WorldWideScience

Sample records for included adjunct eric

  1. The Eric Cantor Upset

    DEFF Research Database (Denmark)

    Ashbee, Edward

    2014-01-01

    US update. The surprise primary defat of Eric Cantor, which shows that the Tea Party is still in business......US update. The surprise primary defat of Eric Cantor, which shows that the Tea Party is still in business...

  2. Adjunct Accounting

    Science.gov (United States)

    Lesesne, Cherise

    2012-01-01

    With colleges and universities recruiting more adjunct professors, schools have been able to reduce the costly expenses of large salary and benefit packages that are typically associated with full-time employees. Yet, schools have started to re-evaluate their use of adjunct professors in order to comply with the Affordable Care Act (ACA), dubbed…

  3. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

    International Nuclear Information System (INIS)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

  4. Women's Suffrage: A Sampler of ERIC Resources.

    Science.gov (United States)

    Risinger, C. Frederick

    1995-01-01

    Discusses the resources available from the ERIC System on issues related to women's suffrage and women's rights. Includes an annotated bibliography of six resources, including lesson plans and historiography reviews. (CFR)

  5. AskERIC and the Virtual Library: Lessons for Emerging Digital Libraries.

    Science.gov (United States)

    Lankes, R. David

    1995-01-01

    Explores major issues in creating and maintaining Internet services for AskERIC, an educational digital library started by the Educational Resources Information Center (ERIC) system. Highlights include the importance of user input to shape the service, human intermediaries, AskERIC as a virtual library, future directions, and a copy of the AskERIC…

  6. Aseka, Eric Masinde

    African Journals Online (AJOL)

    Aseka, Eric Masinde. Vol 24, No 3 (1999) - Articles Ethnicity, Governance and Prevention of Conflict: State of the Issue and Research Perspectives Abstract PDF. ISSN: 0850-3907. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  7. Cultivating adjunct faculty: strategies beyond orientation.

    Science.gov (United States)

    Santisteban, Lisette; Egues, Aida L

    2014-01-01

    Schools of nursing across the country are using adjunct faculty to meet clinical, didactic, and online instructional needs of their nursing programs. While adjunct faculty are vital to the alleviation of the nursing shortage and the shortage of nursing faculty, and to the preparation of the current and future nursing workforce, little is known about cultivating adjunct faculty as nurse educators. To investigate the cultivation of adjunct nursing faculty, the authors engaged in a comprehensive review of the extant literature of primary databases and reports from accredited nursing programs and professional nursing organizations. Scant literature exists that seeks to identify issues associated with developing adjunct nursing faculty as educators, including role transition needs, and useful approaches to orientation, mentorship, or retention. Working toward cultivation of adjunct faculty includes innovative support measures beyond simple orientation. Orientation should be comprehensive, and move to mentorship as a key component that helps establish a sustainable nurse educator career for adjunct nursing faculty. It is incumbent upon schools of nursing to cultivate their adjunct faculty, and this article includes creative approaches to doing so, with recommendations for nursing education, nursing practice, and nursing research settings. While adjunct faculty may successfully meet some of the challenges faced by nursing programs, they themselves face many challenges that may hinder their success as nurse educators. © 2014 Wiley Periodicals, Inc.

  8. Biting. ERIC/EECE Report.

    Science.gov (United States)

    Cesarone, Bernard

    2003-01-01

    This column summarizes recent ERIC documents and journal articles, and highlights some World Wide Web resources, that discuss issues related to the problem of children biting in preschool. (Contains 13 annotated summaries.) (SD)

  9. Women's Issues in an Era of Inclusion. ERIC/ChESS.

    Science.gov (United States)

    Risinger, C. Frederick

    1997-01-01

    Presents a brief annotated bibliography of sources addressing women's issues within the ERIC database. The sources include journal articles, monographs, ERIC Digests, and folksong collections. They cover aspects of women and education, including women in the curriculum, women's suffrage, and women's history. (MJP)

  10. Report of the ERIC Management Review Group.

    Science.gov (United States)

    Carter, Launor F.; And Others

    The mission of the ERIC Management Review Group was to examine the practices and procedures used by Central ERIC Management in their guidance and management of the 19 ERIC clearinghouses. The major topics covered in this report are: recommendations; the role of the clearinghouses; the bibliographic and documentation function; the interpretation…

  11. Gregory Bateson and Eric Voegelin

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    2017-01-01

    This article argues that two important thinkers of the 20th century, Gregory Bateson (1904-1980) and Eric Voegelin (1901-1985), developed a set of ideas that are of importance to the history of the human sciences. The article also argues that their ideas display similarities that have not yet been...

  12. Recent International Documents and Journal Articles from the ERIC Database.

    Science.gov (United States)

    International Journal of Early Years Education, 1998

    1998-01-01

    Annotates recent international documents and journal articles from the ERIC database. Document topics include racial equality, and balancing early childhood education and work. Journal article topics include foster care in Iraqi Kurdistan; child care in Sweden; teacher-child interaction in Australian centers; teacher education in Brazil, Iceland,…

  13. ERIC Abstracts: A Collection of ERIC Document Resumes on Educational Planning. ERIC Abstracts Series, Number Fourteen.

    Science.gov (United States)

    American Association of School Administrators, Washington, DC.

    ERIC abstracts on educational planning, announced in RIE through December 1970, are presented. The key terms used in compiling this collection are "critical path method,""educational planning,""operations research," and "program budgeting." The following information is presented for each document: Author, title, place of publication, publisher,…

  14. Adjunctive Therapies for Bacterial Keratitis.

    Science.gov (United States)

    Dakhil, Turki Abdulaziz Bin; Stone, Donald U; Gritz, David C

    2017-01-01

    Bacterial keratitis is the most common type among all types of infectious keratitis. Currently, antibiotics are the main-stay of treatment. The objective of this systematic review is to review published clinical studies which discuss the adjunctive treatment of bacterial keratitis to guide clinical decision-making. We reviewed the role of a variety of medications and surgeries which can help in managing bacterial keratitis complications, which include as thinning, perforation, and impaired wound healing. We have included appropriate animal and laboratory studies, case reports and case series, and randomized clinical trials regarding each therapy.

  15. The Gilded Age: An ERIC/ChESS Sample.

    Science.gov (United States)

    Kelly, David

    1999-01-01

    Provides a list of teaching materials and general background information from the ERIC database on the Gilded Age and directions for obtaining the full text of these materials; topics include, but are not limited to, immigration, the 1896 presidential election, the Populist movement, the Industrial Revolution, urbanization, and the development of…

  16. Teaching and Learning about the Earth. ERIC Digest.

    Science.gov (United States)

    Lee, Hyonyong

    This ERIC Digest investigates the earth and space science guidelines of the National Science Education Standards. These guidelines are frequently referred to as the earth system and include components such as plate tectonics, the water cycle, and the carbon cycle. This Digest describes the development of earth systems science and earth systems…

  17. The Industrial Revolution: An ERIC/ChESS Sample.

    Science.gov (United States)

    Pinhey, Laura A.

    2000-01-01

    Provides a list, from the ERIC database, of teaching materials and background information on the Industrial Revolution. Specific topics include life in Lowell (Massachusetts), the global impact of the Industrial Revolution, and England's Industrial Revolution. Offers directions for obtaining the full text of these materials. (CMK)

  18. The future seen from Erice

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    A few specialists have been finding time to think beyond the LEP electron- positron Collider now being built at CERN and the SSC Superconducting Super Collider proposed for the US to the physics needs and accelerator possibilities of the future. Despite the modest effort, a lot of progress has been made in sorting the wheat from the chaff amongst proposed accelerator schemes and in defining crucial features of future machines. Some of this thinking came together at a seminar on 'New Techniques for Future Accelerators' held in Erice, Sicily, from 12-17 May

  19. The adjunction theory of complex projective varieties

    CERN Document Server

    Sommese, Andrew J

    1995-01-01

    An overview of developments in the past 15 years of adjunction theory, the study of the interplay between the intrinsic geometry of a projective variety and the geometry connected with some embedding of the variety into a projective space. Topics include consequences of positivity, the Hilbert schem

  20. Technological adjuncts to enhance current psychotherapy practices: a review.

    Science.gov (United States)

    Clough, Bonnie A; Casey, Leanne M

    2011-04-01

    Although there are several of reviews of technology in psychology, none to date has focused on technological adjuncts for improving traditional face to face therapy. However, examination of response, adherence, and dropout rates suggests there is considerable scope for improving traditional face to face services. The purpose of this paper was to examine technological adjuncts used to enhance psychotherapy practice. This review focused only on those technologies designed to supplement or enhance traditional therapy methods. Adjuncts designed to reduce direct therapist contact or change the medium of communication were not included. Adjuncts reviewed were mobile phones, personal digital assistants, biofeedback and virtual reality. Limitations in the current literature and directions for future research were identified and discussed. This review provides a comprehensive examination of the way in which adjunctive technologies may be incorporated into face to face therapy. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Highlights of the Erice conference of November 1981

    International Nuclear Information System (INIS)

    Ruchti, R.

    1982-01-01

    The central theme of the recent Europhysics Study Conference organized by G. Bellini and held at Erice was ''The Search for Charm, Beauty, and Truth at High Energies.'' A list of specific topics covered at the conference includes: photoproduction of heavy flavors, hadroproduction of heavy flavors, latest e + e - results, lifetime measurements, theory of production and decay of heavy states, vertex detectors - visual and electronic; and trigger schemes for spectrometers. Each of these subjects are briefly reported

  2. Adolescents: Your Children and Mine. ERIC Report.

    Science.gov (United States)

    Demo, Mary Penasack

    1981-01-01

    Reviews 10 items from the ERIC collection covering various aspects of adolescence: the impact of pop music, attitudes about drinking, television viewing, the effect of the new morality, the adolescent learning process, popular books, attitudes toward school, and others. (JMF)

  3. Early Childhood Curricula. ERIC/EECE Report.

    Science.gov (United States)

    Cesarone, Bernard

    2003-01-01

    Summarizes recent ERIC documents and journal articles, and highlights some World Wide Web resources that describe, evaluate, or compare various curricula or instructional methods, such as Creative Curriculum, High/Scope, the Montessori Method, Waldorf Schools, and Direct Instruction. (Author)

  4. Locative object marking and the argument-adjunct distinction ...

    African Journals Online (AJOL)

    adjunct distinction. We look at verbal locative agreement and at other morphosyntactic patterns related to locative phrases in different Bantu languages including Kiswahili, Sambaa, Haya, and several Nguni languages. We propose that object ...

  5. ERIC Abstracts: A Collection of ERIC Document Resumes on Systems Approaches in Education. ERIC Abstracts Series, Number Eight.

    Science.gov (United States)

    American Association of School Administrators, Washington, DC.

    ERIC abstracts on systems approaches in education, announced in RIE through January 1970, are compiled. The key terms used in compiling this collection are "systems approach,""systems analysis,""critical path method," and "systems concepts." The following information is presented for each document: author, title, place of publication, publisher,…

  6. La Disciplina Positiva (Positive Discipline). ERIC Digest.

    Science.gov (United States)

    ERIC Clearinghouse on Elementary and Early Childhood Education, Urbana, IL.

    This ERIC Digest suggests methods and language that can be used in handling difficult, but common, situations involving young children. The digest explains 12 methods of disciplining children that promote children's self-worth. These methods are: (1) showing children that the reasons for their actions are understood; (2) stating reasons; (3)…

  7. Review of "Cultures merging" by Eric Jones

    OpenAIRE

    Schlicht, Ekkehart

    2016-01-01

    This is an electronic reprint of a review of the book "Cultures Merging: A Historical and Economic Critique of Culture" by Eric L. Jones, Princeton: Princeton University Press that appeared in the Journal of Institutional and Theoretical Economics 2007, vol. 163, issue 3, pages 526-529, URL \\url{http://www.jstor.org/stable/40752660}.

  8. Eric Garcia: Warrior with a Pen

    Science.gov (United States)

    Briggs, Judith

    2013-01-01

    Eric Garcia's large-scale oil paintings, drawings, installations, prints, and political cartoons examine versions of American history that have been overlooked and whitewashed. Aware that dominant history reflects a strategy of power, Garcia embraces the confluence of history, culture, and politics to challenge historical mythologies and…

  9. Manejo de riesgo (Risk Management). ERIC Digest.

    Science.gov (United States)

    Gaustad, Joan

    The ordinary conduct of school business is accompanied today by risks that were rare or unknown a few decades ago. This ERIC Digest in Spanish discusses how risk management, a concept long used by corporate decision makers, can help school boards and administrators conserve their districts' assets. Risk management is a coordinated effort to…

  10. Learning from a Sea Snail: Eric Kandel

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 6; Issue 6. Learning from a Sea Snail: Eric Kandel. Rohini Balakrishnan. Research News Volume 6 Issue 6 June 2001 pp 86-90. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/006/06/0086-0090 ...

  11. Adjunct methods for caries detection

    DEFF Research Database (Denmark)

    Twetman, Svante; Axelsson, Susanna Bihari; Dahlén, Gunnar

    2012-01-01

    Abstract Objective. To assess the diagnostic accuracy of adjunct methods used to detect and quantify dental caries. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion and exclusion criteria. Abstracts and full text articles were assessed...

  12. The World War II Homefront: An ERIC/ChESS Sample.

    Science.gov (United States)

    Pinhey, Laura

    2002-01-01

    Provides citations with abstracts from the ERIC database focusing on the U.S. homefront during World War II. Includes background information and teaching materials on topics such as popular music from 1941-1945, propaganda directed towards women, and learning about Japanese American internment. (CMK)

  13. Teaching about World War II: An ERIC/ChESS Sample.

    Science.gov (United States)

    Schlene, Vickie L.

    1991-01-01

    Presents nine documents from the ERIC database dealing with teaching about World War II. Includes articles addressing the lessons of Pearl Harbor, the Holocaust, the wartime internment of Japanese Americans, industry's response to the war, and the moral lessons of Nazism. (SG)

  14. Eric Hobsbawm y su lectura marxista de la historia

    Directory of Open Access Journals (Sweden)

    Pilatowsky, Mauricio

    2014-06-01

    Full Text Available This paper presents a brief survey of the contributions made by the historian Eric Hobsbawm to the field of History and his Marxist stance, both in his academic work and political practice. According to the author, the circumstances in which the researchers live are determinant to their study; hence this analysis includes a review of his biography. This perspective discusses his interpretation of Marx and Marxism, his understanding of History, his militancy in the Communist Party, his Jewish identity, and how he addresses nationalism in relation to the study of capitalism.En este ensayo se presenta un breve estudio de las aportaciones del historiador Eric Hobsbawm en el campo de la historia y de sus posturas marxistas; tanto en su trabajo académico como en su práctica política. El análisis incluye una revisión de su biografía ya que según el autor los investigadores y su manera de investigar responden a las circunstancias que les toca vivir. Desde esta perspectiva se aborda su interpretación de Marx y del marxismo, su forma de entender la historia, su militancia en el Partido Comunista, su identidad judía y el tratamiento del nacionalismo en su relación con el estudio del capitalismo.

  15. The Adjunct Advocate @ FIT: Bringing Part Time Faculty into the Mainstream

    Science.gov (United States)

    Maldonado, Elaine; Riman, Jeffrey

    2009-01-01

    The Adjunct Advocate @ FIT is an online, faculty development program at FIT, part of the State University of New York. This convenient new resource, developed by the Center for Excellence in Teaching, reaches out to adjunct and off-campus faculty with professional development that includes printable materials, video, discussion boards, and…

  16. Skyview Foods: Eric's Real Dilemma with Channel Partners

    Science.gov (United States)

    Castleberry, Stephen B.

    2011-01-01

    As a marketing analyst, Eric is faced with several ethical dilemmas. When asked to engage in unethical and illegal behavior, Eric must decide whether to obey his boss and fudge the numbers (the counts of product purchased in order to get reimbursed more from the manufacturer during special sales) or take the ethical route. The case consists of two…

  17. Educating the Educator: Teaching Airway Adjunct Techniques in Athletic Training

    Science.gov (United States)

    Berry, David C.; Seitz, S. Robert

    2011-01-01

    The 5th edition of the "Athletic Training Education Competencies" ("Competencies") now requires athletic training educators (ATEs) to introduce into the curriculum various types of airway adjuncts including: (1) oropharyngeal airways (OPA), (2) nasopharyngeal airways (NPA), (3) supraglottic airways (SGA), and (4) suction. The addition of these…

  18. Evaluation of the ERIC-PCR as a probable method to differentiate Avibacterium paragallinarum serovars.

    Science.gov (United States)

    Hellmuth, Julius Eduard; Hitzeroth, Arina Corli; Bragg, Robert Richard; Boucher, Charlotte Enastacia

    2017-06-01

    Infectious coryza, an upper respiratory tract disease in chickens, caused by Avibacterium paragallinarum, leads to huge economic losses. The disease is controlled through vaccination; but vaccination efficacy is dependent on correct identification of the infecting serovar, as limited cross-protection is reported amongst some serovars. Current identification methods include the heamagglutination inhibition test, which is demanding and could be subjective. To overcome this, molecular typing methods proposed are the Multiplex polymerase chain reaction (PCR) and Restriction Fragment Length Polymorphism-PCR, but low reproducibility is reported. Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR has been suggested for molecular groupings of various bacterial species. This study focuses on evaluating the ERIC-PCR as a probable method to differentiate between different Av. paragallinarum serovars by grouping with reference isolates, based on clonal relations. The ERIC-PCR was performed on 12 reference isolates and 41 field isolates originating from South Africa and South America. The data indicate that the ERIC-PCR is not ideal for the differentiation or for molecular typing of Av. paragallinarum serovars, as no correlation is drawn upon comparison of banding patterns of field isolates and reference strains. However, the results do indicate isolates from the same origin sharing unique banding patterns, indicating potential clonal relationship; but when compared to the reference isolates dominant in the specific area, no correlation could be drawn. Furthermore, although the ERIC-PCR serves a purpose in epidemiological studies, it has proved to have little application in differentiating amongst serovars of Av. paragallinarum and to group untyped field strains with known reference strains.

  19. Eric Ambler and the Trick of Boundaries

    OpenAIRE

    Nadia Priotti

    2018-01-01

    One of the dominant themes of Eric Ambler's novels of the 1930s is certainly the crossing of frontiers as both a physical and symbolic element, which results not only in the living of a nightmarish adventure but also in what spy fiction expert Michael Denning defines as 'loss of innocence'. Focusing mainly on two of Ambler's novels, Epitaph for a Spy and Cause for Alarm, the essay analyses the experience abroad as a challenge both for the protagonists' worldviews and for the readers' expectat...

  20. Understanding Sensory Integration. ERIC Digest.

    Science.gov (United States)

    DiMatties, Marie E.; Sammons, Jennifer H.

    This brief paper summarizes what is known about sensory integration and sensory integration dysfunction (DSI). It outlines evaluation of DSI, treatment approaches, and implications for parents and teachers, including compensatory strategies for minimizing the impact of DSI on a child's life. Review of origins of sensory integration theory in the…

  1. Effect of Adjunct Postquestions on Achievement.

    Science.gov (United States)

    Sutliff, Ronald I.

    1986-01-01

    Describes a study conducted to determine whether adjunct postquestions induced mathemagenic behaviors to contribute to more effective learning from the self-instructional slide-tape presentation. Another purpose was to determine whether the effect of adjunct postquestions would be more beneficial for lower-ability students than for upper-ability…

  2. Adjuncts and the Processing of Lexical Rules

    NARCIS (Netherlands)

    Noord, G. van; Bouma, G.

    2001-01-01

    Abstract: The standard HPSG analysis of Germanic verb clusters can not explain the observed narrow-scope readings of adjuncts in such verb clusters. We present an extension of the HPSG analysis that accounts for the systematic ambiguity of the scope of adjuncts in verb cluster constructions, by

  3. Eric Kandel'sReductionism in Art and Brain Science - Bridging the Two Cultures.

    Science.gov (United States)

    Bilsky, Ed

    2017-01-01

    Reductive art is a term to describe an artistic style or an aesthetic, rather than an art movement. It is stripping down as a new way of seeing. Movements and other terms that are sometimes associated with reductive art include abstract art, minimalism, ABC art, anti-illusionism, cool art, and rejective art. Eric Kandel's fifth book focuses on reductionism as the principle guiding an ongoing dialogue between the worlds of science and art .

  4. CAS Accelerator Physics held in Erice, Italy

    CERN Document Server

    CERN Accelerator School

    2013-01-01

    The CERN Accelerator School (CAS) recently organised a specialised course on Superconductivity for Accelerators, held at the Ettore Majorana Foundation and Centre for Scientific Culture in Erice, Italy from 24 April-4 May, 2013.   Photo courtesy of Alessandro Noto, Ettore Majorana Foundation and Centre for Scientific Culture. Following a handful of summary lectures on accelerator physics and the fundamental processes of superconductivity, the course covered a wide range of topics related to superconductivity and highlighted the latest developments in the field. Realistic case studies and topical seminars completed the programme. The school was very successful with 94 participants representing 23 nationalities, coming from countries as far away as Belorussia, Canada, China, India, Japan and the United States (for the first time a young Ethiopian lady, studying in Germany, attended this course). The programme comprised 35 lectures, 3 seminars and 7 hours of case study. The case studies were p...

  5. ERIC Resources for Teaching about the Seventies and Women.

    Science.gov (United States)

    Cohen, Cheryl; Seiter, David M.

    1988-01-01

    Highlights a variety of ERIC materials to use for instruction and reflection about the 1970s. Materials cover Watergate, environmental issues, drug use, the new ethnicity, terrorism, the Vietnam War, and women's employment. (LS)

  6. Freedom of Expression: A Troublesome Imperative. ERIC Report.

    Science.gov (United States)

    Del Polito, Carolyn M.

    1980-01-01

    Presents an annotated bibliography of 19 items from ERIC identifying troublesome paradoxes regarding the media and freedom of expression. Items are categorized by issues identified as relevant to radio and television, commercial advertising, and the press. (JMF)

  7. Understanding Mathematics and Culture in Rural Contexts. ERIC Digest.

    Science.gov (United States)

    Bush, William S.

    This ERIC Digest provides an overview of concepts, writers, and tenets associated with the study of mathematics and culture and offers researchers a framework for the field, particularly with regard to rural contexts. (Author)

  8. Eric Soovere fotodest sõjafotograafia kontektis / Ahto Sooaru

    Index Scriptorium Estoniae

    Sooaru, Ahto

    2011-01-01

    Püütakse selgitada Eric Soovere piltide ja teksti tausta põgenemisel kodumaalt, näidatakse tema töö tähtsust Eesti visuaalkultuuris ja käsitletakse ka sõjafotograafia ajalugu ning sõjafotograafia peegeldusi kunstis. Praktilise tööna sündis DVD, kuhu on koondatud Eric Soovere päevik ja fotomaterjal kaasaegse formaadina

  9. The Impact of Denominational Affiliation on Organizational Sense of Belonging and Commitment of Adjunct Faculty at Bible Colleges and Universities

    Science.gov (United States)

    Pilieci, Kimberly M.

    2016-01-01

    The majority of faculty in higher education, including secular and biblical institutions, are adjunct faculty. The literature suggests that adjunct faculty are less effective and satisfied, and have weaker organizational sense of belonging (OSB) and affective organizational commitment (AOC). Denominational affiliation (DA) and religious commitment…

  10. Adjunctive Orthodontic Applications in Dental Implantology.

    Science.gov (United States)

    Borzabadi-Farahani, Ali; Zadeh, Homayoun H

    2015-08-01

    Implant placement is often necessitated for replacement of teeth with pathologically damaged alveolar bone due to periodontitis or traumatic injury. Surgical augmentation of resorbed bone has many limitations, including lower efficacy of vertical augmentation than horizontal augmentation, as well as morbidity associated with grafting procedure. Orthodontic therapy has been proposed as a useful method for augmenting the resorbed alveolar bone and reforming aesthetically appealing gingival margin, prior to implant placement. This narrative review summarizes the available evidence for the application of orthodontic strategies that can be used as adjunct in selected cases to augment bone volume for the future implant site and maintain space for the prosthetic parts of the implant. These are (1) orthodontic extrusion of compromised teeth to generate vertical bone volume and enhance gingival architecture, (2) tooth preservation and postponing orthodontic space opening to maintain bone volume in future implant site, (3) orthodontic implant site switching to eliminate the deficient bone volume or risky implant sites, and (4) the provision of a rigid fixed-bonded retainer to maintain the implant site. Although there are no randomized controlled clinical trials to evaluate the efficacy of orthodontic therapy for implant site development, clinical case reports and experience document the efficacy of orthodontic therapy for this application.

  11. Adjunction, Labeling, and Bare Phrase Structure

    Directory of Open Access Journals (Sweden)

    Norbert Hornstein

    2008-03-01

    Full Text Available The primary aim in this paper is to propose a phrase structure for adjunction that is compatible with the precepts of Bare Phrase Structure (BPS. Current accounts are at odds with the central vision of BPS and current practice leans more to descriptive eclecticism than to theoretical insight. A diagnosis for this conceptual disarray is suggested here: It stems from a deeply held though seldom formulated intuition; the tacit view that adjuncts are the abnormal case while arguments describe the grammatical norm. In actuality, it is argued, adjuncts are so well behaved that they require virtually no grammatical support to function properly. Arguments, in contrast, are refractory and require grammatical aid to allow them to make any propositional contribution. This last remark should come as no surprise to those with neo-Davidsonian semantic sympathies. Connoisseurs of this art form are well versed in the important role that grammatical (aka, thematic roles play in turning arguments into modifiers of events. Such fulcra are not required for meaningfully integrating adjuncts. into sentences. In what follows, we take this difference to be of the greatest significance and we ask ourselves what this might imply for the phrase structure of adjunction.

  12. ERIC Abstracts: A Collection of ERIC Document Resumes on the Use of Futurism in Educational Planning. ERIC Abstracts Series, Number Thirty.

    Science.gov (United States)

    American Association of School Administrators, Washington, DC. National Academy for School Executives.

    Futurism is a process of speculation on alternative possibilities for the future. Such a process leads to a clearer conception of future needs and resources. Applied to education, futurism can aid in longrange planning on a local, district, State, or national level. ERIC abstracts on the application of futurism to educational planning, announced…

  13. Pharmacological adjuncts for chronic venous ulcer healing: a systematic review.

    Science.gov (United States)

    Varatharajan, Lavanya; Thapar, Ankur; Lane, Tristan; Munster, Alex B; Davies, Alun Huw

    2016-06-01

    The aim of this study was to systematically review the current evidence and determine whether there is a clinical benefit for using pharmacological agents as adjunctive treatment for chronic venous ulcers. A systematic review of the MEDLINE and EMBASE (from 1 January 1947 through 15 August 2013) and Cochrane databases (from inception through 15 August 2013) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were all randomised controlled trials investigating pharmacological adjuncts for the treatment of venous ulcers with a minimum sample size of 20 patients for each treatment arm. Ten relevant articles were identified; one pilot randomised controlled trial and four Cochrane reviews were included. Pentoxifylline, aspirin, sulodexide, mesoglycan, flavonoids, thromboxane A2 antagonist (ifetroban), zinc, prostaglandin and prostacyclin analogues were the drugs reviewed. Pentoxifylline was found to be more effective than placebo in terms of complete ulcer healing or in causing a significant improvement (greater than 60% reduction in ulcer size) (RR 1.70, 95% CI 1.30 to 2.24). Aspirin and flavonoids show potential to be effective adjuncts but methodological shortcomings and issues with bias limit the validity of results from trials involving each of these drugs, respectively. There was no significant difference between placebo and Ifetroban and likewise pooled results from trials investigating sulodexide and zinc showed no benefit in comparison to placebo. Many systemic pharmacological agents have been investigated as adjuncts to venous ulcer healing; however, pentoxifylline (400 mg, three times a day) is currently the only drug that has promising evidence to support its use. Other compounds are in early stage research. © The Author(s) 2015.

  14. Setting the stage for the EPOS ERIC: Integration of the legal, governance and financial framework

    Science.gov (United States)

    Atakan, Kuvvet; Bazin, Pierre-Louis; Bozzoli, Sabrina; Freda, Carmela; Giardini, Domenico; Hoffmann, Thomas; Kohler, Elisabeth; Kontkanen, Pirjo; Lauterjung, Jörn; Pedersen, Helle; Saleh, Kauzar; Sangianantoni, Agata

    2017-04-01

    , software and services (DDSS) accessible through EPOS. From a financial standpoint, EPOS elaborated common guidelines for all institutions providing services, and selected a costing model and funding approach which foresees a mixed support of the services via national contributions and ERIC membership fees. In the EPOS multi-disciplinary environment, harmonization and integration are required at different levels and with a variety of different stakeholders; to this purpose, a Service Coordination Board (SCB) and technical Harmonization Groups (HGs) were established to develop the EPOS metadata standards with the EPOS Integrated Central Services, and to harmonize data and product standards with other projects at European and international level, including e.g. ENVRI+, EUDAT and EarthCube (US).

  15. Adjunctive hyperbaric oxygen treatment for idiopathic sudden sensorineural hearing loss.

    Science.gov (United States)

    Chin, Chun-Shih; Lee, Tsai-Yun; Wu, Ming-Feng

    2017-01-01

    This study aims to evaluate the hearing gain efficacy from adjunctive hyperbaric oxygen (HBO₂) treatment in patients with idiopathic sudden sensorineural hearing loss (ISSHL). A retrospective analysis of chart reviews was performed on patients with ISSHL between January 2013 through December 2015. All patients were referred to us from our ENT Department for adjunctive hyperbaric oxygen treatment. The results were assessed through pure-tone audiometry (PTA) data change (hearing gain), both before and after HBO₂) treatment. Age, gender, affected ear side, HBO₂) treatment sessions, both before and after HBO₂ treatment PTA were all recorded. Ninety-three (93) patients with ISSHL were included in the study. The average hearing gain in this study was 17.9 dB (p=0.001), where a total of 46 (49.46%) patients showed an improvement (hearing gain≥dB) in response to HBO₂ treatment (p=0.002). Patients with the poorest initial severity of hearing loss who displayed a greater degree of hearing improvement after HBO₂ treatment were male and in the 40- to 59-year-old age group. This study found that adjunctive hyperbaric oxygen treatment was efficacious for patients with idiopathic sudden sensorineural hearing loss. The total average hearing gain was recorded to be 17.9 dB.

  16. Recovering traditional raw-milk Tetilla cheese flavour and sensory attributes by using Kocuria varians and Yarrowia lipolytica adjunct cultures.

