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Sample records for incidence clinical significance

  1. Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma.

    Science.gov (United States)

    Keung, Emily Z; Chiang, Yi-Ju; Voss, Rachel K; Cormier, Janice N; Torres, Keila E; Hunt, Kelly K; Feig, Barry W; Roland, Christina L

    2018-01-01

    The incidence and clinical significance of lymph node metastasis (LNM, N1) in soft tissue sarcoma (STS) is unclear. Recent studies have focused on extremity/trunk STS (ETSTS). We sought to define the subgroup of patients with LNM at sarcoma diagnosis across all disease sites and histologies. We identified and categorized 89,870 STS patients from the National Cancer Data Base (1998-2012) by nodal stage. Pathologically confirmed LNM (pN1) were identified in 1404 patients; 1750 had clinically suspicious but not pathologically confirmed LNM (cN1). Survival analyses were performed by Kaplan-Meier method. Of 3154 patients (3.5%) with pN1 or cN1 LNM at presentation, 1310 had synchronous distant metastasis (M1). LNM affected a small proportion of patients (5.8% head/neck, 5.3% intrathoracic, 5.1% intra-abdominal, 2.0% ETSTS). Angiosarcoma (6%), epithelioid (13%), clear cell (16%), and small cell sarcoma (19%) had the highest incidence of LNM, although liposarcoma, fibrous histiocytoma, and leiomyosarcoma accounted for the greatest number of LNM patients. For pN1M0 disease, median overall survival (OS) was 28.2 months, varying by histology. Among patients with pN1M0 STS, angiosarcoma, clear cell sarcoma, leiomyosarcoma, and fibrous histiocytoma were associated with worse median OS (19.4, 23.8, 27.1, and 29.3 months) compared to epithelioid sarcoma and liposarcoma (49.6 and 56.0 months, p < 0.001). Despite clinical suspicion, pathologic LN evaluation in STS is inconsistently performed. LNM occurs across anatomic disease sites and is unevenly distributed across histologies. Although M1 disease portends poor prognosis regardless of LN status, LNM predicts worse OS in a histology-dependent manner in M0 disease. Published by Elsevier Ltd.

  2. Cavum septi pellucidi and cavum vergae. Incidence on CT scan and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, S.; Hojo, H.; Kataoka, K.; Yamasaki, S. (Shizuoka Children' s Hospital, Shizuoka (Japan))

    1980-10-01

    1050 CT scans of patients under 15 years were reviewed. We also investigated the clinical features of these cases and made an attempt to disclose the incidence of cavum septi pellucidi (CSP) and cavum Vergae (CV) on the CT scan and to clarify their clinical significance. As a whole, CSP was demonstrated in 23 patients (2.2%), CV in 4 (0.4%), and both CSP and CV at the same time in 31 (3.0%). The incidence of CSP and CV in each age bracket decreased with an advance in age. No sexual differences were found. The incidences of CSP and CV in the patients with convulsive disorders, developmental delay, and other disorders were 6.4%, 5.1%, and 5.2% respectively. Of 64 patients with febrile convulsion, 4 had both CSP and CV at the same time, while one had only CSP. The four patients with both CSP and CV had convulsions three or more times, while the patient with only CSP had only one. These results suggested that those patients with febrile convulsions who had both CSP and CV at the same time were liable to have recurrent convulsions. Of 32 patients with benign infantile convulsions, only one had both CSP and CV. On the other hand, of 29 patients with infantile spasms, 2 had only CSP, and another 2 had both CSP and CV. Some patients with infantile spasms had CT scans demonstrating cerebral atrophy, porencephaly, cerebral angioma, and calcification in the brain, suggesting various types of etiology. Of 187 patients with other convulsive disorders, 4 had only CSP and 6 had both CSP and CV. Of 468 patients with developmental delay, 13 had only CSP (2.8%), one had only CV (0.2%), and 10 had both (2.1%). Of these 24 patients with developmental delay who had CSP and/or CV, 14 had cerebral atrophy besides, suggesting other etiological factors. Of 270 patients with other disorders, 3 had only CSP (1.1%), other 3 had only CV (1.1%), and 8 had both (3.0%).

  3. Eosinophilia detected by automated blood cell counting in ambulatory North American outpatients. Incidence and clinical significance.

    Science.gov (United States)

    Brigden, M; Graydon, C

    1997-09-01

    To audit a cohort of ambulatory outpatients with eosinophilia detected on automated blood cell counting. Specific objectives included the determination of whether the eosinophilia had been anticipated, the etiology of the eosinophilia, the clinical follow-up and investigations performed on patients with eosinophilia, and the effect of the detection of eosinophilia on patient management and ultimate clinical outcome. A year-long retrospective review of all patients with an absolute eosinophil count of greater than 0.7 x 10(9)/L. A large outpatient laboratory system. The patient population was managed by family physicians and specialists. Data collection included the results of the hematology profile, the absolute eosinophil count, the clinical situation responsible for the hematologic profile determination, and the probable cause of eosinophilia. Individual physicians were surveyed to determine if discovery of the eosinophilia had changed patient management plan or clinical outcome. Out of 195,300 patients who had a hematology profile performed, 225 were found to have an absolute eosinophilia count higher than 0.7 x 10(9)/L. The overall incidence of eosinophilia in the study population was 0.1%. The eosinophilia was not anticipated in 85% of patients. No obvious cause was detected for the eosinophilia in 36% of patients. Various allergic diseases were responsible for the eosinophilia in the majority of the remaining patients. Fewer than 9% of individuals manifested a serious systemic illness or parasitemia. Further clinical follow-up had been performed in 69% of patients. Additional laboratory tests had been ordered in 59% of patients. The laboratory tests most frequently ordered were a repeat hematology profile or stool examinations for ova and parasites. In only two instances did the discovery of the eosinophilia appear to result in a significant change in patient management or ultimate clinical income. The vast majority of eosinophilias detected in ambulatory

  4. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus.

    Science.gov (United States)

    Chang, Chia-Ming; Ko, Edward C; Kao, Chu-Chiang; Chang, Pei-Ying; Chen, Michael Y C

    2012-06-01

    Trismus is frequently a sequel of temporomandibular joint (TMJ) involvement in a zygomaticomaxillary complex (ZMC) fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT) imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs) (OMFS group) and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group) between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO) less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28) and 50% (87/174) of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40%) patients had limited mouth opening (MIO range, 7-33 mm) preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3%) patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ. Copyright © 2012. Published by Elsevier B.V.

  5. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus

    Directory of Open Access Journals (Sweden)

    Chia-Ming Chang

    2012-06-01

    Full Text Available Trismus is frequently a sequel of temporomandibular joint (TMJ involvement in a zygomaticomaxillary complex (ZMC fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs (OMFS group and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28 and 50% (87/174 of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40% patients had limited mouth opening (MIO range, 7–33 mm preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3% patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ.

  6. [The euthyroid sick syndrome. Its incidence and clinical significance in an internal medicine department].

    Science.gov (United States)

    Di Napoli, M; Reda, G; Zannoni, G; Russo, S; Morace, G; Vasselli, C

    1994-04-01

    In this paper the authors have evaluated the incidence and the clinical implications of sick euthyroid syndrome (SES) in a group of 144 patients in a department of internal medicine. SES is an alteration of thyroid hormone values in the absence of a thyroid disease, which is seen in patients suffering from serious diseases. Having classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG, they show the hypotheses that explain the biochemical mechanisms which are at the basis of these hormonal alterations. Fourteen of the 144 patients under observation were excluded as they were suffering from ascertained or subclinical thyroid disease. Thirty (23% of cases) of the remaining 130 patients had alterations of the thyroid hormones in accordance with SES diagnosis. Of these 30 patients, 19 had hormone values found in SES type I (63%), 2 in SES type II (6.5%) and 9 in SES type III (30.5%). In SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure. The incidence of SES in 23% of the admitted to hospital patients was found to be slightly higher than in other studies; this could be explained by a stricter selection of inpatients: in fact self-sufficient patients or those not needing urgent admission, were sent to an efficient out patient clinic where necessary examinations were quickly carried out

  7. Incidence of Accessory Phrenic Nerve and its Clinical Significance: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Soubhagya R. Nayak

    2008-01-01

    Full Text Available The description of accessory phrenic nerve (APN in the standard textbooks and available literature is vague and sometimes limited to few lines. The incidence of APN varies a great deal from 17.6 % to 80.9 % in the available literature. The aim of the present study was to calculate the incidence and variation of APN in Indian population. Material and methods: Forty five adult formalin-fixed cadavers (35 male, 10 female; 90 sides used for gross anatomy dissection for undergraduates; during the 2 year period 2006–2007 were considered. Findings were recorded at different stages of the dissection. Results: Out of 90 body sides studied, the APN was present in 48 sides (53.3 %. In 17 of the above sides the APN was confined to the cervical region (Cervical type and in 31 sides the APN entered the thorax (Thoracic type, all anterior to the subclavian vein (SV. In eleven specimens the APN was found bilaterally. Conclusion: The incidence of APN, with its course and relation to the various structures in cervical and thoracic region will help the surgeons while performing internal thoracic artery (ITA grafting and other radical neck surgery.

  8. [Incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and its clinical significance].

    Science.gov (United States)

    Liu, Liping; Lin, Ping; Xu, Yi; Wu, Lijia; Zou, Runmei; Xie, Zhenwu; Wang, Cheng

    2016-04-01

    To analyze the incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and the clinical significance.
 Twelve-lead body surface electrocardiogram was taken to measure the heart rates and PR intervals from 4 025 healthy individuals (age range from 6 min after birth to 83 years old) who performed physical examination from Jan, 1993 to Dec, 2012 in the Second Xiangya Hospital, Central South University. Statistics were analyzed by SPSS 16.0.
 The total incidence of short PR interval was 19.65% (791/4 025). The age group from birth to 13 years old had a higher incidence than the other age groups (χ2=432, PPR intervals was 3.58% (144/4 025). The 1 year-old group had the highest incidence (6.74%), which decreased with the increase of age. The lowest incidence of long PR intervals occurred in the age group from 14-17 years old, which gradually increased after 50 years old. There were no significant differences in long (short) PR intervals between the gender (P>0.05).
 The incidence of long (short) PR intervals varies in different age groups of healthy people. The incidences of long (short) PR intervals in children before 10 years old are higher than those in adults, especially the short PR intervals, as a result of the heart rate affected by childhood autonomic nervous function and the change in atrial volume with age. Adults have long (short) PR interval should be regularly followed-up to prevent cardiovascular events.

  9. Significant incidents in nuclear fuel cycle facilities

    International Nuclear Information System (INIS)

    1996-03-01

    In contrast to nuclear power plants, events in nuclear fuel cycle facilities are not well documented. The INES database covers all the nuclear fuel cycle facilities; however, it was developed in the early 1990s and does not contain information on events prior to that. The purpose of the present report is to collect significant events and analyze them in order to give a safety related overview of nuclear fuel cycle facilities. Significant incidents were selected using the following criteria: release of radioactive material or exposure to radiation; degradation of items important to safety; and deficiencies in design, quality assurance, etc. which include criticality incidents, fire, explosion, radioactive release and contamination. This report includes an explanation, where possible, of root causes, lessons learned and action taken. 4 refs, 4 tabs

  10. Clinical significance of incident hypokalemia and hyperkalemia in treated hypertensive patients in the antihypertensive and lipid-lowering treatment to prevent heart attack trial.

    Science.gov (United States)

    Alderman, Michael H; Piller, Linda B; Ford, Charles E; Probstfield, Jeffrey L; Oparil, Suzanne; Cushman, William C; Einhorn, Paula T; Franklin, Stanley S; Papademetriou, Vasilios; Ong, Stephen T; Eckfeldt, John H; Furberg, Curt D; Calhoun, David A; Davis, Barry R

    2012-05-01

    Concerns exist that diuretic-induced changes in serum potassium may have adverse effects in hypertensive patients. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, a large practice-based clinical trial, made it possible to examine consequences of observed changes in potassium during care in conventional practice settings. Normokalemic participants randomized to chlorthalidone (C) versus amlodipine or lisinopril as a first-step drug were stratified by year-1 potassium. Postyear-1 outcomes among hypokalemics (potassium, 5.4 mmol/L) were compared with normokalemics (potassium, 3.5-5.4 mmol/L). Year-1 hypokalemia incidence was 6.8%; incidence in C (12.9%) differed from amlodipine (2.1%; Pheart disease occurred in 8.1% with hypokalemia, 8.0% with normokalemia, and 11.1% with hyperkalemia. Overall, mortality was higher in hypokalemics than in normokalemics (Cox hazard ratio, 1.21 [95% CI, 1.02-1.44]) with statistically significant (interaction, P<0.01) disparity in hazard ratios for the 3 treatment arms (hazard ratios, C=1.21, amlodipine=1.60, lisinopril=3.82). Hyperkalemia was associated with increased risk of combined cardiovascular disease (hazard ratio, 1.58 [95% CI, 1.15-2.18]) without significant treatment interactions. In conventional practice settings, the uncommon appearance of hyperkalemia was associated with increased cardiovascular disease risk. Hypokalemia was associated with increased mortality; however, the statistically significant heterogeneity in hazard ratios across treatment groups strongly suggests that the observed increase in mortality is unrelated to the specific effects of C. Thus, for most patients, concerns about potassium levels should not influence the clinician's decision about initiating hypertension treatment with low-moderate doses of thiazide diuretics (12.5-25.0 mg of C).

  11. High incidence of clinically significant concomitant prostate cancer in patients undergoing radical cystectomy for bladder cancer: A 10-year single-center experience.

    Science.gov (United States)

    Heidegger, Isabel; Oberaigner, Willi; Horninger, Wolfgang; Pichler, Renate

    2017-04-01

    To analyze prostate cancer (PCa) incidence, clinical significance, and recurrence in 213 patients who underwent radical cystectomy (RC) for advanced bladder cancer (BC). We conducted a 10-year retrospective analysis of a single-center database comprising the effect of PCa in RC specimens. In total, 113/213 male patients (53.1%) had PCa in the RC specimen. Patients׳ age, prostate-specific antigen (PSA), and also free PSA% were significant predictors for PCa. In addition, adverse bladder histology (≥pT3) was found in 63.7% of patients with PCa. A total of 52.2% (59/113) of patients had at least a Gleason score (GS) 7 in final pathology and 10.6% of RC specimens showed an organ border growth (≥pT3a). It was noted that 28.3% of patients experienced a biochemical recurrence (PSA≥0.2ng/ml), among them 86.7% had GS≥7 in the RC specimen; however, 2 patients were diagnosed with a GS 5. Moreover, we found that 80% of patients with biochemical recurrence had an organ-extended (≥pT3) histology of the bladder and 40% of patients with biochemical recurrence died of PCa rather than from BC. Concomitant PCa is occurring in>50% of RC specimens with a significant proportion having characteristics (GS, pathological stage) of clinically relevant disease. Adverse bladder histology is a risk factor for both PCa and biochemical PSA recurrence. Follow-up analyses after RC should include PSA measurements also in low-risk PCa as a considerable number of patients develop biochemical recurrence and metastases from PCa partly ending up with death related to PCa in patients suffering from BC. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Incidence of clinically significant antibodies in patients and healthy blood donors: a prospective cross-sectional study from a tertiary healthcare center in India.

    Science.gov (United States)

    Tiwari, Aseem K; Pandey, Prashant; Sharma, Jyoti; Shailja, Kumari; Dixit, Surbhi; Raina, Vimarsh

    2014-04-01

    Since there is scarce data available on incidence and type of irregular antibodies in patients and donors in India, a study was undertaken to find the incidence of irregular antibodies in patients and irregular antibodies and a positive Direct Antiglobulin Test (DAT) in blood donors. Antibody screening was performed using commercial pooled "O" cells and three-cell panel for donors and patients respectively and an 11-cell panel for identification using Column Agglutination Technology (CAT) with Low-Ionic-Strength Saline-Indirect Antiglobulin Test (LISS-IAT) technique (Ortho Clinical Diagnostics, Johnson & Johnson, USA). The cassettes used were Anti-human Globulin (AHG) type. DAT on donors was also performed using the AHG cassettes. Cumulative incidence of irregular antibodies amongst patients (n=32,560) and donors (n=31,367) were 0.12-0.009%, respectively. In patients, the commonest antibodies were from Rh system with anti-D being the most common antibody type (14/40; 35%) while in donors it was the MNS system with anti M (2/3) being the most common. Incidence of a positive DAT amongst the healthy blood donors was 0.04% (n=13/32,560). Incidence of irregular antibodies in patients at 0.12% was slightly lower than published reports and could be because of the fact that the patient population studied comprised largely of surgical patients many of whom have never received blood transfusion. This data could also be more representative since the number of patients studied was much higher as compared to the previous Indian studies (32,560 vs. 531-2026). The report on incidence of irregular antibodies and DAT (0.009-0.04%) in blood donors was first such attempt in India. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Incidence and Significance of Haematemesis in Cirrhosis

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... tract (oesophageal varices) is an uncommon cause of death in patients with cirrhosis and portal hypertension. The view was that death occurs from liver failure per se more often than from haemorrhage, although opinion was not available as to whether this was because of a low incidence of haemorrhage ...

  14. Incidence and Significance of Haematemesis in Cirrhosis

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... The indication for doing a barium swallow, how- ever, was not clear, and in 50 of the 75 patients there wa no history or clinical evidence of gastro-intestinal tract bleeding. Of [he 50 patients 20 had oesophageal varice . Contrast studies were done in only 16 of the 45 patients with a history of haematemesis, ...

  15. Clinical significance of procoagulant microparticles.

    Science.gov (United States)

    Nomura, Shosaku; Shimizu, Michiomi

    2015-01-01

    Microparticles (MPs) are small membrane vesicles that are released from many different cell types by exocytic budding of the plasma membrane in response to cellular activation or apoptosis. MPs may also be involved in clinical diseases because they express phospholipids, which function as procoagulants. Although flow cytometry is the most widely used method for studying MPs, some novel assays, such as tissue factor-dependent procoagulant assay or the ELISA method, have been reported. However, the use of quantification of MP as a clinical tool is still controversial. Elevated platelet-derived MP, endothelial cell-derived MP, and monocyte-derived MP concentrations are documented in almost all thrombotic diseases occurring in venous and arterial beds. However, the significance of MPs in various clinical conditions remains controversial. An example of this controversy is that it is unknown if MPs found in peripheral blood vessels cause thrombosis or whether they are the result of thrombosis. Numerous studies have shown that not only the quantity, but also the cellular origin and composition of circulating MPs, are dependent on the type of disease, the disease state, and medical treatment. Additionally, many different functions have been attributed to MPs. Therefore, the number and type of clinical disorders associated with elevated MPs are currently increasing. However, MPs were initially thought to be small particles with procoagulant activity. Taken together, our review suggests that MPs may be a useful biomarker to identify thrombosis.

  16. Clinical significance of the fabella

    International Nuclear Information System (INIS)

    Dodevski, A.; Lazarova-Tosovska, D.; Zhivadinovik, J.; Lazareska, M.

    2012-01-01

    Full text: Introduction: There is variable number of sesamoid bones in the human body; one of them is fabella, located in the tendon of the gastrocnemius muscle. Aim of this study was to investigate the frequency of occurrence of fabella in the Macedonian population and to discuss about clinical importance of this bone. Materials and methods: We retrospectively examined radiographs of 53 patients who had knee exams undertaken for a variety of clinical reasons, performed as a part of their medical treatment. Over a time span of six months, 53 patients (38 males and 15 females, age range 19-60 years, mean age of 36.7±12.3 years) were examined. Results: In seven (13.2%) patients of 53 analyzed reports, fabella was found in the lateral tendon of gastrocnemius muscle. We did not find a significant gender or side difference in the appearance of fabella. Conclusion: Although anatomic studies emphasized a lack of significance of the fabella, this bone has been associated with a spectrum of pathology affecting the knee as fabellar syndrome, perineal nerve injury and fracture. We should think of this sesamoid bone while performing diagnostic and surgical procedures

  17. Increased detection of clinically significant antibodies and decreased incidence of delayed haemolytic transfusion reaction with the indirect antiglobulin test potentiated by polyethylene glycol compared to albumin: a Japanese study

    Science.gov (United States)

    Okutsu, Miho; Ohto, Hitoshi; Yasuda, Hiroyasu; Kawabata, Kinuyo; Ono, Satoshi; Saito, Shunnichi; Sugawara, Akiko; Kikuchi, Masami; Miura, Saori; Ishii, Youko; Watanabe, Kazuya; Tohyama, Yuriko; Nollet, Kenneth E.

    2011-01-01

    Background The indirect antiglobulin test (IAT) can be potentiated by agents such as polyethylene glycol (PEG-IAT) and albumin (Alb-IAT). PEG-IAT is generally regarded as superior to Alb-IAT for the detection of clinically significant red blood cell (RBC) antibodies. However, supporting data come from Caucasian-dominant populations. Non-Caucasian populations should be investigated as well. Material and methods In this single-centre, retrospective, sequential study, Alb-IAT was used from 1989 to 1996 (8 years) and PEG-IAT from 1997 to 2008 (12 years). Pre-transfusion RBC alloantibody detection rates and specificity, post-transfusion alloantibody production, and the incidence of delayed haemolytic transfusion reaction were assessed and compared for the two periods. Results Although overall RBC alloantibody detection rates were comparable, PEG-IAT more frequently detected clinically significant antibodies such as anti-E, anti-Fyb, and anti-Jka, and less frequently detected insignificant antibodies such as anti-Leb and anti-P1. New alloantibodies emerged comparably during the two periods. Delayed haemolytic transfusion reaction was less frequent during the PEG-IAT period (0.30% versus 0.12%, ptransfusion reaction better than Alb-IAT among Japanese transfusion recipients in this retrospective survey of limited power. PMID:21251459

  18. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-01-01

    Abstract Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77–0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout. PMID:26683907

  19. The Epidemiology of Pheochromocytoma: Increasing incidence and changing clinical presentation

    DEFF Research Database (Denmark)

    Ebbehoj, A; Søndergaard, Esben; Trolle, Christian

    2017-01-01

    (population 1.75 million).Incidence rates were calculated using Poisson regression and time trends were analysed with year as a continuous explanatory variable. As incidence increased significantly in 2007–2015, we compared the clinical characteristics of patients diagnosed in this time interval with patients...

  20. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors.

    Science.gov (United States)

    Gaida, J E; Maloney, S; Lo, K; Morgan, P

    2015-06-01

    Students are sometimes involved in incidents during clinical training. To the authors' knowledge, no quantitative studies of incidents specifically involving physiotherapy students on clinical placement are available in the literature. A retrospective audit (2008 to 2011) of incident reports involving physiotherapy students was conducted to identify the nature and features of incidents. The study aimed to determine if injuries to a student or patient were more or less likely when the supervisor was in close proximity, and whether students with lower academic performance in their preclinical semester were more likely to be involved in an incident. There were 19 care-delivery-related and three equipment-related incidents. There were no incidents of violent, aggressive or demeaning behaviour towards students. The incident rate was 9.0/100,000 student-hours for third-year students and 6.8/100,000 student-hours for fourth-year students. The majority of incidents (55%) occurred from 11 am to 12-noon and from 3 pm to 3.30 pm. Incidents more often resulted in patient or student injury when the supervisor was not in close proximity (approximately 50% vs approximately 20%), although the difference was not significant (P=0.336). The academic results of students involved in incidents were equivalent to the whole cohort in their preclinical semester {mean 75 [standard deviation (SD) 6] vs 76 (SD 7); P=0.488}. The unexpected temporal clustering of incidents warrants further investigation. Student fatigue may warrant attention as a potential contributor; however, contextual factors, such as staff workload, along with organisational systems, structures and procedures may be more relevant. The potential relationship between supervisor proximity and injury also warrants further exploration. The findings of the present study should be integrated into clinical education curricula and communicated to clinical educators. Copyright © 2014 Chartered Society of Physiotherapy. Published by

  1. Analysis of significant factors for dengue fever incidence prediction.

    Science.gov (United States)

    Siriyasatien, Padet; Phumee, Atchara; Ongruk, Phatsavee; Jampachaisri, Katechan; Kesorn, Kraisak

    2016-04-16

    Many popular dengue forecasting techniques have been used by several researchers to extrapolate dengue incidence rates, including the K-H model, support vector machines (SVM), and artificial neural networks (ANN). The time series analysis methodology, particularly ARIMA and SARIMA, has been increasingly applied to the field of epidemiological research for dengue fever, dengue hemorrhagic fever, and other infectious diseases. The main drawback of these methods is that they do not consider other variables that are associated with the dependent variable. Additionally, new factors correlated to the disease are needed to enhance the prediction accuracy of the model when it is applied to areas of similar climates, where weather factors such as temperature, total rainfall, and humidity are not substantially different. Such drawbacks may consequently lower the predictive power for the outbreak. The predictive power of the forecasting model-assessed by Akaike's information criterion (AIC), Bayesian information criterion (BIC), and the mean absolute percentage error (MAPE)-is improved by including the new parameters for dengue outbreak prediction. This study's selected model outperforms all three other competing models with the lowest AIC, the lowest BIC, and a small MAPE value. The exclusive use of climate factors from similar locations decreases a model's prediction power. The multivariate Poisson regression, however, effectively forecasts even when climate variables are slightly different. Female mosquitoes and seasons were strongly correlated with dengue cases. Therefore, the dengue incidence trends provided by this model will assist the optimization of dengue prevention. The present work demonstrates the important roles of female mosquito infection rates from the previous season and climate factors (represented as seasons) in dengue outbreaks. Incorporating these two factors in the model significantly improves the predictive power of dengue hemorrhagic fever forecasting

  2. The thresholds for statistical and clinical significance

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian; Gluud, Christian; Winkel, Per

    2014-01-01

    , assessment of intervention effects in randomised clinical trials deserves more rigour in order to become more valid. METHODS: Several methodologies for assessing the statistical and clinical significance of intervention effects in randomised clinical trials were considered. Balancing simplicity......BACKGROUND: Thresholds for statistical significance are insufficiently demonstrated by 95% confidence intervals or P-values when assessing results from randomised clinical trials. First, a P-value only shows the probability of getting a result assuming that the null hypothesis is true and does...... not reflect the probability of getting a result assuming an alternative hypothesis to the null hypothesis is true. Second, a confidence interval or a P-value showing significance may be caused by multiplicity. Third, statistical significance does not necessarily result in clinical significance. Therefore...

  3. Original Article Clinical Significance of Bacteriuria in Patients with ...

    African Journals Online (AJOL)

    mn

    Cystectomy. E. Elsotohi. Department of Urology Al-Azhar University, Cairo, Egypt. ABSTRACT. Objectives: To evaluate the incidence and clinical significance of bacteriuria in patients who ... encountered was E Coli (72%) followed by Klebsiella (12%). Conclusion: ... Date accepted (after revision): 22/12/2009 fever and ...

  4. IMPORTANCE AND CLINICAL SIGNIFICANCE OF SERUM SIALIC ...

    African Journals Online (AJOL)

    Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. IMPORTANCE AND CLINICAL SIGNIFICANCE OF SERUM SIALIC ACID AND LACTATE DEHYDROGENASE DETERMINATION IN CERVICAL CANCER PATIENTS. Farouk H. Saber, Essam F. Hammouda, Mohamed Khaled M, Essam A. Afifi. Abstract.

  5. The incidence and economic significance of ovine toxoplasmosis in Uruguay.

    Science.gov (United States)

    Freyre, A; Bonino, J; Falcón, J; Castells, D; Correa, O; Casaretto, A

    1999-02-01

    Antibodies to Toxoplasma gondii were measured before and after pregnancy in a 1:64 dilution of sera with the direct agglutination test in 1613 ewes from 18 farms in eight different counties of Uruguay from 1992 to 1994. The overall seroprevalence increased from 28.7% before mating to 38.5% after lambing in 2.5 years and thus the incidence was 9.8%. Losses due to toxoplasmosis during pregnancy were estimated to be 1.4-3.9% of the total number of ewes investigated, amounting to approximately US$1.4-4.7 million for the whole country.

  6. Sonographic ally Detected Architectural Distortion: Clinical Significance

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Shin Kee; Seo, Bo Kyoung; Yi, Ann; Cha, Sang Hoon; Kim, Baek Hyun; Cho, Kyu Ran; Kim, Young Sik; Son, Gil Soo; Kim, Young Soo; Kim, Hee Young [Korea University Ansan Hospital, Ansan (Korea, Republic of)

    2008-12-15

    Architectural distortion is a suspicious abnormality for the diagnosis of breast cancer. The aim of this study was to investigate the clinical significance of sonographic ally detected architectural distortion. From January 2006 to June 2008, 20 patients were identified who had sonographic ally detected architectural distortions without a history of trauma or surgery and abnormal mammographic findings related to an architectural distortion. All of the lesions were pathologically verified. We evaluated the clinical and pathological findings and then assessed the clinical significance of the sonographic ally detected architectural distortions. Based on the clinical findings, one (5%) of the 20 patients had a palpable lump and the remaining 19 patients had no symptoms. No patient had a family history of breast cancer. Based on the pathological findings, three (15%) patients had malignancies. The malignant lesions included invasive ductal carcinomas (n = 2) and ductal carcinoma in situ (n = 1). Four (20%) patients had high-risk lesions: atypical ductal hyperplasia (n = 3) and lobular carcinoma in situ (n = 1). The remaining 13 (65%) patients had benign lesions, however, seven (35%) out of 13 patients had mild-risk lesions (three intraductal papillomas, three moderate or florid epithelial hyperplasia and one sclerosing adenosis). Of the sonographic ally detected architectural distortions, 35% were breast cancers or high-risk lesions and 35% were mild-risk lesions. Thus, a biopsy might be needed for an architectural distortion without an associated mass as depicted on breast ultrasound, even though the mammographic findings are normal

  7. Sonographic ally Detected Architectural Distortion: Clinical Significance

    International Nuclear Information System (INIS)

    Kim, Shin Kee; Seo, Bo Kyoung; Yi, Ann; Cha, Sang Hoon; Kim, Baek Hyun; Cho, Kyu Ran; Kim, Young Sik; Son, Gil Soo; Kim, Young Soo; Kim, Hee Young

    2008-01-01

    Architectural distortion is a suspicious abnormality for the diagnosis of breast cancer. The aim of this study was to investigate the clinical significance of sonographic ally detected architectural distortion. From January 2006 to June 2008, 20 patients were identified who had sonographic ally detected architectural distortions without a history of trauma or surgery and abnormal mammographic findings related to an architectural distortion. All of the lesions were pathologically verified. We evaluated the clinical and pathological findings and then assessed the clinical significance of the sonographic ally detected architectural distortions. Based on the clinical findings, one (5%) of the 20 patients had a palpable lump and the remaining 19 patients had no symptoms. No patient had a family history of breast cancer. Based on the pathological findings, three (15%) patients had malignancies. The malignant lesions included invasive ductal carcinomas (n = 2) and ductal carcinoma in situ (n = 1). Four (20%) patients had high-risk lesions: atypical ductal hyperplasia (n = 3) and lobular carcinoma in situ (n = 1). The remaining 13 (65%) patients had benign lesions, however, seven (35%) out of 13 patients had mild-risk lesions (three intraductal papillomas, three moderate or florid epithelial hyperplasia and one sclerosing adenosis). Of the sonographic ally detected architectural distortions, 35% were breast cancers or high-risk lesions and 35% were mild-risk lesions. Thus, a biopsy might be needed for an architectural distortion without an associated mass as depicted on breast ultrasound, even though the mammographic findings are normal

  8. Early memories: Clinical relevance and significance.

    Science.gov (United States)

    van der Watt, Gillian; Coall, David; Sng, Adelln; Janca, Aleksandar

    2016-02-01

    The purpose of this research was to examine earliest memories in patients with a mental disorder and their clinical relevance to diagnosis and treatment. A semi-structured early memory questionnaire was developed and 50 patients with anxiety, depression or a psychotic disorder were interviewed. A thematic analysis was conducted to extract dominant themes from the qualitative data. Family events, play, and receiving attention were dominant themes of pleasant memories, while unpleasant memories consisted of fear-provoking situations, abuse/violence, and death-related themes. Participants were able to recall the feelings they had experienced at the time of their earliest memories and most participants stated that their first memories had significant impact in their lives. The findings of this exploratory study suggest that earliest memories may be of clinical significance for diagnostic and therapeutic interventions in psychiatry. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  9. Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors.

    Science.gov (United States)

    Jo, Yu Ri; Kim, Ji Young; Jeon, Myung Jae

    2014-07-01

    This study aimed to quantify the risk of significant gastrointestinal (GI) morbidity after sacrocolpopexy (SCP), and to identify related risk factors. A retrospective study was performed of 258 patients who underwent laparotomic SCP for symptomatic pelvic organ prolapse (POP) from November 2008 to August 2013. By the review of medical records, the frequency of significant GI morbidity that resulted in a prolonged initial hospitalization, readmission, or reoperation was assessed. Thereafter, risk factors for significant GI morbidity were assessed using univariate and multivariate analyses. Ten patients (3.9%) were identified as having significant GI morbidity; nine (3.5%) had a prolonged initial hospital stay or were readmitted for the medical treatment of postoperative ileus and 1 (0.4%) underwent reoperation for small bowel obstruction. The occurrence of significant GI morbidity was significantly associated with patient's age and prior laparotomy. By multivariable logistic regression analysis, age (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.01-1.27; P=0.03) and prior laparotomy (OR, 6.82; 95% CI, 1.37-34.07; P=0.02) were found as independent risk factors for significant GI morbidity. One in 25 (3.9%) women after SCP experiences significant GI morbidity. Particularly, women with older age and prior laparotomy have a higher risk for significant GI morbidity. This data will aid preoperative counseling for Korean POP patients undergoing SCP.

  10. Quantifying the clinical significance of cannabis withdrawal.

    Directory of Open Access Journals (Sweden)

    David J Allsop

    Full Text Available Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV. This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt.A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p=0.0001. Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p=0.03. Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p=0.001.Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes.

  11. Quantifying the Clinical Significance of Cannabis Withdrawal

    Science.gov (United States)

    Allsop, David J.; Copeland, Jan; Norberg, Melissa M.; Fu, Shanlin; Molnar, Anna; Lewis, John; Budney, Alan J.

    2012-01-01

    Background and Aims Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt. Methods and Results A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p = 0.0001). Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p = 0.03). Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p = 0.001). Conclusions Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes. PMID:23049760

  12. Clinically significant drug interactions with newer antidepressants.

    Science.gov (United States)

    Spina, Edoardo; Trifirò, Gianluca; Caraci, Filippo

    2012-01-01

    After the introduction of selective serotonin reuptake inhibitors (SSRIs), other newer antidepressants with different mechanisms of action have been introduced in clinical practice. Because antidepressants are commonly prescribed in combination with other medications used to treat co-morbid psychiatric or somatic disorders, they are likely to be involved in clinically significant drug interactions. This review examines the drug interaction profiles of the following newer antidepressants: escitalopram, venlafaxine, desvenlafaxine, duloxetine, milnacipran, mirtazapine, reboxetine, bupropion, agomelatine and vilazodone. In general, by virtue of a more selective mechanism of action and receptor profile, newer antidepressants carry a relatively low risk for pharmacodynamic drug interactions, at least as compared with first-generation antidepressants, i.e. monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). On the other hand, they are susceptible to pharmacokinetic drug interactions. All new antidepressants are extensively metabolized in the liver by cytochrome P450 (CYP) isoenzymes, and therefore may be the target of metabolically based drug interactions. Concomitant administration of inhibitors or inducers of the CYP isoenzymes involved in the biotransformation of specific antidepressants may cause changes in their plasma concentrations. However, due to their relatively wide margin of safety, the consequences of such kinetic modifications are usually not clinically relevant. Conversely, some newer antidepressants may cause pharmacokinetic interactions through their ability to inhibit specific CYPs. With regard to this, duloxetine and bupropion are moderate inhibitors of CYP2D6. Therefore, potentially harmful drug interactions may occur when they are coadministered with substrates of these isoforms, especially compounds with a narrow therapeutic index. The other new antidepressants are only weak inhibitors or are not inhibitors of CYP isoforms at

  13. Significant reduction in the incidence of C5 palsy after cervical laminoplasty using chilled irrigation water.

    Science.gov (United States)

    Takenaka, S; Hosono, N; Mukai, Y; Tateishi, K; Fuji, T

    2016-01-01

    The aim of this study was to determine whether chilled irrigation saline decreases the incidence of clinical upper limb palsy (ULP; a reduction of one grade or more on manual muscle testing; MMT), based on the idea that ULP results from thermal damage to the nerve roots by heat generated by friction during bone drilling. Irrigation saline for drilling was used at room temperature (RT, 25.6°C) in open-door laminoplasty in 400 patients (RT group) and chilled to a mean temperature of 12.1°C during operations for 400 patients (low-temperature (LT) group). We assessed deltoid, biceps, and triceps brachii muscle strength by MMT. ULP occurring within two days post-operatively was categorised as early-onset palsy. The incidence of ULP (4.0% vs 9.5%, p = 0.003), especially early-onset palsy (1.0% vs 5.5%, p irrigation saline use, concomitant foraminotomy, and opened side were significant predictors for ULP. Using chilled irrigation saline during bone drilling significantly decreased the ULP incidence, particularly the early-onset type, and shortened the recovery period for ULP. Chilled irrigation saline can thus be recommended as a simple method for preventing ULP. Chilled irrigation during laminoplasty reduces C5 palsy. ©2016 The British Editorial Society of Bone & Joint Surgery.

  14. Significance of FISH in clinical cytogenetics

    Energy Technology Data Exchange (ETDEWEB)

    Gopal Rao, V.V.N.; Harris, S.; Roop, H. [H.A. Chapman Institute of Medical Genetics, Tulsa, OK (United States)] [and others

    1994-09-01

    Ever since its discovery, FISH technology has become an invaluable adjunct to conventional cytogenetics. FISH has been instrumental in resolving previously unresolved cytogenetic dilemmas. FISH has been used to elucidate complex as well as subtle chromosomal translocations, in detection of microdeletions, to confirm duplications and inversions and to identify marker chromosomes. We report a few selected cases where FISH proved to be invaluable in not only confirming the anomaly, but also in arriving at an accurate diagnosis and appropriate counseling of the patients. These include 3 cases of prenatal and 3 cases of postnatal diagnosis. The results clearly demonstrate the significance of FISH in identifying and interpreting the difficult karyotype in clinical cytogenetics. In addition, FISH has been used to rule out microdeletions in Prader-Willi (16), Angelman (3), Miller-Dieker (7), DiGeorge (4) and Smith-Magenis (1) syndrome patients. Without FISH in the majority of these cases, it would not have been possible to accurately identify the karyotype and interpret the results. Hence, we recommend that FISH be used as a powerful adjunct to conventional cytogenetics in order to arrive at an accurate interpretation of the results but not to replace routine cytogenetic studies.

  15. [Incidence and clinical characteristics of maculopapular exanthemas of viral aetiology].

    Science.gov (United States)

    Vega Alonso, T; Gil Costa, M; Rodríguez Recio, M J; de la Serna Higuera, P

    2003-11-30

    To estimate the incidence of maculo-papular viral exanthemas and to describe the epidemiological and clinical patterns. Observational descriptive study with a sample design. 154 practitioners from the Castilla y León Sentinel Network with a surveilled population of 23 237 people-year under 15 years old, notified in 2002 the cases of diseases by means of a standard form with the variables and inclusion and exclusion criteria. It was included the maculo-papular exanthemas associated to a presumable systemic virus disease in patients under 15 years old. It was excluded the infectious mononucleose, the chickenpox, and other non viral infections or exanthemas. 368 cases were notified which represent a incidence rate of 158.37 cases per 10 000 (95% CI, 142.31-174.42). The incidence was maximum under four years old, more than 350 per 10 000, decreasing significantly in children over this age. Erythema infectiousum presented the highest rate, followed by exanthema subitum. The exanthemas caused by measles or rubella were insignificants. Childhood exanthematous diseases of presumable viral etiology have an important incidence in primary care, although the majorities are banal and self-limited diseases. Clinical characteristics supported the suspicion diagnosis, which was consistent with the observed epidemiological description and expected presentations of each disease. Although serological analysis could diminish the uncertainly on notification and control of diseases submited to especial programs of vaccination and eradication, they would not improve substantially the diagnosis and treatment of these patients.

  16. Management practices associated with the incidence rate of clinical mastitis.

    Science.gov (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A

    1999-08-01

    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  17. Qualitative analysis of factors leading to clinical incidents.

    Science.gov (United States)

    Smith, Matthew D; Birch, Julian D; Renshaw, Mark; Ottewill, Melanie

    2013-01-01

    The purpose of this paper is to evaluate the common themes leading or contributing to clinical incidents in a UK teaching hospital. A root-cause analysis was conducted on patient safety incidents. Commonly occurring root causes and contributing factors were collected and correlated with incident timing and severity. In total, 65 root-cause analyses were reviewed, highlighting 202 factors implicated in the clinical incidents and 69 categories were identified. The 14 most commonly occurring causes (encountered in four incidents or more) were examined as a key-root or contributory cause. Incident timing was also analysed; common factors were encountered more frequently during out-hours--occurring as contributory rather than a key-root cause. In total, 14 commonly occurring factors were identified to direct interventions that could prevent many clinical incidents. From these, an "Organisational Safety Checklist" was developed to involve departmental level clinicians to monitor practice. This study demonstrates that comprehensively investigating incidents highlights common factors that can be addressed at a local level. Resilience against clinical incidents is low during out-of-hours periods, where factors such as lower staffing levels and poor service provision allows problems to escalate and become clinical incidents, which adds to the literature regarding out-of-hours care provision and should prove useful to those organising hospital services at departmental and management levels.

  18. CLINICAL SIGNIFICANCE OF EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAM

    Directory of Open Access Journals (Sweden)

    L. Yu. Glukhova

    2016-01-01

    Full Text Available The article is devoted to some issues of sensitivity and specificity of epileptiform activity in the electroencephalogram (EEG. Epileptiform activity – it is sharp waves and spikes on EEG. Normal EEG does not exclude the diagnosis of epilepsy and viсe versa: presence of epileptiform activity on EEG is not necessarily caused by epilepsy. Several EEGs may be needed to detect epileptiform activity in patients with epilepsy. EEG recording during sleep with the use of different activation methods (hyperventilation, rhythmic photic stimulation, sleep deprivation can increase the probability of epileptiform activity detection. Clinical presentation should be taken into account while interpreting EEG results with registered epileptiform activity. The issues of epileptiform activity classification and differential interpretation of other electrical activity types are also discussed in the article. Main epileptiform patterns, their neurophysiological basis and correlation with clinical manifestations are described.

  19. Moving and handling and patient safety: analysis of clinical incidents.

    Science.gov (United States)

    Cornish, Jocelyn; Jones, Anne

    The aim of this study is to identify the potential contribution of moving and handling practice to clinical incidents through an analysis of incident data. Previous studies focusing on moving and handling have highlighted potential harm to patients through poor practice, and have suggested that this might be an issue for patient safety. However, this has not been identified in studies analysing clinical incident reports, where the potential contribution of moving and handling has not been recognized. This study reports an analysis of clinical incident data from the specific perspective of moving and handling. Survey of clinical incident reports in hospital in-patient care settings Method: A random sample of 500 incident reports was analysed using descriptive statistics and thematic analysis of qualitative data. There is an indication that some staff are not following recommended moving and handling policy through a lack of risk assessment; for example, in the selection of appropriate actions to assist patients, and in the prevention of further occurrences of incidents where patients had fallen. The limited detail within the reports affected consideration of the causes of the incidents and actions that could be taken to prevent a further occurrence. Some of the reported staff actions may contravene policy guidelines. Missing detail in the incident reports inhibited investigation of incidents that could lead to appropriate and safe systems of work being identified.

  20. Twelve clinically significant points in medulloblastoma

    International Nuclear Information System (INIS)

    Sugiyama, Kazuhiko; Yamasaki, Fumiyuki; Kajiwara, Yoshinori; Watanabe, Yosuke; Takayasu, Takeshi; Kurisu, Kaoru

    2011-01-01

    Though medulloblastoma is the most common malignant brain tumor during childhood, only 80 newly-diagnosed tumors develos every year, as the annual incidence is extremely rare with an occurrence of 0.5 per 100,000 children younger than 15-year-old and of 0.7 per 100,000 for the entire population. Images obtained of medulloblastoma are characterized by a round heterogeously-enhanced mass in or adjacent to the VIth ventricle. Objectives of surgical treatment are the maximum resectioning of the main mass and the relief of the obstructive hydrocephalus. Cerebellar mutism occurs a few days after one fourth of medulloblastoma surgery, and lasts approximately for 50 days followed by subsequent dysarthria. Pathological subtypes include classic medulloblastoma, desmoplastic/nodular medulloblastoma, medulloblastoma with extensive nodularity, large cell/anaplastic medulloblastoma, all corresponding to World Health Organization (WHO) grade IV. According to age, residual tumor size, and disseminated staging, patients are divided into average-risk group, high-risk group, or baby-medulloblastoma after surgery. Standard treatment in average-risk group includes 23.4-Gy cranio-spinal irradiation (CSI) with posterior boost followed by chemotherapy consisting of cisplatin (CDDP), alkylating agents, and vincristine. Patients in high-risk group receive over 36-Gy CSI with boost radiotherapy to nodular lesions before, concomitantly with, or followed by dose-intensity chemotherapy. In cases with gross total removal, or desmoplastic/nodular pathology radiotherapy for patients younger than 3-year-old are often delayed until they turn 3-year-old, and are able to survive for long time by appropriate chemotherapy alone. Adolescent survivors with childhood medulloblastoma have a number of late adverse effects regarding another neoplasm, neuro-cognitive function, endocrine activity, cardiovascular organs, and skeletal system. Comprehensive follow-up and support system are mandatory. (author)

  1. Pancreatic hyperamylasemia during acute gastroenteritis: incidence and clinical relevance

    Directory of Open Access Journals (Sweden)

    Pignattari Elena

    2001-09-01

    Full Text Available Abstract Background Many case reports of acute pancreatitis have been reported but, up to now, pancreatic abnormalities during acute gastroenteritis have not been studied prospectively. Objectives To evaluate the incidence and the clinical significance of hyperamylasemia in 507 consecutive adult patients with acute gastroenteritis. Methods The clinical significance of hyperamylasemia, related predisposing factors and severity of gastroenteritis were assessed. Results Hyperamylasemia was detected in 10.2 % of patients studied. Although amylasemia was found over four times the normal values in three cases, the clinical features of acute pancreatitis were recorded in only one case (0.1%. Hyperamylasemia was more likely (17% where a microorganism could be identified in the stools (p Salmonella spp. and in particular S. enteritidis, was the microorganism most frequently associated with hyperamylasemia [17/84 (20.2 % and 10/45 (22.2%, respectively], followed by Rotavirus, Clostridium difficile and Campylobacter spp. Patients with hyperamylasemia had more severe gastroenteritis with an increased incidence of fever (80 % vs 50.6 %, O.R. 3.0; P Conclusions Hyperamylasemia is relatively frequent, and is associated with severe gastroenteritis. However, acute pancreatitis in the setting of acute gastroenteritis, is a rare event.

  2. Clinical significance of bone age estimation

    International Nuclear Information System (INIS)

    Heinrich, U.E.

    1986-01-01

    Skeletal development is an important maturity indicator during childhood. In clinical practice determination of skeletal age is helpful for the diagnosis of disorders of growth and development. Most hormones have specific effects on skeletal maturation. Thus, different disease states (growth disorders, disorders of pubertal development, chornic disorders of the bowels, kidneys, heart etc.) are characterized by retardation or acceleration of skeletal maturation. Therapeutic effects as well as side effects of hormones can be monitored by skeletal age determination. Typical disharmonic patterns in the appearance of bone centres of hand and wrist have been found in certain disorders of development. (orig.) [de

  3. Arcuate foramen and its clinical significance

    International Nuclear Information System (INIS)

    Cakmark, O.; Gurdal, E.; Cavdar, S.; Ekinci, G.; Yildiz, E.

    2005-01-01

    The present study determines the degree of ossification of the posterior atlanto-occipital membrane in dry bone, plane lateral cervical spine radiographs and computer tomography (CT). The average length, width and the area of the arcuate foramen were measured on dry bone and on cervical CT. Further, age, gender and complaints of the patients of shoulder and arm pain, neck pain, headache, vertigo, and lacrimation in relation to the presence of bony complete or incomplete arcuate foramen were evaluated. From February 2004 to January 2005 60 dry atlases were obtained from the Anatomy Department, University of Marmara, Istanbul, Turkey and 416 lateral cervical spine radiographs were obtained from the Radiology department for neurological and orthopedic evaluations. Each complete arcuate foramen was calculated with the aid of Clemex Vision PE demo version computer program. Among the 60 dry atlases examined 7 (11.7%) had complete and 2 (3.3 %) had incomplete bony bridge formation. Of the 416 plane lateral cervical spine radiographs examined, 30 (7.2%) had complete and 26 (6.25%) had incomplete bony bridge formation. Of the 30 complete arcuate foramen 24 (80%) were females and 6 (20%) were males. The frequency of having a complete arcuate foramen in females was 8.45%, and in males it was 4.55%. Further, of the 26 incomplete arcuate foramen 20 (76.9%) were females and 6 (23.1%) were males. The frequency of having an incomplete arcuate foramen in females was 7%, and in males was 4.55%. The statistical evaluations showed that patients with complete arcuate foramen had significant complaints of shoulder-arm pain (p=0.0072), neck pain (p=0.0072) and vertigo (p=0.0598) compared to patients with incomplete arcuate foramen. The patients with complete arcuate foramen had a headache ratio of 12:30 and this ratio was 2:26 in patients with incomplete arcuate foramen and the difference between complete and incomplete arcuate foramen was statistically significant (p=0.0062). Further

  4. [Clinical significance of nausea in migraine].

    Science.gov (United States)

    Serousova, O V; Karpova, M I; Dolgushina, A I; Vasilenko, A F; Markova, V V; Altman, D S

    2017-01-01

    To study the prevalence and intensity of nausea in pain, prodromal and postdromal phases of migraine paroxysm, and in between the paroxysms in migraine patients, depending on the type of migraine paroxysm and frequency of pain days, and to evaluate an effect of nausea on the course of migraine. One hundred and four patients with migraine, aged from 18 to 60 years, were examined. The intensity of nausea was evaluated by a 5-point verbal analogue scale, and its intensity in between the paroxysms by the Gastrointestinal Symptom Rating Scale. All of the patients underwent a complex examination of the gastrointestinal tract. Paroxysms with accompanying nausea were found in 90% patients. Acute nausea was associated with older age, earlier onset and longer experience of migraine. In a group of patients with acute nausea, the frequency and intensity of migraine paroxysms, probability of reoccuring pain in the first day and the severity of social disability were higher. Development of nausea in between the paroxysms and its intensity was significantly higher in patients with high intensity of nausea in migraine paroxysms. Nausea in the prodrome was significantly associated with migraine without aura and chronicity of the disorder. Patients with nausea in the prodrome also had a longer painful phase and more severe social disability. No relationship between organic diseases of the digestive tract and nausea was found. Nausea can have its own pathological mechanisms not related to concomitant diseases of the digestive tract that should be taken into account in therapeutic interventions aimed at improving quality of life of the patients.

  5. Clinical significance of perceptible fetal motion.

    Science.gov (United States)

    Rayburn, W F

    1980-09-15

    The monitoring of fetal activity during the last trimester of pregnancy has been proposed to be useful in assessing fetal welfare. The maternal perception of fetal activity was tested among 82 patients using real-time ultrasonography. All perceived fetal movements were visualized on the scanner and involved motion of the lower limbs. Conversely, 82% of all visualized motions of fetal limbs were perceived by the patients. All combined motions of fetal trunk with limbs were preceived by the patients and described as strong movements, whereas clusters of isolated, weak motions of the fetal limbs were less accurately perceived (56% accuracy). The number of fetal movements perceived during the 15-minute test period was significantly (p fetal motion was present (44 of 45 cases) than when it was absent (five of 10 cases). These findings reveal that perceived fetal motion is: (1) reliable; (2) related to the strength of lower limb motion; (3) increased with ruptured amniotic membranes; and (4) reassuring if considered to be active.

  6. National Emergency Preparedness and Response: Improving for Incidents of National Significance

    National Research Council Canada - National Science Library

    Clayton, Christopher M

    2006-01-01

    .... More appropriately, the Department of Defense (DoD), the Department of Homeland Security (DHS), and the states need to become better partners in planning for, exercising for, and responding to Incidents of National Significance...

  7. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  8. Incidence and prognostic significance of postoperative complications demonstrated on CT after brain tumor removal

    International Nuclear Information System (INIS)

    Fukamachi, Akira; Koizumi, Hidehito; Kimura, Ryoichi; Nukui, Hideaki; Kunimine, Hideo.

    1987-01-01

    We surveyed the computed tomographic (CT) findings in 273 patients who had undergone 301 craniotomies for brain tumors to determine the incidence and clinical outcome of the postoperative complications demonstrated on CT. The frequencies of medium-sized or large postoperative lesions were as follows: intracerebral hemorrhage, 11 % of 301 operations; subdural fluid collection, 8 %; brain edema, 6 %; extradural hemorrhage, 4 %; cerebral infarction, 3 %; ventricular enlargement, 3 %; intraventricular hemorrhage, 2 %; chronic subdural hematoma, 1 %; porencephalic cyst, 0.7 %; tension pneumocephalus, 0.7 %. In association with these complications, poor outcomes (deaths) developed with the following frequencies: intracerebral hemorrhage including an association with other types of hemorrhage, 4 % (deaths, 2 %) of 301 operations; cerebral infarction, 1 % (deaths, 0.7 %); brain edema, 0.7 % (deaths, 0.7 %); simple intraventricular hemorrhage, 0.3 % (no deaths); tension pneumocephalus, 0.3 % (no deaths). From these results, we conclude that medium-sized or large intracerebral hemorrhage, massive cerebral infarction and edema have a grave clinical significance in the postoperative course of patients with brain tumors. (author)

  9. Clinical significance of computed tomography assessment for third molar surgery.

    Science.gov (United States)

    Nakamori, Kenji; Tomihara, Kei; Noguchi, Makoto

    2014-07-28

    Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery. Third molar surgery is warranted when there is inadequate space for eruption, malpositioning, or risk for cyst or odontogenic tumor formation. Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues. Due to developments in medical engineering technology, computed tomography (CT) now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery. Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation, whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve. Multiple factors, including demographic, anatomic, and treatment-related factors, influence the incidence of nerve injury during or following removal of the third molar. CT assessment of the third molar prior to surgery can identify some of these risk factors, such as the absence of cortication between the mandibular third molar and the inferior alveolar canal, prior to surgery to reduce the risk for nerve damage. This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.

  10. Deformation and fracture incidence of Reciproc instruments: a clinical evaluation.

    Science.gov (United States)

    Plotino, G; Grande, N M; Porciani, P F

    2015-02-01

    To investigate the incidence of fracture and deformation observed on Reciproc instruments after clinical use. A total of 1696 Reciproc NiTi instruments that were discarded after normal clinical usage over 30 months were collected. Of these 1580 instruments were R25 (93%), 76 were R40 (5%), and 40 were R50 (2%). The treatments included 3780 root canal preparations, 3023 primary treatments and 757 retreatments. Root canal preparation was standardized and followed the manufacturer's directions for the use of Reciproc files without creating prior glide path with hand instruments. In retreatment cases, Reciproc R25 instrument was used to remove all filling material and to complete the preparation. Each instrument was used for shaping only one tooth. All the instruments used were inspected under a microscope to detect signs of fracture or deformation and, if any fracture existed, the length of the files was measured. Data were analysed using a chi-square test with a level of significance set at P < .05. A total of 8 Reciproc R25 instruments fractured during treatment, which represents 0.47% of the number of instruments used and 0.21% of the root canals treated. Five instruments fractured in primary treatment cases and three instruments during retreatments. Six Reciproc R25 deformed during clinical use (0.35% of the number of instruments used and 0.15% of the root canals treated), four during retreatments and two during primary treatments. The deformation reported was unwinding of the blades, one at 1 mm from the tip and five between 2 and 3 mm from the tip. No deformations or fracture were registered for the Reciproc R40 and R50 instruments. Root canal instrumentation following the manufacturer's instructions can be performed with Reciproc instruments with a very low incidence of instrument fracture and deformation. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  11. Clinical significance of pregnancy in adolescence in Japan.

    Science.gov (United States)

    Suzuki, Shunji

    2018-01-07

    We examined the clinical characteristics and obstetric outcomes in adolescent pregnancies in Japanese women. The present study was a retrospective investigation of all primiparous Japanese women with singleton pregnancies who gave birth at ≥22 weeks' gestation aged ≤18 years old (adolescent pregnancy, n = 325) and aged 28-30 years old (n = 2029) at Japanese Red Cross, Katsushika Maternity Hospital between 2002 and 2016. The frequencies of smoking, economic problems, an unmarried single status at delivery and the start of prenatal care in the first trimester in the adolescent pregnancy group were significantly higher than in the control group (p < .01). The incidences of Chlamydia trachomatis, Condyloma acuminatum, and mental disorders in the adolescent pregnancy group were significantly higher than in the control group (p < .01). Pregnancy in adolescence was not related to adverse obstetric outcomes except preterm delivery (p = .02). Adolescent pregnancy was not associated with adverse obstetric outcomes; however, adequate social, economic, and mental support is needed for adolescent pregnant women.

  12. Incidence rate of clinical bovine mastitis in selected smallholder ...

    African Journals Online (AJOL)

    A study was conducted in Gondar town in six selected smallholder farms from. August 2005 to January 2006 for six months to measure incidence rate of clinical bovine mastitis. Monitoring was performed by animal attendants of each farm after training and supervision of the monitoring activities and collection of data.

  13. Incidence rate of clinical bovine mastitis in selected smallholder ...

    African Journals Online (AJOL)

    A study was conducted in Gondar town in six selected smallholder farms from August 2005 to January 2006 for six months to measure incidence rate of clinical bovine mastitis. Monitoring was performed by animal attendants of each farm after training and supervision of the monitoring activities and collection of data was ...

  14. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients: A 12-Year Cohort Study.

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-12-01

    Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77-0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout.

  15. Automated validation of patient safety clinical incident classification: macro analysis.

    Science.gov (United States)

    Gupta, Jaiprakash; Patrick, Jon

    2013-01-01

    Patient safety is the buzz word in healthcare. Incident Information Management System (IIMS) is electronic software that stores clinical mishaps narratives in places where patients are treated. It is estimated that in one state alone over one million electronic text documents are available in IIMS. In this paper we investigate the data density available in the fields entered to notify an incident and the validity of the built in classification used by clinician to categories the incidents. Waikato Environment for Knowledge Analysis (WEKA) software was used to test the classes. Four statistical classifier based on J48, Naïve Bayes (NB), Naïve Bayes Multinominal (NBM) and Support Vector Machine using radial basis function (SVM_RBF) algorithms were used to validate the classes. The data pool was 10,000 clinical incidents drawn from 7 hospitals in one state in Australia. In first part of the study 1000 clinical incidents were selected to determine type and number of fields worth investigating and in the second part another 5448 clinical incidents were randomly selected to validate 13 clinical incident types. Result shows 74.6% of the cells were empty and only 23 fields had content over 70% of the time. The percentage correctly classified classes on four algorithms using categorical dataset ranged from 42 to 49%, using free-text datasets from 65% to 77% and using both datasets from 72% to 79%. Kappa statistic ranged from 0.36 to 0.4. for categorical data, from 0.61 to 0.74. for free-text and from 0.67 to 0.77 for both datasets. Similar increases in performance in the 3 experiments was noted on true positive rate, precision, F-measure and area under curve (AUC) of receiver operating characteristics (ROC) scores. The study demonstrates only 14 of 73 fields in IIMS have data that is usable for machine learning experiments. Irrespective of the type of algorithms used when all datasets are used performance was better. Classifier NBM showed best performance. We think the

  16. MRI detection of unsuspected vertebral injury in acute spinal trauma: incidence and significance

    International Nuclear Information System (INIS)

    Qaiyum, M.; Tyrrell, P.N.M.; McCall, I.W.; Cassar-Pullicino, V.N.

    2001-01-01

    Objective. Multilevel spinal injury is well recognised. Previous studies reviewing the radiographs of spinal injury patients have shown an incidence of 15.2% of unsuspected spinal injury. It is recognised that magnetic resonance imaging (MRI) can identify injuries that are not demonstrated on radiographs. The objective of this study was to determine the incidence and significance of spinal injuries using MRI in comparison with radiographs.Design and patients. The radiographs and MR images of 110 acute spinal injury patients were reviewed independently of each other and the findings were then correlated to determine any unsuspected injury.Results. MRI detected vertebral body bone bruises (microtrabecular bone injury) in 41.8% of spinal injury patients which were not seen on radiographs. These bone bruises were best appreciated on sagittal short tau inversion recovery MR sequences and seen at contiguous and non-contiguous levels in relation to the primary injury.Conclusion. This level of incidence of bone bruises has not previously been appreciated. We recommend that patients undergoing MRI for an injured segment of the spine are better assessed by MRI of the entire spine at the same time to exclude further injury. (orig.)

  17. COMPARATIVE ANATOMICAL STUDY AND INCIDENCE OF OS PERONEUM IN PERONEUS LONGUS TENDON AND ITS CLINICAL SIGNIFICANCE. Estudio anatómico comparativo e incidencia del os peroneum en el tendón de peroneo largo y su significación clínica

    Directory of Open Access Journals (Sweden)

    Poonam Verma

    2016-03-01

    Full Text Available Introducción: El objetivo de nuestro estudio fue evaluar la tasa de incidencia del os peroneo (OP en el tendón del peroneo lateral largo (PLT y su importancia clínica. Métodos: La disección de 60 cadáveres embalsamados (56 hombres y 4 mujeres del grupo de mediana edad se hizo para tener acceso a la  tasa de incidencia del os peroneo en PLT. Resultados: En nuestro estudio se observó que la  tasa de incidencia del os peroneo fue de  86,6% (52  extremidades. La ubicación del os peroneo es también un tema de controversia. La mayoría de los autores afirman que se relaciona con el hueso cuboides y de vez en cuando se ve inferior al calcáneo distal a la articulación calcáneo-cuboidea. Pero en el presente estudio el os- peroneo estuvo en relación al hueso cuboides en 40 extremidades (76.9%  y distal a articulación calcaneocuboidea en el resto de las 12 extremidades (23.1%. Conclusión: Este estudio sugiere que existe una alta tasa de incidencia de un OP en cadaveres. Esto puede ser como consecuencia de la técnica utilizada para localizar el mismo. La importancia clínica ha sido mencionada en relación con la ubicación del os peroneo, que puede ser confundido con fracturas estiloides y de Jones. Introduction: The aim of our study was to assess the incidence rate of the os peroneum (OP in the peroneus longus tendon (PLT and its clinical significance. Methods: Dissection of 60 embalmed cadavers (56 male and 4 female of middle age group was done to access the incidence rate of os peroneum in peroneus longus tendon. Results: In our study the incidence rate of os peroneum was 86.6% (52 limbs. The location of os peroneum is also a subject of dispute. Most authors stated that it is related to the cuboid bone and occasionally it is seen inferior to the calcaneum distal to the calcaneocuboid joint. But in the present study os peroneum was in relation to cuboid bone in 40 limbs (76.9% and distal to calcaneocuboid joint in 12 limbs (23

  18. Clinical significance of carotid and ocular bruits in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Yoshikiyo; Yanagi, Tsutomu; Ito, Yasuhiro; Yasuda, Takeshi (Nagoya Daini Red Cross Hospital (Japan))

    1992-10-01

    We investigated the clinical significance of carotid and ocular bruits (CB and OB) in 250 consecutive patients with cerebrovascular disease (CVD). The incidence of bruits was compared with that in 100 age- and sex-matched neurological controls without CVD. In the CVD group, CB alone were found in 12 patients, both carotid and ocular bruits in 7, and OB alone in 2. CB were found only in 3 controls. We then evaluated CVD in the 25 patients (16 men and 9 women) who had bruits. The patients ranged from 55 to 81 years in age (mean: 70.6 years). The patients with CB alone constituted the largest group, and those with OB alone were the smallest group. CB were heard and abnormal blood flow was observed in 19/28 arteries of the 21 patients who underwent echo-flow studies. Carotid artery stenosis/occlusion was detected in 24/31 arteries (77%) in 23 patients who underwent digital subtraction angiography (DSA). Thus, the sensitivity was 0.77 and specificity of a CB 0.91. In 9/10 patients with unilateral OB, ipsilateral or contralateral carotid artery stenosis/occlusion was detected. Diminished cerebral blood flow was observed in 10/15 patients with bruits who underwent SPECT. Of these 8 had reduced cerebral blood flow ipsilaterally to the bruit. Blood flow was reduced in the carotid artery territory in all of the patients, and watershed reductions were commonnest. Among the 25 patients, some showed neurological semiology of the vertebrobasilar territory in addition to that of the carotid territory. There were recurrences in 92% of the patients who had possible lesion in the territory of carotid artery. In 11 patients infarcts in the area of the cortical branch were shown using CT scans. Since bruits are more often audible in patients with CVD disease than in controls and since vascular stenosis and occlusion are detectable more frequently in these patients, bruits can serve as an important sign indicating CVD. (author).

  19. Acute ischemic stroke associated with nephrotic syndrome: Incidence and significance — Retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Hirotaka Iwaki

    2015-09-01

    Full Text Available We report 10 cases with arterial ischemic stroke (AIS with nephrotic syndrome (NS, and clarified its incidence and clinical characteristics. The patients having albumin less than 3.0 g/dl and serum cholesterol greater than 250 mg/dl at the same time were retrospectively screened from 11,161 cases of stroke. Furthermore, the patients of AIS showing heavy proteinuria were selected. The 10 cases were diagnosed as AIS with NS. Its incidence was 0.09% of all kinds of stroke and 0.12% of AIS. Their subtypes were 6 large-artery atherosclerosis, 3 small-vessel occlusion, and 1 cardioembolism. We carried out a retrospective cohort study to assess the association between NS and atherosclerosis progression in AIS patients. Seven AIS patients with NS due to diabetic nephropathy (cases; NS group were compared with patients with AIS and diabetes mellitus (DM without NS (control group. Control group subjects were matched in a 2:1 ratio to cases by age, sex, use of medications for DM, and hemoglobin A1c (HbA1c level. The NS group had high cerebral artery atherosclerosis scores, especially in the anterior circulation. The NS group demonstrated atherosclerosis of the internal carotid and lower extremity arteries, although there were no statistical differences between the two groups. Study subjects had high serum fibrinogen and D-dimer levels, suggesting that AIS patients with NS have a greater degree of hypercoagulability than AIS patients without NS.

  20. [Second victim : Critical incident stress management in clinical medicine].

    Science.gov (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

    2013-09-01

    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  1. Sleep duration is significantly associated with carotid artery atherosclerosis incidence in a Japanese population.

