netherlands)

    van Veldhuisen, Dirk J.; Aass, Halfdan; El Allaf, Dia; Dunselman, Peter H. J. M.; Gullestad, Lars; Halinen, Matti; Kjekshus, John; Ohlsson, Lis; Wedel, Hans; Wikstrand, John

    2006-01-01

    Background: Atrial fibrillation is common in heart failure, but data regarding beta-blockade in these patients and its ability to prevent new occurrence of atrial fibrillation are scarce. Methods: Baseline ECGs in MERIT-HF were coded regarding baseline rhythm, and outcome was analyzed in relation to

  6. Amino-terminal pro-B-type natriuretic peptide testing to assist the diagnostic evaluation of heart failure in symptomatic primary care patients

    DEFF Research Database (Denmark)

    Hildebrandt, P.; Collinson, P.O.

    2008-01-01

    When used for the evaluation of symptomatic patients in general practice, amino-terminal pro-B-type natriuretic peptide (NT-proBNP) testing is highly sensitive, with an excellent negative predictive value for cost-effective exclusion of the diagnosis of heart failure (HF). Importantly (similar...... to other NP assays), lower values for NT-proBNP are expected among patients with HF in the primary care setting compared with patients with acute dyspnea. Among primary care patients with dyspnea, a noncardiac source of dyspnea is most likely in patients with findings below the recommended age......-stratified NT-proBNP cut points. Conversely, an NT-proBNP result above the age-stratified primary care cut points does not absolutely indicate the presence of HF; a more directed cardiovascular workup is indicated Udgivelsesdato: 2008/2/4...

  7. Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure

    DEFF Research Database (Denmark)

    Lewinter, Christian; Bland, John M; Crouch, Simon;

    2014-01-01

    AIMS: Aspirin and statins are established therapies for acute myocardial infarction (MI), but their benefits in patients with chronic heart failure (HF) remain elusive. We investigated the impact of aspirin and statins on long-term survival in patients hospitalized with acute MI complicated by HF....... METHODS AND RESULTS: Of 4251 patients in the Evaluation of Methods and Management of Acute Coronary Events (EMMACE)-1 and -2 observational studies, 1706 patients had HF. A propensity score-matching method estimated the average treatment effects (ATEs) of aspirin and statins on survival over 90 months....... ATEs were calculated as relative risk differences in all-cause mortality comparing patients receiving aspirin and statins with controls, respectively. Moreover, combined aspirin and statins vs. none (ATE I), aspirin or statins vs. none (ATE II), and aspirin and statins vs. aspirin or statins (ATE III...

  8. Fundus autofluorescence and colour fundus imaging compared during telemedicine screening in patients with diabetes.

    Science.gov (United States)

    Kolomeyer, Anton M; Baumrind, Benjamin R; Szirth, Bernard C; Shahid, Khadija; Khouri, Albert S

    2013-06-01

    We investigated the use of fundus autofluorescence (FAF) imaging in screening the eyes of patients with diabetes. Images were obtained from 50 patients with type 2 diabetes undergoing telemedicine screening with colour fundus imaging. The colour and FAF images were obtained with a 15.1 megapixel non-mydriatic retinal camera. Colour and FAF images were compared for pathology seen in nonproliferative and proliferative diabetic retinopathy (NPDR and PDR, respectively). A qualitative assessment was made of the ease of detecting early retinopathy changes and the extent of existing retinopathy. The mean age of the patients was 47 years, most were male (82%) and most were African American (68%). Their mean visual acuity was 20/45 and their mean intraocular pressure was 14.3 mm Hg. Thirty-eight eyes (76%) did not show any diabetic retinopathy changes on colour or FAF imaging. Seven patients (14%) met the criteria for NPDR and five (10%) for severe NPDR or PDR. The most common findings were microaneurysms, hard exudates and intra-retinal haemorrhages (IRH) (n = 6 for each). IRH, microaneurysms and chorioretinal scars were more easily visible on FAF images. Hard exudates, pre-retinal haemorrhage and fibrosis, macular oedema and Hollenhorst plaque were easier to identify on colour photographs. The value of FAF imaging as a complementary technique to colour fundus imaging in detecting diabetic retinopathy during ocular screening warrants further investigation.

  9. Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy.