    Science.gov (United States)

    Centeno, J A; Garabal, J I; Docampo, F; Lorenzo, J M; Carballo, J

    2017-06-19

    The rationale of the present study was to evaluate the potential of microbial adjunct cultures including Kocuria varians and/or Yarrowia lipolytica strains in the recovery of the typical sensory profile of traditional (raw-milk) Tetilla cheese. Four batches of Tetilla cheese, a short ripened cows' milk cheese produced in Galicia (NW Spain), were made in duplicate from pasteurized milk inoculated with different microbial cultures. A control batch was manufactured by adding a mesophilic commercial D-starter only. The other three batches were made with the same starter after a cheese-milk pre-ripening step carried out with (i) an adjunct culture of K. varians, (ii) an adjunct culture of Y. lipolytica, or (iii) a combination of both adjunct cultures. The highest pH and water activity values, associated with softer textures were determined in the cheeses manufactured with the Y. lipolytica adjunct after 21days of ripening. The contents of the volatile compounds 3-methylbutanol, dimethyl disulfide and dimethyl trisulfide were higher in the cheeses made with only the K. varians adjunct than in the cheeses made with the only yeast adjunct and in the control cheeses. The contents of hexanoic and octanoic acids were highest in the cheeses made with the Y. lipolytica adjunct, and levels of ethyl hexanoate, ethyl octanoate and ethyl decanoate were higher in the cheeses made with only the yeast adjunct than in the other batches of cheese. The cheeses manufactured with both adjunct cultures were awarded the highest scores for flavour and overall sensory parameters (considering the standards of the traditional product) and were considered very similar to 'good quality' artisanal raw-milk cheeses. We conclude that use of selected Micrococcaceae and Y. lipolytica strains as adjunct cultures would differentiate the sensory properties and contribute to the quality and typicality of the short-ripened rennet-curd Galician Tetilla and Arzúa-Ulloa cheeses. Copyright © 2017 Elsevier B

  17. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment.

    Science.gov (United States)

    2016-01-01

    Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer. We searched Ovid MEDLINE, Ovid Embase, EBM Reviews, and the NHS Economic Evaluation Database, from January 1998 to June 2015, for evidence of effectiveness, harms, diagnostic accuracy, and cost-effectiveness. Only studies evaluating the use of ultrasound as an adjunct to mammography in the specified populations were included. We also conducted a cost analysis to estimate the costs in Ontario over the next 5 years to fund ultrasound as an adjunct to mammography in breast cancer screening for high-risk women who are contraindicated for MRI, the current standard of care to supplement mammography. No studies in average-risk women met the inclusion criteria of the clinical review. We included 5 prospective, paired cohort studies in high-risk women, 4 of which were relevant to the Ontario context. Adjunct ultrasound identified between 2.3 and 5.9 additional breast cancers per 1,000 screens. The average pooled sensitivity of mammography and ultrasound was 53%, a statistically significant increase relative to mammography alone (absolute increase 13%; P mammography screening alone. The GRADE for this body of evidence was low. Additional annual costs of using breast ultrasound as an adjunct to mammography for high-risk women in Ontario contraindicated for MRI would range from $15,500 to $30,250 in the next 5 years. We found no evidence that evaluated the comparative effectiveness or diagnostic accuracy of screening breast ultrasound as an adjunct to mammography among average

  18. Saladusi mäletavad pildid : järelvaade Eric Soovere fotograafilisele dokumentalistikale / Peeter Linnap

    Index Scriptorium Estoniae

    Linnap, Peeter, 1960-

    2010-01-01

    Eric Sooverest ja tema fotoloomingust. Eric Soovere ja Johannes Pääsukese loomingu võrdlus. Katkendeid Eric Soovere raamatust "Käru ja kaameraga : pilte ja päevikulehti põgenemisteelt 1944-1949". Pikemalt emigreerumisest Ameerikasse

  19. MICROsearch--A Project to Extend the ERIC Database to Microcomputers.

    Science.gov (United States)

    Clark, W. Bruce

    A project at the ERIC Clearinghouse on Information Resources has resulted in the extension of the ERIC database to microcomputer. Small subject-related files for current-awareness purposes are downloaded from the ERIC tapes and are made available for searching with Apple II Plus microcomputers. Since the target audience for this system is…

  20. Entrevista com Eric McLuhan

    Directory of Open Access Journals (Sweden)

    McLuhan, Eric

    2011-01-01

    Full Text Available Marshall McLuhan faria 100 anos em 2011. Para marcar esta data, que já provocou uma recente revisitação à obra do teórico, o XI Seminário Internacional da Comunicação, promovido pela PUCRS, destacou temas como as relações do homem com as tecnologias e os efeitos psicológicos das mídias para nortear às discussões dos três dias de evento. Mas se engana que acredita que entender a obra mcluhiana é tarefa fácil. Mesmo tendo se dedicado com afinco a explicar metáforas como ‘o meio é a mensagem’ e ‘aldeia global’, McLuhan nunca chegou a ser completamente entendido. Ou as pessoas não sedavam ao trabalho de entendê-lo, ou, simplesmente, não conseguiam enxergar as mudanças que estavam acontecendo com a mesma clareza que o pesquisador. Numa tentativa não só de entender a obra do ‘profeta da globalização’, mas de ampliar os entendimentos sobre as tecnologias e as extensões do homem, Eric McLuhan, filho do teórico, participou como palestrante do Seminário para falar, entre outros assuntos, da percepção acadêmica quanto a obra de seu pai, além de introduzir novas ideias sobre televisão, globalização e ecologia

  1. Fractal dimensions the digital art of Eric Hammel

    CERN Document Server

    Hammel, Eric

    2014-01-01

    The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volume 1 of Eric Hammel's Fractal Dimensions, Volume 2 is filled wit

  2. Fractal dimensions the digital art of Eric Hammel

    CERN Document Server

    Hammel, Eric

    2014-01-01

    The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volumes 1 and 2 of Eric Hammel's Fractal Dimensions, Volume 3 is fil

  3. Fractal dimensions the digital art of Eric Hammel

    CERN Document Server

    Hammel, Eric

    2014-01-01

    The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volumes 1, 2, and 3 of Eric Hammel's Fractal Dimensions, Volume 4 is

  4. Deferasirox as adjunctive therapy for mucormycosis.

    NARCIS (Netherlands)

    Donnelly, J.P.; Lahav, M.

    2012-01-01

    Mucormycosis can be devastating and, as yet, there are no ideal therapies available. Observations that iron chelation may be a useful adjunct to antifungal treatment encouraged Spellberg et al. (J Antimicrob Chemother 2012; 715-22) to undertake a trial of deferasirox combined with liposomal

  5. Adjuncts in Social Work Programs: Good Practice or Unethical?

    Science.gov (United States)

    Pearlman, Catherine A.

    2013-01-01

    Social work education programs rely heavily on adjunct instructors, as do most academic institutions. This article adds to existing literature on adjuncts by focusing on the unique issues in social work education, using social work values and ethics as a focus. The benefits and detriments for adjuncts, programs, and students in schools of social…

  6. Research from the ERIC Files: July 1991-June 1992.

    Science.gov (United States)

    Minor, Barbara B.

    1993-01-01

    Reviews research on school library media programs from the ERIC database that addressed the status of school library media programs, the information seeking process, the use of technology, censorship, school library media collections, collection development, funding, use studies, the role of the library media specialist, and professional training.…

  7. Research from the ERIC Files: July 1992-June 1993.

    Science.gov (United States)

    Minor, Barbara B.

    1994-01-01

    Reviews 49 reports of research on school library media programs from the ERIC database that address the status of school library media programs, library media resources, the use of technology, the role of the school library media specialist, and professional training. (49 references) (KRN)

  8. The Role of Different Literary Genres (ERIC/RCS).

    Science.gov (United States)

    Smith, Carl B.

    1991-01-01

    Suggests that each type of literature presented to young readers serves two important functions: to develop a schema for that literary genre; and to encourage the application of thinking skills in a variety of literary engagements. Presents four related resources from the ERIC database. (MG)

  9. Drug Testing. ERIC Digest Series Number EA 35.

    Science.gov (United States)

    Klauke, Amy

    The issue of drug testing is the focus of this ERIC Digest. Several aspects of drug testing discussed in question-and-answer format: (1) What is the current status of drug use in the schools? (2) What legal questions arise when schools consider drug testing? (3) How might drug testing be applied in a fair, economical, and legally safe manner? (4)…

  10. DSM-5 and ADHD ? an interview with Eric Taylor

    OpenAIRE

    Taylor, Eric

    2013-01-01

    In this podcast we talk to Prof Eric Taylor about the changes to the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in DSM-5 and how these changes will affect clinical practice. The podcast for this interview is available at: http://www.biomedcentral.com/sites/2999/download/Taylor.mp3.

  11. National Standards for Civics and Government. ERIC Digest.

    Science.gov (United States)

    Bahmueller, Charles F.

    This ERIC digest discusses the National Standards for Civics and Government for students from grades K-12. The Standards are organized around five central questions dealing with the following subjects: (1) the nature and necessity of government; (2) the foundations of American constitutionalism; (3) the functioning of American government and the…

  12. Kunst elada piiri peal / Eric Kluitenberg ; interv. Heie Treier

    Index Scriptorium Estoniae

    Kluitenberg, Eric

    1999-01-01

    Võrguteoreetik Eric Kluitenberg Amsterdamist valgustab 'Interstanding 3' 'Ülalpool piire' tagamaad ja seost Eestiga. Üritus toob Eestisse rahvusvahelisi tippteoreetikuid, kes analüüsivad elu piiri peal, ja kunstnikke, kes seda seisundit oma loomingus kajastavad. Osalema kutsutuid. Piiripealsuset seoses poliitika, interneti, meediaga, äärealadest.

  13. Complementary therapies as adjuncts in the treatment of postpartum depression.

    Science.gov (United States)

    Weier, Kira M; Beal, Margaret W

    2004-01-01

    Postpartum depression affects an estimated 13% of women who have recently given birth. This article discusses several alternative or complementary therapies that may serve as adjuncts in the treatment of postpartum depression. The intent is to help practitioners better understand the treatments that are available that their clients may be using. Complementary modalities discussed include herbal medicine, dietary supplements, massage, aromatherapy, and acupuncture. Evidence supporting the use of these modalities is reviewed where available, and a list of resources is given in the appendix.

  14. Eric Hobsbawm, sociólogo do milenarismo campesino Eric Hobsbawm, sociologist of peasant millenarianism

    Directory of Open Access Journals (Sweden)

    Michael Löwy

    2010-01-01

    Full Text Available Graças à problemática do milenarismo, a historiografia de Eric Hobsbawm integra toda a riqueza da subjetividade sociocultural, a profundidade das crenças, sentimentos e emoções em sua análise dos acontecimentos históricos, que não são mais, nessa perspectiva, percebidos simplesmente como produtos do jogo "objetivo" das forças econômicas ou políticas. Ainda distinguindo cuidadosamente os milenarismos primitivos dos revolucionários modernos, não deixa de mostrar sua afinidade eletiva. Isso não quer dizer que todos os movimentos revolucionários sejam milenaristas em sentido estrito ou, pior todavia, que respondam a um quiliasmo de tipo primitivo. Isso não impede afirmar que a afinidade entre os dois seja um fato fundamental na história das revoltas camponesas contra a modernização capitalista. Trata-se de uma das hipóteses de investigação mais interessantes esquematizadas em seus trabalhos desta época. Hobs-bawm ilustra seus propósitos com dois estudos de caso apaixonantes: o anarquismo rural na Andaluzia e as ligas camponesas da Sicília, os dois surgidos em fins do século XIX com prolongamentos no XX.Thanks to the problematic of millenarianism, Eric Hobsbawm's historiography incorporates all the richness of socio-cultural subjectivity - the depth of beliefs, feelings and emotions - into his analysis of historical events, which, from this viewpoint, are no longer perceived simply as products of the "objective" interplay of economic or political forces. Although he makes a careful distinction between primitive millenarianisms and modern revolutionary movements, Hobsbawm nevertheless shows their elective affinity between them. This does not mean that all revolutionary movements are millenarian in the strict sense or - which is even worse - that they are connected to a primitive type of chiliasm. All the same, the affinity between them is a basic fact in the history of peasant revolts against capitalist modernization. This

  15. Fans of Columbine shooters Eric Harris and Dylan Klebold

    OpenAIRE

    Andrew Ryan Rico

    2015-01-01

    On April 20, 1999, Eric Harris and Dylan Klebold murdered 12 students and one teacher at Columbine High School in Littleton, Colorado, in what was then the deadliest school shooting in American history. Despite causing a national panic and serving as a flash point for larger narratives on bullying, gun control, and media violence, both boys have gained active online fans. These fandoms dedicated to the Columbine shooters are widely referred to as dark examples of Internet communities, while t...

  16. Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris.

    Science.gov (United States)

    Lee, John K; Smith, Andrew D

    2017-11-15

    The purpose of this literature review is to evaluate the use of metformin as an adjunct therapy in the treatment of moderate-to-severe acne in those not diagnosed with polycystic ovary syndrome (PCOS) or androgen excess. The authors conducted independent literature searches. Results were limited to clinical trials and randomized controlled trials. Studies with participants diagnosed with moderateto-severe acne vulgaris taking metformin versus placebo or other active treatment were included;studies with participants diagnosed with PCOS or androgen excess were excluded. The authors found three studies consistent with the search guidelines that evaluated the effects of metformin as adjunct therapy in moderate to severe acne vulgaris. In eachstudy, metformin was an effective adjunct therapy in the treatment of moderate-to-severe acne vulgaris.

  17. Polypodium leucotomos as an Adjunct Treatment of Pigmentary Disorders.

    Science.gov (United States)

    Nestor, Mark; Bucay, Vivian; Callender, Valerie; Cohen, Joel L; Sadick, Neil; Waldorf, Heidi

    2014-03-01

    Extracts of the tropical fern Polypodium leucotomos appear to possess beneficial properties for the skin attributed to the presence of numerous compounds within the extract that have antioxidant and photoprotective properties. Orally administered Polypodium leucotomos may provide protection against the detrimental photoaging effects of sunlight and can also help reduce the frequency and severity of polymorphous light eruption. Polypodium leucotomos has also been shown to be beneficial for the prevention and potential treatment of several aesthetically relevant conditions. The purpose of this review is to investigate the beneficial role of Polypodium leucotomos as an adjunct treatment for vitiligo, melasma, and postinflammatory hyperpigmentation. Based on a review of relevant literature including the results of a randomized, placebo-controlled study, the oral administration of Polypodium leucotomos significantly improved the severity of melasma in women after 12 weeks. Three randomized, double-blind, placebo-controlled studies have demonstrated significant improvements in vitiligo when oral Polypodium leucotomos therapy was combined with psoralens plus ultraviolet A and narrowband ultraviolet B. No controlled studies have assessed the efficacy of Polypodium leucotomos for the treatment of postinflammatory hyperpigmentation; however, its known antioxidant and anti-inflammatory properties and demonstrated effectiveness for melasma support its use for treating this condition. No adverse events have been associated with the use of Polypodium leucotomos. In addition to preventing many harmful effects associated with sunlight exposure, orally administered Polypodium leucotomos also appears to provide adjunctive benefits in treating vitiligo, melasma, and may have the potential to help with postinflammatory hyperpigmentation.

  18. Adjunctive aerosolized colistin for multi-drug resistant gram-negative pneumonia in the critically ill: a retrospective study

    OpenAIRE

    Doshi, Neha M; Cook, Charles H; Mount, Kari L; Stawicki, Stanislaw P; Frazee, Erin N; Personett, Heather A; Schramm, Garrett E; Arnold, Heather M; Murphy, Claire V

    2013-01-01

    Background The incidence of multi-drug resistant (MDR) gram-negative (GN) organisms including Pseudomonas and Acinetobacter spp has increased in the last decade, prompting re-evaluation of colistin for the management of these infections. Aerosolized colistin as an adjunct to intravenous therapy is a current option for the management of MDR-GN pneumonia, although data supporting this practice is limited. This study evaluates the efficacy of adjunctive aerosolized colistin in combination with i...

  19. Arginine Adjunctive Therapy in Active Tuberculosis

    Directory of Open Access Journals (Sweden)

    Aliasghar Farazi

    2015-01-01

    Full Text Available Background. Dietary supplementation has been used as a mechanism to augment the immune system. Adjunctive therapy with L-arginine has the potential to improve outcomes in active tuberculosis. Methods. In a randomized clinical trial 63 participants with smear-positive pulmonary tuberculosis in Markazi Province of Iran were given arginine or placebo for 4 weeks in addition to conventional chemotherapy. The final treatment success, sputum conversion, weight gain, and clinical symptoms after one and two months were considered as primary outcomes and secondary outcomes were ESR, CRP, and Hg. Data were collected and analyzed with SPSS software (ver. 18. Results. Arginine supplementation reduced constitutional symptoms (P=0.032 in patients with smear-positive TB at the end of the first month of treatment. Arginine treated patients had significantly increased BMI at the end of the first and second months of treatment (P=0.032 and P=0.04 and a reduced CRP at the end of the first month of treatment (P=0.03 versus placebo group. Conclusion. Arginine is useful as an adjunctive therapy in patients with active tuberculosis, in which the effects are more likely mediated by the increased production of nitric oxide and improved constitutional symptoms and weight gain. This trial is registered with Clinical Trials Registry of Iran: IRCT201211179855N2.

  20. Systematic review of adjunct therapies to improve outcomes following botulinum toxin injection for treatment of limb spasticity.

    Science.gov (United States)

    Mills, Patricia Branco; Finlayson, Heather; Sudol, Malgorzata; O'Connor, Russell

    2016-06-01

    To determine the quality of evidence from randomized controlled trials on the efficacy of adjunct therapies following botulinum toxin injections for limb spasticity. MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials electronic databases were searched for English language human studies from 1980 to 21 May 2015. Randomized controlled trials assessing adjunct therapies postbotulinum toxin injection for treatment of spasticity were included. Of the 268 studies screened, 17 met selection criteria. Two reviewers independently assessed risk of bias using the Physiotherapy Evidence Database (PEDro) scale and graded according to Sackett's levels of evidence. Ten adjunct therapies were identified. Evidence suggests that adjunct use of electrical stimulation, modified constraint-induced movement therapy, physiotherapy (all Level 1), casting and dynamic splinting (both Level 2) result in improved Modified Ashworth Scale scores by at least 1 grade. There is Level 1 and 2 evidence that adjunct taping, segmental muscle vibration, cyclic functional electrical stimulation, and motorized arm ergometer may not improve outcomes compared with botulinum toxin injections alone. There is Level 1 evidence that casting is better than taping, taping is better than electrical stimulation and stretching, and extracorporeal shock wave therapy is better than electrical stimulation for outcomes including the Modified Ashworth Scale, range of motion and gait. All results are based on single studies. There is high level evidence to suggest that adjunct therapies may improve outcomes following botulinum toxin injection. No results have been confirmed by independent replication. All interventions would benefit from further study. © The Author(s) 2015.

  1. La Base de Donnees ERIC: Evaluation de Son Utilisation et Discussion des Choix du Systeme (The ERIC Database: An Evaluation of Its Use and a Discussion of the System Model).

    Science.gov (United States)

    Malrieu, Denise

    1983-01-01

    This overview of the ERIC system begins with a brief history of the system; a description of the types and numbers of materials contained in the database; sources of types of information for educators that are not processed by ERIC; and the various publications and reference materials produced by and for the system. The analysis of ERIC usage in…

  2. Comparison of Alcohol Withdrawal Outcomes in Patients Treated with Benzodiazepines Alone versus Adjunctive Phenobarbital: a Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Lauren Z. Gashlin

    2015-03-01

    Full Text Available Background: For treatment of severe alcohol withdrawal syndrome, high dose benzodiazepines (BZDs may cause delirium and over-sedation. Phenobarbital (PBT is a long-acting barbiturate effective for the treatment of alcohol withdrawal. Given the potential benefits of PBT, we sought to investigate the effectiveness of PBT as adjunctive treatment for alcohol withdrawal. Methods: This was a retrospective cohort study on patients with a diagnosis of alcohol withdrawal who had a CIWA-Ar score > 10 treated with either BZDs alone (BZD alone group or BZDs with adjunctive PBT (PBT-adjunct group. The patients received at least one dose of PBT in addition to BZDs (variable doses in the PBT-adjunct group, and three doses of 20 mg diazepam equivalents within 6 hours in the BZD alone group. The primary endpoint was the proportion of patients with a CIWA-Ar score < 10 at 24 hours after initial treatment. Duration of withdrawal and cumulative dose of BZDs were also assessed. Results: Seven subjects in the adjunctive phenobarbital and 21 in the benzodiazepine group were included in the final analysis. Two patients (28.6% in the PBT-adjunct group and 5 patients (23.8% in the BZD only group achieved the primary endpoint, though the difference between the two groups was not statistically significant (P = 0.588. The median (IQR duration of withdrawal symptoms was 44 (12-62 hours in the PBT-adjunct group compared to 53 (37-87 hours in the BZD only group, with no significant difference between the groups (P = 0.249. The median (IQR cumulative BZD dose requirement (diazepam equivalent in the PBT-adjunct group was significantly lower than BZD alone group (25 (20-226 vs. 326 (160-550 mg, P = 0.02. Conclusion: PBT appears to be a safe and effective alternative to BZDs for the treatment of alcohol withdrawal in non-critically ill patients and may be BZD sparing.

  3. The Drug Problem and the Schools. ERIC Abstracts Series, Number Sixteen.

    Science.gov (United States)

    American Association of School Administrators, Washington, DC.

    ERIC abstracts on the drug problem and the schools, announced in RIE through December 1970, are presented. The key terms used in compiling this collection are "drug abuse" and "drug addiction." The following information is presented for each document: Author, title, place of publication, publisher, publication date, number of pages, ERIC document…

  4. Comparison of intraocular pressure reduction of initial and adjunct ...

    African Journals Online (AJOL)

    Objective: The objective was to compare the intraocular pressure (IOP) lowering effect of selective laser trabeculoplasty (SLT) as initial and adjunct therapy in primary open angle glaucoma (POAG). Subjects and Methods: Retrospective chart review of POAG patients who had SLT either as initial or adjunct therapy over a ...

  5. Gleaning in Academe: Personal Decisions for Adjuncts and Graduate Students.

    Science.gov (United States)

    Papp, James

    2002-01-01

    Argues that the situation of adjunct instructors, particularly those who piece full-time employment from part-time appointments, is appalling and that there is responsibility to be meted out to all the various interests connected to the academy that benefit from it. Explores how adjunct instructors and graduate student can make decisions about…

  6. Adjunctive orthodontic treatment with lingual orthodontic system.

    Science.gov (United States)

    Kafle, D; Humagain, M; Upadhaya, C

    2011-01-01

    The lingual orthodontic therapy though started in 1972, could not be popular till the beginning of 1990. In Nepal it does not have a history of more than a year. It is started in Dhulikhel Hospital for the first time in Nepal. Usually orthodontic therapy is meant for putting braces on the labial surface of the teeth which is called labial orthodontic system. Lingual orthodontic system is a purely invisible kind of orthodontic therapy in which braces are placed behind the teeth. The advantages of lingual orthodontic therapy are: invisibility, better biomechanics and improved patient compliance. On the other hand it is difficult to master and costlier than labial orthodontics. We have presented six adjunctive orthodontic cases treated by lingual system with the same end result comparable to labial orthodontic system.

  7. Novel adjunctive treatments of myocardial infarction

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Pryds, Kasper; Bøtker, Hans Erik

    2014-01-01

    Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve...... by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary...... clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic...

  8. The rationale for chemical adjuncts in plaque control.

    Science.gov (United States)

    Newman, H N

    1998-06-01

    The rationale for the adjunctive use of chemical anti-plaque agents depends on many factors in addition to the inherent antimicrobial properties of those agents. What is indicated generally is a basic oral hygiene regimen, as simple as it can be, bearing in mind the practical difficulties of getting people to clean their teeth optimally. Chemical adjuncts in many cases have the potential to simplify plaque control regimens. The mode of delivery may be critical to the success or otherwise of an adjunct. Adjuncts may simplify and accelerate the work of hygienists as well as patients. They may also serve to control plaque in severe forms of infectious inflammatory periodontal disease, as well as providing practical means of plaque control in the handicapped, or in those unable to practice optimal conventional home care oral hygiene. Chemical anti-plaque adjuncts offer a prospect of re-establishing the homeostasis of oral microbial biofilms fully consonant with the aims of modern periodontal medicine.

  9. A Canonical Approach to the Argument/Adjunct Distinction

    Directory of Open Access Journals (Sweden)

    Diana Forker

    2014-01-01

    Full Text Available This paper provides an account of the argument/adjunct distinction implementing the 'canonical approach'. I identify five criteria (obligatoriness, latency, co-occurrence restrictions, grammatical relations, and iterability and seven diagnostic tendencies that can be used to distinguish canonical arguments from canonical adjuncts. I then apply the criteria and tendencies to data from the Nakh-Daghestanian language Hinuq. Hinuq makes extensive use of spatial cases for marking adjunct-like and argument-like NPs. By means of the criteria and tendencies it is possible to distinguish spatial NPs that come close to canonical arguments from those that are canonical adjuncts, and to place the remaining NPs bearing spatial cases within the argument-adjunct continuum.

  10. Eric Woods - A lone radiographer at the Normandy landings

    International Nuclear Information System (INIS)

    Barrett, Jean; Ferris, Christine

    2009-01-01

    Although much of the activity around D-day is recorded many of the support services such as radiography do not feature. This account of a radiographer at the Normandy landings gives an insight into the everyday work of a lone radiographer in the Armed Forces in the 1940s. This work is the product of an oral history taken by Jean Barrett in accordance with the acknowledged ethical requirements of oral history. Eric Wood has given his permission for the publication of his stories. The work was presented at the conference for the British Society for the History of Radiology 2008 (Sheffield).

  11. Biotechnology Education and the Internet. ERIC Digest.

    Science.gov (United States)

    Lee, Thomas

    The world of modern biotechnology is based on recent developments in molecular biology, especially those in genetic engineering. Since this is a relatively new and rapidly advancing field of study, there are few traditional sources of information and activities. This digest highlights biotechnology resources including those that can be found on…

  12. Creativity in Adulthood. ERIC Digest No. 204.

    Science.gov (United States)

    Kerka, Sandra

    Popular misconceptions about creativity include the following: it is limited to a few unique individuals, it declines seriously with age, and it is associated with uniqueness or innovation. As the focus of creativity research has shifted from examination of the personality traits of creative individuals to examination of the social and…

  13. Efficacy of adjunctive celecoxib treatment for patients with major depressive disorder: a meta-analysis.

    Science.gov (United States)

    Na, Kyoung-Sae; Lee, Kang Joon; Lee, Ji Sung; Cho, Young Sung; Jung, Han-Yong

    2014-01-03

    Numerous studies have reported that inflammation is closely associated with depression, and adjunctive non-steroidal anti-inflammatory drug (NSAID) treatment has been suggested as a novel therapeutic approach for depression. We searched electronic databases including Medline, Embase, and the Cochrane Central Register of Controlled Trials. We only included randomized controlled trials comparing adjunctive NSAIDs with placebos for treating depressive episodes. Of the 654 retrieved entries, we identified four relevant studies with a total of 150 patients (75 NSAID patients and 75 placebo patients) with depressive episodes. All four studies used celecoxib as the NSAID. The patients receiving adjunctive celecoxib had significantly higher mean changes in the Hamilton Rating Scale for Depression scores between baseline and endpoint measurements compared with those receiving placebo (weighted mean difference=3.26, 95% confidence interval; CI=1.81 to 4.71). The adjunctive celecoxib group also showed better remission (odds ratio; OR=6.58, 95% CI=2.55 to 17.00) and response rates (OR=6.49, 95% CI=2.89 to 14.55) than the placebo group. The all-cause drop-out rate was more favorable for the celecoxib group than for the placebo group (OR=0.45, 95% CI=0.18 to 1.13), although the statistical significance was not statistically significant (p=0.09). Adjunctive treatment with NSAIDs, particularly celecoxib, can be a promising strategy for patients with depressive disorder. Future studies with a larger sample size and longer study duration are needed to confirm the efficacy and tolerability of NSAIDs for depression. © 2013.

  14. Adjunctive cognitive behavioural treatment for chronic pain couples improves marital satisfaction but not pain management outcomes.

    Science.gov (United States)

    Ramke, S; Sharpe, L; Newton-John, T

    2016-11-01

    Data have consistently shown that patient coping with chronic pain can be affected by various factors associated with the primary relationship, and hence efforts to include the patient's partner in the treatment process have merit. This study evaluated the benefit of adding an adjunctive, couples-based, cognitive behavioural treatment (CBT) for chronic pain to a standard cognitive behavioural pain management programme. Forty-five couples were randomly assigned to either an adjunctive couples intervention (n = 19) or the pain programme only (n = 26). All patient participants completed a 3-week multi-disciplinary pain management programme, to which their partners were invited to attend one full day. In addition, partners in the adjunctive condition received four, one hour treatment sessions focusing on pain education, patient-partner communication, operant behavioural principles and relapse prevention strategies. Partner sessions for the adjunctive intervention were provided over the telephone. By the completion of the pain programme the adjunctive couples intervention demonstrated significant improvements in marital satisfaction for the spouses over and above attendance at the pain management programme alone (p = 0.003). However, spouse involvement did not facilitate any additional response to treatment for pain patients on marital satisfaction, pain, disability or any indices of distress. All treatment gains were maintained at 1 month follow-up. These data demonstrate that a brief CBT intervention can significantly improve marital satisfaction for spouses of chronic pain patients, but the treatment does not translate to improvements in function on any outcomes, including marital satisfaction, for patients of chronic pain. WHAT DOES THIS STUDY ADD?: A brief, telephone-based intervention for couples living with chronic pain is an acceptable format for intervention. This intervention can significantly improve marital satisfaction for partners of chronic pain

  15. "Innovation and Intellectual Property Policies in European Research Infrastructure Consortia - PART I: The Case of the European Spallation Source ERIC"

    DEFF Research Database (Denmark)

    Yu, Helen; Wested, Jakob; Minssen, Timo

    2017-01-01

    of the problems society is facing today. To facilitate the creation and operation of such RIs, the EU adopted legal frameworks for European Research Infrastructure Consortia (ERIC). On August 31, 2015, the European Spallation Source (ESS) was established as an ERIC. Under the ERIC Regulations and ESS Statutes......, the European Spallation Source ERIC is required to adopt various policy documents relating to the operation and management of the facility. These cover a wide variety of issues such as user access, public procurement, intellectual property rights (IPR), data management, and dissemination. One of the main goals...... international research collaborations? The complex relationship between scientific excellence, innovation, and IPRs must be carefully considered. Taking the European Spallation Source ERIC as an example, this article investigates ERIC Regulations and EU policies and discusses what issues and perspectives ERICs...