    Science.gov (United States)

    Abe, Tsueko; Aoki, Toshinari; Yata, Syogo; Okada, Masahiko

    2011-08-01

    Previous studies have indicated that sleep duration is associated with total mortality in a U-shaped fashion. The purpose of the current study was to examine the relationship between self-reported sleep duration and carotid artery atherosclerosis in a Japanese population. In 2009-2010, a total of 2498 participants (1195 men, 1303 women; age range, 23-92 years) were recruited from members of a Japanese community receiving annual health check-up at a local health center who agreed to participate in the study. Exclusion criteria were as follows: age <40 or ≥85 years; and more than one missing value from either laboratory data or questionnaire responses. A total of 2214 participants were entered into the study. Carotid artery arteriosclerosis was evaluated ultrasonographically and quantified as intima-medial thickness (IMT). The presence of carotid artery atherosclerosis was defined as IMT≥1.2 mm. Sleep durations were compared with IMT measurements after controlling for confounding factors such as age, sex, lipid profile, fasting plasma glucose, hemoglobin A1c, blood pressure, alcohol intake, and smoking habit. Sleep duration ≥7 h correlated significantly with the incidence of IMT≥1.2 m when compared with a sleep duration of 6 h (multivariate-adjusted odds ratio, 1.263; 95% confidence interval, 1.031-1.546, P=0.024). Shorter sleep duration ≤5 h did not correlate significantly with the risk compared with a sleep duration of 6 h. Long sleep duration (≥7 h) correlated significantly with the incidence of carotid artery atherosclerosis compared with a sleep duration of 6 h, but shorter sleep duration did not. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  2. Incidence of clinical symptoms during long-duration orbital spaceflight

    Directory of Open Access Journals (Sweden)

    Crucian B

    2016-11-01

    Full Text Available Brian Crucian,1 Adriana Babiak-Vazquez,2 Smith Johnston,1 Duane L Pierson,1 C Mark Ott,1 Clarence Sams1 1Biomedical Research and Environmental Sciences Division, NASA-Johnson Space Center, 2Epidemiology/Lifetime Surveillance of Astronaut Health, KBR-Wyle, Houston, TX, USA Background: The environment of spaceflight may elevate an astronaut’s clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical “incidence” data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS.Methods: Electronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20.57 total flight years. Incidence for immunological-related adverse health events or relevant clinical symptoms was tabulated in a non-identifiable fashion. Event categories included infectious diseases, allergies, and rashes/hypersensitivities. A subsequent re-evaluation of more notable events, either of prolonged duration or unresponsive to treatment, was performed.Results: For the disease/symptom categories used in this evaluation, the ISS incidence rate was 3.40 events per flight year. Skin rashes were the most reported event (1.12/flight year followed by upper respiratory symptoms (0.97/flight year and various other (non-respiratory infectious processes. During flight, 46% of crew members reported an event deemed “notable”. Among the notable events, 40% were classified as rashes/hypersensitivities. Characterization of on-orbit rashes manifested as redness with irritation, and could present on a variety of body locations.Conclusion: Based on reported symptoms, astronauts experience adverse medical events of varying severity during long-duration spaceflights. The data suggests caution, from both a vehicle design and biomedical countermeasures perspective, as space

  3. Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis.

    Science.gov (United States)

    Imazio, Massimo; Lazaros, George; Picardi, Elisa; Vasileiou, Panagiotis; Orlando, Fabrizio; Carraro, Mara; Tsiachris, Dimitris; Vlachopoulos, Charalambos; Georgiopoulos, George; Tousoulis, Dimitrios; Belli, Riccardo; Gaita, Fiorenzo

    2015-09-01

    Data on the incidence of new onset atrial fibrillation and flutter (AF/f) in patients with acute pericarditis are limited. We sought to determine the incidence and prognostic significance of AF/f in this setting. Between January 2006 and June 2014, consecutive new cases of acute pericarditis were included in two urban referral centres for pericardial diseases. All new cases of AF/f defined as episodes lasting ≥30 s were recorded. Events considered during follow-up consisted of AF/f and pericarditis recurrence, cardiac tamponade, pericardial constriction and death. 822 consecutive new cases of acute pericarditis (mean age 53±15 years, 444 men) were analysed. AF/f was detected in 35 patients (4.3%, mean age 66.5±11.3 years, 18 men). Patients with AF/f were significantly older (p=0.017) and presented more frequently with pericardial effusion (ppericarditis onset in 91.4% of cases, lasted >24 h in 25.7% and spontaneously converted in 74.3% of patients. Underlying structural heart disease was present in 17% of AF/f cases. In a 30-month follow-up, patients with history of AF/f at the initial episode had a higher rate of arrhythmia occurrence (34.3% vs 0.9%, ppericarditis identifies a predisposed population to AF/f with a high recurrence risk (about 35%): in these patients, pericarditis may act as an arrhythmic trigger and oral anticoagulation should be seriously considered according to guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Mass Spectrometric Immunoassays in Characterization of Clinically Significant Proteoforms

    Directory of Open Access Journals (Sweden)

    Olgica Trenchevska

    2016-03-01

    Full Text Available Proteins can exist as multiple proteoforms in vivo, as a result of alternative splicing and single-nucleotide polymorphisms (SNPs, as well as posttranslational processing. To address their clinical significance in a context of diagnostic information, proteoforms require a more in-depth analysis. Mass spectrometric immunoassays (MSIA have been devised for studying structural diversity in human proteins. MSIA enables protein profiling in a simple and high-throughput manner, by combining the selectivity of targeted immunoassays, with the specificity of mass spectrometric detection. MSIA has been used for qualitative and quantitative analysis of single and multiple proteoforms, distinguishing between normal fluctuations and changes related to clinical conditions. This mini review offers an overview of the development and application of mass spectrometric immunoassays for clinical and population proteomics studies. Provided are examples of some recent developments, and also discussed are the trends and challenges in mass spectrometry-based immunoassays for the next-phase of clinical applications.

  5. Incidence of clinical symptoms during long-duration orbital spaceflight

    Science.gov (United States)

    Crucian, Brian; Babiak-Vazquez, Adriana; Johnston, Smith; Pierson, Duane L; Ott, C Mark; Sams, Clarence

    2016-01-01

    Background The environment of spaceflight may elevate an astronaut’s clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical “incidence” data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS). Methods Electronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20.57 total flight years. Incidence for immunological-related adverse health events or relevant clinical symptoms was tabulated in a non-identifiable fashion. Event categories included infectious diseases, allergies, and rashes/hypersensitivities. A subsequent re-evaluation of more notable events, either of prolonged duration or unresponsive to treatment, was performed. Results For the disease/symptom categories used in this evaluation, the ISS incidence rate was 3.40 events per flight year. Skin rashes were the most reported event (1.12/flight year) followed by upper respiratory symptoms (0.97/flight year) and various other (non-respiratory) infectious processes. During flight, 46% of crew members reported an event deemed “notable”. Among the notable events, 40% were classified as rashes/hypersensitivities. Characterization of on-orbit rashes manifested as redness with irritation, and could present on a variety of body locations. Conclusion Based on reported symptoms, astronauts experience adverse medical events of varying severity during long-duration spaceflights. The data suggests caution, from both a vehicle design and biomedical countermeasures perspective, as space agencies plan for prolonged deep space exploration missions. PMID:27843335

  6. Misdiagnosis and clinical significance of non-tuberculous ...

    African Journals Online (AJOL)

    2011-09-09

    Sep 9, 2011 ... MISDIAGNOSIS AND CLINICAL SIGNIFICANCE OF NON-TUBERCULOUS MYCOBACTERIA IN WESTERN KENYA. IN THE ERA OF HUMAN ... Mycobacterium cM and genotype® Mycobacterium as kits. consenting clients were screened for hiv ..... M. ulcerans are fastidious and require special nutrient.

  7. Identification of clinically significant drug-drug interactions in cardiac ...

    African Journals Online (AJOL)

    Purpose: To identify clinically significant potential drug-drug interactions in cardiac intensive care units of two tertiary care hospitals in Peshawar, Pakistan, and to compare the various potential drug-drug interactions related parameters between the government and private hospitals included in the study. Method: A ...

  8. Novel perspectives on diagnosis and clinical significance of the post-thrombotic syndrome in children.

    Science.gov (United States)

    Jones, Sophie; Newall, Fiona; Monagle, Paul

    2016-10-01

    Given the increase in venous thromboembolic events (VTE) in children, the incidence, diagnosis and management of post thrombotic syndrome (PTS) in children is of increasing interest. Current challenges facing clinicians caring for children with VTE is the limited evidence of the long-term outcomes for this cohort; specifically the significance and potential functional impairment associated with PTS. This paper reviews the current evidence to elucidate the risk factors for PTS in children, methods for diagnosis and management of PTS in children (aged less than 18 years). Medline, Cinahl and PsycINFO database searches were undertaken using key search terms. Priority areas in need of further research are highlighted. Expert commentary: The two paediatric PTS assessment tools currently in use have been acknowledged to overcall the incidence of mild PTS in children. A PTS tool's ability to distinguish between clinically significant PTS and mild PTS is crucial. Variation in how PTS has been reported in children across the literature suggests that the real incidence of moderate and /or clinically significant PTS in children is unknown. Furthermore, evidence is lacking about the functional impairment experienced by children with clinically significant PTS and what this means for their long-term health.

  9. Clinical significance of gamma camera renography in chronic renal insufficiency

    International Nuclear Information System (INIS)

    Dudczak, R.; Frischauf, H.; Kletter, K.

    1980-01-01

    Gamma camera renography allows, together with renal imaging, an evaluation of individual renal function. For these examinations, I 123 orthoiodohippurate is preferred and most widely used. The results on patients with chronic renal insufficiency, including urologic and posttransplantation patients, are reported. Whereas the method is of clinical significance in evaluating posttransplantation complications and in assessing individual kidney function preoperatively in urology, as well as in monitoring therapeutic effects in the early period of renal disease, it is of limited diagnostic value in chronic renal insufficiency. In this latter regard, clinical and laboratory examinations are of primary importance. (author)

  10. Clinical implications of medulloblastoma subgroups: incidence of CSF diversion surgery.

    Science.gov (United States)

    Schneider, Christian; Ramaswamy, Vijay; Kulkarni, Abhaya V; Rutka, James T; Remke, Marc; Tabori, Uri; Hawkins, Cynthia; Bouffet, Eric; Taylor, Michael D

    2015-03-01

    While medulloblastoma was initially thought to comprise a single homogeneous entity, it is now accepted that it in fact comprises 4 discrete subgroups, each with its own distinct demographics, clinical presentation, transcriptomics, genetics, and outcome. Hydrocephalus is a common complication of medulloblastoma and not infrequently requires CSF diversion. The authors report the incidence of CSF diversion surgery in each of the subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). The medical and imaging records for patients who underwent surgery for medulloblastoma at The Hospital for Sick Children were retrospectively reviewed. The primary outcome was the requirement for CSF diversion surgery either before or within 60 days of tumor resection. The modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH) was compared among subgroups. Of 143 medulloblastoma patients, treated from 1991 to 2013, sufficient data were available for 130 patients (15 with Wnt, 30 with Shh, 30 with Group 3, and 55 with Group 4 medulloblastomas). Of these, 28 patients (22%) ultimately underwent CSF diversion surgery: 0% with Wnt, 29% with Shh, 29% with Group 3, and 43% with Group 4 tumors. Patients in the Wnt subgroup had a lower incidence of CSF diversion than all other patients combined (p = 0.04). Wnt patients had a lower mCPPRH score (lower risk of CSF diversion, p = 0.045), were older, had smaller ventricles at diagnosis, and had no leptomeningeal metastases. The overall rate of CSF diversion surgery for Shh, Group 3, and Group 4 medulloblastomas is around 30%, but no patients in the present series with a Wnt medulloblastoma required shunting. The low incidence of hydrocephalus in patients with Wnt medulloblastoma likely reflects both host factors (age) and disease factors (lack of metastases). The absence of hydrocephalus in patients with Wnt medulloblastomas likely contributes to their excellent rate of survival and may also contribute to a higher quality

  11. Clinical Significance of Autoantibodies in Some Thyroid Disorders

    International Nuclear Information System (INIS)

    Choi, Sung Kyu; Han, Sang Ho; Kim, Young Ju; Song, Jun Ho; Lee, Man Ho; Chung, Eul Sun; Lee, Sang Jong

    1984-01-01

    Clinical measurement of thyroid autoantibodies in sera of some thyroid disorders have been widely applied since about twenty years ago. We investigated the incidence and titers of both antimicrosomal and antithyroglobulin antibodies in forty eight cases with controls and one hundred and thirty three patients with some form of thyroid disorders. The results were as follows; 1) In controls, antimicrosomal antibodies were positive in 2% but antithyroglobulin antibodies were all negative. 2) In a series of one hundred and thirty three patients with thyroid disease, antimicrosomal antibodies were positive in 44% but antithyroglobulin antibodies were positive in only 15%. 3) The rate disclosing the positive results of antimicrosomal antibodies were 71% in Hashimoto disease, 60% in Graves' disease, and 38% in primary hypothyroidism, respectively. On the other hand, the positive results of antithyroglobulin antibodies showed 21% in Graves' disease, 19% in primary hypothyroidism, and 18% in Hashimoto, disease, respectively. Though there were relatively high rate of both antimicrosomal and antithyroglobulin antibodies in patients with nodular goiter, they were only seven cases in our series. 4) The rate with the extremely high titers of antimicrosomal and antithyroglobulin antibodies (>1 : 160 2 ) was 83% and 67% in Hashimoto's disease, 50% and 67% in primary hypothyroidism, and 41% and 18% in Graves' disease. Accordingly, the thyroid autoantibodies, were commonly found higher positive rate in patients with Hashimoto disease, primary hypothyroidism, and Graves' disease. Among these disorders, the extremely high positive rate of the thyroid autoantibodies was found in patients with Hashimoto's disease.

  12. Assessing the clinical significance of tumor markers in common neoplasms.

    Science.gov (United States)

    Beketic-Oreskovic, Lidija; Maric, Petra; Ozretic, Petar; Oreskovic, Darko; Ajdukovic, Mia; Levanat, Sonja

    2012-06-01

    The term tumor markers include a spectrum of molecules and substances with widely divergent characteristics whose presence in the significant amount can be related to the malignant disease. An ideal tumor marker should have high specificity and sensitivity, which would allow its use in early diagnosis and prognosis of malignant disease, as well as in prediction of therapeutic response and follow-up of the patients. Numerous biochemical entities have emerged as potentially valuable tumor markers so far, but only few markers showed to be of considerable clinical reliability and have been accepted into standard clinical practice. Recent development of genomics and proteomics has enabled the examination of many new potential tumor markers. Scientific studies on discovery, development, and application of tumor markers have been proceeding quite rapidly providing great opportunities for improving the management of cancer patients. This review is focusing on the clinical usefulness of various tumor markers already in clinical practice as well as certain potential markers, giving a brief description of their prognostic and predictive significance in most common malignancies.

  13. Incidence and significance of FLT3-ITD and NPM1 mutations in patients with normal karyotype acute myeloid leukaemia.

    LENUS (Irish Health Repository)

    Haslam, K

    2012-02-01

    BACKGROUND: Acute myeloid leukaemia (AML) is a heterogeneous clonal disorder of haematopoietic progenitor cells. Approximately half of all adult AML patients have a normal karyotype (NK-AML) and an intermediate risk prognosis. AIMS: To determine the incidence and prognostic significance of NPM1 and FLT3-ITD mutations in a population of patients with NK-AML. METHODS: FLT3-ITD and NPM1 mutation status was retrospectively sought in presentation samples from 44 NK-AML patients. RESULTS: FLT3-ITD and NPM1 mutations were detected in 45.5 and 54.5% of patients, respectively, allowing stratification according to genotype. CONCLUSIONS: FLT3-ITD and NPM1 mutation status can be defined in NK-AML. Prospective screening for these mutations is advocated in all NK-AML patients, as the genotype is of clinical importance when considering treatment options including stem cell transplantation.

  14. Incidence of Dermatomyositis and Clinically Amyopathic Dermatomyositis: A Population-Based Study in Olmsted County, Minnesota

    Science.gov (United States)

    Reeder, Margo J.; Wetter, David A.; Li, Xujian; Davis, Mark D. P.

    2010-01-01

    Objective To identify new and existing cases of dermatomyositis and its subtypes in Olmsted County, Minnesota, from 1976 through 2007, and to establish a population-based estimate of the incidence and prevalence of dermatomyositis and amyopathic dermatomyositis. Design Retrospective population-based study. Setting Community-based epidemiology project. Patients Using the Rochester Epidemiology Project, patients with a diagnosis of dermatomyositis were identified. Main Outcome Measures Incidence of dermatomyositis and clinically amyopathic dermatomyositis; risk of malignancy in clinically amyopathic dermatomyositis. Results Of the 29 patients identified, 6 (21%) of these had the clinically amyopathic subtype of dermatomyositis, and 22 (76%) were female. Overall age- and sex-adjusted incidence (95% confidence interval) of dermatomyositis including all subtypes was 9.63 (6.09-13.17) per 1,000,000 and was 2.08 (0.39-3.77) per 1,000,000 for clinically amyopathic dermatomyositis. Age- and sex-adjusted prevalence was 21.42 (13.07-29.77) per 100,000. Eight patients (28%) had a malignancy during the study period; risk of malignancy (odds ratio) for classic dermatomyositis compared with clinically amyopathic dermatomyositis was 4.61 but was not statistically significant (0.22-96.09) (P=.44). Conclusions Dermatomyositis is a rare disease, and clinically amyopathic dermatomyositis represents an estimated 20% of all dermatomyositis cases. Larger population-based studies are needed to estimate the risk of malignancy associated with subtypes of dermatomyositis, particularly clinically amyopathic dermatomyositis. PMID:20083689

  15. Multiparametric MRI in the detection of clinically significant prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Futterer, Jurgen J. [Dept. of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen (Netherlands)

    2017-08-01

    Prostate cancer is the most common cancer among men aged 50 years and older in developed countries and the third leading cause of cancer-related death in men. Multiparametric prostate MR imaging is currently the most accurate imaging modality to detect, localize, and stage prostate cancer. The role of multi-parametric MR imaging in the detection of clinically significant prostate cancer are discussed. In addition, insights are provided in imaging techniques, protocol, and interpretation.

  16. Clinical Significance of Microsatellite Instability in Sporadic Epithelial Ovarian Tumors

    OpenAIRE

    Yoon, Bo-Sung; Kim, Young-Tae; Kim, Jae-Hoon; Kim, Sang-Wun; Nam, Eun-Ji; Cho, Nam-Hoon; Kim, Jae-Wook; Kim, Sunghoon

    2008-01-01

    Purpose We evaluated the expression of microsatellite instability (MSI) in sporadic ovarian tumors using 5 standard and 9 new MSI markers to determine the clinical significance of MSI in sporadic epithelial ovarian tumors. Materials and Methods MSI was examined in 21 borderline and 25 malignant ovarian tumors. Polymerase chain reaction (PCR) was performed using the 5 markers recommended by the National Cancer Institute (NCI) for colon cancer and 9 additional markers. MSI was determined using ...

  17. [Clinical significance of positive sputum culture for filamentous fungi].

    Science.gov (United States)

    Shi, Xiao-Chun; Liu, Zheng-Yin; Xu, Ying-Chun; Wang, Ai-Xia

    2010-01-26

    To investigate the clinical significance of positive sputum culture for filamentous fungi. The medical data of 140 patients positive for filamentous fungi in sputum culture at Peking Union Medical College Hospital were reviewed retrospectively. Based on the diagnostic criteria by European Organization for Research and Treatment of Cancer/Mycoses Study Group, invasive pulmonary fungal infection (IPFI) was diagnosed. The clinical characteristics of cases with and without IPFI were analyzed respectively. Among all 140 cases positive for filamentous fungi in sputum culture, only 22 cases could be diagnosed as IPFI. Two of 22 IPFI cases were confirmed by post-operative pathology, 1 case was confirmed by positive blood culture for filamentous fungi and the remaining 19 cases were diagnosed clinically according to the nature of hosts, characteristics of pulmonary infections and microbiological evidence (positive sputum culture for filamentous fungi, 2 - 5 times for each case). Most of etiological fungi in IPFI patients belonged to Aspergillus. And the identity of isolated fungal strain was mostly one strain for each patient. In IPFI group, patients who had been treated with broad-spectrum antibiotics (100%), steroids (13, 59.1%) or immunosuppressant (7, 31.8%) or who had pulmonary X-ray imaging changes (100%), primary diseases (21, 95.5%), hypoalbuminemia (18, 81.8%) or hemoptysis (10, 45.5%), were significantly more than those in non-IPFI group (66.9%, 34.7%, 18.6%, 79.7%, 72.0%, 45.8% and 4.2% respectively; P significance of positive sputum culture for filamentous fungi are associated with the times of positive culture, the number and species of isolated fungal strains. Meanwhile it is important to determine whether there is IPFI according to the nature and clinical characteristics of patients.

  18. Clinical significance of intramammary arterial calcifications in diabetic women

    Directory of Open Access Journals (Sweden)

    Milošević Zorica

    2004-01-01

    Full Text Available Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient’s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2, as well as of 208 nondiabetic women (the control group were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001. Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001, while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age in relation to the control group (p=0.176. The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3% in comparison to the group without calcifications (26.1%, (p=0.005. The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by

  19. Expression and clinical significance of Pax6 gene in retinoblastoma

    Directory of Open Access Journals (Sweden)

    Hai-Dong Huang

    2013-07-01

    Full Text Available AIM: To discuss the expression and clinical significance of Pax6 gene in retinoblastoma(Rb. METHODS: Totally 15 cases of fresh Rb organizations were selected as observation group and 15 normal retinal organizations as control group. Western-Blot and reverse transcriptase polymerase chain reaction(RT-PCRmethods were used to detect Pax6 protein and Pax6 mRNA expressions of the normal retina organizations and Rb organizations. At the same time, Western Blot method was used to detect the Pax6 gene downstream MATH5 and BRN3b differentiation gene protein level expression. After the comparison between two groups, the expression and clinical significance of Pax6 gene in Rb were discussed. RESULTS: In the observation group, average value of mRNA expression of Pax6 gene was 0.99±0.03; average value of Pax6 gene protein expression was 2.07±0.15; average value of BRN3b protein expression was 0.195±0.016; average value of MATH5 protein expression was 0.190±0.031. They were significantly higher than the control group, and the differences were statistically significant(PCONCLUSION: Abnormal expression of Pax6 gene is likely to accelerate the occurrence of Rb.

  20. 42 CFR 405.2452 - Services and supplies incident to clinical psychologist and clinical social worker services.

    Science.gov (United States)

    2010-10-01

    ... psychologist and clinical social worker services. 405.2452 Section 405.2452 Public Health CENTERS FOR MEDICARE... Qualified Health Center Services § 405.2452 Services and supplies incident to clinical psychologist and clinical social worker services. (a) Services and supplies incident to a clinical psychologist's or...

  1. Subclassification of autoimmune pancreatitis: a histologic classification with clinical significance.

    Science.gov (United States)

    Deshpande, Vikram; Gupta, Rajib; Sainani, Nisha; Sahani, Dushyant V; Virk, Renu; Ferrone, Cristina; Khosroshahi, Arezou; Stone, John H; Lauwers, Gregory Y

    2011-01-01

    Autoimmune pancreatitis (AIP) is a chronic inflammatory disease of the pancreas. Examination of pancreatic resection specimens from patients with AIP has shown that there are 2 subclasses of this disease. However, there is no widely accepted pathologic classification scheme and the clinical significance of such a classification remains to be established. In this study, we revisited the subclassification of AIP and examine whether this provides clinically and prognostically meaningful information. We evaluated 29 pancreatic resection specimens from patients with AIP. Demographic, clinical, and imaging data were recorded, as was evidence of extrapancreatic manifestations. In addition to a detailed and semiquantitative histologic evaluation, immunohistochemistry for IgG4 was performed on pancreatic and extrapancreatic tissues. We also evaluated 48 consecutive cases of chronic pancreatitis, not otherwise specified. The resected specimens could readily be subclassified into 2 subtypes: type 1 (n=11) and type 2 (n=18). In comparison with patients with type 2 disease, patients with type 1 disease were significantly more likely to be males (P=0.09), older (P=0.02), and present with jaundice (P=0.01), and less likely to be associated with abdominal pain (P=0.04). On imaging, the pancreatic tail cut-off sign was exclusively seen in patients with type 2 disease (4 of 10 cases). Hypercellular inflamed interlobular stroma was unique to type 1 pattern (91%), whereas significant ductal injury in the form of microabscesses and ductal ulceration was almost exclusively seen in type 2 pattern (78%). Eight of 10 patients with a type 1 pattern had evidence of a systemic disease. Three patients with type 2 disease had recurrent episodes of pancreatitis after their pancreatic resection. In comparison with the cohort of chronic pancreatitis, not otherwise specified, type 2 AIP cases were less likely to be associated with a history of alcohol abuse, and showed significantly more foci of

  2. Clinical significance of Phosphatidyl Inositol Synthase overexpression in oral cancer

    International Nuclear Information System (INIS)

    Kaur, Jatinder; Sawhney, Meenakshi; DattaGupta, Siddartha; Shukla, Nootan K; Srivastava, Anurag; Ralhan, Ranju

    2010-01-01

    We reported increased levels of Phosphatidyl Inositol synthase (PI synthase), (enzyme that catalyses phosphatidyl inositol (PI) synthesis-implicated in intracellular signaling and regulation of cell growth) in smokeless tobacco (ST) exposed oral cell cultures by differential display. This study determined the clinical significance of PI synthase overexpression in oral squamous cell carcinoma (OSCC) and premalignant lesions (leukoplakia), and identified the downstream signaling proteins in PI synthase pathway that are perturbed by smokeless tobacco (ST) exposure. Tissue microarray (TMA) Immunohistochemistry, Western blotting, Confocal laser scan microscopy, RT-PCR were performed to define the expression of PI synthase in clinical samples and in oral cell culture systems. Significant increase in PI synthase immunoreactivity was observed in premalignant lesions and OSCCs as compared to oral normal tissues (p = 0.000). Further, PI synthase expression was significantly associated with de-differentiation of OSCCs, (p = 0.005) and tobacco consumption (p = 0.03, OR = 9.0). Exposure of oral cell systems to smokeless tobacco (ST) in vitro confirmed increase in PI synthase, Phosphatidylinositol 3-kinase (PI3K) and cyclin D1 levels. Collectively, increased PI synthase expression was found to be an early event in oral cancer and a target for smokeless tobacco

  3. Clinical mastitis in Spanish dairy cows: incidence and costs

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Cabal, M. A.; Yaici, S.; Alenda, R.

    2008-07-01

    Clinical mastitis in Spanish dairy herds has been studied. Since April 2005 up to December 2006, in 25 Spanish herds 1,054 cases registered were available. Aims were to determine mastitis incidence and factors of risk, to analyze whether yield production has been affected, and to quantify mastitis costs along 2006. The 25% lactations were infected at least once with average recurrence of 1.64. Descriptive analysis showed that 29% of cases occurred within the first month after calving. Primiparous showed higher mastitis frequency at early and late lactation while in multiparous cases number was progressively decreasing since the first month. Multiparous were statistically more liable to mastitis than primiparous. Mastitis did not show effect on yield production. Mastitis costs included treatment products and discarded milk. Individual daily production at each case onset was estimated by using monthly official milking records. An average mastitis case cost was 73.93, cheaper in primiparous than in multiparous because of lower milk production. Average discarded milk represented 74% of total cost per case. Mastitis costs were 117 per infected cow and lactation. Then, annual economic losses due to mastitis were 3,190 per average herd, showing the concern of producers on selecting resistant animals as well as the importance of the implementation of systematic recording for clinical mastitis in Spanish dairy farms. Additional key words: genetic selection, udder health. (Author) 28 refs.

  4. The prostate health index selectively identifies clinically significant prostate cancer.

    Science.gov (United States)

    Loeb, Stacy; Sanda, Martin G; Broyles, Dennis L; Shin, Sanghyuk S; Bangma, Chris H; Wei, John T; Partin, Alan W; Klee, George G; Slawin, Kevin M; Marks, Leonard S; van Schaik, Ron H N; Chan, Daniel W; Sokoll, Lori J; Cruz, Amabelle B; Mizrahi, Isaac A; Catalona, William J

    2015-04-01

    The Prostate Health Index (phi) is a new test combining total, free and [-2]proPSA into a single score. It was recently approved by the FDA and is now commercially available in the U.S., Europe and Australia. We investigate whether phi improves specificity for detecting clinically significant prostate cancer and can help reduce prostate cancer over diagnosis. From a multicenter prospective trial we identified 658 men age 50 years or older with prostate specific antigen 4 to 10 ng/ml and normal digital rectal examination who underwent prostate biopsy. In this population we compared the performance of prostate specific antigen, % free prostate specific antigen, [-2]proPSA and phi to predict biopsy results and, specifically, the presence of clinically significant prostate cancer using multiple criteria. The Prostate Health Index was significantly higher in men with Gleason 7 or greater and "Epstein significant" cancer. On receiver operating characteristic analysis phi had the highest AUC for overall prostate cancer (AUCs phi 0.708, percent free prostate specific antigen 0.648, [-2]proPSA 0.550 and prostate specific antigen 0.516), Gleason 7 or greater (AUCs phi 0.707, percent free prostate specific antigen 0.661, [-2]proPSA 0.558, prostate specific antigen 0.551) and significant prostate cancer (AUCs phi 0.698, percent free prostate specific antigen 0.654, [-2]proPSA 0.550, prostate specific antigen 0.549). At the 90% sensitivity cut point for phi (a score less than 28.6) 30.1% of patients could have been spared an unnecessary biopsy for benign disease or insignificant prostate cancer compared to 21.7% using percent free prostate specific antigen. The new phi test outperforms its individual components of total, free and [-2]proPSA for the identification of clinically significant prostate cancer. Phi may be useful as part of a multivariable approach to reduce prostate biopsies and over diagnosis. Copyright © 2015 American Urological Association Education and Research

  5. Ferritin. Radioimmunological determination in serum and clinical significance

    International Nuclear Information System (INIS)

    Kaltwasser, J.P.; Werner, E.; Gesellschaft fuer Strahlen- und Umweltforschung m.b.H., Frankfurt am Main

    1977-01-01

    Ferritin is an iron storage protein which has been shown to be present in blood serum only recently. An immunoradiometric determination of ferritin in 324 subjects with different iron stores is reported. In healthy men and women a ferritin concentration of 131 μg/l (SD: 1.59) and 67 μg/l (SD: 1.79) was found respectively. In male and female blood donors as well as patients with iron deficiency and iron overload significant differences of serum ferritin concentration could be demonstrated. In clinical practice the determination of serum ferritin is a valuable method for the estimation of body iron stores. (orig.) [de

  6. Clinical significance of CRNDE transcript variants in glioblastoma multiforme

    Directory of Open Access Journals (Sweden)

    Karrie M.Y. Kiang

    2017-06-01

    Full Text Available The long non-coding RNA CRNDE is an oncogene that promotes tumor growth in glioblastoma multiforme (GBM. At least five CRNDE transcript variants with possibly different functional roles have been described in recent studies. Here, we report our preliminary findings on the differential expressions of CRNDE transcript variants in GBM, and their prognostic significance. Our preliminary data suggest that different transcript variants of CRNDE might have different functions in GBM and should be further studied as potential biomarkers for clinical prognostication. Keywords: Long non-coding RNA, CRNDE, Transcript variant, Glioblastoma

  7. Nocturnal leg cramps in children: incidence and clinical characteristics.

    Science.gov (United States)

    Leung, A. K.; Wong, B. E.; Chan, P. Y.; Cho, H. Y.

    1999-01-01

    The records of 2527 healthy children seen in an ambulatory care clinic were evaluated for nocturnal leg cramps in the preceding 12 months, frequency and duration of the cramps, whether the cramps affected one leg or both legs at a time, whether there was associated muscle cramps in feet, whether the cramps occurred when the child was awake or asleep, and whether there was residual tenderness in the affected muscles. Nocturnal leg cramps were present in 185 children for an overall incidence of 7.3%. Leg cramps were noted only in children aged > or = 8 years. The incidence increased at 12 years and peaked at 16 to 18 years of age. A majority (81.6%) of the affected children had nocturnal leg cramps 1 to 4 times per year. The mean duration of episodes was 1.7 minutes. Leg cramps were unilateral in 98.9% of cases and the ipsilateral foot also was involved in 18.9% of cases. One hundred thirty-five (73%) children had leg cramps while asleep, and the remaining 23 (12.4%) children had leg cramps in either state. Fifty-seven (30.8%) children had residual tenderness in the affected muscles. The mean duration of residual tenderness was 33.2 minutes (range: 2 minutes-1 day). We conclude that nocturnal leg cramps are common in children aged > 12 years. A majority of the affected children have leg cramps 1 to 4 times per year. The cramps are usually unilateral and occur when the children are asleep. Normal duration of the leg cramp is < 2 minutes. Residual tenderness is present in approximately 30% of the affected children. Residual tenderness, if present, usually lasts for half an hour. PMID:10388258

  8. Angiogenesis in salivary gland tumors: from clinical significance to treatment.

    Science.gov (United States)

    Theocharis, Stamatios; Gribilas, George; Giaginis, Constantinos; Patsouris, Efstratios; Klijanienko, Jerzy

    2015-06-01

    Salivary gland tumors (SGTs) represent a rare cancer entity, consisting of various morphological features that complicate diagnosis. Their diversity in terms of morphology and clinical course makes defining risk factors difficult, while the molecular steps responsible for SGT development remain unclear. Angiogenesis, a hallmark of cancer development, is considered as an attractive target. This review aims to summarize the available research regarding angiogenesis in SGTs from clinical significance to treatment options. The available data suggest that microvessel density (MVD) evaluation may be capable of discriminating between benign and malignant SGTs, while the use of CD105 antibody seems to be the most suitable. Substantial evidence also suggests that MVD and VEGF expression could be used as prognostic factors in malignant SGTs. Although several agents have shown antiangiogenic activities in adenoid cystic carcinoma cells and xenograft tumors, limited effectiveness in the existing clinical trials was noted. Further studies are strongly recommended for the validation of already well-known and the identification of novel prognostic and predictive angiogenic markers. There is also a strong demand for relatively larger cohorts, homogenous samples referring to same histological SGT subtypes and including an equivalent number of low- and high-grade SGTs.

  9. Dog and cat respiratory capilariasis - clinical, parasitological and epidemiological significance

    Directory of Open Access Journals (Sweden)

    Ilić Tamara

    2015-01-01

    Full Text Available Respiratory capillariasis is a disease of domestic and wild carnivores as well as of people, caused by nematode Eucoleus aerophilus syn. Capillaria aerophila, which lives as a parasite in mucosa of trachea, bronchi and bronchioles, rarely in nasal and frontal sinuses of the host. This parasite has either direct or indirect development cycle which includes optional transition hosts - earthworms. Clinical picture is manifested in the form of a very severe respiratory disease, which is accompanied by an increased bronchovesicular sound, sneezing, gasping and chronic dry cough. Despite the fact that this nematode is widespread in all the parts of the world, that it causes a disease followed by a severe clinical picture and has a zoonotic potential as well, it has been insufficiently investigated and moreover from clinical and parasitological aspect it has not been given enough attention so far. The reason for this is the fact that C. aerophila had been considered to be a strain of very low level of pathogenicity causing only sporadic respiratory infections in dogs and cats. The interest of scientific community for this parasitosis increased the moment when its causative agent spread outside the endemic areas. From the standpoint of monitoring and health protection of both carnivores and peorle, knowledge of basic epizootiological and epidemiological characteristics of these nematodes is of crucial importance, having in mind that its prevalence has significantly increased in dogs and cats in the last ten years, both in Europe and worldwide.

  10. Communicating risk: news media reportage of a significant nuclear contamination incident in the UK

    International Nuclear Information System (INIS)

    Walker, G.P.; Macgill, S.M.

    1988-02-01

    The way the mass media reported a controversial discharge incident at British Nuclear Fuel's reprocessing plant at Sellafield in Cumbria in November 1983 is discussed. Apart from the Windscale fire in 1957 this was the most serious radiation incident at any nuclear installation in the United Kingdom. The aim of the study was to use that incident to develop a more complete understanding of the way information about risk is communicated through the news media. Two issues, in particular, are assessed. First, the accuracy of the reports of events and how factual, technical or scientific aspects of risk are portrayed through the news media. Secondly, risk evaluation is studied: what value judgements are made, what sentiments of alarm, danger and hazard are presented. (author)

  11. Workload and clinical significance of the isolation of zygomycetes in a tertiary general hospital.

    Science.gov (United States)

    Torres-Narbona, M; Guinea, J; Martínez-Alarcón, J; Muñoz, P; Peláez, T; Bouza, E

    2008-05-01

    Several reports of increases in invasive zygomycosis (IZ) at individual institutions across the USA and Europe have contributed to a generalized concept that IZ is an increasing problem and the overestimation of the clinical significance of the isolation of zygomycetes in microbiology departments. We assessed the workload and clinical significance of zygomycetes isolates recovered from clinical samples in our institution over a 19-year period (1988-2006). We retrospectively reviewed the charts of those patients from who isolates of zygomycetes were obtained and calculated the workload of its isolation, the incidence of IZ during this period and the positive predictive value (PPV) of a positive culture. Zygomycetes were recovered from 210 samples (176 patients), i.e., 0.086/1,000 clinical samples processed and 6.3/1,000 samples submitted for fungal isolation. Zygomycetes represented 0.6% of the total fungi recovered. The mean incidence of the disease was 1.2 cases/100,000 admissions (range 0-20). Only 16 of the samples which grew zygomycetes (7.6%) were from infected patients. The workload generated by zygomycetes in our institution and the PPV for IZ of their isolation in our laboratory were very low and the disease was not found to have significantly increased in recent years in our institution. Data from specific institutions cannot be generalized.

  12. The Clinical Significance of Unknown Sequence Variants in BRCA Genes

    International Nuclear Information System (INIS)

    Calò, Valentina; Bruno, Loredana; Paglia, Laura La; Perez, Marco; Margarese, Naomi; Gaudio, Francesca Di; Russo, Antonio

    2010-01-01

    Germline mutations in BRCA1/2 genes are responsible for a large proportion of hereditary breast and/or ovarian cancers. Many highly penetrant predisposition alleles have been identified and include frameshift or nonsense mutations that lead to the translation of a truncated protein. Other alleles contain missense mutations, which result in amino acid substitution and intronic variants with splicing effect. The discovery of variants of uncertain/unclassified significance (VUS) is a result that can complicate rather than improve the risk assessment process. VUSs are mainly missense mutations, but also include a number of intronic variants and in-frame deletions and insertions. Over 2,000 unique BRCA1 and BRCA2 missense variants have been identified, located throughout the whole gene (Breast Cancer Information Core Database (BIC database)). Up to 10–20% of the BRCA tests report the identification of a variant of uncertain significance. There are many methods to discriminate deleterious/high-risk from neutral/low-risk unclassified variants (i.e., analysis of the cosegregation in families of the VUS, measure of the influence of the VUSs on the wild-type protein activity, comparison of sequence conservation across multiple species), but only an integrated analysis of these methods can contribute to a real interpretation of the functional and clinical role of the discussed variants. The aim of our manuscript is to review the studies on BRCA VUS in order to clarify their clinical relevance

  13. The Clinical Significance of Unknown Sequence Variants in BRCA Genes

    Energy Technology Data Exchange (ETDEWEB)

    Calò, Valentina; Bruno, Loredana; Paglia, Laura La; Perez, Marco; Margarese, Naomi [Department of Surgery and Oncology, Regional Reference Center for the Biomolecular Characterization and Genetic Screening of Hereditary Tumors, University of Palermo, Via del Vespro 127, 90127 Palermo (Italy); Gaudio, Francesca Di [Department of Medical Biotechnologies and Legal Medicine, University of Palermo, Palermo (Italy); Russo, Antonio, E-mail: lab-oncobiologia@usa.net [Department of Surgery and Oncology, Regional Reference Center for the Biomolecular Characterization and Genetic Screening of Hereditary Tumors, University of Palermo, Via del Vespro 127, 90127 Palermo (Italy)

    2010-09-10

    Germline mutations in BRCA1/2 genes are responsible for a large proportion of hereditary breast and/or ovarian cancers. Many highly penetrant predisposition alleles have been identified and include frameshift or nonsense mutations that lead to the translation of a truncated protein. Other alleles contain missense mutations, which result in amino acid substitution and intronic variants with splicing effect. The discovery of variants of uncertain/unclassified significance (VUS) is a result that can complicate rather than improve the risk assessment process. VUSs are mainly missense mutations, but also include a number of intronic variants and in-frame deletions and insertions. Over 2,000 unique BRCA1 and BRCA2 missense variants have been identified, located throughout the whole gene (Breast Cancer Information Core Database (BIC database)). Up to 10–20% of the BRCA tests report the identification of a variant of uncertain significance. There are many methods to discriminate deleterious/high-risk from neutral/low-risk unclassified variants (i.e., analysis of the cosegregation in families of the VUS, measure of the influence of the VUSs on the wild-type protein activity, comparison of sequence conservation across multiple species), but only an integrated analysis of these methods can contribute to a real interpretation of the functional and clinical role of the discussed variants. The aim of our manuscript is to review the studies on BRCA VUS in order to clarify their clinical relevance.

  14. Clinical Significance of CK19 Negative Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fujisue, Mamiko, E-mail: nishimura.reiki@cityhosp-kumamoto.jp; Nishimura, Reiki; Okumura, Yasuhiro [Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto City, Kumamoto 862-8505 (Japan); Tashima, Rumiko [Department of Surgery, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto City, Kumamoto 862-8505 (Japan); Nishiyama, Yasuyuki; Osako, Tomofumi [Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto City, Kumamoto 862-8505 (Japan); Toyozumi, Yasuo; Arima, Nobuyuki [Department of Pathology, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto City, Kumamoto 862-8505 (Japan)

    2012-12-21

    Analysis of sentinel lymph nodes (SLNs) by means of One-Step Nucleic Acid Amplification (OSNA) is gaining widespread use as a quick and accurate method. This assay detects the expression level of cytokeratin 19 (CK19) which is present in some but not all breast tumors. In this study, the clinical significance of negative CK19 was investigated in 219 cases of primary breast cancer. In 179 patients with clinically negative nodes, OSNA and imprint smear cytology of SLN were performed simultaneously. The OSNA revealed a node-positive rate of 24.6%. Negative CK19 correlated significantly with negative ER/PgR and higher Ki-67 values, and marginally with higher nuclear grade and p53 overexpression. The triple negative subtype showed lower CK19 expression. OSNA revealed that one of the negative CK19 cases was actually a false negative but this was corrected with the use of the imprint smear cytology. In conclusion, CK19 negativity reflected the aggressiveness of primary breast cancer. OSNA assay used to analyze SLN was useful, but there is a possibility that it will mistakenly detect false negatives in CK19 negative tumors. Therefore, in tumors with negative CK19, the imprint smear cytology may be more useful in cases with macrometastasis.

  15. Clinical Significance of CK19 Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    Nobuyuki Arima

    2012-12-01

    Full Text Available Analysis of sentinel lymph nodes (SLNs by means of One-Step Nucleic Acid Amplification (OSNA is gaining widespread use as a quick and accurate method. This assay detects the expression level of cytokeratin 19 (CK19 which is present in some but not all breast tumors. In this study, the clinical significance of negative CK19 was investigated in 219 cases of primary breast cancer. In 179 patients with clinically negative nodes, OSNA and imprint smear cytology of SLN were performed simultaneously. The OSNA revealed a node-positive rate of 24.6%. Negative CK19 correlated significantly with negative ER/PgR and higher Ki-67 values, and marginally with higher nuclear grade and p53 overexpression. The triple negative subtype showed lower CK19 expression. OSNA revealed that one of the negative CK19 cases was actually a false negative but this was corrected with the use of the imprint smear cytology. In conclusion, CK19 negativity reflected the aggressiveness of primary breast cancer. OSNA assay used to analyze SLN was useful, but there is a possibility that it will mistakenly detect false negatives in CK19 negative tumors. Therefore, in tumors with negative CK19, the imprint smear cytology may be more useful in cases with macrometastasis.

  16. The clinical significance of keratinized gingiva around dental implants.

    Science.gov (United States)

    Greenstein, Gary; Cavallaro, John

    2011-10-01

    Whether or not keratinized tissue is needed around dental implants to maintain peri-implant health is a controversial subject. To clarify this issue a search was conducted for clinical trials that appraised the significance ofkeratinized gingiva (KG) around teeth and dental implants. A critical assessment of the data revealed that the literature is replete with studies that contradict one another with respect to the need for KG as it relates to survivability of implants, gingival response to plaque, inflammation, probing depths, recession, and loss of bone. When groups of patients with and without KG were compared with respect to various clinical parameters, a statistically significant better result in the presence of KG could be interpreted to indicate that having KG is advantageous. However, quantitative differences between groups with and without KG were usually very small. Overall, the data was interpreted to indicate that some patients may need augmentation of keratinized tissue to maintain peri-implant health. Ultimately, the decision to augment KG is a judgment call that needs to be made by the treating clinician, because there are not enough data to facilitate development of definitive guidelines relevant to this subject. Apparently, the need for KG is patient specific, and at present there is no method to reliably predict who would benefit from tissue augmentation.

  17. Clinically significant change in stroke volume in pulmonary hypertension.

    Science.gov (United States)

    van Wolferen, Serge A; van de Veerdonk, Marielle C; Mauritz, Gert-Jan; Jacobs, Wouter; Marcus, J Tim; Marques, Koen M J; Bronzwaer, Jean G F; Heymans, Martijn W; Boonstra, Anco; Postmus, Pieter E; Westerhof, Nico; Vonk Noordegraaf, Anton

    2011-05-01

    Stroke volume is probably the best hemodynamic parameter because it reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular function in response to its load, without the correction of compensatory increased heart rate as is the case for cardiac output. For this reason, stroke volume, which can be measured noninvasively, is an important hemodynamic parameter to monitor during treatment. However, the extent of change in stroke volume that constitutes a clinically significant change is unknown. The aim of this study was to determine the minimal important difference (MID) in stroke volume in PH. One hundred eleven patients were evaluated at baseline and after 1 year of follow-up with a 6-min walk test (6MWT) and cardiac MRI. Using the anchor-based method with 6MWT as the anchor, and the distribution-based method, the MID of stroke volume change could be determined. After 1 year of treatment, there was, on average, a significant increase in stroke volume and 6MWT. The change in stroke volume was related to the change in 6MWT. Using the anchor-based method, an MID of 10 mL in stroke volume was calculated. The distribution-based method resulted in an MID of 8 to 12 mL. Both methods showed that a 10-mL change in stroke volume during follow-up should be considered as clinically relevant. This value can be used to interpret changes in stroke volume during clinical follow-up in PH.

  18. Expression and clinical significance of Wee1 in colorectal cancer.

    Science.gov (United States)

    Egeland, Eivind Valen; Flatmark, Kjersti; Nesland, Jahn M; Flørenes, Vivi Ann; Mælandsmo, Gunhild M; Boye, Kjetil

    2016-09-01

    Wee1 is a nuclear kinase regulating cell cycle progression, and has emerged as a promising therapeutic target in cancer. Expression of Wee1 has been associated with poor outcome in certain tumor types, but the prognostic impact and clinical significance in colorectal cancer is unknown. The expression of Wee1 was examined by immunohistochemistry in primary colorectal carcinomas from a prospectively collected patient cohort, and associations with clinicopathological parameters and outcome were investigated. Cell culture experiments were performed using the cell lines RKO and SW620, and the relationship with the metastasis-promoting protein S100A4 was investigated. Nuclear expression was detected in 229 of the 258 tumors analyzed (89 %). Wee1 staining was associated with low pT stage, but no other significant associations with demographic or histopathological variables were found. Moderate Wee1 staining intensity was a predictor of favorable metastasis-free and overall survival compared to strong intensity and no or weak staining. The fraction of positive cells was not a prognostic factor in the present cohort. Inhibition of Wee1 expression using siRNA or treatment with the Wee1 inhibitor MK-1775 reduced expression of the metastasis-promoting protein S100A4, but no relationship between Wee1 and S100A4 was found in the patient samples. In conclusion, Wee1 is highly expressed in primary colorectal carcinomas, but few relevant associations with clinicopathological parameters or outcome were found. The lack of clinical significance of Wee1 expression could indicate that other tumor types might be better suited for further development of Wee1 inhibitors.

  19. Glenohumeral arthritis after Latarjet procedure: Progression and it's clinical significance.

    Science.gov (United States)

    Kee, Young Moon; Kim, Hwan Jin; Kim, Jung Youn; Rhee, Yong Girl

    2017-09-01

    The risk factors of glenohumeral arthritis after the Latarjet procedure remain relatively unexplored. The purposes of this study are to evaluate the clinical significance of glenohumeral arthritis after the Latarjet procedure, and to investigate risk factors associated with arthritis progression. We evaluated 110 patients (110 shoulders) who underwent the Latarjet procedure for recurrent anterior shoulder instability. Patients had a mean age of 23.8 years (range, 14-52 years) at the time of the operation, and the mean duration of follow-up was 31 months (range, 24-111 months). At the last follow-up, the mean Visual Analog Scale (VAS), Rowe and University of California at Los Angeles (UCLA) scores significantly improved from 3.1, 36.5 and 23.6 points preoperatively to 1.6, 87.6 and 32.6 points (all P Latarjet procedure was in 20 shoulders (18.2%). At the final, overall prevalence of arthritis was 23.6% (26 shoulders). The non-arthritis group showed significantly better functional outcomes (VAS score: 0.9, Rowe Score: 89.3, UCLA score: 33.5) than the arthritis group (2.1, 84.9, 29.2; all P Latarjet procedure yielded satisfactory functional outcomes with low recurrent rate at mid-term follow-up. Development or progression of arthritis was observed in 18.2% of patients, postoperatively. Glenohumeral arthritis after the Latarjet procedure had an adverse effect on clinical outcome. Generalized laxity and lateral overhang should be considered as risk factors of progression to glenohumeral arthritis after the Latarjet procedure. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  20. Clinical significance of the corpus callosum in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Kim, Ji Chang [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Jong Chul [School of Medicine, Chungnam National University, Taejon (Korea, Republic of); And Others

    2000-10-01

    To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury.

  1. Prostate atypia: does repeat biopsy detect clinically significant prostate cancer?

    Science.gov (United States)

    Dorin, Ryan P; Wiener, Scott; Harris, Cory D; Wagner, Joseph R

    2015-05-01

    While the treatment pathway in response to benign or malignant prostate biopsies is well established, there is uncertainty regarding the risk of subsequently diagnosing prostate cancer when an initial diagnosis of prostate atypia is made. As such, we investigated the likelihood of a repeat biopsy diagnosing prostate cancer (PCa) in patients in which an initial biopsy diagnosed prostate atypia. We reviewed our prospectively maintained prostate biopsy database to identify patients who underwent a repeat prostate biopsy within one year of atypia (atypical small acinar proliferation; ASAP) diagnosis between November 1987 and March 2011. Patients with a history of PCa were excluded. Chart review identified patients who underwent radical prostatectomy (RP), radiotherapy (RT), or active surveillance (AS). For some analyses, patients were divided into two subgroups based on their date of service. Ten thousand seven hundred and twenty patients underwent 13,595 biopsies during November 1987-March 2011. Five hundred and sixty seven patients (5.3%) had ASAP on initial biopsy, and 287 (50.1%) of these patients underwent a repeat biopsy within one year. Of these, 122 (42.5%) were negative, 44 (15.3%) had atypia, 19 (6.6%) had prostatic intraepithelial neoplasia, and 102 (35.6%) contained PCa. Using modified Epstein's criteria, 27/53 (51%) patients with PCa on repeat biopsy were determined to have clinically significant tumors. 37 (36.3%) proceeded to RP, 25 (24.5%) underwent RT, and 40 (39.2%) received no immediate treatment. In patients who underwent surgery, Gleason grade on final pathology was upgraded in 11 (35.5%), and downgraded 1 (3.2%) patient. ASAP on initial biopsy was associated with a significant risk of PCa on repeat biopsy in patients who subsequently underwent definitive local therapy. Patients with ASAP should be counseled on the probability of harboring both clinically significant and insignificant prostate cancer. © 2015 Wiley Periodicals, Inc.

  2. Incidence, clinical features, treatment and outcome of primary central nervous system lymphoma in Norway.

    Science.gov (United States)

    Salvesen Haldorsen, Ingfrid; Aarseth, Jan Harald; Hollender, Aase; Larsen, John Ludvig; Espeland, Ansgar; Mella, Olav

    2004-01-01

    The incidence of primary central nervous system lymphoma (PCNSL) has been reported to increase in some parts of the world, while being stable in other regions. In an attempt to characterize the incidence rate, clinical features, treatment, outcome, and prognostic factors of PCNSL in Norway, we report our experience in a large unselected series of patients. Clinical features, histological diagnosis, radiological findings, treatment, and outcome of all patients diagnosed with PCNSL in Norway in the years 1989-1998 were registered. During the 10-year period 58 new cases of histologically verified PCNSL were registered in Norway. The annual incidence rate of PCNSL was on average 1.34 cases per million people with a non-significant increasing trend (p=0.069). For patients diagnosed before death (n=45) the estimated survival following histological diagnosis was 55%, 47%, and 23% at 1, 2, and 5 years, respectively. In Cox-regression analysis age, WHO performance status and treatment had independent prognostic impact on survival. In the studied decade, there was a non-significant trend towards increased incidence of PCNSL, perhaps due to increased availability of diagnostic imaging, especially magnetic resonance imaging.

  3. Incident reporting in dentistry: Clinical supervisor's awareness, practice and perceived barriers.

    Science.gov (United States)

    AlBlaihed, R M; AlSaeed, M I; Abuabat, A A; Ahsan, S H

    2017-12-21

    The significance of patient safety and risk management in dentistry has surfaced as dental settings bear delicate procedures carried out by teams utilising numerous devices and tools in complex environments. Our aim is to assess awareness, practice, attitude and perceived barriers of reporting incidents amongst dental clinical supervisors working at dental colleges in Riyadh, Saudi Arabia. The objectives are as follows: (i) Determine if correlations exist between socio-demographic data and supervisors' awareness, practice, attitude and perceived barriers. (ii) Identify most common perceived barriers. An online questionnaire was sent to the 450 clinical supervisors working at five dental colleges of Riyadh. The collected data included items assessing the awareness, practice and attitude of reporting students' incidents along with the perceived barriers. A response rate of (60.1% n = 264 of 450) was established. The majority of the respondents (62.9% n = 166) were aware of the incident reporting policy. Yet, only (35.4% n = 93) of them had completed an incident reporting form before. Most of the participants (90.5% n = 239) agreed on the necessity of reporting student's incidents, but only (67.0% n = 177) agreed on the necessity of reporting well-handled incidents. The possible negative relationship with students was the most agreed on barrier to reporting. This study shows that certain demographics of supervisors had significant relationship with their awareness, attitude, perceived barriers and practice. Awareness of the policy and form was linked to the increase in supervisors' practice, although they tend to report verbally rather than in writing. The possible negative relationship with students was the most common perceived barrier. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Clinical and prognostic significance of plasma fibrinogen in lung cancer

    Directory of Open Access Journals (Sweden)

    Chen YS

    2014-01-01

    Full Text Available Objectives: Hyperfibrinogenemia is a common problem associated with various carcinomas. The recent studies have shown that high plasma fibrinogen concentration is associated with invasion, growth and metastases of cancer. Furthermore, the recent studies focus on the prognostic significance of fibrinogen in the patients with advanced NSCLC (stage IIIB -IV. However, the prognostic significance of the plasma fibrinogen levels in early stage NSCLC patients (stage I -IIIA still remains unclear. In addition, it remains unclear whether or not chemotherapy-induced changes in fibrinogen level relate to the prognosis. The aims of this study were to 1 further explore the relationship between the plasma fibrinogen concentration and the stage and metastases of lung cancer 2 evaluate the prognostic significance of the basal plasma fibrinogen level in patients with lung cancer 3 explore the prognostic value of the change in fibrinogen levels between pre and post-chemotherapy. Methods: In this retrospective study, the data from 370 patients with lung cancer were enrolled into this study. The plasma fibrinogen levels were compared with the clinical and prognostic significance of lung cancer. The association between the plasma fibrinogen level and clinical-prognostic characteristics were analyzed using SPSS 17.0 software. Results: 1 The median pre-treatment plasma fibrinogen levels were 4.20g/L. Pre-treatment plasma fibrinogen levels correlated significantly with gender (p = 0.013. A higher plasma fibrinogen concentration was associated with squamous cell carcinoma versus adenocarcinoma (4.83±1.50 g/L versus 4.15±1.30 g/L; P<0.001, there was a significant association between plasma fibrinogen level and metastases of lung cancer, pointing a higher plasma fibrinogen level in lymph nodes or distant organ metastases (p < 0.001. 2 Patients with low plasma fibrinogen concentration demonstrates higher overall survival compared with those with high plasma fibrinogen

  5. [Clinical Significance of HBV Detection in NHL Patients].

    Science.gov (United States)

    Zhang, Tian-Ling; Zhang, Juan; Lv, Cheng-Xiu; Hu, Tian-Yu; Li, Qing

    2018-04-01

    To analyze the relation of HBV infection with clinical characteristics and prognosis in NHL patients, so as to explore the significance of HBV detection. Sixty-eight NHL patients from December 2013 to December 2016 were enrolled in NHL group and 136 patients with other malignancies were chosen in control group, the detectable rate of HBV was compared between 2 groups. The correlation of HBV infection with sex, age, stage, cell origin, expression of P53 and BCL-2 in NHL patients was analyzed. The prognosis-related factors in NHL patients were also analyzed. The infection rate of HBV in NHL group was 51.47%(35/68), that in control group was 15.44% (21/136), and the difference was statistically significant(χ 2 =27.768,PHBV infection correlated with cell origins and expression of BCL-2 in NHL patients(PHBV infection (P>0.05), while the prognosis was significantly related with stage, expression of P53 and BCL-2(PHBV infection correlates with BCL-2 expression level of NHL patients, and shows influence on the prognosis of patients.

  6. Clinical significance of HuR expression in human malignancy.

    Science.gov (United States)

    Kotta-Loizou, Ioly; Giaginis, Constantinos; Theocharis, Stamatios

    2014-09-01

    Hu-antigen R (HuR) is an RNA-binding protein that regulates the stability, translation, and nucleus-to-cytoplasm translocation of target mRNAs. The aim of the present review was to summarize and present the currently available information in the English literature on HuR expression in various human tumors, verifying its possible clinical significance. HuR function is directly linked to its subcellular localization. In normal cells, HuR is mostly localized in the nucleus, while in malignant cells, an increase in cytoplasmic HuR levels has been noted, in both cell lines and tissue samples. Moreover, in malignancy, elevated HuR expression levels and cytoplasmic immunohistochemical pattern have been correlated with advanced clinicopathological parameters and altered expression levels of proteins implicated in neoplasia. Additionally, elevated HuR expression levels and mainly cytoplasmic immunohistochemical pattern were correlated with decreased patients' survival rate in various human tumors. HuR is a putative drug target for cancer therapy, since it is expressed ubiquitously in malignant clinical samples and has an apparently consistent role in tumor formation and progression.

  7. Clinical Significance of Excess Lactose in the Diet (Part 2

    Directory of Open Access Journals (Sweden)

    O.Ye. Abaturov

    2016-03-01

    Full Text Available The article on the basis of published data presents the ideas about the clinical significance of excess lactose in the diet. Lactose is a specific inhibitor of β-galactoside-binding protein — galectin-9 (Gal-9 which regulates the intracellular metabolism (cell growth, inflammation, immune response, apoptosis. Lactose, competitively binding to Gal-9, prevents activation of Gal-9/TIM-3-associated signaling pathways that promotes proliferation of the T-helper 1 and 17 cells, causing the induction of inflammation. Excess lactose reduces Treg-cells representation, which have immunosuppressive action, and increases insulin resistance. Lactose inhibits the interaction of Gal-9 with immunoglobulin E and hyaluronan-binding molecule CD44 and contributes to allergic manifestations. The limitations of using exogenous lactase preparations for patho­gnomonic treatment of inflammatory and allergic diseases in children with lactase deficiency are presented.

  8. Clinical significance of farnesoid X receptor expression in thyroid neoplasia.

    Science.gov (United States)

    Giaginis, Constantinos; Tsoukalas, Nikolaos; Alexandrou, Paraskevi; Tsourouflis, Gerasimos; Dana, Eugene; Delladetsima, Ioanna; Patsouris, Efstratios; Theocharis, Stamatios

    2017-08-01

    To evaluate the clinical significance of farnesoid X receptor (FXR) in thyroid neoplasia. FXR expression was assessed immunohistochemically on 88 thyroid neoplastic tissues (benign = 44, malignant = 44). Enhanced FXR was more frequently observed in papillary carcinomas compared with hyperplastic nodules (p = 0.0489). In malignant lesions, elevated FXR was associated with capsular (p = 0.0004) and vascular invasion (p = 0.0056) and increased follicular cells' proliferative rate (p < 0.0001). Elevated FXR expression was also associated with larger tumor size (p = 0.0086), presence of lymph node metastases (p = 0.0239) and lymphatic invasion (p = 0.0086) and increased recurrence rate risk (p = 0.0239). FXR may be associated with tumor aggressiveness that affects patients' survival in thyroid neoplasia.

  9. Clinical significance of amniotic fluid glucose concentration in polyhydramnios.

    Science.gov (United States)

    Ogawa, Masaki; Sato, Akira; Mori, Koutaro; Nagao, Daisuke; Kamada, Kumiko; Sato, Megumi; Terada, Yukihiro

    2012-07-01

    To evaluate whether amniotic fluid glucose concentration can predict poor neonatal outcome in cases with polyhydramnios as an overall assessment. In this retrospective study, we have reviewed 42 consecutive pregnant women with singleton gestations complicated with polyhydramnios who gave birth at one tertiary care center between January 2003 and September 2010. Perinatal clinical findings were reviewed, and the neonatal outcome, such as livebirth or stillbirth and early neonatal death, was compared. A p value less than 0.05 was considered to be significant. Thirteen of 42 neonates had a poor outcome, including stillbirth or early neonatal death. Multiple logistic regression analysis showed that amniotic fluid glucose (p = 0.042) was significant factor influencing poor neonatal prognosis [odds ratio 0.66; 95% confidence interval 0.44-0.98]. Receiver operating characteristics curve and sensitivity and specificity curve showed that the optimal cut-off value of amniotic fluid glucose concentration for predicting poor neonatal outcome was 17 mg/dl. Amniotic glucose concentration less than 17 mg/dl and the presence of congenital heart anomaly were better predictors for a poor postnatal outcome in cases with polyhydramnios.

  10. Predictive models of choroidal neovascularization and geographic atrophy incidence applied to clinical trial design.

    Science.gov (United States)

    McCarthy, Linda C; Newcombe, Paul J; Whittaker, John C; Wurzelmann, John I; Fries, Michael A; Burnham, Nancy R; Cai, Gengqian; Stinnett, Sandra W; Trivedi, Trupti M; Xu, Chun-Fang

    2012-09-01

    To develop comprehensive predictive models for choroidal neovascularization (CNV) and geographic atrophy (GA) incidence within 3 years that can be applied realistically to clinical practice. Retrospective evaluation of data from a longitudinal study to develop and validate predictive models of CNV and GA. The predictive performance of clinical, environmental, demographic, and genetic risk factors was explored in regression models, using data from both eyes of 2011 subjects from the Age-Related Eye Disease Study (AREDS). The performance of predictive models was compared using 10-fold cross-validated receiver operating characteristic curves in the training data, followed by comparisons in an independent validation dataset (1410 AREDS subjects). Bayesian trial simulations were used to compare the usefulness of predictive models to screen patients for inclusion in prevention clinical trials. Logistic regression models that included clinical, demographic, and environmental factors had better predictive performance for 3-year CNV and GA incidence (area under the receiver operating characteristic curve of 0.87 and 0.89, respectively), compared with simple clinical criteria (AREDS simplified severity scale). Although genetic markers were associated significantly with 3-year CNV (CFH: Y402H; ARMS2: A69S) and GA incidence (CFH: Y402H), the inclusion of genetic factors in the models provided only marginal improvements in predictive performance. The logistic regression models combine good predictive performance with greater flexibility to optimize clinical trial design compared with simple clinical models (AREDS simplified severity scale). The benefit of including genetic factors to screen patients for recruitment to CNV prevention studies is marginal and is dependent on individual clinical trial economics. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Mandible osteoradionecrosis. Incidence and clinical evaluation of its therapy

    International Nuclear Information System (INIS)

    Biazolla, E.R.

    1989-01-01

    The incidence and the efficiency of mandible osteoradionecrosis in patients with oral neoplasms and submitted to radiotherapy were studied. The osteoradionecrosis incidence in mandible was 6,67%. The treatment with sodium iodide 2% and hydrogen peroxide 10 v was the best treatment for mandible osteoradionecrosis. (L.M.J.)

  12. Clinical study on the incidence of vancomycin intraocular injection in treatment with suppurative endophthalmitis

    Directory of Open Access Journals (Sweden)

    Yi-Qin Duan

    2015-05-01

    Full Text Available AIM:To estimate the clinical significance of the microculture of humor and vitreous and vancomycin intraocular injection in treatment of suppurative endophthalmitis associated with intraocular foreign bodies.METHODS: Totally 65 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation and intraocular injection from January 2012 to September 2014 were regarded as the study group, another 62 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation without intraocular injection before August 2011 were regarded as the control group. Aqueous humor and vitreous humor were taken from each patient of the study group and the control group for bacteria and fungus cultivation. The study group was treated with 1mg vancomycin intraocular injection after operation, while the control group was not. RESULTS: The incidence of endophthalmitis in the control group was 16%(10 cases, while in the study group was 3%(2 cases, with significant difference between two groups(x2=6.32, PP>0.05. The positive rate of vitreous humor germiculture in study group was 14%(9 cases, and the incidence of endophthalmitis was 3%. The positive rate of vitreous humor germiculture in control group was 11%(7 casesand the incidence of endophthalmitis was 16%, with significant differences between two groups(PCONCLUSION: Intraocular foreign bodies treated with emergency operation and vancomycin intraocular injections can decrease the incidence of suppurative endophthalmitis and have a good vision prognosis for the second stage of operation.

  13. Clinical significance of giant negative T waves in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Alfonso, F.; Nihoyannopoulos, P.; Stewart, J.; Dickie, S.; Lemery, R.; McKenna, W.J. (St. George' s Hospital Medical School, London (England))

    1990-04-01

    To assess the clinical significance of giant negative T waves in patients with hypertrophic cardiomyopathy from Western nations, clinical, echocardiographic, radionuclide and 48 h electrocardiographic (ECG) monitoring findings were compared in 27 patients with and 56 patients without giant negative T waves. Patients with giant negative T waves were older at diagnosis (43 +/- 15 versus 32 +/- 14 years, p less than 0.005), had greater ECG voltage (SV1 + RV5 = 57 +/- 20 versus 37 +/- 18 mm, p less than 0.001) and had a more vertical frontal plane axis (38.4 +/- 34 versus 13.4 +/- 45 degrees, p less than 0.05). Left ventricular wall thickness on two-dimensional echocardiography was similar at the mitral valve level (mean 16.5 +/- 4 versus 16.6 +/- 3 cm), but was greater at the papillary muscle level (mean 20.7 +/- 5 versus 17.6 +/- 3 mm, p less than 0.01) and apex (mean 23.3 +/- 5 versus 17.3 +/- 3 mm, p less than 0.001) in patients with giant negative T waves. Fewer patients with giant negative T waves had asymmetric septal hypertrophy (12 (44%) of 27 versus 36 (64%) of 56, p = 0.08) or systolic anterior motion of the mitral valve (4 (14%) of 27 versus 25 (45%) of 56, p less than 0.01), whereas left ventricular end-diastolic (44.1 +/- 6 versus 39.6 +/- 5 mm, p = 0.01) and end-systolic dimensions (27.8 +/- 4 versus 24 +/- 6 mm, p less than 0.05) were greater in this group. Nonsustained ventricular tachycardia was seen on ECG monitoring in 21% of patients in both groups.