    Science.gov (United States)

    Greenspan, Michael; Chehl, Navdeep; Shawron, Krista; Barnes, Lisa; Li, Hong; Avery, Elizabeth; Sims, Shannon; Losurdo, John; Mobarhan, Sohrab; Melson, Joshua

    2015-10-01

    A significant proportion of the eligible population is non-adherent to colonoscopy for colorectal cancer (CRC) screening. To define the demographic and clinical variables associated with non-adherence and multiple cancellations to scheduled colonoscopy within 1 year in a CRC screening and adenomatous polyp surveillance population. This was an observational cohort study of 617 consecutive patients scheduled to undergo colonoscopy at an outpatient academic tertiary care center for CRC screening or adenomatous polyp surveillance from January 2012 to September 2012. Overall, 551 patients (89.3%) were adherent and 66 (10.7%) were non-adherent to scheduled colonoscopy at 1 year. The relative risk for non-adherence was 5.42 [95% confidence interval (CI) 2.74-10.75] in patients undergoing colonoscopy for screening compared to those for surveillance (16.7 vs. 3.5% non-adherence, respectively, P non-adherence [odds ratio (OR) 12.69, 95% CI 4.18-38.51] and multiple cancellations (OR 2.33, 95% CI 1.27-4.31) by multiple regression analysis. Patients undergoing colonoscopy for CRC screening are significantly less likely to attend their scheduled procedure within a year and have more procedure cancellations than those undergoing surveillance colonoscopy.

  10. Personality traits in recent-onset-of-psychosis patients compared to a control sample by gender.

    Science.gov (United States)

    Sevilla-Llewellyn-Jones, Julia; Cano-Domínguez, Pablo; de-Luis-Matilla, Antonia; Espina-Eizaguirre, Alberto; Moreno-Küstner, Berta; Ochoa, Susana

    2017-08-31

    Personality traits in recent onset of psychosis (ROP) patients are an under-researched area. Our aim was to examine clinical and clinically significant personality traits in ROP patients compared with a healthy control sample by gender. Data were obtained from 94 ROP patients and a control sample matched in gender and age. The Millon Clinical Multiaxial Inventory and a sociodemographic scale were used. T for independent samples, U-Mann-Whitney and Fisher tests were applied to make comparisons. All personality traits were significantly higher in ROP than control participants in the general sample, except histrionic, narcissistic, and compulsive traits which were higher in controls. Clinically significant schizoid, avoidant, dependent and antisocial personality traits were more common in the ROP than the control participants. However, histrionic clinically significant trait was more common in the control sample. In relation to the males and female samples, more significant differences were found in the male sample in comparison to their control counterparts than in the female sample. These results highlight the importance of the study of clinical personality traits in patients with ROP and the importance of viewing these differences in relation to gender because of the possible therapeutic implications. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. [Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

    Science.gov (United States)

    García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

    2005-03-01

    Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

  12. Psychosocial Functioning in Depressive Patients: A Comparative Study between Major Depressive Disorder and Bipolar Affective Disorder

    Directory of Open Access Journals (Sweden)

    Shubham Mehta

    2014-01-01

    Full Text Available Introduction. Major depressive disorder (MDD and bipolar affective disorder (BAD are among the leading causes of disability. These are often associated with widespread impairments in all domains of functioning including relational, occupational, and social. The main aim of the study was to examine and compare nature and extent of psychosocial impairment of patients with MDD and BAD during depressive phase. Methodology. 96 patients (48 in MDD group and 48 in BAD group were included in the study. Patients were recruited in depressive phase (moderate to severe depression. Patients having age outside 18–45 years, psychotic symptoms, mental retardation, and current comorbid medical or axis-1 psychiatric disorder were excluded. Psychosocial functioning was assessed using Range of Impaired Functioning Tool (LIFE-RIFT. Results. Domains of work, interpersonal relationship, life satisfaction, and recreation were all affected in both groups, but the groups showed significant difference in global psychosocial functioning score only (P=0.031 with BAD group showing more severe impairment. Conclusion. Bipolar depression causes higher global psychosocial impairment than unipolar depression.