  16. DNA fingerprinting by ERIC-PCR for comparing Listeria spp. strains isolated from different sources in San Luis: Argentina Caracterización molecular por ERIC-PCR de cepas de Listeria spp. aisladas de diversos orígenes en San Luis: Argentina

    Directory of Open Access Journals (Sweden)

    A. Laciar

    2006-04-01

    Full Text Available In this study, a total of 24 Listeria spp. strains were analyzed. Twenty-two isolates were obtained in San Luis (Argentina from human, animal, and food samples. Two types of strains, Listeria monocytogenes CLIP 22762 and Listeria innocua CLIP 74915, were included as reference strains. All isolates were biochemically identified and characterized by serotyping, phage typing, and amplification of the flaA gene by polymerase chain reaction (PCR. Repetitive intergenic consensus (ERIC sequence-based PCR was used to generate DNA fingerprints. On the basis of ERIC-PCR fingerprints, Listeria spp. strains were divided into three major clusters matching origin of isolation. ERIC-PCR fingerprints of human and animal isolates were different from those of food isolates. In addition, groups I and II included ten L. monocytogenes strains, and only one Listeria seeligeri strain. Group III included nine L. innocua strains and four L. monocytogenes strains. Computer evaluation of ERIC-PCR fingerprints allowed discrimination between the tested serotypes 1/2b, 4b, 6a, and 6b within each major cluster. The index of discrimination calculated was 0.94. This study suggests that the ERIC-PCR technique provides an alternative method for the identification of Listeria species and the discrimination of strains within one species.En este estudio se analizaron 24 cepas de Listeria spp. De ellas, 22 fueron obtenidas en San Luis (Argentina, a partir de muestras humanas, de animales y alimentos. Se incluyeron 2 cepas de referencia Listeria monocytogenes CLIP 22762 y Listeria innocua CLIP 74915. Todos los aislamientos fueron identificados bioquímicamente y caracterizados por serotipificación, fagotipificación y detección del gen flaA por reacción en cadena de la polimerasa (PCR. Se generaron perfiles de bandas de ADN mediante la amplificación de secuencias repetitivas de consenso intergénico de enterobacterias (ERIC-PCR. De acuerdo a los resultados obtenidos por ERIC

  17. Calretinin as a Diagnostic Adjunct for Ameloblastoma

    Directory of Open Access Journals (Sweden)

    Chitra Anandani

    2014-01-01

    Full Text Available Background. Calretinin is a 29 kDa calcium-binding protein of the EF-hand family which is expressed in a variety of normal and tumorigenic tissues. Its expression in odontogenic epithelium during odontogenesis and in neoplastic odontogenic tissues has been demonstrated. Unicystic ameloblastoma poses a diagnostic challenge, as its histologic presentation can be sometimes mistaken for keratocystic odontogenic tumor (KCOT. This study was performed to assess the usefulness of calretinin as a confirmatory marker for ameloblastic tissue. Methodology. Total of 40 cases: 16 unicystic ameloblastoma, 4 multicystic ameloblastoma, and 20 KCOT, were evaluated immunohistochemically for the presence, localization, distribution, and intensity of calretinin expression. Statistical analysis was done using Chi-square test to intercompare the expression between ameloblastoma and KCOT. Results. Sixteen cases of ameloblastoma (12 unicystic, 4 multicystic showed positive calretinin staining of ameloblastic epithelium and only one case of KCOT was positive for calretinin, with the positivity restricted to the stellate reticulum like epithelium. Intercomparison between two groups revealed statistically significant difference (P=0.000. Conclusion. Calretinin appears to be a specific immunohistochemical marker for neoplastic ameloblastic epithelium and may be an important diagnostic adjunct in the differential diagnosis of ameloblastoma and KCOT.

  18. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY

    Directory of Open Access Journals (Sweden)

    Ece Barça

    2015-10-01

    Full Text Available Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic.

  19. Hyperbaric Oxygen as an Adjunct Treatment of Freezing Cold Injury

    National Research Council Canada - National Science Library

    Mekjavic, Igor B; Gorjanc, Jurij; Mekjavic, Polana J; Bajrovic, Fajko; Milcinski, Metka

    2005-01-01

    .... With the exception of freezing cold injury, hyperbaric oxygen therapy is now accepted as an adjunct therapy for the management of all other acute traumatic peripheral ischaemias, such as crush...

  20. Adjunct Faculty Job Satisfaction in California Community Colleges: A Narrative Inquiry

    Science.gov (United States)

    Nagle, Tonya

    2016-01-01

    The problem addressed in the qualitative narrative inquiry is the perceived level of adjunct faculty job satisfaction. The general problem is the inconclusive and contradictory information on job satisfaction for adjuncts nationwide. The specific problem is poor job satisfaction for adjunct faculty in California where adjuncts are 48% of the…

  1. A Worthy Asset: The Adjunct Faculty and the Influences on Their Job Satisfaction

    Science.gov (United States)

    Rich, Telvis

    2015-01-01

    The author explored the intrinsic factors that foster job satisfaction of adjunct faculty members working in the southeastern United States. The literature concerning adjunct work experiences is limited, although adjuncts comprise the great majority of the faculty pool in many community and technical colleges. Twenty-seven adjuncts' work…

  2. Metabolic assessment of aripiprazole as adjunctive therapy in major depressive disorder: a pooled analysis of 2 studies.

    Science.gov (United States)

    Fava, Maurizio; Wisniewski, Stephen R; Thase, Michael E; Baker, Ross A; Tran, Quynh-Van; Pikalov, Andrei; Yang, Huyuan; Marcus, Ronald N; Berman, Robert M

    2009-08-01

    In 2 identical multicenter, double-blind, placebo-controlled trials, an 8-week prospective treatment phase to ensure inadequate response to standard antidepressants was followed with 6 weeks of aripiprazole (2-20 mg/d) or placebo, plus a standard antidepressant. This pooled analysis involving 737 patients across the 2 studies evaluated the metabolic effects of adjunctive aripiprazole in patients with major depressive disorder. Outcomes included mean change from end of prospective treatment phase to endpoint in body weight, waist circumference, fasting levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides (TG), fasting plasma glucose, and glycosylated hemoglobin (hemoglobin A1C). Logistic regression determined whether baseline variables were associated with weight gain or whether weight change was associated with clinical outcome. Statistically significant increases occurred in mean body weight (adjunctive aripiprazole, +1.73 kg, vs adjunctive placebo, +0.38 kg; P or = 7%) weight gain versus placebo (5.2% vs 0.6%; P Depression Rating Scale score, fasting TG, fasting glucose, and standard antidepressants were not clinically meaningful predictors of weight gain with adjunctive aripiprazole, and change in weight had no correlation with clinical outcome. Adjunctive aripiprazole produced no significant changes versus placebo in mean waist circumference, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, TG, fasting plasma glucose, or hemoglobin A1C. Also, there was no apparent change in the incidence of National Cholesterol Education Program-defined abnormal metabolic measures after treatment with aripiprazole.

  3. Physics and medicine: at Erice the new perspectives of an ancient cooperation

    CERN Multimedia

    2004-01-01

    From April the 15th to the 17th, at Ettore Majorana Foundation in Erice, in the context of the International School on Physics and Industry, there will be a congress entitled "Particle accelerators and detectors: from physics to medicine".

  4. Meditation as an Adjunct to the Management of Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Adam B. Levin

    2014-01-01

    Full Text Available Background. Multiple sclerosis (MS disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS. Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness. Results. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL and improved coping skills. Conclusion. All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.

  5. Characteristics of Dutch and Swiss primary care COPD patients - baseline data of the ICE COLD ERIC study.

    Science.gov (United States)

    Siebeling, Lara; Puhan, Milo A; Muggensturm, Patrick; Zoller, Marco; Ter Riet, Gerben

    2011-01-01

    INTERNATIONAL COLLABORATIVE EFFORT ON CHRONIC OBSTRUCTIVE LUNG DISEASE: Exacerbation Risk Index Cohorts (ICE COLD ERIC) is a prospective cohort study with chronic obstructive pulmonary disease (COPD) patients from Switzerland and The Netherlands designed to develop and validate practical COPD risk indices that predict the clinical course of COPD patients in primary care. This paper describes the characteristics of the cohorts at baseline. Standardized assessments included lung function, patient history, self-administered questionnaires, exercise capacity, and a venous blood sample for analysis of biomarkers and genetics. A total of 260 Dutch and 151 Swiss patients were included. Median age was 66 years, 57% were male, 38% were current smokers, 55% were former smokers, and 76% had at least one and 40% had two or more comorbidities with cardiovascular disease being the most prevalent one. The use of any pulmonary and cardiovascular drugs was 84% and 66%, respectively. Although lung function results (median forced expiratory volume in 1 second [FEV(1)] was 59% of predicted) were similar across the two cohorts, Swiss patients reported better COPD-specific health-related quality of life (Chronic Respiratory Questionnaire) and had higher exercise capacity. COPD patients in the ICE COLD ERIC study represent a wide range of disease severities and the prevalence of multimorbidity is high. The rich variation in these primary care cohorts offers good opportunities to learn more about the clinical course of COPD.

  6. Characteristics of Dutch and Swiss primary care COPD patients – baseline data of the ICE COLD ERIC study

    Science.gov (United States)

    Siebeling, Lara; Puhan, Milo A; Muggensturm, Patrick; Zoller, Marco; ter Riet, Gerben

    2011-01-01

    Introduction International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts (ICE COLD ERIC) is a prospective cohort study with chronic obstructive pulmonary disease (COPD) patients from Switzerland and The Netherlands designed to develop and validate practical COPD risk indices that predict the clinical course of COPD patients in primary care. This paper describes the characteristics of the cohorts at baseline. Material and methods Standardized assessments included lung function, patient history, self-administered questionnaires, exercise capacity, and a venous blood sample for analysis of biomarkers and genetics. Results A total of 260 Dutch and 151 Swiss patients were included. Median age was 66 years, 57% were male, 38% were current smokers, 55% were former smokers, and 76% had at least one and 40% had two or more comorbidities with cardiovascular disease being the most prevalent one. The use of any pulmonary and cardiovascular drugs was 84% and 66%, respectively. Although lung function results (median forced expiratory volume in 1 second [FEV1] was 59% of predicted) were similar across the two cohorts, Swiss patients reported better COPD-specific health-related quality of life (Chronic Respiratory Questionnaire) and had higher exercise capacity. Discussion COPD patients in the ICE COLD ERIC study represent a wide range of disease severities and the prevalence of multimorbidity is high. The rich variation in these primary care cohorts offers good opportunities to learn more about the clinical course of COPD. PMID:22135502

  7. Topical corticosteroids as adjunctive therapy for bacterial keratitis

    Science.gov (United States)

    Herretes, Samantha; Wang, Xue; Reyes, Johann MG

    2014-01-01

    Background Bacterial keratitis is a serious ocular infectious disease that can lead to severe visual disability. Risk factors for bacterial corneal infection include contact lens wear, ocular surface disease, corneal trauma, and previous ocular or eyelid surgery. Topical antibiotics constitute the mainstay of treatment in cases of bacterial keratitis, whereas the use of topical corticosteroids as an adjunctive therapy to antibiotics remains controversial. Topical corticosteroids are usually used to control inflammation using the smallest amount of the drug. Their use requires optimal timing, concomitant antibiotics, and careful follow-up. Objectives The objective of the review was to assess the effectiveness and safety of corticosteroids as adjunctive therapy for bacterial keratitis. Secondary objectives included evaluation of health economic outcomes and quality of life outcomes. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2014), EMBASE (January 1980 to July 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to July 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 July 2014. We also searched the Science Citation Index to identify additional studies that had cited the only trial included in the original version of this review, reference lists of included trials, earlier reviews, and the American Academy of Ophthalmology guidelines. We also contacted experts to identify any unpublished and

  8. Meta-analysis of adjunctive levetiracetam in refractory partial sei

    Directory of Open Access Journals (Sweden)

    ZHANG Ying

    2012-10-01

    Full Text Available Objective To evaluate the effects and tolerability of adjunctive levetiracetam (LEV in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive LEV in refractory partial seizures from January 1998 to December 2010 were retrieved from Cochrane Library, MEDLINE, EMbase, Social Sciences Citation Index (SSCI, VIP, Chinese National Knowledge Infrastructure (CNKI database, China Biology Medicine (CBM. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted by using RevMan 5.0 software. Results According to the enrollment criteria, eleven prospective, randomized controlled clinical trials with a total of 1192 in LEV group and 789 in placebo group were finally selected. The reduction in three endpoints (a 50% or greater reduction of partial seizure frequency per week, a 75% or greater reduction of partial seizure frequency per week and seizure free was significant in LEV group than placebo group. There was no significance between LEV group and placebo group in the withdrawl rate (1000 mg/d: OR = 1.180, 95%CI: 0.690-2.010, P = 0.540; 2000 mg/d: OR = 1.530, 95%CI: 0.770-3.030, P = 0.230; 3000 mg/d: OR = 1.000, 95% CI: 0.620-1.600, P = 1.000. The following adverse events were associated with LEV: somnolence (OR = 1.720, 95%CI: 1.280-2.310, P = 0.000, dizziness (OR = 1.490, 95%CI: 1.000-2.220, P = 0.050, asthenia (OR = 1.670, 95%CI: 1.140-2.240, P = 0.008, nasopharyngitis (OR = 1.120, 95% CI: 0.710-1.760, P = 0.630, psychiatric and behavioral abnormalities (OR = 2.120, 95% CI: 1.370-3.280, P = 0.000. Conclusion LEV is effective and well tolerated when added to existing therapy in patients with refractory partial seizures compared with control drugs. Further studies are needed to identify the effects of monotherapy of LEV in partial seizures.

  9. Economic Evaluation of Adjunctive Azithromycin Prophylaxis for Cesarean Delivery.

    Science.gov (United States)

    Harper, Lorie M; Kilgore, Meredith; Szychowski, Jeff M; Andrews, William W; Tita, Alan T N

    2017-08-01

    To compare the costs associated with adjunctive azithromycin compared with standard cefazolin antibiotic prophylaxis alone for unscheduled and scheduled cesarean deliveries. A decision analytic model was created to compare cefazolin alone with azithromycin plus cefazolin. Published incidences of surgical site infection after cesarean delivery were used to estimate the baseline incidence of surgical site infection in scheduled and unscheduled cesarean delivery using standard antibiotic prophylaxis. The effectiveness of adjunctive azithromycin prophylaxis was obtained from published randomized controlled trials for unscheduled cesarean deliveries. No randomized study of its use in scheduled procedures has been completed. Cost estimates were obtained from published literature, hospital estimates, and the Healthcare Cost and Utilization Project and considered costs of azithromycin and surgical site infections. A series of sensitivity analyses were conducted by varying parameters in the model based on observed distributions for probabilities and costs. The outcome was cost per cesarean delivery from a health system perspective. For unscheduled cesarean deliveries, cefazolin prophylaxis alone would cost $695 compared with $335 for adjunctive azithromycin prophylaxis, resulting in a savings of $360 (95% CI $155-451) per cesarean delivery. In scheduled cesarean deliveries, cefazolin prophylaxis alone would cost $254 compared with $111 for adjunctive azithromycin prophylaxis, resulting in a savings of $143 (95% CI 98-157) per cesarean delivery, if proven effective. These findings were robust to a multitude of inputs; as long as adjunctive azithromycin prevented as few as seven additional surgical site infections per 1,000 unscheduled cesarean deliveries and nine additional surgical site infections per 10,000 scheduled cesarean deliveries, adjunctive azithromycin prophylaxis was cost-saving. Adjunctive azithromycin prophylaxis is a cost-saving strategy in both unscheduled

  10. Host modulation therapeutics in periodontics: role as an adjunctive periodontal therapy.

    Science.gov (United States)

    Shinwari, Muhammad Saad; Tanwir, Farzeen; Hyder, Pakiza Raza; Bin Saeed, Muhammad Humza

    2014-09-01

    Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades. However, its use in dentistry has only been recently reported. The objective of this article is to present a review of the various literatures available on HMT and also its role as adjunct therapy in periodontics. For identifying studies for this review, a PUBMED search was carried out in 2013 for all articles published till December 2012. The search was restricted to English language publications only. Longitudinal prospective and retrospective studies were included in the search. The key words used were: Host Modulation Therapy; Sub antimicrobial dose doxycycline and Non-Surgical Periodontal Therapy. The main outcomes sought were host modulation therapeutics in periodontics. Exclusion criteria included cross sectional studies, short case series as well as studies with short follow-up periods. There is a paucity of literature on HMT in periodontics although the only drug approved by United States Food and Drug Administration (FDA) is a subantimicrobial dose of doxycycline (SDD) with highly predictable results as a host modulating agent in periodontal diseases and also an effective adjunctive therapy in various diseases of periodontium. However, more randomized controlled trials are needed to obtain clinical guidelines on the usage of other host modulating agents as adjunct as well as definite therapy for periodontal diseases. SDD is an effective adjunct therapy when used in dosage of 20mg twice daily for minimum 3 months duration in various periodontal diseases with predictable clinical outcomes. It is also recommended that future clinical research on anti cytokine drugs, chemically modified tetracycline and other HMT agents should be conducted so that new drugs are available with highly predictable results.

  11. Anti-inflammatory Actions of Adjunctive Tetracyclines and Other Agents in Periodontitis and Associated Comorbidities

    Science.gov (United States)

    Tilakaratne, Aruni; Soory, Mena

    2014-01-01

    The non-antimicrobial properties of tetracyclines such as anti-inflammatory, proanabolic and anti-catabolic actions make them effective pharmaceuticals for the adjunctive management of chronic inflammatory diseases. An over-exuberant inflammatory response to an antigenic trigger in periodontitis and other chronic inflammatory diseases could contribute to an autoimmune element in disease progression. Their adjunctive use in managing periodontitis could have beneficial effects in curbing excessive inflammatory loading from commonly associated comorbidities such as CHD, DM and arthritis. Actions of tetracyclines and their derivatives include interactions with MMPs, tissue inhibitors of MMPs, growth factors and cytokines. They affect the sequence of inflammation with implications on immunomodulation, cell proliferation and angiogenesis; these actions enhance their scope, in treating a range of disease entities. Non-antimicrobial chemically modified tetracyclines (CMTs) sustain their diverse actions in organ systems which include anti-inflammatory, anti-apoptotic, anti-proteolytic actions, inhibition of angiogenesis and tumor metastasis. A spectrum of biological actions in dermatitis, periodontitis, atherosclerosis, diabetes, arthritis, inflammatory bowel disease, malignancy and prevention of bone resorption is particularly relevant to minocycline. Experimental models of ischemia indicate their specific beneficial effects. Parallel molecules with similar functions, improved Zn binding and solubility have been developed for reducing excessive MMP activity. Curbing excessive MMP activity is particularly relevant to periodontitis, and comorbidities addressed here, where specificity is paramount. Unique actions of tetracyclines in a milieu of excessive inflammatory stimuli make them effective therapeutic adjuncts in the management of chronic inflammatory disorders. These beneficial actions of tetracyclines are relevant to the adjunctive management of periodontitis subjects

  12. The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Tsung-Lung Yang

    2013-01-01

    Full Text Available Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT and digital mammography (DM for breast cancers. Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test. Result. A total of 59 breast cancers were reviewed, including 17 (28.8% mass lesions, 12 (20.3% focal asymmetry/density, 6 (10.2% architecture distortion, 23 (39.0% calcifications, and 1 (1.7% intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (<0.001 between the BIRADS category and index lesions was noted. Conclusion. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

  13. The adjunctive digital breast tomosynthesis in diagnosis of breast cancer.

    Science.gov (United States)

    Yang, Tsung-Lung; Liang, Huei-Lung; Chou, Chen-Pin; Huang, Jer-Shyung; Pan, Huay-Ben

    2013-01-01

    To compare the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for breast cancers. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications) and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test. A total of 59 breast cancers were reviewed, including 17 (28.8%) mass lesions, 12 (20.3%) focal asymmetry/density, 6 (10.2%) architecture distortion, 23 (39.0%) calcifications, and 1 (1.7%) intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (BIRADS category and index lesions was noted. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

  14. Efficacy, safety and tolerability of rasagiline as adjunctive therapy in elderly patients with Parkinson's disease.

    Science.gov (United States)

    Tolosa, E; Stern, M B

    2012-02-01

    Rasagiline, an MAO-B inhibitor, is indicated for the treatment of Parkinson's disease (PD). In this post hoc analysis, the efficacy, safety and tolerability of rasagiline as an adjunct to levodopa were compared with placebo in elderly (≥70 years) and younger (Rasagiline: Efficacy and Safety on the Treatment of 'OFF' and Lasting effect in Adjunct therapy with Rasagiline Given Once daily randomized, double-blind, placebo-controlled trials with the primary efficacy end-point being the reduction from baseline in daily OFF time. Secondary efficacy end-points included scores for Clinical Global Improvement (CGI)-Examiner during ON time, Unified Parkinson's Disease Rating Scale (UPDRS)-ADL during OFF time, UPDRS-Motor during ON time and total daily ON time with and without troublesome dyskinesia. Tolerability was evaluated from adverse events (AEs) in the two age groups. Rasagiline decreased daily OFF time versus placebo (Prasagiline but were not significant. Between-group comparisons (≥70 vs. 0.1), and rasagiline was well tolerated amongst both groups of patients with a comparable incidence of total and dopaminergic AEs (P>0.1). Adjunct rasagiline is efficacious and well tolerated in elderly non-demented patients (≥70 years) with moderate to advanced PD. Confirmation of the efficacy and safety of rasagiline in the elderly patient subgroup is especially relevant because of the increasing number of elderly patients with PD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

  15. Retention and recruitment of general dentists in an adjunct teaching model-A pilot study.

    Directory of Open Access Journals (Sweden)

    Brian J Howe

    Full Text Available Retention and recruitment of part time clinical adjunct faculty members in dental education is becoming increasingly difficult as dental schools come to rely on this workforce for their increased involvement in clinical education. Contributing factors include full time faculty shortage, aging workforce, practice and student debt, practice and family commitments, and financial compensation. This study attempts to ascertain barriers to teaching so appropriate strategies can be formulated to address this issue.In the spring of 2016 an email survey was sent to current and former adjunct faculty members to ascertain demographics and retention and recruitment strategies. Descriptive analyses were completed for all variables in the sample.Twenty nine of forty six subjects responded to the survey with a response rate of 63%. Subjects over the age of sixty comprised 55% with only 17% being under the age of forty five. Overall family and practice commitments along with compensation were the primary barriers to teaching part time. For new dentists, student loan debt was the primary barrier to teaching. Travel to teach was also a barrier as 70% of respondents drove 200 miles or less to the dental school.The study demonstrated that the aging part time work force is a great concern and new part time clinical adjunct faculty members must be recruited. Barriers to recruitment and retention of faculty must be considered and addressed to sustain this teaching model.

  16. Effects of adjunctive exercise on physiological and psychological parameters in depression: a randomized pilot trial.

    Science.gov (United States)

    Kerling, Arno; Tegtbur, Uwe; Gützlaff, Elke; Kück, Momme; Borchert, Luise; Ates, Zeynep; von Bohlen, Anne; Frieling, Helge; Hüper, Katja; Hartung, Dagmar; Schweiger, Ulrich; Kahl, Kai G

    2015-05-15

    Major depressive disorder (MDD) is associated with decreased physical activity and increased rates of the metabolic syndrome (MetS), a risk factor for the development of type 2 diabetes and cardiovascular disorders. Exercise training has been shown to improve cardiorespiratory fitness and metabolic syndrome factors. Therefore, our study aimed at examining whether patients receiving an exercise program as an adjunct to inpatient treatment will benefit in terms of physiological and psychological factors. Fourty-two inpatients with moderate to severe depression were included. Twenty-two patients were randomized to additional 3x weekly exercise training (EXERCISE) and compared to treatment as usual (TAU). Exercise capacity was assessed as peak oxygen uptake (VO2peak), ventilatory anaerobic threshold (VAT) and workload expressed as Watts (W). Metabolic syndrome was defined according to NCEP ATPIII panel criteria. After 6 weeks of treatment, cardiorespiratory fitness (VO2peak, VAT, Watt), waist circumference and HDL cholesterol were significantly improved in EXERCISE participants. Treatment response expressed as ≥50% MADRS reduction was more frequent in the EXERCISE group. Adjunctive exercise training in depressed inpatients improves physical fitness, MetS factors, and psychological outcome. Given the association of depression with cardiometablic disorders, exercise training is recommended as an adjunct to standard antidepressant treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. On the structural position of non-peripheral adjunct clauses

    Directory of Open Access Journals (Sweden)

    Maria Lobo

    2002-06-01

    Full Text Available This paper is concerned with the structural position occupied by a subset of adjunct clauses, namely those which can occur in final position without a special intonational break. After a definition of the structures to be considered, it will be shown that the classical assumption according to which they are generated as adjuncts is empirically superior to the adjunct-as-complement analysis (cf. Larson 1988; 1990, and to more recent analyses, which follow an antisymmetric framework (cf. Kayne 1994. It will also be shown that a base generation account of preverbal adverbial clauses is to be preferred over a movement analysis on the basis of empirical data, and in conformity with theoretical economy assumptions (Merge over Move.

  18. Fans of Columbine shooters Eric Harris and Dylan Klebold

    Directory of Open Access Journals (Sweden)

    Andrew Ryan Rico

    2015-09-01

    Full Text Available On April 20, 1999, Eric Harris and Dylan Klebold murdered 12 students and one teacher at Columbine High School in Littleton, Colorado, in what was then the deadliest school shooting in American history. Despite causing a national panic and serving as a flash point for larger narratives on bullying, gun control, and media violence, both boys have gained active online fans. These fandoms dedicated to the Columbine shooters are widely referred to as dark examples of Internet communities, while the fans are also frequently denigrated as unstable and violent outcasts. Such dark online fandoms are yet to permeate mainstream culture or to challenge the preexisting perception of these communities as breeding grounds for the next wave of school shooters. While studies have covered the types of fans and their myriad interests, the field remains focused on more conventional examples of fan communities. In an effort to challenge and expand the object of focus when we study fandom, this qualitative study examines Columbine fans and their activity in order to understand the dominant motives they appear to have for engaging with and around such controversial figures and then concludes by exploring how this community might help us reflect more broadly on our concept of fandom. Redeeming these fans as part of diverse and complex communities of social relevance can demonstrate how even a dark fandom such as that of these Columbine shooters provides valuable cultural insights and benefits the field of fan studies.

  19. Eric Hermelin and mystical hermeneutics: interpretation beyond itself

    Directory of Open Access Journals (Sweden)

    Tina Hamrin

    1999-01-01

    Full Text Available Eric Hermelin (1860-1944 translated more than 10.000 pages Persian Sufi poetry, German texts by Jakob Böhme and Latin texts by Emmanuel Swedenborg. In the translation process Hermelin shaped his strategies and perceptions in ways which served their patterns of desire, and what they constructed reflected and served their own unique identity. Added up, the devices which constitute strategies of reading set in motion by the selfs defense of its identity are: Defenses, Expectations, Fantasies, and Transformations. Hermelin's mystical hermeneutics produced not only understanding of texts, but often no less produced an increased awareness, with appropriate hermeneutical sensitivity, of self-perception and self-identity. A self-awareness and a strengthening of an individual and corporate identity as one who has a stake in the texts and that to which they bear witness constitutes an important reader-effect in this case of Sufi poetry. But without any principle of suspicion, in Gadamer's terminology a premature fusion of horizons will take place before Hermelin has listened in openness with respect for the tension between the horizons of the text and the horizon of Hermelin. The textual horizon has col-lapsed into that of Hermelin's narrative biography, and is unable to do more than to speak back his own valnes and desires. Something socio-pragmatical was after all woven into the controversial bon vivant, when he used literary works to replicate himself. At the same time, the texts spoke from beyond the self.

  20. Exercise as an adjunctive treatment for cannabis use disorder.

    Science.gov (United States)

    Brellenthin, Angelique G; Koltyn, Kelli F

    2016-09-01

    Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users. The aim of this paper is to inform the topic regarding exercise's potential as an adjunctive treatment for individuals with CUD. We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD. Cannabis use is widespread and increasing in the United States. Chronic, heavy cannabis use may dysregulate the endogenous cannabinoid system, which has implications for several psychobiological processes that interact with the eCB system such as reward processing and the stress response. Given that exercise is a potent activator of the eCB system, it is mechanistically plausible that exercise could be an optimal method to supplement cessation efforts by reducing psychophysical withdrawal, managing stress, and attenuating drug cravings. We suggest there is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD. Moreover, it will be especially important to include the investigation of psychobiological mechanisms (e.g., eCBs, hippocampal volume), which have been associated with both exercise and SUDs, to examine the broader impact of exercise on behavioral and physiological responses to treatment.

  1. Embracing complexity: the post-secular pilgrimage of Eric-Emmanuel Schmitt

    Directory of Open Access Journals (Sweden)

    Ruth Illman

    2010-01-01

    Full Text Available This article deals with the phenomenon of pilgrimage as a personal transformative process; an exploration of spiritual space rather than a journey undertaken to a physical place. The analysis focuses on the life story and authorship of the novelist and playwright Eric-Emmanuel Schmitt (b. 1960. Schmitt began his career as an academic philosopher specialised in enlightenment rationality. A mystical experience in the deserts of Sahara, however, opened his eyes to the spiritual dimensions of reality and encouraged him to redirect his professional strivings from academic writing to fiction. Today, Schmitt has reached a world-wide audience with his plays and novels on interreligious dialogue, especially the series of five short novellas called Le cycle d’Invisible. These narratives all deal with inter-religious encounters in a complex and compassionate way as Schmitt is particularly concerned with preserving the mystery of the situations he describes. The atheist conviction of his previous life has thus given way to an agnostic and mystically inspired world view focusing on diversity, divinity and inexplicability: “I am obsessed with complexity”, as he puts it himself. The presentation is based on ethnographic material, and key themes to be addressed include pilgrimage as a spiritual journey, interreligious encounters and mystical experiences.

  2. Similarity-Based Interference and the Acquisition of Adjunct Control

    NARCIS (Netherlands)

    Gerard, Juliana; Lidz, Jeffrey; Zuckerman, Shalom; Pinto, M.|info:eu-repo/dai/nl/159504198

    2017-01-01

    Previous research on the acquisition of adjunct control has observed non-adultlike behavior for sentences like “John bumped Mary after tripping on the sidewalk.” While adults only allow a subject control interpretation for these sentences (that John tripped on the sidewalk), preschool-aged children

  3. Short term results of pterygium surgery with adjunctive amniotic ...

    African Journals Online (AJOL)

    One patient developed dellen 1 week post‑operatively with complete resolution following conservative large soft contact lens application. Conclusion: Short term results suggests that adjunctive amniotic membrane transplant with pterygium excision is effective and safe. A larger randomized clinical trial with a longer ...