  14. Clinical significance of metallothioneins in cell therapy and nanomedicine

    Directory of Open Access Journals (Sweden)

    Sharma S

    2013-04-01

    Full Text Available Sushil Sharma,1 Afsha Rais,1 Ranbir Sandhu,1 Wynand Nel,1 Manuchair Ebadi21Saint James School of Medicine, Bonaire, The Netherlands; 2Department of Pharmacology, Physiology, and Therapeutics, Center of Excellence in Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USAAbstract: Mammalian metallothioneins (MTs are low molecular weight (6–7 kDa cysteine-rich proteins that are specifically induced by metal nanoparticles (NPs. MT induction in cell therapy may provide better protection by serving as antioxidant, anti-inflammatory, antiapoptotic agents, and by augmenting zinc-mediated transcriptional regulation of genes involved in cell proliferation and differentiation. Liposome-encapsulated MT-1 promoter has been used extensively to induce growth hormone or other genes in culture and gene-manipulated animals. MTs are induced as a defensive mechanism in chronic inflammatory conditions including neurodegenerative diseases, cardiovascular diseases, cancer, and infections, hence can serve as early and sensitive biomarkers of environmental safety and effectiveness of newly developed NPs for clinical applications. Microarray analysis has indicated that MTs are significantly induced in drug resistant cancers and during radiation treatment. Nutritional stress and environmental toxins (eg, kainic acid and domoic acid induce MTs and aggregation of multilamellar electron-dense membrane stacks (Charnoly body due to mitochondrial degeneration. MTs enhance mitochondrial bioenergetics of reduced nicotinamide adenine dinucleotide–ubiquinone oxidoreductase (complex-1, a rate-limiting enzyme complex involved in the oxidative phosphorylation. Monoamine oxidase-B inhibitors (eg, selegiline inhibit α-synuclein nitration, implicated in Lewy body formation, and inhibit 1-methyl 4-phenylpyridinium and 3-morpholinosydnonimine-induced apoptosis in cultured human dopaminergic neurons and mesencephalic fetal stem cells. MTs

  15. Clinical significance of the VEGF level in urinary bladder carcinoma.

    Science.gov (United States)

    Sankhwar, Monica; Sankhwar, Satya Narayan; Abhishek, Amar; Rajender, Singh

    2015-01-01

    To investigate the correlation of Vascular Endothelial Growth Factor (VEGF) and micro-vessel density (MVD) with urinary bladder tumor and its stage. The study was conducted between January 2010 and December 2012. The study included screening of 122 patients at elevated risk for bladder cancer, of which 35 patients were finally enrolled in the study. Diagnosis was made on the basis of urine cytology, radiological investigation (ultrasound KUB, and CT-scan) and histopathology. Thirty-five normal cancer-free individuals were enrolled as controls. Human VEGF levels were measured using an enzyme linked immunoassay and protein content (pg/mg protein) by Lowry method. SPSS for Windows version 10.0.7 (SPSS, Chicago, IL, USA) was used for statistical analysis of the data. Mean urine VEGF level in the cases was significantly higher in comparison to the control group. There was a direct correlation between VEGF level and tumor stage. Mean urine VEGF values were minimum in the control group (22.75 ± 15.41 pg/mg creatinine) and maximum in stage IV patients (180.15 ± 75.93 pg/mg creatinine). Tissue VEGF levels also showed a similar trend of increase with increase in stage. Urine VEGF level also showed a correlation with tissue VEGF level. Similarly, MVD showed a significant increase with increase in tumor stage. A correlation between bladder cancer and MVD and VEGF suggest that the latter can serve as markers for therapeutic guidance. This is the first study from India on clinical and pathological correlation among urine VEGF, tumor tissue VEGF levels, and Micro Vessel Density (MVD) in urinary bladder cancer patients.

  16. Photocoagulation treatment for clinically significant radiation macular oedema

    Energy Technology Data Exchange (ETDEWEB)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M. [Washington Univ., Seattle, WA (United States)

    1995-02-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author).

  17. Photocoagulation treatment for clinically significant radiation macular oedema

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M.

    1995-01-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author)

  18. Clinical significance of {sup 123}I-BMIPP myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Junichi [Toho Univ., Tokyo (Japan). School of Medicine

    1998-07-01

    {sup 123}I-BMIPP is a radioiodinated branched chain fatty acid analog, showing high accumulation as well as prolonged retention in the myocardium. Therefore, it is used as a metabolic imaging agent suitable for myocardial SPECT. After {sup 123}I-BMIPP is taken in the myocardium, it remains there mainly as a storage type fatty acid of triglyceride, and it shows different behavior by the stage of cardiac disease. Usually, we evaluate metabolic findings by early imaging (20 minutes) after intravenous injection of {sup 123}I-BMIPP, however, sometimes washout or fill in are seen in the case of myocardial infarction or hypertrophic cardiomyopathy by delayed imaging (after 4 hours). The mismatch of {sup 201}TlCl and {sup 123}I-BMIPP are useful for the diagnosis of stunned myocardium or evaluation of prognosis. However, behavior of {sup 123}I-BMIPP in myocardium is known still not completely. Therefore clinical significance of this examination is thought to be clarified by the stock of cases of various heart diseases. (author)

  19. Candiduria: A review of clinical significance and management

    International Nuclear Information System (INIS)

    Bukhary, Z.A.

    2008-01-01

    Candiduria is a common nosocomial infection afflicting the urinary tract. This review is aimed at providing an updated summary of the problem in hospitalized adult patients. A review of English Medline literature published between January 1970 until June 2007 was performed. Reviews, clinical trials and case-controlled studies in adult patients were included. Risk factors for candiduria included urinary indwelling catheters, use of antibiotics, elderly age, underlying genitourinary tract abnormality, previous surgery and presence of diabetes mellitus. Presence of candiduria may represent only colonization and there are no consistent diagnostic criteria to define significant infection. Candiduria may not be associated with candidemia and most cases are asymptomatic. Asymptomatic canididuria is usually benign, and does not require local or systemic antifungal therapy. Physicians need to confirm the infection by a second sterile urine sample, adopt non-pharmacologic interventions and modify risk factors. Mortality rate can be high particularly in debilitated patients and awareness to validate candiduria is necessary to stratify treatment according to patient status. Appropriate use of antifungal drugs, when indicated, should not replace correction of the underlying risk factors. Treatment of symptomatic candiduria is less controversial and easier. (author)

  20. Evaluating clinical significance: incorporating robust statistics with normative comparison tests.

    Science.gov (United States)

    van Wieringen, Katrina; Cribbie, Robert A

    2014-05-01

    The purpose of this study was to evaluate a modified test of equivalence for conducting normative comparisons when distribution shapes are non-normal and variances are unequal. A Monte Carlo study was used to compare the empirical Type I error rates and power of the proposed Schuirmann-Yuen test of equivalence, which utilizes trimmed means, with that of the previously recommended Schuirmann and Schuirmann-Welch tests of equivalence when the assumptions of normality and variance homogeneity are satisfied, as well as when they are not satisfied. The empirical Type I error rates of the Schuirmann-Yuen were much closer to the nominal α level than those of the Schuirmann or Schuirmann-Welch tests, and the power of the Schuirmann-Yuen was substantially greater than that of the Schuirmann or Schuirmann-Welch tests when distributions were skewed or outliers were present. The Schuirmann-Yuen test is recommended for assessing clinical significance with normative comparisons. © 2013 The British Psychological Society.

  1. Sonographic diagnosis and clinical significance of umbilical arterial atresia.

    Science.gov (United States)

    Ren, Jinhe

    2017-05-01

    To evaluate the feasibility of antenatal sonographic diagnosis of umbilical arterial atresia and its clinical significance. Data of 5 cases with umbilical arterial atresia diagnosed in our hospital were studied retrospectively. The antenatal ultrasonogram of umbilical arterial atresia was obtain, and the pathological examination of umbilical cords and the prognosis of neonates were analyzed. Among 5 cases with umbilical arterial atresia in this group, 1 case with double umbilical arterial atresia was found with dead fetus in uterus, and the rest 4 cases with single umbilical arterial atresia were found with survival fetuses. In the latter 4 cases with live fetus, once umbilical arterial atresia was diagnosed, cesarean section was performed to terminate pregnancy, and the 4 fetus were all healthy. The chromosome karyotypes and S/D value of umbilical arteries were showed normal in all 5 cases. Accurate antenatal diagnosis can be made according to the specific ultrasonogram of umbilical arterial atresia. Instant intervention should be performed upon observing umbilical arterial atresia with live fetus, so as to avoid dead fetus as much as possible.

  2. Clinical Significance of Excess Lactose in the Diet (part 1

    Directory of Open Access Journals (Sweden)

    A.Ye. Abaturov

    2016-02-01

    Full Text Available In the article on the basis of the literature there has been considered the statistics of average consumption of lactose in the countries of the world community, reviewed the clinical significance of the excess lactose in the diet depending on the polymorphism of the lactase gene. Lactose is the main source of energy for the children of the first months of life, which provides about 40–45 % of the daily energy needs of a body of a child. Lactose malabsorption, deficiency of the enzyme lactase is accompanied by symptoms of lactose intolerance. Interest in the study of the influence of an immunomodulatory β-galactoside lactose was caused by the suppression of its galectin 9 ­(Gal-9, the regulatory T-cell immune response involving T-helper cells 1 and 17 (Th1, Th17 and regulatory T-lymphocytes (Treg, which are involved in many immune-mediated human disea­ses. Galectin 9 is the representative of the class of galectins such as «tandem repeat». The highest level of LGALS9 expression is observed in the tissues of colon, lung, bone marrow, lymph nodes, thymus, liver, kidney, endocrine glands, placenta, skin, smooth muscle, adipose tissue.

  3. The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks.

    Science.gov (United States)

    Pan, Chih-Long; Lin, Chih-Hao; Lin, Yan-Ren; Wen, Hsin-Yu; Wen, Jet-Chau

    2018-02-02

    Due to the increasing number of natural and man-made disasters, mass casualty incidents occur more often than ever before. As a result, health care providers need to adapt in order to cope with the overwhelming patient surge. To ensure quality and safety in health care, accurate information in pandemic disease control, death reduction, and health quality promotion should be highlighted. However, obtaining precise information in real time is an enormous challenge to all researchers of the field. In this paper, innovative strategies are presented to develop a sound information network using the concept of "witness sensors." To overcome the reliability and quality limitations of information obtained through social media, researchers must focus on developing solutions that secure the authenticity of social media messages, especially for matters related to health. To address this challenge, we introduce a novel concept based on the two elements of "witness" and "sensor." Witness sensors can be key players designated to minimize limitations to quality of information and to distinguish fact from fiction during critical events. In order to enhance health communication practices and deliver valid information to end users, the education and management of witness sensors should be further investigated, especially for implementation during mass casualty incidents and epidemic outbreaks. ©Chih-Long Pan, Chih-Hao Lin, Yan-Ren Lin, Hsin-Yu Wen, Jet-Chau Wen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2018.

  4. [The pathogenetic and clinical significance of disorders in hemostatic homeostasis in diabetics].

    Science.gov (United States)

    Lapchyns'ka, I I; Bielits'ka, H O; Kovalenko, S O

    1997-01-01

    DM patients who do not present with clinical manifestations of nephropathy exhibited significant reduction of urine fibrinolytic activity which is regarded as suggesting a preclinical stage of renal lesion in DM as well as hyperaggregation of platelets, enhanced activity of coagulative link of hemostasis and changes of different directions in the system of fibrinolysis. Among coagulologic methods, of most informative value is the turbidimetric method. In DM and low tolerability to glucosa, there is an increased incidence of gastroduodenal abnormalities, ulcer disease included, which fact warrants a gastroenterologic evaluation to be done in this patient population prior to prescribing anticoagulants.

  5. Incidence, frequency and clinical characteristics of type 3 myocardial infarction in clinical practice

    DEFF Research Database (Denmark)

    Jangaard, Nikolaj; Sarkisian, Laura; Saaby, Lotte

    2017-01-01

    OBJECTIVES: Cardiac death in a patient with symptoms and electrocardiographic changes indicative of myocardial ischemia but without available measurements of cardiac biomarkers is designated a type 3 myocardial infarction. We wanted to investigate the incidence, the frequency and the characterist...... is a rare observation in clinical practice with an annual incidence below 10/100.000 person years and a frequency of 3-4% among all types of myocardial infarction. If autopsy data are included the number of type 3 myocardial infarctions will increase.......OBJECTIVES: Cardiac death in a patient with symptoms and electrocardiographic changes indicative of myocardial ischemia but without available measurements of cardiac biomarkers is designated a type 3 myocardial infarction. We wanted to investigate the incidence, the frequency...... individuals, corresponding to an annual incidence of 7.3/100.000 person years. During the same one-year period 488 patients had other types of myocardial infarction implying a 3.6% frequency of type 3 myocardial infarction (18 of 506) among all myocardial infarctions. CONCLUSIONS: Type 3 myocardial infarction...

  6. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance.

    Science.gov (United States)

    Kim, Chong Jai; Romero, Roberto; Chaemsaithong, Piya; Chaiyasit, Noppadol; Yoon, Bo Hyun; Kim, Yeon Mee

    2015-10-01

    -term complications (ie, sterile inflammation in fetuses, neonatal sepsis, bronchopulmonary dysplasia, periventricular leukomalacia, and cerebral palsy). This article reviews the definition, pathogenesis, grading and staging, and clinical significance of the most common lesions in placental disease. Illustrations of the lesions and diagrams of the mechanisms of disease are provided. Published by Elsevier Inc.

  7. Cracked tooth syndrome--incidence, clinical findings and treatment.

    Science.gov (United States)

    Homewood, C I

    1998-08-01

    Cracked tooth syndrome (CTS) is a common occurrence in modern general practice. This article reviews the forces placed on the human dentition and the effect restorative dentistry has on the strength of tooth structure. The study reports on the incidence of CTS in a general practice, finding a far higher incidence in teeth which have had the marginal ridge restored than those which have not. The various types of treatment modalities advocated and their relative merits are discussed.

  8. Prevalence and Clinical Significance of Epileptiform EEG Discharges in a Large Memory Clinic Cohort

    NARCIS (Netherlands)

    Liedorp, M.; Stam, C.J.; van der Flier, W.M.; Pijnenburg, Y.A.L.; Scheltens, P.

    2010-01-01

    Background: Although EEG is not considered as standard in memory clinics, evidence indicates that epileptiform discharges are of value in diagnosing cognitive complaints as epilepsy. Objective: To determine prevalence and significance of epileptiform discharges in a memory clinic. Methods: 1,674

  9. Significance and clinical value of the transitional zone volume (TZV ...

    African Journals Online (AJOL)

    Introduction: A lot of diagnostic tools are present for assessing the degree of LUTs. Pressure-flow studies are invasive and cannot be justified in all patients suffering from LUTs. From here came the clinical importance of searching for another clinical tool, to help in assessing the degree of LUTS. Objective: The aim of this ...

  10. Adverse effects of anticoagulation treatment: clinically significant upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2006-12-01

    Full Text Available Background: Over the last years, the use of oral anticoagulant treatment has increased dramatically, principally for the prevention of venous thrombosis and thrombembolic events. This treatment is demanding, especially among the elderly with concommitant diseases and different medication. Aim of the study to evaluate the rate of serious complications, clinically significant hemorrhage from upper gastointestinal tract in patients treated with oral antiocoagulants in a prospective cohort study.Patients and methods: Included were patients admitted to our institution between January 1, 1994 and December 31, 2003 due to gastrointestinal hemorrhage. Emergency endoscopy and laboratory testing was performed in all patients.Results: 6416 patients were investigated: 2452 women (38.2 % and 3964 men (61.8 %, mean age 59.1 years, SD 17.2. Among our patients, 55 % were aged over 60 years. In 86.4 % of patients the source of bleeding was confirmed in the upper gastrointestinal tract. In the last week prior to bleeding, 20.4 % (1309/6416 of all patients were regularly taking nonsteroidal anti-inflammatory drugs, anticoagulant therapy or antiplatelet agents in single daily doses at least. 6.3 % of patients (82/1309 with abundant hemorrhage from upper gastrointestinal tract were using oral anticoagulant therapy and had INR > 5 at admission, 25.6 % of them had INR > 10. The mortality of patients using oral anticoagulants and INR > 5 was 17.1 %.Conclusions: Upper gastrointestinal hemorrhage is a serious complication of different medications, particularly in elderly patients. Safe use of anticoagulant therapy is based on careful selection of patients and correct intake of the prescribed drugs.

  11. The babkin reflex in infants: clinical significance and neural mechanism.

    Science.gov (United States)

    Futagi, Yasuyuki; Yanagihara, Keiko; Mogami, Yukiko; Ikeda, Tae; Suzuki, Yasuhiro

    2013-09-01

    There have been very few studies concerning the Babkin reflex-opening of the mouth and flexion of the arms in response to stimulation of the palms. We attempted to clarify the clinical significance and neural mechanism of the reflex through systematic review. Searches were conducted on Medline, Embase, and Google Scholar from their inception through August 2012. In normal term infants, the Babkin reflex can be elicited from the time of birth, becomes increasingly suppressed with age, and disappears in the great majority by the end of the fifth month of age. A marked response in the fourth or fifth month of age and persistence of the reflex beyond the fifth month of age are generally regarded as abnormal. On the other hand, because there are some normal infants showing no response during the neonatal period or early infancy, the absence of the response during these periods is not necessarily an abnormal finding. Infants with these abnormal findings should be carefully observed for the appearance of neurological abnormalities including cerebral palsy and mental retardation. It is most likely that the Babkin reflex is mediated by the reticular formation of the brainstem, which receives inputs from the nonprimary motor cortices. On the basis of the hand-mouth reflex, more adaptive movement develops as control of the nonprimary motor cortices over the reflex mechanism in the reticular formation increases. Soon it evolves into the voluntary eye-hand-mouth coordination necessary for food intake as the control of the prefrontal cortex over the nonprimary motor cortices becomes predominant. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. The clinical significance of fatty acid binding proteins

    Directory of Open Access Journals (Sweden)

    Barbara Choromańska

    2011-11-01

    Full Text Available Excessive levels of free fatty acids are toxic to cells. The human body has evolved a defense mechanism in the form of small cytoplasmic proteins called fatty acid binding proteins (FABPs that bind long-chain fatty acids (LCFA, and then refer them to appropriate intracellular disposal sites (oxidation in mitochondria and peroxisomes or storage in the endoplasmic reticulum. So far, nine types of these proteins have been described, and their name refers to the place in which they were first identified or where they can be found in the greatest concentration. The most important FABPs were isolated from the liver (L-FABP, heart (H-FABP, intestine (I-FABP, brain (B-FABP, epidermis (E-FABP and adipocytes (A-FABP. Determination of H-FABP is used in the diagnosis of myocardial infarction, and L-FABP in kidney lesions of different etiologies. It is postulated that FABPs play an important role in the pathogenesis of metabolic diseases. Elevated levels of A-FABP have been found in the pericardial fat tissue and were associated with cardiac dysfunction in obese people. A rise in A-FABP has been observed in patients with type II diabetes. I-FABP is known as a marker of cell damage in the small intestine. Increased concentration of B-FABP has been associated with human brain tumors such as glioblastoma and astrocytoma, as well as with neurodegenerative diseases (Alzheimer’s, Parkinson’s and other disorders of cognitive function. The aim of this work was to present current data on the clinical significance of fatty acid binding proteins.

  13. Necrotizing pneumonia: CT findings and its clinical significance

    International Nuclear Information System (INIS)

    Park, Hong Suk; Im, Jung Gi; Ryoo, Jae Wook; Yeon, Kyung Mo; Han, Man Chung

    1995-01-01

    To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy (n = 7) and culture (n = 15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47 years). The pathogens of necrotizing pneumonia were Klebsiella spp (n = 7), Enterobacter spp (n = 5), Actinomyces spp (n = 4), Pseudomonas spp (n = 4), Nocardia spp (n = 4), and others (n = 5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients (16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia

  14. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015.

    Science.gov (United States)

    Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takahiro; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-01-01

    The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5-52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008-2009: 48.2/1,000 person-years, 2010-2011: 51.1/1,000 person-years, 2012-2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22-7.18, pTokyo. Regular screening for syphilis needs to be strictly applied to this population.

  15. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

    Science.gov (United States)

    Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takahiro; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-01-01

    Background The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. Methods The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. Results Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5–52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008–2009: 48.2/1,000 person-years, 2010–2011: 51.1/1,000 person-years, 2012–2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22–7.18, pTokyo. Regular screening for syphilis needs to be strictly applied to this population. PMID:27992604

  16. Clinical significance of postvoid residual volume in older ambulatory women.

    Science.gov (United States)

    Huang, Alison J; Brown, Jeanette S; Boyko, Edward J; Moore, Elya E; Scholes, Delia; Walter, Louise C; Lin, Feng; Vittinghoff, Eric; Fihn, Stephan D

    2011-08-01

    To examine the prevalence, natural history, and clinical significance of high postvoid residual (PVR) volume in ambulatory older women. Prospective cohort study. Group health plan in Washington state. Nine hundred eighty-seven ambulatory women aged 55 to 75. PVR was measured using bladder ultrasonography at baseline, 1 year, and 2 years. Participants completed questionnaires about urinary symptoms and provided urine samples for microbiological evaluation. Of the 987 participants, 79% had a PVR less than 50 mL, 10% of 50 to 99 mL, 6% of 100 to 199 mL, and 5% of 200 mL or greater at baseline. Of women with a PVR less than 50 mL, 66% reported at least one urinary symptom at baseline. Of women with a PVR of 200 mL or greater, 27% reported no significant symptoms at baseline. In adjusted analyses using data from all study visits, women with a PVR of 100 mL or greater were more likely to report urinating more than eight times during the day (odds ratio (OR)=1.42, 95% confidence interval (CI)=1.07-1.87), and women with a PVR of 200 mL or greater were more likely to report weekly urgency incontinence (OR=1.50, 95% CI=1.03-2.18) than those with a PVR less than 50 mL. High PVR was not associated with greater risk of stress incontinence, nocturnal frequency, or urinary tract infection in adjusted analyses. Forty-six percent of those with a PVR of 200 mL or greater and 63% of those with a PVR of 100 to 199 mL at baseline had a PVR less than 50 mL at 2 years. More than 10% of ambulatory older women may have a PVR of 100 mL or greater, which is associated with greater risk of some urinary symptoms, but many with high PVR are asymptomatic, and high PVR frequently resolves within 2 years. Symptom-guided management of urinary symptoms may be more appropriate than PVR-guided management in this population. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  17. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015.

    Directory of Open Access Journals (Sweden)

    Takeshi Nishijima

    Full Text Available The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM largely remains unknown.The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8 among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods.Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21% or became infected with syphilis during follow-up (13%. After excluding 214 patients (MSM with syphilis at baseline (n = 190 and no follow-up syphilis test (n = 24, of 671 men, 112 (17% developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5-52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008-2009: 48.2/1,000 person-years, 2010-2011: 51.1/1,000 person-years, 2012-2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315. Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22-7.18, p<0.001, history of syphilis at baseline (HR 3.0, 95%CI 2.03-4.47, p<0.001, positive anti-amoeba antibody (HR 1.8, 95%CI 1.17-2.68, p = 0.006, and high baseline CD4 count (CD4 ≥350 /μL versus CD4 <200, HR 1.6, 95%CI 1.00-2.53, p = 0.050 as risk factors for incident syphilis. Incidence of syphilis was particularly high among young patients (age <33 years: 60.1/1,000 person-years. Interestingly, 37% of patients with incident syphilis were asymptomatic.Although incidence of syphilis did not increase during the observation period, it was high among HIV-1-infected MSM, especially among young HIV-1-infected MSM and those with history of syphilis, in Tokyo. Regular screening for syphilis needs to be

  18. Do glycine-extended hormone precursors have clinical significance?

    DEFF Research Database (Denmark)

    Rehfeld, Jens Frederik

    2014-01-01

    Half of the known peptide hormones are C-terminally amidated. Subsequent biogenesis studies have shown that the immediate precursor is a glycine-extended peptide. The clinical interest in glycine-extended hormones began in 1994, when it was suggested that glycine-extended gastrin stimulated cancer...... and clinical effects of glycine-extended precursors for most other amidated hormones than gastrin and cholecystokinin (CCK). The idea of glycine-extended peptides as independent messengers was interesting. But clinical science has to move ahead from ideas that cannot be supported at key points after decades...

  19. Clinical significance of surveillance culture in liver transplant recipients.

    Science.gov (United States)

    Kim, Y J; Kim, S I; Jun, Y H; Choi, J Y; Yoon, S K; You, Y-K; Kim, D-G

    2014-04-01

    Routine microbiologic surveillance is a method of infection control, but its clinical significance in transplant recipients is not known. We analyzed microbiologic data to evaluate the influence of cultured microorganisms between the point of surveillance and infectious episodes in liver transplant recipients. We performed surveillance culture for sputum and peritoneal fluid in liver transplant recipients from January 2009 to December 2011, at the time of transplantation (T1), 5 days (T2), and 10 days (T3) postoperatively. Of the 179 recipients, 32.9% had a positive sputum culture result and 37.4% had a positive peritoneal culture result during surveillance. In the culture surveillance of sputum, 37 organisms were isolated from 35 recipients at T1, and the most common organism was Staphylococcus aureus (n = 13). At T2, 45 organisms were isolated from 39 recipients, including Klebsiella pneumoniae (n = 10), S aureus (n = 8), and Acinetobacter baumannii (n = 6). At T3, 18 organisms were isolated from 15 patients, including Stenotrophomonas maltophilia (n = 5) and K pneumonia (n = 4). In the peritoneal fluid, 11 organisms were isolated from 10 recipients at T1, including Pseudomonas aeruginosa (n = 2) and Enterococcus species (n = 2). At T2, 39 organisms were isolated from 36 recipients, including coagulase-negative Staphylococcus species (CNS; n = 8) and Enterococcus species (n = 7). At T3, 54 organisms were isolated from 51 recipients, including CNS (n = 17) and Candida species (n = 8). Among the 59 patients with positive culture results for sputum surveillance, 16.9% developed pneumonia caused by the same organisms. Among the 67 patients with positive peritoneal fluid culture, 16.4% developed an intra-abdominal infection caused by the same organisms cultured. The recipients with positive surveillance culture had a higher risk of pneumonia (20.3% [12/59] vs 1.6% [2/120]; P < .001) and intra-abdominal infection (31.3% [21/67] vs 18.7% [21/112]; P

  20. Granulocyte antigen systems and antibodies and their clinical significance

    International Nuclear Information System (INIS)

    McCullough, J.

    1983-01-01

    Granulocyte alloantibodies and autoantibodies have a key role in the pathophysiology of several clinical problems. These include febrile transfusion reactions, severe pulmonary reactions to transfusion, isoimmune neonatal neutropenia, failure of effective granulocyte transfusion, autoimmune neutropenia, drug-induced neutropenia, and neutropenias secondary to many other diseases. Although many techniques are available for detecting granulocyte antibodies, the optimal in-vitro tests for predicting the antibodies' clinical effects are not established. Use of indium-111-labeled granulocytes may provide valuable information regarding the in-vivo effects of different granulocyte antibodies. Granulocyte transfusions continue to be used for a limited number of severely infected neutropenic patients who do not respond to antibiotic therapy

  1. The incidence and clinical presentation of infantile rotavirus ...

    African Journals Online (AJOL)

    Objectives. An effective vaccine is needed to protect against severe rotavirus disease, an important cause of gastroenteritis. Since there are no data on the incidence and antigenic diversity of rotavirus infection in Sierra Leone, we studied its epidemiology to enable an effective vaccine strategy to be designed. Methods.

  2. [Abnormality of blood coagulation indexes in patients with de novo acute leukemia and its clinical significance].

    Science.gov (United States)

    Xiao, Fang-Fang; Hu, Kai-Xun; Guo, Mei; Qiao, Jian-Hui; Sun, Qi-Yun; Ai, Hui-Sheng; Yu, Chang-Lin

    2013-04-01

    To explore hemorrhage risk and the clinical significance of abnormal change of prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB), plasma thrombin time (TT) and d-dimer (D-D) in de novo acute leukemia (except for APL), the different bleeding manifestations of 114 cases of de novo acute leukemia with different coagulation indexes were analyzed retrospectively. The correlation between these blood coagulation indexes and the possible correlative clinical characteristics were analysed, including age, sex, type of acute leukemia, initial white blood cell(WBC) and platelet(Plt) count, the proportion of blast cells in bone marrow and cytogenetic abnormality of patients at diagnosis. The results indicated that the incidence of abnormal blood coagulation was as high as 78.1% for de novo AL patients. These patients with 5 normal blood coagulation indexes may have mild bleeding manifestation, but the more abnormal indexes, the more severe bleeding. Both PT and D-D were sensitive indexes for diagnosis of level II bleeding. Incidence of abnormal blood coagulation significantly correlates with the proportion of blast cells in bone marrow (χ(2) = 4.184, OR = 1.021, P coagulation. It is concluded that the coagulation and fibrinolysis are abnormal in most patients with de novo acute leukemia. More abnormal indexes indicate more severe bleeding, and both PT and D-D are sensitive indexes for diagnosis of level II bleeding. Higher proportion of blast cells in bone marrow predicts higher incidence of abnormal blood clotting. Acute leukemia with elderly age, high white blood cell count and adverse cytogenetics do not predict severer abnormal blood clotting. Detection of PT, APTT, TT, FIB, and D-D may help to judge whether the patients are in a state of hypercoagulability or disseminated intravenous coagulation, which will provide experiment evidences for early intervention and medication.

  3. Puerperous pulmonary thromboembolism: Incidence, clinical features, treatment and outcome, study of 13 cases

    Directory of Open Access Journals (Sweden)

    Chuang CAI

    2013-01-01

    Full Text Available Objective  To explore the clinical features, treatment and outcome of puerperium pulmonary thromboembolism (PTE. Methods  To count the cases of spontaneous labor and cesarean section, as well as the incidence of PTE, treated in the First Affiliated Hospital of Guangzhou Medical University from Jan. 2006 to Nov. 2011, and retrospectively analyze the data of hospitalized parturients with PTE. Results  A total of 5052 cases of spontaneous delivery were collected at the obstetric ward, of which 2910 cases (57.6% were cesarean sections and 2142 cases (42.4% were vaginal delivery. On the duration of hospital stay, 13 cases (0.26% were diagnosed as puerperal PTE by CT pulmonary angiography, of which 11 cases occurred within 3 days after delivery. The incidence of puerperal PTE was significantly higher in cases with cesarean section than in those with vaginal delivery (0.38% vs0.09%, P=0.043. The most common symptoms of puerperal PTE were breathless (76.9%, cough (53.8%, pleuritic chest pain (23.1% and fever (30.8%. The clinical symptoms were improved by anticoagulation therapy (11 cases or thrombolysis (2 cases with zero mortality. Conclusions  The incidence of puerperal PTE in the hospital the authors served is 0.26%. Puerperal PTE should be considered especially to those parturients with sudden dyspnea, chest tightness or pleuritic chest pain within 3 days after cesarean section.

  4. Medication errors and adverse drug events in kidney transplant recipients: incidence, risk factors, and clinical outcomes.

    Science.gov (United States)

    Taber, David J; Pilch, Nicole A; Bratton, Charles F; McGillicuddy, John W; Chavin, Kenneth D; Baliga, Prabhakar K

    2012-12-01

    To determine the incidence, risk factors, and clinical outcomes associated with clinically significant medication errors or adverse drug events in kidney transplant recipients. Retrospective observational study. Transplant center at an academic medical center. A total of 476 adults who received kidney transplants between June 2006 and July 2009. Severe or significant medication errors and adverse drug events (medication-related problems [MRPs]) were identified by medical record review. Only patient-induced medication errors (e.g., took wrong dose or frequency of drug, took drug not prescribed) were captured. Clinical outcomes included patient and graft survival, infections (including cytomegalovirus), readmissions, and acute rejection episodes. Thirty-seven (8%) of the 476 patients developed a clinically significant MRP. Univariate and confirmatory multivariate analyses revealed that female sex, African-American race, pretransplantation diabetes mellitus, delayed graft function, and retransplant recipients were independent risk factors for developing an MRP. Patients with MRPs had significantly higher rates of acute rejection (11% vs 30%, p=0.004), cytomegalovirus infection (15% vs 30%, p=0.033), and 30-day readmissions (5% vs 16%, p=0.018). Graft survival was also significantly lower in patients who had MRPs (pmedication errors and associated adverse drug events were common in kidney transplant recipients. General and transplant-specific risk factors were associated with the development of these MRPs, and MRPs were associated with increased risk of rejection and graft loss. © 2012 Pharmacotherapy Publications, Inc.

  5. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Science.gov (United States)

    Campos Polo, Rafael; Rubio Sánchez, Consuelo; García Guisado, Diego Manuel; Díaz Luque, María José

    2018-01-01

    Purpose To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME) in daily clinical practice. Methods Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] letters) was the primary outcome. Results The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001). Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%), with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2). A significant reduction in central macular thickness from a mean of 460.5 (11.8) μm at baseline to 229.0 (43.8) μm at 12 months (P<0.001) was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. PMID:29386883

  6. MRI diagnosis of pituitary abscess and its clinical significance

    International Nuclear Information System (INIS)

    Chen Shuang; Qian Ruiling; Tang Zhiwei; Liu Ke; Huang Yong; Li Xi

    2007-01-01

    Objective: To investigate the MR features of pituitary abscess. Methods: The MR features of 14 eases of pituitary abscess proved by surgical pathology and clinical treatments were analyzed retrospectively. Results: Pre-contrast MR showed hypointense heterogeneous intensity on T 1 WI in 12 cases and iso-hyperintense on T 1 WI in 2 cases, hyperintense on T 2 WI in all cases. Post-gadolinium MR showed the ring-like enhancement around the uneven edge of abscess and the surrounding enhanced meninges connecting to the focus. The normal pituitary could not be identified in all 14 cases. The MR specific findings include the fluid-fluid level, nodule on the edge and the enhanced patchy shadow. Conclusions: The pituitary abscess has specific findings on MR examination, which can be used to combine with clinical symptoms to achieve the diagnosis before operation, so that the cases could be treated with antibiotic without operation. (authors)

  7. Treatment-resistant panic disorder: clinical significance, concept and management.

    Science.gov (United States)

    Chen, Mu-Hong; Tsai, Shih-Jen

    2016-10-03

    Panic disorder is commonly prevalent in the population, but the treatment response for panic disorder in clinical practice is much less effective than that in our imagination. Increasing evidence suggested existence of a chronic or remitting-relapsing clinical course in panic disorder. In this systematic review, we re-examine the definition of treatment-resistant panic disorder, and present the potential risk factors related to the treatment resistance, including the characteristics of panic disorder, other psychiatric and physical comorbidities, and psychosocial stresses. Furthermore, we summarize the potential pathophysiologies, such as genetic susceptibility, altered brain functioning, brain-derived neurotrophic factor, and long-term inflammation, to explain the treatment resistance. Finally, we conclude the current therapeutic strategies for treating treatment-resistant panic disorder from pharmacological and non-pharmacological views. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Clinical significance of adrenal computed tomography in Addison's disease

    International Nuclear Information System (INIS)

    Sun, Zhong-Hua; Nomura, Kaoru; Toraya, Shohzoh; Ujihara, Makoto; Horiba, Nobuo; Suda, Toshihiro; Tsushima, Toshio; Demura, Hiroshi; Kono, Atsushi

    1992-01-01

    Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n=8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands was atrophied bilaterally, in contrast to adrenal glands in idiopathic Addison's disease which was atrophied bilaterally from disease onset (n=2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment. (author)

  9. Ossified Sacrotuberous Ligament and its Clinical Significance: A Case Report

    Directory of Open Access Journals (Sweden)

    Yuvaraj Maria Francis

    2018-01-01

    Full Text Available The present study describes the morphometry of a unilateral ossified sacrotuberous ligament. It aims to discuss its Anatomical and clinical implications.The pudendal nerve, internal pudendal artery, nerve to obturator internus and coccygeal branch of inferior gluteal artery, are the important structures related to sacrotuberous ligament. An ossified sacrotuberous ligament may be an important etiological factor in neurovascular compression syndromes and its anatomical knowledge may help in the development of new treatment strategy for this common clinical problem. The ossified sacrotuberous ligament in the present case exhibits, a characteristic anterior and posterior segment, a base at the ischial tuberosity and an apex attached to alae of sacrum. The ossified sacrotuberous ligament may be important in differential diagnosis of soft tissue pain and tenderness after trauma. It may be a challenging puzzle for the present day surgeon and radiologist in interpretation of radiological problems.

  10. Clinical significance of computed tomography assessment for third molar surgery

    OpenAIRE

    Nakamori, Kenji; Tomihara, Kei; Noguchi, Makoto

    2014-01-01

    Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery. Third molar surgery is warranted when there is inadequate space for eruption, malpositioning, or risk for cyst or odontogenic tumor formation. Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues. Due to developments in medical engineering technology, computed ...

  11. Hyperprolactinemia with normal serum prolactin: Its clinical significance

    Directory of Open Access Journals (Sweden)

    Manika Agarwal

    2010-01-01

    Full Text Available Amenorrhea and infertility with an added feature of galactorrhea makes a provisional diagnosis of hyperprolactinemia. But again, normal serum prolactin with all clinical features of hyperprolactinemia might question the diagnosis and further management. The answer lies in the heterogeneity of the peptide hormone - the immunoactive and the bioactive forms. This has been further illustrated with the help of a case which had been treated with cabergoline.

  12. Early diagnosis of Alzheimer's disease. Clinical significance and future perspectives

    International Nuclear Information System (INIS)

    Buerger, K.; Teipel, S.J.; Hampel, H.

    2000-01-01

    Early diagnosis of Alzheimer's disease describes the recognition and diagnosis in patients with very mild dementia. Internationally accepted diagnostic criteria support the diagnosis based on clinical evaluation. Recent advances in structural and functional neuroimaging as well as studies on specific proteins in the cerebro-spinal fluid that are related to distinct pathophysiological disease processes are most promising approaches to defining biological markers of Alzheimer's disease. (orig.) [de

  13. Resistance to antivirals in human cytomegalovirus: mechanisms and clinical significance.

    Science.gov (United States)

    Pérez, J L

    1997-09-01

    Long term therapies needed for managing human cytomegalovirus (HCMV) infections in immunosupressed patients provided the background for the emergence of the resistance to antivirals active against HCMV. In addition, laboratory selected mutants have also been readily achieved. Both clinical and laboratory resistant strains share the same determinants of resistance. Ganciclovir resistance may be due to a few mutations in the HCMV UL97 gene and/or viral DNA pol gene, the former being responsible for about 70% of clinical resistant isolates. Among them, V464, V594, S595 and F595 are the most frequent mutations. Because of their less extensive clinical use, much less is known about resistance to foscarnet and cidofovir (formerly, HPMPC) but in both cases, it has been associated to mutations in the DNA pol. Ganciclovir resistant strains showing DNA pol mutations are cross-resistant to cidofovir and their corresponding IC50 are normally higher than those from strains harboring only mutations at the UL97 gene. To date, foscarnet resistance seems to be independent of both ganciclovir and cidofovir resistance.

  14. Adapting Cognitive Task Analysis to Investigate Clinical Decision Making and Medication Safety Incidents.

    Science.gov (United States)

    Russ, Alissa L; Militello, Laura G; Glassman, Peter A; Arthur, Karen J; Zillich, Alan J; Weiner, Michael

    2017-05-03

    Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred. We also leveraged the electronic health record (EHR) to expand data capture and used EHR-stimulated recall to aid reconstruction of safety incidents. We investigated 3 categories of medication-related incidents: adverse drug reactions, drug-drug interactions, and drug-disease interactions. Healthcare professionals submitted incidents, and a subset of incidents was selected for CTA. We analyzed several outcomes to characterize incident capture and completed CTA interviews. We captured 101 incidents. Eighty incidents (79%) met eligibility criteria. We completed 60 CTA interviews, 20 for each incident category. Capturing incidents before interviews allowed us to shorten the interview duration and reduced reliance on healthcare professionals' recall. Incorporating the EHR into CTA enriched data collection. The adapted CTA technique was successful in capturing specific categories of safety incidents. Our approach may be especially useful for investigating safety incidents that healthcare professionals "fix and forget." Our innovations to CTA are expected to expand the application of this method in healthcare and inform a wide range of studies on clinical decision making and patient safety.

  15. Incidence and clinical vital parameters in primary ketosis of Murrah buffaloes

    Science.gov (United States)

    Kumar, Ankit; Sindhu, Neelesh; Kumar, Parmod; Kumar, Tarun; Charaya, Gaurav; Surbhi; Jain, V. K.; Sridhar

    2015-01-01

    Aim: The present study was undertaken to ascertain the incidence and clinical vital parameters in cases of primary ketosis in Murrah buffaloes brought to teaching veterinary clinical complex, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar and from adjoining villages of the district Hisar, Haryana, India. Materials and Methods: The investigation was conducted on 24 clinical cases (out of total 145 screened) of primary ketosis. The diagnosis was confirmed on the basis of clinical signs and significantly positive two tests for ketone bodies in urine (Rothera’s and Keto-Diastix strip test). Data collected were statistically analyzed using independent Student’s t-test. Results: Overall incidence of disease in these areas was found to be 16.55% and all the animals were recently parturited (mean: 1.42±0.14 month), on an average in their third lactation (mean: 2.38±0.30) and exhibited clinical signs such as selective anorexia (refusal to feed on concentrate diet), drastic reduction in milk yield (mean: 64.4±5.35%), ketotic odor from urine, breath, and milk and rapid loss of body condition. All the clinical vital parameters in ketotic buffaloes (body temperature, heart rate, respiration rate, and rumen movements) were within normal range. Conclusion: Primary ketosis in Murrah buffaloes was the most common seen in the third lactation, within the first 2 months after parturition with characteristics clinical signs and no variability in vital parameters. The disease has severe effect on the production status of affected animal. PMID:27047203

  16. Incidence and clinical vital parameters in primary ketosis of Murrah buffaloes

    Directory of Open Access Journals (Sweden)

    Ankit Kumar

    2015-09-01

    Full Text Available Aim: The present study was undertaken to ascertain the incidence and clinical vital parameters in cases of primary ketosis in Murrah buffaloes brought to teaching veterinary clinical complex, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar and from adjoining villages of the district Hisar, Haryana, India. Materials and Methods: The investigation was conducted on 24 clinical cases (out of total 145 screened of primary ketosis. The diagnosis was confirmed on the basis of clinical signs and significantly positive two tests for ketone bodies in urine (Rothera’s and Keto-Diastix strip test. Data collected were statistically analyzed using independent Student’s t-test. Results: Overall incidence of disease in these areas was found to be 16.55% and all the animals were recently parturited (mean: 1.42±0.14 month, on an average in their third lactation (mean: 2.38±0.30 and exhibited clinical signs such as selective anorexia (refusal to feed on concentrate diet, drastic reduction in milk yield (mean: 64.4±5.35%, ketotic odor from urine, breath, and milk and rapid loss of body condition. All the clinical vital parameters in ketotic buffaloes (body temperature, heart rate, respiration rate, and rumen movements were within normal range. Conclusion: Primary ketosis in Murrah buffaloes was the most common seen in the third lactation, within the first 2 months after parturition with characteristics clinical signs and no variability in vital parameters. The disease has severe effect on the production status of affected animal.

  17. Misdiagnosis and clinical significance of non-tuberculous ...

    African Journals Online (AJOL)

    2011-09-09

    ® ... were confirmed with the enzyme linked immunosorbent assay. A questionnaire was used to obtain demographic data. ..... recovered with egg yolk supplementation (9). Worthy noting also is that a significant proportion of ...

  18. [Measurement of the lumbosacral angle and its clinical significance].

    Science.gov (United States)

    Bene, E

    1981-01-01

    The author reports about the result of a series of investigations and tests concerning the angle of the L-S vertebral column. Different factors influencing the values of L-S angle are analyzed. The clinical importance of the respective angles is small, the statics of the L-S transition is determined by all angles together. The reduced L-S angle cannot be considered as an aetiological factor of the spondylolysthesis. The pathological angle values as well as the positions play a role in the induction of the discopathy

  19. Serum Interleukin-6 Expression Level and Its Clinical Significance in Patients with Dermatomyositis

    Directory of Open Access Journals (Sweden)

    Min Yang

    2013-01-01

    Full Text Available Objective. To analyze serum interleukin-6 (IL-6 expression level and its clinical significance in patients with dermatomyositis. Methods. Blood samples from 23 adult patients with dermatomyositis (DM, 22 with systemic lupus erythematosus (SLE, 22 with rheumatoid arthritis (RA, 16 with Sjögren's syndrome (SS, and 20 healthy controls were collected. The IL-6 concentration was detected by chemiluminescence immunoassay. Correlations between IL-6 expression levels and clinical features or laboratory findings in patients with DM were investigated. Results. IL-6 expression level of DM patients was significantly higher than that of normal controls, significantly lower than that of RA patients, and slightly lower than that of SLE or SS patients with no significant differences. The incidence of fever was significantly higher in the IL-6 elevated group. Serum ferritin (SF and C-reactive protein (CRP were positively correlated with IL-6. Conclusions. IL-6 plays a less important role in DM than in RA. IL-6 monoclonal antibodies may have poor effect in patients with DM.

  20. Nanomaterial-Based Electrochemical Immunosensors for Clinically Significant Biomarkers

    Science.gov (United States)

    Ronkainen, Niina J.; Okon, Stanley L.

    2014-01-01

    Nanotechnology has played a crucial role in the development of biosensors over the past decade. The development, testing, optimization, and validation of new biosensors has become a highly interdisciplinary effort involving experts in chemistry, biology, physics, engineering, and medicine. The sensitivity, the specificity and the reproducibility of biosensors have improved tremendously as a result of incorporating nanomaterials in their design. In general, nanomaterials-based electrochemical immunosensors amplify the sensitivity by facilitating greater loading of the larger sensing surface with biorecognition molecules as well as improving the electrochemical properties of the transducer. The most common types of nanomaterials and their properties will be described. In addition, the utilization of nanomaterials in immunosensors for biomarker detection will be discussed since these biosensors have enormous potential for a myriad of clinical uses. Electrochemical immunosensors provide a specific and simple analytical alternative as evidenced by their brief analysis times, inexpensive instrumentation, lower assay cost as well as good portability and amenability to miniaturization. The role nanomaterials play in biosensors, their ability to improve detection capabilities in low concentration analytes yielding clinically useful data and their impact on other biosensor performance properties will be discussed. Finally, the most common types of electroanalytical detection methods will be briefly touched upon. PMID:28788700

  1. Nanomaterial-Based Electrochemical Immunosensors for Clinically Significant Biomarkers

    Directory of Open Access Journals (Sweden)

    Niina J. Ronkainen

    2014-06-01

    Full Text Available Nanotechnology has played a crucial role in the development of biosensors over the past decade. The development, testing, optimization, and validation of new biosensors has become a highly interdisciplinary effort involving experts in chemistry, biology, physics, engineering, and medicine. The sensitivity, the specificity and the reproducibility of biosensors have improved tremendously as a result of incorporating nanomaterials in their design. In general, nanomaterials-based electrochemical immunosensors amplify the sensitivity by facilitating greater loading of the larger sensing surface with biorecognition molecules as well as improving the electrochemical properties of the transducer. The most common types of nanomaterials and their properties will be described. In addition, the utilization of nanomaterials in immunosensors for biomarker detection will be discussed since these biosensors have enormous potential for a myriad of clinical uses. Electrochemical immunosensors provide a specific and simple analytical alternative as evidenced by their brief analysis times, inexpensive instrumentation, lower assay cost as well as good portability and amenability to miniaturization. The role nanomaterials play in biosensors, their ability to improve detection capabilities in low concentration analytes yielding clinically useful data and their impact on other biosensor performance properties will be discussed. Finally, the most common types of electroanalytical detection methods will be briefly touched upon.

  2. The Coracoacromial Ligament: Anatomy, Function, and Clinical Significance.

    Science.gov (United States)

    Rothenberg, Adam; Gasbarro, Gregory; Chlebeck, Jesse; Lin, Albert

    2017-04-01

    The coracoacromial ligament (CAL) was first described as a pain generator by Dr Charles Neer in the early 1970s. Since that time, considerable controversy regarding CAL management during acromioplasty has persisted. This review aims to better understand the role of the CAL in shoulder physiology and pathology. Sixty-six articles from 1958 to 2016 were identified using an electronic search of PubMed, Cochrane Library, AccessMedicine, and MD Consult for case series as well as cohort and prospective studies. The authors used "coracoacromial ligament" and "coracoacromial veil" as medical subject headings (MeSH). In addition, reference lists from all identified articles were reviewed for studies that the search terms may have omitted. The CAL plays an important role in shoulder biomechanics, joint stability, and proprioception. Morphological variance of the CAL is evident throughout the literature. Age-dependent changes due to chronic stress and cellular degradation cause thickening and stiffening of the CAL that may contribute to a spectrum of shoulder pathology from capsular tightness to rotator cuff tear arthropathy and impingement syndrome. The CAL is an integral component of the coracoacromial arch. CAL release during acromioplasty remains controversial. Future clinical outcomes research should endeavor to advance the understanding of the CAL to refine clinical and intraoperative decision making regarding its management.

  3. Diagnosis and clinical significance of dens invaginatus to practicing dentist.

    Science.gov (United States)

    Mupparapu, Muralidhar; Singer, Steven R; Pisano, Dominic

    2006-01-01

    Dens invaginatus, commonly known as dens in dente, is a developmental malformation of teeth that most commonly affects permanent maxillary lateral incisors. Deciduous teeth are infrequently affected. Presence of dens invaginatus in mandibular permanent teeth is extremely uncommon. A rare presentation of coronal double dens invaginatus incidentally detected in a mandibular canine tooth on radiographic examination is being reported, along with a discussion of this anomaly. The patient had presented for routine dental treatment unrelated to this finding. In addition, the various radiographic appearances of dens invaginatus, as they present within the maxillary and mandibular teeth, are described. Essential clinical considerations and treatment options are presented. A review of the pertinent literature is undertaken, and tables summarizing previously published reports of mandibular dens invaginatus and double dens invaginatus are presented. A review of the literature indicates that dens invaginatus in mandibular teeth is extremely rare, with only 11 other cases, involving 14 teeth, reported previously. Cases of double dens invaginatus are even more atypical, with only eight previously reported cases. Dens invaginatus is an anomaly that should be familiar to all practicing dentists because of the clinical implications and potential sequelae.

  4. Development of serial magnification angiography and its clinical significance

    International Nuclear Information System (INIS)

    Sasaki, Tsuneo; Matsubara, Kazuhito; Ishiguchi, Tsuneo; Mashita, Shinichi; Kaii, Osamu

    1979-01-01

    In order to apply serial magnification angiography to clinical examinations so easily, a serial cardioangiography apparatus was equipped with a tube having 0.1 mm focal spot and with DRX-431HD diode. A CAT-FK Type catheter bed (Toshiba) was used as a roentgenographic table and a PUCK film changer was used. Thus, serial magnification angiography can be easily used to clinical examinations, and can be set in a usual x-ray photographic studio. Serial magnification angiography was used to examine the cerebral vessels in 6 patients, vessels of the pulmonary circulation in 1 patient, bronchial arteries in 6 patients, the celiac artery in 18 patients, the superior mesenteric artery in 2 patients, inferior mesenteric artery in 2 patients, the renal artery in 2 patients, and the adrenal vein in 7 patients. Owing to this angiography, minute changes in the vessel in the lesion can be observed and fine neovascularity can be detected. Thus, serial magnification angiography makes diagnoses of vascular disorders easier. (Ichikawa, K.)

  5. Clinical examination is highly sensitive for detecting clinically significant spinal injuries after gunshot wounds.

    Science.gov (United States)

    Inaba, Kenji; Barmparas, Galinos; Ibrahim, David; Branco, Bernardino C; Gruen, Peter; Reddy, Sravanthi; Talving, Peep; Demetriades, Demetrios

    2011-09-01

    The optimal method for spinal evaluation after penetrating trauma is currently unknown. The goal of this study was to determine the sensitivity and specificity of a standardized clinical examination for the detection of spinal injuries after penetrating trauma. After Institutional Review Board approval, all evaluable penetrating trauma patients aged 15 years or more admitted to the Los Angeles County + University of Southern California Medical Center were prospectively evaluated for spinal pain, tenderness to palpation, deformity, and neurologic deficit. During the 6-month study period, 282 patients were admitted after sustaining a penetrating injury; 143 (50.7%) as a result of gunshot wound (GSW) and 139 (49.3%) as a result of stab wound (SW). None of the patients sustaining a SW had a spinal injury. Of the 112 evaluable GSW patients, 9 sustained an injury: 6 with a true-positive and 3 with a false-negative clinical examination. The overall sensitivity, specificity, positive predictive value, and negative predictive value were 66.7%, 89.6%, 46.2% and 95.2%, respectively. For clinically significant injuries requiring surgical intervention, cervical or thoracolumbar spine orthosis, or cord transections, however, the sensitivity of clinical examination was 100.0%, specificity 87.5%, positive predictive value 30.8%, and negative predictive value 87.5%. Clinically significant spinal injury, although rare after SWs, is not uncommon after GSWs. A structured clinical examination of the spine in evaluable patients who have sustained a GSW is highly reliable for identifying those with clinically significant injuries.

  6. Biomarkers of atherosclerotic plaque vulnerability and their clinical significance

    Directory of Open Access Journals (Sweden)

    Ran LIU

    2016-09-01

    Full Text Available Inflammatory reaction plays a crucial role in the occurence and development of atherosclerosis. Both basic and clinical trials have provided evidence that the expression of inflammatory biomarkers are closely related with the degree of atherosclerosis. Treatment towards inflammatory factors would bring benefit to atherosclerotic patients. This review highlighted the mechanistic rationale and specific therapies targeting traditional and novel inflammatory biomarkers, including C-reactive protein (CRP, interleukin-17 (IL-17, secretory phospholipase A2 (sPLA2, lipoprotein-associated phospholipase A2 (Lp-PLA2, endoglin, chemokine receptor and 5-lipoxygenase (5-LO, so as to review its mechanism of action and treatment prospect. DOI: 10.3969/j.issn.1672-6731.2016.09.004

  7. Clinical significance of multi-leaf collimator calibration errors

    International Nuclear Information System (INIS)

    Norvill, Craig; Jenetsky, Guy

    2016-01-01

    This planning study investigates the clinical impact of multi-leaf collimator (MLC) calibration errors on three common treatment sites; head and neck (H&N), prostate and stereotactic body radiotherapy (SBRT) for lung. All plans used using either volumetric modulated adaptive therapy or dynamic MLC techniques. Five patient plans were retrospectively selected from each treatment site, and MLC errors intentionally introduced. MLC errors of 0.7, 0.4 and 0.2 mm were sufficient to cause major violations in the PTV planning criteria for the H&N, prostate and SBRT lung plans. Mean PTV dose followed a linear trend with MLC error, increasing at rates of 3.2–5.9 % per millimeter depending on treatment site. The results indicate that an MLC quality assurance program that provides sub-millimeter accuracy is an important component of intensity modulated radiotherapy delivery techniques.

  8. The true clinical significance of renography in nephro-urology

    International Nuclear Information System (INIS)

    Woolfson, R.G.; Neild, G.H.

    1997-01-01

    Isotopic renography is a non-invasive technique used routinely by the clinician to provide information about kidney structure and function. Whilst there is no doubt of its value in the accurate measurement of glomerular filtration rate and in the detection of parenchymal abnormalities, its role in the diagnosis of renovascular disease (especially in patients with renal insufficiency), the exclusion of obstruction and the evaluation of the patient with either acute renal failure or renal transplant dysfunction remains unproven. In part, this reflects a failure to standardise protocols and rigorously evaluate diagnostic techniques. Recent developments in ultrasound, computerised X-ray tomography and nuclear magnetic resonance now present the clini- cian with rival techniques and emphasise the need for the clinical development of isotopic renography. (orig.)

  9. Non-alcoholic steatohepatitis : Clinical significance and pathogenesis

    NARCIS (Netherlands)

    de Knegt, RJ

    2001-01-01

    Non-alcoholic steatohepatitis (NASH) is a form of liver disease resembling alcoholic liver disease in a patient who does not consume significant amounts of alcohol. Since its first description in 1980 it has been recognized with increasing frequency. The natural course is relatively benign, but

  10. Laboratory Survey of Significant Bacteriuria in a Family Practice Clinic

    African Journals Online (AJOL)

    This study was carried out to determine the causative agents of significant bacteriuria and their antibiotic sensitivity pattern. ... high rate of antibiotic resistance suggest that many patients in this population will probably benefit more from treatment of UTI based on routine antibiotic sensitivity testing rather than empiric therapy.

  11. Significant Incidence of Extra-Articular Tibia Vara Affects Radiological Outcome of Total Knee Arthroplasty

    Science.gov (United States)

    Saibaba, Balaji; Chouhan, Devendra K.; Kanojia, Rajendra K.; Prakash, Mahesh; Bachhal, Vikas

    2015-01-01

    Purpose To identify and quantify the presence of extra-articular tibia vara that might influence the mechanical axis alignment after total knee arthroplasty (TKA). Materials and Methods A total of 48 TKAs in 30 osteoarthritic Indian patients were prospectively evaluated. The hip-knee-ankle angle (HKA), joint line convergence angle, and varus angulation at the femur and tibia were measured from the preoperative and postoperative standing hip-to-ankle radiographs. Four different methods were used to measure the varus angulation at the tibia: metaphyseo-diaphyseal angle (MDA), the angle between the anatomical axis and mechanical axis of the tibia, the angle between the proximal third and distal third of tibia and the angle between the proximal half and distal half of tibia. Results Extra-articular tibia vara quantified using MDA had the most positive correlation with HKA. Receiver operating characteristic plotting showed that MDA of >4° predicts abnormal postoperative HKA. Twenty-eight out of 48 knees had MDA of >4°, and 78.6% of these had postoperative HKA under-correction and 21.4% had less than ideal tibial component position. Conclusions A significant inherent extra-articular varus angulation best measured using MDA exists in the proximal tibia in osteoarthritic Indian patients undergoing TKA. MDA of >4° is associated with abnormal postoperative HKA. Computer navigation may be useful for achieving ideal correction in such cases. PMID:26389071

  12. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Directory of Open Access Journals (Sweden)

    Campos Polo R

    2018-01-01

    Full Text Available Rafael Campos Polo, Consuelo Rubio Sánchez, Diego Manuel García Guisado, María José Díaz Luque Unit of Retina, Department of Ophthalmology, Hospital Virgen del Puerto, Plasencia, Cáceres, Spain Purpose: To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME in daily clinical practice. Methods: Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA (Early Treatment Diabetic Retinopathy Study [ETDRS] letters was the primary outcome. Results: The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001. Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%, with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2. A significant reduction in central macular thickness from a mean of 460.5 (11.8 µm at baseline to 229.0 (43.8 µm at 12 months (P<0.001 was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion: Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. Keywords: aflibercept, central macular thickness, diabetic macular

  13. Minimal residual disease in breast cancer. Clinical significance

    International Nuclear Information System (INIS)

    Kvalheim, G.

    2004-01-01

    Previously we have reported our results on minimal residual disease in breast cancer. Briefly, B M-aspirates were collected from 817 patients at primary surgery. Tumor cells in B M were detected by immunocytochemistry using anticytokeratin-antibodies (A E1/ A E3). Analyses of the primary tumor included histological grading, vascular invasion and immunohistochemical detection of cerbB2, cathepsin D, p53 and ER/PgRexpression. These analyses were compared to clinical outcome. Median follow-up was 49 months. ITC were detected in 13.2% of the patients. The detection rate rose with increasing tumor size (p=0.011) and lymph node involvement (p<0.001). Systemic relapse and death from breast cancer occurred in 31.7% and 26.9% of the B M-positive versus 13.7% and 10.9% of B M-negative patients, respectively (p<0.001). Analyzing node-positive and node-negative patients separately, ITC-positivity was associated with poor prognosis in the node-positive group and in node-negative patients not receiving adjuvant therapy (T1N0). In multivariate analysis, ITC in B M was an independent prognostic factor together with N-, T-, ER/Pg R-status, histological grade and vascular invasion. Combination of several independent prognostic factors can classify subgroups of patients into excellent and high-risk prognosis groups. Like other groups we have investigated the clinical role of monitoring minimal residual disease before and after adjuvant therapy in breast cancer. One hundred and eighteen high risk stage II breast cancer patients entering the Scandinavian Study Group multicenter trial were randomized to 9 cycles of dose escalated and tailored FEC (5-flurouracil, epirubicin, cyclophosphamide) or standard FEC followed by high dose chemotherapy. B M samples at diagnosis and 6 months after completion of chemotherapy were assessed for the presence of I CT. Median observation time for patients was 68 months. ITC positivity in bone marrow was evaluated as a prognostic and predictive marker and

  14. FOXO Transcription Factors: Their Clinical Significance and Regulation

    Directory of Open Access Journals (Sweden)

    Yu Wang

    2014-01-01

    Full Text Available Members of the class O of forkhead box transcription factors (FOXO have important roles in metabolism, cellular proliferation, stress resistance, and apoptosis. The activity of FOXOs is tightly regulated by posttranslational modification, including phosphorylation, acetylation, and ubiquitylation. Activation of cell survival pathways such as phosphoinositide-3-kinase/AKT/IKK or RAS/mitogen-activated protein kinase phosphorylates FOXOs at different sites which regulate FOXOs nuclear localization or degradation. FOXO transcription factors are upregulated in a number of cell types including hepatocytes, fibroblasts, osteoblasts, keratinocytes, endothelial cells, pericytes, and cardiac myocytes. They are involved in a number of pathologic and physiologic processes that include proliferation, apoptosis, autophagy, metabolism, inflammation, cytokine expression, immunity, differentiation, and resistance to oxidative stress. These processes impact a number of clinical conditions such as carcinogenesis, diabetes, diabetic complications, cardiovascular disease, host response, and wound healing. In this paper, we focus on the potential role of FOXOs in different disease models and the regulation of FOXOs by various stimuli.

  15. 42 CFR 410.71 - Clinical psychologist services and services and supplies incident to clinical psychologist services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical psychologist services and services and supplies incident to clinical psychologist services. 410.71 Section 410.71 Public Health CENTERS FOR... MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.71 Clinical psychologist services...

  16. Rational classification of portal vein thrombosis and its clinical significance.

    Directory of Open Access Journals (Sweden)

    Jingqin Ma

    Full Text Available Portal vein thrombosis (PVT is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women with PVT were examined using contrast-enhanced computed tomography (CT. The percentage of vein occlusion, including portal vein (PV and superior mesenteric vein (SMV, was measured on CT image. Of 60 patients, 17 (28.3% met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT compared to those without SMVT (p<0.001. However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001. Complications of portal hypertension were significantly associated with cirrhosis (p<0.001 rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

  17. LEFT ATRIAL FUNCTION: MODERN ASSESSMENT METHODS AND CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    E. N. Pavlyukova

    2017-01-01

    Full Text Available Assessment of the left atrial (LA function is important aspect of comprehensive cardiovascular system estimation. Many cardiac diseases make an impact to LA work either by direct affect on myocardium or hemodynamic condition changing. It is considered, LA and left ventricle diastolic pressure is interrelated, thus without mitral valve disease LA expanding is a sign of LV filling pressure augmentation. Examination of LA size and function by analysis of atrial reservoir, conduit, and booster pump can predict cardiovascular outcomes in patients with cardiomyopathy, ischemic heart disease and valvular heart disease. The last two decades gave new technologies to accurate and comprehensive LA mechanics estimation, in the first place related to tissue Doppler imaging. Atrial strain and strain rate obtained using two-dimensional speckle-tracking echocardiography have proved to be feasible and reproducible techniques to evaluate LA mechanics.In physiological settings, LA is a highly expandable chamber with relatively low pressures. However in the presence of acute and chronic injury, LA wall stretches. LA stretching is a hallmark of structure changing with myocardial fibrosis and has influence on LA strain and strain rate. LA strain estimation could be useful in the prediction of sinus rhythm restoration and maintenance after cardioversion and catheter ablation. Low values of global longitudinal LA strain indicate irreversible LA remodeling and are related to the atrial fibrillation progression from paroxysmal to permanent forms. The most interesting in these circumstances is the potential contribution of echocardiography to thromboembolic risk stratification in atrial fibrillation and invasive procedures such as atrial ablation. Therefore, at present, the main task is to understand the ways of clinical application of data  obtained during the LA study.

  18. Clinical significance of time to positivity for yeast in candidemia.

    Science.gov (United States)

    Chen, Liang-Yu; Yang, Su-Pen; Chen, Te-Li; Liao, Shu-Yuan; Chen, Yin-Yin; Chan, Yu-Jiun; Chen, Liang-Kung; Wang, Fu-Der

    2015-08-01

    Candidemia is an important issue of nosocomial bloodstream infections, and is associated with a high mortality rate. However, little information is available before final species identification, which takes days after the episode of candidemia. This study tried to determine whether time to positivity (TTP) for yeast helps in predicting the species of candidemia. A retrospective cohort study was conducted in Taiwan, which included 434 episodes of nonduplicated candidemia during the period between 2006 and 2009. The demographic features, clinical characteristics, TTP for yeast, and acute illness scores were included for analysis. The mean age of patients with candidemia was 70.4 ± 15.2 years, and the 30-day crude mortality rate was 48.2%. Forty-five percent of patients suffered from shock status with a mean Acute Physiological and Chronic Health Evaluation II score of 27.0 ± 8.7 and a mean Sequential Organ Failure Assessment score of 9.7 ± 4.5, whereas 50% were admitted to the intensive care units. Candida albicans was still the most commonly identified pathogen (58.1%), followed by C. tropicalis (14.7%), C. parapsilosis (13.1%), and C. glabrata (8.3%). Results of multivariate logistic regression showed that TTP for yeast within 48 hours would more favor C. tropicalis (p = 0.044), and less favor C. glabrata (p = 0.025) and C. parapsilosis (p candidemia. The association between antifungal agents and TTP would need more evidence for elucidation. Copyright © 2013. Published by Elsevier B.V.