  13. Clinical characteristics of patients with Rutherford category IV, compared with V and VI

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    Taketsugu Tsuchiya

    2015-07-01

    Full Text Available Objective: Patients categorized Rutherford category IV might have different characteristics compared with Rutherford category V and VI. Our study aims were to estimate the clinical differences between Rutherford category IV and Rutherford category V and VI, for those underwent endovascular therapy for isolated infrapopliteal disease, and also to find risk factors for endovascular therapy in Rutherford category IV. Methods: Based on the Japanese multi-center registry data, 1091 patients with 1332 limbs (Rutherford category IV: 226 patients with 315 limbs, Rutherford category V and VI: 865 patients with 1017 limbs were analyzed retrospectively. Results: Patients’ backgrounds and lesions’ characteristics had significant differences. Both freedom rate from major adverse limb event with perioperative death and amputation-free survival rate at 1 year were better in Rutherford category IV than Rutherford category V and VI (93.6% vs 78.3%, 87.7% vs 66.7% and those maintained to 3 years (p  3.0 mg/dL, chronic obstructive pulmonary disease, and coronary artery disease in Rutherford category IV. Conclusion: From the present results, Rutherford category IV should be recognized to have quite different backgrounds and better outcome from Rutherford category V and VI.

  14. Neurohormonal activation and diagnostic value of cardiac peptides in patients with suspected mild heart failure

    DEFF Research Database (Denmark)

    Mikkelsen, Kirsten V.; Bie, Peter; Møller, Jacob E.;

    2006-01-01

    BACKGROUND: Data describing activation of brain natriuretic peptide (BNP) system relative to the renin-angiotensin-aldosterone system (RAAS) are sparse in the early phase of heart failure (HF). AIMS: To compare activation of BNP system relative to RAAS hyperactivity and to assess diagnostic...... accuracy of cardiac peptides to detect any left ventricular dysfunction (LVD) in patients referred from primary care with suspected HF before institution of medical therapy. METHODS: Of 166 referred patients 150 were consecutively included (14 were excluded and two refused consent). Echocardiography...

  15. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Boesgaard, Søren

    2012-01-01

    A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF).......A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF)....

  16. Is low VO2max/kg in obese heart failure patients indicative of cardiac dysfunction?

    Science.gov (United States)

    Hothi, S S; Tan, D K; Partridge, G; Tan, L B

    2015-04-01

    Low peak O2 consumption (VO2max/kg) has been widely used as an indirect indicator of poor cardiac fitness, and often guides management of patients with severe heart failure (HF). We hypothesized that it should be as good an indicator of cardiac dysfunction in obese and non-obese HF patients. We compared the cardiopulmonary exercise performance and non-invasive hemodynamics of 152 obese (BMI>34 kg.m(-2)) and 173 non-obese (BMI≤32) male HF patients in NYHA classes II and III, with reference to 101 healthy male controls. Their physical and cardiac functional reserves were measured during treadmill exercise testing with standard respiratory gas analyses and CO2 rebreathing to measure cardiac output non-invasively during peak exercise. Data are given as mean ± SD. Obese HF patients with BMI 40.9 ± 7.5 kg·m(-2) (age 56.1 ± 14.0 years, NYHA 2.5 ± 0.5) exercised to acceptable cardiopulmonary limits (peak RER=1.07 ± 0.12), and achieved a mean VO2max/kg of 18.6 ± 5.2 ml·kg(-1)·min(-1), significantly lower than in non-obese HF counterparts (19.9 ± 5.6 ml·kg(-1)·min(-1), P=0.02, age 55.8 ± 10.6 years, BMI 26.6 ± 3.1, NYHA 2.4 ± 0.5, peak RER=1.07 ± 0.09), with both lower than controls (38.5 ± 9.7 ml·kg(-1)·min(-1), PVO2max was higher in obese (2.31 ± 0.69 ml·min(-1)) than non-obese HF patients (1.61 ± 0.49 ml·min(-1), PVO2max/kg is not a generally reliable indicator of cardiac fitness in all patients. Instead, we found that despite having lower VO2max/kg, obese HF patients had stronger hearts capable of generating greater cardiac power than non-obese HF patients of equivalent clinical HF status. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. COMPARATIVE EVALUATION OF QTC INTERVAL CHANGES WITH INTRAVENOUS ONDANSETRON AND PALONOSETRON IN PATIENTS UNDERGOING LAPROSCOPIC CHOLECYSTECTOMY

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    Anju

    2015-06-01

    Full Text Available Post - operative nausea and vomiting (PONV is a common and distressing symptom after surgery performed under general anesthesia. 5HT 3 antagonists are routinely used for PONV but are dreaded to cause QTc interval prolongation. The aim of our