  4. Soaps and Germicides as Adjunct Topical Antimycotic Agents on ...

    African Journals Online (AJOL)

    Objective: The study aims at evaluating the potentials of soaps and germicides / disinfectants as adjunct topical anti-vulvovaginal candidasis agents. Methods: In vitro inhibitory activities of the test agents, prepared according to the manufacturer's specification for toilet and midwifery purposes were determined using modified ...

  5. Pharmacodynamic Effect of N-Acetylcysteine as Adjunctive Therapy ...

    African Journals Online (AJOL)

    Purpose: To evaluate the pharmacodynamic effect of N-acetylcysteine (NAC) in mild systemic lupus erythematosus (SLE) patients in order to implement NAC as adjunctive therapy in SLE population. Methods: Forty mild SLE patients were randomly allocated to receive 1800 mg of NAC with SLE standard therapy or receive ...

  6. Zonisamide efficacy as adjunctive therapy in children with refractory epilepsy.

    Science.gov (United States)

    Karimzadeh, Parvaneh; Ashrafi, Mahmoud Reza; Bakhshandeh Bali, Mohammad Kazem; Nasehi, Mohammad Mahdi; Taheri Otaghsara, Seyedeh Mohadeseh; Taghdiri, Mohammad Mahdi; Ghofrani, Mohammad

    2013-01-01

    Approximately one third of epileptic children do not achieve complete seizure improvement. Zonisamide is a new antiepileptic drug which is effective as adjunctive therapy in treatment of intractable partial seizures. The purpose of the current study was to evaluate the effectiveness, safety, and tolerability of Zonisamide in epileptic children. From November 2011 until October 2012, 68 children who referred to Children's Medical Center and Mofid Children Hospital due to refractory epilepsy (failure of seizure control with the use of two or more anticonvulsant drugs) entered the study. The patients were treated with Zonisamide by dose of 2- 12 mg/kg daily in addition to the previous medication. We followed the children every three to four-weeks intervals based on daily frequency, severity and duration of seizures. During the follow-up equal and more than fifty percent reduction in seizure frequency or severity known as response to the drug. In this study 68 patients were examined that 61 children reached the last stage.35 (57.4%) were male and 26 (42.6%) patients were female. After first and six months of Zonisamide administration daily seizure frequency decreased to 2.95±3.54 and 3.73±3.5 respectively. There was significant difference between seizure frequency in first and six month after Zonisamide toward initial attacks. After six months ZNS therapy a little side effects were created in 10 patients (16.4%) including stuttering(4.9%), decreased appetite (4.9%), hallucination (1.6%), dizziness(1.6%), blurred vision(1.6%) and suspiring(1.6%) as all of them eliminated later dosage reduction. This study confirms the short term efficacy and safety of Zonisamide in children with refractory epilepsies.

  7. Meeting Ontario's Need for Educational Information: An Evaluation of the SDC/ERIC On-Line Bibliographic Search Service.

    Science.gov (United States)

    Auster, Ethel; Lawton, Stephen B.

    Using an opportunity to test the latest developments of computerized retrieval of Educational Resources Information Center (ERIC) data, various aspects of the ERIC system that had previously gone unexamined were explored. The test of the system, which involved the use of an on-line computer terminal, is documented. Investigators were concerned…

  8. Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

    2013-04-01

    Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

  9. Saladusi mäletavad pildid : järelvaade Eric Soovere fotograafilisele dokumentalistikale / Peeter Linnap

    Index Scriptorium Estoniae

    Linnap, Peeter, 1960-

    2009-01-01

    Ameerikas elanud eesti fotograafi Eric Soovere (sünd. Erich Soeson, 1916-2008) eluloolisi andmeid. Tema loomingust, mis jaguneb kolme perioodi: etnograafiline fotokooslus Lõuna-Eesti külaelanikest (1930ndate lõpp), Sooverede perekonna põgenemisteekond Eestist USA-sse (ca 1944-1949), perekonna elu Cincinnatis USA-s (1950ndad). Fotod eestlaste põgenemisteekonnast on avaldatud raamatus Eric Soovere. Käru ja kaameraga : pilte ja päevikulehti põgenemisteelt 1944-1949. Tallinn : Olion, 1999

  10. The Analog (Computer) As a Physiology Adjunct.

    Science.gov (United States)

    Stewart, Peter A.

    1979-01-01

    Defines and discusses the analog computer and its use in a physiology laboratory. Includes two examples: (1) The Respiratory Control Function and (2) CO-Two Control in the Respiratory System. Presents diagrams and mathematical models. (MA)

  11. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health.

    Science.gov (United States)

    James, Patrice; Worthington, Helen V; Parnell, Carmel; Harding, Mairead; Lamont, Thomas; Cheung, Andrea; Whelton, Helen; Riley, Philip

    2017-03-31

    Dental plaque associated gingivitis is a reversible inflammatory condition caused by accumulation and persistence of microbial biofilms (dental plaque) on the teeth. It is characterised by redness and swelling of the gingivae (gums) and a tendency for the gingivae to bleed easily. In susceptible individuals, gingivitis may lead to periodontitis and loss of the soft tissue and bony support for the tooth. It is thought that chlorhexidine mouthrinse may reduce the build-up of plaque thereby reducing gingivitis. To assess the effectiveness of chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for the control of gingivitis and plaque compared to mechanical oral hygiene procedures alone or mechanical oral hygiene procedures plus placebo/control mouthrinse. Mechanical oral hygiene procedures were toothbrushing with/without the use of dental floss or interdental cleaning aids and could include professional tooth cleaning/periodontal treatment.To determine whether the effect of chlorhexidine mouthrinse is influenced by chlorhexidine concentration, or frequency of rinsing (once/day versus twice/day).To report and describe any adverse effects associated with chlorhexidine mouthrinse use from included trials. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 28 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (searched 28 September 2016); MEDLINE Ovid (1946 to 28 September 2016); Embase Ovid (1980 to 28 September 2016); and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 28 September 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We included randomised controlled trials assessing

  12. Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure

    Science.gov (United States)

    Kim, Carole H; Chen, Monica F; Coleman, Anne L

    2017-01-01

    Background Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management. Objectives To assess the effects of antibiotics combined with steroids versus antibiotics alone for the treatment of acute endophthalmitis following intraocular surgery or intravitreous injection. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1980 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 8 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 8 December 2016, and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 8 December 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized controlled trials comparing the effectiveness of adjunctive steroids with antibiotics alone in the management of acute, clinically diagnosed endophthalmitis following intraocular surgery or intravitreous injection. We excluded trials with participants with endogenous endophthalmitis unless outcomes were reported by source of infection. We imposed no restrictions on the method or order of administration, dose, frequency, or duration of antibiotics and

  13. Efficacy of Adjunctive Sleep Interventions for PTSD

    Science.gov (United States)

    2008-03-01

    included obstructive sleep apnea , lack of interest and incompatible time requests, substance use disorder, and severe ongoing psychiatric conditions...therapeutic strategies for post-deployment mental health difficulties, and provide novel information regarding predictors of sleep treatment response...Returning Veterans with PTSD: Preliminary Findings. Oral Presentation. Sleep 2008, June 7-12, 2008, Baltimore, MD • Walsh C, Germain A

  14. Phytochemicals as Adjunctive with Conventional Anticancer Therapies.

    Science.gov (United States)

    Farzaei, Mohammad Hosein; Bahramsoltani, Roodabeh; Rahimi, Roja

    2016-01-01

    Cancer is defined as the abnormal proliferations of cells which could occur in any tissue and can cause life-threatening malignancies with high financial costs for both patients and health care system. Plant-derived secondary metabolites are shown to have positive role in various diseases and conditions. The aim of the present study is to summarize clinical evidences on the benefits of phytochemicals as adjuvant therapy along with conventional anticancer therapies. Electronic databases including Pubmed, Scopus and Cochrane library were searched with the keywords "chemotherapeutic", "anticancer", "antineoplastic" or "radiotherapy" with "plant", "extract", "herb", or "phytochemical", until July 2015. Only clinical studies were included in this review. The findings showed that positive effects of phytochemicals are due to their direct anticarcinogenic activity, induction of relief in cancer complications, as well as their protective role against side effects of conventional chemotherapeutic agents. Results obtained from current review demonstrated that numerous phytochemical agents from different chemical categories including alkaloid, benzopyran, coumarin, carotenoid, diarylheptanoid, flavonoid, indole, polysaccharide, protein, stilbene, terpene, and xanthonoid possess therapeutic effect in patients with different types of cancer. Polyphenols are the most studied components. Curcumin, ginsenosides, lycopene, homoharringtonine, aviscumine, and resveratrol are amongst the major components with remarkable volumes of clinical evidence indicating their direct anticancer activities in different types of cancer including hepatocarcinoma, prostate cancer, leukemia and lymphoma, breast and ovarian cancer, and gastrointestinal cancers. Cannabinoids, cumarin, curcumin, ginsenosides, epigallocatechin gallate, vitexin, and salidroside are phytochemicals with significant alleviative effect on synthetic chemotherapy- induced toxicities. There is lack of evidence from clinical

  15. Osteopathic manipulative treatment as a useful adjunctive tool for pneumonia.

    Science.gov (United States)

    Yao, Sheldon; Hassani, John; Gagne, Martin; George, Gebe; Gilliar, Wolfgang

    2014-05-06

    Pneumonia, the inflammatory state of lung tissue primarily due to microbial infection, claimed 52,306 lives in the United States in 2007 (1) and resulted in the hospitalization of 1.1 million patients (2). With an average length of in-patient hospital stay of five days (2), pneumonia and influenza comprise significant financial burden costing the United States $40.2 billion in 2005 (3). Under the current Infectious Disease Society of America/American Thoracic Society guidelines, standard-of-care recommendations include the rapid administration of an appropriate antibiotic regiment, fluid replacement, and ventilation (if necessary). Non-standard therapies include the use of corticosteroids and statins; however, these therapies lack conclusive supporting evidence (4). (Figure 1) Osteopathic Manipulative Treatment (OMT) is a cost-effective adjunctive treatment of pneumonia that has been shown to reduce patients' length of hospital stay, duration of intravenous antibiotics, and incidence of respiratory failure or death when compared to subjects who received conventional care alone (5). The use of manual manipulation techniques for pneumonia was first recorded as early as the Spanish influenza pandemic of 1918, when patients treated with standard medical care had an estimated mortality rate of 33%, compared to a 10% mortality rate in patients treated by osteopathic physicians (6). When applied to the management of pneumonia, manual manipulation techniques bolster lymphatic flow, respiratory function, and immunological defense by targeting anatomical structures involved in the these systems(7,8, 9, 10). The objective of this review video-article is three-fold: a) summarize the findings of randomized controlled studies on the efficacy of OMT in adult patients with diagnosed pneumonia, b) demonstrate established protocols utilized by osteopathic physicians treating pneumonia, c) elucidate the physiological mechanisms behind manual manipulation of the respiratory and

  16. Adjunctive therapy in Parkinson's disease: the role of rasagiline

    Directory of Open Access Journals (Sweden)

    Gaines KD

    2012-07-01

    Full Text Available Kathryn D Gaines,1 Vanessa K Hinson21Department of Neurology, Aurora Advanced Healthcare, Milwaukee, WI, 2Department of Neurosciences, Movement Disorders Program, Medical University of South Carolina, Charleston, SC, USAAbstract: Parkinson's disease is the second most common neurodegenerative disorder, currently affecting 1.5 million people in the US. In this review, we describe the diagnostic and pathological features of Parkinson's disease, as well as its clinical course. We then review pharmacologic treatments for the disease, with a particular focus on therapies adjunctive to levodopa and specifically the role of rasagiline. We review the four pivotal rasagiline trials, and discuss rasagiline and its use as adjunctive therapy for Parkinson's disease. Finally, we discuss potential side effects, drug interactions, and other practical aspects concerning the use of rasagiline in Parkinson's disease.Keywords: Parkinson's disease, treatment, rasagiline, clinical trials

  17. Social networking sites: an adjunctive treatment modality for psychological problems.

    Science.gov (United States)

    Menon, Indu S; Sharma, Manoj Kumar; Chandra, Prabha S; Thennarasu, K

    2014-07-01

    Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. It has implications for developing social networking based adjunctive treatment modality for psychological problems.

  18. Similarity-Based Interference and the Acquisition of Adjunct Control

    Directory of Open Access Journals (Sweden)

    Juliana Gerard

    2017-10-01

    Full Text Available Previous research on the acquisition of adjunct control has observed non-adultlike behavior for sentences like “John bumped Mary after tripping on the sidewalk.” While adults only allow a subject control interpretation for these sentences (that John tripped on the sidewalk, preschool-aged children have been reported to allow a much wider range of interpretations. A number of different tasks have been used with the aim of identifying a grammatical source of children’s errors. In this paper, we consider the role of extragrammatical factors. In two comprehension experiments, we demonstrate that error rates go up when the similarity increases between an antecedent and a linearly intervening noun phrase, first with similarity in gender, and next with similarity in number marking. This suggests that difficulties with adjunct control are to be explained (at least in part by the sentence processing mechanisms that underlie similarity-based interference in adults.

  19. Utility of adjunctive modalities in Coronary chronic total occlusion intervention

    Directory of Open Access Journals (Sweden)

    Hemal Bhatt

    2017-05-01

    Full Text Available Coronary chronic total occlusion (CTO intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i.e., using fractional flow reserve. In this review we present the current literature describing the utility and efficacy of these adjunctive modalities in CTO intervention.

  20. Sensorimotor rhythm neurofeedback as adjunct therapy for Parkinson's disease.

    Science.gov (United States)

    Philippens, Ingrid H C H M; Wubben, Jacqueline A; Vanwersch, Raymond A P; Estevao, Dave L; Tass, Peter A

    2017-08-01

    Neurofeedback may enhance compensatory brain mechanisms. EEG-based sensorimotor rhythm neurofeedback training was suggested to be beneficial in Parkinson's disease. In a placebo-controlled study in parkinsonian nonhuman primates we here show that sensorimotor rhythm neurofeedback training reduces MPTP-induced parkinsonian symptoms and both ON and OFF scores during classical L-DOPA treatment. Our findings encourage further development of sensorimotor rhythm neurofeedback training as adjunct therapy for Parkinson's disease which might help reduce L-DOPA-induced side effects.

  1. Social Networking Sites: An Adjunctive Treatment Modality for Psychological Problems

    OpenAIRE

    Menon, Indu S.; Sharma, Manoj Kumar; Chandra, Prabha S.; Thennarasu, K.

    2014-01-01

    Background: Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Materials and Methods: Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psyc...

  2. An update on adjunctive treatment options for bipolar disorder.

    Science.gov (United States)

    Dean, Olivia M; Gliddon, Emma; Van Rheenen, Tamsyn E; Giorlando, Francesco; Davidson, Sandra K; Kaur, Manreena; Ngo, Trung T; Williams, Lana J

    2018-03-01

    Bipolar disorder is a complex illness often requiring combinations of therapies to successfully treat symptoms. In recent years, there have been significant advancements in a number of therapies for bipolar disorder. It is therefore timely to provide an overview of current adjunctive therapeutic options to help treating clinicians to inform their patients and work towards optimal outcomes. Publications were identified from PubMed searches on bipolar disorder and pharmacotherapy, nutraceuticals, hormone therapy, psychoeducation, interpersonal and social rhythm therapy, cognitive remediation, mindfulness, e-Health and brain stimulation techniques. Relevant articles in these areas were selected for further review. This paper provides a narrative review of adjunctive treatment options and is not a systematic review of the literature. A number of pharmacotherapeutic, psychological and neuromodulation treatment options are available. These have varying efficacy but all have shown benefit to people with bipolar disorder. Due to the complex nature of treating the disorder, combination treatments are often required. Adjunctive treatments to traditional pharmacological and psychological therapies are proving useful in closing the gap between initial symptom remission and full functional recovery. Given that response to monotherapy is often inadequate, combination regimens for bipolar disorder are typical. Correspondingly, psychiatric research is working towards a better understanding of the disorder's underlying biology. Therefore, treatment options are changing and adjunctive therapies are being increasingly recognized as providing significant tools to improve patient outcomes. Towards this end, this paper provides an overview of novel treatments that may improve clinical outcomes for people with bipolar disorder. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Acupuncture as an adjunct to pulmonary rehabilitation.

    LENUS (Irish Health Repository)

    Deering, Brenda M

    2012-02-01

    PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and by both systemic and airway inflammation. In COPD, acupuncture has been shown to improve quality-of-life scores and decrease breathlessness; similar findings have also been reported after pulmonary rehabilitation (PR). The hypothesis of this study was that acupuncture in conjunction with pulmonary rehabilitation would improve COPD outcome measures compared to pulmonary rehabilitation alone. METHODS: The design was a randomized prospective study; all subjects had COPD. There were 19 controls, 25 who underwent PR, and 16 who had both acupuncture and PR. The primary outcome measure was a change in measures of systemic inflammation at the end of PR and at 3 month followup. Lung function, including maximum inspiratory pressure (PiMax), quality-of-life scores, functional capacity including steps taken, dyspnea scores, and exercise capacity, were secondary endpoints. RESULTS: After PR, both groups had significantly improved quality-of-life scores, reduced dyspnea scores, improved exercise capacity, and PiMax, but no change in measures of systemic inflammation compared with the controls. There were no differences in most of the outcome measures between the 2 treatment groups except that subjects who had both acupuncture and PR remained less breathless for a longer period. CONCLUSION: The addition of acupuncture to PR did not add significant benefit in most of the outcomes measured.

  4. Freedom of Speech: A Clear and Present Need to Teach. ERIC Report.

    Science.gov (United States)

    Boileau, Don M.

    1983-01-01

    Presents annotations of 21 documents in the ERIC system on the following subjects: (1) theory of freedom of speech; (2) theorists; (3) research on freedom of speech; (4) broadcasting and freedom of speech; and (5) international questions of freedom of speech. (PD)

  5. Safety Hazards in Science Classrooms. ERIC/SMEAC Science Education Digest No. 1, 1986.

    Science.gov (United States)

    Blosser, Patricia E.

    Safety hazards that are frequently found in science classrooms are addressed in this digest which updates and supplements the 1980 ERIC/SMEAC information bulletin "Safety in the Science Classroom." Information obtained from journal articles and safety guides is presented in the categories of: (1) risks involved in science activities; (2)…

  6. Guia Para Ver La Television En Familia (Guidelines for Family Television Viewing). ERIC Digest.

    Science.gov (United States)

    ERIC Clearinghouse on Elementary and Early Childhood Education, Urbana, IL.

    This ERIC digest addresses problems associated with children's excessive viewing of television programs and commercials and provides suggestions to help parents guide their children's television viewing. Children who watch television 3 to 5 hours a day have little time for other activities such as play, reading, and talking with others. Excessive…

  7. Use of the Spanish Language in the United States: Trends, Challenges, and Opportunities. ERIC Digest.

    Science.gov (United States)

    Santiestevan, Stina

    This ERIC digest examines the Spanish-speaking group in the United States, its growth through net immigration and natural increase, and its eventual decline as speakers shift to English. The Hispanic population is growing rapidly, but data suggest that U.S. Hispanics do learn and speak English. Research predicts that by the year 2001 the…

  8. Automating the School Library Media Center. A Select ERIC Bibliography. Mini-Bib.

    Science.gov (United States)

    Preston, Nancy R., Comp.

    This 13-item annotated bibliography was compiled through a search of the Educational Resources Information Center (ERIC) database using the following descriptors: Library Automation, Bibliographic Databases, Bibliographic Utilities, Online Catalogs, Machine Readable Cataloging, and Integrated Library Systems. Among the issues addressed are the…

  9. Small-Group Cooperative Learning. The Best of ERIC on Educational Management Number 76.

    Science.gov (United States)

    ERIC Clearinghouse on Educational Management, Eugene, OR.

    Annotations from 12 entries in the ERIC database were selected as significant and useful sources of information about small-group cooperative learning. Five of the citations are literature reviews. Among these is a meta-analysis, drawn from 217 studies, about the effects of cooperative learning on student achievement and interpersonal attraction;…

  10. Cooperative Learning in Social Studies Education: What Does the Research Say? ERIC Digest No. 20.

    Science.gov (United States)

    ERIC Clearinghouse for Social Studies/Social Science Education, Boulder, CO.

    This ERIC Digest describes research findings, mainly in elementary social studies classrooms, on the effects of cooperative learning on multicultural awareness and cross-ethnic friendships, interpersonal relationships, and prosocial behavior. Research findings on cooperative techniques in the classroom are summarized as follows: compared with…

  11. Learning about the Human Genome. Part 2: Resources for Science Educators. ERIC Digest.

    Science.gov (United States)

    Haury, David L.

    This ERIC Digest identifies how the human genome project fits into the "National Science Education Standards" and lists Human Genome Project Web sites found on the World Wide Web. It is a resource companion to "Learning about the Human Genome. Part 1: Challenge to Science Educators" (Haury 2001). The Web resources and…

  12. Patient Susceptibility to Candidiasis—A Potential for Adjunctive Immunotherapy

    Science.gov (United States)

    Davidson, Linda; Netea, Mihai G.; Kullberg, Bart Jan

    2018-01-01

    Candida spp. are colonizing fungi of human skin and mucosae of the gastrointestinal and genitourinary tract, present in 30–50% of healthy individuals in a population at any given moment. The host defense mechanisms prevent this commensal fungus from invading and causing disease. Loss of skin or mucosal barrier function, microbiome imbalances, or defects of immune defense mechanisms can lead to an increased susceptibility to severe mucocutaneous or invasive candidiasis. A comprehensive understanding of the immune defense against Candida is essential for developing adjunctive immunotherapy. The important role of underlying genetic susceptibility to Candida infections has become apparent over the years. In most patients, the cause of increased susceptibility to fungal infections is complex, based on a combination of immune regulation gene polymorphisms together with other non-genetic predisposing factors. Identification of patients with an underlying genetic predisposition could help determine which patients could benefit from prophylactic antifungal treatment or adjunctive immunotherapy. This review will provide an overview of patient susceptibility to mucocutaneous and invasive candidiasis and the potential for adjunctive immunotherapy. PMID:29371502

  13. Patient Susceptibility to Candidiasis—A Potential for Adjunctive Immunotherapy

    Directory of Open Access Journals (Sweden)

    Linda Davidson

    2018-01-01

    Full Text Available Candida spp. are colonizing fungi of human skin and mucosae of the gastrointestinal and genitourinary tract, present in 30–50% of healthy individuals in a population at any given moment. The host defense mechanisms prevent this commensal fungus from invading and causing disease. Loss of skin or mucosal barrier function, microbiome imbalances, or defects of immune defense mechanisms can lead to an increased susceptibility to severe mucocutaneous or invasive candidiasis. A comprehensive understanding of the immune defense against Candida is essential for developing adjunctive immunotherapy. The important role of underlying genetic susceptibility to Candida infections has become apparent over the years. In most patients, the cause of increased susceptibility to fungal infections is complex, based on a combination of immune regulation gene polymorphisms together with other non-genetic predisposing factors. Identification of patients with an underlying genetic predisposition could help determine which patients could benefit from prophylactic antifungal treatment or adjunctive immunotherapy. This review will provide an overview of patient susceptibility to mucocutaneous and invasive candidiasis and the potential for adjunctive immunotherapy.

  14. Adjunct Antimicrobial Therapy and Periodontal Surgery to Treat Generalized Aggressive Periodontitis: A Case Report.

    Science.gov (United States)

    Irokawa, Daisuke; Makino-Oi, Asako; Fujita, Takahisa; Yamamoto, Shigeki; Tomita, Sachiyo; Saito, Atsushi

    2016-01-01

    Here we report a case of generalized aggressive periodontitis treated with periodontal therapy including adjunct antimicrobial therapy and periodontal surgery. The patient was a 22-year-old woman who presented with the chief complaint of gingival recession. Baseline examination revealed generalized plaque deposition and gingival inflammation. Thirty-nine percent of the sites had a probing depth (PD) of 4-6 mm and 2% a PD of ≥7 mm; 63% exhibited bleeding on probing (BOP). Radiographic examination revealed vertical bone loss in the molars and horizontal bone loss in other teeth. Microbiological examination of subgingival plaque revealed the presence of Aggregatibacter actinomycetemcomitans and Tannerella forsythia. Oral health-related quality of life was assessed as a measure of patient-reported outcome. Based on a clinical diagnosis of generalized aggressive periodontitis, initial periodontal therapy and adjunct antimicrobial therapy were implemented. After reducing inflammation and subgingival bacteria, open flap debridement was performed for teeth with a PD of ≥4 mm. Reevaluation showed no sites with a PD of ≥5 mm, a minimal level of BOP, and a marked reduction in the level of the targeted periodontal pathogens. The patient's oral health-related quality of life was slightly worsened during supportive periodontal therapy (SPT). Implementation of adjunct antimicrobial therapy targeting periodontal pathogens and subsequent periodontal surgery resulted in improvement in periodontal and microbiological parameters. This improvement has been adequately maintained over a 2-year period. However, additional care is necessary to further improve the patient's oral health-related quality of life during SPT.

  15. Adjunctive use of the diode laser in non-surgical periodontal therapy: exploring the controversy.

    Science.gov (United States)

    Porteous, Mary Sornborger; Rowe, Dorothy J

    2014-04-01

    Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.

  16. Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

    Science.gov (United States)

    Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

    2017-08-01

    Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p depressive disorder. Further studies are warranted to confirm the potential of this accessible agent to optimise

  17. Randomized trial of adjunctive topiramate therapy in infants with refractory partial seizures.

    Science.gov (United States)

    Novotny, E; Renfroe, B; Yardi, N; Nordli, D; Ness, S; Wang, S; Weber, T; Kurland, C L; Yuen, E; Eerdekens, M; Venkatraman, L; Nye, J S; Ford, L

    2010-03-02

    To evaluate the efficacy and safety of adjunctive topiramate (sprinkle capsules or oral liquid) in reducing daily rates of partial-onset seizures (POS) in infants with refractory POS. In this double-blind, placebo-controlled, parallel-group, international study, infants (n = 149) with clinical or EEG evidence of refractory POS were randomly allocated (1:1:1:1) to receive adjunctive topiramate 5, 15, or 25 mg/kg/d or placebo for 20 days. The primary variable was the median percentage reductions in daily POS rate from baseline to final assessment as recorded on a 48-hour video-EEG. Of the 149 infants (mean age 12 months) included in the intent-to-treat analysis set, 130 completed the study. Median percentage reduction from baseline in daily POS rate was not significantly different (p = 0.97) between topiramate 25 mg/kg (20.4%) and placebo (13.1%). Lower doses were not formally tested, but nominal p values for comparisons with placebo were not significant (15-mg/kg/d dose: p = 0.97; 5-mg/kg/d dose: p = 0.91). Treatment-emergent fever, diarrhea, vomiting, anorexia, weight decrease, somnolence, and viral infection occurred more frequently (> or = 10% difference) with topiramate than with placebo. In infants aged 1-24 months, topiramate 5, 15, or 25 mg/kg/d was not effective as adjunctive treatment for refractory partial-onset seizures. No new safety concerns associated with topiramate use were noted. This interventional study provides Class I evidence that topiramate 5, 15, or 25 mg/kg/d compared with placebo does not significantly reduce seizure rates in infants aged 1 month to 2 years with refractory partial-onset seizures.

  18. Meta-analysis of adjunctive dexamethasone to improve clinical outcome of bacterial meningitis in children.

    Science.gov (United States)

    Wang, Ying; Liu, Xinjie; Wang, Yuzhen; Liu, Qi; Kong, Cuicui; Xu, Guixia

    2018-02-01

    The current recommended therapies for bacterial meningitis are effective antimicrobial agents and the implementation of childhood vaccination programs. However, the role of adjunctive dexamethasone therapy in bacterial meningitis remains controversial. Using meta-analysis, this study aims to investigate the efficacy of adjunctive dexamethasone therapy in bacterial meningitis by comparing it with antibiotic therapy. Documents of randomized controlled trials (RCT) related to the treatment of bacterial meningitis in children with dexamethasone published since the establishment of the databases to December in 2016 were retrieved from the databases of Cochrane Library, Pubmed, MEDLINE, EMBASE, Chinese BioMedical Literature Database, and China National Knowledge Infrastructure. The references in RCT were retrieved by hands at the same time. Full texts of screened documents were searched and given qualitative review, and then, all RCT included were analyzed statistically by using Review Manger 5.3 software. The search yielded 15 studies (2409 children cases), among which 4 fall in grade A and 11 were grade B. The results of meta-analysis have shown that patients who received dexamethasone have significantly lower risks in incidence of hearing loss (OR = 0.68, 95%CI 0.53-0.89, P = 0.004) and severe neurological sequelae (OR = 0.59, 95%CI 0.37-0.95, P = 0.03), but the follow-up mortality is hardly effected (OR = 0.86, 95%CI 0.67-1.10, P = 0.23). Evidence has proven that the adjunctive administration of dexamethasone is conducive to treating children with bacterial meningitis to a certain extent, to decreasing the possibility of hearing loss and severe neurological sequelae, but has no significant effect on the follow-up mortality.

  19. A double-blind, placebo-controlled study of edivoxetine as an adjunctive treatment for patients with major depressive disorder who are partial responders to selective serotonin reuptake inhibitor treatment.