  19. Prevalence of Haemophilus Influenzae Biotypes and their Clinical Significance

    Directory of Open Access Journals (Sweden)

    H. Forouhesh Tehrani

    2007-04-01

    Full Text Available Background and objectives Haemophilus influenza can lead to several infections in humans. For example it can lead to meningitis, epiglottitis, pneumonia, cellulitis, bacteremia, septic arthritis and conjunctivitis. H. influenza can be classified into seven biotypes independent of their serotypes. Biotypes are determined by three tests including indol production, urease and ornithine decarboxylase. As specific biotypes are associated with different types of infections, sources and antimicrobial resistance patterns, this study was designed to evaluate biotyping in H.influenza and its relationship with the type of infection. Methods In an 18 month period from April 2005 to September 2006, all clinical specimens that were candidate for Haemophilus isolation, were cultured on standard chocolate agar and blood agar with staphylococcal streak technique. Those isolates that showed the phenomenon of satellitism were biotyped by indol production, urease and ornithine decarboxylation tests.Results From 24 samples positive for Haemophilus influenza, 11 were isolated from eyes, 11 from paranasal sinuses, one from cerebrospinal fluid (CSF and one from blood. The isolates from sinuses belonged to the biotype III, the biotype of 6 of the eye isolates was II and that of the other 5 biotypes were III, and the isolates from blood were type I. Another biotype was not isolated from these samples.Conclusion In other studies, biotype I was the most frequently isolated biotype from CSF and blood. Biotypes II and III have been isolated from the eyes and sputum. The relationship between biotypes II and III in conjunctivitis is well documented. In this study, the most frequently isolated biotypes from conjunctivitis samples were II and III, type III was also common in sinusitis. Biotype IV has been isolated from genital tracts. Due to correlation of biotype and antimicrobial resistance, biotyping is recommended in Haemophilus isolates.Keywords: Influenza B Virus

  20. Expression and clinical significance of SALL4 and LGR5 in patients with lung cancer

    Science.gov (United States)

    GAUTAM, AJAY KUMAR; WANG, CHANGMING; ZENG, JINRONG; WANG, JIYING; LU, JINGYAN; WEI, JIANGHONG; HUANG, GUOJIN; MO, BIFAN; LUO, MIAO; MO, BIWEN

    2015-01-01

    Lung cancer is the most frequent cancer worldwide, in terms of incidence and mortality. Due to challenges in the diagnosis of the disease, the 5-year overall survival rate is only ~16%. Previous studies have suggested that malignant transformations originate from adult stem cells, and malignant lesions may therefore express stem-cell-associated markers. The purpose of the present study is to investigate the expression and clinical significance of the stem cell-associated markers Sal-like protein 4 (SALL4) and leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) in lung cancer, and to provide novel diagnostic markers and targets for the treatment of lung cancer. The expression of the stem cell-associated markers SALL4 and LGR5 was analyzed by immunohistochemistry performed on 135 human lung cancer tissue specimens and 10 non-cancer lung tissue specimens. The clinical significance of the expression of these markers and correlation between their expression and clinical parameters was also assessed. SALL4 expression was highly upregulated in lung cancer tissues, but was not present in non-cancerous lung tissues, and the sensitivity and specificity of SALL4 reached 88% and 100%, respectively. By contrast, LGR5 demonstrated 97% sensitivity, but the specificity was poor. Therefore, SALL4 may be an extremely useful diagnostic marker for lung cancer, but LGR5 is not as useful. PMID:26788181

  1. Clinical significance of lymphadenectomy in patients with gastric cancer.

    Science.gov (United States)

    Tóth, Dezső; Plósz, János; Török, Miklós

    2016-02-15

    Approximately thirty percent of patients with gastric cancer undergo an avoidable lymph node dissection with a higher rate of postoperative complication. Comparing the D1 and D2 dissections, it was found that there is a significant difference in morbidity, favoured D1 dissection without any difference in overall survival. Subgroup analysis of patients with T3 tumor shows a survival difference favoring D2 lymphadenectomy, and there is a better gastric cancer-related death and non-statistically significant improvement of survival for node-positive disease in patients with D2 dissection. However, the extended lymphadenectomy could improve stage-specific survival owing to the stage migration phenomenon. The deployment of centralization and application of national guidelines could improve the surgical outcomes. The Japanese and European guidelines enclose the D2 lymphadenectomy as the gold standard in R0 resection. In the individualized, stage-adapted gastric cancer surgery the Maruyama computer program (MCP) can estimate lymph node involvement preoperatively with high accuracy and in addition the Maruyama Index less than 5 has a better impact on survival, than D-level guided surgery. For these reasons, the preoperative application of MCP is recommended routinely, with an aim to perform "low Maruyama Index surgery". The sentinel lymph node biopsy (SNB) may decrease the number of redundant lymphadenectomy intraoperatively with a high detection rate (93.7%) and an accuracy of 92%. More accurate stage-adapted surgery could be performed using the MCP and SNB in parallel fashion in gastric cancer.

  2. Evaluation of clinical significance of dermoscopy in alopecia areata

    Directory of Open Access Journals (Sweden)

    Akhila Sai Guttikonda

    2016-01-01

    Full Text Available Background: Alopecia areata (AA is a common, chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair-bearing area of the body. Recently, dermoscopy, a noninvasive diagnostic procedure, has been employed for the diagnosis of AA. Aim: To evaluate various dermoscopic patterns in AA and correlate these patterns with the disease activity and severity. Materials and Methods: Dermoscopy was performed on AA patients using DL1 dermoscope (magnification ×10 was used. The dermoscopic patterns recorded were analyzed to identify any correlation with the disease activity and severity. Results: A total of fifty patients of AA were recruited in the study. Female outnumbered males with the ratio being 1.173:1. Mean age of the patients was 25.06 years. Mean duration of disease was 14 months. The most common site involved was scalp (80% and type noted was patchy (84%. Various dermoscopic patterns noted were yellow dots (YD (88%, short vellus hair (66%, black dots (BD (58%, broken hairs (BHs (56%, tapering hair (TH (26%, Coudability hairs (14%, pigtail hair (14%, and Pohl-Pinkus constrictions (2%. Statistically significant correlation was observed between BD, BHs, THs, and disease activity. No significant correlation was found between severity and any of the dermoscopic features. Conclusion: The most common dermoscopic pattern in our study was YD. Presence of BDs, BHs, and THs indicate active disease. Dermoscopic patterns were not affected by severity of the disease.

  3. Incidence of nevirapine-associated hepatitis in an antenatal clinic ...

    African Journals Online (AJOL)

    based highly active antiretroviral therapy at a dedicated antenatal antiretroviral clinic between July 2004 and December 2006. Results. Three hundred and ninety women were included in the analysis. Median age was 29 (interquartile range (IQR)

  4. Prevalence of Haemophilus Influenzae Biotypes and their Clinical Significance

    Directory of Open Access Journals (Sweden)

    Homa Fourohesh

    2012-05-01

    Full Text Available

    Background and objectives

     Haemophilus influenza can lead to several infections in humans. For example it can lead to meningitis, epiglottitis, pneumonia, cellulitis, bacteremia, septic arthritis and conjunctivitis. H. influenza can be classified into seven biotypes independent of their serotypes. Biotypes are determined by three tests including indol production, urease and ornithine decarboxylase. As specific biotypes are associated with different types of infections, sources and antimicrobial resistance patterns, this study was designed to evaluate biotyping in H.influenza and its relationship with the type of infection.

    Methods

     In an 18 month period from April 2005 to September 2006, all clinical specimens that were candidate for Haemophilus isolation, were cultured on standard chocolate agar and blood agar with staphylococcal streak technique. Those isolates that showed the phenomenon of satellitism were biotyped by indol production, urease and ornithine decarboxylation tests.

    Results

     From 24 samples positive for Haemophilus influenza, 11 were isolated from eyes, 11 from paranasal sinuses, one from cerebrospinal fluid (CSF and one from blood. The isolates from sinuses belonged to the biotype III, the biotype of 6 of the eye isolates was II and that of the other 5 biotypes were III, and the isolates from blood were type I. Another biotype was not isolated from these samples.

    Conclusion

     In other studies, biotype I was the most frequently isolated biotype from CSF and blood. Biotypes II and III have been isolated from the eyes and sputum. The relationship between biotypes II and III in

  5. Incidence, Clinical Presentation, and Predictors of Clinical Restenosis in Coronary Bioresorbable Scaffolds.

    Science.gov (United States)

    Polimeni, Alberto; Weissner, Melissa; Schochlow, Katharina; Ullrich, Helen; Indolfi, Ciro; Dijkstra, Jouke; Anadol, Remzi; Münzel, Thomas; Gori, Tommaso

    2017-09-25

    The aim of this study was to describe the incidence and clinical characteristics, including intracoronary imaging features, of clinical restenosis in bioresorbable coronary scaffolds (BRS). Further, the authors searched for clinical and procedural predictors of scaffold restenosis (ScR) and report on the clinical outcomes after treatment of ScR in a cohort of consecutive all-comer patients. Data from randomized controlled trials demonstrate a higher rate of target lesion failure in patients treated with BRS as compared with those treated with metal drug-eluting stents. Although in-scaffold thrombosis has been thoroughly investigated, there are little data available on the incidence and characteristics of ScR. A total of 657 consecutive patients (age 63 ± 12 years, 79% men, 21% diabetics, 67% acute coronary syndrome) who received a total of 883 BRS for the treatment of coronary artery stenoses between May 2012 and January 2015 were enrolled in a retrospective registry. During the median follow-up of 1,076 days (interquartile range: 762 to 1,206 days), a total of 49 cases of ScR were found in 41 patients (Kaplan-Meier incidence: 2.4%, 6.0%, and 9.0% at 12-, 24-, and 36-month follow-up, respectively). ScR presented as stable angina or as incidental finding in 73% of the cases. The angiographic pattern was complex (type II to IV) in 55% of the ScR lesions. The neointima was homogeneous with high signal intensity in all but 3 cases at optical coherence tomography. Prior revascularization (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.5 to 5.1; p = 0.002), diabetes (HR: 2.9; 95%CI: 1.5 to 5.4; p = 0.001), lesion types B2 or C (HR: 2.8; 95% CI: 1.5 to 5.4; p = 0.002), and implantation technique (HR: 0.3; 95% CI: 0.1 to 0.6; p = 0.001) emerged as independent predictors of ScR. Oversizing (HR: 6.29; 95% CI: 2.4 to 16.4), undersizing (HR: 5.15; 95% CI: 1.99 to 13.30), and a residual stenosis >27% (HR: 8.9; 95% CI: 3.6 to 21.8) were associated with an

  6. [Contact lens dynamometry influences the systemic blood circulation: clinical significance].

    Science.gov (United States)

    Rüfer, F; Köpke, B

    2014-11-01

    The diastolic and systolic pressure in the ophthalmic artery (OAPdia, OAPsys) as well as the venous pulsation pressure (VPP) can be determined by contact lens dynamometry (CLD). With these parameters, carotid artery stenosis, ocular perfusion, e.g., in glaucoma patients and the cerebrospinal pressure can be examined indirectly. In the underlying study comparative data were collected and it was investigated to what extent CLD itself leads to changes of the systemic blood pressure. In the course of a prospective trial CLD was performed in 162 eyes of 81 healthy volunteers (mean age 41.0 ± 17.3 years). VPP, OAPdia and OAPsys were measured. A mean was calculated from 5 single readings. Directly before and after CLD automated blood pressure measurements according to Riva-Rocci (RR) and the heart rate were obtained in both arms. In the entire group, the mean VPP was 21 ± 9 mmHg on the right side and 19 ± 8 mmHg on the left side. The mean OAPdia was 60 ± 14 mmHg on the right and 67 ± 14 mmHg on the left side. The mean OAPsys was 91 ± 17 and 101 ± 21 mmHg, respectively. The mean variation coefficient from 5 single readings was 13/16 % for VPP (right/left), 7.4/8.2 % for OAPdia and 6.2/6.2 % for OAPsys. The difference between right and left eyes concerning OAPdia and OAPsys was statistically significant (Wilcoxon test; p < 0.001). VPP and OAPsys were not correlated with age, OAPdia showed a weak correlation with age on the right side (Spearman R = 0.23; p = 0.03). Blood pressure (RR) dropped from a mean 137/84 to 135/82 mmHg in the right arm and from 135/84 to 132/83 mmHg in the left arm. The change of the diastolic values of the right side and of the systolic values of the left side reached statistical significance (p < 0.05). The difference of the systolic blood pressure and the heart rate before and after CLD were weakly correlated (Spearman R = - 0.28; p = 0.01). The extent of the systemic

  7. Clinical significance of melatonin receptors in the human myometrium.

    Science.gov (United States)

    Olcese, James; Beesley, Stephen

    2014-08-01

    To review and update the research on melatonin receptor expression in the human myometrium, in particular as it pertains to uterine contractility at labor. Summary of previous studies with the addition of new data on the transcriptional regulation of melatonin receptor expression in human myometrial cells. Not applicable. Late-term pregnant volunteers. Biopsy collection for in vitro analyses provided the original data. More recently, uterine contractions in late-term pregnant volunteers were assessed before, during, and after acute white-light exposure. Melatonin receptor signaling in myometrial cells and uterine contractions in late-term pregnant volunteers. Melatonin acts through the MTNR1B melatonin receptor that is expressed in the myometrium at late term to synergistically enhance oxytocin-dependent signaling and contractions. Acute inhibition of endogenous melatonin levels with light reversibly suppresses uterine contractions. These results point to a significant role for circulating melatonin in the timing and degree of uterine contractions in late-term pregnancy. Understanding the regulation of melatonin receptors remains a future objective. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. EXPERIMENTAL AND CLINICAL SIGNIFICANCE OF RENAL FUNCTIONAL RESERVE DETERMINATION

    Directory of Open Access Journals (Sweden)

    Jernej Pajek

    2002-07-01

    Full Text Available Background. Renal functional reserve (RFR is defined as the temporary increase in glomerular filtration rate (GFR which follows the ingestion of proteins or infusion of aminoacids. This renal vasodilatatory response is probably mediated by several mechanisms, with nitric oxide being one of the most important mediators. In the last years significant progress in measuring renal functional reserve has been achieved on the basis of improvements in methods for accurate and timely appropriate GFR measurement. The method of GFR measurement using the sinistrin clearence calculation after bolus injection of sinistrin is increasingly employed.Conclusions. The article presents the latest results of experiments with RFR using this method and compares them with older reports. RFR is affected by several patophysiological processes: arterial hypertension, diabetes mellitus, deteriorating function of transplanted kidney. The results and impact of RFR determination in this conditions are described. Finally, potential for further research of RFR in atherosclerotic vascular disease is considered. Accurate determination of RFR is important for detection of early renal hemodynamic abnormalities, which can be influenced by therapeutic interventions and in this way the progression of renal functional deterioration could be prevented or at least slowed.

  9. Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

    Science.gov (United States)

    Martinez, Raquel M.; Hulten, Kristina G.; Bui, Uyen

    2014-01-01

    Lactobacillus spp. are part of the normal human flora and are generally assumed to be nonpathogenic. We determined the genotypic identification of >100 Lactobacillus isolates from clinical specimens in the context of presumed pathogenic potential (e.g., recovered as the single/predominant isolate from a sterile site or at ≥105 CFU/ml from urine). This study assessed the clinical significance and the frequency of occurrence of each Lactobacillus sp. We identified 16 species of Lactobacillus by 16S rRNA gene sequence analysis, 10 of which could not be associated with disease. While Lactobacillus rhamnosus, Lactobacillus gasseri, and Lactobacillus paracasei were associated with infections, L. gasseri was also a common colonizing/contaminating species. Lactobacillus casei, Lactobacillus johnsonii, and Lactobacillus delbrueckii were associated with at least one infection. Species commonly used in probiotic products (e.g., L. rhamnosus and L. casei) were identical, by 16S rRNA gene sequencing, to our isolates associated with disease. Human isolates of Lactobacillus spp. have differing site associations and levels of clinical significance. Knowing the niche and pathogenic potential of each Lactobacillus sp. can be of importance to both clinical microbiology and the food and probiotic supplement industry. PMID:24131686

  10. Clinically significant cardiopulmonary events and the effect of definition standardization on apnea of prematurity management.

    Science.gov (United States)

    Powell, M B F; Ahlers-Schmidt, C R; Engel, M; Bloom, B T

    2017-01-01

    To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge. Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared. Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (Pdefinitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.

  11. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    International Nuclear Information System (INIS)

    Rennie, W.J.; Saifuddin, A.

    2005-01-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  12. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

    2005-07-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  13. Thyroid Incidentalomas on 18F-FDG PET/CT: Clinical Significance and Controversies

    Directory of Open Access Journals (Sweden)

    William Makis

    2017-10-01

    Full Text Available Objective: The purpose of the current study is to examine the incidence and clinical significance of unexpected focal uptake of 18F-fluorodeoxyglucose (18F-FDG on positron emission tomography/computed tomography (PET/CT in the thyroid gland of oncology patients, the maximum standardized uptake value (SUVmax of benign and malignant thyroid incidentalomas in these patients, and review the literature. Methods: Seven thousand two hundred fifty-two 18F-FDG PET/CT studies performed over four years, were retrospectively reviewed. Studies with incidental focal 18F-FDG uptake in the thyroid gland were further analyzed. Results: Incidental focal thyroid 18F-FDG uptake was identified in 157 of 7252 patients (2.2%. Sufficient follow-up data (≥12 months were available in 128 patients, of whom 57 (45% had a biopsy performed and 71 had clinical follow-up. Malignancy was diagnosed in 14 of 128 patients (10.9%. There was a statistically significant difference between the median SUVmax of benign thyroid incidentalomas (SUVmax 4.8 vs malignant (SUVmax 6.3, but the wide range of overlap between the two groups yielded no clinically useful SUVmax threshold value to determine malignancy. Conclusion: 18F-FDG positive focal thyroid incidentalomas occurred in 2.2% of oncologic PET/CT scans, and were malignant in 10.9% of 128 patients. This is the lowest reported malignancy rate in a North American study to date, and significantly lower than the average malignancy rate (35% reported in the literature. Invasive biopsy of all 18F-FDG positive thyroid incidentalomas, as recommended by some studies, is unwarranted and further research to determine optimal management is needed. There was no clinically useful SUVmax cut-off value to determine malignancy and PET/CT may not be a useful imaging modality to follow these patients conservatively.

  14. US diagnosis of choledocholithiasis in patients with acute cholecystitis: Its clinical significance

    International Nuclear Information System (INIS)

    Koo, Joon Bum; Kim, Young Hoon; Cho, Woo Ho; Kim, Joung Sook; Kim, Soung Hee; Kim, Jae Hyung; Bae, Sang Jin

    2002-01-01

    It is essential to identify the presence of choledocholithiasis in patients with acute cholecystitis for elucidating the cause of cholecystitis and deciding the surgical planning. In this study, we tried to evaluate the incidence of choledocholithiasis and its ultrasonographic (US) diagnostic values in patients with acute cholecystitis and to discuss its clinical significance. During a 17 months period, seventy six patients with surgically proven acute cholecystitis who underwent preoperative US and endoscopic retrograde cholangiopancreatography (ERCP) were included in this study. US, ERCP and surgical findings of these patients were compared by reviewing their medical records as well as the US and ERCP images. The incidence of choledocholithiasis in these patients and its US diagnostic values were assessed. Of all 76 patients with acute cholecystitis, 20 (26%) were proved to have choledocholithiasis by ERCP and surgery. Among them, 13 were correctly diagnosed to have choledocholithiasis by US. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of US for the detection of choledocholithiasis in these patients were 65%, 100%, 100%, 89%, and 91%, respectively. Our results indicated that on fourth of patients with acute cholecystitis had choledocholithiasis, and the US diagnostic accuracy in detecting choledocholithiasis proved to be 91%, higher than previously reported results. Therefore, it is essential to undergo US in patients with acute cholecystitis to identify the presence of choledocholithiasis.

  15. US diagnosis of choledocholithiasis in patients with acute cholecystitis: Its clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Joon Bum; Kim, Young Hoon; Cho, Woo Ho; Kim, Joung Sook; Kim, Soung Hee; Kim, Jae Hyung; Bae, Sang Jin [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2002-12-15

    It is essential to identify the presence of choledocholithiasis in patients with acute cholecystitis for elucidating the cause of cholecystitis and deciding the surgical planning. In this study, we tried to evaluate the incidence of choledocholithiasis and its ultrasonographic (US) diagnostic values in patients with acute cholecystitis and to discuss its clinical significance. During a 17 months period, seventy six patients with surgically proven acute cholecystitis who underwent preoperative US and endoscopic retrograde cholangiopancreatography (ERCP) were included in this study. US, ERCP and surgical findings of these patients were compared by reviewing their medical records as well as the US and ERCP images. The incidence of choledocholithiasis in these patients and its US diagnostic values were assessed. Of all 76 patients with acute cholecystitis, 20 (26%) were proved to have choledocholithiasis by ERCP and surgery. Among them, 13 were correctly diagnosed to have choledocholithiasis by US. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of US for the detection of choledocholithiasis in these patients were 65%, 100%, 100%, 89%, and 91%, respectively. Our results indicated that on fourth of patients with acute cholecystitis had choledocholithiasis, and the US diagnostic accuracy in detecting choledocholithiasis proved to be 91%, higher than previously reported results. Therefore, it is essential to undergo US in patients with acute cholecystitis to identify the presence of choledocholithiasis.

  16. Incidence of ricket clinical symptoms and relation between clinical and laboratory findings in infants

    Directory of Open Access Journals (Sweden)

    Čukalović M.

    2014-01-01

    Full Text Available Rickets presents osteomalacia which is developed due to negative balance of calcium and / or phosphorus during growth and development. Therefore it appears only in children. The most common reason of insufficient mineralization is deficiency of vitamin D, which is necessary for inclusion of calcium in cartilage and bones. As result, proliferation of cartilage and bone tissue appears, creating calluses on typical places. Bones become soft and curve, resulting in deformities. Our present study included 86 infants, in whom, besides other diseases, clinical and laboratory signs of rickets were identified. In our study, rickets is most common (82.5% in infants older than 6 months. By clinical picture, craniotabes is present in 46.5% of cases, Harisson groove in 26.7%, rachitic bracelets in 17.4%, rachitic rosary in 17.4% and carpopedal spasms in 2.3% of cases. Leading biochemical signs of vitamin D deficient rickets is hypophosphatemia (in 87.3% of cases, normal calcemia (in 75.6% of cases and increased values of alkaline phosphatase (in 93% of cases. It has been shown that rickets in infant age may later affect higher incidence of juvenile diabetes, infection of lower respiratory tract, osteoporosis, and so on.

  17. Prevalence of Mupirocin Resistance Among Staphylococci, its Clinical Significance and Relationship to Clinical Use.

    Science.gov (United States)

    Rudresh, Manohar Shoorashetty; Ravi, Giriyapur Siddappa; Motagi, Aravind; Alex, Ann Mary; Sandhya, Parthasarathi; Navaneeth, Bangalore Viswanath

    2015-01-01

    Mupirocin competitively inhibits bacterial isoleucyl transfer-RNA synthetase and inhibit bacterial protein synthesis. Widespread usage and over the counter availability of the drug has resulted in resistance among Staphylococcus species. This study aimed to determine the overall prevalence of mupirocin resistance among staphylococci. Correlate clinical significance of mupirocin resistance and its relationship to clinical use. Consecutive, nonrepetitive, clinical isolates of Staphylococcus aureus (n = 98), and coagulase-negative staphylococci (CoNS) (n = 45) from skin and soft-tissue infections between January 2014 and June 2014 were studied. Antibiotic susceptibility testing was done according to Clinical and Laboratory Standards Institute guidelines. Low- and high-level mupirocin resistance was screened by using 5 µg and 200 µg discs respectively and confirmed by agar dilution. Annual consumption of mupirocin was studied and correlated with resistance. High-level mupirocin resistance was found in 8.2% S. aureus and 15.6% of CoNS, while low-level mupirocin resistance was found in 17% S. aureus and 8.9% CoNS. High-level mupirocin resistance was more common in methicillin-sensitive S. aureus isolates when compared with methicillin-resistant S. aureus isolates (P staphylococci demands the judicious use of the drug in the community.

  18. Do clinical incidents, complaints and medicolegal claims overlap?

    Science.gov (United States)

    Goldsmith, Paul; Moon, Jackie; Anderson, Paul; Kirkup, Steve; Williams, Susan; Gray, Margaret

    2015-01-01

    Error reporting by healthcare staff, patient-derived complaints and patient-derived medico-legal claims are three separate processes present in most healthcare systems. It is generally assumed that all relate to the same cases. Given the high costs associated with these processes and strong desire to maximise quality and standards, the purpose of this paper is to see whether it was indeed the case that most complaints and claims related to medical errors and the relative resource allocation to each group. Electronic databases for clinical error recording, patient complaints and medico-legal claims in a large NHS healthcare provider organisation were reviewed and case overlap analysed. Most complaints and medico-legal claims do not associate with a prior clinical error. Disproportionate resource is required for a small number of complaints and the medico-legal claims process. Most complaints and claims are not upheld. The authors have only looked at data from one healthcare provider and for one period. It would be useful to analyse other healthcare organisations over a longer time period. The authors were unable to access data on secondary staffing costs, which would have been informative. As the medico-legal process can go on for many years, the authors do not know the ultimate outcomes for all cases. The authors also do not know how many medico-legal cases were settled out of court pragmatically to minimise costs. Practical implications - Staff error reporting systems and patient advisory services seem to be efficient and working well. However, the broader complaints and claims process is costing considerable time and money, yet may not be useful in driving up standards. System changes to maximise helpful complaints and claims, from a quality and standards perspective, and minimise unhelpful ones are recommended. This study provides important data on the lack of overlap between errors, complaints and claims cases.

  19. Incidence of cerebral microbleeds A longitudinal study in a memory clinic population

    NARCIS (Netherlands)

    Goos, J.D.C.; Henneman, W.J.P.; Sluimer, J.D.; Vrenken, H.; Sluimer, I.C.; Barkhof, F.; Blankenstein, M.A.; Scheltens, P.; van der Flier, W.M.

    2010-01-01

    Background: Cerebral microbleeds (MBs) are commonly observed in memory clinic patients. Little is known about occurrence of and risk factors for developing new MBs in this population. Objective: To investigate incidence of lobar and nonlobar MBs in a memory clinic population. Furthermore, to assess

  20. Clinical-genetic model predicts incident impulse control disorders in Parkinson’s disease

    Science.gov (United States)

    Kraemmer, Julia; Smith, Kara; Weintraub, Daniel; Guillemot, Vincent; Nalls, Mike A; Cormier-Dequaire, Florence; Moszer, Ivan; Brice, Alexis; Singleton, Andrew B; Corvol, Jean-Christophe

    2016-01-01

    Objectives Impulse control disorders (ICD) are commonly associated with dopamine replacement therapy (DRT) in patients with Parkinson’s disease (PD). Our aims were to estimate ICD heritability and to predict ICD by a candidate genetic multivariable panel in patients with PD. Methods Data from de novo patients with PD, drug-naïve and free of ICD behaviour at baseline, were obtained from the Parkinson’s Progression Markers Initiative cohort. Incident ICD behaviour was defined as positive score on the Questionnaire for Impulsive-Compulsive Disorders in PD. ICD heritability was estimated by restricted maximum likelihood analysis on whole exome sequencing data. 13 candidate variants were selected from the DRD2, DRD3, DAT1, COMT, DDC, GRIN2B, ADRA2C, SERT, TPH2, HTR2A, OPRK1 and OPRM1 genes. ICD prediction was evaluated by the area under the curve (AUC) of receiver operating characteristic (ROC) curves. Results Among 276 patients with PD included in the analysis, 86% started DRT, 40% were on dopamine agonists (DA), 19% reported incident ICD behaviour during follow-up. We found heritability of this symptom to be 57%. Adding genotypes from the 13 candidate variants significantly increased ICD predictability (AUC=76%, 95% CI (70% to 83%)) compared to prediction based on clinical variables only (AUC=65%, 95% CI (58% to 73%), p=0.002). The clinical-genetic prediction model reached highest accuracy in patients initiating DA therapy (AUC=87%, 95% CI (80% to 93%)). OPRK1, HTR2A and DDC genotypes were the strongest genetic predictive factors. Conclusions Our results show that adding a candidate genetic panel increases ICD predictability, suggesting potential for developing clinical-genetic models to identify patients with PD at increased risk of ICD development and guide DRT management. PMID:27076492

  1. Clinical significance of troponin elevations in acute decompensated diabetes without clinical acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Eubanks Anthony

    2012-12-01

    Full Text Available Abstract Background Elevation of cardiac troponin has been documented in multiple settings without acute coronary syndrome. However, its impact on long-term cardiac outcomes in the context of acute decompensated diabetes remains to be explored. Methods We performed a retrospective analysis of 872 patients admitted to Temple University Hospital from 2004–2009 with DKA or HHS. Patients were included if they had cardiac troponin I (cTnI measured within 24 hours of hospital admission, had no evidence of acute coronary syndrome and had a follow up period of at least 18 months. Of the 264 patients who met the criteria, we reviewed the baseline patient characteristics, admission labs, EKGs and major adverse cardiovascular events during the follow up period. Patients were categorized into two groups with normal and elevated levels of cardiac enzymes. The composite end point of the study was the occurrence of a major cardiovascular event (MACE during the follow up period and was compared between the two groups. Results Of 264 patients, 24 patients were found to have elevated cTnI. Compared to patients with normal cardiac enzymes, there was a significant increase in incidence of MACE in patients with elevated cTnI. In a regression analysis, which included prior history of CAD, HTN and ESRD, the only variable that independently predicted MACE was an elevation in cTnI (p = 0.044. Patients with elevated CK-MB had increased lengths of hospitalization compared to the other group (p  Conclusions Elevated cardiac troponin I in patients admitted with decompensated diabetes and without evidence of acute coronary syndrome, strongly correlate with a later major cardiovascular event. Thus, elevated troponin I during metabolic abnormalities identify a group of patients at an increased risk for poor long-term outcomes. Whether these patients may benefit from early detection, risk stratification and preventive interventions remains to be investigated.

  2. Small airway function changes and its clinical significance of asthma patients in different clinical phases

    Directory of Open Access Journals (Sweden)

    Yan-Hui Zhou

    2016-11-01

    Full Text Available Objective: To observe the small airways function changes of asthmatic patients in different clinical phases and to discuss its clinical significance. Methods: A total of 127 patients diagnosed as asthma were selected randomly and pulmonary function (PF of them was determined by conventional method. Then they were divided into A, B and C group based on PF results. All 34 patients in A group suffered from acute asthma attack for the first time. All 93 patients in B group had been diagnosed as asthma but in remission phase. C Group was regarded as Control group with 20 healthy volunteers. Then FEV1, FEF50%, FEF75% levels of patients in each group were analyzed, and ΔFEV1, ΔFEF75% and ΔFEF50% levels of patients in each group were compared after bronchial dilation test. Results: It was found that most patients in group A and B had abnormal small airways function, and their small airways function was significantly different compared with that of group C (P<0.01. In addition, except for group C, ΔFEF75%,ΔFEF50% levels in A and B group were improved more significantly than ΔFEV1 levels (P<0.01. Conclusions: Asthma patients in acute phase all have abnormal small airways function. Most asthma patients in remission phase also have abnormal small airways function. After bronchial dilation test, whether patients in acute phase or in remission phase, major and small airways function of them are improved, but improvement of small airways function is weaker than that of major airways. This indicates that asthma respiratory tract symptoms in different phases exists all the time and so therapeutic process is needed to perform step by step.

  3. Clinical significance of right ventricular function in the cases with congestive heart failure

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa; Kozuka, Takahiro.

    1988-01-01

    Recently, right and left ventricular ejection fraction (RVEF and LVEF) were accurately assessed by gated blood pool scan and these clinical parameters were applied to evaluate the pre and postoperative evaluation of ischemic, valvular and congenital heart disease. This study was under taken to investigate the clinical significance of right ventricular function in the case with congestive heart failure which had lower LVEF (≤35%). There were divided into three groups: (A) 37 cases of myocardial infarction with normal RVEF (RVEF>46%), (B) 16 cases of myocardial infarction with decreased RVEF (RVEF≤46%) and (C) 20 cases of dilated cardiomyopathy with decreased RVEF (RVEF≤46%). Group (B) had increased pulmonary artery pressure, and left ventricular end-diastolic pressure. The incidence of recurrent attack and multivessel disease were not different between group (A) and (B), however, the exercise tolerance was decreased in group (B), Group (C) had also decreased exercise tolerance. These data demonstrated that decreased RVEF in congestive heart failure had high risk sub-group, and RVEF correlated with exercise tolerance compared to LVEF. (author)

  4. Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review.

    Science.gov (United States)

    Noordhoek, Iris; Koning, Marvyn T; Jacobs, Wilco C H; Vleggeert-Lankamp, Carmen L A

    2018-04-01

    The placement of intervertebral cages in anterior cervical discectomy (ACDF) supposedly maintains foraminal height. The most commonly reported cage-related complication is subsidence, although it is unknown whether a correlation between subsidence and clinical outcome exists. To assess the incidence and relevance of subsidence. Literature searches were performed in PubMed, MEDLINE, Embase, Web of Science, COCHRANE, and CENTRAL. The inclusion criteria were as follows: ≥ 20 patients, ADCF with cage, subsidence assessed, and primary data. Risk of bias was assessed using adjusted Cochrane checklists. Seventy-one studies, comprising 4784 patients, were included. Subsidence was generally defined as ≥ 3-mm loss of height comparing postoperative intervertebral heights with heights at last follow-up. Mean incidence of subsidence was 21% (range 0-83%). Of all patients, 46% of patients received polyether-ether-ketone (PEEK) cages, 31% received titanium cages, 18% received cage-screw-combinations, and 5% received polymethyl-methacrylate (PMMA) cages. Patients treated with cage-screw-combinations had significantly less subsidence than patients treated with PEEK, titanium, or PMMA cages (15.1% vs. 23.5% vs. 24.9% vs. 30.2%; p subsidence; the majority did not find a significant correlation. Only four studies correlated subsidence to cage size and/or height; no correlation was established. Subsidence in ACDF with cages occurs in 21% of patients. The risk for subsidence seems lower using PEEK or titanium cages or adding screws. Whether subsidence affects clinical outcome is not satisfactorily evaluated in the available literature. Future studies on this correlation are warranted in order to establish the additional value of the interposition of a cage in ACDF.

  5. Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

    International Nuclear Information System (INIS)

    Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Chae, Eun Young; Myung, Seung Jae; Ko, Gi Young; Gwon, Dong Il; Sung, Kyu Bo

    2009-01-01

    To evaluate the incidence, predictive factors, and clinical outcomes of angiographically negative acute arterial upper and lower gastrointestinal (GI) bleeding. From 2001 to 2008, 143 consecutive patients who underwent an angiography for acute arterial upper or lower GI bleeding were examined. The angiographies revealed a negative bleeding focus in 75 of 143 (52%) patients. The incidence of an angiographically negative outcome was significantly higher in patients with a stable hemodynamic status (p < 0.001), or in patients with lower GI bleeding (p = 0.032). A follow-up of the 75 patients (range: 0-72 months, mean: 8 ± 14 months) revealed that 60 of the 75 (80%) patients with a negative bleeding focus underwent conservative management only, and acute bleeding was controlled without rebleeding. Three of the 75 (4%) patients underwent exploratory surgery due to prolonged bleeding; however, no bleeding focus was detected. Rebleeding occurred in 12 of 75 (16%) patients. Of these, six patients experienced massive rebleeding and died of disseminated intravascular coagulation within four to nine hours after the rebleeding episode. Four of the 16 patients underwent a repeat angiography and the two remaining patients underwent a surgical intervention to control the bleeding. Angiographically negative results are relatively common in patients with acute GI bleeding, especially in patients with a stable hemodynamic status or lower GI bleeding. Most patients with a negative bleeding focus have experienced spontaneous resolution of their condition

  6. Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

    2015-11-15

    patients had a history of malignancy. Of the remaining 31 patients without follow-up CT studies, none had a history of malignancy. Clinical follow-up data was available in 26 of these 31 patients (84%) and none had any evidence of malignant pulmonary nodule development. There was a significant association between history of malignancy and incidentally detected pulmonary nodules on abdominal CT studies subsequently found to be malignant (P = 0.036). The size was significantly larger for the malignant pulmonary nodules compared to the benign pulmonary nodules with a size ≥7 mm in diameter being the optimal cut-off for suggesting a high risk of malignancy (11.5 ± 6.4 mm vs. 4.7 ± 3.0 mm, P = 0.003). The incidence of pulmonary nodules found on pediatric abdominal CT studies is 1.2%. The incidence of malignancy in such pulmonary nodules is low (3%) and only seen in the setting of pulmonary nodules ≥7 mm in diameter in children with a history of malignancy. Therefore, further investigation is warranted for pulmonary nodules that are ≥7 mm in children with a history of malignancy while further imaging work-up may not be necessary in the remaining patients in this pediatric patient population. (orig.)

  7. Why general practitioners and consultants change their clinical practice: a critical incident study.

    OpenAIRE

    Allery, L. A.; Owen, P. A.; Robling, M. R.

    1997-01-01

    OBJECTIVE: To describe the complete range of factors which doctors recognise as changing their clinical practice and provide a measure of how often education is involved in change. DESIGN: Interviews using the critical incident technique. SETTING: Primary and secondary care. SUBJECTS: Random sample of 50 general practitioners and 50 consultants. MAIN OUTCOME MEASURES: Categories of reasons for change in clinical practice. RESULTS: Doctors described 361 changes in clinical practice, with an av...

  8. Incidence and correlates of delirium in a West African mental health clinic

    OpenAIRE

    Ola, B.A.; Crabb, J.; Krishnadas, R.; Erinfolami, A.R.; Olagunju, A.

    2010-01-01

    Objective:\\ud \\ud \\ud To determine the incidence of delirium in those patients presenting to a psychiatric clinic in Nigeria and to examine if any demographic or clinical variables were correlated with this diagnosis.\\ud \\ud \\ud Method \\ud \\ud \\ud A prospective survey design; 264 consecutive new referrals to a psychiatric clinic in Nigeria were assessed for the presence of delirium using a standardised diagnostic scale. Data was analysed for normality and appropriate statistical test employed...

  9. Clinically significant discrepancies between sleep problems assessed by standard clinical tools and actigraphy

    Directory of Open Access Journals (Sweden)

    Kjersti Marie Blytt

    2017-10-01

    Full Text Available Abstract Background Sleep disturbances are widespread among nursing home (NH patients and associated with numerous negative consequences. Identifying and treating them should therefore be of high clinical priority. No prior studies have investigated the degree to which sleep disturbances as detected by actigraphy and by the sleep-related items in the Cornell Scale for Depression in Dementia (CSDD and the Neuropsychiatric Inventory – Nursing Home version (NPI-NH provide comparable results. Such knowledge is highly needed, since both questionnaires are used in clinical settings and studies use the NPI-NH sleep item to measure sleep disturbances. For this reason, insight into their relative (disadvantages is valuable. Method Cross-sectional study of 83 NH patients. Sleep was objectively measured with actigraphy for 7 days, and rated by NH staff with the sleep items in the CSDD and the NPI-NH, and results were compared. McNemar's tests were conducted to investigate whether there were significant differences between the pairs of relevant measures. Cohen's Kappa tests were used to investigate the degree of agreement between the pairs of relevant actigraphy, NPI-NH and CSDD measures. Sensitivity and specificity analyses were conducted for each of the pairs, and receiver operating characteristics (ROC curves were designed as a plot of the true positive rate against the false positive rate for the diagnostic test. Results Proxy-raters reported sleep disturbances in 20.5% of patients assessed with NPI-NH and 18.1% (difficulty falling asleep, 43.4% (multiple awakenings and 3.6% (early morning awakenings of patients had sleep disturbances assessed with CSDD. Our results showed significant differences (p<0.001 between actigraphy measures and proxy-rated sleep by the NPI-NH and CSDD. Sensitivity and specificity analyses supported these results. Conclusions Compared to actigraphy, proxy-raters clearly underreported NH patients' sleep disturbances as assessed

  10. Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus

    Directory of Open Access Journals (Sweden)

    Kwon Keun-Sang

    2010-07-01

    Full Text Available Abstract Background This study was designed to investigate the clinical significance of hypoalbuminemia as a marker of severity and mortality in patients with Scrub typhus. Methods The patients with scrub typhus were divided into two groups based on the serum albumin levels; Group I (serum albumin Results Of the total 246 patients who underwent the study, 84 patients (34.1% were categorized as Group I and 162 patients were (65.9% as Group II. Group I showed significantly higher incidence of confusion (24.6% vs. 5.3%, p p = 0.002, pleural effusion (22.8% vs. 11.1%, p = 0.03, arrhythmia (12.3% vs. 2.6%, p = 0.008 and non-oliguric acute renal failure (40.4% vs. 11.1%, p p p = 0.012, and higher hospital cost compared to Group II. Conclusions This study showed hypoalbuminemia in scrub typhus was closely related to the frequency of various complication, longer hospital stay, consequently the higher medical cost, necessitating more efficient management of patients, including medical resources.

  11. Clinical Significance of Serum Adipokines according to Body Mass Index in Patients with Clinically Localized Prostate Cancer Undergoing Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Minyong Kang

    2018-01-01

    Full Text Available Purpose: The aim of this study was to investigate the clinical significance of 7 circulating adipokines according to body mass index (BMI in Korean men with localized prostate cancer (PCa undergoing radical prostatectomy (RP. Materials and Methods: Sixty-two of 65 prospectively enrolled patients with clinically localized PCa who underwent RP between 2015 and 2016 were evaluated. Patients were classified into 2 groups according to their BMI: non-obese (<25 kg/m2 and obese (≥25 kg/m2. The adipokines evaluated were interleukin-2, insulin-like growth factor 1 (IGF-1, chemerin, C-X-C motif chemokine 10, adiponectin, leptin, and resistin. Multivariate logistic regression analysis was used to identify the independent predictors of advanced tumor stage. Results: We found that obese patients with PCa who underwent RP had a higher incidence of tumors with a high Gleason score (≥8, pathological T3 (pT3 stage, and positive extraprostatic extension than patients with a normal BMI. Additionally, patients with obesity showed significantly lower serum adiponectin and higher serum leptin levels, but did not show differences in other adipokines. Multivariate analysis demonstrated that IGF-1 (odds ratio [OR]=1.03 was identified as a predictor of advanced tumor stage (≥pT3 in the overall population. However, only leptin remained an independent predictive factor for advanced tumor stage (≥pT3 (OR=1.15 in patients with obesity. Conclusions: In conclusion, our results indicate that a higher leptin level in obese men can be considered a risk factor for aggressive PCa. This prospective study provides greater insight into the role of circulating adipokines in Korean patients with PCa undergoing RP, particularly in patients with obesity.

  12. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    International Nuclear Information System (INIS)

    Fiorella, D.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  13. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiorella, D.; Helms, C.A. [Dept. of Radiology, Duke Univ., Durham, NC (United States); Speer, K.P. [Dept. of Orthopedic Surgery, Duke Univ., Durham, NC (United States)

    2000-12-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  14. Masked Hypertension and Incident Clinic Hypertension among African Americans in the Jackson Heart Study

    Science.gov (United States)

    Abdalla, Marwah; Booth, John N.; Seals, Samantha R.; Spruill, Tanya M.; Viera, Anthony J.; Diaz, Keith M.; Sims, Mario; Muntner, Paul; Shimbo, Daichi

    2016-01-01

    Masked hypertension, defined as non-elevated clinic blood pressure and elevated out-of-clinic blood pressure may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic blood pressure and masked hypertension using ambulatory blood pressure monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of African Americans. Analyses included 317 participants with clinic blood pressure hypertension was defined as mean daytime blood pressure ≥135/85mmHg; masked nighttime hypertension as mean nighttime blood pressure ≥120/70mmHg; and masked 24-hour hypertension as mean 24-hour blood pressure ≥130/80mmHg. Incident clinic hypertension, assessed at study visits in 2005–2008 and 2009–2012, was defined as the first visit with clinic systolic/diastolic blood pressure ≥140/90mmHg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked nighttime hypertension and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% CI) of incident clinic hypertension for any masked hypertension and masked daytime, nighttime, and 24-hour hypertension were 2.13 (1.51–3.02), 1.79 (1.24–2.60), 2.22 (1.58–3.12), and 1.91 (1.32–2.75), respectively. These findings suggest that ambulatory blood pressure monitoring can identify African Americans at increased risk for developing clinic hypertension. PMID:27185746

  15. Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Elaine; Weir-McCall, Jonathan R.; Houston, J.G.; Struthers, Allan D. [Ninewells Hospital, Division of Cardiovascular and Diabetes Medicine, Dundee (United Kingdom); Patel, Rajan K.; Jardine, Alan G.; Mark, Patrick B. [Institute of Cardiovascular and Medical Sciences, Glasgow (United Kingdom); Roditi, Giles [NHS Greater Glasgow and Clyde, Department of Radiology, Glasgow Royal Infirmary, Glasgow (United Kingdom)

    2017-01-15

    Left ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants. Between 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF. There were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival. Without radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF. (orig.)

  16. Biomarker Tools to Design Clinical Vaccines Determined from a Study of Annual Listeriosis Incidence in Northern Spain

    Science.gov (United States)

    Calderon-Gonzalez, Ricardo; Teran-Navarro, Hector; Marimon, José María; González-Rico, Claudia; Calvo-Montes, Jorge; Frande-Cabanes, Elisabet; Alkorta-Gurrutxaga, Miriam; Fariñas, M. C.; Martínez-Martínez, Luis; Perez-Trallero, Emilio; Alvarez-Dominguez, Carmen

    2016-01-01

    Two regions of northern Spain, Gipuzkoa, and Cantabria present high annual incidence of listeriosis (1.86 and 1.71 cases per 100,000 inhabitants, respectively). We report that the high annual incidences are a consequence of infection with highly virulent Listeria monocytogenes isolates linked to fatal outcomes in elderly patients with cancer. In addition, listeriosis patients with cancer present low IL-17A/IL-6 ratios and significantly reduced levels of anti-GAPDH1–22 antibodies, identified as two novel biomarkers of poor prognosis. Analysis of these biomarkers may aid in reducing the incidence of listeriosis. Moreover, GAPDH1–22-activated monocyte-derived dendritic cells of listeriosis patients with cancer seem useful tools to prepare clinical vaccines as they produce mainly Th1 cytokines. PMID:27965668

  17. Persistent perforation in non-faeculant diverticular peritonitis--incidence and clinical significance.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2013-02-01

    Non-resectional strategies (NRS) have improved outcomes for a sub-group of patients with perforated diverticulitis. NRS are applicable to patients with non-faeculant peritonitis (Hinchey II and III). Success is dependent on the initial perforation sealing, which Hinchey estimated occurred \\'most of the time\\'. An exact percentage remains ill-defined.

  18. Focal cerebral hyperemia in acute stroke. Incidence, pathophysiology and clinical significance

    DEFF Research Database (Denmark)

    Olsen, T S; Larsen, B; Skriver, E B

    1981-01-01

    tissue pressure on brain tissue. Cortical infarcts (10 patients) all had extensive hyperemic areas. Because the 254 detector camera has an excellent resolution in the cortical surface, our findings strongly suggest that all acute cerebral infarcts are, in fact, associated with hyperemic areas......In a consecutive study comprising 41 patients with completed stroke of less than 72 hours duration, cerebral angiography and measurements of the regional cerebral blood flow (rCBF) were performed within 24 hours after admission. The rCBF study was done using the 133-Xenon intracarotid injection...... method and a 254 multi-detector camera. CT scan was done 24 hours after the rCBF study. Focal cerebral hyperemia was found in 16 patients. The study revealed 3 different types of hyperemia: Border-zone hyperemia, surrounding ischemic areas, was seen in patients with occluded arteries on angiography...

  19. Incidence, clinical predictors and outcome of acute renal failure among North Indian trauma patients

    Science.gov (United States)

    Medha; Subramanian, Arulselvi; Pandey, Ravindra Mohan; Sawhney, Chhavi; Upadhayay, Ashish Dutt; Albert, Venencia

    2013-01-01

    Context: There is a need for identifying risk factors aggravating development of acute renal failure after attaining trauma and defining new parameters for better assessment and management. Aim of the study was to determine the incidence of acute renal failure among trauma patients, and its correlation with various laboratory and clinical parameters recorded at the time of admission and in-hospital mortality. Subjects and Methods: The retrospective cohort study included admitted 208 trauma patients over a period of one year. 135 trauma patients at the serum creatinine level >2.0 mg/dL were enrolled in under the group of acute renal failure. 73 patients who had normal creatinine level made the control group. They were further assessed with clinical details and laboratory investigations. Results: Incidence of acute renal failure was 3.1%. There were 118 (87.4%) males and average length of stay was 9 (1, 83) days. Severity of injury (ISS, GCS) was relatively more among the renal failure group. Renal failure was transient in 35 (25.9%) patients. They had higher incidence of bone fracture (54.0%) (P= 0.04). Statistically significant association was observed between patients with head trauma and mortality 72 (59.0%) (P= 0.001). Prevalence of septic 24 (59.7%) and hemorrhagic 9 (7.4%) shock affected the renal failure group. Conclusion: Trauma patients at the urea level >50 mg/dL, ISS >24 on the first day of admission had 23 times and 7 times the risk of developing renal failure. Similarly, patients with hepatic dysfunction and pulmonary dysfunction were 12 times and 6 times. Patients who developed cardiovascular dysfunction, hematological dysfunction and post-trauma renal failure during the hospital stay had risk for mortality 29, 7 and 8 times, respectively. The final prognostic score obtained was: 14*hepatic dysfunction + 11*cISS + 18*cUrea + 12*cGlucose + 10*pulmonary dysfunction. Optimal score cut-off for prediction of renal failure was found to be ≥25 with

  20. Incidence, clinical predictors and outcome of acute renal failure among North Indian trauma patients.

    Science.gov (United States)

    Medha; Subramanian, Arulselvi; Pandey, Ravindra Mohan; Sawhney, Chhavi; Upadhayay, Ashish Dutt; Albert, Venencia

    2013-01-01

    There is a need for identifying risk factors aggravating development of acute renal failure after attaining trauma and defining new parameters for better assessment and management. Aim of the study was to determine the incidence of acute renal failure among trauma patients, and its correlation with various laboratory and clinical parameters recorded at the time of admission and in-hospital mortality. The retrospective cohort study included admitted 208 trauma patients over a period of one year. 135 trauma patients at the serum creatinine level >2.0 mg/dL were enrolled in under the group of acute renal failure. 73 patients who had normal creatinine level made the control group. They were further assessed with clinical details and laboratory investigations. Incidence of acute renal failure was 3.1%. There were 118 (87.4%) males and average length of stay was 9 (1, 83) days. Severity of injury (ISS, GCS) was relatively more among the renal failure group. Renal failure was transient in 35 (25.9%) patients. They had higher incidence of bone fracture (54.0%) (P= 0.04). Statistically significant association was observed between patients with head trauma and mortality 72 (59.0%) (P= 0.001). Prevalence of septic 24 (59.7%) and hemorrhagic 9 (7.4%) shock affected the renal failure group. Trauma patients at the urea level >50 mg/dL, ISS >24 on the first day of admission had 23 times and 7 times the risk of developing renal failure. Similarly, patients with hepatic dysfunction and pulmonary dysfunction were 12 times and 6 times. Patients who developed cardiovascular dysfunction, hematological dysfunction and post-trauma renal failure during the hospital stay had risk for mortality 29, 7 and 8 times, respectively. The final prognostic score obtained was: 14*hepatic dysfunction + 11*cISS + 18*cUrea + 12*cGlucose + 10*pulmonary dysfunction. Optimal score cut-off for prediction of renal failure was found to be ≥25 with specificity, sensitivity and positive likelihood ratio to be

  1. Incidence, clinical predictors and outcome of acute renal failure among North Indian trauma patients

    Directory of Open Access Journals (Sweden)

    Medha

    2013-01-01

    Full Text Available Context: There is a need for identifying risk factors aggravating development of acute renal failure after attaining trauma and defining new parameters for better assessment and management. Aim of the study was to determine the incidence of acute renal failure among trauma patients, and its correlation with various laboratory and clinical parameters recorded at the time of admission and in-hospital mortality. Subjects and Methods: The retrospective cohort study included admitted 208 trauma patients over a period of one year. 135 trauma patients at the serum creatinine level >2.0 mg/dL were enrolled in under the group of acute renal failure. 73 patients who had normal creatinine level made the control group. They were further assessed with clinical details and laboratory investigations. Results: Incidence of acute renal failure was 3.1%. There were 118 (87.4% males and average length of stay was 9 (1, 83 days. Severity of injury (ISS, GCS was relatively more among the renal failure group. Renal failure was transient in 35 (25.9% patients. They had higher incidence of bone fracture (54.0% (P = 0.04. Statistically significant association was observed between patients with head trauma and mortality 72 (59.0% (P = 0.001. Prevalence of septic 24 (59.7% and hemorrhagic 9 (7.4% shock affected the renal failure group. Conclusion: Trauma patients at the urea level >50 mg/dL, ISS >24 on the first day of admission had 23 times and 7 times the risk of developing renal failure. Similarly, patients with hepatic dysfunction and pulmonary dysfunction were 12 times and 6 times. Patients who developed cardiovascular dysfunction, hematological dysfunction and post-trauma renal failure during the hospital stay had risk for mortality 29, 7 and 8 times, respectively. The final prognostic score obtained was: 14FNx01hepatic dysfunction + 11FNx01cISS + 18FNx01cUrea + 12FNx01cGlucose + 10FNx01pulmonary dysfunction. Optimal score cut-off for prediction of renal failure was

  2. Medication safety: using incident data analysis and clinical focus groups to inform educational needs.

    Science.gov (United States)

    Hesselgreaves, Hannah; Watson, Anne; Crawford, Andy; Lough, Murray; Bowie, Paul

    2013-02-01

    Medication-related safety incidents are a source of concern to patients, policy makers and clinicians. The role of education in improving safety-critical practices in health care is poorly appreciated. This pilot study aimed to initiate collective discussion among professional groups of clinical staff about a range of medicine-related patient safety issues which were identified from a local incident reporting system. In engaging staff to collectively reflect on reported medication incidents we attempted to uncover a deeper understanding of local contextual issues and potential educational needs. A mixed method study was conducted involving categorical analysis of 1058 medication incident reports (Phase 1) and the use of three mixed focus groups of clinical staff (Phase 2) in three acute hospitals in one locality in NHS Scotland. Focus group transcript analysis produced four main themes (e.g. the medical role) and 12 related sub-themes (e.g. pharmacological education and skill mix for administration of medicines) concerning medication-related practices and possible educational interventions. While it is necessary to review reported incident data and disseminate the educational messages for the improvement of quality, this traditional risk management process is inadequate on its own. Reporting systems can be enhanced by collective examination of reported information about medicines by local clinical teams. We identified a strong message from the focus groups for learning about each other and from each other, and that the method piloted may be an important inter-professional mechanism for improvement. © 2011 Blackwell Publishing Ltd.

  3. Models and Mechanisms of Acquired Antihormone Resistance in Breast Cancer: Significant Clinical Progress Despite Limitations

    Science.gov (United States)

    Sweeney, Elizabeth E.; McDaniel, Russell E.; Maximov, Philipp Y.; Fan, Ping; Jordan, V. Craig

    2012-01-01

    Translational research for the treatment and prevention of breast cancer depends upon the four Ms: models, molecules, and mechanisms in order to create medicines. The process, to target the estrogen receptor (ER) in estrogen-dependent breast cancer, has yielded significant advances in patient survivorship and the first approved medicines (tamoxifen and raloxifene) to reduce the incidence of any cancer in high- or low-risk women. This review focuses on the critical role of the few ER-positive cell lines (MCF-7, T47D, BT474, ZR-75) that continue to advance our understanding of the estrogen-regulated biology of breast cancer. More importantly, the model cell lines have provided an opportunity to document the development and evolution of acquired antihormone resistance. The description of this evolutionary process that occurs in micrometastatic disease during up to a decade of adjuvant therapy would not be possible in the patient. The use of the MCF-7 breast cancer cell line in particular has been instrumental in discovering a vulnerability of ER-positive breast cancer exhaustively treated with antihormone therapy. Physiologic estradiol acts as an apoptotic trigger to cause tumor regression. These unanticipated findings in the laboratory have translated to clinical advances in our knowledge of the paradoxical role of estrogen in the life and death of breast cancer. PMID:23308083

  4. [Clinical significance of vertebral artery MRA to vertebral artery type of cervical spondylosis' diagnosis and treatment].

    Science.gov (United States)

    Zhang, Ming-Cai; Shi, Yin-Yu; Chen, Dong-Yu; Huang, Shi-Rong; Chen, Bo; Wang, Xiang; Wang, Hui-Hao; Zhang, Kai-Yong; Guo, Kai; Zhan, Hong-Sheng

    2013-11-01

    To study clinical significance of vertebral artery magnetic resonance angiography (MRA) to vertebral artery type of cervical spondylosis' diagnosis and treatment. There were two groups in the study, which were observation group and control group. There were 53 patients in observation group,including 19 males and 34 females,with a mean age of (52.51 +/- 11.29) years. There were 30 subjects in control group,including 10 males and 20 females,with a mean age of (48.11 +/- 12.21) years. Based on the vertebral artery MRA picture,the course and caliber of vertebral artery were compared between two groups. The abnormal incidence of course and caliber of vertebral artery in observation group was higher than that of control group, which had statistic difference (P=0.000). Furthermore, the patterns of abnormal course and caliber of vertebral artery in observation group were complicated and diverse, but the regional circuity and stegnosis was the most common pattern,about 47.18%(25/53). The cause of circuity and stegnosis was vertebra Gu-Cuofeng,about 43.41% (23/53). The vertebral artery MRA provides a guidance for the diagnosis of abnormal course and caliber of vertebral artery in vertebral artery cervical spondylosis.

  5. The incidence and clinical spectrum of refractory celiac disease in a north american referral center.

    Science.gov (United States)

    Roshan, Bakht; Leffler, Daniel A; Jamma, Shailaja; Dennis, Melinda; Sheth, Sunil; Falchuk, Kenneth; Najarian, Robert; Goldsmith, Jeffrey; Tariq, Sohaib; Schuppan, Detlef; Kelly, Ciaran P

    2011-05-01

    Refractory celiac disease (RCD) is one of the most serious causes of persistent symptoms in patients with celiac disease (CD). Published reports suggest that approximately half of patients in Europe are RCD type II, which carries a poor prognosis with a 5-year survival rate of ~50% compared with ~90% for RCD type I. However, disease patterns may be different in North America. The aim of this study was to explore the clinical spectrum of RCD in a North American population. Medical records of patients with biopsy-proven CD presenting to our institution were reviewed for a diagnosis of RCD. Demographic data, clinical characteristics, and mortality were evaluated and compared with our general CD population. In all, 34 out of 844 (4.0%) CD patients had RCD. The cumulative incidence of RCD for patients diagnosed with CD at our center was 1.5%. Unintentional weight loss at diagnosis of RCD was found in 76.5% (n=26) compared with 16.7% (n=141) at diagnosis of CD (PRCD was found in 79.4% (n=27) compared with 40.5% (342) at diagnosis of CD (PRCD type II and of these, two died of enteropathy-associated lymphoma within 24 months of diagnosis of CD (observed mortality rate 5.9%). Although RCD is a serious condition with significant morbidity; the observed mortality rates are low in our population. This study suggests that RCD may be less severe in North American vs. European populations.

  6. Clinical Significance of Psychotherapy for Unipolar Depression: A Meta-Analytic Approach to Social Comparison.

    Science.gov (United States)

    Nietzel, Michael T.; And Others

    1987-01-01

    Used meta-analysis to study the clinical significance of psychotherapy for symptoms of unipolar depression, using the Beck Depression Inventory. Results indicated that psychotherapy produces outcomes of moderate clinical significance which are well-maintained at follow-up, that individual therapy is associated with greater clinical significance…

  7. Posterior inferior cerebellar artery aneurysms: incidence, clinical presentation, and outcome of endovascular treatment

    NARCIS (Netherlands)

    Peluso, J. P.; van Rooij, W. J.; Sluzewski, M.; Beute, G. N.; Majoie, C. B.

    2008-01-01

    BACKGROUND AND PURPOSE: Results of endovascular treatment of PICA aneurysms are not well established. The purpose of this study was to report incidence, clinical presentation, and outcome of endovascular treatment in 46 patients with 47 posterior inferior cerebellar artery (PICA) aneurysms.

  8. Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013

    DEFF Research Database (Denmark)

    Nielsen, Stine E.; Nielsen, Esben; Julian, Hanne Olsen

    2015-01-01

    PURPOSE: Fungal keratitis is a severe sight-threatening condition. The aim of this study was to investigate the incidence and clinical characteristics of fungal keratitis patients living in a temperate climate. METHODS: By reviewing medical records from 2000 to July 2013, patients with fungal ker...

  9. Incidence of shoulder pain after neck dissection : A clinical explorative study for risk factors

    NARCIS (Netherlands)

    Dijkstra, PU; van Wilgen, PC; Brendeke, W; de Goede, CJT; Kerst, A; Koolstra, M; Marinus, J; Schoppink, EM; Stuiver, MM; van de Velde, CF; Roodenburg, JLN

    2001-01-01

    Background. It is the purpose of this study to determine the incidence of shoulder pain and restricted range of motion of the shoulder after neck dissection, and to identify risk factors for the development of shoulder pain and restricted range of motion. Methods. Clinical patients who underwent a

  10. Incidence of dog bite injuries and clinical rabies in a tertiary health ...

    African Journals Online (AJOL)

    Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.

  11. The Effect of a Designed Respiratory Care Program on the Incidence of Ventilator-Associated Pneumonia: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinia

    2016-01-01

    Full Text Available Introduction: Ventilator-associated pneumonia is a common complication of mechanical ventilation. This study aimed to evaluate the effect of designed respiratory care program on incidence of ventilator-associated pneumonia (VAP in the mechanically ventilated patient. Methods: In this clinical trial, 64 patients were selected among those who had undergone mechanical ventilation in the ICU of Al‑Zahra Hospital, Isfahan, Iran, using convenience sampling method. The subjects were randomly allocated to intervention and control groups. In the intervention group an upper respiratory care program and in the control group, routine cares were done. Modified Clinical Pulmonary Infection Questionnaire was completed before and on the third, fourth and fifth day of study. Data were analyzed by Chi-square and independent t-test through SPSS Ver.13. Results: The results of this study showed that until the third day of study, the incidence of VAP was similar in the both groups. However, on the fifth day of study, the incidence of VAP in the intervention group was significantly lower than control group. Conclusion: The results of this study showed that an upper respiratory care program reduced the incidence of VAP. Therefore, nurses are recommended to perform this program for prevention of VAP.

  12. Incidence Rates of Clinical Mastitis among Canadian Holsteins Classified as High, Average, or Low Immune Responders

    Science.gov (United States)

    Miglior, Filippo; Mallard, Bonnie A.

    2013-01-01

    The objective of this study was to compare the incidence rate of clinical mastitis (IRCM) between cows classified as high, average, or low for antibody-mediated immune responses (AMIR) and cell-mediated immune responses (CMIR). In collaboration with the Canadian Bovine Mastitis Research Network, 458 lactating Holsteins from 41 herds were immunized with a type 1 and a type 2 test antigen to stimulate adaptive immune responses. A delayed-type hypersensitivity test to the type 1 test antigen was used as an indicator of CMIR, and serum antibody of the IgG1 isotype to the type 2 test antigen was used for AMIR determination. By using estimated breeding values for these traits, cows were classified as high, average, or low responders. The IRCM was calculated as the number of cases of mastitis experienced over the total time at risk throughout the 2-year study period. High-AMIR cows had an IRCM of 17.1 cases per 100 cow-years, which was significantly lower than average and low responders, with 27.9 and 30.7 cases per 100 cow-years, respectively. Low-AMIR cows tended to have the most severe mastitis. No differences in the IRCM were noted when cows were classified based on CMIR, likely due to the extracellular nature of mastitis-causing pathogens. The results of this study demonstrate the desirability of breeding dairy cattle for enhanced immune responses to decrease the incidence and severity of mastitis in the Canadian dairy industry. PMID:23175290

  13. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kwon, Bae Ju; Joo, Kyung Bin; Lee, Hak Soo; Song, Ho Taek; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok

    2000-01-01

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  14. Recommendations for recording and calculating the incidence of selected clinical diseases of dairy cattle.

    Science.gov (United States)

    Kelton, D F; Lissemore, K D; Martin, R E

    1998-09-01

    The report upon which the current discussion is based was prepared in response to the increasing interest of the dairy industry in the recording of clinical disease data. The major objective was to introduce guidelines and standards for the recording and presentation of the diseases of dairy cattle. Eight clinically identifiable diseases of economic importance to the dairy industry were considered: milk fever, retained placenta, metritis, ketosis, left displaced abomasum, cystic ovarian disease, lameness, and clinical mastitis. Standardized definitions for these diseases were established through consultation with industry partners. Two approaches to summarization and reporting were proposed. For retrospective analysis, which is used when historical data are summarized for genetic evaluation for example, lactational incidence risk (cumulative incidence) has been recommended. For current analysis, which is used for herd health monitoring, a true incidence rate has been recommended. Milk fever and retained placenta were exceptions to the latter because of their short periods of risk. For these two diseases, lactational incidence risks are reported.

  15. Incidence of bovine clinical mastitis in Jammu region and antibiogram of isolated pathogens

    Science.gov (United States)

    Bhat, Adil Majid; Soodan, Jasvinder Singh; Singh, Rajiv; Dhobi, Ishfaq Ahmad; Hussain, Tufail; Dar, Mohammad Yousuf; Mir, Muheet

    2017-01-01

    Aim: This study was conducted to evaluate the incidence of clinical mastitis in bovines of Jammu region, to identify the infectious organisms responsible for it, and the antimicrobial sensitivity of isolated pathogens. Materials and Methods: The study was conducted on cases that were presented to the Medicine Division of Teaching Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, R.S. Pura, Jammu, Jammu and Kashmir. A total of 260 cases of bovines were presented from June 30, 2012, to July 01, 2013, out of which 30 cases were of clinical mastitis. The diagnosis of clinical mastitis was made on the basis of history and clinical examination of affected animals. Results: Animal and quarter-wise incidence of clinical mastitis were found to be 11.5% and 5.76%, respectively. Of the 23 isolates obtained, Staphylococcus aureus (60.87%) was the most frequently isolated organism, followed by coagulase negative Staphylococci (13.04%), Streptococcus uberis (4.35%), Streptococcus dysgalactiae (8.69%), and Escherichia coli (13.04%). The antimicrobial sensitivity of isolates revealed maximum sensitivity to enrofloxacin, gentamicin, amoxicillin/sulbactam, ceftriaxone/tazobactam, ceftizoxime, ampicillin/sulbactam and least sensitivity for oxytetracycline and penicillin. Conclusion: Staphylococcus spp. is the major causative agent of clinical mastitis in bovines of Jammu region. The causative agents of the clinical mastitis were most sensitive to enrofloxacin and gentamicin. PMID:28919694

  16. Evidence-Based Clinical Significance in Health Care: Toward an Inferential Analysis of Clinical Relevance

    Directory of Open Access Journals (Sweden)

    Mahsa Dousti

    2011-09-01

    Full Text Available Evidence-based dental practice requires the developmment and evaluation of protocols that en-sure translational effectiveness: that is, the efficient incorporation of the best available efficacy and effec-tiveness findings in specific clinical dentistry settings and environments. Evidence-based dentistry predi-cates the synthesis of research for obtaining the best available evidence in a validated, stringent, systematic and unbiased fashion. Research synthesis is now established as a science in its own right, precisely because it adheres to the scientific process that is driven by a research question and a hypothesis, follows through clearly defined methodology and design, yielding quantifiable data that are analyzed statistically, and from which stringent statistical inferences are drawn. The conclusions from the protocol of research synthesis define the best available evidence, which is used in the process of evidence-based revision of clinical practice guidelines. One important hurdle of the process of applying research synthesis in evidence-based dentistry lies in the fact that the statistical inferences produced by research must be translated into clinical relevance. Here, we present a model to circumvent this limitation by means of text analysis/mining protocols, which could lead the path toward a novel, valid and reliable ap-proach for the inferential analysis of clinical relevance.

  17. Clinical and pathogenetic significance of tetanus toxin. Clinical сase

    Directory of Open Access Journals (Sweden)

    G.O. Revenko

    2017-02-01

    Full Text Available Tetanus is a serious, potentially life-threatening infectious disease, occurrence of which is limited to post-vaccination immunity and develops as a result of Clostridium tetani spores penetration into the wound. This pathogen produces one of the strongest toxins, tetanospasmin, that causes clinical manifestations. The most common symptoms are lockjaw, dysphagia, sardonic smile and tetanic seizures with tonic tension of the muscles. Death usually occurs as a result of respiratory or cardiac failure. Treatment is usually performed in the intensive care departments to avoid development of potential complications that are life-threatening. This article clearly shows the clinical case of tetanus in unvaccinated 6-year-old child with favorable outcome. The disease duration was 64 days. Targeting primary care physicians to provide immunization to risk groups will help to prevent tetanus.

  18. Comparison of 5 health care professionals’ratings of the clinical significance of drug related problems

    DEFF Research Database (Denmark)

    Villesen, Christine; Hojsted, Jette; Kjeldsen, Lene Juel

    2014-01-01

    reviews conducted by a clinical pharmacist. Two hospital pharmacists, a general practitioner and two specialists in pain management from hospital care (the Panel) evaluated each DRP considering the potential clinical outcome for the patient. The DRPs were rated either nil, low, minor, moderate or highly.......12 showing nil agreement when comparing the ratings of clinical significance. The Panel disagreed on which DRPs were of minor or moderate clinical significance. Further analysis of the interrelationship of the five Panel members described fair agreement between one specialist and the two pharmacists. In two...... types of DRPs, sub-therapeutic dosing and side effects, the Panel agreed fairly well on moderate clinical significance.Conclusions Each profession rates the clinical significance of DRPs differently, especially in cases of intervention by pharmacist versus practitioner, and opinion also varies within...

  19. Characteristics, clinical outcome, and prognostic significance of IDH mutations in AML.

    Science.gov (United States)

    DiNardo, Courtney D; Ravandi, Farhad; Agresta, Sam; Konopleva, Marina; Takahashi, Koichi; Kadia, Tapan; Routbort, Mark; Patel, Keyur P; Mark Brandt; Pierce, Sherry; Garcia-Manero, Guillermo; Cortes, Jorge; Kantarjian, Hagop

    2015-08-01

    The pathophysiology of IDH mutations in tumorigenesis is increasingly described, yet the prognostic significance of IDH1 and IDH2 mutations in AML remains controversial. The primary objective of this study was to define the natural history and prognosis of patients with AML and IDH1 or IDH2 mutations and provide historical survival expectations. A total of 826 patients treated from 2010 to 2014 at a single institution were evaluated, including 167 patients (20%) with AML and IDH1 or IDH2 mutations. Median age was 62 years (range 18-92). There were 59 IDH1-R132, 83 IDH2-R140, and 23 IDH2-R172 mutations. Clinicopathologic characteristics associated with IDH-mutations included older age, less frequent therapy-related status, and increased incidence of intermediate-risk cytogenetics, FLT3-ITD mutations, and NPM1 mutations. Remission rates (CR/CRi) by AML treatment status were: induction, 68%; Salvage-1 (S1), 42%; and Salvage-2 and beyond (S2+), 27%. No difference in response was identified by IDH mutation status. Similarly, overall survival (OS) was not dependent on IDH status within any cohort. The median OS was 15.4 months in induction, 8.7 months in S1, and 4.8 months in S2+. This analysis defines the clinical outcome associated with IDH-mutations in both the front-line and salvage AML treatment settings, and confirms that response rate and OS for both IDH-mutated and IDH wild-type AML patients is comparable. This provides contemporary data to be used for comparison with results of novel investigational (e.g., selective IDH inhibitor) strategies. © 2015 Wiley Periodicals, Inc.

  20. Yoga & Cancer Interventions: A Review of the Clinical Significance of Patient Reported Outcomes for Cancer Survivors

    Directory of Open Access Journals (Sweden)

    S. Nicole Culos-Reed

    2012-01-01

    Full Text Available Limited research suggests yoga may be a viable gentle physical activity option with a variety of health-related quality of life, psychosocial and symptom management benefits. The purpose of this review was to determine the clinical significance of patient-reported outcomes from yoga interventions conducted with cancer survivors. A total of 25 published yoga intervention studies for cancer survivors from 2004–2011 had patient-reported outcomes, including quality of life, psychosocial or symptom measures. Thirteen of these studies met the necessary criteria to assess clinical significance. Clinical significance for each of the outcomes of interest was examined based on 1 standard error of the measurement, 0.5 standard deviation, and relative comparative effect sizes and their respective confidence intervals. This review describes in detail these patient-reported outcomes, how they were obtained, their relative clinical significance and implications for both clinical and research settings. Overall, clinically significant changes in patient-reported outcomes suggest that yoga interventions hold promise for improving cancer survivors' well-being. This research overview provides new directions for examining how clinical significance can provide a unique context for describing changes in patient-reported outcomes from yoga interventions. Researchers are encouraged to employ indices of clinical significance in the interpretation and discussion of results from yoga studies.

  1. Increased incidence of thyroid cancer in Navarra (Spain). Evolution and clinical characteristics, 1986-2010.

    Science.gov (United States)

    Rojo Álvaro, Jorge; Bermejo Fraile, Begoña; Menéndez Torre, Edelmiro; Ardanaz, Eva; Guevara, Marcela; Anda Apiñániz, Emma

    The latest published studies show an increased incidence of thyroid cancer worldwide. The aim of this study was to analyze the changes in the incidence of thyroid cancer in Navarra and its clinical presentation regarding sex, histological subtype and size over the last 25 years. Thyroid cancer incidence rates were calculated on the basis of data from the Cancer Registry of Navarra during 1986-2010. Clinical data were obtained from the historical cohort of the Hospital Registry of Cancer of Navarra, which includes all the new cases of differentiated thyroid carcinoma diagnosed and treated in the public health network of this Community in that period. The overall incidence of thyroid cancer in Navarra increased over the last 25 years, with an increase in the adjusted rate in men from 2.24 (1986-1990) to 5.85 (2006-2010) per 100,000 population/year (P<.001) and in women from 9.05 to 14.04, respectively (P<.001). This increase occurs only in papillary carcinoma. The clinical characteristics of 739 patients with differentiated thyroid cancer were studied. The mean age at diagnosis increased over the years and the predominance of women (about 80%) remains stable. Mean tumor size decreased over the five-year periods from 30.9 to 22.5mm (P<.001), the proportion of microcarcinomas (T1a) increased from 8.8% to 30% (P<.001) and, despite this increase, there were no statistical differences in the TNM stage at diagnosis during the study period. The distribution of histological variants of papillary and follicular carcinoma did not change over 25 years. During the period studied, the incidence of thyroid cancer increased in Navarra in both sexes. The increase occurred only in papillary carcinoma, without changes in the distribution of his histological variants. The increase in the proportion of T1a tumors is remarkable, but the TNM stage distribution was maintained. These results suggest an increase in the diagnosis of thyroid microcarcinomas due to changes in clinical practice

  2. Incidence and clinical profile of patients with frozen shoulder after cardiac surgery

    Directory of Open Access Journals (Sweden)

    M Chokkalingam

    2017-01-01

    Full Text Available Background: Frozen shoulder is a condition characterized by pain and global restriction of movement with loss of external rotation. Cardiac surgery may predispose frozen shoulder as patients tend to immobilize their upper limbs after surgery. Objectives: The aim of this study is to analyze the clinical profile of patients presenting with symptoms of periarthritis shoulder and to determine the incidence of frozen shoulder among patients undergoing cardiac surgery as well as to find the factors associated with its development. Methods: It is a clinical observational study done in the Cardiology Department of Chettinad Hospital and Research Institute, Chennai, between August 2015 and May 2016, on 100 patients who underwent cardiac surgery and attended the follow-up session as an outpatient. Data were collected by face-to-face interview using a standardized questionnaire. Respondents presenting with pain and restricted movement of shoulder joint with positive limitation in lateral rotation, abduction, and medial rotation (LAM test were considered to have frozen shoulder. Each participant was followed up for 3 months postcardiac surgery. Results: The mean age of the study participants was 53.63 ± 13.03 years, and 65% were males. Of the 100 participants, 20 (20% developed frozen shoulder. Age (P < 0.01, diabetes mellitus (<0.01, hypertension (P < 0.001, type of surgery (P < 0.02, and regularity of physiotherapy follow-up (P < 0.01 had significant association with positive LAM test on univariate analysis. However, on multivariate logistic regression analysis, only hypertension and physiotherapy regularity were found to have a trend toward a significant independent association with the occurrence of frozen shoulder (P = 0.090 and 0.097, respectively. Conclusion: The present study shows that cardiac surgery increases the risk of developing frozen shoulder during the early postoperative period. Statistically significant correlation existed between

  3. Increased incidence of clinical hypotension with etomidate compared to ketamine for intubation in septic patients: A propensity matched analysis.

    Science.gov (United States)

    Van Berkel, Megan A; Exline, Matthew C; Cape, Kari M; Ryder, Lindsay P; Phillips, Gary; Ali, Naeem A; Doepker, Bruce A

    2017-04-01

    This study compared the incidence of clinical hypotension between ketamine and etomidate within a 24 hour period following endotracheal intubation. This single-center, retrospective propensity-matched cohort study included septic patients admitted to our medical intensive care unit who received either etomidate or ketamine for intubation. Clinical hypotension was defined as any one of the following: mean arterial pressure (MAP) decrease >40% compared to baseline and MAP 30% of the initial vasopressor dose. Patients were matched based on propensity scores determined by demographics and baseline characteristics. A total of 384 (200 etomidate and 184 ketamine) patients were included for analysis with 230 patients (115 in each group) matched. Clinical hypotension was less prevalent in patients who received ketamine as compared to etomidate [51.3% vs. 73% (odds ratio=0.39, 95% confidence interval=0.22-0.67, P=.001]. The etomidate group experienced significantly lower MAPs at time periods 6.1-12 hours (65.1 mmHg vs. 69.3 mmHg, P=.01) and 12.1-24 hours (63.9 mmHg vs. 68.4 mmHg, P=.003). Ketamine was associated with a lower incidence of clinical hypotension within the 24 hour period following endotracheal intubation in septic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Clinical significance of incidental focal bowel uptake on 18F-FDG PET/CT as related to colorectal cancer

    DEFF Research Database (Denmark)

    Soltau, Sofus Rønne; Hess, Søren; Nguyen, Tram

    2016-01-01

    with this finding in the clinic. Due to the non-specific appearance of such lesions and a certain rate of false positive findings, patients may by subjected to unnecessary invasive procedures or, conversely, cancers may be overlooked if the risk of malignancy is downplayed. The purpose of this study was to examine...... the incidence and clinical significance of focal colorectal incidentalomas (FCI) at our institution and to assess the potential benefit of using semi-quantitative measures instead of visual interpretation to discern malignant from benign lesions. SUBJECTS AND METHODS: We identified all patients in 2011...... criteria (mean age 71 years, 13 females, 12 males). RESULTS: Of the 25 included patients, eight presented with no pathologic or non-malignant findings (e.g. inflammation), while ten had polyps/adenomas and seven a hitherto undiagnosed colorectal cancer. Semi-quantitative SUVmax values and ROC analysis...

  5. Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

    Science.gov (United States)

    Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

    2006-01-01

    Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…

  6. Confidence Intervals for Effect Sizes: Compliance and Clinical Significance in the "Journal of Consulting and Clinical Psychology"

    Science.gov (United States)

    Odgaard, Eric C.; Fowler, Robert L.

    2010-01-01

    Objective: In 2005, the "Journal of Consulting and Clinical Psychology" ("JCCP") became the first American Psychological Association (APA) journal to require statistical measures of clinical significance, plus effect sizes (ESs) and associated confidence intervals (CIs), for primary outcomes (La Greca, 2005). As this represents the single largest…

  7. The spinal cord independence measure: how much change is clinically significant for spinal cord injury subjects.

    Science.gov (United States)

    Scivoletto, Giorgio; Tamburella, Federica; Laurenza, Letizia; Molinari, Marco

    2013-10-01

    To calculate the clinical significance of the SCIM III according to distribution-based approaches. Retrospective review of the charts of 255 patients with registration of the total SCIM and of the four subscales. Clinical significance was calculated per several distribution-based approaches. The calculated clinical significance was compared with improvements by the patients to determine the percentage of patients who achieved significant improvement. An improvement of at least 4 points of the total SCIM is needed to obtain a small significant improvement and of 10 points to obtain a substantial improvement. Based on these results, the percentages of patients who achieved an improvement varied from 60% to 100%. The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress. An improvement of at least four points of the total SCIM is needed to obtain a small significant improvement and of 10 points to obtain a substantial improvement. The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress.

  8. Clinical significance of ischemic electrocardiographic changes during stress myocardial perfusion imaging: sub-analysis of the J-ACCESS study.

    Science.gov (United States)

    Takehana, Kazuya; Nishimura, Shigeyuki; Maeba, Hirofumi; Ueyama, Takanao; Iwasaka, Toshiji; Nishimura, Tsunehiko

    2010-04-01

    The cardiac event rate among the countries varies according to ethnicity. Some reports have identified that ischemic heart disease often occurs at a low incidence and is often milder in Japan compared to other countries. Therefore, the present study was designed to determine the clinical significance and prediction for cardiac events in patients who showed ischemic ECG changes during stress myocardial perfusion SPECT. Among 4,670 registered patients for Japanese-assessment of cardiac event and survival (J-ACCESS) study, patients with conduction abnormality on baseline were excluded and revascularization within 60 days of SPECT study were censored from the prognostic portion of analysis. Stress and rest myocardial perfusion SPECT imaging with (99m)Tc-tetrofosmin were performed and occurrence and nature of cardiac events were investigated at 1, 2 and 3 years after registration. Both PCI and CABG, as well as recurrent angina and non-severe heart failure were classified as soft events. Cardiac death, non-fatal MI and heart failure requiring hospitalization were classified as major cardiac events, and hard events comprised cardiac death and non-fatal MI. A total of 3,125 patients performed exercise (n = 2,383) or vasodilator (n = 742) stress MPI and significant ischemic ECG changes were obtained in 538 during exercise and 35 during vasodilator stress. Kaplan-Meier analysis revealed that the patients with both ischemic ECG changes and reversible perfusion defect on MPI had significantly higher incidence for major cardiac events, such as cardiac death, non-fatal MI and severe heart failure (P = 0.0038), and for cardiac hard events, such as cardiac death and non-fatal MI (P = 0.0028), in exercise stress. Interestingly, patients without reversible perfusion defect showed significantly fewer events despite presence of ischemic ECG changes. Ischemic ECG changes during exercise stress are well associated with higher incidence of cardiac events in patients demonstrated

  9. Clinical significance of anti-neutrophil cytoplasmic antibodies (ANCA) in autoimmune liver diseases

    NARCIS (Netherlands)

    Roozendaal, C; de Jong, MA; van den Berg, AP; Limburg, PC; Kallenberg, CGM; van Wijk, R.

    Background/Aims: The clinical relevance of anti-neutrophil cytoplasmic antibodies (ANCA) in autoimmune liver disease is unclear. Defining the antigenic specificities of ANCA in these diseases may improve their clinical significance. Methods: We studied the target antigens of ANCA in 88 patients with

  10. Clinical significance of corpus callosum atrophy in a mixed elderly population

    DEFF Research Database (Denmark)

    Ryberg, C; Rostrup, E; Stegmann, M B

    2007-01-01

    Corpus callosum (CC) is the main tract connecting the hemispheres, but the clinical significance of CC atrophy is poorly understood. The aim of this work was to investigate clinical and functional correlates of CC atrophy in subjects with age-related white matter changes (ARWMC). In 569 elderly s...

  11. Prevalence and clinical significance of extracardiac findings in cardiovascular magnetic resonance.

    Science.gov (United States)

    Ulyte, Agne; Valeviciene, Nomeda; Palionis, Darius; Kundrotaite, Simona; Tamosiunas, Algirdas

    2016-09-22

    In cardiac magnetic resonance imaging (CMR), incidental pathological findings are frequently found outside the investigated cardiovascular system. Some of these findings might have clinical implications. The aim of this study was to determine the prevalence of incidental extracardiac findings (ECF) in CMR and their clinical significance. A total of 4165 CMR reports from 2009-2012 were retrospectively reviewed for ECF. Two hundred-twenty reports with ECF were found. For each case, we obtained information on sex, age of the patient, reported ECF and radiologist recommendation. Follow-up data were analyzed by reviewing available electronic medical records. ECF was considered clinically significant if there was an associated diagnosis, additional treatment or further investigations in the clinical follow-up data. In total, 356 ECF were recorded in 220 (5.3%) CMR reports. Sixty (23.7%) of the 253 ECF with follow-up data available were clinically significant. The most prevalent ECF were pleural effusions (n=54), kidney cysts (n=54), diffuse lung parenchyma changes (n=33) and liver cysts (n=29). Adrenal pathology (n=3, 100% significant), renal masses (n=3, 100%) and pulmonary masses (n=5, 62.5%) were the most clinically significant ECF. Although prevalence of these ECF was low, they were significant particularly frequently. When radiologist recommendations for further investigation were present in the report, the frequency of clinically significant ECF was higher compared to reports with no further investigation recommended (preported not very commonly (5.3%). A substantial part of ECF was clinically significant, changing patient diagnosis or management, with an overall prevalence of 1.3%. Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

  12. Isolated syndesmotic injuries in acute ankle sprains: diagnostic significance of clinical examination and MRI.

    Science.gov (United States)

    Großterlinden, Lars Gerhard; Hartel, Maximilian; Yamamura, Jin; Schoennagel, Bjoern; Bürger, Nils; Krause, Mathias; Spiro, Alexander; Hoffmann, Michael; Lehmann, Wolfgang; Rueger, Johannes Maria; Rupprecht, Martin

    2016-04-01

    Acute ankle sprains are frequently accompanied by syndesmotic injuries. These injuries are often overlooked in clinical examinations. The aim of this study was (1) to evaluate the incidence of syndesmotic injuries in acute ankle sprains using MRI, (2) to determine the accuracy of common clinical diagnostic tests, (3) to analyse their inter-rater reliability, and (4) to evaluate the role of clinical symptoms in the diagnosis of syndesmotic injuries. A total of 100 patients with acute ankle sprain injury without associated fractures in plane radiographs were enrolled. The clinical assessment was performed by two independent examiners. Local findings, ankle ligament palpation, squeeze test, external rotation test, Drawer test, Cotton test, and the crossed-leg test (two examiners) were compared with MRI results (read by two blinded radiologists) as a reference standard. Ninety-six participants (57% male) met the inclusion criteria. MRI detected a ruptured anterior inferior tibiofibular ligament (AITFL) in 14 patients (15%); 9 partial tears and 5 complete tears were evident. Evidence of pain at rest was found to predict syndesmotic injuries most accurately (p = 0.039). The palpation test over the proximal fibula produced the highest inter-rater correlation (κ = 0.65), but the lowest sensitivity for syndesmotic injuries of 8%. All other clinical tests demonstrated moderate to fair inter-rater reliabilities (κ = 0.37-0.52). Low sensitivity values were found with all clinical tests (13.9-55.6%). In this study, clinical examination was insufficient to detect syndesmotic injuries in acute ankle sprains. MRI scanning revealed a syndesmotic lesion in 15% of patients. MRI scanning should be recommended in patients with ongoing pain at rest following ankle sprains. I.

  13. Are potentially clinically meaningful benefits misinterpreted in cardiovascular randomized trials? A systematic examination of statistical significance, clinical significance, and authors' conclusions.

    Science.gov (United States)

    Allan, G Michael; Finley, Caitlin R; McCormack, James; Kumar, Vivek; Kwong, Simon; Braschi, Emelie; Korownyk, Christina; Kolber, Michael R; Lindblad, Adriennne J; Babenko, Oksana; Garrison, Scott

    2017-03-20

    While journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes and if these are associated with authors' conclusions. Cardiovascular studies published in six high-impact journals between 1 January 2010 and 31 December 2014 were identified via PubMed. Two independent reviewers selected trials with major adverse cardiovascular events (stroke, myocardial infarction, or cardiovascular death) as primary outcomes and extracted data on trial characteristics, quality, and primary outcome. Potentially clinically meaningful effects were defined broadly as a relative risk point estimate ≤0.94 (based on the effects of ezetimibe) and/or a lower confidence interval ≤0.75 (based on the effects of statins). We identified 127 randomized trial comparisons from 3200 articles. The primary outcomes were statistically significant (SS) favoring treatment in 21% (27/127), NSS in 72% (92/127), and SS favoring control in 6% (8/127). In 61% of NSS trials (56/92), the point estimate and/or lower confidence interval included potentially meaningful effects. Both point estimate and confidence interval included potentially meaningful effects in 67% of trials (12/18) in which authors' concluded that treatment was superior, in 28% (16/58) with a neutral conclusion, and in 6% (1/16) in which authors' concluded that control was superior. In a sensitivity analysis, 26% of NSS trials would include potential meaningful effects with relative risk thresholds of point estimate ≤0.85 and/or a lower confidence interval ≤0.65. Point estimates and/or confidence intervals included potentially clinically meaningful effects in up to 61% of NSS cardiovascular trials. Authors' conclusions often reflect potentially meaningful results of

  14. PDGFRα/β and VEGFR2 polymorphisms in colorectal cancer: incidence and implications in clinical outcome

    International Nuclear Information System (INIS)

    Estevez-Garcia, Purificacion; Carnero, Amancio; Paz-Ares, Luis; Garcia-Carbonero, Rocio; Castaño, Angel; Martin, Ana C; Lopez-Rios, Fernando; Iglesias, Joaquin; Muñoz-Galván, Sandra; Lopez-Calderero, Iker; Molina-Pinelo, Sonia; Pastor, Maria D

    2012-01-01

    Angiogenesis plays an essential role in tumor growth and metastasis, and is a major target in cancer therapy. VEGFR and PDGFR are key players involved in this process. The purpose of this study was to assess the incidence of genetic variants in these receptors and its potential clinical implications in colorectal cancer (CRC). VEGFR2, PDGFRα and PDGFRβ mutations were evaluated by sequencing their tyrosine kinase domains in 8 CRC cell lines and in 92 samples of patients with CRC. Correlations with clinicopathological features and survival were analyzed. Four SNPs were identified, three in PDGFRα [exon 12 (A12): c.1701A>G; exon 13 (A13): c.1809G>A; and exon 17 (A17): c.2439+58C>A] and one in PDGFRβ [exon 19 (B19): c.2601A>G]. SNP B19, identified in 58% of tumor samples and in 4 cell lines (LS174T, LS180, SW48, COLO205), was associated with higher PDGFR and pPDGFR protein levels. Consistent with this observation, 5-year survival was greater for patients with PDGFR B19 wild type tumors (AA) than for those harboring the G-allele genotype (GA or GG) (51% vs 17%; p=0.073). Multivariate analysis confirmed SNP B19 (p=0.029) was a significant prognostic factor for survival, independent of age (p=0.060) or TNM stage (p<0.001). PDGFRβ exon 19 c.2601A>G SNP is commonly encountered in CRC patients and is associated with increased pathway activation and poorer survival. Implications regarding its potential influence in response to PDGFR-targeted agents remain to be elucidated

  15. PDGFRα/β and VEGFR2 polymorphisms in colorectal cancer: incidence and implications in clinical outcome

    Directory of Open Access Journals (Sweden)

    Estevez-Garcia Purificacion

    2012-11-01

    Full Text Available Abstract Background Angiogenesis plays an essential role in tumor growth and metastasis, and is a major target in cancer therapy. VEGFR and PDGFR are key players involved in this process. The purpose of this study was to assess the incidence of genetic variants in these receptors and its potential clinical implications in colorectal cancer (CRC. Methods VEGFR2, PDGFRα and PDGFRβ mutations were evaluated by sequencing their tyrosine kinase domains in 8 CRC cell lines and in 92 samples of patients with CRC. Correlations with clinicopathological features and survival were analyzed. Results Four SNPs were identified, three in PDGFRα [exon 12 (A12: c.1701A>G; exon 13 (A13: c.1809G>A; and exon 17 (A17: c.2439+58C>A] and one in PDGFRβ [exon 19 (B19: c.2601A>G]. SNP B19, identified in 58% of tumor samples and in 4 cell lines (LS174T, LS180, SW48, COLO205, was associated with higher PDGFR and pPDGFR protein levels. Consistent with this observation, 5-year survival was greater for patients with PDGFR B19 wild type tumors (AA than for those harboring the G-allele genotype (GA or GG (51% vs 17%; p=0.073. Multivariate analysis confirmed SNP B19 (p=0.029 was a significant prognostic factor for survival, independent of age (p=0.060 or TNM stage (p Conclusions PDGFRβ exon 19 c.2601A>G SNP is commonly encountered in CRC patients and is associated with increased pathway activation and poorer survival. Implications regarding its potential influence in response to PDGFR-targeted agents remain to be elucidated.

  16. Computational Approach to Annotating Variants of Unknown Significance in Clinical Next Generation Sequencing.

    Science.gov (United States)

    Schulz, Wade L; Tormey, Christopher A; Torres, Richard

    2015-01-01

    Next generation sequencing (NGS) has become a common technology in the clinical laboratory, particularly for the analysis of malignant neoplasms. However, most mutations identified by NGS are variants of unknown clinical significance (VOUS). Although the approach to define these variants differs by institution, software algorithms that predict variant effect on protein function may be used. However, these algorithms commonly generate conflicting results, potentially adding uncertainty to interpretation. In this review, we examine several computational tools used to predict whether a variant has clinical significance. In addition to describing the role of these tools in clinical diagnostics, we assess their efficacy in analyzing known pathogenic and benign variants in hematologic malignancies. Copyright© by the American Society for Clinical Pathology (ASCP).

  17. Incidence of Osteoporosis in Patients Admitted to our Physical Medicine and Rehabilitation Outpatient Clinics

    Directory of Open Access Journals (Sweden)

    Berat Meryem Alkan

    2011-04-01

    Full Text Available Aim: Osteoporosis is a skeletal disease characterized with decreased bone mass and microarchtitectural deterioration of bone tissue which increases bone fragility and fracture risk. Osteoporosis and osteoporotic fractures constitute an important health problem in general population. This study aimed to determine the incidence of osteoporosis, chronic diseases accompanying osteoporosis and incidence of falls in male and female patients admitted to our out patient clinics retrospectively. Material and Methods: Patient records of the 11624 patients admitted to Ankara Atatürk Education and Research Hospital Physical Medicine and Rehabilitation Outpatient clinics between January 2010 and July 2010 were retrospectively reviewed and 644 patients diagnosed as osteoporosis according to femoral neck and/or lumbar dual energy x ray absoptiometry measurements were included in the study. Ages of the patients, sexes, chronic ilnesses, musculoskeletal sytem complaints and fall histories were also recorded. Results: The incidence of osteoporosis was found to be 7.61% in female patients and it was determined that incidence was 5-fold increased in women than in men. Besides, chronic ilnesses and fall history were accompanying in higher ratios in osteoporotic patients. Conclusion: Heart diseases, hypertension, diabetes, neurological diseases leading to impairment in balance and musculoskelatal system complaints were quite frequent in patients with osteoporosis and these diseases should be taken seriously since they increase the risk of falling. It is important to avoid using drugs which lead to balance impairment, to use walk aids like canes or walkers, to perform exercises including balance and coordination training and endurance exercises in order to prevent falls. (Turkish Journal of Osteoporosis 2011;17:10-3

  18. Incidence, Prevalence, Diagnostic Delay, and Clinical Presentation of Female 46,XY Disorders of Sex Development

    DEFF Research Database (Denmark)

    Berglund, Agnethe; Johannsen, Trine H; Stochholm, Kirstine

    2016-01-01

    , prevalence, age at diagnosis, and clinical presentation at diagnosis in 46,XY females. DESIGN AND SETTING: A nationwide study covering all known females with a 46,XY karyotype in Denmark since 1960. The diagnosis of 46,XY disorder of sex development (DSD) was determined by medical record evaluation, data......CONTEXT: The prevalence of phenotypic females with a 46,XY karyotype is low, thus current knowledge about age and clinical presentation at diagnosis is sparse even for the most frequent conditions, androgen insensitivity syndrome (AIS), and gonadal dysgenesis. OBJECTIVE: To estimate incidence.......0-13.5; range, 0-34 y) in AIS and 17.0 years (95% confidence interval, 15.5-19.0; range, 0-28 y) in gonadal dysgenesis (P = .001). Clinical presentation was dependent on cause of DSD. CONCLUSIONS: The first estimate on prevalence of 46,XY females is 6.4 per 100 000 live born females. The presentation of AIS...

  19. Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned.

    Science.gov (United States)

    Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D

    2017-02-09

    Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial. Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers. ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be

  20. Clinical peculiarities of antibiotic associated bowels impairment and its significance in irritable bowel syndrome appearance

    Directory of Open Access Journals (Sweden)

    І. O. Pasichna

    2016-06-01

    Full Text Available Aim: the main objective of this study was to investigate bowels impairment due to treatment with antibiotics, its incidence and clinical peculiarities; to evaluate its role in appearance of in irritable bowel syndrome. Material and Methods. We studied 110 patients (33 males and 77 females, age range 16-83 years, who received treatment with antibiotic. We evaluated the function of the intestine before treatment with antibiotic, then in 1 week, 3 months after treatment finish (1, 2, 3, 4 visits respectively. Control group included 20 healthy persons, who haven't had antibiotics administered during recent two years. Results. We revealed that the signs of bowel function impairment took place at the first visit in 18.2% of patients, at the second visit – in 60.0% of patients, at the third visit – in 45.5% of patients and at the fourth visit – in 41.1% of patients. At the second, third and fourth visits the signs of bowels function impairment were observed reliably more often then at the first visit (before antibiotic administration, p<0.001. At the second visit the signs bowels function disorders were the most prominent: abdominal pain – in 44.5%, distention – in 46.4%, diarrhea – in 29.1%, constipation – in 18.2%, presence of both (diarrhea and periodically constipation manifestations – in 2.7%; and extraintestinal manifestations (depression. depressed mood, sorrow, apathy, decreased stamina, sleep disturbances – in 29.1% of patients. Clinical manifestations of irritable bowel syndrome occured in 6 months of observation in 32.2% of patients. Conclusions. The signs of bowel function impairment were observed in 60.0% of patients after finishing treatment with antibiotic. This incidence is much higher than in control group (р<0.001. Bowel disorders mostly manifested as the changes in quantity and consistency of feaces, pain, abdominal distention and extraintestinal manifestations. In 32.2% of patients clinical manifestations of

  1. The clinical significance of gastrointestinal decontamination in the occurrence of endogenous infections.

    Science.gov (United States)

    Ozawa, A; Nagao, T; Sawamura, S; Ikigai, H

    1984-12-01

    No significant difference was seen in the incidence of infections between subjects receiving complete, selective and no decontamination aimed at the intestinal microflora in studies evaluating the preventative potential against endogenous infections in the compromised host maintained under protective isolation. This finding is reported together with a report of Serratia marcescens septicemia in a patient with leukemia who was given antibiotics systemically and kept under protective isolation. The establishment of opportunistic infections in relation to these results is discussed in terms of the biological phenomena of the interaction between the intestinal flora and the host, and between the species comprising the intestinal flora.

  2. Clinical significance of percutaneous endoscopic gastrostomy for patients with severe craniocerebral injury

    Directory of Open Access Journals (Sweden)

    Du Hanggen

    2014-12-01

    Full Text Available Objective: To investigate the application of percutaneous endoscopic gastrostomy (PEG to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention. Methods: A total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identifi ed and compared. Results: Both PEG and nasal-feeding nutrition therapies have significantly levated serum albumin levels (P<0.05. Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05. The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05. Conclusion: PEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal refl ux. Key words: Gastrostomy; Craniocerebral trauma; Enteral nutrition

  3. Clinical significance of normal exercise thallium-201 myocardial scintigraphy in subjects with abnormal exercise electrocardiographic findings

    International Nuclear Information System (INIS)

    Matsuo, Takeshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Chiba, Hiroshi; Mitani, Isao; Saito, Muneyasu; Sumiyoshi, Tetsuya

    1988-01-01

    The relationship between exercise thallium-201 scintigraphic findings and clinical features (chest pain, risk factors, resting electrocardiography, exercise electrocardiography and prognosis) was studied in the 234 patients with profound ST-segment depression (J 80 ≥ -2 mm) or negative U wave in exercise electrocardiography. We classified these cases into two groups by exercise thallium perfusion; (I) normal thallium-201 perfusion (n = 24), (II) abnormal thallium-201 perfusion (n = 210). The incidence of female in group I was larger than that in group II. In resting electrocardiography, left ventricular hypertrophy was found more frequent in group I. In exercise electrocardiography, most of ST-segment depression in group I revealed up-slope type and a rapid recovery to baseline. Group I had lower incidence of cardiac events (cardiac death, nonfatal myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting). In conclusion, normal thallium-201 perfusion in exercise thallium-201 scintigraphy was more useful indicator for prognosis, even if the patients had the findings of profound ST-segment depression or negative U wave in exercise electrocardiography. (author)

  4. High incidence of functional ion-channel abnormalities in a consecutive Long QT cohort with novel missense genetic variants of unknown significance

    DEFF Research Database (Denmark)

    Steffensen, Annette Buur; Refaat, Marwan M; David, Jens-Peter

    2015-01-01

    The Long QT syndrome (LQTS) is a disorder characterized by a prolongation of the QT interval and a propensity to ventricular tachyarrhythmias, which may lead to syncope, cardiac arrest, or sudden death. Our objective was to (1) determine the incidence of variants with unknown significance (VUS) i...

  5. Evaluation of the Clinical Significance of Serum Carcinoembryonic Antigen in Patients with Resectable Gastric Adenocarcinoma.

    Science.gov (United States)

    Dang, Yuan; Ouyang, Xiaojuan; Wang, Kai; Zhang, Fan; Huang, Qiaojia

    2016-04-01

    Carcinoembryonic antigen (CEA) is the most commonly used tumor marker for gastrointestinal cancers but its value for resectable gastric adenocarcinoma (RGA) patients in areas of high GA incidence is uncertain. We retrospectively studied 400 subjects with RGA from the Fujian Province in China, which has a high incidence of GA. Patients had surgery between January 2010 and December 2013. CEA was measured and correlated to pathology. High pretreatment serum CEA (>5 ng/mL) was associated with patient age (p = 0.000), tumor size (p = 0.008), and T and N stages (p = 0.002, p = 0.032, respectively), alpha fetoprotein (p = 0.014), and CA19-9 (p = 0.000). High CEA was significantly associated with poor overall survival. Overall survival in the whole group of patients was 63.8%, whereas it was only 42.9% in the high CEA group (p = 0.0001). Mean overall survival for high CEA patients was significantly shorter than patients with low CEA (36.5 ± 2.63 months vs. 47.4 ± 0.98 months, p = 0.000). Multivariate analysis confirmed that pretreatment serum CEA was an independent prognostic factor for increased death risk. Additionally, mean CEA in 45 high CEA patients was reduced after surgery. Pretreatment serum CEA may help to predict survival for patients with RGA in high GA incidence areas. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

  6. Occasional head of flexor pollicis longus muscle: a study of its morphology and clinical significance.

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    Hemmady M

    1993-01-01

    Full Text Available A cadaveric dissection study of 54 upper extremities to determine the incidence of occurrence, morphology and relations of the occasional head of the flexor pollicis longus muscle is presented. The occasional head of the flexor pollicis longus muscle was found to be present more frequently (66.66% than absent. It mainly arose from the medical epicondyle of the humerus (55.55% and the medial border of the coronoid process of the ulna (16.66%. It was found to be in close association with the median nerve (anteriorly and the anterior interosseous nerve (posteriorly. The clinical implications of these findings are discussed viz. entrapment neuropathies of the median and anterior interosseous nerves, cicatricial contraction of the occasional head leading to flexion deformity of the thumb and the likely necessity to lengthen/release the occasional head in spastic paralysis of the flexor pollicis longus muscle.

  7. Effectiveness of Telemetry Guidelines in Predicting Clinically Significant Arrhythmias in Hospitalized Patients

    Science.gov (United States)

    Dhillon, Sandeep K.; JosephTawil; Goldstein, Baruch; Eslava-Manchego, Dayana; Singh, Jagdeep; Hanon, Sam; Schweitzer, Paul; Bergmann, Steven R.

    2012-01-01

    Background Cardiac rhythm monitoring is widely applied on hospitalized patients. However, its value has not been evaluated systematically. Methods This study considered the utility of our institutional telemetry guidelines in predicting clinically significant arrhythmias. A retrospective analysis was performed of 562 patients admitted to the telemetry unit. A total of 1932 monitoring days were evaluated. Patients were divided into 2 groups based on telemetry guidelines: “telemetry indicated” and “telemetry not indicated”. Results Differences in arrhythmia event rates and pre-defined clinical significance were determined. One hundred and forty-four (34%) vs. 16 (11%) patients had at least one arrhythmic event in the “telemetry indicated” group compared with the “telemetry not indicated” group, respectively (P = 0.001). No patient in the “telemetry not indicated” group had a clinically significant arrhythmia. In contrast, of patients in the “telemetry indicated” group who had at least one arrhythmic event, 36% were considered clinically significant (P telemetry guidelines to allocate this resource appropriately and predict clinically significant arrhythmias. PMID:28357019

  8. Oral magnesium supplementation reduces the incidence of gastrointestinal complications following cardiac surgery: a randomized clinical trial.

    Science.gov (United States)

    Moradian, Seyed Tayeb; Ghiasi, Mohammad Saeid; Mohamadpour, Alireza; Siavash, Yadollah

    2017-02-01

    Gastrointestinal complications are common after coronary artery bypass graft surgery. These complications are ranged from nausea and vomiting to mesenteric ischemia and liver failure. It seems that nausea, vomiting, and constipation are related to magnesium deficiency. This study was designed to examine the effect of oral magnesium supplementation on the incidence of gastrointestinal complications in patients undergoing cardiac surgery. In a single blinded randomized clinical trial, 102 patients who were undergoing coronary artery bypass graft surgery were randomly allocated into two groups, 52 patients in the intervention and 50 patients in control group. Patients in the experimental group received 800 milligram magnesium oxide (2 tablets each of them containing 240 mg elemental magnesium) daily from the admission to discharge from hospital. The incidence of post-operative nausea and vomiting, constipation, and atrial fibrillation was compared between the groups. Our results showed that postoperative hypomagnesemia is present in 41.20 and 70.80 percent of the patients in the intervention and control group patients, respectively. The overall incidence of constipation was 62%. Patients who received magnesium supplementation experienced less atrial fibrillation, nausea, vomiting, and constipation. Our data showed that oral magnesium supplementation could reduce the postoperative complications. Despite the better status in the intervention group, the hypomagnesemia was present in many of intervention group patients. It seems that supplementation with higher doses is needed.

  9. Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact.

    Directory of Open Access Journals (Sweden)

    Takashi Morishita

    Full Text Available Deep brain stimulation (DBS is an effective treatment for multiple movement disorders and shows substantial promise for the treatment of some neuropsychiatric and other disorders of brain neurocircuitry. Optimal neuroanatomical lead position is a critical determinant of clinical outcomes in DBS surgery. Lead migration, defined as an unintended post-operative displacement of the DBS lead, has been previously reported. Despite several reports, however, there have been no systematic investigations of this issue. This study aimed to: 1 quantify the incidence of lead migration in a large series of DBS patients, 2 identify potential risk factors contributing to DBS lead migration, and 3 investigate the practical importance of this complication by correlating its occurrence with clinical outcomes.A database of all DBS procedures performed at UF was queried for patients who had undergone multiple post-operative DBS lead localization imaging studies separated by at least two months. Bilateral DBS implantation has commonly been performed as a staged procedure at UF, with an interval of six or more months between sides. To localize the position of each DBS lead, a head CT is acquired ~4 weeks after lead implantation and fused to the pre-operative targeting MRI. The fused targeting images (MR + stereotactic CT acquired in preparation for the delayed second side lead implantation provide an opportunity to repeat the localization of the first implanted lead. This paradigm offers an ideal patient population for the study of delayed DBS lead migration because it provides a large cohort of patients with localization of the same implanted DBS lead at two time points. The position of the tip of each implanted DBS lead was measured on both the initial post-operative lead localization CT and the delayed CT. Lead tip displacement, intracranial lead length, and ventricular indices were collected and analyzed. Clinical outcomes were characterized with validated rating

  10. Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact.

    Science.gov (United States)

    Morishita, Takashi; Hilliard, Justin D; Okun, Michael S; Neal, Dan; Nestor, Kelsey A; Peace, David; Hozouri, Alden A; Davidson, Mark R; Bova, Francis J; Sporrer, Justin M; Oyama, Genko; Foote, Kelly D

    2017-01-01

    Deep brain stimulation (DBS) is an effective treatment for multiple movement disorders and shows substantial promise for the treatment of some neuropsychiatric and other disorders of brain neurocircuitry. Optimal neuroanatomical lead position is a critical determinant of clinical outcomes in DBS surgery. Lead migration, defined as an unintended post-operative displacement of the DBS lead, has been previously reported. Despite several reports, however, there have been no systematic investigations of this issue. This study aimed to: 1) quantify the incidence of lead migration in a large series of DBS patients, 2) identify potential risk factors contributing to DBS lead migration, and 3) investigate the practical importance of this complication by correlating its occurrence with clinical outcomes. A database of all DBS procedures performed at UF was queried for patients who had undergone multiple post-operative DBS lead localization imaging studies separated by at least two months. Bilateral DBS implantation has commonly been performed as a staged procedure at UF, with an interval of six or more months between sides. To localize the position of each DBS lead, a head CT is acquired ~4 weeks after lead implantation and fused to the pre-operative targeting MRI. The fused targeting images (MR + stereotactic CT) acquired in preparation for the delayed second side lead implantation provide an opportunity to repeat the localization of the first implanted lead. This paradigm offers an ideal patient population for the study of delayed DBS lead migration because it provides a large cohort of patients with localization of the same implanted DBS lead at two time points. The position of the tip of each implanted DBS lead was measured on both the initial post-operative lead localization CT and the delayed CT. Lead tip displacement, intracranial lead length, and ventricular indices were collected and analyzed. Clinical outcomes were characterized with validated rating scales for all

  11. A Significant Breakthrough in the Incidence of Childhood Cancers and Evaluation of its Risk Factors in Southern Iran.

    Science.gov (United States)

    Erjaee, Asma; Niknam, Maryam; Sadeghi, Ahmadreza; Dehghani, Maryam; Safaei, Zeinab; Teshnizi, Saeed Hosseini; Karimi, Mehran

    2017-01-01

    This study investigates epidemiologic and practical information about the incidence and risk factors of childhood cancer in a population of Southern Iranian children. A total number of 300 cancer patients along with 600 age- and gender-matched healthy control were interviewed by a trained physician regarding their demographic characteristics, and major family-associated risk factors, childhood malignancies. The average annual percentage change for cancers in the studied population is calculated as 45%. Our study indicated that possible risk factors which could contribute to the development of childhood cancer are maternal oral contraceptive pill use during pregnancy, exposure to radiation during pregnancy, parental smoking, residence near high voltage electricity lines, exposure to pesticides and fertilizers, patient allergy, contact with domestic animals and father's educational degree. Furthermore, new ecological risk factors such as air pollution due to nonstandard petroleum or toxic inhalant particles, nonhealthy food consumption, and satellite jamming are other predisposing factors. Our study reported a higher average annual percentage change of childhood cancers in our area, compared to the existing literature. In conclusion, detection and prevention of the consistent and possible new environmental risk factors such as nonstandard petroleum or satellite jamming from all around the country should be taking into consideration.

  12. Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis

    Science.gov (United States)

    Keefer, Laurie; Taft, Tiffany H; Kiebles, Jennifer L; Martinovich, Zoran; Barrett, Terrence A; Palsson, Olafur S

    2013-01-01

    Summary Background Psychotherapy is not routinely recommended for in ulcerative colitis (UC). Gut-directed hypnotherapy (HYP) has been linked to improved function in the gastrointestinal tract and may operate through immune-mediated pathways in chronic diseases. Aims To determine the feasibility and acceptability of hypnotherapy and estimate the impact of hypnotherapy on clinical remission status over a 1 year period in patients with an historical flare rate of 1.3 times per year. Methods 54 patients were randomized at a single site to 7 sessions of gut-directed hypnotherapy (N = 26) or attention control (CON; N = 29) and followed for 1 year. The primary outcome was the proportion of participants in each condition that had remained clinically asymptomatic (clinical remission) through 52 weeks post-treatment. Results One-way ANOVA comparing hypnotherapy and control subjects on number of days to clinical relapse favored the hypnotherapy condition [F = 4.8 (1, 48), p = .03] by 78 days. Chi square analysis comparing the groups on proportion maintaining remission at 1 year was also significant [X2(1) = 3.9, p = .04], with 68% of hypnotherapy and 40% of control patients maintaining remission for 1 year. There were no significant differences between groups over time in quality of life, medication adherence, perceived stress or psychological factors. Conclusions This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent UC. Clinical Trial # NCT00798642 PMID:23957526

  13. The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    M. Taraborelli

    2016-12-01

    Full Text Available The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL in a cohort of systemic lupus erythematosus (SLE patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM >99th percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher’s exact test for categorical variables and Student’s t or Mann-Whitney test for continuous variables and multivariate analysis (logistic regression analysis. P values <0.05 were considered significant. Among 317 SLE patients studied, 117 (37% had a clinically significant aPL profile at baseline. Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS, but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR 0.43] and ENA positivity (p<0.001, OR 0.37, with increased risk of cardiac valvular disease (p=0.024, OR 3.1 and APS (p<0.0001, OR 51.12. Triple positivity was the most frequent profile and was significantly associated to APS (p<0.0001, OR 28.43. Our study showed that one third of SLE patients had clinically significant aPL, and that this is associated with an increased risk, especially for triple positive, of APS, and to a different clinical and serological pattern of disease even in the absence of APS.

  14. Inpatient Treatment for Adolescents with Anorexia Nervosa: Clinical Significance and Predictors of Treatment Outcome.

    Science.gov (United States)

    Schlegl, Sandra; Diedrich, Alice; Neumayr, Christina; Fumi, Markus; Naab, Silke; Voderholzer, Ulrich

    2016-05-01

    This study evaluated the clinical significance as well as predictors of outcome for adolescents with severe anorexia nervosa (AN) treated in an inpatient setting. Body mass index (BMI), eating disorder (ED) symptoms [Eating Disorder Inventory-2 (EDI-2)], general psychopathology and depression were assessed in 238 patients at admission and discharge. BMI increased from 14.8 + 1.2 to 17.3 + 1.4 kg/m(2). Almost a fourth (23.6%) of the patients showed reliable changes, and 44.7% showed clinically significant changes (EDI-2). BMI change did not significantly differ between those with reliable or clinically significant change or no reliable change in EDI-2. Length of stay, depression and body dissatisfaction were negative predictors of a clinically significant change. Inpatient treatment is effective in about two thirds of adolescents with AN and should be considered when outpatient treatment fails. About one third of patients showed significant weight gain, but did not improve regarding overall ED symptomatology. Future studies should focus on treatment strategies for non-responders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  15. Incidence, clinical presentation, and outcome of HIV-1-associated cryptococcal meningitis during the highly active antiretroviral therapy era

    DEFF Research Database (Denmark)

    Touma, Madeleine; Rasmussen, Line D; Martin-Iguacel, Raquel

    2017-01-01

    BACKGROUND: Human immunodeficiency virus (HIV) infection with advanced immunosuppression predisposes to cryptococcal meningitis (CM). We describe the incidence, clinical presentation, and outcome of CM in HIV-infected individuals during the highly active antiretroviral therapy (HAART) era. METHODS...

  16. [Expression of Prion protein and its clinical significance in oral squamous cells carcinoma and oral leukoplakia].

    Science.gov (United States)

    Zhang, Jie; Zeng, Yan; Zheng, Jun; Xu, Jiang

    2013-12-01

    To examine Prion protein(PrP) expression and its clinical significance in oral mucosa, oral leukoplakia, oral squamous cell carcinoma(OSCC) and its subgroups. Expression of PrP in OSCC, oral leukoplakia and mucosa specimen was detected by immunohistochemistry. The association between the expression and gender, TNM clinical stages, pathological grades was evaluated. The positive expression rate of PrP in normal, oral leukoplakia and OSCC tissues was 15% (3/20) , 42% (11/26) and 95% (80/84) , respectively. There was a significant difference between the expression of PrP in leukoplakia and in high, moderately and poorly differentiated OSCC(P 0.05). Between stages I+II and III+IV in the overa II expression of PrP, there was a significant difference(P leukoplakia to OSCC was closely related to the carcinogenesis of OSCC, pathologic stage and clinical TNM stage.

  17. Thirty-one novel biomarkers as predictors for clinically incident diabetes.

    Directory of Open Access Journals (Sweden)

    Veikko Salomaa

    2010-04-01

    Full Text Available The prevalence of diabetes is increasing in all industrialized countries and its prevention has become a public health priority. However, the predictors of diabetes risk are insufficiently understood. We evaluated, whether 31 novel biomarkers could help to predict the risk of incident diabetes.The biomarkers were evaluated primarily in the FINRISK97 cohort (n = 7,827; 417 cases of clinically incident diabetes during the follow-up. The findings were replicated in the Health 2000 cohort (n = 4,977; 179 cases of clinically incident diabetes during the follow-up. We used Cox proportional hazards models to calculate the relative risk of diabetes, after adjusting for the classic risk factors, separately for each biomarker. Next, we assessed the discriminatory ability of single biomarkers using receiver operating characteristic curves and C-statistics, integrated discrimination improvement (IDI and net reclassification improvement (NRI. Finally, we derived a biomarker score in the FINRISK97 cohort and validated it in the Health 2000 cohort. A score consisting of adiponectin, apolipoprotein B, C-reactive protein and ferritin almost doubled the relative risk of diabetes in the validation cohort (HR per one standard deviation increase 1.88, p = 2.8 e-5. It also improved discrimination of the model (IDI = 0.0149, p<0.0001 and reclassification of diabetes risk (NRI = 11.8%, p = 0.006. Gender-specific analyses suggested that the best score differed between men and women. Among men, the best results were obtained with the score of four biomarkers: adiponectin, apolipoprotein B, ferritin and interleukin-1 receptor antagonist, which gave an NRI of 25.4% (p<0.0001. Among women, the best score included adiponectin, apolipoprotein B, C-reactive protein and insulin. It gave an NRI of 13.6% (p = 0.041.We identified novel biomarkers that were associated with the risk of clinically incident diabetes over and above the classic risk factors. This gives new insights into

  18. Treatment Success: Investigating Clinically Significant Change in Quality of Life Following Bariatric Surgery.

    Science.gov (United States)

    Reynolds, Claire L; Byrne, Susan M; Hamdorf, Jeffrey M

    2017-07-01

    One of the most important outcomes following bariatric surgery is an improvement in health-related quality of life (QOL). This study aimed to explore what degree of weight loss is required after bariatric surgery in order to achieve a clinically significant change in QOL from pre-surgery to 4 to 5 years after surgery. Participants were assessed prior to having surgery (N = 280) and were invited to participate in a follow-up study 4 to 5 years after surgery. Sixty-seven of the original participants agreed to take part and completed a Web-based survey, which included the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Several analyses were conducted to examine the association between weight loss and clinically significant change in QOL. Mean age was 48.13 ± 10.37 years, 51 (76%) were female, 62 (92.5%) Caucasian, and mean baseline body mass index (BMI) was 41.11 ± 6.03 kg/m 2 . The mean percent of excess weight loss (EWL) was 46% (17% total weight loss), and 64% (n = 43) achieved a clinically significant change in QOL. The majority of those who lost ≥40% EWL had a clinically significant change in QOL, and their odds of achieving this change were 2.81 times higher than those that did not. Results indicated that an EWL of ≥40% may be sufficient for the majority of patients to achieve clinically significant change, but that ≥50% is a better predictor of clinically significant change.

  19. The impact of anti HPV vaccination on cervical cancer incidence and HPV induced cervical lesions: consequences for clinical management.

    Science.gov (United States)

    Brinkman, J A; Caffrey, A S; Muderspach, L I; Roman, L D; Kast, W M

    2005-01-01

    prevent persistent infection with the virus are high and may be implemented in the near future. The consequences for clinical management may include a significant reduction in the frequency of Pap smear screening in the case of prophylactic vaccines, and the availability of less invasive and disfiguring treatment options for women with pre-existing HPV associated lesions in the case of therapeutic vaccines. Implementation of both prophylactic and therapeutic vaccine regimens could result in a significant reduction of health care costs and reduction of worldwide cervical cancer incidence.

  20. Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Peluso, Jo P.P.; Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N. [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2007-09-15

    The aim of this retrospective study was to determine the incidence, clinical presentation and midterm clinical and imaging outcome of endovascular treatment of 34 superior cerebellar artery (SCA) aneurysms in 33 patients. Between January 1995 and January 2007, 2,112 aneurysms were treated in our institution, and 36 aneurysms in 35 patients were located on the SCA (incidence 1.7%). Two of three distal SCA aneurysms were excluded. All the remaining 34 SCA aneurysms, of which 22 (65%) were ruptured and 12 (35%) were unruptured, in 33 patients were treated by endovascular techniques. There were 6 men and 27 women ranging from 29-72 years. In 14 patients (42%) multiple aneurysms were present. Initial angiographic occlusion was (near) complete in 32 aneurysms (94%) and incomplete in 2 aneurysms (6%). Complications leading to permanent morbidity or death occurred in two patients (6.1%, 95% CI 0.6 to 20.60%). Outcome at 6 months follow-up in 31 surviving patients was GOS5 in 26 (84%), GOS4 in 4 (13%) and GOS3 in 1 patient (3%). There were no episodes of (re)bleeding during 118 patient-years of follow-up. The 6-month angiographic follow up in 28 SCA aneurysms and extended angiographic follow-up in 19 showed stable occlusion in 27 aneurysms. No additional treatments were performed. SCA aneurysms are rare with an incidence of 1.7% of treated aneurysms at our institution. They are frequently associated with other aneurysms. Endovascular treatment is effective and safe in excluding the aneurysms from the circulation. (orig.)

  1. Clinical significance of measurements of serum IL-6 levels in patients with cardiovascular and cerebrovascular diseases

    International Nuclear Information System (INIS)

    Wu Cuihua; Luo Nanping; Zhang Daojie; Wei Hong

    2004-01-01

    Objective: To explore the clinical significance of changes of serum IL-6 levels in patients with cardiovascular and cerebrovascular diseases. Methods: Serum IL-6 levels were determined with RIA in 35 patients with coronary heart disease, 20 patients with essential hypertension, 28 patients with cerebral infarction and 30 controls. Results: Serum IL-6 levels in patients with coronary heart disease and cerebral infarction were significantly higher than those in the controls (P 0.05). Conclusion: Serum IL-6 levels changes could reflect the severity of the inflammatory process and would be helpful in clinical assessment. (authors)

  2. Clinical profile and incidence of ventricular arrhythmia in patients undergoing defibrillator generator replacement in Spain.

    Science.gov (United States)

    Fontenla, Adolfo; López Gil, María; Martínez Ferrer, José; Alzueta, Javier; Fernández Lozano, Ignacio; Viñolas, Xavier; Rodríguez, Aníbal; Fernández de la Concha, Joaquín; Anguera, Ignasi; Arribas, Fernando

    2014-12-01

    Implantable cardioverter-defibrillators reduce mortality in some patients with heart disease. Battery replacement is a frequent occurrence in clinical practice and is required in up to 30% of implants. The benefit/risk ratio of defibrillators varies over time and should be reevaluated at the time of replacement. The aim of this study was to determine the clinical characteristics and incidence of defibrillator therapies in patients who underwent generator replacement. This multicenter retrospective study involved patients from the UMBRELLA national registry who underwent replacement due to defibrillator battery depletion. The incidence of ventricular arrhythmias was determined via remote monitoring. Risk factors for sustained ventricular arrhythmia after replacement were analyzed. A total of 354 patients were included (mean age [standard deviation], 61.8 [14.5] years; men, 80%; secondary prevention, 42%; ventricular arrhythmias in the explanted generator, 62%). After a 25-month follow-up, 70 patients (20%) received appropriate therapies and 8 (2.3%) received inappropriate discharges. Male sex, structural heart disease, heart failure, and the absence of resynchronization were independent predictors of ventricular arrhythmia occurrence. One-fifth of patients had appropriate defibrillator therapies in the first 2 years after generator replacement. Determination of the factors associated with arrhythmia occurrence after replacement may be useful to optimize implantable cardioverter-defibrillator treatment. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  3. Clinical and epidemiological features of extrapulmonary tuberculosis in a high incidence region.

    Directory of Open Access Journals (Sweden)

    Carlos Pérez-Guzmán

    2014-03-01

    Full Text Available Objective. To describe the clinical features of extrapulmonary tuberculosis (EXPTB and to evaluate epidemiological data to search for potential explanations for its high frequency in the state of Aguascalientes, Mexico. Materials and methods. Clinical records of all patients with tuberculosis seen in Aguascalientes in 2008 were reviewed, and official databases were analyzed. Results. EXPTB comprised 60.5% of the 86 cases evaluated, being lymph nodes the main site affected. Patients with EXPTB were younger and more obese than subjects with pulmonary tuberculosis (PTB. One third of cases in either group had diabetes, a frequency much higher than expected. Epidemiological analysis showed that PTB incidence, but not EXPTB incidence, decreases as geographical altitude increases, and had a descendent trend from 1997 to 2011. Conclusions. The lower frequency of PTB (due to its inverse relationship with altitude and its descendent trend in last years might explain the high frequency of EXPTB. Obesity appeared to protect against developing pulmonary involvement, and diabetes was more frequent than expected among PTB and EXPTB cases.

  4. Evaluating research for clinical significance: using critically appraised topics to enhance evidence-based neuropsychology.

    Science.gov (United States)

    Bowden, Stephen C; Harrison, Elise J; Loring, David W

    2014-01-01

    Meehl's (1973, Psychodiagnosis: Selected papers. Minneapolis: University of Minnesota Press) distinction between statistical and clinical significance holds special relevance for evidence-based neuropsychological practice. Meehl argued that despite attaining statistical significance, many published findings have limited practical value since they do not inform clinical care. In the context of an ever expanding clinical research literature, accessible methods to evaluate clinical impact are needed. The method of Critically Appraised Topics (Straus, Richardson, Glasziou, & Haynes, 2011, Evidence-based medicine: How to practice and teach EBM (4th ed.). Edinburgh: Elsevier Churchill-Livingstone) was developed to provide clinicians with a "toolkit" to facilitate implementation of evidence-based practice. We illustrate the Critically Appraised Topics method using a dementia screening example. We argue that the skills practiced through critical appraisal provide clinicians with methods to: (1) evaluate the clinical relevance of new or unfamiliar research findings with a focus on patient benefit, (2) help focus of research quality, and (3) incorporate evaluation of clinical impact into educational and professional development activities.

  5. Understanding the Supersensitive Anti-Drug Antibody Assay: Unexpected High Anti-Drug Antibody Incidence and Its Clinical Relevance

    Directory of Open Access Journals (Sweden)

    Sam Song

    2016-01-01

    Full Text Available Numbers of biotherapeutic products in development have increased over past decade. Despite providing significant benefits to patients with unmet needs, almost all protein-based biotherapeutics could induce unwanted immunogenicity, which result in a loss of efficacy and/or increase the risk of adverse reactions, such as infusion reactions, anaphylaxis, and even life-threatening response to endogenous proteins. Recognizing these possibilities, regulatory agencies request that immunogenicity be assessed as part of the approval process for biotherapeutics. Great efforts have been made to reduce drug immunogenicity through protein engineering. Accordingly the immunogenicity incidence has been reduced from around 80% in murine derived products to 0–10% in fully human products. However, recent improvements in immunogenicity assays have led to unexpectedly high immunogenicity rates, even in fully human products, leading to new challenges in assessing immunogenicity and its clinical relevance. These new immunogenicity assays are becoming supersensitive and able to detect more of anti-drug antibodies (ADA than with earlier assays. This paper intends to review and discuss our understanding of the supersensitive ADA assay and the unexpected high ADA incidence and its potential clinical relevance.

  6. Clinical Significance of Plasma CEA Levels in the Patients with Cervical Carcinoma during Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Sung Beom; Kim, Joo Young; Choi, Myung Sun; Rha, Joong Yeol; Lee, Min Jae [Korea University College of Medicine, Seoul (Korea, Republic of)

    1991-12-15

    Carcinoembryonic antigen (CEA) has been studied in the field of gynecologic malignancy to determine whether it can be used as a tumor marker for early detection of recurrence or evaluation of therapeutic results. From January 1985 through December 1989, a total of 239 cervical cancer patients were entered for an analysis of plasma CEA level in the group with cervical cancer compared to the control group consisting of 65 normal healthy women and 18 women with benign gynecologic disease. Plasma CEA levels appear to be directly related with the tumor extension and as stages advance, the incidence of patients with abnormal plasma CEA levels is increased. Also, there seems to be a little higher incidence of abnormal CEA levels in patients with adenocarcinomas or adenosquamous carcinoma but not statistically significant because of small number of patients. When the patients developed recurrence, plasma CEA levels are markedly elevated in the majority, particularly in patients with hepatic metastases. In conclusion, serial plasma CEA checks could be used to detect recurrence during follow-up after treatment of cervical cancer.

  7. Significant relationship between soil bacterial community structure and incidence of bacterial wilt disease under continuous cropping system.

    Science.gov (United States)

    She, Siyuan; Niu, Jiaojiao; Zhang, Chao; Xiao, Yunhua; Chen, Wu; Dai, Linjian; Liu, Xueduan; Yin, Huaqun

    2017-03-01

    Soil bacteria are very important in biogeochemical cycles and play significant role in soil-borne disease suppression. Although continuous cropping is responsible for soil-borne disease enrichment, its effect on tobacco plant health and how soil bacterial communities change are yet to be elucidated. In this study, soil bacterial communities across tobacco continuous cropping time-series fields were investigated through high-throughput sequencing of 16S ribosomal RNA genes. The results showed that long-term continuous cropping could significantly alter soil microbial communities. Bacterial diversity indices and evenness indices decreased over the monoculture span and obvious variations for community structures across the three time-scale tobacco fields were detected. Compared with the first year, the abundances of Arthrobacter and Lysobacter showed a significant decrease. Besides, the abundance of the pathogen Ralstonia spp. accumulated over the monoculture span and was significantly correlated with tobacco bacterial wilt disease rate. Moreover, Pearson's correlation demonstrated that the abundance of Arthrobacter and Lysobacter, which are considered to be beneficial bacteria had significant negative correlation with tobacco bacterial wilt disease. Therefore, after long-term continuous cropping, tobacco bacterial wilt disease could be ascribed to the alteration of the composition as well as the structure of the soil microbial community.

  8. [The changes in vestibular function in patients with diabetes mellitus and its clinical significance].

    Science.gov (United States)

    Li, Juan; Zhang, Tianyu; Shen, Jianzhong; Gong, Jingrong; Wang, Hongli; Zhang, Jimin; Pang, Yufeng

    2008-01-01

    To study the changes of vestibular function in patients with diabetes mellitus and its clinical significance. Electronystagmography (ENG) was used to examine 76 patients with diabetes mellitus and 60 healthy adults subjects. After clinical detection of vestibular function including spontaneous nystagmus, positional test, head shaking nystagmus, neck torsion test, caloric test, and sensory organization tests which consist of gaze, saccade and smooth pursuit test, the results of these two groups were recorded for qualitative and quantitative statistical analysis. The rate of vestibular dysfunction in patients with diabetes mellitus were 68.4%. and that of the controls were 8.3%. There was significant difference between these two groups (chi2 = 15.472, P Vertigo or dizziness occurred in patients with diabetes mellitus might be related to vestibular dysfunction. ENG test could be used as one of the objective clinical examinations in patients with diabetes mellitus.

  9. Incidence, clinical correlates and treatment effect of rage in anxious children.

    Science.gov (United States)

    Johnco, Carly; Salloum, Alison; De Nadai, Alessandro S; McBride, Nicole; Crawford, Erika A; Lewin, Adam B; Storch, Eric A

    2015-09-30

    Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Frameworks for improvement: clinical audit, the plan-do-study-act cycle and significant event audit.

    Science.gov (United States)

    Gillam, Steve; Siriwardena, A Niroshan

    2013-01-01

    This is the first in a series of articles about quality improvement tools and techniques. We explore common frameworks for improvement, including the model for improvement and its application to clinical audit, plan-do-study-act (PDSA) cycles and significant event analysis (SEA), examining the similarities and differences between these and providing examples of each.

  11. Risk Factors for Clinically Significant Intimate Partner Violence among Active-Duty Members

    Science.gov (United States)

    Smith Slep, Amy M.; Foran, Heather M.; Heyman, Richard E.; Snarr, Jeffery D.

    2011-01-01

    Hypothesized risk factors for men's and women's clinically significant intimate partner violence (CS-IPV) from four ecological levels (i.e., individual, family, workplace, community) were tested in a representative sample of active-duty U.S. Air Force members (N = 42,744). When considered together, we expected only individual and family factors to…

  12. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Ahlehoff, O; Gislason, G H; Charlot, M

    2011-01-01

    of Southern Denmark, Copenhagen; Copenhagen University Hospital Gentofte, Hellerup; University of Copenhagen, Copenhagen, Denmark) Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med 2010; doi: 10.1111/j.1365-2796.2010.02310.x. Objective...

  13. Statistical significance versus clinical importance: trials on exercise therapy for chronic low back pain as example.

    NARCIS (Netherlands)

    van Tulder, M.W.; Malmivaara, A.; Hayden, J.; Koes, B.

    2007-01-01

    STUDY DESIGN. Critical appraisal of the literature. OBJECIVES. The objective of this study was to assess if results of back pain trials are statistically significant and clinically important. SUMMARY OF BACKGROUND DATA. There seems to be a discrepancy between conclusions reported by authors and

  14. Reliability and Clinical Significance of Mobility and Balance Assessments in Multiple Sclerosis

    Science.gov (United States)

    Learmonth, Yvonne C.; Paul, Lorna; McFadyen, Angus K.; Mattison, Paul; Miller, Linda

    2012-01-01

    The aim of the study was to establish the test-retest reliability, clinical significance and precision of four mobility and balance measures--the Timed 25-Foot Walk, Six-minute Walk, Timed Up and Go and the Berg Balance Scale--in individuals moderately affected by multiple sclerosis. Twenty four participants with multiple sclerosis (Extended…

  15. [Incidence and clinical risk factors for the development of diabetes mellitus in women with previous gestational diabetes].