    Science.gov (United States)

    Ball, Susan; Dellva, Mary Anne; D'Souza, Deborah N; Marangell, Lauren B; Russell, James M; Goldberger, Celine

    2014-01-01

    This phase 2 study examined the efficacy and tolerability of edivoxetine, a highly selective norepinephrine reuptake inhibitor, as an adjunctive treatment for patients with major depressive disorder (MDD) who have a partial response to selective serotonin reuptake inhibitor (SSRI) treatment. Study design consisted of double-blind, 10-week therapy of adjunctive edivoxetine (6-18 mg once daily) or adjunctive placebo with SSRI. Inclusion/entry criteria included partial response to current SSRI by investigator opinion and a GRID 17-item Hamilton Rating Scale for Depression (HAMD17) total score ≥16. The primary efficacy measure was the Montgomery-Asberg Depression Rating Scale (MADRS). Safety measures included treatment-emergent adverse events (TEAE) and vital signs. For the primary evaluable population (n=63 for adjunctive edivoxetine and n=68 for adjunctive placebo), the treatment groups did not differ significantly on the primary outcome of change from baseline to week 8 in the MADRS total score; the effect size of edivoxetine treatment was 0.26. Significant treatment differences, favoring adjunctive edivoxetine (p≤.05), were shown for improvements in role functioning and the functional impact of fatigue. For the adjunctive edivoxetine randomized group (N=111), the most frequent TEAEs were hyperhidrosis (7.2%), nausea (7.2%), erectile dysfunction (6.3%) and testicular pain (6.3%). Hemodynamic changes were observed in blood pressure and pulse rate between treatment groups. Study was underpowered for an alpha 2-sided 0.05 significance level for the primary outcome. For patients with MDD who had a partial response to SSRIs, adjunctive edivoxetine treatment was not statistically superior to adjunctive placebo on the primary outcome measure. However, pending further study, improved functioning and remission rate suggest a potential role for edivoxetine for patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Adjunct Faculty: Perception of Leadership Styles, Leadership Outcomes, and Organizational Commitment in Online and Faith-Based Education Settings

    Science.gov (United States)

    Pope Zinsser, Kam Lara

    2017-01-01

    Research indicates that adjunct faculty continues to grow in the higher education setting. Overall, universities continue to hire adjunct faculty to facilitate online courses and as a cost saving measure. While institutions continue to rely on adjunct faculty, a disconnection exists between the adjunct and the higher education administrators. This…

  1. Identification of a Proton-Chloride Antiporter (EriC) by Himar1 Transposon Mutagenesis in Lactobacillus reuteri and Its Role in Histamine Production

    Science.gov (United States)

    Hemarajata, P; Spinler, JK; Balderas, MA; Versalovic, J

    2014-01-01

    The gut microbiome may modulate intestinal immunity by luminal conversion of dietary amino acids to biologically active signals. The model probiotic organism Lactobacillus reuteri ATCC PTA 6475 is indigenous to the human microbiome, and converts the amino acid L-histidine to the biogenic amine, histamine. Histamine suppresses TNF production by human myeloid cells and is a product of L-histidine decarboxylation, which is a proton-facilitated reaction. A transposon mutagenesis strategy was developed based on a single-plasmid nisin-inducible Himar1 transposase/transposon delivery system for L. reuteri. A highly conserved proton-chloride antiporter gene (eriC), a gene widely present in the gut microbiome was discovered by Himar1 transposon (Tn)-mutagenesis presented in this study. Genetic inactivation of eriC by transposon insertion and genetic recombineering resulted in reduced ability of L. reuteri to inhibit TNF production by activated human myeloid cells, diminished histamine production by the bacteria and downregulated expression of histidine decarboxylase (hdc) cluster genes compared to those of WT 6475. EriC belongs to a large family of ion transporters that includes chloride channels and proton-chloride antiporters and may facilitate the availability of protons for the decarboxylation reaction, resulting in histamine production by L. reuteri. This report leverages the tools of bacterial genetics for probiotic gene discovery. The findings highlight the widely conserved nature of ion transporters in bacteria and how ion transporters are coupled with amino acid decarboxylation and contributed to microbiome-mediated immunomodulation. PMID:24488273

  2. Characteristics of Dutch and Swiss primary care COPD patients - baseline data of the ICE COLD ERIC study

    NARCIS (Netherlands)

    Siebeling, Lara; Puhan, Milo A.; Muggensturm, Patrick; Zoller, Marco; ter Riet, Gerben

    2011-01-01

    INTERNATIONAL COLLABORATIVE EFFORT ON CHRONIC OBSTRUCTIVE LUNG DISEASE: Exacerbation Risk Index Cohorts (ICE COLD ERIC) is a prospective cohort study with chronic obstructive pulmonary disease (COPD) patients from Switzerland and The Netherlands designed to develop and validate practical COPD risk

  3. Friginal, Eric & Hardy, Jack A. (2014. Corpus-based sociolinguistics: A guide for students. New York and London: Routledge

    Directory of Open Access Journals (Sweden)

    Pierfranca Forchini

    2015-08-01

    Full Text Available This review highlights the content of Corpus-Based Sociolinguistics: A Guide for Students by Eric Friginal and Jack A. Hardy, which maps out a clear and systematic path for corpus applications in sociolinguistics.

  4. Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics-a retrospective study.

    Science.gov (United States)

    Eick, Sigrun; Nydegger, Jasmin; Bürgin, Walter; Salvi, Giovanni E; Sculean, Anton; Ramseier, Christoph

    2018-02-21

    The purpose of this retrospective study was to assess the impact of microbiological diagnostics on the outcomes of periodontal treatment with or without adjunctive use of systemic antibiotics. Patient files were screened for microbiological analysis before (T1) and after non-surgical periodontal therapy (T2). Medical history, diagnosis, clinical data, and results of the microbiological analysis were extracted from the patient's file. After descriptive statistics, logistic regression analysis was performed to model the presence of 90 and 50% reductions of numbers of sites with probing depths (PD) of ≥ 5 mm at T2 (90%-PD5 and 50%-PD5), respectively, against the presence of bacterial species, clinical diagnosis, and adjunctive use of systemic antibiotics. Eighteen patients diagnosed with aggressive periodontitis (AP, 17 with adjunctive antibiotics) and 84 with chronic periodontitis (CP, 31 with adjunctive antibiotics) were included in the analysis. Logistic modeling of bacteria at T1 to 90%-PD5 failed to show any statistical significance. Using 50%-PD5, presence of all Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola and in particular of T. denticola at T1 was associated with good response to therapy. Modeling of bacterial presence to 90-%PD5 and to 50-%PD5 at T2 found an association with absence of T. forsythia (90-%PD5 and 50-%PD5) and of T. denticola and Campylobacter rectus (50%-PD5). Modeling bacteria at T1, antibiotic group and oral hygiene at T2 on 50%-PD5 revealed odds ratio (OR) of the adjunctive antibiotic group between 2.70 and 52.4, of the oral hygiene between 3.27 and 4.11, and of the bacteria at T1 up to 28.6 (Porphyromonas gingivalis, T. forsythia, or T. denticola). Microbiological analysis of the most important species associated with periodontal diseases appears to support a clinically based decision for the adjunctive use of systemic antibiotics. The present findings appear to support the use microbiological testing to

  5. Adjunctive pregabalin in partial responders with major depressive disorder and residual anxiety.

    Science.gov (United States)

    Vitali, Mario; Tedeschini, Enrico; Mistretta, Martino; Fehling, Kiki; Aceti, Franca; Ceccanti, Mauro; Fava, Maurizio

    2013-02-01

    Anxiety symptoms in depression result often in treatment resistance, residual symptoms, and persistent functional impairment. To assess the effectiveness and safety of adjunctive pregabalin to antidepressants for residual anxiety in patients with major depressive disorder (MDD). A retrospective chart review was conducted to identify partial responders among patients with MDD with residual anxiety. Twenty such patients (age, 58.4 ± 11.2 years; 15 women; baseline Hamilton Depression Rating Scale [HDRS], 17.1 ± 3.5) who received adjunctive pregabalin for residual anxiety were included. Antidepressants augmented were the selective serotonin reuptake inhibitors (n = 12), mirtazapine (n = 2), and selective serotonin-norepinephrine reuptake inhibitors (n = 6). Twenty patients received at least 4 weeks of pregabalin treatment after 8 weeks of antidepressant therapy. At week 1 (9 weeks after initiating treatment), pregabalin was prescribed at a mean ± SD dose of 71.2 ± 31.7 mg, and the mean maximum pregabalin dose prescribed was 156.2 ± 76.5 mg (range, 75-300 mg). At week 8, there were 13 responders (13/20 [65%]), and 7 of these 13 patients achieved remission (HDRS17 anxiety/somatization subscale scores (6.3 ± 2 to 3.6 ± 1.7, P anxiety in MDD.

  6. Individual psychotherapy as an adjunct to group psychotherapy.

    Science.gov (United States)

    Amaranto, E A; Bender, S S

    1990-01-01

    This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.

  7. Exercise as adjunctive treatment for alcohol use disorder

    DEFF Research Database (Denmark)

    Roessler, Kirsten K; Bilberg, Randi; Søgaard Nielsen, Anette

    2017-01-01

    AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled study.......02 [95% CI: 0.47; 2.18], p = 0.968 in the individual exercise condition, which, when compared to the control group as reference, did not differ statistically significantly. Participants with moderate level physical activity had lower odds for excessive drinking OR = 0.12 [0.05; 0.31], p

  8. Tissue-engineering as an adjunct to pelvic reconstructive surgery

    DEFF Research Database (Denmark)

    Jangö, Hanna

    This PhD-thesis is based on animal studies and comprises three original papers and unpublished data. The studies were conducted during my employment as a research fellow at the Department of Obstetrics and Gynecology, Herlev University Hospital, Denmark. New strategies for surgical reconstruction...... functional tissue using stem cells, scaffolds and trophic factors. The aim of this thesis was to investigate the potential adjunctive use of a tissue-engineering technique for pelvic reconstructive surgery using two synthetic biodegradable materials; methoxypolyethyleneglycol-poly(lactic-co-glycolic acid...

  9. Topiramate as an adjunctive therapy in children with intractable epilepsy

    Directory of Open Access Journals (Sweden)

    Hardiono D. Pusponegoro

    2006-12-01

    Full Text Available Background Epilepsy is a chronic disease that requires antiepileptic drugs (AEDs. Only 60-70% of new patients could be controlled effectively by standard AEDs and this stimulates the search for new, more effective and well-tolerated AEDs. Objective To asses the efficacy and safety of topiramate, as an adjunctive therapy to standard AEDs for children with intractable epilepsy. Methods This was an open label, parallel group study. Forty children with at least 4 seizures during a 4-week baseline period were randomly assigned to topiramate (n=20 or control group (n=20. In the topiramate group, the drug was given in adjunct to AEDs for  2-week titration dosage continued with a 12-week stabilization period, while the control group received only AEDs adjusted to their clinical responses. Results Mean reduction from baseline in monthly seizures frequency was significantly greater in the topiramate group (88.6% vs. 25%; P=0.030. Other variable of efficacy was significantly different (e"50% reduction in seizures: 14/20 vs. 6 /20; P=0.049. Adverse effects of topiramate, such as decreased weight, paresthesia, somnolence, diarrhea, fever, aggressive reaction and flushing, were temporary and mild. Conclusion Results of this trial strongly suggested that topiramate is effective and well tolerated in reducing seizures of intractable epilepsy.

  10. Interpretation and grammar interaction in the Spanish subjunctive adjuncts

    Directory of Open Access Journals (Sweden)

    Jeannette Sanchez-Naranjo

    2014-06-01

    Full Text Available This article proposes a multifactor analysis of the Spanish subjunctive adjuncts. By examining the features that govern Spanish mood and their interaction, I present a complete overview of diverse accounts on the Spanish subjunctive. I outline the general principles of those explanations and comment on their advantages and disadvantages in formalizing an explanation concerning the interaction of mood with syntax, semantics, and pragmatics. Next, from mood contribution to the flow in discourse, based on Quer’s (1998, 2001 approach, I provide a role for the subjunctive mood in the discourse, which can be established by a variety of factors. Instead of assigning rigid meanings to the subjunctive, this approach allows the speaker to relate the proposition to the actual world and provide an evaluation of it. In addition to this, I present a proposal to explain mood alternation in adjuncts considering the interaction of different components of the grammar in the process of interpretation. This contribution offers a dynamic view of meaning in which context and individuals are crucial for the interpretation of the Spanish subjunctive.

  11. Exercise as adjunctive treatment for alcohol use disorder

    DEFF Research Database (Denmark)

    Roessler, Kirsten K.; Bilberg, Randi; Søgaard Nielsen, Anette

    2017-01-01

    AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled stu...... was protective against excessive drinking following treatment. A dose-response effect of exercise on drinking outcome supports the need for implementing physically active lifestyles for patients in treatment for alcohol use disorder.......AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled study...... regression model was used to evaluate the odds of excessive drinking among the three groups, based on intention-to-treat. Changes in level of physical activity in all three groups were tested by using a generalized linear mixed model. A multiple linear model was used to test if there was an association...

  12. Efficacy and Safety of Basimglurant as Adjunctive Therapy for Major Depression: A Randomized Clinical Trial.

    Science.gov (United States)

    Quiroz, Jorge A; Tamburri, Paul; Deptula, Dennis; Banken, Ludger; Beyer, Ulrich; Rabbia, Michael; Parkar, Nikhat; Fontoura, Paulo; Santarelli, Luca

    2016-07-01

    Antagonism of the postsynaptic metabotropic glutamate subtype 5 receptor is a novel approach to modulate glutamatergic function and has proven efficacy in a number of preclinical behavioral models of depression. To evaluate the safety and efficacy of basimglurant modified-release (MR) vs placebo as adjunctive therapy to ongoing antidepressant medication therapy in patients with MDD who had inadequate response within the current episode. In this phase 2b, double blind, randomized clinical trial of 333 adult patients with a DSM-IV-TR diagnosis of MDD across 59 research clinics globally, patients were assigned to 1 of 2 doses of basimglurant MR (0.5 or 1.5 mg) or placebo once daily, adjunctive to ongoing antidepressant medication therapy (selective serotonin reuptake inhibitor or serotonin and norepinephrine reuptake inhibitor). Patients were enrolled from October 5, 2011, through July 26, 2013. Six-week treatment with 0.5 mg of basimglurant MR, 1.5-mg basimglurant MR, or placebo once daily, adjunctive to ongoing antidepressant medication therapy. The primary end point was the mean change from baseline score on the Montgomery-Åsberg Depression Rating Scale (MADRS), as rated by the clinician at week 6. Other measures included patient-rated MADRS, Quick Inventory of Depressive Symptomatology-Self-Report, Clinical Global Impression-Improvement, Patient Global Impression-Improvement, and Clinical Global Impression-Severity Scales and adverse events. A total of 596 patients were screened, and 333 were randomized into the study (mean [SD] age, 47 [11.2] years; 216 female [65.1%]). The primary end point (mean change in clinician-rated MADRS score from baseline to end of treatment) was not met (effect size [ES] = 0.16, P = .42; intent-to-treat [ITT] mixed-effects model for repeated measures [MMRM] analysis for comparing 1.5-mg basimglurant MR and placebo). Across secondary and exploratory end points, 1.5-mg basimglurant MR revealed larger improvements vs placebo on

  13. On measurements of Effective Residual Ink Concentration (ERIC) of deinked papers using Kubelka-Munk theory

    Science.gov (United States)

    D.W. Vahey; J.Y. Zhu; C.J. Houtman

    2006-01-01

    The measurement of effective residual ink concentration (ERIC) in recycled papers depends on their opacity. For opacity less than 97.0%, the method is based on application of the Kubelka-Munk theory to diffuse reflection from papers measured once with a black backing and again with a thick backing of the same papers. At opacities above 97.0%, the two reflection values...

  14. Rasagiline adjunct therapy in patients with Parkinson's disease: post hoc analyses of the PRESTO and LARGO trials.

    Science.gov (United States)

    Elmer, Lawrence W

    2013-11-01

    Rasagiline was safe and effective when used as adjunct therapy with levodopa in patients with moderate-to-advanced Parkinson's disease (PD) in the phase III PRESTO and LARGO studies. To assess clinical effects of rasagiline 1 mg/day on cardinal PD symptoms and motor fluctuations in defined patient subgroups using pooled data from PRESTO and LARGO. Both double-blind, randomized, and placebo-controlled studies included PD patients with motor fluctuations despite optimized therapy with levodopa, with or without concomitant dopamine agonists (DA) or catechol-O-methyltransferase inhibitor (COMT-I) treatment. These post hoc analyses measured effects of rasagiline 1 mg vs placebo on individual cardinal PD symptoms during ON time and mean change from baseline in daily OFF time in subgroups of patients who at baseline were receiving only levodopa, were considered "mild fluctuators" (daily OFF time ≤ 4 h), and who were or were not receiving concomitant DA or COMT-I therapy. Compared with placebo, rasagiline significantly improved all cardinal PD symptoms and significantly reduced adjusted mean daily OFF time when used as first adjunct therapy in levodopa-treated patients and in patients with mild motor fluctuations. Significant improvement in motor fluctuations was reported with rasagiline regardless of concomitant DA or COMT-I use. Overall incidence of dopaminergic adverse events did not increase with concomitant DA or COMT-I use. Rasagiline was an effective first adjunct therapy in levodopa-treated patients; benefited patients with signs of early "wearing off"; improved all cardinal PD symptoms; and further improved symptoms in patients already receiving other adjunctive dopaminergic treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Recent results of exenatide use as adjunctive therapy in the treatment of patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Peggy Soule Odegard

    2009-07-01

    Full Text Available Peggy Soule Odegard1, Anthony DeSantis21School of Pharmacy, 2Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA Abstract: Exenatide is a GLP-1 receptor agonist approved for use in type 2 diabetes mellitus. In clinical trials, significant reductions in serum glucose and weight were demonstrated for exenatide with primary glycemic effects of the twice daily formulation on prandial glucose control. In this paper, we review recent research with exenatide as adjunctive therapy in type 2 diabetes mellitus. In particular, studies demonstrate ongoing benefit on glycemic control and weight reduction with continued therapy up to 82 weeks duration and efficacy as adjunctive therapy for patients taking metformin, thiazolidinediones, and/or a sulfonylurea and as compared to sitagliptin and various insulin formulations. Compared to insulin, exenatide likely has greatest benefit for those patients who are overweight or who need improved prandial glucose control. The new long-acting release formulation of exenatide has demonstrated slightly improved efficacy compared to the twice daily formulation as well as a reduction in gastrointestinal side effects. Emerging research is further exploring novel benefits of exenatide as adjunctive DM therapy, effects on prandial glycemic control, markers of hepatic inflammation, alternative dosage forms including intra-nasal administration, and effects on beta cell function.Keywords: exenatide, diabetes, GLP-1

  16. [Virulence-associated gene detection and ERIC-PCR typing of Campylobacter jejuni strains isolated from foods in four Southern Chinese provinces].

    Science.gov (United States)

    Zheng, Yangyun; Wu, Qingping; Wu, Kui; Zhang, Jumei; Guo, Weipeng; Wu, Kegang

    2014-01-04

    To know food contamination and genetic diversity of Campylobacter jejuni in four provinces of South China, and to provide data for C. jejuni-associated foodborne disease prevention and control. According to the national standard and the most probable number (MPN) method, we detected the contamination of C. jejuni from 558 food samples including vegetables, meat product, cooked food, seafood, frozen food, dairy product and edible fungi during 2011 and 2012. The isolates were used to detect 12 virulence-associated genes with PCR methods and construct ERIC-PCR fingerprints. Fourteen positive samples were determined from 558 samples, and all positive samples come from meat product samples. The average value of MPN of positive samples was 8.77 MPN/g. Virulence-associated gene analysis reveals that more than 50% of the C. jejuni isolates had at least 9 virulence genes. Interestingly, virB11 gene was not found and the genes of pldA and wlaN were 14.30% in all isolates. Total of 15 C. jejuni isolates could be divided into 10 genotypes belonging to 3 clusters by ERIC-PCR fingerprints. Meat product was the main source of C. jejuni food contamination in four provinces of South China. More control measures must be taken to avoid C. jejuni contamination.

  17. Escaping institutionality: rebellion and gendered space in Eric, or Little by Little and A Little Princess

    Directory of Open Access Journals (Sweden)

    Kim, Soyoun

    2015-06-01

    Full Text Available By the convention of nineteenth-century school narratives, students are supposed to grow up in the school while their characters are being molded by the standardized educational system. Eric, or Little by Little and A Little Princess both resist the very idea of linear growth that is a trope of the Bildungsroman through endowing their protagonists with the rebelliousness and outsider status of the unruly child. This essay examines how Eric Williams and Sara Crewe, disobedient students who leave their schools after deriving no benefit from the institutional education, illuminate the ways in which institutionality is incorporated with the gendered agendas of nineteenth-century England. Eric and Sara both challenge the authority of the central adult in each tale by exploiting and changing the interior space of the schools; not only the inner structures of each school but also the connection/disconnection between school and home differ in the two stories. My proposition is that in the nineteenth-century school narratives discipline and character-building in the institution are not viewed as inevitable in reaching adulthood for girls, while for boys there is neither exit from the institutionality nor way to recover their lost home and childhood.

  18. [Comparison of Bacteria ERIC-PCR Fingerprints of Index Fingers and Contactants].

    Science.gov (United States)

    Liu, Y T; Sun, D M; Shi, S P; Yang, X

    2018-02-01

    To explore the bacteria relevance between index fingers and contactant' surfaces (mobile phone touch screen and desktop of personal office table). Bacteria were collected from the index fingers, mobile phone touch screen and desktop of personal office table of 10 volunteers. Enterobacterial repetitive intergenic consensus (ERIC)-PCR fingerprint was established by PCR amplification technique of metagenome. There were 7 volunteers' ERIC-PCR fingerprints of index fingers matched that took from the mobile phone touch screens, and different from each other. There were 3 volunteers' ERIC-PCR fingerprints of index fingers matched that took from desk top of personal office table, and other 7 volunteers' ERIC-PCR fingerprints did not match perfectly with that took from desk top of personal office table, but had at least one similar band for both. The bacteria on index finger shows individual specificity, which on mobile phone touching screen and personal desktop may be a new biological sample of forensic identification. Copyright© by the Editorial Department of Journal of Forensic Medicine.

  19. Effectiveness of adjunctive interventions for accelerating orthodontic tooth movement: a systematic review of systematic reviews.

    Science.gov (United States)

    Yi, J; Xiao, J; Li, H; Li, Y; Li, X; Zhao, Z

    2017-08-01

    This study was aimed to summarise published systematic reviews (SRs) that assess the effects of adjunctive interventions on the acceleration of orthodontic tooth movement (OTM). Electronic and manual searches were performed up to August 2016. Systematic reviews investigating the impact of adjunctive techniques on the promotion of OTM were included. The methodological quality of the included reviews was evaluated using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) scale. The quality of evidence for each intervention was assessed using GRADE. The Jadad decision algorithm was used to select a study to provide body evidence from discordant reviews on the same intervention. A total of 11 SRs were included in this study. AMSTAR scores ranged from 4 to 10 of 11. The quality of evidence ranged from very low to low. The short-term (1-3 months) effects of low-level laser therapy (LLLT, 5 and 8 J cm -2 ) and corticotomy were supported by low-quality evidence. The evidence regarding the efficacy of photobiomodulation, pulsed electromagnetic field, interseptal bone reduction, two vibrational devices (Tooth Masseuse and Orthoaccel) and electrical current was of very low quality. Relaxin injections and extracorporeal shock waves were reported to have no impact on OTM according to low- and very low-quality evidence, respectively. Based on currently available information, we conclude that low-quality evidence indicates that LLLT (5 and 8 J cm -2 ) and corticotomy are effective to promote OTM in the short term. Future high-quality trials are required to determine the optimal protocols, as well as the long-term effects of LLLT and corticotomy, before warranting recommendations for orthodontics clinics. © 2017 John Wiley & Sons Ltd.

  20. Characteristics of Dutch and Swiss primary care COPD patients - baseline data of the ICE COLD ERIC study

    Directory of Open Access Journals (Sweden)

    Siebeling L

    2011-10-01

    Full Text Available Lara Siebeling1, Milo A Puhan2,3, Patrick Muggensturm4, Marco Zoller5, Gerben ter Riet11Department of General Practice, Academic Medical Center, University of Amsterdam, The Netherlands; 2Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 3Horten Center for Patient-oriented Research, University of Zurich, 4Department of Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland; 5Department of General Practice, University of Zurich, Zurich, SwitzerlandIntroduction: International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts (ICE COLD ERIC is a prospective cohort study with chronic obstructive pulmonary disease (COPD patients from Switzerland and The Netherlands designed to develop and validate practical COPD risk indices that predict the clinical course of COPD patients in primary care. This paper describes the characteristics of the cohorts at baseline.Material and methods: Standardized assessments included lung function, patient history, self-administered questionnaires, exercise capacity, and a venous blood sample for analysis of biomarkers and genetics.Results: A total of 260 Dutch and 151 Swiss patients were included. Median age was 66 years, 57% were male, 38% were current smokers, 55% were former smokers, and 76% had at least one and 40% had two or more comorbidities with cardiovascular disease being the most prevalent one. The use of any pulmonary and cardiovascular drugs was 84% and 66%, respectively. Although lung function results (median forced expiratory volume in 1 second [FEV1] was 59% of predicted were similar across the two cohorts, Swiss patients reported better COPD-specific health-related quality of life (Chronic Respiratory Questionnaire and had higher exercise capacity.Discussion: COPD patients in the ICE COLD ERIC study represent a wide range of disease severities and the prevalence of multimorbidity is high

  1. Functioning outcomes with adjunctive treatments for major depressive disorder: a systematic review of randomized placebo-controlled studies

    Directory of Open Access Journals (Sweden)

    Weiller E

    2017-12-01

    Full Text Available Emmanuelle Weiller,1 Catherine Weiss,2 Christopher P Watling,3 Christopher Edge,3 Mary Hobart,2 Hans Eriksson,1 Maurizio Fava4–6 1H. Lundbeck A/S, Valby, Copenhagen, Denmark; 2Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA; 3Cambridge Medical Communication Ltd, Cambridge, UK; 4Division of Clinical Research of the MGH Research Institute, 5Department of Psychiatry, 6Clinical Trials Network & Institute (CTNI, Massachusetts General Hospital, Boston, MA, USA Objective: Patients with major depressive disorder (MDD with inadequate response to antidepressant treatment (ADT may suffer a prolonged loss of functioning. This review aimed to determine if self-rated functional measures are informative in randomized placebo-controlled studies of adjunctive therapy in patients with MDD and inadequate response to ADT. Methods: This was a systematic literature review of articles in any language from the MEDLINE database published between January 1990 and March 2017. Eligible studies met the following criteria: patients with MDD; inadequate response to at least one ADT; adjunctive therapy (pharmacological or otherwise to ADT; placebo control group; randomized controlled trial or a post hoc analysis of a randomized controlled trial; reported a self-rated functioning scale. Study characteristics and functioning efficacy data were extracted. Results: A total of 2,090 discrete records were screened, 293 full-text articles were assessed for eligibility, and 26 studies were included. All studies were acute (6–12 weeks except for one 52-week study. The only self-rated functioning scale used in the included studies was the Sheehan Disability Scale (SDS. Of the 13 adjunctive agents identified, aripiprazole, brexpiprazole, edivoxetine, and risperidone improved functioning versus placebo (p<0.05, as measured by the SDS total or mean score. On the SDS “work/studies” item, only aripiprazole had a statistically significant benefit, in one

  2. Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder.

    Science.gov (United States)

    Verduin, Marcia L; LaRowe, Steven D; Myrick, Hugh; Cannon-Bowers, Jan; Bowers, Clint

    2013-03-01

    This study examined the impact of a computer simulation designed to provide the opportunity for individuals with alcohol use disorders (AUDs) to practice relapse prevention skills. Participants were 41 male veterans enrolled in an intensive outpatient substance abuse treatment program. Participants were randomly assigned to either view educational slides about treatment for AUD or play a simulation videogame for eight sessions within 12 weeks. Participants were assessed at a 4-week follow-up visit. Outcome measures included relapse rates as well as ratings on the Obsessive Compulsive Drinking Scale (OCDS) and a custom-designed relapse prevention self efficacy scale. While rates of relapse did not differ between groups, those who played the game showed overall reductions in ratings on the OCDS, as well as higher ratings of self-efficacy at week 8, suggesting that the videogame simulation may be a useful adjunct to AUD treatment. Published by Elsevier Inc.

  3. No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement

    DEFF Research Database (Denmark)

    Petersen, Tom; Hautopp, Holger; Duus, Benn

    2018-01-01

    Objective: Acupuncture is a low risk option in pain management following total knee replacement as an alternative to opioid analgesics. Therefore, the benefit of acupuncture as adjunct to an exercise program was investigated. Furthermore, the modifying effect of previous benefit from acupuncture...... was explored. Design: Three weeks postoperatively, eligible patients were randomized to acupuncture and exercises or exercises alone. Setting: An outpatient rehabilitation centre in the municipality of Copenhagen, Denmark. Subjects: A total of 172 patients were included. Methods: Main outcome was proportion...... of the course of treatment were assessed. Results: No additional benefit of acupuncture was found on any of the main outcomes. Between-group differences were non-significant in proportions of patients with a clinically important reduction of night pain (Relative Risk: 0.98; 95% Confidence Interval (CI): 0...

  4. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study.

    Science.gov (United States)

    Singh, Divya; Samadi, Firoza; Jaiswal, Jn; Tripathi, Abhay Mani

    2014-01-01

    The purpose of the present study was to evaluate the eff-cacy of 'audio distraction' in anxious pediatric dental patients. Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation. 'Audio distraction' was found efficacious in alleviating anxiety of pediatric dental patients. 'Audio distraction' did decrease the anxiety in pediatric patients to a significant extent. How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152.

  5. Telephone technical support: an essential adjunct to a computer intervention for rural chronically ill women.

    Science.gov (United States)

    Cudney, Shirley A; Weinert, Clarann; Phillips, Larry D

    2007-01-01

    The purposes of this article are to describe the telephone technical support system used in the Women to Women support and health education computer outreach project for chronically ill rural women, discuss the preparation and role of the information systems specialist, and examine the nature and quality of telephone support requested and received. Telephone support records were tallied and categorized to determine the number of participants requiring assistance and the nature of problems described. The quality of telephone support received was assessed through a postintervention mail survey. About one third of participants sought telephone support, most frequently for problems related to impaired Internet service provider delivery and the university's Web-application platform. The quality of telephone support was rated highly by 96% of respondents. It was concluded that telephone technical support is a useful adjunct to a computer-based intervention and that quality support can be provided by including a competent information systems specialist on the research team.

  6. Ketamine hydrochloride - an adjunct for analgesia in dogs with burn wounds : clinical communication

    Directory of Open Access Journals (Sweden)

    K. Joubert

    1998-07-01

    Full Text Available The management of pain in patients with burn wounds is complex and problematic. Burn-wound pain is severe, inconsistent and underestimated. Patients experience severe pain, especially during procedures, until wound healing has occurred. A multi-modality approach is needed for effective management of pain, which requires an understanding of the mechanisms of pain. Altered pharmacokinetics and pharmacodynamics in burn-wound patients makes drug actions unpredictable. Opioids alone are seldom sufficient for pain control. The multi-modality approach includes the use of opioids and non-steroidal antiinflammatory, anxiolytic and alternative drugs. Ketamine has been found to be a useful agent for analgesia in burn-wound patients; a dose of 10 mg/kg qid per os was found to be an effective adjunct to pain therapy.

  7. Plant foods in the management of diabetes mellitus: spices as beneficial antidiabetic food adjuncts.

    Science.gov (United States)

    Srinivasan, K

    2005-09-01

    Diet has been recognized as a corner stone in the management of diabetes mellitus. Spices are the common dietary adjuncts that contribute to the taste and flavour of foods. Besides, spices are also known to exert several beneficial physiological effects including the antidiabetic influence. This review considers all the available information from animal experimentation as well as clinical trials where spices, their extracts or their active principles were examined for treatment of diabetes. Among the spices, fenugreek seeds (Trigonella foenumgraecum), garlic (Allium sativum), onion (Allium cepa), and turmeric (Curcuma longa) have been experimentally documented to possess antidiabetic potential. In a limited number of studies, cumin seeds (Cuminum cyminum), ginger (Zingiber officinale), mustard (Brassica nigra), curry leaves (Murraya koenigii) and coriander (Coriandrum sativum) have been reported to be hypoglycaemic.