    Science.gov (United States)

    Domínguez-Vigo, P; Álvarez-Silvares, E; Alves-Pérez M T; Domínguez-Sánchez, J; González-González, A

    2016-04-01

    Gestational diabetes is considered a variant of diabetes mellitus as they share a common pathophysiological basis: insulin resistance in target and insufficient secretion of it by pancreatic p-cell bodies. Pregnancy is a unique physiological situation provides an opportunity to identify future risk of diabetes mellitus. To determine the long-term incidence of diabetes mellitus in women who have previously been diagnosed with gestational diabetes and identifying clinical risk factors for developing the same. nested case-control cohort study. 671 patients between 1996 and 2009 were diagnosed with gestational diabetes were selected. The incidence of diabetes mellitus was estimated and 2 subgroups were formed: Group A or cases: women who develop diabetes mellitus after diagnosis of gestational diabetes. Group B or control: random sample of 71 women with a history of gestational diabetes in the follow-up period remained normoglycemic. Both groups were studied up to 18 years postpartum. By studying Kaplan Meier survival of the influence of different gestational variables it was obtained in the later development of diabetes mellitus with time parameter and COX models for categorical variables were applied. Significant variables were studied by multivariate Cox analysis. In all analyzes the Hazard ratio was calculated with confidence intervals at 95%. The incidence of diabetes mellitus was 10.3% in patients with a history of gestational diabetes. They were identified as risk factors in the index pregnancy to later development of diabetes mellitus: greater than 35 and younger than 27 years maternal age, BMI greater than 30 kg/m2, hypertensive disorders of pregnancy, insulin therapy, poor metabolic control and more than a complicated pregnancy with gestational diabetes. Clinical factors have been identified in the pregnancy complicated by gestational diabetes that determine a higher probability of progression to diabetes mellitus in the medium and long term.

  16. Clinical significance of GLUT-1 expression in patients with esophageal cancer treated with concurrent chemoradiotherapy.

    Science.gov (United States)

    Chiba, Itaru; Ogawa, Kazuhiko; Morioka, Takamitsu; Shimoji, Hideaki; Sunagawa, Nao; Iraha, Shiro; Nishimaki, Tadashi; Yoshimi, Naomi; Murayama, Sadayuki

    2011-01-01

    This study aimed to investigate whether glucose transporter-1 (GLUT-1) expression in a pretreatment esophageal cancer biopsy was predictive of clinical outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CRT). A total of 25 patients with esophageal cancer treated with concurrent CRT were reviewed. Radiotherapy was administered up to total doses of 40-66.6 Gy (median 66.6 Gy) with a single fraction of 1.8-2 Gy. Regarding chemotherapy, cisplatin (80 mg/m(2) on day 1) and 5-fluorouracil (800 mg/m(2) on days 2-6) were used concurrently with radiotherapy, every 3-4 weeks for a total of 1-2 courses. Tissue samples from esophageal carcinoma were obtained from the 25 patients by biopsy prior to concurrent CRT, and a semiquantitative analysis of GLUT-1 expression was performed using immunohistochemical staining. High GLUT-1 expression was observed in 7 of 25 (28%) patients, and GLUT-1 expression was significantly correlated with clinical T stage (p=0.0454), clinical N stage (p=0.0324) and initial response to CRT (p=0.0185). Patients with a high GLUT-1 expression had significantly poorer local control (LC) (5-year LC 28.6%) than those with a low expression (5-year LC 73.4%, pGLUT-1 and the number of chemotherapy courses were independent prognostic factors for LC. Patients with a high GLUT-1 expression had significantly lower recurrence-free survival (RFS) compared to those with a low GLUT-1 expression (p=0.0405). Multivariate analysis revealed that GLUT-1, the number of chemotherapy courses and clinical M stage were independent prognostic factors for RFS. GLUT-1 expression was significantly correlated with clinical T stage, clinical N stage and initial response to concurrent CRT, and was predictive of LC and RFS for patients with esophageal cancer treated with concurrent CRT.

  17. Caval Penetration by Inferior Vena Cava Filters: A Systematic Literature Review of Clinical Significance and Management.

    Science.gov (United States)

    Jia, Zhongzhi; Wu, Alex; Tam, Mathew; Spain, James; McKinney, J Mark; Wang, Weiping

    2015-09-08

    Limited penetration into the caval wall is an important securing mechanism for inferior vena cava (IVC) filters; however, caval penetration can also cause unintentional complications. The aim of this study was to assess the incidence, severity, clinical consequences, and management of filter penetration across a range of commercially available IVC filters. The MEDLINE database was searched for all studies (1970-2014) related to IVC filters. A total of 88 clinical studies and 112 case reports qualified for analysis; these studies included 9002 patients and 15 types of IVC filters. Overall, penetration was reported in 19% of patients (1699 of 9002), and 19% of those penetrations (322 of 1699) showed evidence of organ/structure involvement. Among patients with penetration, 8% were symptomatic, 45% were asymptomatic, and 47% had unknown symptomatology. The most frequently reported symptom was pain (77%, 108 of 140). Major complications were reported in 83 patients (5%). These complications required interventions including surgical removal of the IVC filter (n=63), endovascular stent placement or embolization (n=11), endovascular retrieval of the permanent filter (n=4), and percutaneous nephrostomy or ureteral stent placement (n=3). Complications led to death in 2 patients. A total of 87% of patients (127 of 146) underwent premature filter retrieval or interventions for underlying symptoms or penetration-related complications. Caval penetration is a frequent but clinically underrecognized complication of IVC filter placement. Symptomatic patients accounted for nearly 1/10th of all penetrations; most of these cases had organ/structure involvement. Interventions with endovascular retrieval and surgery were required in most of these symptomatic patients. © 2015 American Heart Association, Inc.

  18. Does recreational scuba diving have clinically significant effect on routine haematological parameters?

    Science.gov (United States)

    Perovic, Antonija; Nikolac, Nora; Braticevic, Marina Njire; Milcic, Ana; Sobocanec, Sandra; Balog, Tihomir; Dabelic, Sanja; Dumic, Jerka

    2017-06-15

    Scuba diving represents a combination of exercise and changes in environmental conditions. This study aimed to evaluate changes in haematological parameters after recreational scuba diving in order to identify clinically significant changes. The study included males, 17 recreational divers, median age (range) 41 (30-52) years. Blood samples were taken before diving, immediately after diving to 30 meters for 30 minutes, 3 hours and 6 hours after diving. Complete blood counts were analyzed on the Cell Dyn Ruby haematology analyzer. Statistical significance between successive measurements was tested using Friedman test. The difference between the two measurements was judged against desirable bias (DSB) derived from biological variation and calculated reference change values (RCV). The difference higher than RCV was considered clinically significant. A statistically significant increase and difference judging against DSB was observed: for neutrophils immediately, 3 and 6 hours after diving (18%, 34% and 36%, respectively), for white blood cells (WBCs) 3 and 6 hours after diving (20% and 25%, respectively), for lymphocytes (20%) and monocytes (23%) 6 hours after diving. A statistically significant decrease and difference judging against DSB was found: immediately after diving for monocytes (- 15%), 3 and 6 hours after diving for red blood cells (RBCs) (- 2.6% and -2.9%, respectively), haemoglobin (- 2.1% and - 2.8%, respectively) and haematocrit (- 2.4% and - 3.2%, respectively). A clinically significant change was not found for any of the test parameters when compared to RCV. Observed statistically significant changes after recreational scuba diving; WBCs, neutrophils, lymphocytes, monocytes increase and RBCs, haemoglobin, haematocrit decrease, probably will not affect clinical decision.

  19. Change and clinical significance of serum PG in patients with chronic gastritis

    Directory of Open Access Journals (Sweden)

    Wei-Hua Huan

    2017-06-01

    Full Text Available Objective: To observe the change and clinical significance of serum PG in patients with chronic atrophic gastritis (CAG. Methods: ELISA was used to detect the peripheral blood PG level in patients confirmed with CAG, gastric polyps, and gastric cancer who were admitted in our hospital from January, 2015 to January, 2016. The normal individuals who came for physical examinations were served as the control group. The peripheral blood PG level in patients with various gastric diseases was observed. Results: The serum PG Ⅰ expression and PG I/PG Ⅱ in the gastritis group were significantly lower than those in the gastric polyps group and control group, but were significantly higher than those in the gastric cancer group; while PG Ⅱ expression was significantly higher than that in the gastric polyps group and control group, but was significantly lower than those in the gastric cancer group. PG Ⅰ expression and PG I/ PG Ⅱ in the gastric polyps group were significantly higher than those in the gastritis group and gastric cancer group, while PG Ⅱ expression was significantly lower than that in the gastritis group and gastric cancer group. PG Ⅰ expression and PG I/ PG Ⅱ in the gastric cancer group were significantly lower than those in the other three groups, while PG Ⅱ expression was significantly higher than that in the other three groups. The serum PG Ⅰ expression in patients with positive HP infection in the gastritis group and gastric cancer group was significantly higher than that in patients with negative HP infection, but the comparison of PG I/ PG Ⅱ was not statistically significant. The serum PG Ⅰ expression and PG I/ PG Ⅱ in patients with negative and positive HP infection in the gastritis group were significantly higher than those in patients with negative and positive HP infection in the gastric cancer group; while PG Ⅱ expression was significantly was significantly lower than that in the gastric cancer group

  20. Prevalence and clinical significance of cathepsin G antibodies in systemic sclerosis

    Directory of Open Access Journals (Sweden)

    M. Favaro

    2011-09-01

    Full Text Available Objectives: To evaluate the prevalence and clinical significance of cathepsin G antibodies in patients affected with systemic sclerosis (SSc, scleroderma. Methods: 115 patients affected by SSc, 55 (47,8% with diffuse scleroderma (dSSc and 60 (52,2% with limited scleroderma (lSSc, were tested for cathepsin G antibodies by ELISA method. Moreover these sera were evaluated by indirect immunofluorescence (IIF on ethanol and formalin fixed human neutrophils. Results: By means of the ELISA method 16 (13,9% patients were found to be sera positive for anti-cathepsin G, 2 (12.5% of which showed a perinuclear fluorescence pattern (P-ANCA and 4 (25% an atypical ANCA staining, while 10 (62,5% were negative on IIF. The IIF on scleroderma sera revealed 5 (4,3% P-ANCA and 18 (15,7% atypical ANCA patterns. The anti-cathepsin G antibodies significantly prevailed in scleroderma sera (p=0.02 when their frequency was compared with that of healthy controls; while they were not significantly associated to any clinical or serological features of SSc patients. Conclusions: The anti-cathepsin G antibodies were significantly frequent in scleroderma sera; however, no clinical correlations were found. Thus, the significance of their presence in SSc still needs to be clarified.

  1. Clinical significance of corpus callosum atrophy in a mixed elderly population

    DEFF Research Database (Denmark)

    Ryberg, C.; Rostrup, E.; Stegmann, Mikkel Bille

    2007-01-01

    Corpus callosum (CC) is the main tract connecting the hemispheres, but the clinical significance of CC atrophy is poorly understood. The aim of this work was to investigate clinical and functional correlates of CC atrophy in subjects with age-related white matter changes (ARWMC). In 569 elderly......) score, history of depression, geriatric depression scale (GDS) score, subjective gait difficulty, history of falls, walking speed, and total score on the short physical performance battery (SPPB) were analyzed. Significant correlations between CC atrophy and MMSE, SPPB, and walking speed were identified......, and the CC areas were smaller in subjects with subjective gait difficulty. The correlations remained significant after correction for ARWMC grade. In conclusion, CC atrophy was independently associated with impaired global cognitive and motor function in subjects with ARWMC. (c) 2006 Elsevier Inc. All rights...

  2. Clinical significance of determination serum sex hormones levels in patients with secondary amenorrhea

    International Nuclear Information System (INIS)

    Jiang Hua

    2007-01-01

    Objective: To explore the clinical significance of changes of serum sex hormones levels in patients with secondary amenorrhea. Methods: Serum levels of E 2 , FSH, LH, PRL and P were detected with RIA in 33 patients with secondary amenorrhea and 30 controls. Results: In the patients, the serum E 2 levels were significantly lower and FSH, LH, PRL and P levels were significantly higher than those in controls (P 2 , FSH, LH, PRL and P levels is of help for assessment of severity of secondary amenorrhea as well as outcome prediction. (authors)

  3. Incidence trends and clinical-pathological characteristics of invasive cutaneous melanoma from 1980 to 2010 in the Canton of Zurich, Switzerland.

    Science.gov (United States)

    Minini, Remo; Rohrmann, Sabine; Braun, Ralph; Korol, Dimitri; Dehler, Silvia

    2017-04-01

    The aims of this paper are to describe the incidence trends of invasive cutaneous melanoma in the Canton of Zurich and to evaluate clinical and pathological factors such as cancer subtype, localization, age and Breslow thickness. A retrospective analysis was carried out with data from the population-based Cancer Registry of Zurich and Zug located in Zurich. A total of 8469 cases in 8034 different patients of invasive cutaneous melanoma were registered for the period 1980-2010 in the Canton of Zurich. Incidence trends were age standardized to the European standard population. Joinpoint regression was used to compute changes in incidence and mortality rates, measured as the annual percent change (APC). The most common subtypes of cutaneous melanoma were superficial spreading melanoma (SSM, 41.1%), followed by nodular melanoma (16.5%), lentigo maligna melanoma (13.5%), acral-lentiginous melanoma (5.0%) and other types of melanoma (2.8%); 21.1% were melanoma not otherwise specified. The trunk was the most frequent location (30.8%), followed by the lower limb and hip (26.4%) and the upper limb and shoulder (22.8%). Statistically significantly increasing incidence trends were observed for both men (APC=3.0%) and women (APC=2.1%). Incidences of SSM and melanoma not otherwise specified were the histological subtypes for which a significant increase in incidence was observed (APC for the period 1980-2010=3.2% for both). In terms of Breslow thickness, thin melanomas (0.01-1.00 mm) showed an increasing incidence. The incidence of melanoma increased in both men and women between 1980 and 2010. In terms of the different subtypes and Breslow thickness, increasing incidences of the SSM and of thin melanomas (0.01-1.00 mm) were observed. These observations are in agreement with other studies from Southern and Western Switzerland as well as other European countries and the USA.

  4. Clinical significance of incidental focal 18F-FDG uptake in the spinal cord of patients with cancer

    International Nuclear Information System (INIS)

    Lim, Chae Hong; Hyun, Seung Hyup; Moon, Seung Hwan; Cho, Young Seok; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae; Choi, Joon Young

    2017-01-01

    We investigated the incidence, location, and clinical significance of focal 18 F-FDG uptake of the spinal cord in patients with cancer. We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent 18 F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUV max ) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed. Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence = 0.3%; M:F = 31:38; age, 55.8 ± 14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUVmax for cord uptake was 2.5 ± 0.5 (range, 1.4∼3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up. Although incidental focal 18 F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels

  5. Clinical significance of incidental focal {sup 18}F-FDG uptake in the spinal cord of patients with cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Hong; Hyun, Seung Hyup; Moon, Seung Hwan; Cho, Young Seok; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae; Choi, Joon Young [Dept. of Nuclear Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-09-15

    We investigated the incidence, location, and clinical significance of focal {sup 18}F-FDG uptake of the spinal cord in patients with cancer. We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent {sup 18}F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUV{sub max}) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed. Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence = 0.3%; M:F = 31:38; age, 55.8 ± 14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUVmax for cord uptake was 2.5 ± 0.5 (range, 1.4∼3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up. Although incidental focal {sup 18}F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels.

  6. Clinical Significance of Incidental Focal 18F-FDG Uptake in the Spinal Cord of Patients with Cancer.

    Science.gov (United States)

    Lim, Chae Hong; Hyun, Seung Hyup; Moon, Seung Hwan; Cho, Young Seok; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae; Choi, Joon Young

    2017-09-01

    We investigated the incidence, location, and clinical significance of focal 18 F-FDG uptake of the spinal cord in patients with cancer. We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent 18 F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUV max ) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed. Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence = 0.3%; M:F = 31:38; age, 55.8 ± 14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUV max for cord uptake was 2.5 ± 0.5 (range, 1.4∼3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up. Although incidental focal 18 F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels.

  7. Syndrome of rapid onset end stage renal disease in incident Mayo Clinic chronic hemodialysis patient

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    M. A. C. Onuigbo

    2014-01-01

    Full Text Available Despite decades of research, a full understanding of chronic kidney disease (CKD-end stage renal disease (ESRD progression remains elusive. The common consensus is a predictable, linear, progressive and time-dependent decline of CKD to ESRD. Acute kidney injury (AKI on CKD is usually assumed to be transient, with recovery as the expected outcome. AKI-ESRD association in current nephrology literature is blamed on the so-called "residual confounding." We had previously described a relationship between AKI events and rapid onset yet irreversible ESRD happening in a continuum in a high-risk CKD cohort. However, the contribution of the syndrome of rapid onset-ESRD (SORO-ESRD to incident United States ESRD population remained conjectural. In this retrospective analysis, we analyzed serum creatinine trajectories of the last 100 consecutive ESRD patients in 4 Mayo Clinic chronic hemodialysis units to determine the incidence of SORO-ESRD. Excluding 9 patients, 31 (34% patients, including two renal transplant recipients, had SORO-ESRD: 18 males and 13 females age 72 (range 50-92 years. Precipitating AKI followed pneumonia (8, acutely decompensated heart failure (7, pyelonephritis (4, post-operative (5, sepsis (3, contrast-induced nephropathy (2, and others (2. Time to dialysis was shortest following surgical procedures. Concurrent renin angiotensin aldosterone system blockade was higher with SORO-ESRD - 23% versus 5%, P = 0.0113. In conclusion, SORO-ESRD is not uncommon among the incident general US ESRD population. The implications for ESRD care planning, AV-fistula-first programs, general CKD care and any associations with renal ageing/senescence warrant further study.

  8. Detection of Clinically Significant Retinopathy of Prematurity Using Wide-angle Digital Retinal Photography

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    Chiang, Michael F.; Melia, Michele; Buffenn, Angela N.; Lambert, Scott R.; Recchia, Franco M.; Simpson, Jennifer L.; Yang, Michael B.

    2013-01-01

    Objective To evaluate the accuracy of detecting clinically significant retinopathy of prematurity (ROP) using wide-angle digital retinal photography. Methods Literature searches of PubMed and the Cochrane Library databases were conducted last on December 7, 2010, and yielded 414 unique citations. The authors assessed these 414 citations and marked 82 that potentially met the inclusion criteria. These 82 studies were reviewed in full text; 28 studies met inclusion criteria. The authors extracted from these studies information about study design, interventions, outcomes, and study quality. After data abstraction, 18 were excluded for study deficiencies or because they were superseded by a more recent publication. The methodologist reviewed the remaining 10 studies and assigned ratings of evidence quality; 7 studies were rated level I evidence and 3 studies were rated level III evidence. Results There is level I evidence from ≥5 studies demonstrating that digital retinal photography has high accuracy for detection of clinically significant ROP. Level III studies have reported high accuracy, without any detectable complications, from real-world operational programs intended to detect clinically significant ROP through remote site interpretation of wide-angle retinal photographs. Conclusions Wide-angle digital retinal photography has the potential to complement standard ROP care. It may provide advantages through objective documentation of clinical examination findings, improved recognition of disease progression by comparing previous photographs, and the creation of image libraries for education and research. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. PMID:22541632

  9. X-ray study of gastric hypokinesia (587 cases analysis) and its clinical significance

    International Nuclear Information System (INIS)

    Cao Zuyi; Chen Xiaodong; Zhang Huilin; Guo Yingfeng; Deng Mingxing

    1999-01-01

    Objective: To study the gastric hypokinesia X-ray findings and its clinical significance. Methods: In 2822 patients with upper barium meal examination and 112 with alimentary tract barium meal examination was determined according to the gastrorrhea, pattern, pyloric reflux, peristalsis and emptying with clinical data, hypokinesia. Results: 562 of 2822 patients suffered from gastric hypokinesia (19.9%) and 25 of 112 patients with alimentary tract barium meal examination suffered from gastric hypokinesia (22.3%). There were 587 cases of functional dyspepsia in total. Conclusion: It's a useful method to find gastric hypokinesia by X-ray examination and it may be helpful for treatment of FD

  10. [SIRS (systemic inflammatory response syndrome): clinical entity, definitions, and the significance].

    Science.gov (United States)

    Kushimoto, S; Yamamoto, Y

    1999-01-01

    The clinical entity, definitions, and the significance of SIRS (systemic inflammatory response syndrome) were reviewed. The term, SIRS was proposed to define sepsis and its sequelae clearly in 1991, in order to make early detection of the disease possible, and to improve the ability to compare innovative potential diagnostic and therapeutic modalities by standardizing terms. Although the criteria of SIRS is not strict and too sensitive, SIRS has been shown to be useful as a warning sign of severe condition in clinical setting. We also discussed about a new concept, CARS (compensatory anti-inflammatory response syndrome), which was characterized as anti-inflammatory mediators-dominant condition, in this issue.

  11. Clinical Bioprosthetic Heart Valve Thrombosis After Transcatheter Aortic Valve Replacement: Incidence, Characteristics, and Treatment Outcomes.

    Science.gov (United States)

    Jose, John; Sulimov, Dmitriy S; El-Mawardy, Mohamed; Sato, Takao; Allali, Abdelhakim; Holy, Erik W; Becker, Björn; Landt, Martin; Kebernik, Julia; Schwarz, Bettina; Richardt, Gert; Abdel-Wahab, Mohamed

    2017-04-10

    The aim of this study was to determine the incidence, characteristics, and treatment outcomes of patients diagnosed with clinical transcatheter heart valve thrombosis. Limited data exists on clinical or manifest transcatheter heart valve thrombosis. Prior studies have focused on subclinical thrombosis. A retrospective analysis was conducted of prospectively collected data from a single-center registry that included 642 consecutive patients who underwent transcatheter aortic valve replacement between 2007 and 2015 (305 patients had self-expanding valves; balloon-expandable, n = 281; mechanically expanding, n = 56). Long-term oral anticoagulation (OAC) was indicated in 261 patients, while 377 patients received dual-antiplatelet therapy post-procedure. All patients underwent scheduled clinical and echocardiographic follow-up. The overall incidence of clinical valve thrombosis was 2.8% (n = 18). No patient on OAC developed thrombosis. Of the detected thrombosis cases, 13 patients had balloon-expandable, 3 had self-expanding, and 2 had mechanically expanding valves. Thrombosis occurred significantly more often with balloon-expandable valves (odds ratio: 3.45; 95% confidence interval: 1.22 to 9.81; p = 0.01) and following valve-in-valve procedures (odds ratio: 5.93; 95% confidence interval: 2.01 to 17.51; p = 0.005). Median time to diagnosis of valve thrombosis was 181 days. The median N-terminal pro-brain natriuretic peptide level was 1,318 pg/ml (interquartile range: 606 to 1,676 pg/ml). The mean transvalvular gradient and valve area were 34 ± 14 mm Hg and 1.0 ± 0.46 cm 2 , respectively. Computed tomography showed hypoattenuating areas with reduced leaflet motion. Initiation of OAC resulted in significant reduction of transvalvular gradient and clinical improvement. No deaths were related to valve thrombosis. Clinical transcatheter heart valve thrombosis is more common than previously considered, characterized by imaging abnormalities and increased gradients

  12. Incidence and Clinical Predictors of Ocular Candidiasis in Patients with Candida Fungemia

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    Ayesha Khalid

    2014-01-01

    Full Text Available Purpose. The aim of this study is to determine the incidence and the predictors of ocular candidiasis among patient with Candida fungemia. Methods. We retrospectively reviewed the charts of all patients diagnosed with candidemia at the University of Kansas Medical Center during February 2000–March 2010. Data regarding patients’ demographics, clinical characteristics, laboratory results, and ophthalmology examination findings were collected. Results. A total of 283 patients with candidemia were enrolled. The mean age (± standard deviation was 55 ± 18 years; 66% were male. The most commonly isolated Candida species were C. albicans (54%, C. parapsilosis (20%, C. glabrata (13%, and C. tropicalis (8%. Only 144 (51% patients were evaluated by ophthalmology; however, the proportion of patients who were formally evaluated by an ophthalmologist increased during the study period (9%in 2000 up to 73%in 2010; P<0.0001. Evidence of ocular candidiasis was present in 18 (12.5% patients. Visual symptoms were reported by 5 of 18 (28% patients. In multivariable analysis, no predictors of ocular candidiasis were identified. Conclusions. The incidence of ocular candidiasis among patients with fungemia remains elevated. Most patients are asymptomatic and therefore all patients with candidemia should undergo fundoscopic examination to rule out ocular involvement.

  13. [Incidence and clinical impact of seizures after surgery for chronic subdural haematoma].

    Science.gov (United States)

    Battaglia, F; Lubrano, V; Ribeiro-Filho, T; Pradel, V; Roche, P-H

    2012-08-01

    Seizures can occur in patients who have surgery for a chronic subdural hematoma. However, the incidence of seizures and their impact on the clinical course of patients in the perioperative period is not well known. In this retrospective study, we reviewed 161 cases of patients treated for chronic subdural hematoma in our institution. The surgical procedures consisted in trephine craniotomy in 156 cases, burr-hole craniotomy in three cases, and bone flap craniotomy in two cases. All the patients had systematic antiepileptic drug prophylaxis. In our patients' population, the incidence of seizures was 10.6% before surgery and 14.9% after surgery. Low initial score on the Glasgow Coma Scale (Pcognitive impairment (P=0.005) were associated with a higher rate of postoperative seizures. In our study, the mortality rate was 14.9%. Low initial score on the Glasgow Coma Scale (P=0.068) and postoperative seizures (P=0.002) were associated with a higher mortality rate. We have shown that patients suffering from seizures may have worse outcome. The benefit of a systematic perioperative prophylaxis using antiepileptic drugs has to be evaluated. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Incidence of cycloid psychosis. A clinical study of first-admission psychotic patients.

    Science.gov (United States)

    Lindvall, M; Axelsson, R; Ohman, R

    1993-01-01

    The concept of cycloid psychosis has gained increasing acceptance during recent decades. Using the diagnostic criteria of Perris and Brockington, an intelligible delineation of a group of patients has been obtained. Few epidemiological data on cycloid psychosis have been reported so far. The objective of the present study was to describe the one-year incidence of cycloid psychosis in a clinical sample. The diagnostic registers of all patients hospitalized for a functional or an organic psychosis and discharged in the year 1983, in Lund, Sweden were investigated. 514 patients were identified of whom 83 were admitted to hospital for the first time. 29 of these patients had a functional psychosis and were below the age of 50. In this age group 7 cases (4 women, 3 men) fulfilled the diagnostic criteria of cycloid psychosis and thus constituted almost one fourth of all first admissions of functional psychoses that year. The one-year incidence for first admission in cycloid psychosis was 5.0 per 100,000 inhabitants in women and 3.6 per 100,000 inhabitants in men within the age group 15-50 years in the catchment area of 163,175 persons. We conclude that cycloid psychosis constitutes a considerable proportion of functional psychoses in both sexes.

  15. Expression and Clinical Significance of Progesterone and Adiponectin Receptor Family Member 3 in Lung Cancer

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    Xiaohui LIANG

    2017-04-01

    Full Text Available Background and objective Progesterone and adiponectin receptor family member 3 (PAQR3 is a recently discovered tumor suppressor gene, which affects the development of a tumor by inhibiting cell proliferation, cell malignant transformation, angiogenesis, and tumor metastasis. This study investigates the expression of PAQR3 in lung cancer and its clinical significance. Methods A total of 106 patients with lung cancer received surgical treatment in hospital, and adjacent normal tissues of these patients were utilized as control group. The diagnosis of all patients was confirmed through clinical pathology. The expression of PAQR3 protein was detected by immunohistochemistry in lung cancer and adjacent normal tissues. The clinical significance of its expression was also investigated. Results The positive expression rate of PAQR3 protein in lung cancer was lower than that in adjacent normal tissues (P<0.01. The positive expression rate of PAQR3 protein was unrelated to age, tumor size, and gender, but it exhibited a significant relationship with the pathological type and differentiation, TNM staging, and lymph node metastasis (P<0.05. Kaplan-Meier survival analysis showed that the five-year survival rate of patients with PAQR3 protein positive expression was higher than that in patients with negative expression (P=0.026. Conclusion The expression of PAQR3 protein significantly decreased in lung cancer, indicating that PAQR3 protein plays an important role in the pathogenesis of PAQR3 in lung cancer.

  16. INCIDENCE AND CHARACTERIZATION OF ELDERLY IN THE ORTHOPEDIC CLINIC FOR FEMUR FRACTURE, CACERES MT

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    Andréia Costa Ferreira

    2013-05-01

    Full Text Available Introduction:The elderly population is growing gradually in recent years, it increases theincidence of elderly people at risk of falls and hip fractures develop.Objective:To identifythe incidence and characterize elderly patients hospitalized with hip fractures in theOrthopedic Clinic of the Hospital Regional Dr º Antonio Cáceres sources.Methodology:Thisis an epidemiological, descriptive, quantitative and retrospective data collection documentbasis. The study population comprised 105.Results:It was found that the fracture of thefemur showed predominance in females, comprising 40.90% of the cases and the right lowerlimb most affected. As for location, the trochanteric fractures showed 39.04%, followed byfractures of the femoral shaftwith 27.61% of the cases. The treatment applied in 62.85% ofpatients went to surgery.Conclusion:It is concluded that the femur fracture may preclude theelderly in their daily activities.

  17. [Expression and Clinical Significance of Numb and P53 Proteins in Epithelial Ovarian Carcinoma].

    Science.gov (United States)

    Xu, Min; He, Hong-Ju; Zhang, Huan; Wang, Ao; Chen, Jie

    2017-01-01

    To investigate the expression and clinical significance of Numb and P53 proteins in epithelial ovarian carcinoma. We co-tested the expressions of Numb and P53 proteins in epithelial ovarian tissues by immunohistochemistry, including 20 cases of normal tissues, 29 cases of benign tumors, 35 cases of borderline ovarian tumors and 87 cases of epithelial ovarian carcinoma. Their clinical significance was analyzed. The positive expression rates of Numb protein in normal ovarian tissues, benign ovarian tumors, borderline ovarian tumors and epithelial ovarian carcinoma were 5%, 13.8%, 51.4% and 70.1%, respectively, and with the rising trend and significantly difference among four groups ( P 0.05). The positive expression rates of P53 protein in normal ovarian tissues, benign ovarian tumors, borderline ovarian tumors and epithelial ovarian carcinoma were 0%, 3.4%, 28.6% and 63.2%, respectively, which had a gradually rising trend with significantly difference among four groups ( P ovarian tumors was significantly higher than those in normal ovarian tissues and benign ovarian tumors ( P ovarian carcinoma group was significantly higher than those in the rest three groups ( P 0.05). The expression of Numb protein was positive correlated with the expression of P53 protein in borderline ovarian tumors and epithelial ovarian carcinoma ( r =0.488, P ovarian carcinoma and two proteins might work together in the development process of epithelial ovarian carcinoma.

  18. Clinical significance of left ventricular apical aneurysms in hypertrophic cardiomyopathy patients: the role of diagnostic electrocardiography.

    Science.gov (United States)

    Ichida, Masaru; Nishimura, Yoshioki; Kario, Kazuomi

    2014-10-01

    Some patients with hypertrophic cardiomyopathy (HCM) develop left ventricular apical aneurysm, leading to serious cardiovascular complications. The aims of this study were to identify the incidence and clinical course of HCM patients with apical aneurysms in Japan, and to evaluate the role of electrocardiography (ECG) as a screening test to detect apical aneurysms in HCM patients. In a retrospective, single center analysis of a population of 247 HCM patients, 21 patients (8.5%) had left ventricular apical aneurysms. Their mean age was 60 ± 14 years (range: 23-77 years) at study entry. Over 4.7 ± 3.3 years of follow-up, 10 patients (47.6%) experienced an adverse clinical event (annual event rate: 10.1%/y), including five implantable cardioverter-defibrillator (ICD) implantations for ventricular tachycardia/ventricular fibrillation (VT/VF), an appropriate discharge of ICD for VT/VF, and four nonfatal thromboembolic strokes. Two patients developed systolic dysfunction (ejection fraction <50%). No sudden cardiac death or progressive heart failure was detected. Fourteen patients showed ST-segment elevation (≥ 1 mm) in V3 through V5 of ECG. In four patients, progression of the ST-segment elevation was recognized. When the ST-segment elevation was used to identify apical aneurysms in HCM patients, the sensitivity was 66.7%, and the specificity was 98.7%. Apical aneurysms in HCM patients in Japan are not rare, and are associated with serious cardiovascular complications. The early diagnosis of apical aneurysms can be achieved by serial ECG. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  19. Clinical significance of routine lacrimal sac biopsy during dacryocystorhinostomy: A comprehensive review of literature

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    Zoran Koturović

    2017-02-01

    Full Text Available The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases. Lacrimal sac-specific pathologies were present in 226 (5.85% cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34% cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1 lacrimal stones-dacryoliths, (2 pyogenic granuloma, (3 granulation tissues, (4 reactive lymphoid hyperplasia, and (5 lacrimal sac-specific inflammation (Wegener’s granulomatosis and sarcoidosis. Neoplastic pathology was found in 55/3865 (1.42% lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction.

  20. Breast cancer in kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk

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    Safar Banaz M

    2009-12-01

    Full Text Available Abstract Background Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in the Kurdish region of Iraq and evaluates risk associated with parity and family history. Findings are compared with nearby countries and the West. Methods Sulaimaniyah Directorate of Health records identified 539 women diagnosed with breast cancer during 2006-2008. Clinical survey forms were completed on 296 patients and on 254 age-matched controls. Age specific incidence rates were calculated from Directorate of Health population estimates. Results Average patient age was 47.4 ± 11 years and 59.5% were pre-menopausal. Diagnosis was at clinical stage 1 for 4.1%, stage 2 for 43.5%, stage 3 for 26.0%, and stage 4 for 8.1% of patients. For 18.2%, stage was unknown. Annual breast cancer incidence rates per 100,000 women peaked at 168.9 at age 55 to 59 and declined to 57.3 at 60 and above. Patients had an average of 5.0 ± 3.3 children compared to 5.4 ± 3.5 for controls, P = 0.16. A first degree family member had breast cancer among 11.1% of patients and 2.1% of controls (P 50% of these patients and controls being ≥50 years old. No statistically significant relationship was found between tumor stage and age, P = 0.59. Conclusions In Kurdish Iraq, breast cancer is predominantly a disease of pre-menopausal women having multiple pregnancies. For younger patients, breast cancer incidence was similar to the West and possibly higher than many Middle-Eastern countries, but unlike the West, the estimated rates declined markedly in the elderly. The familial breast cancer risk for both older and younger women was within the general population risk of Western countries. Clinical stages were advanced and indicated delays in diagnosis that were

  1. The incidence risk, clustering, and clinical presentation of La Crosse virus infections in the eastern United States, 2003-2007.

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    Andrew D Haddow

    Full Text Available BACKGROUND: Although La Crosse virus (LACV is one of the most common causes of pediatric arboviral infections in the United States, little has been done to assess its geographic distribution, identify areas of higher risk of disease, and to provide a national picture of its clinical presentation. Therefore, the objective of this study was to investigate the geographic distribution of LACV infections reported in the United States, to identify hot-spots of infection, and to present its clinical picture. METHODS AND FINDINGS: Descriptive and cluster analyses were performed on probable and confirmed cases of LACV infections reported to the Centers for Disease Control and Prevention from 2003-2007. A total of 282 patients had reported confirmed LACV infections during the study period. Of these cases the majority (81 percent presented during the summer, occurred in children 15 years and younger (83.3 percent, and were found in male children (64.9 percent. Clinically, the infections presented as meningioencephalitis (56.3 percent, encephalitis (20.7 percent, meningitis (17.2 percent, or uncomplicated fever (5 percent. Deaths occurred in 1.9 percent of confirmed cases, and in 8.6 percent of patients suffering from encephalitis. The majority of these deaths were in patients 15 years and younger. The county-level incidence risk among counties (n = 136 reporting both probable and confirmed cases for children 15 years and younger (n = 355 ranged from 0.2 to 228.7 per 100,000 persons. The southern United States experienced a significantly higher (p<0.05 incidence risk during the months of June, July, August, and October then the northern United States. There was significant (p<0.05 clustering of high risk in several geographic regions with three deaths attributed to complications from LAC encephalitis occurring in two of these hot-spots of infections. CONCLUSIONS: Both the incidence risk and case fatality rates were found to be higher than previously

  2. Clinical Significance of Focal Breast Lesions Incidentally Identified by 18F-FDG PET/CT

    International Nuclear Information System (INIS)

    Cho, Young Seok; Choi, Joon Young; Lee, Su Jin; Hyun, Seung Hyup; Lee, Ji Young; Choi, Yong; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae

    2008-01-01

    We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by 18 F-FDG PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. The subjects were 3,768 consecutive 18 F-FDG PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal 18 F-FDG uptake or a focal nodular lesion on CT image irrespective of 18 F-FDG uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value > 75 HU or 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone (0.680±0.093 vs. 0.786±0.076, p 18 F-FDG PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both 18 F-FDG uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion

  3. Clinical significance of neonatal parafrontal horn cysts detected by cranial sonography

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    Woo, Jeong Joo [Eulji University of Medicine, Daejeon (Korea, Republic of); Jung, Myung Ja [Sanggye Paik Hospital, Inje University of Medicine, Seoul (Korea, Republic of); Kim, Eun Ryung [Sungae General Hospital, Seoul (Korea, Republic of)

    2005-07-15

    The describe the significance, incidence and characteristics of sonographic findings and long term outcomes of parafrontal horn cysts detected by screening cranial sonography done within the first week following birth. 2122 first cranial ultrasound scans performed over a five year period were retrospectively evaluated and 23 neonates with parafrontal horn cysts were found (which are different from secondary cystic lesions). 17 cases had a birth weight of < 2400 gm with gestation between 30 and 35 weeks, 6 cases had a birth weight of > 2400 gm with gestation between 34 and 41 weeks. The size, shape and location of the parafrontal horn cysts and other associated abnormalities shown on the cranial sonogram were evaluated and sequential ultrasound study, maternal records, neonatal events and neurodevelopmental evaluations were retrospectively assessed. Of the 23 subjects, 21 had isolated parafrontal horn cysts and 2 had subependymal hemorrhages. There was no record of any abnormal perinatal history. The cysts were bilateral in 20 neonates and unilateral in the others. The size of the cysts ranged from 3 to 18 mm in diameter (mean 9 mm). Sonographic features of the parafrontal horn cysts were distinctive morphology (elliptical, thin walled) and location (adjacent to the tip of the frontal horn). In 17 of the cases a follow-up cranial sonography was performed, and all parafrontal horn cysts disappeared within 3 to 6 months. Neurodevelopmental outcomes were normal in those 17 cases. Screening cranial sonography of neonates discovers isolated parafrontal horn cyst. The incidence of parafrontal horn cysts in neonates in our study was 1.1%. They are present in the first week following birth and resolve themselves without medical treatment within a few months. In addition, they show normal neurodevelopment. The parafrontal cysts are suspected to be a benign variant of normal neurodevelopment.

  4. Clinical significance of neonatal parafrontal horn cysts detected by cranial sonography

    International Nuclear Information System (INIS)

    Woo, Jeong Joo; Jung, Myung Ja; Kim, Eun Ryung

    2005-01-01

    The describe the significance, incidence and characteristics of sonographic findings and long term outcomes of parafrontal horn cysts detected by screening cranial sonography done within the first week following birth. 2122 first cranial ultrasound scans performed over a five year period were retrospectively evaluated and 23 neonates with parafrontal horn cysts were found (which are different from secondary cystic lesions). 17 cases had a birth weight of 2400 gm with gestation between 34 and 41 weeks. The size, shape and location of the parafrontal horn cysts and other associated abnormalities shown on the cranial sonogram were evaluated and sequential ultrasound study, maternal records, neonatal events and neurodevelopmental evaluations were retrospectively assessed. Of the 23 subjects, 21 had isolated parafrontal horn cysts and 2 had subependymal hemorrhages. There was no record of any abnormal perinatal history. The cysts were bilateral in 20 neonates and unilateral in the others. The size of the cysts ranged from 3 to 18 mm in diameter (mean 9 mm). Sonographic features of the parafrontal horn cysts were distinctive morphology (elliptical, thin walled) and location (adjacent to the tip of the frontal horn). In 17 of the cases a follow-up cranial sonography was performed, and all parafrontal horn cysts disappeared within 3 to 6 months. Neurodevelopmental outcomes were normal in those 17 cases. Screening cranial sonography of neonates discovers isolated parafrontal horn cyst. The incidence of parafrontal horn cysts in neonates in our study was 1.1%. They are present in the first week following birth and resolve themselves without medical treatment within a few months. In addition, they show normal neurodevelopment. The parafrontal cysts are suspected to be a benign variant of normal neurodevelopment

  5. Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging

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    Mellado, J.M.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, Carrer Doctor Mallafre Guasch, 4, 43007 Tarragona (Spain); Calmet, J.; Domenech, S. [Department of Orthopaedic Surgery, Hospital Universitari de Tarragona Joan XXIII, Carrer Doctor Mallafre Guasch, 4, 43007 Tarragona (Spain)

    2003-07-01

    Several skeletal variations of the upper extremity may cause painful conditions or precipitate early degenerative changes, either spontaneously or in response to overuse and trauma. Magnetic resonance imaging has proved particularly useful for accurate interpretation of many of these clinically significant skeletal variations; however, the widespread use of MR imaging may have contributed to over-emphasizing their clinical importance, which is still controversial in many cases. We review, illustrate, and discuss clinically significant skeletal variations of the upper extremity as seen on MR images, particularly those involving the shoulder and the wrist. In the shoulder region, we evaluate variations of acromial and coracoid processes as well as variations and minor dysplastic deformities of the glenoid fossa. We also review different skeletal variations of the carpal region, including ulnar variance, ulnar styloid, lunate morphology, carpal coalition, and carpal accessory ossicles. The role of MR imaging in assessing the clinical importance of such conditions, whether potential, controversial, or well established, is emphasized in this review. (orig.)

  6. Clinical Significance of Arterial Stiffness and Metabolic Syndrome Scores in Vestibular Neuritis.

    Science.gov (United States)

    Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Jeong, Jin Hyeok; Shin, Jeong-Hun

    2017-06-01

    To investigate the clinical significance of cardiovascular factors, including arterial stiffness and metabolic syndrome scores, in the development of vestibular neuritis. A prospective, case-control study. Tertiary referral center. Fifty-eight adult patients with vestibular neuritis (VN) and 58 age- and sex-matched controls were evaluated between January 2015 and January 2016. Measurement of arterial stiffness. Arterial stiffness was assessed from brachial-ankle pulse wave velocity (baPWV), and cardiovascular markers including blood pressure, body mass index and lipid profiles, and metabolic syndrome scores were determined. The dizziness handicap inventory (DHI) and vestibular function tests, including the caloric test and video head impulse test were evaluated. The correlations between cardiovascular factors and clinical parameters of VN were assessed. Blood pressure, baPWV, and metabolic syndrome scores were higher in the VN group than in the control group (p = 0.002, p = 0.001, and p = 0.001, respectively), whereas comorbidity, anthropometric characteristics, and lipid profiles did not differ significantly. baPWV and metabolic syndrome scores were not correlated with the clinical parameters of the DHI scores, canal paresis, and spontaneous nystagmus duration. In addition, cardiovascular factors did not associate with the vestibular compensation. Higher baPWV, representative of arterial stiffness, and higher metabolic syndrome scores, are associated with the development of VN. This supports the hypothesis of a vascular etiology of the disease. However, cardiovascular risk factors had limited value in predicting the clinical course of VN.

  7. Expression and clinical significance of MMP-2, MVD, MEK-2 in endometriosis

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    Wei Zhang

    2016-03-01

    Full Text Available Objective: To investigate the expression and clinical significance of MMP-2, MVD, MEK-2in the endometriosis. Methods: A total of 42 endometrial endometriosis patients with surgery were selected in our hospital obstetrics and gynecology from September 1, 2008 to December 18, 2014. Endometriosis were removed during surgery and served as ectopic group. A total of 42 examples of the above-described patients with endometriosis eutopic were taken out as the eutopic group. Another 34 patients with uterine fibroids were selected in our hospital obstetrics and gynecology during the same period. Normal endometrium were taken as the normal endometrium group. Clinical expression of MMP-2, MVD, MEK-2 of three groups were analyzed. Results: MVD in ectopic endometrium group were significantly higher than those in eutopic and normal endometrium (P<0.05. MEK-2 expression in normal endometrial tissue mainly was negative and weakly positive. The expression was positive in ectopic endometrium and eutopic. The expression of ectopic endometrium MEK-2and MMP-2 were the highest, followed by the reign of endometrium, and the expression of normal endometrium were the lowest. Conclusions: MMP-2, MVD, MEK-2 in ectopic endometrium show high expression, detection of MMP-2, MVD, MEK-2-clinical expression in endometriosis can help in pathogenesis, clinical diagnosis and treatment.

  8. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis

    Directory of Open Access Journals (Sweden)

    Wang C

    2016-01-01

    Full Text Available Chuanling Wang,1,* Fuming Tian,1,* Yingjun Zhou,2 Wenbo He,1 Zhiyou Cai1 1Department of Neurology, 2Physical Examination Center, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People’s Republic of China *These authors contributed equally to this work Background and purpose: Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data.Methods: In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05.Results: The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age

  9. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  10. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de, E-mail: quadros.pesquisa@gmail.com [Instituto de Cardiologia / Fundação Universitária de Cardiologia - IC/FUC, Porto Alegre, RS (Brazil)

    2013-12-15

    Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

  11. Clinical significance of bone marrow edema in patients with osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Gao Zhenhua; Meng Quanfei; Huang Zhaomin; Liu Jihua; Xu Aide

    2005-01-01

    Objective: To study the correlation between bone marrow edema (BME), the amount of joint fluid and clinical symptoms in order to strengthen further understandings about clinical significance of BME in osteonecrosis of the femoral head (ONFH). Methods: Fifty-seven patients (91 hips) with ONFH proved by clinical follow-up or pathology were examined by conventional radiography, 1.5 T MRI, and radionuclide imaging. BME, necrotic area, and joint fluid were analyzed respectively in ONFH with preorpost-collapse of the femoral head and different MR signal intensities within necrotic area. Results: 1)The characteristic 'line-like sign' appeared on MRI in 88 of 91 affected hips, and BME was seen in the distal zone away from line(s) in 61 hips, extending to the femoral neck and intertrochanteric region. 2)The ratio of the occurance of BME in the collapse was greater than that in noncollapse, and in mixed signals within necrotic area without collapse greater than pure fat-like signal (P 0.05), and both were greater than noncollapse without BME (P<0.01). Conclusion: Most patients without clinical symptoms have no BME. Femoral heads without BME or collapse often accompany with mild joint fluid. For most patients with BME whether collapse of the femoral head or not, large joint fluid and clinical symptoms are usually seen. The presence or enlargement of BME means the potential progression of ONFH. (authors)

  12. Serum BAFF and APRIL levels in patients with autoimmune hemolytic anemia and their clinical significance.

    Science.gov (United States)

    Xu, Zi-Zhen; Zhao, Bing-Bing; Xiong, Hong; Wei, Bei-Wen; Wang, Ye-Fei

    2015-10-01

    B cell-activating factor of the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) play crucial roles in B cell development, survival, and antibody production. Autoimmune hemolytic anemia (AIHA) is an acquired autoimmune disease that occurs when antibodies target autologous red blood cells. Here, we analyzed the serum levels of BAFF and APRIL and their respective clinical associations in patients with AIHA. Serum BAFF and APRIL levels in patients with AIHA were significantly higher (P BAFF and APRIL levels were significantly augmented in patients with lower hemoglobin levels (hemoglobin was 480 IU/mL). Glucocorticoid treatment dramatically reduced serum levels of BAFF and APRIL. Thus, serum BAFF and APRIL levels may reflect the clinical activity of this disease. Our results indicate that analysis of serum concentrations of BAFF and APRIL potentially represents a useful tool for the assessment of AIHA disease activity and progression.

  13. The clinical significance of detection of serum Pre-S1 antigen

    International Nuclear Information System (INIS)

    Jiang Xuehua; Huang Zhuqing; Han Yi; Gong Shoujun

    2003-01-01

    To study the clinical significance of detection of serum Pre-S 1 Ag, the serum Pre-S 1 Ag, HBV-marks and HBV-DNA were detected in 338 patients with hepatitis B. The positive rate and the relationship between them were analyzed and compared. In 338 patients, the positive rate of serum Pre-S 1 Ag, HBeAg, HBV-DNA was 63.02%, 48.52%, 68.05% respectively, and the co-positive rate of Pre-S 1 Ag with HBV-DNA, HBeAg was 78.56%, 81.17% respectively. There was a significant correlation between Pre-S 1 Ag, HBeAg and HBV-DNA (P 1 Ag could well reflect the reproductive status of hepatitis B virus, and so it could be used as the clinical marker of the reproductive status of hepatitis B virus

  14. Clinical significance of combined measurement of serum sex hormones in secondary amenorrhea

    International Nuclear Information System (INIS)

    Chen Boxun; Chen Yue; Gan Xilun

    2004-01-01

    Objective: To study the clinical significance of changes of levels of serum sex hormones in the diagnosis of the types of secondary amenorrhea. Methods: Serum sex hormones levels were measured with chemiluminescence in 100 patients with secondary amenorrhea and 42 controls. The serum hormones determined were: estradiol (E 2 )-, progesterone (PROG), follicle stimulating hormone (FSH)-, luteinizing hormone (LH), prolactin (PRL), testosterone (TSTO). Results: Patients with secondary amenorrhea had significantly higher levels of serum FSH, LH and PRL ( P 2 (P<0.05) than those in the controls. Serum levels of PROG and TSTO were about the same in the patients and controls. Conclusion: Determination of serum hormones levels with chemiluminescence is clinically useful for diagnosis of the types of secondary amenorrhea. (authors)

  15. The clinical significance of brain microbleeds in patients with Alzheimer′s disease: Preliminary study

    Directory of Open Access Journals (Sweden)

    Jae-Hyeok Heo

    2016-01-01

    Full Text Available Background: Microbleeds (MBs are observed frequently in Alzheimer′s disease (AD and suggested to play a crucial role in the pathophysiology, but their clinical significance remains unclear. Materials and Methods: The study recruited 100 patients with AD who were diagnosed at the memory clinic in Seoul Medical Center in 2014. For each patient, baseline characteristics, neuropsychological tests, cerebrovascular risk factors, medial temporal lobe atrophy (MTLA, and severity of small vessel disease (SVD according to the existence of MBs were evaluated. Results: The prevalence of MBs in patients with AD was 33%. The percentage of male gender, the severity of SVD and MTLA were significantly increased in MB(+ group. The MB(+ group showed more severe MTLA and SVD than MB(− group. Conclusions: These results suggested that MBs might reflect the burden of amyloid and ischemic vascular pathology.

  16. Clinical Significance of Immuno phenotypic Markers in Pediatric T-cell Acute Lymphoblastic Leukemia

    International Nuclear Information System (INIS)

    SIDHOM, I.; SHAABAN, Kh.; SOLIMAN, S.; HAMDY, N.; YASSIN, D.; SALEM, Sh.; HASSANEIN, H.; MANSOUR, M.T.; EZZAT, S.; EL-ANWAR, W.

    2008-01-01

    Background: Cell-marker profiling has led to conflicting conclusions about its prognostic significance in T-ALL. Aim: To investigate the prevalence of the expression of CD34, CD10 and myeloid associated antigens (CD13/ CD33) in childhood T-ALL and to relate their presence to initial clinical and biologic features and early response to therapy. Patients and Methods: This study included 67 consecutive patients with newly diagnosed T-ALL recruited from the Children's Cancer Hospital in Egypt during the time period from July 2007 to June 2008. Immuno phenotypic markers and minimal residual disease (MRD) were studied by five-color flow cytometry. Results: The frequency of CD34 was 34.9%, CD10 33.3%, while CD13/CD33 was 18.8%. No significant association was encountered between CD34, CD10 or myeloid antigen positivity and the presenting clinical features as age, sex, TLC and CNS leukemia. Only CD10+ expression had significant association with initial CNS involvement (p=0.039). CD34 and CD13/CD33 expression was significantly associated with T-cell maturation stages (p<0.05). No relationship was observed for age, TLC, gender, NCI risk or CNS involvement with early response to therapy illustrated by BM as well as MRD day 15 and day 42. CD34+, CD13/CD33+ and early T-cell stage had high MRD levels on day 15 that was statistically highly significant (p<0.01), but CD10+ had statistically significant lower MRD level on day 15 (p=0.049). However, only CD34 retained its significance at an MRD cut-off level of 0.01%. Conclusion: CD34, CD10, CD13/CD33 expression, as well as T-cell maturation stages, may have prognostic significance in pediatric T-ALL as they have a significant impact on early clearance of leukemic cells detected by MRD day 15.

  17. Clinical significance of pretreatment FDG PET/CT IN MOBG-avid pediatric neuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Seo Young; Kim, Yong Il; Cheon, Gi Jeong; Kang, Keon Wook; Chung, June Key; Lee, Dong Soo; Kang, Hyoung Jin; Shin, Hee Young [Seoul National University Hospital, Seoul (Korea, Republic of); Kim, E. Edmund [Seoul National University, Seoul (Korea, Republic of); Rahim, Muhammad Kashif [Nishtar Medical College and Hospital, Multan (Pakistan)

    2017-06-15

    {sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is well known to have clinical significance in the initial staging and response evaluation of the many kinds of neoplasms. However, its role in the pediatric neuroblastoma is not clearly defined. In the present study, the clinical significance of FDG-PET/computed tomography (CT) in 123I- or 131I-metaiodobenzylguanidine (MIBG)-avid pediatric neuroblastoma was investigated. Twenty patients with neuroblastoma who undertook pretreatment FDG PET/CT at our institute between 2008 and 2015 and showed MIBG avidity were retrospectively enrolled in the present study. Clinical information—including histopathology, and serum markers—and several PET parameters—including SUVmax of the primary lesion (Psuv), target-to-background ratio (TBR), metabolic tumor volume (MTV), and coefficient of variation (CV)—were analyzed. The prognostic effect of PET parameters was evaluated in terms of progression-free survival (PFS). Total 20 patients (4.5 ± 3.5 years) were divided as two groups by disease progression. Six patients (30.0 %) experienced disease progression and one patient (5.0 %) died during follow-up period. There were not statistically significant in age, stage, MYCN status, primary tumor size, serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE), and ferritin level between two groups with progression or no progression. However, Psuv (p = 0.017), TBR (p = 0.09), MTV (p = 0.02), and CV (p = 0.036) showed significant differences between two groups. In univariate analysis, PFS was significantly associated with Psuv (p = 0.021) and TBR (p = 0.023). FDG-PET parameters were significantly related with progression of neuroblastoma. FDG-PET/CT may have the potential as a valuable modality for evaluating prognosis in the patients with MIBG-avid pediatric neuroblastoma.

  18. Expression of the Nrf2 and Keap1 proteins and their clinical significance in osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jihong, E-mail: zhangjihong63@163.com [Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan 442000 (China); Wang, Xiaojuan, E-mail: yangjian142@163.com [Department of Internal Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan 442000 (China); Wu, Wuzhou, E-mail: jiangchunli68@163.com [Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan 442000 (China); Dang, Hongsheng, E-mail: luoliping63@163.com [Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan 442000 (China); Wang, Bo, E-mail: wangmian65@163.com [Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, Shiyan 442000 (China)

    2016-04-22

    Objective: To investigate the expression and clinical significance of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and Kelch-like ECH-associated protein 1 (Keap1) in osteosarcoma tissue. Methods: The data of 102 osteosarcoma patients who underwent surgical treatment at our hospital from June 2000 to March 2009 were collected. The expression levels of the Nrf2 and Keap1 proteins in osteosarcoma tissue and normal peritumour tissues were detected by immunohistochemistry, and the relationship between the expression level and the clinical and pathological features as well as the prognosis was explored. Results: The nuclear expression rate of Nrf2 was 77.5% in osteosarcoma tissue, which was significantly higher than the rate in normal peritumour bone tissue (9.8%) (P < 0.05). The expression rate of the Keap1 protein in osteosarcoma tissue was 13.7%, which was significantly lower than the rate in normal peritumour tissue (80.4%). In addition, Nrf2/Keap1 expression was unrelated to patient gender and age, tumour site, and histological type and was related to metastasis and patient response to chemotherapy (P < 0.05). The five-year survival rate was significantly lower in patients with positive Nrf2 expression than in those with negative Nrf2 expression (p = 0.023), and it was significantly higher in patients with positive Keap1 expression than in those with negative Keap1 expression (P = 0.018). Conclusion: The expression of Nrf2-Keap1 is abnormal in osteosarcoma tissue and shows significant clinical relevance for determining the prognosis of osteosarcoma.

  19. Expression of transcription factor Pokemon in non-small cell lung cancer and its clinical significance.

    Science.gov (United States)

    Zhao, Zhi-hong; Wang, Sheng-fa; Yu, Liang; Wang, Ju; Chang, Hao; Yan, Wei-li; Fu, Kai; Zhang, Jian

    2008-03-05

    Transcription factor Pokemon, a central regulation gene of the important tumor suppressor ARF gene, exerted its activity by acting upstream of many tumor-suppressing genes and proto-oncogenes. Its expression in non-small cell lung cancer (NSCLC) and its clinical significance remains unclear. The aim of this study was to investigate the expression of Pokemon in NSCLC and to explore its correlation with the clinical pathological characteristics and its influence on patients' prognosis. Fifty-five cases of NSCLC were involved in this study. The expression of Pokemon in the tumor tissue, the corresponding tumor adjacent tissue and the surrounding tissue was detected via reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting, with the aim of investigating the correlation between the expression of Pokemon in tumor tissue of NSCLC and its clinical pathological characteristics. Moreover, a prognostic analysis was carried out based upon the immunohistochemical (IHC) detection of the expression of Pokemon gene in archival tumor specimens (5 years ago) of 62 cases of NSCLC. Statistical significance of the expression of Pokemon mRNA and protein was determined in the tumor tissue, the tumor adjacent tissue and the surrounding tissue (PPokemon was determined not to be associated with the patients' sex, age, smoking condition, tumor differentiation degree, histology and lymph node metastasis condition. However, its relationship with TNM staging was established (PPokemon expression was significantly higher than that of those with positive Pokemon expression (P=0.004), therefore, the expression of Pokemon is believed to be an independent factor affecting prognosis (P=0.034). Pokemon was over-expressed in NSCLC tissue and the expression of Pokemon might be of clinical significance in non-small cell lung cancer prognostic evaluation.

  20. Markers of Collagen Remodeling Detect Clinically Significant Fibrosis in Chronic Hepatitis C Patients

    DEFF Research Database (Denmark)

    Nielsen, Mette J; Kazankov, Konstantin; Leeming, Diana J

    2015-01-01

    BACKGROUND AND AIM: Detection of advanced fibrosis (Metavir F≥3) is important to identify patients with a high urgency of antiviral treatments vs. those whose treatment could be deferred (F≤2). The aim was to assess the diagnostic value of novel serological extracellular matrix protein fragments ...... as a single marker of liver fibrosis. A model combining Pro-C3 and C4M along with patient's age, body mass index and gender increased the diagnostic power for identifying clinically significant fibrosis....

  1. Types, Prevalence, and Potential Clinical Significance of Medication Administration Errors in Assisted Living

    Science.gov (United States)

    Young, Heather M.; Gray, Shelly L.; McCormick, Wayne C.; Sikma, Suzanne K.; Reinhard, Susan; Trippett, Linda Johnson; Christlieb, Carol; Allen, Tiffany

    2008-01-01

    OBJECTIVES To describe the types and potential clinical significance of medication administration errors in assisted living (AL). DESIGN Cross-sectional observational study. SETTING This study was conducted in 12 AL settings in three states (Oregon, Washington, and New Jersey). PARTICIPANTS Participants included 29 unlicensed assistive personnel and 510 AL residents. MEASUREMENTS Medication administration observations, chart review, and determination of rates, types, and potential clinical significance of errors using standardized methodology. RESULTS Of 4,866 observations, 1,373 errors were observed (28.2% error rate). Of these, 70.8% were wrong time, 12.9% wrong dose, 11.1% omitted dose, 3.5% extra dose, 1.5% unauthorized drug, and 0.2% wrong drug. Excluding wrong time, the overall error rate dropped to 8.2%. Of the 1,373 errors, three were rated as having potential clinical significance. CONCLUSION A high number of daily medications are given in AL. Wrong time accounted for the majority of the errors. The bulk of the medications are low risk and routine; to promote optimal care delivery, clinicians need to focus on high-risk medications and residents with complex health problems. PMID:18482296

  2. Monoscopic versus stereoscopic photography in screening for clinically significant macular edema.

    Science.gov (United States)

    Welty, Christopher J; Agarwal, Anita; Merin, Lawrence M; Chomsky, Amy

    2006-01-01

    The purpose of the study was to determine whether monoscopic photography could serve as an accurate tool when used to screen for clinically significant macular edema. In a masked randomized fashion, two readers evaluated monoscopic and stereoscopic retinal photographs of 100 eyes. The photographs were evaluated first individually for probable clinically significant macular edema based on the Early Treatment Diabetic Retinopathy Study criteria and then as stereoscopic pairs. Graders were evaluated for sensitivity and specificity individually and in combination. Individually, reader one had a sensitivity of 0.93 and a specificity of 0.77, and reader two had a sensitivity of 0.88 and a specificity of 0.94. In combination, the readers had a sensitivity of 0.91 and a specificity of 0.86. They correlated on 0.76 of the stereoscopic readings and 0.92 of the monoscopic readings. These results indicate that the use of monoscopic retinal photography may be an accurate screening tool for clinically significant macular edema.

  3. Clinical significance of changes of serum TBA, CG, HA levels in neonate with parenteral nutrition

    International Nuclear Information System (INIS)

    Huang Weiliang; Zhou Jiongying; Zhang Xiaoyi; Lv Weihua; Ma Yunbao; He Qizhi

    2010-01-01

    Objective: To study the clinical significance of changes of serum levels of TBA, CG, HA in neonate with parenteral nutrition. Methods: Serum total bile acid (TBA, with biochemistry) and CG, HA (with RIA) contents were measured in 52 neonates (full-term 32, preterm 20) with parenteral nutrition and 28 neonates (full-term 16, preterm 12) without parenteral nutrition (as controls). Results: Before parenteral nutrition,the serum TBA, CG and HA levels in full-term neonates were not significantly different from those in the controls (P>0.05). After parenteral nutrition,serum levels were significantly higher than those before parenteral nutrition (P<0.01). The levels in pre-term neonates were significantly higher after parenteral nutrition than those in full-term neonates (P<0.05). Conclusion: Long term parenteral nutrition might be harmful to hepatic and gall bladder function in neonates especially in premature ones. (authors)

  4. The clinical significance of adjacent rib involvement on MRI in patients with acute osteoporotic compression fractures of the thoracic spine

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Joo; Kim, Jae Hyun; Kwon, Kui Hyang; Choi, Deuk Lin; Goo, Dong Erk; Suh, You Sung [Soonchunhyang Univ. Seoul Hospital/Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of); Bae, Won Kyung [Soonchunhyang Univ. Cheonan Hospital/Soonchunhyang Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-05-15

    The purpose of this study was to evaluate the significance of the presence of adjacent rib involvement in osteoporotic compression fractures. All the patients with acute osteoporotic compression fractures of the thoracic spine on thoracic spine MRI that presented to our clinic between September 2003 and January 2010 were retrospectively reviewed. All the vertebrae were divided into two groups: those that showed signal intensity change in the rib adjacent to the compression fracture and those that did not. We compared the results between the two groups to determine if there were differences in the degree of osteoporosis, the compression fracture level and the age of patients between the two groups. We calculated the degree of correlation between the MRI and the bone scan images of these patients. We also reviewed whether percutaneous vertebroplasty relieved symptoms or not. Signal intensity changes were found in the adjacent rib(s) in 12 of the 60 patients and in 14 of the 94 levels (the total number of levels). The MRI and bone scan showed significant correlation (p < 0.001). There was a statistically significant difference in the incidence of pain at the one month outpatient follow up between the two groups (p = 0.0215). The radiologist should comment on the presence or absence of adjacent rib involvement when reporting on the thoracic spine MRI of patients suffering from osteoporotic compression fractures in order to more accurately determine prognosis.

  5. HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England.

    Science.gov (United States)

    Desai, S; Nardone, A; Hughes, G; Delpech, V; Burns, F; Hart, G; Gill, O N

    2017-10-01

    The aim of the study was to determine HIV incidence among men who have sex with men (MSM) who repeat test for HIV at sexually transmitted infection (STI) clinics in England, and identify associated factors. Annual HIV incidence and 95% confidence interval (CI) were calculated for a national cohort of MSM who tested HIV negative at any STI clinic in England in 2012 and had a follow-up test within 1 year using routinely collected data. Cox regression analyses were performed to identify predictors of HIV acquisition and population attributable risk for HIV infection was calculated for predictors. In 2012, 85 500 MSM not known to be HIV positive attended any STI clinic in England, and 31% tested for HIV at least twice within 1 year at the same clinic. HIV incidence was 2.0 per 100 person-years (PY; 95% CI 1.8-2.2) among repeat testers. Incidence was higher among MSM of black ethnicity (3.2 per 100 PY) and those with a bacterial STI diagnosis at the initial attendance (3.2 per 100 PY). MSM with a previous syphilis or gonorrhoea infection were at significantly greater risk of acquiring HIV in the subsequent year [adjusted hazard ratio 4.1 (95% CI 2.0-8.3) and 2.1 (95% CI 1.4-3.2), respectively]. The predictors accounted for 37% of HIV infections. Annual HIV incidence among MSM attending STI clinics in England is high. Previous STIs were predictors of HIV acquisition but only accounted for one in five infections. More discriminatory behavioural predictors of HIV acquisition could provide better triaging of HIV prevention services for MSM attending STI clinics. © 2017 British HIV Association.

  6. Clinical significance of BIM deletion polymorphism in non-small-cell lung cancer with epidermal growth factor receptor mutation.

    Science.gov (United States)

    Isobe, Kazutoshi; Hata, Yoshinobu; Tochigi, Naobumi; Kaburaki, Kyohei; Kobayashi, Hiroshi; Makino, Takashi; Otsuka, Hajime; Sato, Fumitomo; Ishida, Fumiaki; Kikuchi, Naoshi; Hirota, Nao; Sato, Keita; Sano, Go; Sugino, Keishi; Sakamoto, Susumu; Takai, Yujiro; Shibuya, Kazutoshi; Iyoda, Akira; Homma, Sakae

    2014-04-01

    Germline alterations in the proapoptotic protein Bcl-2-like 11 (BIM) can have a crucial role in tumor response to treatment. To determine the clinical utility of detecting BIM deletion polymorphism in non-small-cell lung cancer positive for epidermal growth factor receptor (EGFR) mutation, we examined outcomes of patients with and without BIM alterations. We studied 70 patients with EGFR mutation-positive non-small-cell lung cancer who were treated with an EGFR tyrosine kinase inhibitor between January 2008 and January 2013. BIM deletion was analyzed by polymerase chain reaction in 58 samples of peripheral blood and 24 formalin-fixed paraffin-embedded slides of surgical specimens (20 of lung tissue and four of brain tissue); both blood and tissue specimens were available for 12 patients. We retrospectively analyzed clinical characteristics, response rate, toxicity, and outcomes among patients with and without BIM deletion. BIM deletion was present in 13 of 70 patients (18.6%). There were no significant differences between patients with and without BIM deletion in clinical characteristics, rate of response to EGFR tyrosine kinase inhibitor, or incidence of adverse events. Patients with BIM deletion had significantly shorter progression-free survival (PFS) than those without BIM deletion (median, 227 versus 533 days; p BIM deletion was an independent indicator of shorter PFS (hazard ratio, 3.99; 95% confidence interval, 1.864-8.547; p BIM deletion in samples of peripheral blood and formalin-fixed paraffin-embedded slides of surgical specimens. BIM deletion was the most important independent prognostic factor in shorter PFS.

  7. Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life.

    Science.gov (United States)

    Thong, Melissa S Y; van Dijk, Sandra; Noordzij, Marlies; Boeschoten, Elisabeth W; Krediet, Raymond T; Dekker, Friedo W; Kaptein, Adrian A

    2009-01-01

    To date, the pathophysiology underlying symptoms in renal patients is still unclear. Symptom management research suggests that identification of related clusters of symptoms could provide insight into underlying determinants associated with multiple symptom experience. Theoretically, symptoms within a cluster could have a synergistic relationship. We aimed to identify symptom clusters in incident dialysis patients, and investigated associations between symptom clusters, clinical variables, functional status as measured by the Karnofsky Index and quality of life. 1553 haemodialysis (HD) and peritoneal dialysis (PD) patients completed the Kidney Disease Quality of Life Short Form symptom/problem list at 3 months after the start of dialysis. Principal component analysis using varimax rotation was used to identify symptom clusters. Patients were bothered by an average of 2.8 (+/-2.4) symptoms of 'moderate bother' or more. Three clusters were identified, explaining 49% of the total variance. All clusters showed strong negative associations with the SF-36 quality of life dimensions (-0.142 to -0.593) and with functional status (-0.130 to -0.332) in HD and PD patients. In contrast, only the clinical variables serum albumin (-0.084 to -0.232) and haemoglobin (-0.068 to -0.126) were associated with all clusters in HD patients, and Kt/V(urea) (-0.089 to -0.125) in PD patients. Symptom clustering does not explain the lack of meaningful associations between symptoms and clinical variables. Strong associations of symptom clusters with quality of life dimensions suggest that psychological factors could better explain symptom burden. Patients' perceptions of symptoms should be routinely assessed as part of clinical care to improve self-management strategies.

  8. Artificial neural networks to predict presence of significant pathology in patients presenting to routine colorectal clinics.

    Science.gov (United States)

    Maslekar, S; Gardiner, A B; Monson, J R T; Duthie, G S

    2010-12-01

    Artificial neural networks (ANNs) are computer programs used to identify complex relations within data. Routine predictions of presence of colorectal pathology based on population statistics have little meaning for individual patient. This results in large number of unnecessary lower gastrointestinal endoscopies (LGEs - colonoscopies and flexible sigmoidoscopies). We aimed to develop a neural network algorithm that can accurately predict presence of significant pathology in patients attending routine outpatient clinics for gastrointestinal symptoms. Ethics approval was obtained and the study was monitored according to International Committee on Harmonisation - Good Clinical Practice (ICH-GCP) standards. Three-hundred patients undergoing LGE prospectively completed a specifically developed questionnaire, which included 40 variables based on clinical symptoms, signs, past- and family history. Complete data sets of 100 patients were used to train the ANN; the remaining data was used for internal validation. The primary output used was positive finding on LGE, including polyps, cancer, diverticular disease or colitis. For external validation, the ANN was applied to data from 50 patients in primary care and also compared with the predictions of four clinicians. Clear correlation between actual data value and ANN predictions were found (r = 0.931; P = 0.0001). The predictive accuracy of ANN was 95% in training group and 90% (95% CI 84-96) in the internal validation set and this was significantly higher than the clinical accuracy (75%). ANN also showed high accuracy in the external validation group (89%). Artificial neural networks offer the possibility of personal prediction of outcome for individual patients presenting in clinics with colorectal symptoms, making it possible to make more appropriate requests for lower gastrointestinal endoscopy. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  9. Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy

    Directory of Open Access Journals (Sweden)

    Simon Roh

    2016-04-01

    Full Text Available Background: Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy. Methods: Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined. Results: A total of 395 esophagectomies were performed (mean age, 62.2 years. The indications for the esophagectomy were as follows: malignancy (n=320, high-grade dysplasia (n=14, perforation (n=27, benign stricture (n=7, achalasia (n=16, and other (n=11. A variety of techniques were used including transhiatal (n=351, McKeown (n=35, and Ivor Lewis (n=9 esophagectomies. Operative mortality was 2.8% (n=11. Three hundred and sixty-eight patients (93% underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%. Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively. Conclusion: Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy.

  10. The clinical significance of perivalvular pannus in prosthetic mitral valves: Can cardiac CT be helpful?

    Science.gov (United States)

    Chang, Suyon; Suh, Young Joo; Han, Kyunghwa; Kim, Jin Young; Kim, Young Jin; Chang, Byung-Chul; Choi, Byoung Wook

    2017-12-15

    The clinical significance of pannus in the prosthetic mitral valve (MV) is not well documented. To investigate the clinical significance of pannus on cardiac computed tomography (CT) in patients with a prosthetic MV. A total of 130 patients with previous MV replacement who underwent cardiac CT were retrospectively included in this study. The presence of pannus, paravalvular leak (PVL) around the prosthetic MV and limitation of motion (LOM) of the MV were analyzed using CT. Between patients with MV pannus and those without pannus, CT, echocardiographic, and redo-surgery findings were compared. The diagnostic performance of CT and transesophageal echocardiography (TEE) for the detection of MV pannus was also compared, using surgical findings as a standard reference. MV pannus was observed on cardiac CT in 32.3% of the study population. Patients with MV pannus detected on CT more commonly had LOM (28.2% vs. 15.2%) and less frequently had PVL of the prosthetic MV (16.7% vs. 25%) than patients without MV pannus (P>0.05). Prosthetic valve obstruction (PVO) due prosthetic MV pannus requiring redo-surgery was present in only five patients (11.9%). Cardiac CT detected MV pannus with sensitivity of 65.2% and specificity of 80.9% and showed better diagnostic performance than TEE (PProsthetic MV pannus can frequently be seen on cardiac CT. However, its clinical significance should be assessed with careful consideration, because PVO due to MV pannus is relatively uncommon, and pannus can be seen in patients without any clinical problems. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Association of Trabecular Bone Score (TBS) With Incident Clinical and Radiographic Vertebral Fractures Adjusted for Lumbar Spine BMD in Older Men: A Prospective Cohort Study.

    Science.gov (United States)

    Schousboe, John T; Vo, Tien N; Langsetmo, Lisa; Taylor, Brent C; Cawthon, Peggy M; Schwartz, Ann V; Bauer, Douglas C; Orwoll, Eric S; Lane, Nancy E; Barrett-Connor, Elizabeth; Ensrud, Kristine E

    2017-07-01

    The association of trabecular bone score (TBS) with incident clinical and radiographic vertebral fractures in older men is uncertain. TBS was estimated from baseline spine dual-energy X-ray absorptiometry (DXA) scans for 5831 older men (mean age 73.7 years) enrolled in the Osteoporotic Fractures in Men (MrOS) study. Cox proportional hazard models were used to determine the association of TBS (per 1 SD decrease) with incident clinical vertebral fractures. Logistic regression was used to determine the association between TBS (per 1 SD decrease) and incident radiographic vertebral fracture among the subset of 4309 men with baseline and follow-up lateral spine radiographs (mean 4.6 years later). We also examined whether any associations varied by body mass index (BMI) category. TBS was associated with a 1.41-fold (95% confidence interval [CI] 1.23 to 1.63) higher aged-adjusted odds of incident radiographic fracture, and this relationship did not vary by BMI (p value = 0.22 for interaction term). This association was no longer significant with further adjustment for lumbar spine bone mineral density (BMD; odds ratio [OR] = 1.11, 95% CI 0.94 to 1.30). In contrast, the age-adjusted association of TBS with incident clinical vertebral fracture was stronger in men with lower BMI (≤ median value of 26.8 kg/m 2 ; hazard ratio [HR] = 2.28, 95% CI 1.82 to 2.87) than in men with higher BMI (> median; HR = 1.60, 95% CI 1.31 to 1.94; p value = 0.0002 for interaction term). With further adjustment for lumbar spine BMD, the association of TBS with incident clinical vertebral fracture was substantially attenuated in both groups (HR = 1.30 [95% CI 0.99 to 1.72] among men with lower BMI and 1.11 [95% CI 0.87 to 1.41] among men with higher BMI). In conclusion, TBS is not associated with incident clinical or radiographic vertebral fracture after consideration of age and lumbar spine BMD, with the possible exception of incident clinical vertebral fracture among

  12. Incidence and course of child malnutrition according to clinical or anthropometrical assessment: a longitudinal study from rural DR Congo

    Science.gov (United States)

    2014-01-01

    Background Longitudinal studies describing incidence and natural course of malnutrition are scarce. Studies defining malnutrition clinically [moderate clinical malnutrition (McM) marasmus, kwashiorkor] rather than anthropometrically are rare. Our aim was to address incidence and course of malnutrition among pre-schoolers and to compare patterns and course of clinically and anthropometrically defined malnutrition. Methods Using a historical, longitudinal study from Bwamanda, DR Congo, we studied incidence of clinical versus anthropometrical malnutrition in 5 657 preschool children followed 3-monthly during 15 months. Results Incidence rates were highest in the rainy season for all indices except McM. Incidence rates of McM and marasmus tended to be higher for boys than for girls in the dry season. Malnutrition rates increased from the 0–5 to the 6 – 11 months age category. McM and marasmus had in general a higher incidence at all ages than their anthropometrical counterparts, moderate and severe wasting. Shifts back to normal nutritional status within 3 months were more frequent for clinical than for anthropometrical malnutrition (62.2-80.3% compared to 3.4-66.4.5%). Only a minority of moderately stunted (30.9%) and severely stunted children (3.4%) shifted back to normal status. Alteration from severe to mild malnutrition was more characteristic for anthropometrically than for clinically defined malnutrition. Conclusions Our data on age distribution of incidence and course of malnutrition underline the importance of early life intervention to ward off malnutrition. In principle, looking at incidence may yield different findings from those obtained by looking at prevalence, since incidence and prevalence differ approximately differ by a factor “duration”. Our findings show the occurrence dynamics of general malnutrition, demonstrating that patterns can differ according to nutritional assessment method. They suggest the importance of applying a mix of clinical

  13. Clinical significance of altered nm23-H1, EGFR, RB and p53 expression in bilharzial bladder cancer

    International Nuclear Information System (INIS)

    Khaled, Hussein M; Bahnassy, Abeer A; Raafat, Amira A; Zekri, Abdel-Rahman N; Madboul, Maha S; Mokhtar, Nadia M

    2009-01-01

    Clinical characterization of bladder carcinomas is still inadequate using the standard clinico-pathological prognostic markers. We assessed the correlation between nm23-H1, Rb, EGFR and p53 in relation to the clinical outcome of patients with muscle invasive bilharzial bladder cancer (MI-BBC). nm23-H1, Rb, EGFR and p53 expression was assessed in 59 MI-BBC patients using immunohistochemistry and reverse transcription (RT-PCR) and was correlated to the standard clinico-pathological prognostic factors, patient's outcome and the overall survival (OS) rate. Overexpression of EGFR and p53 proteins was detected in 66.1% and 35.6%; respectively. Loss of nm23-H1and Rb proteins was detected in 42.4% and 57.6%; respectively. Increased EGFR and loss of nm23-H1 RNA were detected in 61.5% and 36.5%; respectively. There was a statistically significant correlation between p53 and EGFR overexpression (p < 0.0001), nm23 loss (protein and RNA), lymph node status (p < 0.0001); between the incidence of local recurrence and EGFR RNA overexpression (p= 0.003) as well as between the incidence of metastasis and altered Rb expression (p = 0.026), p53 overexpression (p < 0.0001) and mutation (p = 0.04). Advanced disease stage correlated significantly with increased EGFR (protein and RNA) (p = 0.003 & 0.01), reduced nm23-H1 RNA (p = 0.02), altered Rb (p = 0.023), and p53 overexpression (p = 0.004). OS rates correlated significantly, in univariate analysis, with p53 overexpression (p = 0.011), increased EGFR (protein and RNA, p = 0.034&0.031), nm23-H1 RNA loss (p = 0.021) and aberrations of ≥ 2 genes. However, multivariate analysis showed that only high EGFR overexpression, metastatic recurrence, high tumor grade and the combination of ≥ 2 affected markers were independent prognostic factors. nm23-H1, EGFR and p53 could be used as prognostic biomarkers in MI-BBC patients. In addition to the standard pathological prognostic factors, a combination of these markers (≥ 2) has

  14. Clinical observations surrounding an increased incidence of postanesthetic myopathy in halothane-anesthetized horses.

    Science.gov (United States)

    Duke, Tanya; Filzek, Ulrike; Read, Matthew R; Read, Emma K; Ferguson, James G

    2006-03-01

    During an 8-year period of clinic improvements, an increased incidence of postanesthetic myopathy (PAM) was observed in horses undergoing anesthesia. A request was made for an independent anesthesiologist to examine possible reasons for this increase. Routine methods used for anesthesia were then compared with new methods introduced by the anesthesiologist. Investigative observations were conducted from October 1999 to April 2000. Following premedication with xylazine or detomidine, anesthesia was induced with diazepam or guiaifenesin followed by ketamine. Maintenance of anesthesia was with halothane/O(2) with mechanical ventilation. Information was gathered from observing routine anesthetics. Seventeen horses were designated group A (October-December 1999) for which hypotension was defined as mean arterial pressure (MAP) horses (group B), hypotension was redefined as MAP horses in group A (two with clinical signs) and in one horse in group B (difference between groups: p = 0.088). Maintaining MAP >70 mmHg with high-volume fluid therapy and dobutamine may help to reduce the severity of myopathy.

  15. Changes and clinical significance of liver function and myocardial zymogram in children with rotavirus enteritis

    Directory of Open Access Journals (Sweden)

    Lan-Ping Yang

    2016-12-01

    Full Text Available Objective: To explore the changes and clinical significance of liver function and myocardial zymogram in children with rotavirus (RV enteritis. Methods: A total of 70 children with RV enteritis who were admitted in our hospital were included in the study and served as the observation group. The liver function and myocardial zymogram before and after treatment were detected. The proportion of RV enteritis children with liver and myocardial damage was calculated. The effect of dehydration on the liver function and myocardial zymogram in children with RV enteritis was analyzed. A total of 65 children with non-RV enteritis who were admitted in our hospital at the same stage were served as the control group. Results: The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels, and liver myocardial damage children proportion in the observation group were significantly higher than those in the control group (P<0.05. The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels in the observation group were significantly elevated with the acceleration of dehydration degree (P<0.05. In the observation group, 45 children had liver and myocardial damage, whose ALT, AST, CK, CKMB, LDH, and α-HBDH levels after treatment were significantly reduced when compared with before treatment (P<0.05. Conclusions: Early detection of liver function and myocardial zymogram can accurately reflect the condition in children with RV enteritis, which can provide an evidence for the formulation of clinical treatment protocol.

  16. Visual presentation of a medical physiology seminar modifies dental students' perception of its clinical significance.

    Science.gov (United States)

    Vuletic, L; Spalj, S; Peros, K

    2016-02-01

    The primary objective of this study was to assess whether exposing dental students to visual stimuli related to dental profession during the medical physiology seminar could affect their perception of the clinical relevance of the topic. A self-administered questionnaire on attitudes towards medical physiology was conducted amongst 105 students of the School of Dental Medicine in Zagreb, Croatia, aged 19-24 years (80% females) following a seminar on respiratory system physiology. Power-point presentation accompanying the seminar for a total of 52 students (study group) was enriched with pictures related to dental practice in order to assess whether these pictures could make the topic appear more clinically relevant for a future dentist. The results of the survey indicated that dental students in the study group perceived the topic of the seminar as more important for them as future dentists when compared to the perception of the control group (P = 0.025). The results of this survey encourage physiology lecturers to present medical physiology as clinically relevant for dental students whenever possible as this could increase students' interest in the subject and their motivation for learning. Such an approach could be particularly beneficial if there is a significant time gap between basic courses and involvement of students into clinical training for it could promote meaningful learning. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. [Clinical significance of WHO classification and MDS 2000 classification in myelodysplastic syndromes].

    Science.gov (United States)

    Akiba, M; Matsuda, A; Misumi, M; Yagasaki, F; Bessho, M

    2001-12-01

    Excluding chronic myelomonocytic leukemia, a total of 92 consecutive patients with myelodysplastic syndrome showing less than 20% blasts in the bone marrow were analyzed. We evaluated the clinical significance of the WHO and MDS 2000 classifications by reviewing each MDS patient according to the classification. The WHO criteria classified the MDS patients into 36 with RA, 22 with RCMD and 33 with RAEB, whereas according to the MDS 2000 criteria there were 19 RAEB-I patients and 15 RAEB-II patients. Based on the WHO classification, the RCMD patients had higher platelet counts and percentages of blasts among BM cells than the RA patients (P = 0.0018, P = 0.0001). Twenty percent of the RA patients, 44.8% of the RCMD patients, and 70.8% of the RAEB patients had cytogenetic abnormalities. Among them, the poor karyotype was present in 6.7% of the RA patients, 21.0% of the RCMD patients and 41.6% of the RAEB patients. The rate of acute leukemia death was 14.3% in the RA patients, 67.7% in the RAEB patients and 50.0% in the RCMD patients. Analysis of survival times revealed significant differences between RA and RCMD patients (P = 0.0482). The clinical features of RCMD patients were intermediate between those of RAEB and RA patients. There was no difference between the clinical features of the RAEB-I and RAEB-II patients in the MDS 2000 classification.

  18. Clinical outcomes and advantages of laparoscopic surgery for primary Crohn's disease: are they significant?

    Science.gov (United States)

    Tanaka, Shinnosuke; Matsuo, Katsuichi; Sasaki, Takamitsu; Nakano, Masahiho; Shimura, Hideo; Yamashita, Yuichi

    2009-01-01

    The clinical outcomes and advantages of laparoscopic surgery for Crohn's disease have not yet been recognized in general. The aim of this study was to critically assess the clinical outcomes, safety, cosmesis, quality of life (QOL) and feasibility of laparoscopic surgery for primary Crohn's disease. The study subjects consisted of 48 patients who had primary surgical treatment for Crohn's disease, 28 through conventional laparotomy and 20 in whom surgery was laparoscopically assisted. The short-term and long-term outcomes, cosmesis, and postoperative QOL were evaluated in both groups. There were no statistically significant differences in the patient characteristics between the two groups. In the laparoscopic group, non-resected procedures were significantly more frequent (p cosmetic results were very satisfactory in 11 patients (64.7%). There were no severe complications and no increase of the recurrence rate for laparoscopic surgery. Moreover, there was no definite clinical disadvantage and no prolonged operating time in the laparoscopic procedures. Laparoscopic surgery for primary Crohn's disease is safe and feasible in selected patients without severe adhesion, fistula or abscess, and was associated with better cosmesis than conventional open surgery. Therefore, laparoscopic procedures should be considered as the preferred operative approach for a primary bowel resection.

  19. Relevance and clinical significance of serum resistin level in obese T2DM rhesus monkey models.

    Science.gov (United States)

    Qi, S-D; He, Z-L; Chen, Y; Ma, J; Yu, W-H; Li, Y-Y; Yang, F-M; Wang, J-B; Chen, L-X; Zhao, Y; Lu, S-Y

    2015-09-01

    Resistin is a type of hormone-like adipocytokines, which is secreted specifically by adipocytes. It may be a key factor in the development of type 2 diabetes mellitus (T2DM) from obesity- associated insulin resistance due to results that show that it has a close relationship with insulin resistance in rodents. We utilized the rhesus monkeys as study objects to preliminarily test the association with glucose metabolism and to conduct a correlation analysis for clinical parameters and serum resistin levels in obese rhesus monkey models of T2DM. The results suggested that resistin was significantly increased in T2DM monkeys (P insulin (FPI) and glycated hemoglobin (HbA1c), Insulin resistance index (HOA-IR), but a negative correlation with islet β-cell function (HOMA-β). In the course of glucose metabolism, reverse release change of resistin and insulin in T2DM monkeys occurred, but the phenomenon that was not observed in the control group, these findings indicated that resistin negatively regulated and interfered with carbohydrate metabolism in T2DM monkey models. The character of the releasing change of resistin might be a unique process in T2DM. Therefore, all of the results could provide references for clinical diagnostic criteria for human cases of T2DM, and could have clinical significance for obese T2DM diagnosis and degree of insulin resistance. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Clinical significance of a first positive nontuberculous mycobacteria culture in cystic fibrosis.

    Science.gov (United States)

    Martiniano, Stacey L; Sontag, Marci K; Daley, Charles L; Nick, Jerry A; Sagel, Scott D

    2014-01-01

    Little is known about outcomes of infection with nontuberculous mycobacteria (NTM) in cystic fibrosis (CF) or about the significance of a positive NTM culture. Determining which patients are at risk for active NTM disease is clinically valuable. To examine the clinical course of subjects with CF with an initial positive NTM culture and identify characteristics associated with active NTM disease. We performed a retrospective study of pediatric and adult subjects with CF with at least one positive NTM culture at the Colorado CF Center from 2000 to 2010. Mycobacterium avium complex was the first identified NTM in the majority of subjects (73%). The frequency of growing a second NTM species was 26% at 5 years. Clinical characteristics and distribution of NTM species between pediatric and adult subjects were similar except for differences in baseline FEV1 (89% vs. 71%; P culture (72% vs. 84 or 86%; P = 0.02) and FEV1 decline in the prior year (-5.8%/yr vs. -0.7%/yr [P = 0.009] or -0.4%/yr [P = 0.001]). The majority of patients with CF with a first positive NTM culture do not progress to active disease. Lower lung function and accelerated lung function decline appear to be indicators of the significance of an initial positive NTM culture.

  1. Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Junqueira Junior

    2012-04-01

    Full Text Available INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

  2. Medial joint line bone bruising at MRI complicating acute ankle inversion injury: What is its clinical significance?

    International Nuclear Information System (INIS)

    Chan, V.O.; Moran, D.E.; Shine, S.; Eustace, S.J.

    2013-01-01

    Aim: To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury. Materials and methods: Forty-five patients who underwent ankle magnetic resonance imaging (MRI) within 2 weeks of acute ankle inversion injury were included in this prospective study. Integrity of the lateral collateral ligament complex, presence of medial joint line bone bruising, tibio-talar joint effusion, and soft-tissue swelling were documented. Clinical follow-up at 6 months was carried out to determine the impact of injury on length of time out of work, delay in return to normal walking, delay in return to sports activity, and persistence of medial joint line pain. Results: Thirty-seven patients had tears of the anterior talofibular ligament (ATFL). Twenty-six patients had medial joint line bone bruising with altered marrow signal at the medial aspect of the talus and congruent surface of the medial malleolus. A complete ATFL tear was seen in 92% of the patients with medial joint line bone bruising (p = 0.05). Patients with an ATFL tear and medial joint line bone bruising had a longer delay in return to normal walking (p = 0.0002), longer delay in return to sports activity (p = 0.0001), and persistent medial joint line pain (p = 0.0003). There was no statistically significant difference in outcome for the eight patients without ATFL tears. Conclusion: Medial joint line bone bruising following an acute ankle inversion injury was significantly associated with a complete ATFL tear, longer delay in the return to normal walking and sports activity, as well as persistent medial joint line pain. Its presence should prompt detailed assessment of the lateral collateral ligament complex, particularly the ATFL

  3. Thresholds for statistical and clinical significance in systematic reviews with meta-analytic methods

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian; Wetterslev, Jorn; Winkel, Per

    2014-01-01

    BACKGROUND: Thresholds for statistical significance when assessing meta-analysis results are being insufficiently demonstrated by traditional 95% confidence intervals and P-values. Assessment of intervention effects in systematic reviews with meta-analysis deserves greater rigour. METHODS......: Methodologies for assessing statistical and clinical significance of intervention effects in systematic reviews were considered. Balancing simplicity and comprehensiveness, an operational procedure was developed, based mainly on The Cochrane Collaboration methodology and the Grading of Recommendations...... conservative results as the main results. (2) Explore the reasons behind substantial statistical heterogeneity using sensitivity analyses. (3) To take account of problems with multiplicity adjust the thresholds for significance according to the number of primary outcomes. (4) Calculate required information...

  4. Clinical significance of circulating vascular cell adhesion molecule-1 to white matter disintegrity in Alzheimer's dementia.

    Science.gov (United States)

    Huang, Chi-Wei; Tsai, Meng-Han; Chen, Nai-Ching; Chen, Wei-Hsi; Lu, Yan-Ting; Lui, Chun-Chung; Chang, Ya-Ting; Chang, Wen-Neng; Chang, Alice Y W; Chang, Chiung-Chih

    2015-11-25

    Endothelial dysfunction leads to worse cognitive performance in Alzheimer's dementia (AD). While both cerebrovascular risk factors and endothelial dysfunction lead to activation of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and E-selectin, it is not known whether these biomarkers extend the diagnostic repertoire in reflecting intracerebral structural damage or cognitive performance. A total of 110 AD patients and 50 age-matched controls were enrolled. Plasma levels of VCAM-1, ICAM-1 and E-selectin were measured and correlated with the cognitive performance, white matter macro-structural changes, and major tract-specific fractional anisotropy quantification. The AD patients were further stratified by clinical dementia rating score (mild dementia, n=60; moderate-to-severe dementia, n=50). Compared with the controls, plasma levels of VCAM-1 (p< 0.001), ICAM-1 (p=0.028) and E-selectin (p=0.016) were significantly higher in the patients, but only VCAM-1 levels significantly reflected the severity of dementia (p< 0.001). In addition, only VCAM-1 levels showed an association with macro- and micro- white matter changes especially in the superior longitudinal fasciculus (p< 0.001), posterior thalamic radiation (p=0.002), stria terminalis (p=0.002) and corpus callosum (p=0.009), and were independent of, age and cortical volume. These tracts show significant association with MMSE, short term memory and visuospatial function. Meanwhile, while VCAM-1 level correlated significantly with short-term memory (p=0.026) and drawing (p=0.025) scores in the AD patients after adjusting for age and education, the significance disappeared after adjusting for global FA. Endothelial activation, especially VCAM-1, was of clinical significance in AD that reflects macro- and micro-structural changes and poor short term memory and visuospatial function.

  5. INCIDENCE AND CLINICAL FEATURES OF TUBERCULOSIS IN HIV-INFECTED CHILDREN IN THE SVERDLOVSK REGION

    Directory of Open Access Journals (Sweden)

    N. V. Eismont

    2014-01-01

    Full Text Available The paper analyzes the structure of HIV-infected children who was ill with tuberculosis in the Sverdlovsk Region in 2004-2012. The incidence of tuberculosis in children aged 0 to 14 years in the Sverdlovsk Region showed a 79.4% increase in the above period due to the introduction of Russian innovative technologies for the diagnosis of this disease in children. At the same time there was a rise in both the number of HIV-infected children aged 0 to 14 years and the proportion of same-age children with late-stage HIV infection. Simultaneously, the incidence of tuberculosis in the non-HIV-infected children aged 0 to 14 years was 55.2-193.2 times lower than that in the HIV-infected children. In 2004-2014, the Sverdlovsk Region notified fewer new cases of tuberculosis among the children without HIV infection than among those with its late stages. Non-HIV-infected children of both sexes were also ill with tuberculosis less frequently than HIV-infected boys and girls. HIV-infected children 1-3 and 7-14 years of age proved to be most vulnerable to tuberculosis. Among those who fell ill with tuberculosis, there was a preponderance of patients with late-stage HIV infection; moreover, the majority (79.6% received highly active antiretroviral therapy. 63.3% of the cases were in contact with a tuberculosis patient, only every five patients had chemoprophylaxis for this disease. High-quality vaccination against tuberculosis prevented complications and bacterial excretion in children with comorbidity. Out of the clinical forms of tuberculosis in children with HIV infection, there was a predominance of primary tuberculous complex and intrathoracic lymph node tuberculosis. The latter was less common in children without HIV infection than in those with this disease; the same was true of bacterial excretion in respiratory tuberculosis.

  6. Evaluation of ATF-2 expression and its clinical significance in DLBCL

    Directory of Open Access Journals (Sweden)

    Xun-Xiu Ji

    2017-05-01

    Full Text Available Objective: Detection of Activating Transcription Factor-2 (ATF-2 expression in Diffuse Large B-cell Lymphoma (DLBCL and its relationship with clinicopathological significance. Method: Pathological diagnosis and clinical data were collected in DLBCL. Immunohistochemical (IHC was applied for ATF-2 expression in DLBCL. Result: Positive rate of ATF2 expression in DLBCL was 81% (64/79. We found ATF2 expression was not related to gender, age, clinical staging, immunological phenotype, and EBV infection, Ki- 67, CyclinD1 and Bcl-2. The positive rate of both ATF-2, Bcl-6 was 62.0% (49/79, ATF-2 was associated with Bcl-6; the higher expression of ATF-2 is correlated with the poor survival time in DLBCL. Conclusion: High expression of ATF-2 expression is associated with poor prognosis in DLBDL, suggesting that ATF-2 may be an independent prognostic factor for diffuse large B cell lymphoma.

  7. Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension

    DEFF Research Database (Denmark)

    Jansen, Christian; Bogs, Christopher; Verlinden, Wim

    2017-01-01

    BACKGROUND & AIMS: Clinically significant portal hypertension (CSPH) is associated with severe complications and decompensation of cirrhosis. Liver stiffness measured either by transient elastography (TE) or Shear-wave elastography (SWE) and spleen stiffness by TE might be helpful in the diagnosis...... of CSPH. We recently showed the algorithm to rule-out CSPH using sequential liver- (L-SWE) and spleen-Shear-wave elastography (S-SWE). This study investigated the diagnostic value of S-SWE for diagnosis of CSPH. METHODS: One hundred and fifty-eight cirrhotic patients with pressure gradient measurements...... were included into this prospective multicentre study. L-SWE was measured in 155 patients, S-SWE in 112 patients, and both in 109 patients. RESULTS: Liver-shear-wave elastography and S-SWE correlated with clinical events and decompensation. SWE of liver and spleen revealed strong correlations...

  8. Procedure-related complications of transjugular intrahepatic portosystemic shunt (TIPS) and its clinical significance

    International Nuclear Information System (INIS)

    Oh, Hyun Han; Byun, Kyung Hwan; Kim, Tae Gwon; Kang, Duk Sik; Kim, Yong Joo

    1995-01-01

    The purpose who to evaluate the procedure-related complications of the TIPS and its clinical significance. The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture (from hepatic vein to the portal vein), contrast material was injected with the with drawl of the puncture needle. Procedure-related complications occurred in 28 patients (54%) among 52 patients. The complications were biliary tree puncture (15 cases), transperitoneal puncture (14 cases), stent malposition (3 cases), stent migration (1 case), hepatic arteries puncture (1 case), splenic vein perforation (1 case), and paroxysmal ventricular tachycardia (1 case). Three patients had acute stent thrombosis with rebleeding immediately after the procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. The procedure related complications were clinically insignificant in most instances, except when stent thrombosis or proxysmal ventricular tachycardia was developed

  9. Clinical significance of 201Tl reverse redistribution in patients with aorto-coronary bypass surgery

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Tashiisa; Hayashida, Kohei; Kozuka, Takahira

    1987-01-01

    Detection of myocardial ischemia by the stress thallium scan has traditionally been performed using transient defect analysis on exercise, followed by redistribution studies. Worsening of the 201 Tl myocardial image from exercise to redistribution is referred to as reverse redistribution. In this study, we found reverse redistribution in 10 (21%) of 48 angina pectoris patients who had undergone aortocoronary bypass surgery. The clinical significance of this phenomenon in these patients was investigated in relation to angiographic and surgical findings. Reverse redistribution was found to occur in regions which were supplied by bypass grafts. These areas showed increased coronary blood flow and rapid thallium washout. Our results indicate that a perfusion defect in the bypass region of the redistribution image might be caused by relatively rapid washout in the bypass graft region compared to the adjacent normal myocardium. These results should be considered in the clinical interpretation of stress thallium scans. (orig.)

  10. The clinical significance of circulating tumor cells in non-metastatic colorectal cancer - A review

    DEFF Research Database (Denmark)

    Thorsteinsson, M; Jess, Per

    2011-01-01

    BACKGROUND: Finding a clinical tool to improve the risk stratification and identifying those colorectal cancer patients with an increased risk of recurrence is of great importance. The presence of circulating tumor cells (CTC) in peripheral blood can be a strong marker of poor prognosis in patients...... with metastatic disease, but the prognostic role of CTC in non-metastatic colorectal cancer is less clear. The aim of this review is to examine the possible clinical significance of circulating tumor cells in non-metastatic colorectal cancer (TNM-stage I-III) with the primary focus on detection methods...... and prognosis. METHODS: The PubMed and Cochrane database and reference lists of relevant articles were searched for scientific literature published in English from January 2000 to June 2010. We included studies with non-metastatic colorectal cancer (TNM-stage I-III) and CTC detected pre- and/or post...

  11. Clinical significance of determination of serum TRAb levels in patients with thyroid diseases

    International Nuclear Information System (INIS)

    Wu Lijian; Tang Bing; Yang Chunying; Lin Jun

    2005-01-01

    Objective: To investigate the clinical Significance of determination of serum thyroid stimulating hormone receptor antibody (TRAb) levels in patients with thyroid diseases, especially in patients with Graves' disease. Methods: Serum TRAb levels were determined with radio-receptor assay (RRA) in 302 patients with various thyroid diseases and 52 controls. Results: In patients with Graves' disease before treatment (n=62) the positive rate of TRAb was 86.3%. In patients with Graves' diseases improved after treatment (n=60), the positive rate was 74.5%; in those clinically cured (n=68) the positive rate was 32.1%. In 58 patients with Graves' disease who relapsed after apparently cure, the positive rate of TRAb rose to 90.3 %. However, there were no positive TRAb cases in 23 patients with simple goiter and 31 patients with benign thyroid adenomas. Also, there were no positive TRAb cases in the controls. Conclusion: TRAb levels correspond well with the severity of Graves' disease. (authors)

  12. Disturbed eating behaviors and eating disorders in type 1 diabetes: clinical significance and treatment recommendations.

    Science.gov (United States)

    Goebel-Fabbri, Ann E

    2009-04-01

    Girls and women with type 1 diabetes have increased rates of disturbed eating behaviors and clinically significant eating disorders than their nondiabetic peers. Type 1 diabetes is strongly associated with several empirically supported eating disorder risk factors (eg, higher body mass index, increased body weight and shape dissatisfaction, low self-esteem and depression, and dietary restraint). It may be that specific aspects of diabetes treatment increase the risk for developing disordered eating. Disturbed eating behaviors and clinical eating disorders predispose women with diabetes to many complex medical risks and increase risk of morbidity and mortality. For this reason, it is critical that diabetes clinicians understand more about eating disorders to improve the likelihood of early risk detection and access to appropriate treatment. This article presents a review of the current scientific literature on eating disturbances in type 1 diabetes and synthesizes the existent findings into recommendations for screening and treatment.

  13. Clinical significance of skin rash in dengue fever: A focus on discomfort, complications, and disease outcome.

    Science.gov (United States)

    Huang, Hsin-Wei; Tseng, Han-Chi; Lee, Chih-Hung; Chuang, Hung-Yi; Lin, Shang-Hung

    2016-07-01

    To assess whether the cutaneous features in patients with dengue fever are associated with abnormal blood biochemistry, complications, and poor disease outcome. Forty five patients with dengue fever were identified at a medical center in Kaohsiung, Taiwan, from September to November 2014. All cases were exclusively caused by type 1 dengue virus. Patients were classified into two groups, based on the presence or absence of skin rash, and their rash was subclassified into maculopapular, morbilliform, and petechial types. Clinical symptoms, laboratory data, disease outcome, and complications were compared between the two groups. Thirty two patients with dengue fever developed skin rash (SP group, n = 32) while the rest of 13 did not (SN group, n = 13). The patient numbers in the maculopapular, morbilliform, and petechial group were 4, 21, and 7, respectively. The SP group was younger (P = 0.001), experienced more pruritus (P = 0.008) and more swollen palms/soles (P = 0.015) than the SN group. However, the SN group had greater genital mucosa involvement (P = 0.008), higher platelet transfusion rate (P = 0.003), and lower hemoglobin and hematocrit levels (P = 0.030) than the SP group. Patients with morbilliform lesions had a higher incidence of palm/sole swelling, less genital mucosal involvement, and a lower platelet transfusion rate than did patients with maculopapular or petechial lesions. Cutaneous manifestations provide an important clue to dengue fever. In patients with dengue fever, those with skin rash tend to have itching and swelling of the palms/soles, however, those without skin rash tend to have more complications and poor disease outcomes. Copyright © 2016 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  14. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis.

    Science.gov (United States)

    Wang, Chuanling; Tian, Fuming; Zhou, Yingjun; He, Wenbo; Cai, Zhiyou

    2016-01-01

    Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of cervical spondylosis increases with aging in the young

  15. Antenatal Sonographic Diagnosis and Clinical Significance of Placenta Previa Accreta after Cesarean Section.

    Science.gov (United States)

    Liu, Zhen-Zhen; Wei, Yao; Wang, Ruo-Jiao; Xu, Wen; Shi, Zhi-Min; Dai, Qing

    2017-10-30

    Objective To investigate the clinical and antenatal sonographic characteristics of placenta previa accreta after cesarean section. Methods The data of 21 inpatients diagnosed as placenta previa accreta after cesarean section in PUMC Hospital from 2006 to 2016 were retrospectively reviewed. The clinical and ultrasound features were recorded and compared among three placental accreta groups,including placenta accrete group(n=5),increta group(n=12),and percreta group(n=4). The relationship between the placental thickness at the uterine anterior lower segment level and the blood loss of the following cesarean section was tested. Results Of 21 patients,placenta previa was diagnosed by ultrasound in 20 cases(95.2%) and placenta previa accreta was diagnosed in 9 cases(42.9%). Antenatal ultrasound findings included following signs:loss of "clear zone"(15/18,83.3%),myometrial thinning(12/18,66.7%),abnormal placental lacunae(12/19,63.2%),bladder wall interruption(2/18,11.1%),and uterovesical hypervascularity(4/9,44.4%). Myometrial thinning(J-T=64.000,P=0.036),abnormal placental lacunae(J-T=74.500,P=0.032) and the placental thickness at the uterine anterior lower segment level(U=83.000,P=0.010) showed significant difference among different placenta accreta groups. Placental thickness at the uterine anterior lower segment level showed linear correlation with the blood loss of the following cesarean section(r=0.669,P=0.002). The blood loss of the following cesarean section showed significant difference among different placenta accreta groups(U=118.500,P=0.000). Conclusions The clinical and sonographic manifestations of placenta previa accreta after cesarean section show a spectrum of demographic characteristics. The measurement of thickness of placenta at the anterior lower segment may help the evaluation of the clinical prognosis of this special pathology.

  16. Clinical significance of intra-host variability of Dengue-1 virus in venous and capillary blood.

    Science.gov (United States)

    Descloux, E; La Fuentez, C; Roca, Y; De Lamballerie, X

    2014-03-01

    Dengue fever represents a major public health problem. Both viral and host immune factors are involved in severe infections. Humans and mosquito-vectors are infected with diverse viral populations that may play a role in viral adaptation and disease pathogenesis. Our objective was to analyse the intra-host genetic variability of dengue virus type 1 (DENV-1) in the venous and capillary blood and its relationships with the clinical presentation of dengue fever. Early serum samples were collected in 2009 from ten DENV-1-infected patients hospitalized in Santa Cruz de la Sierra, Bolivia. Partial viral envelope sequences were analysed at the inter-host and intra-host level. For each patient, an average of 56 clone sequences was analysed both in the venous sector and the capillary sector (from right and left hands). The ten consensus sequences were highly similar. The intra-host DENV-1 genetic variability was significantly lower in the venous sector than in the capillary sector, and in patients with haemorrhagic symptoms than in those without haemorrhagic symptoms, particularly in capillary samples. No relation was found with sex, age, dengue IgG-serological status, day of serum sampling, or viral load. Significant relationships were found between the clinical presentation of dengue fever and the variability of viral populations within hosts, particularly in capillary samples. The observed variability of envelope sequences at the early phase of dengue infection was not critically influenced by the previous dengue serological status of patients. An important part of viral microevolution may occur in the capillary sector and influence the mechanisms of severe forms. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  17. Incidence, degree, and development of graft hypertrophy 24 months after matrix-induced autologous chondrocyte implantation: association with clinical outcomes.

    Science.gov (United States)

    Ebert, Jay R; Smith, Anne; Fallon, Michael; Butler, Rodney; Nairn, Robert; Breidahl, William; Wood, David J

    2015-09-01

    Graft hypertrophy is a common occurrence after periosteal, collagen-covered and matrix-induced autologous chondrocyte implantation (MACI). The purpose of this study was to investigate the incidence, development, and degree of graft hypertrophy at 24 months after MACI. The hypothesis was that graft hypertrophy would not be associated with clinical outcome at 24 months. Case series, Level of evidence, 4. This study was undertaken in 180 consecutive patients (113 male, 67 female) after MACI in the knee. All patients were assessed clinically using the Knee injury and Osteoarthritis Outcome Score (KOOS) and underwent magnetic resonance imaging (MRI) at 3, 12, and 24 months after surgery. The incidence of hypertrophy relevant to anatomic graft site was investigated, as was the progressive change in hypertrophic studies postoperatively. The degree of tissue overgrowth in hypertrophic cases was investigated, as was its association with patient clinical outcome at 24 months after surgery. Of the 180 patients, 50 demonstrated a hypertrophic graft at 1 or more postoperative time points. This included 9 grafts (5.0%) at 3 months and 32 grafts (18.7%) at 12 months. At 24 months, 47 grafts (26.1%)-43 (32.1%) tibiofemoral and 4 (8.7%) patellofemoral-were hypertrophic. Patients with hypertrophic grafts at 24 months (n = 47) were younger (P = .051), they had a lower body mass index (BMI; P = .069), and significantly fewer of them had patellofemoral grafts (P = .007) compared with patients who had grafts with full (100%) tissue infill (n = 61). There were no significant differences in any of the KOOS subscales between patients with graft hypertrophy or full (100%) tissue infill at 24 months after surgery, while the severity of graft hypertrophy was not associated with KOOS subscales at 24 months. Hypertrophic grafts after MACI were common and continued to develop through to 24 months after surgery. Hypertrophic growth was associated with being younger and having a lower BMI, was

  18. Clinical significance of non-mydriatic fundus photography in screening for preschool children ocular fundus disease

    Directory of Open Access Journals (Sweden)

    Jun Luo

    2014-06-01

    Full Text Available AIM: To observe the incidence of ocular fundus disease in preschool children examined by non-mydriatic fundus camera and evaluate its effectiveness compared with direct inspection shadow mirror. METHODS: Three thousand eight hundred and ninety-six preschool children from April 2012 to October 2013 were examined by Topcon TRC-NW300 color fluorescence fundus camera and direct inspection shadow mirror, and images were saved immediately. RESULTS: Detection rate of non-mydriatic fundus photography was higher than that of direct inspection shadow mirror. In 3 896 cases, 41 eyes were detected abnormal fundus accounting for 1.05%. The retinal myelinated nerve fibers, morning glory syndrome, retinitis pigmentosa, congenital retinoschisis were common, accounted for 24.39%, 21.95%, 14.63%, 12.20% respectively. The children eye diseases were often accompanied by abnormal vision(68.30%, ametropia(63.41%, strabismus(19.51%.CONCLUSION: Non-mydriatic fundus photography is a mydriatic method without medicine, so it is easy for preschool children to accept. Image results could directly display the fundus lesions. It shows important significance in the screening for preschool children eye diseases.

  19. The clinical and pathological significance of RCAS1 expression as a prognostic biomarker in non-small cell lung cancer.

    Science.gov (United States)

    Tsoukalas, Nikolaos; Kostakis, Ioannis D; Siakavellas, Spyros; Giaginis, Constantinos; Bournakis, Evangelos; Sfiniadakis, Ioannis; Karameris, Andreas; Patsouris, Efstratios; Theocharis, Stamatios

    2014-01-01

    Lung cancer remains a major health problem due to its incidence and mortality. Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a protein that can be expressed in cancer cells and is involved in tumor cell escape from immune system surveillance. The aim of this study was to evaluate the clinical significance of immunohistochemical staining for RCAS1 in non-small cell lung cancer (NSCLC). Tissue microarrays of tumor specimens from 112 consecutive patients with newly diagnosed primary NSCLC were constructed. RCAS1 and Ki-67 immunohistochemistry were studied through computerized image analysis. Associations between RCAS1 and Ki-67 expression and clinico-pathological variables and survival were analyzed. RCAS1 expression was higher in grade III tumors (p=0.009), regardless of the histological type, and in adenocarcinomas with lymphovascular invasion (p=0.014). A positive correlation between RCAS1 and Ki-67 levels was observed (p=0.002). Moreover, there was an inverse correlation of overall survival with RCAS1 (hazard ratio=0.99, p<0.001) and Ki-67 (hazard ratio=1.05, p=0.003) levels. Particularly, patients with higher expression of RCAS1 or Ki-67 had a significantly shorter survival than those with lower expression. RCAS1 could be a useful immunohistochemical biomarker, indicating not only tumor aggressiveness but also a poorer prognosis for patients with NSCLC.

  20. Clinical significance of C-reactive protein for assessment and outcomes of severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    REN Linan

    2015-05-01

    Full Text Available ObjectiveTo study the change in serum CRP level in patients with severe acute pancreatitis (SAP, and to explore its clinical significance in predicting outcomes and assessing the severity of SAP. MethodsA retrospective analysis was performed on 52 SAP patients with complete case data and admitted to General Hospital of Shenyang Military Area Command from September 2013 to September 2014. Blood drawing was performed and serum CRP concentration was determined on admission and at 24, 48, 72, 96, 120, and 144 hours after admission. The pattern of its dynamic change was observed. ResultsSerum CRP level in SAP patients significantly increased, and had a positive correlation with clinical outcomes. Forty-two cases (80.77% gradually recovered with aggressive treatment and the serum CRP levels were also slowly reduced (P<0.05. The serum CRP levels in four death cases (7.7% had no significant decrease and was maintained at a high level (P<0.05. Six patients (11.53% had aggravated conditions and recovered after aggressive treatment; meanwhile, the serum CRP levels first increased and then decreased (P<0.05. ConclusionFor SAP patients, serum CRP level fluctuates as their conditions change and can be considered as an important reference index for evaluating the severity and judging the outcomes of SAP.

  1. Expression of GLUT-1 in nasopharyngeal carcinoma and its clinical significance.

    Science.gov (United States)

    Zhou, J-C; Zhang, J-J; Zhang, W; Ke, Z-Y; Ma, L-G; Liu, M

    2017-11-01

    To investigate the relationship between the expression of glucose transporter-1 (GLUT-1) and the clinicopathological features and prognosis of patients with nasopharyngeal carcinoma (NPC). Sixty-three patients with NPC (the NPC group) and 24 patients with chronic nasopharyngitis (the control group) who were treated between December 2014 and February 2016 were selected for this study. Pathological nasopharyngeal tissues were collected from patients. The expression of GLUT-1 was detected by immunohistochemistry. The expression of GLUT-1 was correlated with clinicopathological features and survival time. The positive GLUT-1 expression rate in the NPC group was 58.73% (37/63), which was significantly higher than in the control group (29.17%, 7/24) (pGLUT-1 expression rate was significantly correlated with clinical stage, lymph node metastasis, and Epstein-Barr (EB) virus infection (pGLUT-1-positive NPC patients was 75.00% and was significantly lower than that of GLUT-1-negative NPC patients (88.89%) (pGLUT-1 was highly expressed in the nasopharyngeal tissues of patients with NPC, and its expression was associated with clinical stage, lymph node metastasis, and EB virus infection.

  2. Clinically Significant Behavior Problems among Young Children 2 Years after the Great East Japan Earthquake

    Science.gov (United States)

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2014-01-01

    Background On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. Method Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. Results Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10–5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. Conclusions One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be

  3. Prevalence, characterization and clinical significance of Klebsiella pneumoniae carbapenemase (KPC producing Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    : Sarita Nayak, Suman Singh, Soeb Jankhwala, Riddhi Pradhan

    2014-11-01

    Full Text Available Klebsiella peumoniae, a capsulated gram negative bacillus is responsible for causing life threatening infections in humans. Carbapenems are the drug of choice for serious infection caused by multidrug resistant Klebsiella pneumoniae. The emergence of carbapenem resistance has made it extremely difficult to treat such infections resulting in significant morbidity and mortality. Aims: To study the prevalence of carbapenem resistance using ertapenem as a marker and to detect Klebsiella pneumoniae Carbapenemase (KPC producing Klebsiella pneumoniae as a mechanism of resistance. Material and Methods: The study included 102 patients from which Klebsiella pneumoniae isolated. Identification and antibiotic susceptibility testing of Klebsiella pneumoniae was performed on miniAPI (Analytical Profile Index, Semiautomated bacterial identification system according to Clinical and Laboratory Standards Institute (CLSI guidelines of 2011. The modified Hodge test was performed for detection of Carbapenemase production. Patient’s clinical and demographic details along with risk factors and co-morbid conditions, type of response to antimicrobial therapy and mortality were collected. Results: The prevalence of carbapenem resistance was found to be 30.41% with 16.6% KPC producing Klebsiella pneumoniae. The co-morbid conditions like immunocompromised state (p =0.042, prior antibiotics therapy (p=0.047, previous hospitalization (p =0.021, intensive care unit stay (p=0.047 and use of indwelling devices (p =0.013 were found to be significantly associated with carbapenem resistance. Adverse clinical outcomes (death or worsening among patients infected with ertapenem resistant patients was found to be statistically significant than ertapenem sensitive strains (p =0.008. Conclusions: A high degree of carbapenem resistance in present study is alarming and poses therapeutic dilemmas for clinicians. Initiating timely and appropriate infection control measures along with a

  4. Clinically significant behavior problems among young children 2 years after the Great East Japan Earthquake.

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara

    Full Text Available BACKGROUND: On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. METHOD: Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82. Data were collected from September 2012 to June 2013 (around 2 years after the earthquake, thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage, and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL, which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. RESULTS: Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10-5.07. Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. CONCLUSIONS: One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These

  5. Clinically significant behavior problems among young children 2 years after the Great East Japan Earthquake.

    Science.gov (United States)

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2014-01-01

    On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10-5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be useful for developing future interventions in

  6. Assessing clinical significance in measuring oncology patient quality of life: Introduction to the symposium, content overview, and definition of terms

    NARCIS (Netherlands)

    Sloan, Jeff A.; Cella, David; Frost, Marlene; Guyatt, Gordon H.; Sprangers, Mirjam; Symonds, Tara

    2002-01-01

    The Clinical Significance Consensus Meeting Group of the Symposium on the Clinical Significance of Quality-of-Life Measures in Cancer Patients produced 6 articles regarding the clinical significance of quality of life (QOL) assessments in oncology. The 6 articles deal with the methods used to date:

  7. Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Treyaud, Marc-Olivier; Duran, Rafael; Knebel, Jean-Francois; Meuli, Reto A.; Schmidt, Sabine [Lausanne University Hospital, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Zins, Marc [Fondation Hopital St Joseph, Department of Radiology, Paris (France)

    2017-01-15

    To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome. Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome. The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03). In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia. (orig.)

  8. Expression and clinical significance of ATM and PUMA gene in patients with colorectal cancer.

    Science.gov (United States)

    Xiong, Hui; Zhang, Jiangnan

    2017-12-01

    The expression of ataxia-telangiectasia mutated (ATM) and p53 upregulated modulator of apoptosis (PUMA) genes in patients with colorectal cancer were investigated, to explore the correlation between the expression of ATM and PUMA and tumor development, to evaluate the clinical significance of ATM and PUMA in the treatment of colorectal cancer. Quantitative real-time PCR was used to detect the expression of ATM and PUMA in tumor tissue and adjacent healthy tissue of 67 patients with colorectal cancer and in normal colorectal tissue of 33 patients with colorectal polyps at mRNA level. The expression level of ATM mRNA in colorectal cancer tissues was significantly higher than that in normal mucosa tissues and adjacent non-cancerous tissue (P≤0.05), while no significant differences in expression level of ATM mRNA were found between normal mucosa tissues and adjacent noncancerous tissue (P=0.07). There was a negative correlation between the expression of ATM mRNA and the degree of differentiation of colorectal cancer (r= -0.312, P=0.013), while expression level of ATM mRNA was not significantly correlated with the age, sex, tumor invasion, lymph node metastasis or clinical stage (P>0.05). Expression levels of PUMA mRNA in colorectal cancer tissues, adjacent noncancerous tissue and normal tissues were 0.68±0.07, 0.88±0.04 and 1.76±0.06, respectively. Expression level of PUMA mRNA in colorectal cancer tissues and adjacent noncancerous tissue was significantly lower than that in normal colorectal tissues (PPUMA gene in colorectal carcinoma is downregulated, and is negatively correlated with the occurrence of cancer.

  9. Environmental pollution and DNA methylation: carcinogenesis, clinical significance, and practical applications.

    Science.gov (United States)

    Cao, Yi

    2015-09-01

    Environmental pollution is one of the main causes of human cancer. Exposures to environmental carcinogens result in genetic and epigenetic alterations which induce cell transformation. Epigenetic changes caused by environmental pollution play important roles in the development and progression of environmental pollution-related cancers. Studies on DNA methylation are among the earliest and most conducted epigenetic research linked to cancer. In this review, the roles of DNA methylation in carcinogenesis and their significance in clinical medicine were summarized, and the effects of environmental pollutants, particularly air pollutants, on DNA methylation were introduced. Furthermore, prospective applications of DNA methylation to environmental pollution detection and cancer prevention were discussed.

  10. Incidence and predictors of hospitalization or death in patients managed in multidisciplinary heart failure clinics

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Schou, Morten; Videbaek, Lars

    2009-01-01

    AIMS: To assess the rates of death or hospitalization in outpatients with heart failure (HF) followed in multidisciplinary, nurse-based HF clinics and to compare the rates with published data from the literature. A second aim was to identify risk factors for death or hospital admission. METHODS...... left ventricular systolic dysfunction and 52% had been hospitalized within 90 days prior to referral to the HF clinic. The 6 and 12 month rates of hospitalization or death were 31 and 42%. Hospitalization or death was significantly predicted by age 1.12 (1.05-1.19), diabetes 1.21 (1.03-1.42), serum...

  11. Clinical significance of changes of plasma prethrombotic state markers levels in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Chen Yonghua; Qian Haigen; Gao Li; Tang Jie

    2010-01-01

    Objective: To study the clinical significance of changes of plasma prethrombotic state markers levels in patients with rheumatoid arthritis. Methods: The plasma concentrations of TAT, FPA, PC, vWF, P-selectin, TpP and D-D were detected with ELISA in 84 patients with rheumatoid arthritis and 70 controls. Hand and wrist X-ray pictures were taken in all the 84 patients for staging of the disease with ARA 1987 revised criteria. Results: The plasma levels of TpP, TAT, vWF, FPA, P-Selectin and D-D were significantly higher in the patients than those in controls (P<0.05, respectively), but the plasma levels of PC were significantly lower (P<0.01). Changes of levels between successive stages were significantly (P<0.05) with the exception of the change between stage III and stage IV. Except PC, the levels of all the markers were significantly higher in patients with active disease (n=46) than those in patients with inactive disease (n=38) (P<0.05). Conclusion: There was risk for development of thrombotic events in patients with rheumatoid arthritis and prophylactic treatment might be desirable. (authors)

  12. Clinical Significances of Serum Vitamin B12, Folate and Ferritin Levels in Patients with Malignant Tumors

    International Nuclear Information System (INIS)

    Monn, Youn Sung; Soung, In Whan; Kim, Sam Yong; Ro, Heung Kyu; Lee, Bok Hee

    1987-01-01

    In order to evaluate the clinical significances of the serum vitamin B 12 , folate and ferritin levels in patients with malignant tumors, the levels were measured in 10 normal control subjects, 70 patients with malignant tumors, 7 patients with liver cirrhosis and 25 patients with other benign diseases. The results are as follows: 1) In normal control subjects, mean serum values for vitamin B 12 , folate and ferritin level were 588.80±131.58 pg/ml, 5.59±1.52 ng/ml and 89.22±42.78 ng/ml retrospectively. 2) There was no significant difference in serum levels between patients with benign diseases and normal control subjects. 3) The serum vitamin B 12 and ferritin levels in patients with liver cirrhosis were significantly higher than in normal control, and the serum folate levels in these patients were lower than in normal control subjects. 4) The serum vitamin B 12 and ferritin levels in patients with malignant tumors were significantly higher than in normal control subjects, and the serum folate levels in these patients were significantly lower than in normal control subjects. The above results suggest that the serum vitamin B 12 and ferritin may be useful as tumor markers in patients with malignant tumors.

  13. [Clinical significance of suicidal behaviour in delusional disorder: a 44 case-series descriptive study].

    Science.gov (United States)

    González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Penadés Rubio, Rafael; Catalán Campos, Rosa; Bernardo Arroyo, Miguel

    2014-04-07

    Suicidal behaviour in delusional disorder (DD) has been poorly studied. This study aimed to describe the prevalence of clinically significant depression, suicidal ideation and behaviour in these patients, and to relate them with psychotic or depressive symptoms. A cross-sectional study including 44 outpatients with DD (DSM-IV-TR) was conducted. Demographic and clinical data, as well as scores in clinical assessment scales: Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale, Hamilton Depression Rating Scale (17-item version) and Columbia Suicide Severity Rating Scale, were recorded. The sample was divided into 2 groups according to presence or absence of comorbid depression (CD). Fifteen patients (34.1%) had CD, 14 (31.8%) suicidal ideation and 7 (15.9%) suicidal behaviour in the previous 2 years. Patients with CD had an earlier age at onset and for a first psychiatric appointment, and had higher scores on the PANSS general subscale (p=0,043) and in intensity of suicidal ideation (p=0,001). In our sample, patients with DD and CD have more frequently suicidal ideation and behaviour than those without CD. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  14. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Battal, Bilal; Hamcan, Salih; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Ankara (Turkey); Oz, Oguzhan [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Castillo, Mauricio [University of North Carolina School of Medicine, Division of Neuroradiology, Department of Radiology, Chapel Hill, NC (United States)

    2016-06-15

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  15. Three-dimensional (3D) culture in sarcoma research and the clinical significance.

    Science.gov (United States)

    Gao, Songtao; Shen, Jacson; Hornicek, Francis; Duan, Zhenfeng

    2017-08-03

    Sarcomas are rare malignant tumors that arise from transformed cells of mesenchymal origin. Despite the progress in diagnosis and treatment, sarcomas have a high mortality rate due to local recurrence, metastasis, and the development of drug resistance to chemotherapy. New models for sarcoma research are required to further understand the disease and to develop new therapies. In vitro sarcoma modeling is challenging because of significant genetic heterogeneities, diverse pathological, and overlapping clinical characteristics. Studies on the mechanisms of recurrence, metastasis, and drug resistance in sarcoma have resulted in the generation of novel three-dimensional (3D) culture models for sarcoma research. 3D culture models aim to recapitulate the tumor microenvironment that plays a critical role in the pathogenesis of sarcoma using biomaterial scaffolds of natural biological materials and artificial polymers. An ideal 3D culture model can properly mimic not only the microenvironment, oncogenesis, and maintenance of sarcoma cell growth, but also imitate the interactions between cells and to the extracellular matrix. More recently, 3D cell culture has been used to research the biological behavior and mechanism of chemotherapy and radiotherapy resistance in different sarcoma models. Ultimately, findings using 3D models that more accurately reflect human sarcoma biology are likely to translate into improved clinical outcomes. In this review, we discuss the most recent advances of 3D culture technologies in sarcoma research and emerging clinical applications.

  16. Clinical significance of dynamic magnetic resonance imaging in the evaluation of wrist joint in Rheumatoid arthritis

    International Nuclear Information System (INIS)

    Shim, Yong Woon; Suh, Jin Suck; Lee, Soo Kon; Lee, Ji Soo; Cho, Jae Hyun

    1996-01-01

    To assess the role of contrast-enhanced dynamic Magnetic Resonance Imaging in evaluation disease activity of rheumatoid arthritis. Forty-seven wrist joints with rheumatoid arthritis were examined prospectively. Coronal images of the wrist were obtained using fat-suppression Fast multi-planar spoiled gradient recalled (FMPSPGR) acquisition in the steady state ; TR/TE 102/6.4 msec, flip angle = 60, 4 slices per sequence, FOV = 8 cm, matrix 256 X 192 at 1.5 Tesla. Scans were carried out once before and five to eight times after an intravenous Gd-DPTA injection, at 30-second-intervals. The enhancement of synovium were measured, the enhancement ratio was calculated(postcontrast SNR/precontrast SNR) and time-enhancement ratio curves were plotted. Patients were divided into three groups according to the ratio of initial to peak enhancement : less than 30% ; 30-80% more than 80%. Differences among the three groups were statistically tested using clinical indices and laboratory data as variable. Comparing one group with another, there were no significant differences in clinical indices and laboratory data except for the parameter of grip strength. Enhancement pattern measured in a single wrist joint was not comparable to a clinical index in predicting disease activity in rheumatoid arthritis

  17. The clinical significance of corrected seminal plasma prolactin level in men with asthenospermia

    International Nuclear Information System (INIS)

    Zhang Rongfu; Ding Jiefeng; Zhang Wenwei; Shen Erming

    2003-01-01

    Objective: To evaluate the clinical significance of corrected seminal prolactin assay in men with asthenospermia. Methods: Routine semen analysis and seminal plasma prolactin assay were performed on the men with asthenospermia, oligo-asthenospermia, normospermia. Prolactin was assessed by radioimmunoassay. The relationship between the level of corrected seminal plasma prolactin and the quality of semen was analyzed. Results: The mean level of the corrected seminal prolactin in the men with asthenospermia was (26.1±12.8) μg/L and was significantly higher than that of the men with normospermia. Seminal plasma prolactin concentration showed linear increasing alongside with the decreasing of the semen motility and motility degrees. Conclusion: The detection of corrected seminal plasma prolactin level will provide an objective index for evaluating the semen quality of asthenospermic men

  18. Clinical significance of radioimmunological HPL findings in long-term management of premature delivery risk

    International Nuclear Information System (INIS)

    Ruckhaeberle, K.-E.; Bilek, K.; Viehweg, B.; Kuehndel, K.; Colditz, U.; Baer, G.

    1981-01-01

    Premature birth is not only characterized by premature delivery action but it is ever more frequently interpreted as the disturbed fetoplacental unit syndrome. In an attempt to therapeutically prevent premature delivery the placental function should be monitored. Possible intrauterine survival should be assessed as accurately as possible against extrauterine survival in order that the necessary tocolysis time could be determined. In our observations, clinical significance was studied of radioimmunologically determined HPL values in the serum under tocolysis conditions at premature birth risk on the basis of postnatal classification of the postnatal condition and of the particularity of the adaptation phase of the neonates. The significance of HPL determination in checking the fetoplacental unit during tocolysis should be arrived at while also using other diagnostic techniques, such as oxytocinase or estriol, ultrasound biometry, cardiotocography. (author)

  19. Depo-medroxyprogesterone in women on antiretroviral therapy: effective contraception and lack of clinically significant interactions.

    Science.gov (United States)

    Cohn, S E; Park, J-G; Watts, D H; Stek, A; Hitti, J; Clax, P A; Yu, S; Lertora, J J L

    2007-02-01

    We conducted an open-label, steady-state pharmacokinetic (PK) study of drug interactions among HIV-infected women treated with depo-medroxyprogesterone acetate (DMPA) while on nucleoside analogues plus nelfinavir (N=21), efavirenz (N=17), or nevirapine (N=16); or nucleosides only or no antiretroviral therapy as a control group (N=16). PK parameters were estimated using non-compartmental analysis, with between-group comparisons of medroxyprogesterone acetate (MPA) PKs and within-subject comparisons of ARV PKs before and 4 weeks after DMPA dosing. Plasma progesterone levels were measured at baseline and at 2, 4, 6, 8, 10, and 12 weeks after DMPA dosing. There were no significant changes in MPA area under the concentration curve, peak or trough concentrations, or apparent clearance in the nelfinavir, efavirenz, or nevirapine groups compared to the control group. Minor changes in nelfinavir and nevirapine drug exposure were seen after DMPA, but were not considered clinically significant. Suppression of ovulation was maintained.

  20. [3-dimensional CT cephalometry before and after mandibular angle osteotomy and its clinical significance].

    Science.gov (United States)

    Li, Hui-Chao; Li, Dong-Mei; Zhang, Zhi-Yong; Lü, Chang-Sheng; Liu, Yu-Feng; Zhang, Ji; Gui, Lai

    2008-05-01

    To investigate the change of skeleton structure and masseter after mandibular angle osteotomy and its clinical significance in preoperative design. 3-dimensional CT cephalometry was performed before and after surgery in 18 cases of prominent mandibular angle. Pre- and post-operative data were compared. Significant differences between the pre- and post-operative data were found in the mandibular angle, the distance between mandibular angle, length of ramus, ectropion angle of mandibular angle, triangle Go-Me-Go, the thickness, width and length of masseter. It indicates the skeleton structure is changed and some kind of atrophy happens in the masseter after operation. So we suggest partial resection of masseter should be unnecessary for mandibular angle osteotomy.

  1. Clinical significance and changes of TRAb and TSI assay in patients with Graves' disease

    International Nuclear Information System (INIS)

    Hu Xiaolin; Zhang Haiyan

    2006-01-01

    Objective: To explore the changes and clinical significance of TRAb and TSI detection in patients with Graves' disease. Methods: Serum TRAb and TSI levels were detected by enzyme-linked immunosorbent assay, and thyroid hormone levels were detected by microparticle enzyme immunoassay, including normal controls, Graves' disease in period of onset, catabsis group and hashimotos thyroiditis group. Results: The positive rate of TRAb and TSI in Graves' in period of onset group is 86.67% and 95.0%, TGA and TMA in hashimotos thyroiditis group is 85.29% and 91.18%, respectively. More importantly these results were significant difference than normal controls. Conclusions: It's very important for Graves' disease patients to detect TRAb, TSI, TGA, TMA and thyroid hormone simulta-neously, especially to the curative effect and prognosis criterin in patients with Graves' disease and antidi-astole in patients with hashimotos thyroiditis. (authors)

  2. [Clinical significance of determination of serum B7-H4 in patients with malignant hematologic diseases].

    Science.gov (United States)

    Wang, Xiao-Mei; Hu, Guo-Yan; Liu, Wei; Zheng, Shu-Hua; Lv, Jing; Wang, Hong-Mei; Xu, Jun-Fa

    2010-09-01

    To study the clinical significance of determination of serum B7-H4 in patients with malignant hematologic diseases. Serum B7-H4 levels were determined in 65 patients with leucemia, 34 patients with lymphoma, 12 patients with multiple myeloma as well as in 50 healthy controls. The serum B7-H4 levels in patients with lymphoma [(38.81+/-10.34) kappag/L] were significantly higher than healthy controls [(31.62+/-9.850) kappag/L] (Pleucemia, patients with multiple myeloma and healthy controls. These results suggest that the B7-H4 may correlated with lymphoma, but uncorrelated with leucemia and multiple myeloma. Measurement of serum B7-H4 level provide useful information for distinctive diagnosis of different kinds of malignant hematologic diseases.