  8. Hiring, Orientation, Professional Development, and Evaluation: The Administrative Support of Adjunct Faculty

    Science.gov (United States)

    Oprean, Celeste Pramik

    2012-01-01

    In North Carolina (NC) there are a total of 58 community colleges, each of which provides a unique approach to handling support for adjunct faculty. The NC Community College System provided a good setting to explore how one state in particular compares to current research on administrative support of adjunct faculty in the areas of hiring,…

  9. An Examination of Ways to Integrate Adjunct Faculty into a Midwestern Higher Education Institution

    Science.gov (United States)

    Root, Tina M.

    2017-01-01

    Higher education institutions hire adjunct faculty to teach with little or no integration into these institutions. This quantitative study examined the relationship between adjunct faculty's perceived level of integration into a private, Midwest, higher education institution and the types of support services offered by the institution. This…

  10. Herzberg's Theory of Motivation as Applied to Community College Full-Time and Adjunct Online Faculty

    Science.gov (United States)

    Gullickson, Larry

    2011-01-01

    This study was designed to identify the factors that influence full-time and adjunct faculty perceptions regarding job satisfaction and dissatisfaction. It was also designed to determine if those factors relate differently to full-time and adjunct faculty. It is anticipated that this information will aid administrators in improving morale and…

  11. Understanding Burnout and Promoting Engagement among Adjunct Faculty in Community Colleges

    Science.gov (United States)

    Bates, Michael Alan

    2012-01-01

    This mixed methods study explored the phenomenon of job burnout among adjunct faculty at two suburban Illinois community colleges. The Maslach Burnout Inventory-Educators' Survey (MBI-ES) was administered to adjuncts at both colleges to determine overall levels of burnout for the three dimensions of burnout--emotional exhaustion,…

  12. Online Adjunct Faculty: A Quantitative Examination of the Predictive Relationship between Leadership and Job Satisfaction

    Science.gov (United States)

    Barnett, Donald E.

    2018-01-01

    Advances in technology and the rapid expansion and affordability of the internet have helped facilitate the use of online education, or e-learning. To accommodate increased online enrollments, universities are hiring adjunct faculty to teach online courses. Despite the importance of adjunct faculty, there is a lack of research on the experiences…

  13. American Academic: A National Survey of Part-time/Adjunct Faculty. Volume 2

    Science.gov (United States)

    American Federation of Teachers (NJ), 2010

    2010-01-01

    Plainly, part-time/adjunct faculty members now play a vital role in educating the nation's college students. Even so, the data and research on part-time/adjunct faculty members have tended to be pretty spotty. This survey, conducted by Hart Research Associates on behalf of the American Federation of Teachers, is one of the first nationwide…

  14. Evaluating the Feasibility of RESCUE: An Adjunctive HAI-Based Intervention for Veterans with PTSD

    Science.gov (United States)

    2017-05-01

    Amount: $709,517 Study/Product Aim(s) • To develop and pilot test feasibility, acceptability, and efficacy of RESCUE, an adjunct scalable human animal ...Continued animal shelter collaboration. 5. Completed case series, conducted qualitative interviews, and finalized study protocol. 6. Initiated...treatment. Recovery through Engagement with Shelter Canines, Understanding, and Exposure (RESCUE), is an adjunctive, Human Animal Interaction (HAI

  15. Not Just a Matter of Fairness: Adjunct Faculty and Writing Programs in Two-Year Colleges

    Science.gov (United States)

    Klausman, Jeffrey

    2010-01-01

    Several years ago, when his college first financed a writing program administrator (WPA) position--reassigned time and a budget to pay adjunct faculty stipends for program development--the author met with all the most senior adjunct faculty. "Without you," he told them, "this effort to build a better writing program won't work. Participation and…

  16. Adjunctive perampanel in partial-onset seizures: Asia-Pacific, randomized phase III study.

    Science.gov (United States)

    Nishida, T; Lee, S K; Inoue, Y; Saeki, K; Ishikawa, K; Kaneko, S

    2018-04-01

    To evaluate the efficacy, safety, and tolerability of perampanel, a selective, non-competitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, as an adjunctive treatment for patients with refractory partial-onset seizures (POS) from Asia-Pacific. This multicenter, randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov identifier: NCT01618695) involved patients aged ≥12 years with refractory POS (receiving 1-3 antiepileptic drugs). Patients were randomized (1:1:1:1) to receive once-daily placebo or perampanel 4, 8, or 12 mg over a 6-week titration and 13-week maintenance double-blind period. Enzyme-inducing antiepileptic drugs were equally stratified between groups. The primary efficacy endpoint was percent change in POS frequency per 28 days (double-blind phase vs baseline). Other efficacy endpoints included ≥50% responder rate and seizure freedom. Treatment-emergent adverse events (TEAEs) were also monitored. Of 710 randomized patients, seizure frequency data were available for 704 patients. Median percent changes in POS frequency per 28 days indicated dose-proportional reductions in seizure frequency: -10.8% with placebo and -17.3% (P = .2330), -29.0% (P = .0003), and -38.0% (P < .0001) with perampanel 4, 8, and 12 mg, respectively. In total, 108 (15.3%) patients discontinued treatment; 44 (6.2%) due to TEAEs. TEAEs occurring in ≥5% of patients, and reported at least twice as frequently with perampanel vs placebo, included dizziness and irritability. Adjunctive perampanel (8 and 12 mg/d) significantly improved seizure control in patients with refractory POS. Safety and tolerability were acceptable at daily doses of perampanel 4-12 mg. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Inhaled nitric oxide for the adjunctive therapy of severe malaria: Protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Lavery James V

    2011-07-01

    Full Text Available Abstract Background Severe malaria remains a major cause of global morbidity and mortality. Despite the use of potent anti-parasitic agents, the mortality rate in severe malaria remains high. Adjunctive therapies that target the underlying pathophysiology of severe malaria may further reduce morbidity and mortality. Endothelial activation plays a central role in the pathogenesis of severe malaria, of which angiopoietin-2 (Ang-2 has recently been shown to function as a key regulator. Nitric oxide (NO is a major inhibitor of Ang-2 release from endothelium and has been shown to decrease endothelial inflammation and reduce the adhesion of parasitized erythrocytes. Low-flow inhaled nitric oxide (iNO gas is a US FDA-approved treatment for hypoxic respiratory failure in neonates. Methods/Design This prospective, parallel arm, randomized, placebo-controlled, blinded clinical trial compares adjunctive continuous inhaled nitric oxide at 80 ppm to placebo (both arms receiving standard anti-malarial therapy, among Ugandan children aged 1-10 years of age with severe malaria. The primary endpoint is the longitudinal change in Ang-2, an objective and quantitative biomarker of malaria severity, which will be analysed using a mixed-effects linear model. Secondary endpoints include mortality, recovery time, parasite clearance and neurocognitive sequelae. Discussion Noteworthy aspects of this trial design include its efficient sample size supported by a computer simulation study to evaluate statistical power, meticulous attention to complex ethical issues in a cross-cultural setting, and innovative strategies for safety monitoring and blinding to treatment allocation in a resource-constrained setting in sub-Saharan Africa. Trial Registration ClinicalTrials.gov Identifier: NCT01255215

  18. PACS: Do clinical users benefit from it as a training adjunct?

    Directory of Open Access Journals (Sweden)

    J van Heerden

    2011-05-01

    as a training adjunct included the frustrations associated with PACS downtime (especially during the period in 2009 when many electrical power cuts were experienced nationwide, resulting in network interruptions and slow image retrieval during peak work-flow times. The advantages of PACS as a positive training adjunct were highlighted in the areas of multi-site viewing and consultation, the possibility of image manipulation and measurement tools, and better overall image quality. Clinicians felt that their training experience was also enhanced because of better patient follow-up made possible by access to all previous radiological imaging of a particular patient. Of the clinicians who completed the questionnaires, 63.5% felt that the PACS at Steve Biko Academic Hospital contributed positively to their training by creating more overall learning opportunities than other training environments without a PACS.

  19. Homeless Children: Meeting the Educational Challenges. ERIC Digest.

    Science.gov (United States)

    Goins, Brad; Cesarone, Bernard

    Difficulties faced by homeless children include depression, low self-esteem, lack of sleep and nutrition, and feelings of shame and embarrassment. Challenges faced by schools in providing education to homeless children include: (1) keeping children in one school despite frequent family moves; (2) ensuring that children's health records are…

  20. Efficacy of Adjunctive Treatments Added to Olanzapine or Clozapine for Weight Control in Patients with Schizophrenia: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yun-Jung Choi

    2015-01-01

    Full Text Available Objectives. This study was conducted to review systematically adjunctive treatments for weight reduction in patients with schizophrenia and compare efficacies of clinical trials through meta-analysis, so as to provide effective clinical guideline regarding weight control for patients taking atypical antipsychotics. Methods. Candidate clinical trials were identified through searching the Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Fourteen randomized clinical trials were included for systematic review and meta-analysis from 132 potential trials. The Comprehensive Meta-Analysis version 2 was used for meta-analysis. Results. Difference in means and significances from meta-analyses regarding weight control by adjunctive treatments showed that topiramate, aripiprazole, or sibutramine was more effective than metformin or reboxetine. Psychiatric evaluations did not show statistically significant changes between treatment groups and placebo groups except topiramate adjunctive treatments. Adverse effects regarding adjunctive therapies were tolerable and showed statistically no significances compared to control groups. Conclusion. Though having several reports related to exacerbation of psychiatric symptoms, topiramate and aripiprazole are more efficacious than other medications in regard to weight reduction and less burden of critical adverse effects as well as being beneficial for clinical improvement.

  1. Stress Management as an Adjunct to Physical Therapy for Chronic Neck Pain

    Science.gov (United States)

    Bruflat, Angela K.; Balter, Jaclyn E.; McGuire, Denise; Fethke, Nathan B.

    2012-01-01

    Background and Purpose Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment. Case Description A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation. Outcomes Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment. Discussion A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress. PMID:22700538

  2. Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Byarugaba Justus S

    2007-10-01

    Full Text Available Abstract Background Several reports have suggested that raised intracranial pressure (ICP is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. Methods This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. Results Time to regain consciousness (p = 0.11, sit unsupported (p = 0.81, time to start oral intake (p = 0.13 and total coma duration (p = 0.07 were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3% and mannitol (10/76 or 13.2% groups: RR = 1.2 (CI 0.5–2.7. No adverse effects were observed after administration of mannitol. Conclusion Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. Clinical registration number ClinicalTrials.gov ID: NCT00113854

  3. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control?

    Directory of Open Access Journals (Sweden)

    Ricardo Palmier Teles

    2009-06-01

    Full Text Available The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. This is particularly relevant in light of recent evidence suggesting that long standing gingivitis increases the risk of loss of attachment and that prevention of gingival inflammation might reduce the prevalence of mild to moderate periodontitis. Several antimicrobials have been tested as adjuncts to mechanical plaque control in order to improve the results obtained with oral home care. Recent studies, including meta-analyses, have indicated that home care products containing chemical antimicrobials can provide gingivitis reduction beyond what can be accomplished with brushing and flossing. Particularly, formulations containing chlorhexidine, mouthrinses containing essential oils and triclosan/copolymer dentifrices have well documented clinical antiplaque and antigingivitis effects. In vivo microbiological tests have demonstrated the ability of these antimicrobial agents to penetrate the biofilm mass and to kill bacteria growing within biofilms. In addition, chemical antimicrobials can reach difficult-to-clean areas such as interproximal surfaces and can also impact the growth of biofilms on soft tissue. These agents have a positive track record of safety and their use does not seem to increase the levels of resistant species. Further, no study has been able to establish a correlation between mouthrinses containing alcohol and oral cancer. In summary, the adjunct use of chemical plaque control should be recommended to subjects with well documented difficulties in achieving proper biofilm control using only mechanical means.

  4. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Karagülle, Müfit Zeki

    2018-02-01

    This study aims to investigate whether 2-week spa therapy, as an adjunct to usual pharmacological therapy, has any beneficial effect in patients with rheumatoid arthritis (RA). In this single-blind crossover study, 50 patients were randomly assigned in a 1:1 manner to receive usual pharmacological therapy plus 2-week spa therapy or usual pharmacological therapy alone (period 1.6 months); after a 9-month washout, patients were crossed over to the opposite assignment (period 2.6 months). Spa therapy program included a daily saline balneotherapy session at 36-37 °C for 20 min except Sundays. The clinical outcomes were evaluated at baseline, after spa therapy (2 weeks) and 3 and 6 months after the spa therapy in both period and were pain (Visual Analogue Scale (VAS)), patient and physician global assessments (VAS), Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28). Spa therapy was superior to control therapy in improving all the assessed clinical outcomes at the end of the spa therapy. This superiority persisted significantly in physician global assessment ( p = 0.010) and with a trend in favor of spa group in patient global assessment ( p = 0.058), function ( p = 0.092), and disease activity ( p = 0.098) at 3 months. Statistically significant improvements were found in spa therapy compared to control in disease activity ( p = 0.006) and patient ( p = 0.020) and physician global ( p = 0.011) assessments, and a trend toward improvements in pain ( p = 0.069) and swollen joints ( p = 0.070) at 6 months. A 2-week spa therapy adjunct to usual pharmacological therapy provided beneficial clinical effects compared to usual pharmacological therapy alone, in RA patients treated with traditional disease-modifying antirheumatic drugs. These beneficial effects may last for 6 months.

  5. Meta-analyses of newer antiepileptic drugs as adjunct for treatment of focal epilepsy in children.

    Science.gov (United States)

    Mohd-Tahir, Nurul-Ain; Li, Shu-Chuen

    2018-01-01

    This study conducted a systematic review evaluating the effectiveness of newer antiepileptic drugs (AEDs) (namely, lamotrigine, levetiracetam, topiramate, vigabatrin, zonisamide, oxcarbazepine, perampanel, gabapentin, and stiripentol) as add-on for treatment of focal epilepsy in children. Articles were retrieved from EMBASE, Medline and Cochrane Library from inception to January 2016. Treatment outcomes were analysed based on responder, seizure-free, withdrawal and adverse event rates. Quality of each study was also assessed. Twelve articles fulfilled the inclusion criteria. Heterogeneity and quality of the included studies were considered acceptable. Overall, newer AEDs as adjunct therapy in children with inadequate control of focal seizure showed a trend of better seizure outcomes. The pooled ORs for responder, seizure-free and withdrawal rates were 2.15 (95%CI:1.72, 2.69), 1.99 (95%CI:0.72, 5.48) and 0.69 (95%CI:1.13, 2.39) respectively. Adverse events of newer AEDs were comparatively higher than placebo (OR:1.64, 95%CI:1.13, 2.39). In our updated review, newer AEDs as adjunct therapy for focal epilepsy in children have trends of better effectiveness compared to placebo. Newer AEDs are associated with statistically more children with >50% seizure reduction, and a trend of better seizure freedom. Their tolerability would also be considered acceptable with the observed low withdrawal rate. However, the relative lack of well-conducted RCTs evaluating their effectiveness against other active AED treatment in children would not facilitate evidence-based practice. This highlights the knowledge gap and the need for more well-conducted RCTs against active treatments to ascertain the long term effectiveness and the role of newer AEDs in managing epilepsy in children. Copyright © 2017. Published by Elsevier B.V.

  6. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control?

    Science.gov (United States)

    Teles, Ricardo Palmier; Teles, Flavia Rocha Fonseca

    2009-01-01

    The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. This is particularly relevant in light of recent evidence suggesting that long standing gingivitis increases the risk of loss of attachment and that prevention of gingival inflammation might reduce the prevalence of mild to moderate periodontitis. Several antimicrobials have been tested as adjuncts to mechanical plaque control in order to improve the results obtained with oral home care. Recent studies, including meta-analyses, have indicated that home care products containing chemical antimicrobials can provide gingivitis reduction beyond what can be accomplished with brushing and flossing. Particularly, formulations containing chlorhexidine, mouthrinses containing essential oils and triclosan/copolymer dentifrices have well documented clinical antiplaque and antigingivitis effects. In vivo microbiological tests have demonstrated the ability of these antimicrobial agents to penetrate the biofilm mass and to kill bacteria growing within biofilms. In addition, chemical antimicrobials can reach difficult-to-clean areas such as interproximal surfaces and can also impact the growth of biofilms on soft tissue. These agents have a positive track record of safety and their use does not seem to increase the levels of resistant species. Further, no study has been able to establish a correlation between mouthrinses containing alcohol and oral cancer. In summary, the adjunct use of chemical plaque control should be recommended to subjects with well documented difficulties in achieving proper biofilm control using only mechanical means.

  7. The effect of local and systemic statin use as an adjunct to non-surgical and surgical periodontal therapy-A systematic review and meta-analysis.

    Science.gov (United States)

    Bertl, Kristina; Parllaku, Arlinda; Pandis, Nikolaos; Buhlin, Kåre; Klinge, Björn; Stavropoulos, Andreas

    2017-12-01

    To evaluate the effect of local and/or systemic statin use as an adjunct to non-surgical and/or surgical periodontal therapy. Literature search according to PRISMA guidelines with the following eligibility criteria: (a) English or German language; (b) interventional studies; (c) statins as monotherapy or as an adjunct to non-surgical and/or surgical treatment of periodontitis; (d) clinical and/or radiographic treatment effect size of statin intake reported. Medline (PubMed), Embase (Ovid), CENTRAL (Ovid). Thirteen clinical studies regarding local application and 2 with systemic administration of statins as an adjunct to non-surgical treatment (SRP) and 4 studies regarding intrasurgical statin application with a maximum follow-up of 9 months could be included; simvastatin, atorvastatin, and rosuvastatin were used. Local but not systemic statin application as an adjunct to SRP yielded significantly larger probing pocket depth (PD), radiographic defect depth (RDD), and bleeding index reduction, and larger clinical attachment level gain, and less residual PD and RDD (p≤0.016); rosuvastatin appeared as the most efficacious. Three of 4 studies reported a significant positive effect of intrasurgical statin application. No adverse events were reported after statin use. The vast majority of the included studies were from the same research group. Significant additional clinical and radiographic improvements are obtained after local, but not systemic, statin use as an adjunct to SRP in deep pockets associated with intrabony defects and seemingly with furcation defects; intrasurgical statin application seems similarly beneficial. Confirmation of these results, and especially of the effect size, from other research groups is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. A Field Study of Adjunct Faculty: The Impact of Career Stage on Reactions to Non-Tenure-Track Jobs.

    Science.gov (United States)

    Feldman, Daniel C.; Turnley, William H.

    2001-01-01

    A survey of 105 nontenure-track instructors and research associates identified advantages of adjunct status (flexibility, autonomy, challenge) and disadvantages (lack of advancement, remuneration, and respect). Late-career adjuncts had more positive attitudes and work behaviors. Midcareer adjuncts had the most difficulty balancing work and family.…

  9. Covert radar and signals interception the secret career of Eric Ackermann

    CERN Document Server

    Hayson, David

    2014-01-01

    Of German stock dating back to 1530 in Saxony, Eric George Ackermann GM was born on the Isle of Wight in 1919 and became a leading figure in the world of signals and electronic intelligence. As a Junior Scientific Officer at the Telecommunication Research Establishment, Boscombe Down, with an honorary commission in the Royal Air Force, he made numerous flights over occupied territory searching for, monitoring and destroying Germany's Wuerzburg, Knickebein and X Band radar systems. Much of his research was passed to the highest levels of wartime government, and was highly prized, ensuring that

  10. Isotopic separation through ion cyclotron-resonance: results from the ERIC experiment

    International Nuclear Information System (INIS)

    Compant la Fontaine, A.; Louvet, P.

    1994-01-01

    Stable isotope separation by the means of ion cyclotron-resonance is studied at CEA since 1981. Results from the ERIC experiments are of two types: parameter measurements which help characterizing the plasma and optimizing the process, and isotopic separation results. For example, the selective feature of isotope heating was verified in the cases of zinc and calcium using an electrostatic analyzer. The separation factors of various elements (calcium, zinc, barium, chromium...) are depending on the mass relative difference of the isotopes to be separated, difference which must be large compared to the magnetic field inhomogeneities and the Doppler broadening. 2 figs., 1 tab., 3 refs

  11. Genetic diversity of Mycosphaerella fijiensis in Brazil analyzed using an ERIC-PCR marker.

    Science.gov (United States)

    Silva, G F; Paixão, R D V; Queiroz, C B; Santana, M F; Souza, A; Sousa, N R; Hanada, R E; Gasparotto, L

    2014-09-26

    The Enterobacterial repetitive intergenic consensus (ERIC) marker was used to analyze the genetic variability of Mycosphaerella fijiensis, the causative agent of Black Sigatoka disease in banana plants. A total of 123 isolates were used, which were divided into populations based on their original hosts and collection sites in Brazil. A total of 9 loci were amplified, 77.8% of which were found to be polymorphic. The genetic diversity found in the population was 0.20. Analysis of molecular variance (AMOVA) demonstrated that the highest level of genetic variation is within populations. Cluster analysis revealed three main groups in Brazil, with no correlation between geographic and genetic distance.

  12. Teen Courts and Law-Related Education. ERIC Digest.

    Science.gov (United States)

    Nessel, Paula A.

    Teen courts have gained in popularity in the 1990s. These courts include youth courts, peer juries, peer courts, student courts, and other courts using juveniles to determine the sentences of juvenile offenders. The courts issue sentences that are carried out in a school or community setting and generally involve community service, jury duty,…

  13. Promoting Physical Activity and Exercise among Children. ERIC Digest.

    Science.gov (United States)

    Summerfield, Liane M.

    This Digest discusses the importance of and ways to foster activity and exercise in children. Following an introduction, the Digest is organized into four sections. The first section deals with the significant health benefits of physical activity, including: reduction in chronic disease risk; lowered risk of colon cancer; increase in bone density;…

  14. Critical Literacy for Adult Literacy in Language Learners. ERIC Digest.

    Science.gov (United States)

    Van Duzer, Carol; Florez, MaryAnn Cunningham

    This digest examines critical literacy and discusses why it is important to include it in instruction for adults learning English as a Second Language (ESL). Critical literacy takes learners beyond the development of basic literacy skills such as decoding, predicting, and summarizing and asks them to become critical consumers of the information…

  15. Ausencia estudiantil sin permiso (Student Truancy). ERIC Digest.

    Science.gov (United States)

    DeKalb, Jay

    This Digest in Spanish examines some of the ways that truancy affects both individuals and society. It identifies factors that may place students at greater risk of becoming truant and lists some consequences of nonattendance, including delayed promotion and graduation, lowered self-esteem, and lessened employment potential. The causes of truancy…

  16. Understanding and Facilitating Preschool Children's Peer Acceptance. ERIC Digest.

    Science.gov (United States)

    Kemple, Kristen M.

    This digest discusses factors associated with the acceptance and rejection of preschool children by their peers and offers a number of strategies that teachers and other adults can use in their attempts to help children achieve social acceptance. Behaviors and characteristics associated with peer rejection include aggression and misinterpretation…

  17. Television Violence and Behavior: A Research Summary. ERIC Digest.

    Science.gov (United States)

    Smith, Marilyn E.

    This digest describes the overall pattern of the results of research on television violence and behavior. Several variables in the relationship between television violence and aggression related to characteristics of the viewers and to the portrayal of violence are identified. Viewer characteristics included: age, amount of television watched,…

  18. Arab American Students in Public Schools. ERIC Digest, Number 142.

    Science.gov (United States)

    Schwartz, Wendy

    This digest reviews ways to provide Arab Americans with a supportive school environment and all students with an accurate and unbiased education about the Middle East. The school climate will make Arab American students feel more welcome if Arab culture is included in multicultural courses and activities, and if the staff works to eliminate…

  19. Futures. The Best of ERIC Series, No. 4.

    Science.gov (United States)

    ERIC Clearinghouse on Educational Management, Eugene, OR.

    Included in the articles and documents in this annotated bibliography are definitions of futurism, discussions of the background and applications of futurism, and examinations of some futurist writings. Some articles and documents are based in the present and discuss relatively conventional approaches to determining what is to be done to meet the…

  20. Evaluating and Selecting Online Magazines for Children. ERIC Digest.

    Science.gov (United States)

    Lu, Mei-Yu

    This Digest provides an overview of children's online magazines, also known as e-zines. It begins with a brief review of factors that contribute to the popularity of these publications, followed by a list of criteria for selecting high-quality online magazines for children. Samples of high-quality children's e-zines are also included in this…

  1. Teenage Pregnancy. Highlights: An ERIC/CAPS Fact Sheet.

    Science.gov (United States)

    Lachance, Laurie L.

    This fact sheet addresses the issue of teenage pregnancy. Six factors contributing to the current attention focused on teenage pregnancy and parenthood are listed and teenage pregnancy and birth rates are discussed. Other areas covered include teenage nonuse of contraception, sex education by schools and parents, family planning services, and the…

  2. Adults with Attention Deficit Hyperactivity Disorder (ADHD). ERIC Digest.

    Science.gov (United States)

    Wasserstein, Jeanette; Wasserstein, Adella; Wolf, Lorraine E.

    This digest examines attention deficit hyperactivity disorder (ADHD) in adults and symptoms of the disability. Pertinent adult problems include: (1) substance abuse, antisocial behaviors, and criminality, all of which can occur in adults with ADHD; (2) poor social skills or deficits in self-awareness are also frequent; (3) occurrence of ADHD with…

  3. Magnetic Resonance Imaging as an Adjunct to Mammography for Breast Cancer Screening in Women at Less Than High Risk for Breast Cancer: A Health Technology Assessment.

    Science.gov (United States)

    2016-01-01

    Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Among women at high risk for breast cancer, magnetic resonance imaging (MRI) has been suggested as a safe adjunct (supplemental) screening tool that can detect breast cancers missed on screening mammography, potentially reducing the number of deaths associated with the disease. However, the use of adjunct screening tests may also increase the number of false-positive test results, which may lead to unnecessary follow-up testing, as well as patient stress and anxiety. We investigated the benefits and harms of MRI as an adjunct to mammography compared with mammography alone for screening women at less than high risk (average or higher than average risk) for breast cancer. We searched Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Centre for Reviews and Dissemination (CRD) Health Technology Assessment Database, and National Health Service (NHS) Economic Evaluation Database, from January 2002 to January 2016, for evidence of effectiveness, harms, and diagnostic accuracy. Only studies evaluating the use of screening breast MRI as an adjunct to mammography in the specified populations were included. No studies in women at less than high risk for breast cancer met our inclusion criteria. It remains uncertain if the use of adjunct screening breast MRI in women at less than high risk (average or higher than average risk) for breast cancer will reduce breast cancer-related mortality without significant increases in unnecessary follow-up testing and treatment.

  4. Magnetic Resonance Imaging as an Adjunct to Mammography for Breast Cancer Screening in Women at Less Than High Risk for Breast Cancer: A Health Technology Assessment

    Science.gov (United States)

    Nikitovic-Jokic, Milica; Holubowich, Corinne

    2016-01-01

    Background Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Among women at high risk for breast cancer, magnetic resonance imaging (MRI) has been suggested as a safe adjunct (supplemental) screening tool that can detect breast cancers missed on screening mammography, potentially reducing the number of deaths associated with the disease. However, the use of adjunct screening tests may also increase the number of false-positive test results, which may lead to unnecessary follow-up testing, as well as patient stress and anxiety. We investigated the benefits and harms of MRI as an adjunct to mammography compared with mammography alone for screening women at less than high risk (average or higher than average risk) for breast cancer. Methods We searched Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Centre for Reviews and Dissemination (CRD) Health Technology Assessment Database, and National Health Service (NHS) Economic Evaluation Database, from January 2002 to January 2016, for evidence of effectiveness, harms, and diagnostic accuracy. Only studies evaluating the use of screening breast MRI as an adjunct to mammography in the specified populations were included. Results No studies in women at less than high risk for breast cancer met our inclusion criteria. Conclusions It remains uncertain if the use of adjunct screening breast MRI in women at less than high risk (average or higher than average risk) for breast cancer will reduce breast cancer–related mortality without significant increases in unnecessary follow-up testing and treatment. PMID:27990198

  5. Adjunctation and Scalar Product in the Dirac Equation - II

    Science.gov (United States)

    Dima, M.

    2017-02-01

    Part-I Dima (Int. J. Theor. Phys. 55, 949, 2016) of this paper showed in a representation independent way that γ 0 is the Bergmann-Pauli adjunctator of the Dirac { γ μ } set. The distiction was made between similarity (MATH) transformations and PHYS transformations - related to the (covariant) transformations of physical quantities. Covariance is due solely to the gauging of scalar products between systems of reference and not to the particular action of γ 0 on Lorentz boosts - a matter that in the past led inadvertently to the definition of a second scalar product (the Dirac-bar product). Part-II shows how two scalar products lead to contradictions and eliminates this un-natural duality in favour of the canonical scalar product and its gauge between systems of reference. What constitutes a proper observable is analysed and for instance spin is revealed not to embody one (except as projection on the boost direction - helicity). A thorough investigation into finding a proper-observable current for the theory shows that the Dirac equation does not possess one in operator form. A number of problems with the Dirac current operator are revealed - its Klein-Gordon counterpart being significantly more physical. The alternative suggested is finding a current for the Dirac theory in scalar form j^{μ } = < ρ rangle _{_{ψ }}v^{μ }_{ψ }.

  6. Use of adjunctive topical corticosteroids in bacterial keratitis.

    Science.gov (United States)

    Ni, Nina; Srinivasan, Muthiah; McLeod, Stephen D; Acharya, Nisha R; Lietman, Thomas M; Rose-Nussbaumer, Jennifer

    2016-07-01

    Topical corticosteroid use in the setting of infectious keratitis has been a controversial issue. The aim of this review is to provide an update on the evidence for use of topical corticosteroids in addition to antibiotics in bacterial keratitis. Judicious use of steroids is postulated to limit the inflammatory component of bacterial keratitis, but can theoretically retard healing. Three small randomized controlled trials and one large-scale trial, the Steroids for Corneal Ulcers Trial, have provided the most recent evidence to address this debate. Adjunctive topical corticosteroids initiated after at least 48 h of antibiotic usage in cases of culture-proven bacterial keratitis appear generally safe in the treatment of bacterial keratitis. They may be beneficial in cases of severe ulcers especially when initiated early in the course of the infection, in non-Nocardia ulcers, and in certain Pseudomonas ulcers. Several randomized controlled trials have greatly contributed to our understanding of the controversy over steroid use in the management of bacterial keratitis. Future studies are needed to confirm subgroup analysis findings and define optimal timing, dosage, and the most appropriate treatment populations.

  7. Canine tooth dimorphism: An adjunct for establishing sex identity.

    Science.gov (United States)

    Yuwanati, Madhavi; Karia, Ashok; Yuwanati, Monal

    2012-07-01

    Teeth are an excellent material for genetic, odontological and forensic investigations and research purpose. From all the teeth, the mandibular canines are found to exhibit sexual dimorphism. However, very few studies have been published on maxillary canine's measurements. 1. To find out utility of maxillary and mandibular canine width as a tool for sex determination in Central Indian population. 2. To find out the average size of canines in males and females of Central Indian population. 3. To compare the findings with National and International studies. The present study was conducted in 100 cases in the age group of 17-21 years. Mesiodistal width of right and left mandibular and maxillary canines were measured on the casts with digital calliper and subjected to statistical analysis. Statistical analysis was done to assess sex difference using Students "t" test (paired). It was seen that a definite statistically significant sexual dimorphism exists when mandibular and maxillary canine measurements were compared. Thus, it can be suggested that canine width measurements can be used as an adjunct for sex identification purpose in Central Indian Population.

  8. Rehabilitation of Schizophrenia: Adjunctive Therapy of Negative Symptoms

    Directory of Open Access Journals (Sweden)

    Saeed Shoja Shafti

    2004-09-01

    Full Text Available Negative symptoms in schizophrenia are among the important barriers against psychosocial rehabilitation of such patients. Adjunctive drugs can be used for reducing the severity of these symptoms. In this research we studied the efficacy of Clomipramine, Alprazolam, Citalopram, Bromocriptine, Fluoxetine, Nortriptyline, Maprotiline and Fluvoxamine, in this regard. After a primary prevalence survey regarding Negative symptoms, 170 schizophrenic patients were divided into three different groups, and then the aforesaid adjuvant drugs were examined in three double-blind clinical controlled trials. Estimation of negative symptoms by "SANS" were done at the beginning of each trial for the first time and then three weeks later, after prescription of drugs in lower dosage and finally at the end of sixth week, means three weeks after doubling the dosages. The data were analyzed by z and chi-square (X2test formula. Clomipramine, Alprazolam, Citalopram, Nortriptyline and Maprotiline could reduce the severity of negative symptoms. Their effectiveness in comparing with placebo was statistically remarkable. No important side effect or worsening of positive symptoms was seen in our samples during aforesaid trials. Conservative usage of adjuvant drugs can be an advantageous means for making rehabilitative programs more efficacious than before.

  9. Adjunctive Intracoronal Splint in Periodontal Treatment: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Mora Octavia

    2015-05-01

    Full Text Available Reduction of the amount of tooth roots which are embedded in their periodontium could cause tooth mobility. Splinting a weaker tooth with a more stable one, and using the principle of the multiple-root stabilization is one way to overcome tooth mobility. Temporary splinting aims to prevent pathological migration, restore masticatory function, stabilize teeth before/after surgery, and evaluate the prognosis of periodontal treatment. The use of intracoronal splint is still controversial because there are only a few studies that have evaluated the effect of splinting on periodontal health. We report two cases to evaluate the effect of intracoronal splint on periodontal treatment. Two periodontal cases that use intracoronal splint before, during, and after periodontal regenerative therapy using bone graft. Causes of tooth mobility were removed and the splinting principles, terms and guidelines were mastered to get the maximum results of periodontal treatment. Both cases were evaluated radiographically 10 months after treatment. In these cases, intracoronal splint has supported the therapy before, during, or after surgery. Splinting is only for adjunctive therapy, and does not serve as the sole method in getting occlusal stability.DOI: 10.14693/jdi.v21i3.193

  10. Intergenerational work as an adjunct to psychoanalysis and psychotherapy.

    Science.gov (United States)

    Braverman, S

    1995-01-01

    Psychotherapy and psychoanalysis are opportunities for individuals to repair faulty aspects of their development that have resulted in symptoms or other difficulties in living. Although transference is the major therapeutic tool in this work, it is not the only one. The potential resources for healing that exist in family relationships is great, especially as these relationships go on long after therapy has ended. We are all living longer; families of three and four generations are no longer uncommon. There are many adult patients who have one or both parents alive and well. Intergenerational work can be a useful adjunct where there is no severe narcissistic pathology or psychosis in either patient or parent. It is especially helpful in cases where there is severe resistance and insight is not effective in promoting change. "By focusing constantly on the patient's transference distortions and ignoring reality elements we undermine self-esteem and make him feel he is always wrong, sick or crazy" (Greenson, 1978b,p. 434). The addition of intergenerational work in the course of psychoanalysis/psychotherapy can shorten the time of therapy and be another tool for dealing with resistance. This work has theoretical implications for the modification of the place that transference has in psychoanalytic therapy. By placing greater emphasis on the patient's real relationships in influencing intrapsychic change we pave the way to exciting clinical and theoretical possibilities.

  11. Omega-3 fatty acids as adjunctive therapy in Crohns disease.

    Science.gov (United States)

    Macdonald, Angie

    2006-01-01

    Crohns disease is an inflammatory bowel disease that can have a significant impact on the health of those afflicted. The etiology of the disease is unknown, but genetic, environmental, dietary, and immunological factors are thought to be involved. Multiple nutrients can become depleted during active disease due to inadequate intake or malabsorption. Preventing these deficiencies is paramount in the care of those suffering from Crohns disease. Often the traditional treatments (medications) have limited effectiveness and negative side effects that inhibit their use. Enteral nutrition has promising therapeutic benefits, but its use is often limited to the pediatric population due to poor patient acceptability. Omega-3 fatty acids have been investigated for their anti-inflammatory properties as an alternative to traditional care. This article reviews the etiology of Crohns disease, nutritional deficiencies, traditional treatments, and the use of omega-3 fatty acids in the prevention of Crohns recurrence. The results from clinical trials have been conflicting, but a new fish oil preparation that limits the side effects of traditional fish oil therapy shows promise as an adjunctive treatment for Crohns disease. Continued research is needed to validate these findings.

  12. Eric Besson: the financial advantage of nuclear energy is confirmed

    International Nuclear Information System (INIS)

    Anon.

    2012-01-01

    The French minister of energy, E. Besson said that the study of the Court of Auditors on the real costs of nuclear energy confirmed the competitiveness of nuclear power. The Court of Auditors confirmed also that public expenditures in favor of nuclear energy are balanced by the gain through the tax on nuclear facilities. The Court of Auditors confirms also that dismantlement charges and charges for the management of radioactive wastes are included in the present costs of nuclear energy at an adequate level with today's knowledge. The total cost of nuclear energy is very competitive, it ranges form 32.5 euros/MWh to 49.5 euros/MWh according to the cost accounting method used. One of major parameters for cost elaboration is the knowledge of the lengths of the operating life of the power plant. The longer the extension is, the lower is the investment cost. (A.C.)

  13. Balancing Biography and Institutional History: Eric Worrell’s Australian Reptile Park

    Directory of Open Access Journals (Sweden)

    Nancy Cushing

    2009-11-01

    Full Text Available When a young naturalist opened his new wildlife park at Wyoming on the NSW Central Coast in the late 1950s, he gave it his own name: Eric Worrell’s Australian Reptile Park. Through the park, Worrell made a significant contribution to environmental education, the development of knowledge of captive animal care and display and the provision of antivenoms for the bites of a range of dangerous creatures. More than this, it was the geographic and emotional centre of Worrell’s world: the fulfilment of a childhood dream, a home for his family and a site for forming new personal and professional relationships. In preparation for the jubilee of the park, its history is being written by two academics from the University of Newcastle. An attractive means of creating the necessary narrative structure and human interest to ensure the wide appeal of this history is to follow Worrell’s lead and place his life at the centre of this institutional history. This is the direction suggested by the written sources on the park and it is accentuated by many of our oral informants who organise their memories of the park around Worrell. To what extent can an institutional history be a biography of the person at the heart of that institution? Is it possible to disentangle the life from the institution? This article offers some preliminary answers to these questions through a case study of the writing of a history of Eric Worrell’s Australian Reptile Park.

  14. Introduction: Eric Davidson and the molecular biology of evolution and development.

    Science.gov (United States)

    Morange, Michel; Deichmann, Ute

    2017-10-13

    Between November 30th and December 2nd, 2015, the Jacques Loeb Centre for the History and Philosophy of the Life Sciences at Ben-Gurion University of the Negev in Beer Sheva (Israel) held its Eighth International Workshop under the title "From Genome to Gene: Causality, Synthesis and Evolution". Eric Davidson, the founder of the concept of developmental Gene Regulatory Networks, had regularly attended the previous meetings, and his participation in this one was expected, but he suddenly passed away 3 months before. In this paper, we provide an introduction and overview on five papers that were presented at the workshop and examine the importance of genomes and gene regulatory networks in extant biology, developmental biology, evolutionary biology and medicine, as well as a collection of remembrances of Eric Davidson, of his personality as well as of his scientific contributions. Historical perspectives are provided, and the ethical issues raised by the new tools developed to modify the genome are also discussed.

  15. Molecular typing of uropathogenic E. coli strains by the ERIC-PCR method.

    Science.gov (United States)

    Ardakani, Maryam Afkhami; Ranjbar, Reza

    2016-04-01

    Escherichia coli (E. coli) is the most common cause of urinary infections in hospitals. The aim of this study was to evaluate the ERIC-PCR method for molecular typing of uropathogenic E. coli strains isolated from hospitalized patients. In a cross sectional study, 98 E. coli samples were collected from urine samples taken from patients admitted to Baqiyatallah Hospital from June 2014 to January 2015. The disk agar diffusion method was used to determine antibiotic sensitivity. DNA proliferation based on repetitive intergenic consensus was used to classify the E. coli strains. The products of proliferation were electrophoresed on 1.5% agarose gel, and their dendrograms were drawn. The data were analyzed by online Insillico software. The method used in this research proliferated numerous bands (4-17 bands), ranging from 100 to 3000 base pairs. The detected strains were classified into six clusters (E1-E6) with 70% similarity between them. In this study, uropathogenic E. coli strains belonged to different genotypic clusters. It was found that ERIC-PCR had good differentiation power for molecular typing of uropathogenic E. coli strains isolated from the patients in the study.

  16. Adjunctive aerosolized colistin for multi-drug resistant gram-negative pneumonia in the critically ill: a retrospective study.

    Science.gov (United States)

    Doshi, Neha M; Cook, Charles H; Mount, Kari L; Stawicki, Stanislaw P; Frazee, Erin N; Personett, Heather A; Schramm, Garrett E; Arnold, Heather M; Murphy, Claire V

    2013-11-25

    The incidence of multi-drug resistant (MDR) gram-negative (GN) organisms including Pseudomonas and Acinetobacter spp has increased in the last decade, prompting re-evaluation of colistin for the management of these infections. Aerosolized colistin as an adjunct to intravenous therapy is a current option for the management of MDR-GN pneumonia, although data supporting this practice is limited. This study evaluates the efficacy of adjunctive aerosolized colistin in combination with intravenous colistin in critically ill patients with MDR-GN pneumonia. A retrospective multi-center cohort analysis comparing critically ill patients with MDR-GN pneumonia who received intravenous colistin (IV) alone or in combination with adjunctive aerosolized colistin (IV/AER) with a primary endpoint of clinical cure at the end of colistin therapy. Secondary endpoints included microbiologic cure, duration of mechanical ventilation, length of stay, and hospital mortality. A post-hoc subgroup analysis was performed for patients with high quality cultures used for diagnosis of MDR-GN pneumonia. Dichotomous data were compared using Fisher's exact test while the student's t-test or Mann-Whitney U test were used for continuous variables. Ninety-five patients met criteria for evaluation with 51 patients receiving IV and 44 receiving IV/AER. Baseline characteristics were similar between the two groups. Twenty patients (39.2%) receiving IV and 24 (54.5%) receiving IV/AER achieved clinical cure (p = 0.135). There was no difference in microbiologic cure rates between the IV and IV/AER colistin groups (40.7vs. 44.4%, p = 0.805). The IV group demonstrated a trend towards higher pneumonia attributable mortality (70.4 vs. 40%, p = 0.055). In the subgroup analysis of patients with high quality respiratory cultures, there was a significantly lower clinical cure rate for those in the IV group as compared to the IV/AER group (31.3 vs. 57.1%, p = 0.033). Addition of aerosolized colistin to

  17. Effect of vitamin A adjunct therapy for cerebral malaria in children ...

    African Journals Online (AJOL)

    % of deaths among children. Hitherto no adjunct therapy has been identified to improve outcome of cerebral malaria. Retinol suppresses growth of P. falciparum, scavenges free radicals, and exhibits synergistic action with quinine in parasite ...

  18. Clinical Assessment of Drug Adjunctive Therapy Effects in Association with Chronic Generalized Periodontitis and Osteoporotic Disease*

    Directory of Open Access Journals (Sweden)

    Ursarescu Irina-Georgeta

    2015-11-01

    Full Text Available Aim: The present study proposes an assessment of the clinical effects on periodontal level generated by the adjunctive periodontal therapy with sub-antimicrobial doses of doxycycline in patients with chronic periodontitis and osteoporosis.

  19. Lithium as an adjunct to radioactive iodine for the treatment of hyperthyroidism: a systematic review and meta-analysis.

    Science.gov (United States)

    Kessler, Lynn; Palla, Jyothsna; Baru, Joshua S; Onyenwenyi, Chioma; George, Amrutha M; Lucas, Brian P

    2014-07-01

    Radioactive iodine (RAI) is commonly used in the treatment of hyperthyroidism but is not uniformly successful. Lithium increases thyroidal iodine retention without reducing iodide uptake, increasing the radiation dose to the thyroid when administered with RAI. Although these actions suggest that adjuvant lithium may increase the efficacy of RAI, its role as an adjunct to RAI remains contentious. To evaluate the safety and efficacy of adding lithium to RAI to treat hyperthyroidism. Relevant studies were identified by a search of Medline and the Cochrane Central Register of Controlled Trials. To be included, a study had to be a controlled trial comparing the effect of RAI alone to RAI with lithium in the treatment of hyperthyroidism. Relevant data were extracted and meta-analyses were performed. Of the 75 identified studies, 6 met the inclusion criteria; 4 of these studies were interventional and 2 were observational trials. Meta-analysis of the observational trials (N = 851), both of which were retrospective cohort studies, showed significant improvement in the primary outcome (i.e., cure rate) with adjunctive lithium (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.24 to 2.96). The combined interventional trials (N = 485) also showed an improvement in cure rate, but the difference did not reach statistical significance (OR, 1.28; 95% CI, 0.85 to 1.91). Adjunctive lithium reduced time to cure and blunted thyroid hormone excursions after RAI. Lithium-related side effects were infrequent and usually mild. The observational trials demonstrated significant improvement in the cure rate of hyperthyroidism when lithium is added to RAI. The improvements shown in the interventional trials did not reach statistical significance due to the effect of a single, large negative trial.

  20. Examining the Efficacy of Adjunctive Aripiprazole in Major Depressive Disorder: A Pooled Analysis of 2 Studies

    Science.gov (United States)

    Thase, Michael E.; Trivedi, Madhukar H.; Nelson, J. Craig; Fava, Maurizio; Swanink, Rene; Tran, Quynh-Van; Pikalov, Andrei; Yang, Huyuan; Carlson, Berit X.; Marcus, Ronald N.; Berman, Robert M.

    2008-01-01

    Background: Patients with major depressive disorder (MDD) who fail to achieve complete remission with antidepressant therapy may benefit from augmentation therapy with an atypical antipsychotic. Method: A pooled analysis was performed on 2 identical 14-week studies (8-week prospective antidepressant therapy treatment phase followed by 6-week randomized double-blind phase) evaluating the efficacy of adjunctive aripiprazole (2–20 mg/day) in DSM-IV-TR–defined MDD patients with an inadequate response to antidepressant therapy. Primary efficacy endpoint was the mean change in Montgomery-Asberg Depression Rating Scale (MADRS) total score from end of the prospective phase (week 8) to end of randomized phase (week 14, last observation carried forward). Subgroup analyses were performed. The key secondary endpoint was mean change in Sheehan Disability Scale (SDS) mean score. Results: At endpoint, mean change in MADRS total score was significantly greater with adjunctive aripiprazole (–8.7) than with adjunctive placebo (–5.7; p < .001). Except for a differential treatment-by-sex interaction, change in MADRS total scores were consistently greater with adjunctive aripiprazole than with adjunctive placebo, regardless of race, age, episode duration, prior antidepressant therapy response, number of historical treatment failures, severity of depressive symptoms, and antidepressant. At endpoint, MADRS remission rates were significantly greater with adjunctive aripiprazole than with placebo (25.7% vs. 15.4%; p < .001). Adjunctive aripiprazole also demonstrated significantly greater improvements in mean change from baseline in SDS total score than adjunctive placebo (–1.2 vs. –0.6; p = .001). Conclusion: Augmentation of antidepressant therapy with the atypical antipsychotic aripiprazole resulted in significant efficacy benefits across a range of subgroups of patients with MDD. Further study of a treatment-by-sex interaction is needed. Trial Registration: www

  1. Role of argon laser as an adjunctive therapy for treatment of resistant infected corneal ulcers.

    Science.gov (United States)

    Khater, Mohammad M; Selima, Adel A; El-Shorbagy, Mohammad S

    2014-01-01

    To evaluate the role of argon laser as an adjunctive therapy in ten patients with resistant infected corneal ulcers with or without hypopyon. The study included 20 patients, split into two groups of ten, with resistant infected corneal ulcers with or without hypopyon. One group was considered as the control group and treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity tests. The other group started with the same specific therapy as the control group for 1 week with no obvious improvement and then was further treated with argon laser. The ten patients in the control group included five cases of fungal ulcers, three mixed (fungal and bacterial) ulcers, and two viral ulcers. The ten patients in the other group included three cases of fungal ulcers, three mixed (fungal and viral) ulcers, three viral ulcers, and one bacterial ulcer as proven with microbial culture and sensitivity tests. Eight cases of the control group and seven cases of the other group were associated with hypopyon. Before laser treatment, a drop of benoxinate hydrochloride 0.4% and a single drop of fluorescein sodium 0.25% were instilled. Argon laser irradiation of the affected cornea was performed using an argon 532 nm wavelength (Carl Zeiss LSL 532s AG; Carl Zeiss Meditec AG, Jena, Germany). A spot size of 500 μm, pulse duration of 0.2 seconds, and power of 900 mW were used. All cases were followed up for 3 months after healing was achieved. During the first 4 weeks after laser treatment, all patients showed complete healing of the epithelial defect and resolution of stromal infiltration with no adverse effects. In the control group, four cases needed an amniotic membrane graft due to thinning and the other six cases were healed in a duration that ranged from 3 to 7 weeks. Argon laser phototherapy is useful as an adjunctive treatment for resistant infected corneal ulcers. More cases are needed to get more reliable results and to confirm our findings.

  2. Insight into the genomic diversity and relationship of Astragalus glycyphyllos symbionts by RAPD, ERIC-PCR, and AFLP fingerprinting.

    Science.gov (United States)

    Gnat, Sebastian; Małek, Wanda; Oleńska, Ewa; Trościańczyk, Aleksandra; Wdowiak-Wróbel, Sylwia; Kalita, Michał; Wójcik, Magdalena

    2015-11-01

    We assessed the genomic diversity and genomic relationship of 28 Astragalus glycyphyllos symbionts by three methodologies based on PCR reaction, i.e., RAPD, ERIC-PCR, and AFLP. The AFLP method with one PstI restriction enzyme and selective PstI-GC primer pair had a comparable discriminatory power as ERIC-PCR one and these fingerprinting techniques distinguished among the studied 28 A. glycyphyllos symbionts 18 and 17 genomotypes, respectively. RAPD method was less discriminatory in the genomotyping of rhizobia analyzed and it efficiently resolved nine genomotypes. The cluster analysis of RAPD, ERIC-PCR, and AFLP profiles resulted in a generally similar grouping of the test strains on generated dendrograms supporting a great potential of these DNA fingerprinting techniques for study of genomic polymorphism and evolutionary relationship of A. glycyphyllos nodulators. The RAPD, ERIC-PCR, and AFLP pattern similarity coefficients between A. glycyphyllos symbionts studied was in the ranges 8-100, 18-100, and 23-100%, respectively.

  3. Adamson-Eric 100 : XX sajandi kunsti- ja kultuurilugu ühe inimsaatuse kaudu / Ülle Kruus

    Index Scriptorium Estoniae

    Kruus, Ülle

    2002-01-01

    Näitus "Adamson-Eric 100" Eesti Kunstimuuseumi Rüütelkonna hoones ja Adamson-Ericu muuseumis. Koostajad Ülle Kruus, Kersti Koll, Hanno Soans, kujundajad Leonhard Lapin (EKM), Jaak Soans (Adamson-Ericu muuseum). Adamson-Ericu teosed väljaspool Eestit ja Eestisse tagasi jõudnud tööd

  4. After Eric Garner: Invoking the Black Radical Tradition in Practice and in Theory #BlackLivesMatter

    Science.gov (United States)

    Shieh, Eric

    2016-01-01

    In this article, I document a series of pedagogical responses in my high school instrumental music classroom following the events of Eric Garner's murder in New York City. Foregrounding traditions of black radical politics and aesthetics originating with the Black Power Movement in the 1960s, I explore their implications for classroom practice in…

  5. Carl Eric Stalberg : me ei investeerinud 1,5 miljardit eurot, et Hansa hävitada! / Mikk Salu

    Index Scriptorium Estoniae

    Salu, Mikk, 1975-

    2005-01-01

    Intervjuust Swedbanki juhi Carl Eric Stalbergiga, milles käsitletakse Hansapanga ülevõtmisega seotud teemasid. Hansapangas toimuvast nn. integratsiooniprotsessist, panga tulevikust. Indrek Neivelti, Erkki Raasukese kommentaare. Lisad: Hansapanga ülevõtmine; Miks Hansapank üldse osteti?

  6. 78 FR 39057 - In the Matter of the Designation of Eric Breininger as a Specially Designated Global Terrorist...

    Science.gov (United States)

    2013-06-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE In the Matter of the Designation of Eric Breininger as a Specially Designated Global Terrorist Pursuant To... aforementioned individual as a Specially Designated Global Terrorist pursuant to section 1(b) of the Order. This...

  7. Molecular typing among beef isolates of Escherichia coli using consensus repetitive intergenic enterobacteria-polymerase chain reaction (ERIC-PCR)

    Science.gov (United States)

    Zoolkifli, Nurliyana Wan; Mutalib, Sahilah Abd

    2013-11-01

    Genomic DNA of Escherichia coli were characterized by enterobacterial repetitive intergenic consensus-Polymerase chain reaction (ERIC-PCR) and the presence of Shiga toxin gene-I (Stx1) and Shiga toxin gene-2 (Stx2). These isolates were originated from imported raw beef which are come from two countries namely Australia and India. The isolation of E. coli was conducted by using Eosin Methylene Blue Agar (EMBA). A total of 94 strains had been isolated from 30 samples of imported raw beefand 42 strains had been detected positively E. coli by doing biochemical tests. All strains had been tested and the results of biochemical tests showed that 3 strains were from Australia samples while the other 39 strains were from India samples. The biochemical tests used are Indole test, Methyl Red test, Voges-Proskauer test and Citrate test. All the 42 strains were examined for Shiga toxin (stx1 and stx2) gene detection by two pair primers which are stx2F (5'-TTCTTCGGTATCCTATTCCC-3'), stx2R (5'-ATGCATCTCTGGTCATTGTA-3'), stx1F (5'-CAGTTAATGTGGTGGCGAAG-3'), and stx1R (5'-CTGTCACAGTAACAACCGT-3'). The results showed that none of the strains are positive for Shiga toxin gene. Application of ERIC-PCR method towards E. coli had successfully shown the high diversity polymorphism in 21 different genome types of DNA with primers ERIC1R (5'- CACTTAGGGGTCCTCGAATGTA- 3') and ERIC2R (5'- AAGTAAGTGACTGGGGTGACGC- 3').

  8. Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review

    Directory of Open Access Journals (Sweden)

    Neumann Patricia B

    2006-06-01

    Full Text Available Abstract Background Stress urinary incontinence (SUI is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones for the treatment of female SUI. Methods All major electronic sources of relevant information were systematically searched to identify peer-reviewed English language abstracts or papers published between 1995 and 2005. Randomised controlled trials (RCTs and other study designs eg non-randomised trials, cohort studies, case series, were considered for this review in order to source all the available evidence relevant to clinical practice. Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion. Excluded were studies of women who were pregnant, immediately post-partum or with a diagnosis of mixed or urge incontinence. Studies with a PFMT protocol alone and in combination with adjunctive physical therapies were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. Due to the heterogeneity of study designs, the results are presented in narrative format. Results Twenty four studies, including 17 RCTs and seven non-RCTs, met the inclusion criteria. The methodological quality of the studies varied but lower quality scores did not necessarily indicate studies from lower levels of evidence. This review found consistent evidence from a number of high quality RCTs that PFMT alone and in combination with adjunctive therapies is effective treatment for women with SUI with rates of 'cure' and 'cure/improvement' up to 73% and 97% respectively. The contribution of adjunctive therapies is unclear and there is limited

  9. Medical costs and utilization in patients with depression treated with adjunctive atypical antipsychotic therapy

    Directory of Open Access Journals (Sweden)

    Nadkarni A

    2013-01-01

    Full Text Available Anagha Nadkarni,1 Iftekhar Kalsekar,1 Min You,1 Robert Forbes,2 Tony Hebden11Bristol-Myers Squibb, Plainsboro, NJ, USA; 2Otsuka Pharmaceutical Development and Commercialization, Princeton, NJ, USAObjective: To compare total medical costs and utilization over a 12-month period in commercially insured patients receiving FDA-approved adjunctive atypical antipsychotics (aripiprazole, olanzapine, or quetiapine for depression.Methods: A retrospective claims analysis was conducted from 2005–2010 using the PharMetrics database. Subjects were adult commercial health-plan members with depression, identified using International Classification of Diseases codes and followed for 12 months after augmentation with an atypical antipsychotic. Outcomes included total medical costs, hospitalization, and ER visits. Generalized linear models and logistic regression were used to compare the total medical costs and the odds of hospitalization and ER visits between the treatment groups after adjusting for baseline demographic and clinical characteristics.Results: A total of 9675 patients with depression were included in the analysis, of which 68.4% were female, with a mean age of 45.2 (±12.0 years. Adjusted 12-month total medical costs were higher for olanzapine ($14,275 and quetiapine ($12,998 compared to aripiprazole ($9,801; P < 0.05 for all comparisons with aripiprazole. When divided into inpatient and outpatient costs, olanzapine and quetiapine had significantly higher adjusted inpatient costs compared to aripiprazole ($6,124 and $4,538 vs $2,976, respectively; P < 0.05 for all comparisons with aripiprazole. Similar results were seen for adjusted outpatient costs. Adjusted odds of hospitalization for olanzapine (odds ratio [OR] = 1.73; 95% CI confidence interval [CI] = 1.42–2.10 and quetiapine (OR = 1.40; 95% CI = 1.21–1.60 were significantly higher than aripiprazole at 12 months. The adjusted odds of an ER visit for olanzapine (OR = 1.40; 95% CI = 1.18–1

  10. Adjunctive agomelatine therapy in the treatment of acute bipolar II depression: a preliminary open label study

    Directory of Open Access Journals (Sweden)

    Fornaro M

    2013-02-01

    Full Text Available Michele Fornaro,1 Michael J McCarthy,2,3 Domenico De Berardis,4 Concetta De Pasquale,1 Massimo Tabaton,5 Matteo Martino,6 Salvatore Colicchio,7 Carlo Ignazio Cattaneo,8 Emanuela D'Angelo,9 Pantaleo Fornaro61Department of Formative Sciences, University of Catania, Catania, Italy; 2Department of Psychiatry, Veteran's Affairs San Diego Healthcare System, 3University of California San Diego, La Jolla, CA, USA; 4Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "ASL 4", Teramo, Italy; 5Department of Internal Medicine and Medical Specialties, University of Genova, Genoa, Italy; 6Department of Neurosciences, Section of Psychiatry, University of Genova, Genoa, Italy; 7Unit of Sleep Medicine, Department of Neuroscience, Catholic University, Rome, Italy; 8National Health System, "ASL 13", Novara, Italy; 9National Health System, "ASL 3", Genoa, ItalyPurpose: The circadian rhythm hypothesis of bipolar disorder (BD suggests a role for melatonin in regulating mood, thus extending the interest toward the melatonergic antidepressant agomelatine as well as type I (acute or II cases of bipolar depression.Patients and methods: Twenty-eight depressed BD-II patients received open label agomelatine (25 mg/bedtime for 6 consecutive weeks as an adjunct to treatment with lithium or valproate, followed by an optional treatment extension of 30 weeks. Measures included the Hamilton depression scale, Pittsburgh Sleep Quality Index, the Clinical Global Impression Scale–Bipolar Version, Young Mania Rating Scale, and body mass index.Results: Intent to treat analysis results demonstrated that 18 of the 28 subjects (64% showed medication response after 6 weeks (primary study endpoint, while 24 of the 28 subjects (86% responded by 36 weeks. When examining primary mood stabilizer treatment, 12 of the 17 (70.6% valproate and six of the 11 (54.5% lithium patients responded by the first endpoint. At 36 weeks, 14 valproate treated (82.4% and 10 lithium

  11. The use of streptolysin O (SLO) as an adjunct therapy for Rhodococcus equi pneumonia in foals.

    Science.gov (United States)

    Horohov, David W; Loynachan, Alan T; Page, Allen E; Hughes, Katherine; Timoney, John F; Fettinger, Michael; Hatch, Thomas; Spaulding, James G; McMichael, John

    2011-12-29

    Rhodococcus equi is a soil borne bacterium that causes severe morbidity and death in young foals. The economic costs of the disease include loss of life, treatment expenses, veterinary monitoring expenses and, perhaps most importantly, potential reduction in future athletic performance in horses that suffer severe lung abscessations caused by R. equi. Current standard of care for pneumonia caused by R. equi is treatment with a macrolide antimicrobial and rifampicin. However, the hallmark of pneumonia caused by R. equi is severe formation of pyogranulomas and a walling off effect that can prevent systemic antibiotics from reaching antimicrobial concentrations in lung tissues. It is hypothesized that streptolysin O (SLO) used as an adjunct therapy with antibiotics will reduce the duration and severity of disease caused by R. equi pneumonia compared to antibiotic therapy alone. Addition of SLO to the antibiotic enhanced clinical responses compared to the other groups, including the antibiotic alone group. Of particular significance were lower bacterial counts in the lungs and longer survival time in those foals treated with SLO and antibiotics. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Severe alcohol withdrawal syndrome: Evolution of care and impact of adjunctive therapy on course and complications of 171 intensive care unit patients.