  3. Clinical significance of isometric bite force versus electrical activity in temporal and masseter muscles

    DEFF Research Database (Denmark)

    Bakke, Merete; Michler, L; Han, K

    1989-01-01

    bite force was 480 Newton (N) in control subjects and 387 N in patients, with corresponding bilateral values of 347 N and 230 N. At predetermined levels of contraction, temporalis and masseter activity were linearly related. Correlations of bite force and activity in short static contractions were......Bite force and activity in temporal and masseter muscles during biting and chewing were recorded in 19 control subjects and 23 subjects with symptoms and signs of functional disorders of the craniomandibular system. The entire group comprised 13 men and 29 women, 14-63 yr of age. Maximal unilateral...... significant with respect to unilateral, but not to bilateral force measurements. Only in the masseter muscle was strength of dynamic contractions during chewing significantly correlated to bite force. With the present method it was demonstrated that unilateral bite force is a simple clinical indicator...

  4. Expression and clinical significance of fibroblast growth factor 1 in gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Liu NQ

    2015-03-01

    Full Text Available Naiqing Liu,1,2,* Jingyu Zhang,2,* Shuxiang Sun,2 Liguang Yang,2 Zhongjin Zhou,2 Qinli Sun,2 Jun Niu11Department of General Surgery, Qilu Hospital Affiliated to Shandong University, Jinan, People’s Republic of China; 2Department of General Surgery, Yishui Central Hospital, Linyi, People’s Republic of China*These authors contributed equally to this workBackground: The clinical significance of fibroblast growth factor 1 (FGF1 has been revealed in several cancers, including ovarian cancer, breast cancer, and bladder cancer. However, the clinical significance of FGF1 in gastric adenocarcinoma has not been explored.Patients and methods: In our experiments, we systematically evaluated FGF1 expression in 178 cases of gastric adenocarcinoma with immunohistochemistry, and subsequently analyzed the correlation between FGF1 expression and clinicopathologic features. Moreover, FGF1 expression in tumor tissue and corresponding adjacent tissue was detected and compared by real-time polymerase chain reaction. The Kaplan–Meier method and the Cox-regression model were used with univariate and multivariate analysis, respectively, to evaluate the prognostic value of FGF1 in gastric adenocarcinoma.Results: Higher FGF1 expression rate is 56.7% (101/178 in gastric adenocarcinoma. FGF1 expression in gastric adenocarcinoma was significantly higher than adjacent tissue (P<0.0001. Expression of FGF1 is significantly associated with lymph node invasion (P<0.001, distant metastasis (P=0.013, and differentiation (P=0.015. Moreover, FGF1 overexpression was closely related to unfavorable overall survival rate (P=0.021, and can be identified to be an independent unfavorable prognostic factor (P=0.004.Conclusion: FGF1 is an independent prognostic factor, indicating that FGF1 could be a potential molecular drug target in gastric adenocarcinoma.Keywords: fibroblast growth factor 1, gastric adenocarcinoma, prognosis, biomarker, lymph node, gene fusion

  5. Clinical Significance of Pre- and Post-Transplant BAFF Levels in Kidney Transplant Recipients.

    Directory of Open Access Journals (Sweden)

    Ji Won Min

    Full Text Available It is well known that pre-transplant B cell activating factor (BAFF levels are associated with the development of de novo anti-HLA antibodies and antibody mediated rejection post-transplant. However, the clinical significance of BAFF values at allograft rejection has not been determined. In this study, we investigated the clinical significance of pre-transplant BAFF level as well as post-transplant BAFF levels measured when indication biopsy was done. We checked for anti-HLA antibodies in 115 kidney transplant recipients who required allograft biopsy due to an increase in serum creatinine. With the same serum specimen, we measured BAFF levels, and in 78 of these patients, pre-transplant BAFF and anti-HLA antibody levels were detected as well. Patients in each group were divided into tertiles according to BAFF levels. We investigated the relationship between BAFF levels and the occurrence of anti-HLA antibodies. Pre-transplant BAFF levels showed significant association with pre-transplant sensitization, and also with early rejection (Tertile 3, 26.9% vs. Tertile 1, 11.5%; P<0.05. Post-transplant BAFF levels showed significant association with pre-transplant sensitization, but did not show association with anti-HLA antibodies and positive donor-specific antibodies at the time of biopsy. We did not find any association between post-transplant BAFF levels and allograft biopsy results, Banff scores and microvascular inflammation scores. In conclusion, pre-transplant BAFF levels are associated with pre-transplant sensitization and are useful in predicting allograft rejection. But post-transplant BAFF levels measured at the time of indication biopsy are not associated with the appearance of de novo HLA-DSA, allograft rejection, biopsy findings and other allograft outcomes.

  6. Clinical Significance of Pre- and Post-Transplant BAFF Levels in Kidney Transplant Recipients.

    Science.gov (United States)

    Min, Ji Won; Kim, Kyoung Woon; Kim, Bo-Mi; Doh, Kyoung Chan; Choi, Min Seok; Choi, Bum Soon; Park, Cheol Whee; Yang, Chul Woo; Kim, Yong-Soo; Oh, Eun-Jee; Chung, Byung Ha

    2016-01-01

    It is well known that pre-transplant B cell activating factor (BAFF) levels are associated with the development of de novo anti-HLA antibodies and antibody mediated rejection post-transplant. However, the clinical significance of BAFF values at allograft rejection has not been determined. In this study, we investigated the clinical significance of pre-transplant BAFF level as well as post-transplant BAFF levels measured when indication biopsy was done. We checked for anti-HLA antibodies in 115 kidney transplant recipients who required allograft biopsy due to an increase in serum creatinine. With the same serum specimen, we measured BAFF levels, and in 78 of these patients, pre-transplant BAFF and anti-HLA antibody levels were detected as well. Patients in each group were divided into tertiles according to BAFF levels. We investigated the relationship between BAFF levels and the occurrence of anti-HLA antibodies. Pre-transplant BAFF levels showed significant association with pre-transplant sensitization, and also with early rejection (Tertile 3, 26.9% vs. Tertile 1, 11.5%; PBAFF levels showed significant association with pre-transplant sensitization, but did not show association with anti-HLA antibodies and positive donor-specific antibodies at the time of biopsy. We did not find any association between post-transplant BAFF levels and allograft biopsy results, Banff scores and microvascular inflammation scores. In conclusion, pre-transplant BAFF levels are associated with pre-transplant sensitization and are useful in predicting allograft rejection. But post-transplant BAFF levels measured at the time of indication biopsy are not associated with the appearance of de novo HLA-DSA, allograft rejection, biopsy findings and other allograft outcomes.

  7. [The expression and clinical significance of miR-203 in pediatric acute leukemia].

    Science.gov (United States)

    Wang, Na; Pan, Jian; Cao, Lan; Lu, Jun; Xiao, Pei-fang; Zhao, Wen-li; Hu, Shao-yan; Chai, Yi-huan

    2013-09-01

    To investigate the methylation, expression and clinical significance of miR-203 in pediatric acute leukemia. The methylation status of miR-203 promoter CpG islands was detected with methylation-specific polymerase chain reaction. The expression of miR-203 was detected by Taqman real- time quantitative polymerase chain reaction. And the clinical significance of miR-203 in pediatric acute leukemia (ALL) was also analyzed. The promoter of miR-203 was unmethylated in all of 31 pediatric acute lymphoblastic leukemia, all of 15 pediatric acute myeloid leukemia (AML) and all of 23 controls. The relative expression levels of miR-203 in controls, pediatric acute leukemia, ALL and AML were 16.93±6.31, 48.97±10.38, 55.88±12.91, 24.28±9.10 respectively. The results indicated that miR-203 was significantly up- regulated in pediatric acute leukemia (P=0.011) and ALL (P=0.009), not in pediatric AML (P=0.514) compared with control. The expression of miR-203 was significantly related with the gender, immunophenotype, chromosome, fusion gene, BCR-ABL, SIL-TAL1 and prednisone experiment in pediatric ALL and the gender, chromosome, fusion gene, SIL-TAL1 in pediatric acute leukemia (Ppediatric acute leukemia. miR- 203 may be a protooncogene involved in the formation of pediatric acute leukemia and ALL. Further analyses indicated that high expression of miR-203 may be associated with poor prognosis of pediatric ALL and acute leukemia.

  8. Clinical significance of microbial growth on the surfaces of silicone tubes removed from dacryocystorhinostomy patients.

    Science.gov (United States)

    Kim, Sung Eun; Lee, Sung Jun; Lee, Sang Yeul; Yoon, Jin Sook

    2012-02-01

    To investigate the bacterial infection of silicone tubes removed from patients who underwent dacryocystorhinostomy (DCR) and assess the correlation between the culture results and postoperative clinical features. Retrospective observational case series. Consecutive epiphora patients who underwent external or endoscopic DCR surgery were reviewed. The postoperatively removed silicone tubes were cultured. Preoperative canalicular stenosis and nasal septal hypertrophy, postoperative inflammation, membranous obstruction of nasal mucosa, and the duration of silicone intubation were reviewed. Correlations between the results of bacterial culture and clinical features were verified. A total of 39 silicone tubes removed from 33 patients were cultured: 34 (87.2%) external DCR cases and 5 (12.8%) endoscopic DCR. Culture provided positive results in 37 cases (94.9%). A total of 52 isolates were identified: 73.1% gram-positive bacteria, 23.1% gram-negative bacteria, and 3.8% fungi. Of the gram-positive organisms, 73.9% were Staphylococcus aureus. Most of the gram-negative organisms were Pseudomonas aeruginosa, found in 5 eyes. The time of tube placement was significantly longer in cases with P. aeruginosa than in those with other bacteria (P = .001). The rate of pseudomonas infection was significantly higher in cases with revision than in those without revision (P = .001). Final surgical failure was significantly related with canalicular stenosis (P = .017), pus discharge at extubation (P cultured from removed silicone tubes. Although many of them were normal flora, P. aeruginosa infection showed significant relation with membranous obstruction of nasal mucosa, prolonged silicone intubation, and surgical failure. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. The applications and clinical significance of IMA, H-FABP joint CKMB in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Xiao-Hui Zeng

    2016-01-01

    Full Text Available Objective: To investigate the applications and clinical significance of ischemia-modified protein (IMA, heart-type fatty acid binding protein (H-FABP joint creatine kinase isoenzyme (CK-MB in acute myocardial infarction (AMI. Methods: From January 2014 to December 2014, 84 clinical materials of patients with AMI in Department of cardiology were collected, and 80 cases of normal projects were the control group. IMA was determinated with albumincobalt ion binding assay. The levels of H-FABP and CK-MB of 84 cases of AMI patients and 80 cases of normal subjects were determinated with immunoturbidimetric. The value of IMA, H-FABP and CK-MB of AMI patients were analyzed with subject-specific curve (ROC. Results: The levels of serum IMA, H-FABP and CK-MB of AMI group were significantly higher than those of the control group. Differences showed statistical significance (P < 0.05. The levels of serum IMA, H-FABP and CK-MB increased as the increase of coronary lesion vessels in patients with AMI (P < 0.05. The levels of IMA, H-FABP and CK-MB of the death group were significantly higher than those of the surviving group (P < 0.05. ROC curve analysis showed that when IMA, H-FABP and CK-MB joint detections of sensitivity, specificity, positive predictive value and negative predictive value were greater than singleindex detection (P < 0.05. Conclusions: The expression levels of IMA, H-FABP and CK-MB are closely related to the occurrence and development of disease progression in patients with AMI. IMA, H-FABP joint CK-MB detection can improve the sensitivity and specificity for early diagnosis of AMI.

  10. Theileriosis in six dogs in South Africa and its potential clinical significance

    Directory of Open Access Journals (Sweden)

    Chantal T. Rosa

    2014-08-01

    Full Text Available Theileriosis is a tick-borne disease caused by a piroplasma of the genus Theileria that can causeanaemia and thrombocytopenia. Its clinical importance for dogs’ remains poorly understood,as only some develop clinical signs. In this study, physical and laboratory findings, treatment and outcomes of six client-owned diseased dogs presented at the Onderstepoort Veterinary Academic Hospital are described retrospectively. In the dogs, Theileria species (n = 4and Theileria equi (n = 2 were detected by a polymerase chain reaction (PCR-reverse blothybridisation assay in blood samples, whilst PCR for Babesia, Anaplasma and Ehrlichia were negative. The most common physical findings were pale mucous membranes (five out of six dogs, bleeding tendencies (five out of six dogs and lethargy (three out of six dogs. All dogs were thrombocytopenic [median 59.5 x 109/L (range 13–199] and five out of six dogs were anaemic [median haematocrit 18% (range 5–32]. Bone marrow core biopsies performed in two dogs showed myelofibrosis. Theileriosis was treated with imidocarb dipropionate and the suspected secondary immune-mediated haematological disorders with prednisolone and azathioprine. Five dogs achieved clinical cure and post-treatment PCR performed in three out of five dogs confirmed absence of circulating parasitaemia. An immune-mediated response to Theileria species is thought to result in anaemia and/or thrombocytopenia in diseased dogs with theileriosis. A bleeding tendency, most likely secondary to thrombocytopenia and/or thrombocytopathy, was the most significant clinical finding in these cases. The link between thrombocytopenia, anaemia and myelofibrosis in theileriosis requires further investigation and theileriosis should be considered a differential diagnosis for dogs presenting with anaemia and/or thrombocytopenia in endemic tick-borne disease areas.

  11. Lipoprotein Subfractions in Metabolic Syndrome and Obesity: Clinical Significance and Therapeutic Approaches

    Directory of Open Access Journals (Sweden)

    Manfredi Rizzo

    2013-03-01

    Full Text Available Small, dense low density lipoprotein (sdLDL represents an emerging cardiovascular risk factor, since these particles can be associated with cardiovascular disease (CVD independently of established risk factors, including plasma lipids. Obese subjects frequently have atherogenic dyslipidaemia, including elevated sdLDL levels, in addition to elevated triglycerides (TG, very low density lipoprotein (VLDL and apolipoprotein-B, as well as decreased high density lipoprotein cholesterol (HDL-C levels. Obesity-related co-morbidities, such as metabolic syndrome (MetS are also characterized by dyslipidaemia. Therefore, agents that favourably modulate LDL subclasses may be of clinical value in these subjects. Statins are the lipid-lowering drug of choice. Also, anti-obesity and lipid lowering drugs other than statins could be useful in these patients. However, the effects of anti-obesity drugs on CVD risk factors remain unclear. We review the clinical significance of sdLDL in being overweight and obesity, as well as the efficacy of anti-obesity drugs on LDL subfractions in these individuals; a short comment on HDL subclasses is also included. Our literature search was based on PubMed and Scopus listings. Further research is required to fully explore both the significance of sdLDL and the efficacy of anti-obesity drugs on LDL subfractions in being overweight, obesity and MetS. Improving the lipoprotein profile in these patients may represent an efficient approach for reducing cardiovascular risk.

  12. Expression of AQP5 and AQP8 in human colorectal carcinoma and their clinical significance

    Directory of Open Access Journals (Sweden)

    Wang Wei

    2012-11-01

    Full Text Available Abstract Background The aquaporins (AQPs are a family of small membrane transport proteins whose overexpression has been implicated in tumorigenesis. However, the expression of AQP5 and AQP8 in colorectal cancer and the clinical significance remain unexplored. This study aimed to detect the expression of AQP5 and AQP8 in clinical samples of colorectal cancer and analyze the correlations of their expression with the clinicopathological features of colorectal cancer. Methods Forty pairs of colorectal cancer tissue and paraneoplastic normal tissue were obtained at the time of surgery from patients with colorectal cancer. The expression of AQP5 and AQP8 was detected by immunohistochemical staining and reverse transcriptase polymerase chain reaction. Results AQP5 was mainly expressed in colorectal carcinoma cells and barely expressed in paraneoplastic normal tissues. By contrast, AQP8 was mainly expressed in paraneoplastic normal tissues and barely expressed in colorectal carcinoma cells. AQP5 expression was not significantly associated with the sex or age of the patient with colorectal cancer (P>0.05, but was closely associated with the differentiation, tumor-nodes-metastasis stage and distant lymph node metastasis of colorectal carcinoma (P Conclusions AQP5 might be a novel prognostic biomarker for patients with colorectal cancer.

  13. Clinical significance of DVM and its prevalence in pre-gestational diabetes cases versus normal pregnancies

    Directory of Open Access Journals (Sweden)

    Farideh Akhlaghi

    2015-06-01

    Full Text Available Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in such pregnancies. Delayed villous maturation of placental villi, which is one of the findings associated with pre-gestational diabetes increases the rate of perinatal mortality. There is limited literature regarding the delayed maturation of placental villous. This review included trials (randomized and non-randomized, cohort and case-control studies registered in Medline/PubMed database, from January 2001 to September 2012 that evaluated the clinical significance of delayed villous maturation and its prevalence in pre-gestational diabetic cases compared to normal pregnancies.It emphasizes that further studies with focus on possible clinical or ultrasound markers of placental delayed villous maturation, especially in a high risk-group such as women with pre-gestational diabetes mellitus are highly recommended.

  14. Clinical significance of COX-2, GLUT-1 and VEGF expressions in endometrial cancer tissues.

    Science.gov (United States)

    Ma, Xiaoping; Hui, Yuzuo; Lin, Li; Wu, Yu; Zhang, Xian; Liu, Peishu

    2015-01-01

    To analyze the clinical significance of COX-2, GLUT-1 and VEGF expressions in endometrial cancer tissues. One hundred and eight tissue samples from the patients with endometrial cancer enrolled in our hospital from August 2011 to July 2014 were selected, including 60 normal tissue samples (normal group), 60 neoplastic tissue samples (neoplastic group) and 60 cancer tissue samples (cancer group). All the samples were subjected to immunohistochemical assay to detect the expressions of COX-2, GLUT-1 and VEGF. The clinical data were also investigated for correlation analysis. The positive rates of COX-2 in normal group, neoplastic group and cancer groups were 3.3%, 21.7% and 55.0% respectively. The positive rates of GLUT-1 in normal group, neoplastic group and cancer groups were 3.3%, 25.0% and 70.0% respectively. The positive rates of VEGF in normal group, neoplastic group and cancer groups were 1.7%, 23.3% and 63.3% respectively. With increasing stage of such cancer, decreasing degree of differentiation and lymphatic metastasis, the positive expression rates of COX-2, GLUT-1 and VEGF proteins were raised significantly (PGLUT-1 (r=0.207, PGLUT-1 and VEGF (r=0.758, PGLUT-1 and VEGF were highly prominent in endometrial cancer, especially in the patients with low degree of differentiation, late stage and metastasis. They functioned synergistically in the onset and progression of this cancer.

  15. Palatine rugae and their significance in clinical dentistry: a review of the literature.

    Science.gov (United States)

    Patil, Manashvini S; Patil, Sanjayagouda B; Acharya, Ashith B

    2008-11-01

    The palatine rugae have interested dentists not only because of their typical pattern of orientation but also because of their usefulness as a reference landmark in various dental treatment modalities. The pattern of orientation is formed by the 12th to 14th week of prenatal life and remains stable until the oral mucosa degenerates after death. The palatine rugae possess unique characteristics that could be used in circumstances in which it is difficult to identify a dead person according to fingerprints or dental records. The authors reviewed the literature by using key words regarding the anatomy, development, classification, clinical significance and forensic aspects of palatine rugae. Palatine rugae are permanent and unique to each person, and clinicians and scientists can use them to establish identity through discrimination. If particular rugae patterns could be established for different ethnic groups, they would assist the forensic odontologist in the identification of a person. Because they are a stable landmark, the palatine rugae also can play a significant role in clinical dentistry.

  16. Clinical Significance and Characterization of Streptococcus tigurinus Isolates in an Adult Population.

    Science.gov (United States)

    Bourassa, Lori; Clarridge, J E

    2015-11-01

    Streptococcus tigurinus is a newly described member of the Streptococcus mitis group. Due to the difficulty in distinguishing viridans group streptococci (VGS) by phenotype, analysis of 16S rRNA sequences is necessary for the accurate identification of most species. Through a laboratory policy of analyzing all clinically significant isolates from the VGS group by16S rRNA gene sequencing, we identified 14 S. tigurinus isolates from 11 patients. The Vitek 2 system most commonly gave an excellent rating to an incorrect identification (e.g., Streptococcus mitis), as did matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) (e.g., Streptococcus oralis). S. tigurinus strains were recovered from numerous body sites, including the blood, peritoneal fluid, bone, synovial fluid, a perianal abscess, and an arm wound. Retrospective chart review indicated that most isolates were clinically significant, with bacteremia (n = 5), soft tissue infections (n = 3) osteomyelitis (n = 2), infected joint prosthesis (n = 2), and peritonitis (n = 2) being the most common, thus expanding the spectrum of disease associated with S. tigurinus. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  17. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. This was an observational study. Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

  18. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo. PMID:25931828

  19. Over-expressions of AMPK subunits in ovarian carcinomas with significant clinical implications

    International Nuclear Information System (INIS)

    Li, Cuilan; Liu, Vincent WS; Chiu, Pui M; Chan, David W; Ngan, Hextan YS

    2012-01-01

    AMP-activated protein kinase (AMPK) has recently been considered as a potential target for cancer therapy. However, the expression status of various subunits of the heterotrimeric AMPK in human cancers is rarely reported. We decided to determine their expressions in ovarian carcinomas and their relationships with the disease. Expressions and locations of the AMPK-α1, -α2, -β1, -β2, -γ1 and -γ2 were detected by quantitative PCR (Q-PCR) and immunohistochemical staining (IHC). Their expression levels in ovarian tumors were compared with normal controls and also correlated with clinicopathological parameters. Except AMPK-α1, expressions of the other five AMPK subunits are significantly higher in ovarian carcinomas as determined by Q-PCR. Although IHC detection of AMPK-γ1 and -γ2 were not successful, over-expressions of AMPK-α2, -β1, and -β2 were further confirmed by IHC. Over-expressions of various AMPK subunits occurred independently and were mainly detected in the cytoplasm. Interestingly, AMPK-α2 and -β1 were also detected in the nucleus and cell membrane, respectively. Clinical correlation analyses indicate that expressions of different AMPK subunits are associated with different subtypes of carcinoma. High expression of AMPK-α2 is significantly associated with endometrioid carcinomas. On the other hand, high expressions of AMPK-β and -γ subunits are associated with mucinous and serous carcinomas, respectively. Furthermore, high expressions of AMPK-β1 and -γ2 are also associated with early and late stages of disease, respectively. Finally, patients with high expression of AMPK-α2 had better prognosis. Aberrant expressions of AMPK subunits may play important roles in ovarian carcinogenesis. Each AMPK subunit may have its own function other than just a component of the AMPK molecule. Correlations with clinical parameters suggest that expressions of AMPK subunits have different clinical implications in ovarian cancer development

  20. Incidence and clinical characteristics of Guillain-Barré syndrome before the introduction of Zika virus in Puerto Rico.

    Science.gov (United States)

    Salinas, Jorge L; Major, Chelsea G; Pastula, Daniel M; Dirlikov, Emilio; Styczynski, Ashley; Luciano, Carlos A; Wojna, Valerie; Sharp, Tyler M; Sejvar, James J; Rivera-Garcia, Brenda

    2017-06-15

    Zika virus has been associated with increases in Guillain-Barré syndrome (GBS) incidence. A GBS incidence estimation and clinical description was performed to assess baseline GBS epidemiology before the introduction of Zika virus in Puerto Rico. Hospitalization administrative data from an island-wide insurance claims database and U.S. Census Bureau population estimates provided a crude GBS incidence for 2013. This estimate was adjusted using the proportion of GBS cases meeting Brighton criteria for confirmed GBS from nine reference hospitals. Characteristics of confirmed GBS cases in the same nine hospitals during 2012-2015 are described. A total of 136 GBS hospitalization claims were filed in 2013 (crude GBS incidence was 3.8 per 100,000 population). The adjusted GBS incidence was 1.7 per 100,000 population. Of 67 confirmed GBS cases during 2012-2015, 66% had an antecedent illness. Median time from antecedent illness to GBS onset was 7days. Most cases (67%) occurred during July-September. Puerto Rico's GBS incidence for 2013 was estimated using a combination of administrative data and medical records review; this method could be employed in other regions to monitor GBS incidence before and after the introduction of GBS infectious triggers. Published by Elsevier B.V.

  1. Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors.

    Science.gov (United States)

    Arena, Christophe; Amoros, Jean Pierre; Vaillant, Véronique; Ambert-Balay, Katia; Chikhi-Brachet, Roxane; Jourdan-Da Silva, Nathalie; Varesi, Laurent; Arrighi, Jean; Souty, Cécile; Blanchon, Thierry; Falchi, Alessandra; Hanslik, Thomas

    2014-10-30

    Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults. The incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case-control analysis with the aim of identifying risk factors for viral AD. During the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 - 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 - 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD. During the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the

  2. [Somewhere in tertiary hospital clinical laboratory in pursuance of personnel sharp injury incidence status investigation and relative factor analysis].

    Science.gov (United States)

    Ding, E; Li, W H; Wang, P; Jian, X D

    2016-07-20

    Objective: Investigation in tertiary hospital clinical laboratory in pursuance of the current state of the sharp injury incidence and influencing factors, analyze the causes and discuss the control strategy. Methods: Application of cross-sectional survey method, according to the unified investigation questionnaire investigation, with chi-square test and the multi-factor Logistic regression analysis methods to analyze research data. Results: The work environment exit contact with injection needles, glass and other sharps, contact with noise, contact with chemicals, contact the patient's blood and other biological specimens, high-risk groups, the patient and family to negative emotions, by patients and their families complain or abuse related influencing factors. In the organization and management factors, in order to work strength is insufficient for the most dissatisfied, protective equipment, medical staff personal cognitive factors of occupational exposure, failing to abide by the medical care standard operation and high incidence after exposure to failed to report. Somewhere in tertiary hospital clinical laboratory in pursuance of the incidence of sharps injuries associated with five factors: different jobs, working strength, protective equipment perfect or not, sharp instrument use and disposal of medical wastes. Conclusion: Tertiary hospital clinical laboratory in pursuance of the incidence of sharp injury related to many factors, Hospitals should formulate corresponding rules and regulations, improve the working environment, the standard safety operation, reduced the incidence of sharps injuries.

  3. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique

    Directory of Open Access Journals (Sweden)

    S Vyawahare

    2013-01-01

    Full Text Available Introduction: In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student′s perceptions should be considered in any discussion of their education, but there has been no systematic examination of India′s undergraduate dental students learning experiences. Aim: This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students′ viewpoint using critical incident technique (CIT. Study Design: The sample group for this investigation came from all 240 3 rd and 4 th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. Results: They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1 The instructor; 2 the patient; 3 the learning process; and 4 the learning environment. Conclusion: The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  4. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique.

    Science.gov (United States)

    Vyawahare, S; Banda, N R; Choubey, S; Parvekar, P; Barodiya, A; Dutta, S

    2013-01-01

    In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student's perceptions should be considered in any discussion of their education, but there has been no systematic examination of India's undergraduate dental students learning experiences. This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students' viewpoint using critical incident technique (CIT). The sample group for this investigation came from all 240 3rd and 4th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1) The instructor; 2) the patient; 3) the learning process; and 4) the learning environment. The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  5. Diffuse malignant pleural mesothelioma in an urban hospital: Clinical spectrum and trend in incidence over time

    International Nuclear Information System (INIS)

    Shepherd, K.E.; Oliver, L.C.; Kazemi, H.

    1989-01-01

    This retrospective analysis reviews the clinical experience of a major urban referral hospital with diffuse malignant pleural mesothelioma during the 14-year period from 1973 through 1986. Seventy-five cases of definite or equivocal mesothelioma were identified. There were four cases of primary malignant peritoneal mesothelioma, seven cases of benign fibrous mesothelioma, and 64 cases of diffuse malignant pleural mesothelioma. In 43 cases (67%) of diffuse malignant pleural mesothelioma, there was historic evidence of asbestos exposure. In 21 cases (33%), there was no known history of asbestos exposure. An increase in annual incidence of diffuse malignant pleural mesothelioma was observed over the study period, from three cases in 1973 to ten cases in 1986. Despite greater awareness of this disease, the diagnosis remains a difficult one to establish given the nonspecific symptoms, signs and radiographic appearance, variable histologic appearance, and poor diagnostic sensitivity and specificity of thoracentesis and closed pleural biopsy. Thoracotomy, thoracoscopy, and CT-guided needle biopsies gave higher yields and are the diagnostic measures of choice when diffuse malignant pleural mesothelioma is suspected

  6. Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease

    International Nuclear Information System (INIS)

    Masatsugu, Toshihiro; Kuroki, Syoji; Tanaka, Masao

    2005-01-01

    We evaluated the differences in diagnosis and treatment for primary hyperparathyroidism (pHPT) in patients with and those without concomitant thyroid disease. One hundred and ten patients with pHPT underwent parathyroid localization and thyroid examination by ultrasonography (US) and sestamibi scintigraphy (MIBI). The clinical and biochemical findings, parathyroid localization, and operations performed were compared in 49 patients without thyroid disease and 61 patients with thyroid disease. Asymptomatic hypercalcemia was significantly more prevalent in patients with concomitant thyroid disease (88.5%) than in those without thyroid disease (49.0%) (P<0.01). The mean serum calcium was significantly higher and the inorganic phosphate level was significantly lower in patients without concomitant thyroid disease than in those with concomitant thyroid disease (P<0.05, P<0.01, respectively). The pathologic parathyroid gland was identified significantly more often in patients without concomitant thyroid disease than in those with concomitant thyroid disease both by US and MIBI (P<0.05). Unilateral exploration was performed more often in patients without thyroid disease than in those with thyroid disease (P<0.01). Primary hyperparathyroidism was diagnosed at an earlier stage in patients with concomitant thyroid disease. Thyroid disease concomitant with pHPT influenced parathyroid localization as well as the indication for minimally invasive parathyroidectomy. (author)

  7. Clinical significance of {sup 123}I-MIBG myocardial scintigraphy in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ido, Akira; Hasebe, Naoyuki; Nakamura, Hideki [Asahikawa Medical Coll., Hokkaido (Japan)] [and others

    1997-09-01

    We studied the abnormality of myocardial sympathetic nervous system in patients with hypertrophic cardiomyopathy using {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in comparison with the parameters of other clinical examinations. In 50 patients with HCM, the heart to mediastinum {sup 123}I-MIBG uptake ratio (H/M) was significantly low and washout rate (WR) of {sup 123}I-MIBG was significantly high respectively compared with normal subjects (n=8). H/M was negatively correlated with serum norepinephrine level, wall thickness or left ventricle, left ventricular mass index, left ventricular end diastolic pressure respectively, and WR was positively correlated with those parameters respectively. On the other hand, LF/HF calculated by spectral analysis in holter electrocardiogram was positively correlated with H/M, and negatively correlated with WR. In HCM, H/M in patients with subjective symptoms was significantly lower than that without subjective symptoms, and WR in patients with paroxysmal atrial fibrillation was significantly higher than that without paroxysmal atrial fibrillation. This study revealed that H/M and WR reflected the severity and the difference of disease type in HCM. In conclusion, {sup 123}I-MIBG contributes to evaluating more details in diagnosis and pathophysiology of HCM. (author)

  8. Clinical significance of radiation therapy in breast recurrence and prognosis in breast-conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)] [and others

    1999-03-01

    Significant risk factors for recurrence of breast cancer after breast-conserving therapy, which has become a standard treatment for breast cancer, are positive surgical margins and the failure to perform radiation therapy. In this study, we evaluated the clinical significance of radiation therapy after primary surgery or breast recurrence. In 344 cases of breast-conserving surgery, disease recurred in 43 cases (12.5%), which were classified as follows: 17 cases of breast recurrence, 13 cases of breast and distant metastasis, and 13 cases of distant metastasis. Sixty-two patients (16.7%) received radiation therapy. A positive surgical margin and younger age were significant risk factors for breast recurrence in patients not receiving postoperative radiation therapy but not in patients receiving radiation therapy. Radiation therapy may be beneficial for younger patients with positive surgical margins. Furthermore, radiation therapy after recurrence was effective in the cases not treated with postoperative radiation but not in cases with inflammatory recurrence. Patients with breast recurrence alone had significantly higher survival rates than did patients with distant metastases regardless of breast recurrence. These findings suggest that the adaptation criteria of radiation therapy for local control must be clarified. (author)

  9. Variability in anatomical features of human clavicle: Its forensic anthropological and clinical significance

    Directory of Open Access Journals (Sweden)

    Jagmahender Singh Sehrawat

    2016-06-01

    Full Text Available Bones can reflect the basic framework of human body and may provide valuable information about the biological identity of the deceased. They, often, survive the morphological alterations, taphonomic destructions, decay/mutilation and decomposition insults. In-depth knowledge of variations in clavicular shape, size and its dimensions is very important from both clinical (fixation of clavicular fractures using external or inter-medullary devices, designing orthopedic fixation devices as well as forensic anthropological perspectives. Human clavicle is the most frequently fractured bone of human skeleton, possessing high degree of variability in its anatomical, biomechanical and morphological features. Extended period of skeletal growth (up to third decade in clavicle imparts it an additional advantage for forensic identification purposes. In present study, five categories of clavicular features like lengths, diameters, angles, indices and robustness were examined to explore the suitability of collarbone for forensic and clinical purposes. For this purpose, 263 pairs of adult clavicles (195 Males and 68 Females were collected from autopsied cadavers and were studied for 13 anatomical features. Gender and occupational affiliations of cadavers were found to have significant influences on anatomical dimensions of their clavicles. Product index, weight and circumference of collarbone were found the best univariate variables, discriminating sex of more than 80% individuals. The best multivariate Function-I (DF: -17.315 + 0.054 CL-L+0.196 CC-R+0.184 DM-L could identify sex and occupation of 89.4% (89.2% Male and 89.7% Female and 65.4% individuals, respectively. All clavicular variables were found bilaterally asymmetric; left clavicles being significantly longer in length, lighter in weight, smooth in texture and less curved than the right side bones. Among non-metric traits, sub-clavian groove, nutrient foramina and ‘type’ of clavicle exhibited

  10. Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis.

    Science.gov (United States)

    Butjosa, Anna; Gómez-Benito, Juana; Huerta-Ramos, Elena; Del Cacho, Núria; Barajas, Ana; Baños, Iris; Usall, Judith; Dolz, Montserrat; Sánchez, Bernardo; Carlson, Janina; Maria Haro, Josep; Ochoa, Susana

    2016-11-30

    This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Clinical significance of thymidine kinase in Egyptian children with acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Adel A Hagag

    2015-01-01

    Full Text Available Background: Acute lymphoblastic leukemia (ALL is the most common childhood malignancy, representing one-third of pediatric cancers. Thymidine kinase-1 (TK-1 is expressed in proliferating cells so elevated TK-1 indicates active tumor growth. Objective: To study the clinical significance of TK-1 in children with ALL. Patients and Methods: This study was carried out on 40 children with newly diagnosed ALL who were admitted to Oncology Unit, Pediatric department, Tanta University (26 males and 14 females with their ages ranged from 4 to 10 years and 30 healthy children of matched age and sex as a control group. For all patients the following were done: Complete blood picture, bone marrow examination, immunophenotyping and TK-1 serum levels. Results: Mean TK-1 level was significantly higher in patients at diagnosis than controls and significantly higher in patients with unfavorable outcome than patients with favorable outcome. Mean TK-1 level was significantly higher in patients in relapse than patients in remission and controls. No significant differences in mean TK-1 level between patients in remission and controls. There were statistically significant differences in disease free survival and overall survival between patients with favorable and unfavorable outcome. Conclusion: From this study we concluded that TK is a helpful marker in diagnosis and follow-up of patients with ALL. Recommendations: Thymidine kinase-1 should be routinely assessed at diagnosis and during follow-up in ALL patients for better diagnostic and prognostic assessment and should be taken in consideration in designing future therapeutic strategies based on patients-specific risk factors.

  12. Expression and clinical significance of FAK and Src proteins in human endometrial adenocarcinoma.

    Science.gov (United States)

    Chatzizacharias, Nikolaos A; Giaginis, Constantinos; Gatzidou, Elisavet; Tsourouflis, Gerasimos; Sfiniadakis, Ioannis; Alexandrou, Paraskevi; Theocharis, Stamatios E

    2011-06-01

    Focal Adhesion Kinase (FAK) is a protein tyrosine kinase, localised in the focal adhesions, which, upon activation interacts with Src, another tyrosine kinase, regulating several cellular signalling pathways. Both enzymes have been implicated in malignant transformation and disease progression. The aim of the present study was to evaluate the clinical significance of FAK and Src expression in cases of endometrial adenocarcinoma. The total (t) and the activated, phosphorylated (p) forms of FAK and Src proteins were assessed immunohistochemically in tumour specimens obtained from 43 endometrial adenocarcinoma patients and were statistically analyzed in relation to various clinicopathological parameters and tumour proliferative capacity, reflected by Ki-67 labelling index. t-FAK positivity was significantly correlated with FIGO disease stage (p = 0.031), and t-FAK overexpression with patients' age (p = 0.015). No statistically significant correlation was identified between t-FAK staining intensity, t-Src positivity, overexpression or staining intensity and any of the clinicopathological parameters tested. No significant correlation was found between neither the positivity nor the intensity of staining of either p-FAk or p-Src with any of the parameters under study. Nonetheless, important, but non-significant, trends were identified between t-FAK staining intensity, t-Src positivity and overexpression and patients' survival (log rank, p = 0.122, p = 0.090 and p = 0.057 respectively). Similarly, p-FAK and p-Src staining characteristics seemed to correlate, even though non-significantly, with patients' survival (log rank, p = 0.051 and p = 0.070 for p-FAK and p-Src expression, respectively; log rank, p = 0.134 and p = 0.110 for p-FAK and p-Src staining intensity, respectively). These results support an important potential role of FAK-Src signalling in endometrial malignant disease progress and render further research in this field a necessity.

  13. [Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis].

    Science.gov (United States)

    Lin, Q; Ding, S J; Zhu, T H; Li, T T; Huang, X F; Zhang, X M

    2018-03-25

    Objective: To determine the levels of coagulation and inflammatory factors in women with moderate and severe ovarian endometriosis so as to investigate the possible role of coagulation and inflammatory factors in the pathogenesis, diagnosis and treatment of this disease. Methods: From June 2015 and June 2017, clinical data of 366 patients with pathologically diagnosed moderate and severe ovarian endometriosis (case group) and 244 patients with pathologically diagnosed benign ovarian cysts (control group) in Women's Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The levels of coagulation indicators, inflammatory factors and serum tumor markers were measured. Then, the values of these indicators in diagnosis of endometriosis were analyzed. Results: (1) The levels of plasma prothrombin time (PT) and thrombin time (TT) in patients with ovarian endometriosis [median: 12.8 s (range: 12.4-13.2 s) and 15.5 s (range: 15.1-15.9 s), respectively] were significantly shorter than those with benign ovarian cysts [median: 13.0 s (range: 12.5-13.4 s) and 15.7 s (range: 15.3-16.1 s), respectively; all P endometriosis were significantly higher than those with benign ovarian cysts [median: 2.8 g/L (range: 2.6-3.2 g/L) and 0.6 mg/L (range: 0.4-1.2 mg/L), respectively; P =0.000]. Moreover, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio [PLR; median: 2.3 (range: 1.8-3.1) and 144 (range: 113-179), respectively] in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts [median: 2.1 (range: 1.6-2.8) and 128 (range: 104-165), respectively; P endometriosis, the levels of PT were significantly shorter in stage Ⅳ endometriosis than that in stage Ⅲ endometriosis ( P endometriosis were significantly higher than those in patients with stage Ⅲ endometriosis ( P endometriosis, and the detection of coagulation and inflammatory factors may be have important clinical significance for the

  14. How the detector resolution affects the clinical significance of SBRT pre-treatment quality assurance results.

    Science.gov (United States)

    Bruschi, A; Esposito, M; Pini, S; Ghirelli, A; Zatelli, G; Russo, S

    2017-12-01

    Aim of this work was to study how the detector resolution can affect the clinical significance of SBRT pre-treatment volumetric modulated arc therapy (VMAT) verification results. Three detectors (PTW OCTAVIUS 4D 729, 1500 and 100 SRS) used in five configurations with different resolution were compared: 729, 729 merged, 1500, 1500 merged and 1000 SRS. Absolute local gamma passing rates of 3D pre-treatment quality assurance (QA) were evaluated for 150 dose distributions in 30 plans. Five different kinds of error were introduced in order to establish the detection sensitivity of the three devices. Percentage dosimetric differences were evaluated between planned dosevolume histogram (DVH) and patients' predicted DVH calculated by PTW DVH 4D® software. The mean gamma passing rates and the standard deviations were 92.4% ± 3.7%, 94.6% ± 1.8%, 95.3% ± 4.2%, 97.4% ± 2.5% and 97.6% ± 1.4 respectively for 729, 729 merged, 1500, 1500 merged and 1000 SRS with 2% local dose/2mm criterion. The same trend was found on the sensitivity analysis: using a tight gamma analysis criterion (2%L/1mm) only the 1000 SRS detected every kind of error, while 729 and 1500 merged detected three and four kinds of error respectively. Regarding dose metrics extracted from DVH curves, D50% was within the tolerance level in more than 90% of cases only for the 1000 SRS. The detector resolution can significantly affect the clinical significance of SBRT pre-treatment verification results. The choice of a detector with resolution suitable to the investigated field size is of main importance to avoid getting false positive. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. Childhood sarcoidosis in Denmark 1979-1994: incidence, clinical features and laboratory results at presentation in 48 children

    DEFF Research Database (Denmark)

    Hoffmann, A L; Milman, N; Byg, K E

    2004-01-01

    .7-15). In 1979-1994 the incidence was 0.29 per 100000 person-years y of age. The incidence was 0.06 in children y of age and increased gradually with age to 1.02 in children aged 14-15 y. General malaise, fever, weight loss, abdominal discomfort, respiratory symptoms, lymphadenopathy......AIM: To describe the incidence, clinical presentation and paraclinical findings in childhood sarcoidosis in Denmark, 1979-1994. METHODS: Patients (n = 5536) with a diagnosis of sarcoidosis were drawn from the nationwide Patient Registry; 81 patients were y of age. The diagnosis...... of sarcoidosis was reconfirmed in 48/81 (59%) patients. In 35/48 (73%) patients, diagnosis was verified by histology, and in 13 it was substantiated by paraclinical/clinical findings. RESULTS: The series comprised 26 boys and 22 girls (male/female ratio 1.18). Median age at diagnosis was 13 y (range 0...

  16. Clinically significant hemolytic disease of the newborn secondary to passive transfer of anti-D from maternal RhIG.

    Science.gov (United States)

    Cohen, Daniel N; Johnson, Mary S; Liang, Wayne H; McDaniel, Heather L; Young, Pampee P

    2014-11-01

    RhIG is used worldwide to reduce the incidence of alloimmunization to D during pregnancy. We report a case of clinically significant neonatal hemolysis mediated by maternally administered RhIG. A 25-year-old, O-, primigravid mother with a negative antenatal antibody screen delivered a 6-lb 4-oz, blood group A, D+ baby girl at 36.5 weeks' gestation. Prenatal care included a dose of intramuscular RhIG at 28 weeks' gestation. At delivery, the newborn was markedly jaundiced with a total bilirubin of 6.3 mg/dL, which reached more than 20 mg/dL after 6 days. The newborn's lactate dehydrogenase (LDH) was 485 U/L (normal, newborn's direct antiglobulin test (DAT) was positive for immunoglobulin (Ig)G, with an anti-D identified by elution studies. The possibility of hemolytic disease of the newborn (HDN) due to anti-A was considered, but ultimately ruled out by the absence of anti-A1 in the eluate. The newborn's hyperbilirubinemia was adequately managed with phototherapy. Analysis of the mother's plasma 10 days postpartum revealed an anti-D titer of 8. Two months after birth, the child's laboratory studies, DAT, antibody screen, and peripheral smear were unremarkable. In the context of neonatal anemia, elevated LDH, and reticulocytosis, a positive IgG DAT with anti-D identified in the eluate suggests RhIG-mediated HDN. This appears to be a rarely reported event. © 2014 AABB.

  17. The clinical significance of internal mammary lymph node (IMLN) biopsy during autologous reconstruction in breast cancer patients.

    Science.gov (United States)

    Zhang, Xiaofei; Jaffer, Shabnam; Bleiweiss, Ira J; Nayak, Anupma

    2015-10-01

    The clinical significance of IMLN metastases in breast cancer is controversial. Although IMLN status is an integral part of current AJCC staging of breast cancer, the elective sampling of IMLN is not part of routine surgery for breast cancer. The purpose of this study was to determine the incidence of IMLN metastases, associated risk factors if any, and its impact on further management and outcome. We retrospectively studied 470 cases that underwent autologous reconstruction surgery between 2002 and 2014. Of 470 cases, 157 breast cancer cases had histology-confirmed IMLN removal during the reconstruction. Only 9 patients (6 %) showed IMLN metastases as compared to 45 (34 %) that showed axillary nodal metastases (p reconstruction had loco-regional recurrence/metastasis as compared to 20 of 293 (7 %) patients without IMLN removal (p > 0.05) (follow-up, 1-134 months). The overall rate of IMLN metastases (6 %) is much lower than the rate of axillary node metastases. Selective biopsy of IMLNs in patients with breast cancer, especially if younger than 40 years, and with lymphovascular invasion and negative PR status, may guide adjuvant treatment.

  18. CLINICAL SIGNIFICANCE OF ANTIPHOSPHOLIPID ANTIBODIES AND GENE MUTATIONS IN HEMOSTASIS OF CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND JUVENILE DERMATOMYOSITIS

    Directory of Open Access Journals (Sweden)

    O.A. Solntseva

    2006-01-01

    Full Text Available Thrombophilia in children with diffuse connective tissue disorders as systemic lupus erythematosus (SLE and juvenile dermatomyositis (JDM could arise from various causes including peripherial blood circulation of antiphospholipid antibodies (APH and genetic mutations in the system of hemostasis. Thrombosis is a serious and prognostically unfavorable complication that has negative impact on the underlying disease course. The study included 96 children, 65 of them had diagnosed SLE and the other 31 had JDM. The Elisa method was used to detect antiphospholipid antibodies, coagulation method was used to detect lupus anticoagulant (LAC and antibodies to cardiolipins (anticl, ?2:glycoprotein 1 (anti ? 2 gp 1 and prothrombin (APT. The PCR method (DNA diagnostics was used to detect DNA mutations as factor resistance to of activated protein c (Leiden 5,10 methylen tetrahydrofolate reductase (MTHFR gene polymorphism. The incidence of APL antibodies was registered in 61.5% patients with SLE and in 32.2% of patients with JDM. Ac ligg, anti ?2 gp 1 Igg were clinically significant in thrombotic events in patients with SLE and JDM, and so was LAC in patients with SLE. The prevalence of the hemostasis system mutations is concordant with reported data. Conclusion thrombophilia is frequently associated with APH antibodies or combination of APH antibodies with genetic abnormalities. Sole genetic mutations are salient in patients with JDM.Key words: thrombophilia, systemic lupus erythematosus, juvenile dermatomyositis, antiphospholipid antibodies, lupus anticoagulant, leiden, prothrombin, methylentet rahydrofolate reductase.

  19. The incidence of Trichomonas vaginalis infection in women attending nine sexually transmitted diseases clinics in the USA.

    Science.gov (United States)

    Alcaide, Maria L; Feaster, Daniel J; Duan, Rui; Cohen, Stephanie; Diaz, Chanelle; Castro, Jose G; Golden, Matthew R; Henn, Sarah; Colfax, Grant N; Metsch, Lisa R

    2016-02-01

    Trichomoniasis (TV) is associated with an increased risk of acquisition of sexually transmitted diseases (STDs) and HIV. The purpose of this study is to evaluate factors associated with incidence TV among female STD clinic attendees in the USA. Data were collected from women participating in a randomised controlled trial evaluating brief risk reduction counselling at the time of HIV testing to reduce sexually transmitted infections (STIs) incidence in STD clinics. Participants recruited from STD clinics underwent STI testing at baseline and 6-month follow-up. TV testing was performed using Nucleic Acid Amplification Test. 1704 participants completed study assessments. Prevalence of TV was 14.6%, chlamydia 8.6%, gonorrhoea 3.0%, herpes simplex virus 2 44.7% and HIV 0.4%. Cumulative 6-month incidence of TV was 7.5%. Almost 50% of the incident TV cases had TV at baseline and had received treatment. Factors associated with incidence of TV were having chlamydia, TV and HIV at baseline: TV relative risk (RR)=3.37 (95% CI 2.35 to 4.83, pTV is common among STD clinic attendees; and baseline TV is the main risk factor for incident TV, suggesting high rates of reinfection or treatment failures. This supports the importance of rescreening women after treatment for TV, evaluating current treatment regimens and programmes to ensure treatment of sexual partners. NCT01154296. 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/

  20. Clinical Significance of 18F-FDG-PET in Invasive Lobular Carcinoma.

    Science.gov (United States)

    Fujii, Takaaki; Yajima, Reina; Kurozumi, Sasagu; Higuchi, Toru; Obayashi, Sayaka; Tokiniwa, Hideaki; Nagaoka, Rin; Takata, Daisuke; Horiguchi, Jun; Kuwano, Hiroyuki

    2016-10-01

    The diagnostic utility of 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) for breast cancer is controversial. The histological type or tumor size of breast cancer has been reported to be associated with a greater likelihood of positive FDG uptake. Compared to invasive ductal carcinomas (IDCs), invasive lobular carcinomas (ILCs) have a lower level of FDG uptake and are detected at a significantly lower sensitivity. The role of preoperative FDG-PET for ILCs may, thus, be limited. Few data evaluating the significance of FDG-PET in ILCs are available. Here, we evaluated the clinical significance of FDG-PET for ILC patients. We retrospectively investigated the cases of 196 consecutive patients with primary breast cancer who were diagnosed as having ILC (n=15) or IDC (n=181) and underwent FDG-PET preoperatively. Fifteen (7.7%) of patients were histopathologically diagnosed as ILC. A univariate analysis revealed that tumor size, extent of tumor, estrogen receptor (ER) expression and progesterone receptor (PgR) expression were significantly different between the ILC and IDC groups. The maximum standardized uptake value (SUV max ) values of the primary tumors were not significantly different between the two groups but, regardless of the larger size of tumor or ductal spread, the SUV max was relatively lower in the ILC group compared to the IDC group. The tumors in two ILC cases showed no FDG uptake. Among the ILC cases, there were linear associations between SUV max and tumor size and between SUV max and the nuclear grade by Pearson correlation (r=0.447, p=0.048 and r=0.519, p=0.024, respectively). Our findings imply that the preoperative FDG uptake in ILC may be reflective of the tumor size and the nuclear grade of the tumor. FDG uptake may be useful and predictive of aggressive features or prognosis in ILC patients. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  1. The prognostic significance of UCA1 for predicting clinical outcome in patients with digestive system malignancies.

    Science.gov (United States)

    Liu, Fang-Teng; Dong, Qing; Gao, Hui; Zhu, Zheng-Ming

    2017-06-20

    Urothelial Carcinoma Associated 1 (UCA1) was an originally identified lncRNA in bladder cancer. Previous studies have reported that UCA1 played a significant role in various types of cancer. This study aimed to clarify the prognostic value of UCA1 in digestive system cancers. The meta-analysis of 15 studies were included, comprising 1441 patients with digestive system cancers. The pooled results of 14 studies indicated that high expression of UCA1 was significantly associated with poorer OS in patients with digestive system cancers (HR: 1.89, 95 % CI: 1.52-2.26). In addition, UCA1 could be as an independent prognostic factor for predicting OS of patients (HR: 1.85, 95 % CI: 1.45-2.25). The pooled results of 3 studies indicated a significant association between UCA1 and DFS in patients with digestive system cancers (HR = 2.50; 95 % CI = 1.30-3.69). Statistical significance was also observed in subgroup meta-analysis. Furthermore, the clinicopathological values of UCA1 were discussed in esophageal cancer, colorectal cancer and pancreatic cancer. A comprehensive retrieval was performed to search studies evaluating the prognostic value of UCA1 in digestive system cancers. Many databases were involved, including PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure and Wanfang database. Quantitative meta-analysis was performed with standard statistical methods and the prognostic significance of UCA1 in digestive system cancers was qualified. Elevated level of UCA1 indicated the poor clinical outcome for patients with digestive system cancers. It may serve as a new biomarker related to prognosis in digestive system cancers.

  2. Clinical significance of up-regulated ID1 expression in Chinese de novo acute myeloid leukemia.

    Science.gov (United States)

    Zhou, Jing-Dong; Yang, Lei; Zhu, Xiao-Wen; Wen, Xiang-Mei; Yang, Jing; Guo, Hong; Chen, Qin; Yao, Dong-Ming; Ma, Ji-Chun; Lin, Jiang; Qian, Jun

    2015-01-01

    To investigate the clinical significance of ID1 expression in Chinese de novo AML patients. Real-time quantitative PCR was carried out to detect the status of ID1 expression in 102 de novo AML patients and 28 controls. ID1 transcript level was significantly increased in AML compared to normal controls (p=0.029). The age in the patients with high ID1 expression is significantly older than in those with low ID1 expression (p=0.044). ID1 overexpression occurred with the highest frequency in the patients with poor karyotype (7/7, 100%), lower frequency in the patients with intermediate karyotype (28/60, 47%), and the lowest frequency in the patients with favorable karyotype (12/31, 39%). Both whole AML and non-M3 patients with high ID1 expression had significantly lower rate of complete remission than those with low ID1 expression (p=0.007 and 0.038). ID1 high-expressed patients showed significantly shorter overall survival (OS) than ID1 low-expressed patients in both whole AML and non-M3 according to Kaplan-Meier analysis (p=0.007 and 0.040). However, multivariate analysis indicated that ID1 overexpression was not an independent risk factor in both whole AML and non-M3 patients. However, the adverse impact of ID1 overexpression on outcome was revealed by both Kaplan-Meier analysis and multivariate analysis in the non-M3 patients less than 60 years old. Our study reveals that ID1 overexpression may be associated with higher risk karyotype classification and act as an independent risk factor in young non-M3 patients.

  3. Clinical significance of nuclide renal dynamic imaging and urine microalbumin inspection of type II diabetic patients

    International Nuclear Information System (INIS)

    Wang Ying; Jin Yaoge; Shi Xueying; Gao Yong

    2011-01-01

    To investigate clinical value of glomerular filtration rate (GFR) and urine microalbumin in early diagnosis of diabetic nephropathy, GFR in 60 patients with type II diabetes mellitus and a control group of 20 were determined using 99 Tc m DTPA renal dynamic imaging and urine microalbumin. The following results were obtained.Among the 60 patients with diabetes, 5 patients had increased GFRs of, 142.0±13.6 mg/min, which was 35% higher than that of controls and differed significantly from the control (P<0.01); 20 patients had GFRs of 102.2±10.2 mg/min, which differed little from the control; and 35 patients had declined GFRs of 57.2±18.0 mg/min, which was 54.3% lowered than the control and differed significantly from the control (P<0.01). The urine microalbumin in diabetes patients was significantly higher than the control. In conclusion, the GFR is a good index of the early kidney injury in diabetic patients. The combined detection of GFR and urine microalbumin can improve the early diagnosis of diabetic nephropathy, and may help to monitor the treatment response and assess prognosis. (authors)

  4. Clinical significance of FLG gene mutations in children with atopic dermatitis

    Directory of Open Access Journals (Sweden)

    E. E. Varlamov

    2015-01-01

    Full Text Available Skin barrier dysfunction due to deficiency of the skin protein filaggrin is one of the factors involved in the pathogenesis of atopic dermatitis. Objective: to determine the clinical significance of 2282 del CAGT, R501X, R2447X, and S3247X mutations in the FLG gene in children with atopic dermatitis. The investigation included 58 children with atopic dermatitis. A molecular genetic analysis of the four mutations in the FLG gene was done in all the children. In the patients with FLG gene mutations, there was a tendency towards a higher frequency of sensitization to house dust allergens, significantly more often sensitization to cat epidermal allergen, and significantly higher levels of specific IgE to the cat epidermis. Conclusion. Mutations in the FLG gene encoding the protein filaggrin raise the risk for sensitization to domestic and epidermal allergens and, in case of already existing sensitization to the cat epidermis, the patients are found with a high degree of probability to have the high concentration of specific IgE to this allergen. The above fact justifies the need to place special emphasis on measures to eliminate house dust allergens, and cat epidermis allergen in particular, and to personalize approaches to therapy and prevention of atopic dermatitis in children. 

  5. Clinical Significance of Reticulocyte Hemoglobin Content in the Diagnosis of Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Mustafa Karagülle

    2013-06-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the clinical significance of reticulocyte hemoglobin content (CHr in the diagnosis of iron deficiency anemia (IDA and to compare it with other conventional iron parameters. METHODS: A total of 32 female patients with IDA (serum hemoglobin 120 g/L and serum ferritin <20 ng/mL were enrolled. RESULTS: CHr was 24.95±3.92 pg in female patients with IDA and 29.93±2.96 pg in female patients with iron deficiency. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, and transferrin saturation and a significant negative correlation with transferrin and total iron-binding capacity. The cut-off value of CHr for detecting IDA was 29 pg. CONCLUSION: Our data demonstrate that CHr is a useful parameter that can be confidently used in the diagnosis of IDA, and a CHr cut-off value of 29 pg predicts IDA.

  6. Clinical significance of anti-domain 1 β2-glycoprotein I antibodies in antiphospholipid syndrome.

    Science.gov (United States)

    Iwaniec, Teresa; Kaczor, Marcin P; Celińska-Löwenhoff, Magdalena; Polański, Stanisław; Musiał, Jacek

    2017-05-01

    Antiphospholipid syndrome (APS) is characterized by the presence of circulating antiphospholipid antibodies (aPL) in patients with thrombosis and/or pregnancy morbidity. In APS patients anti-domain 1 β2-glycoprotein I (anti-D1 β2GPI) IgG antibodies correlate strongly with thrombosis and to the lesser extent, with pregnancy complications. The aim of this study was to assess clinical utility of the anti-D1 β2GPI antibodies in the diagnosis and risk stratification of antiphospholipid syndrome. In this retrospective study 202 autoimmune patients were studied (primary APS - 58, secondary - 45 SLE - 99). Anticardiolipin (aCL) and anti-β 2 GPI (aβ 2 GPI antibodies) (IgG and IgM class) together with anti-D1 IgG were tested with QUANTA Flash chemiluminescent immunoassay and lupus anticoagulant (LA) with coagulometric methods. The highest anti-D1 values were observed in triple positive patients as compared to patients with other antiphospholipid antibody profiles. A strong correlation was found between levels of anti-D1 IgG and a β2GPI IgG antibodies for all patients analyzed (Spearman's ρ=0.87; p<0.0001). Anti-D1 IgG antibodies increase specificity resulting from classic aPL positivity but at the expense of sensitivity. Anti-D1 test does not add accuracy in predicting APS thrombotic complications on the top of accuracy offered by classic aPL tests and their profiles. Anti-D1 IgG antibodies did not add diagnostic power to the standard laboratory aPL tests as assessed by this retrospective study. A true clinical significance of anti-D1 antibodies in thrombotic risk stratification of aPL positive patients will require a properly designed clinical prospective trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. [The concept of cycloid psychoses. Developments, clinical significance and the state of research].

    Science.gov (United States)

    Pfuhlmann, B

    1998-01-01

    Karl Leonhard developed the concept of cycloid psychoses by further elaborating previous findings of Carl Wernicke and Karl Kleist. A phasic alternating and recurrent as well as remittent course without residual states and a bipolar and polymorphous symptomatology are main features of cycloid psychoses. The symptom constellations are typical in a manner that, in most cases, allows establishing a diagnosis solely by carefully examining a cross-section of the clinical syndromes. 3 sub-forms are differentiated. Anxiety-happiness psychosis is characterised by extreme affective alterations with paranoid anxiety on the one hand and ecstasy with feelings of elation on the other. Formal thought disorder with incoherence, mainly as "incoherence of thematic choice", on the excited pole and perplexedness on the inhibited pole are the central elements of confusion psychosis. Motility psychosis shows hyperkinesis or akinesis of a purely psychomotor nature affecting predominantly expressive and reactive motions as main features. A description of Leonhard's highly operationalised diagnostic criteria for each sub-form of cycloid psychoses is followed by an account of the clinical significance of the concept of cycloid psychoses. Furthermore, important findings of recent research are summarised. The findings point to the fact that cycloid psychoses represent a nosological entity that can be clearly separated from schizophrenic as well as from affective psychoses. Schizophreniform, schizoaffective or acute transient psychotic disorders are also not identical with cycloid psychoses. According to the criteria of DSM-IV or ICD-10, cycloid psychoses are spread over a broad spectrum of heterogeneous diagnoses, thus hampering the recognition of the clinical and scientific importance of this homogeneous group of psychoses.

  8. A PROSPECTIVE STUDY ON INCIDENCE, AETIOPATHOGENESIS, CLINICAL PRESENTATION, MANAGEMENT AND PROGNOSIS OF LIVER ABSCESS

    Directory of Open Access Journals (Sweden)

    Geetha Danasekaran

    2017-05-01

    Full Text Available BACKGROUND Liver abscess continues to be a major diagnostic and therapeutic challenge to the medical fraternity. It is a life-threatening and a potentially serious condition if left untreated. Therefore, it is very important for prompt diagnosis and appropriate management at the earliest. This study was conducted to assess the incidence, aetiology, clinical presentation, management and prognosis of liver abscess in patients attending a tertiary care referral hospital. MATERIALS AND METHODS This study was conducted in Madurai Medical College Hospital, Madurai, from March 2015 to August 2016. The study population consists of patients admitted in General Surgery Wards of Madurai Medical College and Hospital, Madurai, with features suggestive of liver abscess. RESULTS Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest organism causing pyogenic liver abscess. Abdominal pain was the commonest symptom of liver abscess followed by abdominal distension and fever. Right hypochondrial tenderness and intercostal tenderness were the common clinical signs in liver abscess. There was a predominant involvement of the right lobe of the liver. Percutaneous aspiration of abscess with antiamoebic and antibiotics forms the mainstay of treatment. Percutaneous catheter drainage is method of choice in failed aspiration and laparoscopic drainage or laparotomy and drainage is indicated in ruptured liver abscess. CONCLUSION Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two-thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest

  9. Incidence, risk factors, and clinical characteristics of unexplained visual loss after intraocular silicone oil for macula-on retinal detachment

    NARCIS (Netherlands)

    Scheerlinck, Laura M.; Schellekens, Peter A.; Liem, Albert T.; Steijns, Daan; van Leeuwen, R

    2016-01-01

    Purpose: To investigate the incidence, risk factors, and clinical characteristics of unexplained visual loss after macula-on rhegmatogenous retinal detachment (RRD). Methods: Retrospective cohort of patients with primary macula-on rhegmatogenous retinal detachment treated by vitrectomy with gas or

  10. Radiating low back pain in general practice : Incidence, prevalence, diagnosis, and long-term clinical course of illness

    NARCIS (Netherlands)

    Spijker-Huiges, Antje; Groenhof, Feikje; Winters, Jan C.; van Wijhe, Marten; Groenier, Klaas H.; van der Meer, Klaas

    Objective. The aim of this study was to calculate the incidence and prevalence of radiating low back pain, to explore the long-term clinical course of radiating low back pain including the influence of radiculopathy (in a subsample of the study population) and non-radiating low back pain thereon,

  11. Change in anatomic distribution and incidence of colorectal carcinoma over a period of 15 years - Clinical considerations

    NARCIS (Netherlands)

    Mensink, PBF; Kolkman, JJ; van Baarlen, J; Kleibeuker, JH

    2002-01-01

    PURPOSE: Colorectal cancer is the second most common cancer in the Netherlands. Its incidence rates are among the highest in Europe. In the past decades, a right-sided shift of the subsite location of colorectal cancer has been reported. These changes in anatomic distribution might have clinical

  12. Clinical significance of sleep bruxism on several occlusal and functional parameters.

    Science.gov (United States)

    Ommerborn, Michelle A; Giraki, Maria; Schneider, Christine; Fuck, Lars Michael; Zimmer, Stefan; Franz, Matthias; Raab, Wolfgang Hans-michael; Schaefer, Ralf

    2010-10-01

    The aim of this study was to evaluate the association between various functional and occlusal parameters and sleep bruxism. Thirty-nine (39) sleep bruxism patients and 30 controls participated in this investigation. The assessment of sleep bruxism was performed using the Bruxcore Bruxism-Monitoring Device (BBMD) combined with a new computer-based analyzing method. Sixteen functional and/or occlusal parameters were recorded. With a mean slide of 0.95 mm in the sleep bruxism group and a mean slide of 0.42 mm in the control group (Mann Whitney U test; p<0.003), results solely demonstrated a significant group difference regarding the length of a slide from centric occlusion to maximum intercuspation. The results suggest that the slightly pronounced slide could be of clinical importance in the development of increased wear facets in patients with current sleep bruxism activity. Following further evaluation including polysomnographic recordings, the BBMD combined with this new analyzing technique seems to be a clinically feasible instrument that allows the practitioner to quantify abrasion over a short period.

  13. Imaging and clinical significance of hepatic portal venous gas seen in adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Aikawa, Hisayuki; Mori, Hiromu; Miyake, Hidetoshi (Oita Medical Univ. (Japan)) (and others)

    1994-08-01

    In 10 adult patients with hepatic portal venous gas (HPVG), the clinical significance of HPVG and the efficacy of X-ray computed tomography (CT) were evaluated. HPVC was associated with ischemic bowel disease (n=3), trauma (n=4), liver abscess (n=1), sepsis (n=1) and unknown etiology (n=1). The diagnostic ability of CT for the detection of HPVG was far superior to that of plain abnormal radiograph. Of 9 patients who underwent CT, HPVG located in the left hepatic lobe in all patients, and also in right hepatic lobe in 7 patients. Gas could be recognized in the left lobe and the anterior segment of the right lobe more clearly than in the posterior segment of the right lobe because of its larger amount of intravenous collection. The mortality rate of our cases was 100%. Gas was demonstrated simultaneously in the portal vein radicles and hepatic veins on CT in 4 patients with no clinical evidence of sepsis, which suggested the possibility of intraparenchymal shift of gas from the portal vein into the hepatic vein. In a single case with sepsis, gas was noted in various vessels, including arteries, in addition to the portal venous system. The authors conclude that HPVG is still a grave sign in Japan and prompt appropriate treatment is required. CT may be of great value in the early detection of HPVG and may indicate its etiology. (author).

  14. A clinically significant erythrocyte antibody detectable only by 51Cr survival studies

    International Nuclear Information System (INIS)

    Baldwin, M.L.; Barrasso, C.; Ness, P.M.; Garratty, G.

    1983-01-01

    Hemolytic transfusion reactions typically are explained by red cell serologic incompatibilities. We describe a patient in whom a clinically significant red cell alloantibody could not be demonstrated, despite the occurrence of several clinically severe hemolytic reactions. Serologic studies using multiple techniques demonstrated only an anti-Bga; these studies included standard procedures as well as more sensitive experimental techniques. A 51Cr survival study using red cells from a random unit, compatible in vitro with conventional techniques, showed 72 percent survival at 1 hour and 7 percent survival at 24 hours. R2R2 (hr'' (e) negative) red cells in a second 51Cr survival study showed 90 percent survival at 1 hour and 92 percent survival at 6 hours. The patient was transfused with R2R2 units which were tolerated well and survived normally. Extensive serologic testing still demonstrated only an anti-Bga. A third 51Cr survival study, 10 months after the first study, with an R1R1 (hr'' (e) positive) sample showed 90 percent survival at 1 hour and 42 percent survival at 6 hours. A fourth study using a larger aliquot of R2R2 (hr''(e)negative) 51Cr-labeled red cells, examined over 2 weeks showed a near normal 21-day survival of 50 percent. These 51Cr