    Science.gov (United States)

    Puscas, Mircea; Hasoon, Mohammed; Eechevarria, Carlos; Cooper, Tracy; Tamura, Leslie; Chebbo, Ahmad; W Carlson, Richard

    2016-01-01

    This single site retrospective observational study assessed the evolution of sedation therapy for severe alcohol withdrawal syndrome in the intensive care unit. Patient records for 2 intervals were reviewed: Interval 1, which included 87 intensive care unit patients admitted January 2005 through September 2007, for whom benzodiazedpine monotherapy was utilized; and Interval 2, January 2010 through December 2010, for whom 54 of 84 (64.3%) intensive care unit patients, including all those intubated, received adjunctive agents, including dexmedetomidine or propofol. Clinical management was similar for both intervals, as well as prevalence of alcohol withdrawal syndrome versus total adult hospital admissions and comorbid conditions. Overall, respiratory failure (53 versus 39%), seizures (36 versus 18%), and pneumonia (51 versus 38%) were less frequent during Interval 2 (all p intensive care unit admission are excluded, the prevalence of these complications was similar (p = ns) for Interval 1 and Interval 2. Intensive care unit and hospital length of stay were not altered by adjunctive therapy, which was typically employed for more severely affected patients. High intensity sedation with adjunctive drugs led to few cardiovascular adverse events and may have facilitated management, but did not alter intensive care unit course of severe alcohol withdrawal syndrome.

  13. 'Call Eric'

    DEFF Research Database (Denmark)

    Dickson, Thomas

    1999-01-01

    Fremtidens telefoner kan forklædes som øreringe og brillestel, og er styret af brugernes stemme.......Fremtidens telefoner kan forklædes som øreringe og brillestel, og er styret af brugernes stemme....

  14. Non-surgical adjunctive interventions for accelerating tooth movement in patients undergoing fixed orthodontic treatment.

    Science.gov (United States)

    El-Angbawi, Ahmed; McIntyre, Grant T; Fleming, Padhraig S; Bearn, David R

    2015-11-18

    Accelerating the rate of tooth movement may help to reduce the duration of orthodontic treatment and associated unwanted effects including root resorption and enamel demineralisation. Several methods, including surgical and non-surgical adjuncts, have been advocated to accelerate the rate of tooth movement. Non-surgical techniques include low-intensity laser irradiation, resonance vibration, pulsed electromagnetic fields, electrical currents and pharmacological approaches. To assess the effect of non-surgical adjunctive interventions on the rate of orthodontic tooth movement and the overall duration of treatment. We searched the following databases on 25 November 2014: the Cochrane Oral Health Group's Trials Register (November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2014, Issue 10), MEDLINE via OVID (1946 to November 2014), EMBASE via OVID (1980 to November 2014), LILACS via BIREME (1980 to November 2014), metaRegister of Controlled Trials (November 2014), the US National Institutes of Health Trials Register (ClinicalTrials.gov; November 2014) and the WHO International Clinical Trials Registry Platform (November 2014). We checked the reference lists of all trials identified for further studies. There were no restrictions regarding language or date of publication in the searches of the electronic databases. We included randomised controlled trials (RCTs) of people receiving orthodontic treatment using fixed appliances along with non-surgical adjunctive interventions to accelerate tooth movement. We excluded non-parallel design studies (for example, split-mouth) as we regarded them as inappropriate for assessment of the effects of this type of intervention. Two review authors were responsible for study selection, risk of bias assessment and data extraction; they carried out these tasks independently. Any disagreements were resolved by discussion amongst the review team to reach consensus. The review authors contacted

  15. Diode laser-assisted endoscopic dacryocystorhinostomy: a comparison of three different combinations of adjunctive procedures.

    Science.gov (United States)

    Dogan, Remzi; Meric, Aysenur; Ozsütcü, Mustafa; Yenigun, Alper

    2013-08-01

    Chronic dacryocystitis is a frequently encountered condition which can be corrected by dacryocystorhinostomy. Today, the diode laser is increasingly put to use in such corrective operations. This study aims to answer the questions of which adjunctive procedures and which combinations of such procedures are necessary and effective in securing more successful outcomes in diode laser dacryocystorhinostomy. This prospective randomized study included eighty patients (13 male, 67 female) who underwent dacryocystorhinostomy in our hospital during the 2 year period of January 2009-January 2011. The patients were selected consecutively and were randomly allocated to three groups. Group 1 (30): diode laser + mitomycin C + silicone intubation; Group 2 (27): diode laser + silicone intubation; Group 3 (23): diode laser + mitomycin C. All patients were evaluated postoperatively on day 1, week 1, and on the 1st, 3rd, 6th, 12th, 18th, and 24th months. The postoperative evaluation consisted of preoperative and postoperative ostium measurements, recording postoperative complications, and calculating and comparing success rates and operative times. The mean ages of the patients were 63.4 for Group 1, 60.7 for Group 2, and 61.8 for Group 3. No statistically significant difference was found among the groups regarding pre- and postoperative ostium measurements. The success rates were 84.3, 80, and 76.9 % for Groups 1, 2, and 3, respectively. Complications noted in Group 1 were restenosis (3), premature silicone tube loss (1), development of granulation tissue (3), synechia (2), infection (2), and hemorrhage (3). Those for Group 2 were restenosis (5), premature tube loss (2), granulation (8), synechia (6), infection (3), and hemorrhage (4). Group 3 had 6 cases with stenosis, 5 with granulation, 3 with infection, 6 with synechia, and 5 with hemorrhage. The operative times of the groups were 25.5, 15.3, and 18.1 min, respectively, for Group 1, 2, and 3. All three groups had statistically

  16. WhatsApp Messenger as an Adjunctive Tool for Telemedicine: An Overview.

    Science.gov (United States)

    Giordano, Vincenzo; Koch, Hilton; Godoy-Santos, Alexandre; Dias Belangero, William; Esteves Santos Pires, Robinson; Labronici, Pedro

    2017-07-21

    The advent of telemedicine has allowed physicians to deliver medical treatment to patients from a distance. Mobile apps such as WhatsApp Messenger, an instant messaging service, came as a novel concept in all fields of social life, including medicine. The use of instant messaging services has been shown to improve communication within medical teams by providing means for quick teleconsultation, information sharing, and starting treatment as soon as possible. The aim of this study was to perform a comprehensive systematic review of present literature on the use of the WhatsApp Messenger app as an adjunctive health care tool for medical doctors. Searches were performed in PubMed, EMBASE, and the Cochrane Library using the term "whatsapp*" in articles published before January 2016. A bibliography of all relevant original articles that used the WhatsApp Messenger app was created. The level of evidence of each study was determined according to the Oxford Levels of Evidence ranking system produced by the Oxford Centre for Evidence-Based Medicine. The impact and the indications of WhatsApp Messenger are discussed in order to understand the extent to which this app currently functions as an adjunctive tool for telemedicine. The database search identified a total of 30 studies in which the term "whatsapp*" was used. Each article's list of references was evaluated item-by-item. After literature reviews, letters to the editor, and low-quality studies were excluded, a total of 10 studies were found to be eligible for inclusion. Of these studies, 9 had been published in the English language and 1 had been published in Spanish. Five were published by medical doctors. The pooled data presents compelling evidence that the WhatsApp Messenger app is a promising system, whether used as a communication tool between health care professionals, as a means of communication between health care professionals and the general public, or as a learning tool for providing health care information

  17. Partial Tenon’s capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery

    Science.gov (United States)

    Susanna, R

    2003-01-01

    Aim: To verify if partial intraoperative Tenon’s capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. Methods: A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. Results: 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP⩽21 mm Hg) at 1 year after surgery was 70.4% in group A and 77.7% in group B (p>0.05). Overall, 74.2% of the patients achieved an IOP ⩽21 mm Hg and 55.2% an IOP⩽17 mm Hg, with or without additional medication administered to lower IOP. The incidence of complications was similar in both groups. Conclusions: In eyes undergoing Ahmed

  18. Partial Tenon's capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery.

    Science.gov (United States)

    Susanna, R

    2003-08-01

    To verify if partial intraoperative Tenon's capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP0.05). Overall, 74.2% of the patients achieved an IOP glaucoma, PCTR with MMC augmentation showed no additional benefits or complications over MMC augmentation alone; no avascular bleb was obtained with this technique. The incidence of a hypertensive phase was lower than reported in previous studies.

  19. Bone augmentation as an adjunct to dental implant rehabilitation in patients with diabetes mellitus: A review of literature.

    Science.gov (United States)

    Ladha, Komal; Sharma, Ankit; Tiwari, Bhawana; Bukya, Dwaraka N

    2017-01-01

    The aim of the present article is to review the success of bone augmentation performed as an adjunct to dental implant rehabilitation in patients with diabetes mellitus. A literature review was conducted in PubMed on this topic, which yielded a total of 102 publications. For inclusion, publications had to be human studies, written in English language and should report on the success of bone augmentation as an adjunct to dental implant rehabilitation in diabetic patients. After screening the titles and abstracts, 11 full texts publications were obtained, of which seven were included in the review. These studies provided data on various bone augmentation techniques such as sinus floor elevation (SFE), guided bone regeneration (GBR), and onlay bone grafting. Even though the current review revealed that there are not many studies reporting data relevant to the analyzed topic, the data obtained suggests that; (1) staged GBR technique should be considered more feasible and predictable for bone augmentation, (2) clinicians must take meticulous care when planning and conducting SFE, and (3) block bone augmentation technique should be avoided.

  20. Resveratrol treatment as an adjunct to pharmacological management in type 2 diabetes mellitus--systematic review and meta-analysis.

    Science.gov (United States)

    Hausenblas, Heather A; Schoulda, Jennifer A; Smoliga, James M

    2015-01-01

    The red wine polyphenol, resveratrol, is highly effective in treating type 2 diabetes mellitus (T2DM) in animal models, but there is no consensus regarding its efficacy in humans. We conducted a systematic review, which included searches in nine scholarly databases and six clinical trial registries, and identified randomized controlled clinical trials whereby resveratrol was used as an adjunct to pharmaceutical interventions in T2DM. Meta-analysis on clinical parameters was performed for available data. Of 764 articles originally identified, data from six unique datasets, examining a total of 196 T2DM patients (104 resveratrol, 92 control/placebo) ultimately met inclusion criteria. Statistically significant (p fasting glucose, homeostatic model assessment of insulin resistance, diastolic blood pressure, insulin, triglycerides, LDL, or HDL cholesterol. No major adverse events were reported and side effects of resveratrol were not different than placebo/control. Though limitations in sample size and treatment duration preclude definitive changes in clinical practice, significant improvements in multiple cardiometabolic biomarkers and an excellent safety profile support resveratrol as a leading candidate as an adjunct to pharmacological management of T2DM. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Nitric oxide treatments as adjuncts to reperfusion in acute myocardial infarction: a systematic review of experimental and clinical studies.

    Science.gov (United States)

    Bice, Justin S; Jones, Bethan R; Chamberlain, Georgia R; Baxter, Gary F

    2016-03-01

    Unmodified reperfusion therapy for acute myocardial infarction (AMI) is associated with irreversible myocardial injury beyond that sustained during ischemia. Studies in experimental models of ischemia/reperfusion and in humans undergoing reperfusion therapy for AMI have examined potential beneficial effects of nitric oxide (NO) supplemented at the time of reperfusion. Using a rigorous systematic search approach, we have identified and critically evaluated all the relevant experimental and clinical literature to assess whether exogenous NO given at reperfusion can limit infarct size. An inclusive search strategy was undertaken to identify all in vivo experimental animal and clinical human studies published in the period 1990-2014 where NO gas, nitrite, nitrate or NO donors were given to ameliorate reperfusion injury. Articles were screened at title and subsequently at abstract level, followed by objective full text analysis using a critical appraisal tool. In twenty-one animal studies, all NO treatments except nitroglycerin afforded protection against measures of reperfusion injury, including infarct size, creatinine kinase release, neutrophil accumulation and cardiac dysfunction. In three human AMI RCT's, there was no consistent evidence of infarct limitation associated with NO treatment as an adjunct to reperfusion. Despite experimental evidence that most NO treatments can reduce infarct size when given as adjuncts to reperfusion, the value of these interventions in clinical AMI is unproven. Our study raises issues for the design of further clinical studies and emphasises the need for improved design of animal studies to reflect more accurately the comorbidities and other confounding factors seen in clinical AMI.

  2. Nobel Prize Recipient Eric Betzig Presents Lecture on Efforts to Improve High-Resolution Microscopy | Poster

    Science.gov (United States)

    Eric Betzig, Ph.D., a 2014 recipient of the Nobel Prize in Chemistry and a scientist at Janelia Research Campus (JRC), Howard Hughes Medical Institute, in Ashburn, Va., visited NCI at Frederick on Sept. 10 to present a Distinguished Scientist lecture and discuss the latest high-resolution microscopy techniques. Betzig co-invented photoactivation localization microscopy (PALM) in collaboration with scientists at NIH. PALM achieves 10-fold improvement in spatial resolution of cells, going from the resolution limit of approximately 250 nm in standard optical microscopy down to approximately 20 nm, thus producing a so-called “super-resolution” image. Spatial resolution refers to the clarity of an image or, in other words, the smallest details that can be observed from an image.

  3. Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation.

    Science.gov (United States)

    Attias, N; Thabet, A M; Prabhakar, G; Dollahite, J A; Gehlert, R J; DeCoster, T A

    2018-05-01

    Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and radiological records of the patients were analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to 126). Overall, 16 (94%) of the patients achieved radiological filling of their bony defect and united to the native bone ends proximally and distally, resulting in a functioning limb. Complications included device failure in two patients (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients (24%) required secondary surgery, four (24%) had a residual limb-length discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A titanium mesh cage is a useful adjunct in the treatment of an extra-articular segmental defect in a long bone. Cite this article: Bone Joint J 2018;100-B:646-51.

  4. Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review.

    Science.gov (United States)

    Abduljabbar, Tariq; Javed, Fawad; Shah, Altaf; Samer, Mazin Saleh; Vohra, Fahim; Akram, Zohaib

    2017-02-01

    The aim of the study was to assess the efficacy of adjunctive use of laser therapy (LT) alone or antimicrobial photodynamic therapy (aPDT) to improve clinical periodontal and HbA1c levels in patients with both chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). Electronic search of the MEDLINE, PubMed, EMBASE, Science Direct, and SCOPUS databases were combined with hand searching of articles published from 1975 up to and including March 2016 using relevant MeSH terms. Six studies were selected for this review. In these six studies, laser treatment was applied, after scaling and root planing (SRP), in two ways: Three studies used laser alone and three studies used laser with photosensitizer. All the six included studies reporting clinical periodontal and glycemic parameters showed that LT and aPDT were effective in the treatment of CP in T2DM subjects at follow-up. Two studies showed significantly better periodontal outcomes for LT as an adjunct to SRP as compared to SRP alone, whereas four studies showed comparable periodontal outcomes among adjunctive LT or aPDT with SRP. Two studies showed significant reduction of HbA1c levels in LT and aPDT as compared to SRP, whereas three studies showed comparable percentage levels at follow-up. It remains debatable whether LT or aPDT as adjunct to SRP is more effective as compared to SRP alone in the improvement of clinical periodontal and glycemic control in patients with both CP and T2DM, given that the scientific evidence is weak.

  5. Sugar administration is an effective adjunctive therapy in the treatment of Pseudomonas aeruginosa pneumonia.

    Science.gov (United States)

    Bucior, Iwona; Abbott, Jason; Song, Yuanlin; Matthay, Michael A; Engel, Joanne N

    2013-09-01

    Treatment of acute and chronic pulmonary infections caused by opportunistic pathogen Pseudomonas aeruginosa is limited by the increasing frequency of multidrug bacterial resistance. Here, we describe a novel adjunctive therapy in which administration of a mix of simple sugars-mannose, fucose, and galactose-inhibits bacterial attachment, limits lung damage, and potentiates conventional antibiotic therapy. The sugar mixture inhibits adhesion of nonmucoid and mucoid P. aeruginosa strains to bronchial epithelial cells in vitro. In a murine model of acute pneumonia, treatment with the sugar mixture alone diminishes lung damage, bacterial dissemination to the subpleural alveoli, and neutrophil- and IL-8-driven inflammatory responses. Remarkably, the sugars act synergistically with anti-Pseudomonas antibiotics, including β-lactams and quinolones, to further reduce bacterial lung colonization and damage. To probe the mechanism, we examined the effects of sugars in the presence or absence of antibiotics during growth in liquid culture and in an ex vivo infection model utilizing freshly dissected mouse tracheas and lungs. We demonstrate that the sugar mixture induces rapid but reversible formation of bacterial clusters that exhibited enhanced susceptibility to antibiotics compared with individual bacteria. Our findings reveal that sugar inhalation, an inexpensive and safe therapeutic, could be used in combination with conventional antibiotic therapy to more effectively treat P. aeruginosa lung infections.

  6. Ezogabine: a novel antiepileptic for adjunctive treatment of partial-onset seizures.

    Science.gov (United States)

    Amabile, Celene M; Vasudevan, Arvind

    2013-02-01

    Epilepsy is defined as a tendency toward recurrent seizures unprovoked by any systemic or acute neurologic insults. It is a disruption of the electrical conductivity or activity in the brain, resulting in a seizure. In the United States, approximately 120 of every 100,000 people seek medical attention due to new seizure activity. Ezogabine, known as retigabine in Europe, is an ethyl N-(2-amino-4-[{fluorophenyl}methlamino]phenylcarbamate). The drug has been approved by the United States Food and Drug Administration (FDA) and European Medicines Agency for adjunctive treatment of partial-onset seizures in adults. Ezogabine exerts its therapeutic effect by enhancing transmembrane potassium channels (KCNQ ion channels), which is a novel mechanism in comparison with other antiepileptics. There are no specific documented contraindications to ezogabine. Warnings target patients that have benign prostatic hyperplasia or are receiving concomitant anticholinergic drugs due to a risk of urinary retention (2%). The FDA has required that ezogabine be part of a risk evaluation and mitigation strategy program in order to inform health care professionals of the risk of urinary retention. Prescribers should inform patients that ezogabine can cause urinary retention, including urinary hesitation, and instruct them to seek immediate medical attention if these symptoms occur. A medication guide has been developed for distribution to patients. © 2013 Pharmacotherapy Publications, Inc.

  7. Moving beyond subcutaneous insulin: the application of adjunctive therapies to the treatment of type 1 diabetes.

    Science.gov (United States)

    Ang, Kathleen H; Sherr, Jennifer L

    2017-09-01

    With the discovery of insulin nearly a century ago, the diagnosis of Type 1 Diabetes (T1D) transformed from a death sentence to a chronic medical condition. Despite the advances that have been made, the vast majority of those living with T1D still struggle to achieve targeted control. Yet, a plethora of agents have been developed to treat those with Type 2 Diabetes. Exploration of how these agents may benefit those with T1D has been an area of intense investigation, especially due to the overweight/obesity epidemic, which now afflicts more than 60% of those living with T1D. Areas covered: This review focuses on agents that have been utilized, including inhaled insulin preparations, pramlintide, metformin, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, and dual SGLT1/2 inhibitors. Furthermore, with approval of the first hybrid closed loop (CL) system, the development of dual hormone CL systems is being explored. While the most common agent applied to these dual systems has been glucagon, research has been conducted to assess how some of the adjunctive therapies described above could aide with achieving postprandial glucose control while on CL insulin delivery. Expert opinion: By becoming less insulin-centric and incorporating some of these other agents, it is possible we may be able to better combat T1D.

  8. The use of polymethyl-methacrylate (Artecoll) as an adjunct to facial reconstruction

    Science.gov (United States)

    Mok, David; Schwarz, Jorge

    2004-01-01

    BACKGROUND: Injectable polymethyl-methacrylate (PMMA) microspheres, or Artecoll, has been used for the last few years in aesthetic surgery as long-term tissue filler for the correction of wrinkles and for lip augmentation. This paper presents three cases of the use of PMMA microsphere injection for reconstructive patients with defects of varying etiologies. These cases provide examples of a novel adjunct to the repertoire of the reconstructive surgeon. OBJECTIVES: To evaluate the effectiveness (short- and long-term) of PMMA injection for the correction of small soft tissue defects of the face. METHODS: Three case histories are presented. They include the origin of the defect; previous reconstructions of the defect; and area, volume, timing and technical particularities of PMMA administration. RESULTS: All three cases showed improvement of the defect with the PMMA injection with respect to both objective evidence and patient satisfaction. The improvements can still be seen after several years. CONCLUSIONS: PMMA microsphere injection can be effectively used to correct selected small facial defects in reconstructive cases and the results are long lasting. PMID:24115873

  9. Adjunctive cryotherapy for pigmentary keratitis in dogs: a study of 16 corneas.

    Science.gov (United States)

    Azoulay, Thierry

    2014-07-01

    To assess whether soft cryotherapy (dimethylether, isobutene, and propane) can remove pigmentation of the cornea that has accumulated under different conditions when conventional therapy has been unsuccessful. Nine dogs with unilateral or bilateral corneal pigmentation (16 eyes) were included based on progressive corneal pigmentation that was unresponsive to long-term etiological treatment. The dogs had keratoconjunctivitis sicca or chronic superficial keratitis. A cryogen of 95% dimethylether, 3% isobutane, and 2% propane was applied to the pigmented areas of each cornea under anesthesia. Initial corneal pigmentation and changes were documented over the entire study period using a grading scheme and clinical photographs. Most of the pigment deposits were gone by 5-15 days after cryosurgery. Postoperatively, the dogs showed some corneal edema and corneo-conjunctival inflammation, and three dogs had superficial corneal ulcers; these symptoms had resolved by 1 month after the procedure. Follow-up for more than 90 days was available in five dogs (nine corneas), and we observed total or partial repigmentation when the underlying disease was not controlled. A new cryotherapy procedure was successfully performed in two of these dogs. Given the sensitivity to cold of melanocytes, cryotherapy is a viable adjunctive treatment for refractory severe corneal pigmentation. Etiological treatment remains necessary to prevent pigmentation from rapidly reappearing. Only a few dogs were followed for more than 90 days; further study is necessary to evaluate the long-term safety and efficacy of soft cryotherapy. © 2013 American College of Veterinary Ophthalmologists.

  10. Topical Yunnan Baiyao administration as an adjunctive therapy for bleeding complications in adolescents with advanced cancer.

    Science.gov (United States)

    Ladas, E J; Karlik, J B; Rooney, D; Taromina, K; Ndao, D H; Granowetter, L; Kelly, K M

    2012-12-01

    Yunnan Baiyao (White Medicine from Yunnan, YNB) is a Chinese herbal medicinal powder used to stop bleeding and improve circulation in traumatic injuries. We describe the use of YNB in adolescents with cancer as an adjunct to uncontrolled bleeding in the palliative care setting. Through a retrospective chart review of all patients receiving integrative medicine consultations at the Integrative Therapies Program at Columbia University from January 1, 2007 to January 31, 2012, we describe the outcome of patients treated with YNB for management of uncontrolled bleeding. Four patients were identified who received topical YNB for uncontrolled bleeding; patients included two males and two females with diagnoses of solid tumors (n = 3) and Burkitt's lymphoma (n = 1). Mean age was 15.5 years (range 15-17). Fifty percent had life-threatening bleeding from the tumor site and 50 % experienced uncontrollable epistaxis. All patients received preceding therapy with packed red blood cells and platelet transfusions, topical thrombin, and oral aminocaproic acid. Two patients used YNB in the inpatient setting, and all four patients used YNB as outpatients. In all patients, bleeding control improved with the addition of YNB to conventional hemostatic interventions. Two patients using YNB in their home reported control of bleeding episodes. There were no adverse events reported. YNB may be an efficacious agent for uncontrolled bleeding in conjunction with conventional hemostatic agents in adolescents with advanced cancer. It is well accepted by patients. YNB may be especially valuable in the outpatient setting to prevent the recurrence of hemorrhage.

  11. Rugae patterns as an adjunct to sex differentiation in forensic identification.

    Science.gov (United States)

    Saraf, A; Bedia, S; Indurkar, A; Degwekar, S; Bhowate, R

    2011-07-01

    It is widely acknowledged that in some forensic situations there are limitations to identification of the deceased by fingerprints, DNA and dental records. Palatal rugae pattern of an individual may be considered as a useful adjunct for sex determination for identification purposes. The aim of this study was to identify and compare the rugae pattern in Indian males and females, as an additional method of differentiating the sexes in various postmortem scenarios. Dental stone casts of 120 Indians: 60 males and 60 females were obtained. The method of identification of rugae patterns was that of Thomas and Kotze (1983) and Kapali et al (1997) which includes the number, length, shape and unification of rugae. Our study revealed no significant difference in the total number or various length measurements of rugae between the two sexes which conforms to previous results. However, in terms of the different types of rugae shape, the converging type of rugae were statistically greater in number in females whilst the circular type of rugae were statistically greater in number in males, which contrasts with earlier studies. The use of logistic regression analysis (LRA) enabled highly accurate sex prediction (>99%) when all the rugae shapes were analyzed. It may be concluded that rugae pattern through the use of LRA can be an additional method of differentiation between the Indian male and female and assist with the identification process in conjunction with other methods such as visual, fingerprints and dental characteristics in forensic sciences.

  12. A Review of Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Epilepsy

    Directory of Open Access Journals (Sweden)

    Rajinder P. Singh

    2011-01-01

    Full Text Available Eslicarbazepine acetate (ESL is a novel antiepileptic drug indicated for the treatment of partial-onset seizures. Structurally, it belongs to the dibenzazepine family and is closely related to carbamazepine and oxcarbazepine. Its main mechanism of action is by blocking the voltage-gated sodium channel. ESL is a pro-drug that is rapidly metabolized almost exclusively into S-licarbazepine, the biologically active drug. It has a favorable pharmacokinetic and drug-drug interaction profile. However, it may induce the metabolism of oral contraceptives and should be used with caution in females of child-bearing age. In the pre-marketing placebo-controlled clinical trials ESL has proven effective as adjunctive therapy in adult patients with refractory of partial-onset seizures. Best results were observed on a single daily dose between 800 and 1200 mg. In general, ESL was well tolerated, with most common dose-related side effects including dizziness, somnolence, headache, nausea and vomiting. Hyponatremia has been observed (0.6%-1.3%, but the incidence appears to be lower than with the use of oxcarbazepine. There is very limited information on the use of ESL in children or as monotherapy.

  13. Effect of adjuncts on microbiological and chemical properties of Scamorza cheese.

    Science.gov (United States)

    Guidone, Angela; Braghieri, Ada; Cioffi, Silvia; Claps, Salvatore; Genovese, Francesco; Morone, Giuseppe; Napolitano, Fabio; Parente, Eugenio

    2015-03-01

    Scamorza is a semi-hard, pasta filata cheese resembling low-moisture Mozzarella cheese, with a short ripening time (cheeses, it was manufactured using 2 types of milk in the current study: 100% Italian Friesian milk (F) or 90% F and 10% Jersey cow milk (mixed, M), and 2 types of starter: Streptococcus thermophilus or S. thermophilus with peptidolytic Lactococcus lactis, Lactobacillus helveticus, and Lactobacillus paracasei strains as adjuncts). The cheeses were ripened for 30d. The adjunct did not significantly affect acid production or growth of the primary starter; 2 of the species used in the adjunct (Lb. paracasei and Lb. helveticus) rapidly colonized the cheese and persisted until the end of ripening, whereas the counts of nonstarter lactic acid bacteria in the control cheese were low until the end of ripening. The use of adjuncts affected pH, microbial composition (as assessed by both culture-dependent and culture-independent methods), total free amino acid content, and volatile profile (measured using an electronic nose), whereas milk type had only a minor effect. Although differences in primary proteolysis were found, they were probably indirect and related to the effects on pH and moisture. We conclude that, even with a short ripening time (30d), use of a peptidolytic adjunct may significantly affect important features of Scamorza and may be used to create a product that is measurably different from competing products. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  14. The influence of starter and adjunct lactobacilli culture on the ripening of washed curd cheeses

    Directory of Open Access Journals (Sweden)

    E. Hynes

    2002-12-01

    Full Text Available Ten strains of lactobacillus from the CNRZ collection were tested as adjunct culture in miniature washed curd cheeses manufactured under controlled bacteriological conditions with two different starters, Lactococcus lactis subsp. lactis IL 416 and Lactococcus lactis subsp. cremoris AM2. Lactobacilli growth seemed to be dependent on the Lactobacillus strain but was not influenced by the starter strain or counts. Lactococci counts were higher in the miniature cheeses with AM2 starter and added lactobacilli than in the control cheeses without lactobacilli. Gross composition and hydrolysis of s1 casein were similar for miniature cheeses with and without lactobacilli. In the miniature cheeses manufactured with IL416 starter, the lactobacilli adjunct slightly increased the soluble nitrogen content, but that was not verified in the AM2 miniature cheeses. Phosphotungstic acid nitrogen content increased in miniature cheeses manufactured with IL416 when Lactobacillus plantarum 1572 and 1310 adjunct cultures were added. That was also verified for several Lactobacillus strains, specially Lactobacillus casei 1227, for miniature cheeses manufactured with AM2 starter. Free fatty acid content increased in miniature cheeses made with lactobacilli adjuncts 1310, 1308 and 1219 with IL416 starter, and with strains 1218, 1244 and 1308 for miniature cheeses with AM2 starter. These results indicate that production of soluble nitrogen compounds as well as free fatty acid content could be influenced by the lactobacilli adjunct, depending on the starter strain.

  15. Zinc as an adjunct to antibiotics for the treatment of severe pneumonia in children <5 years: a meta-analysis of randomised-controlled trials.

    Science.gov (United States)

    Tie, Hong-Tao; Tan, Qi; Luo, Ming-Zhu; Li, Qiang; Yu, Jia-Lin; Wu, Qing-Chen

    2016-03-14

    The effect of Zn, as an adjunct to antibiotics, on the treatment of severe pneumonia in young children is still under debate; therefore, we performed a meta-analysis to evaluate the therapeutic role of Zn for severe pneumonia in children younger than 5 years. PubMed, Cochrane library and Embase databases were systematically searched from inception until October 2015 for randomised-controlled trials (RCT) that assessed the effect of Zn as an adjunct to antibiotics for severe pneumonia. Random-effects model was used for calculating the pooled estimates, and intention-to-treat principle was also applied. Nine RCT involving 2926 children were included. Overall, the pooled results showed that adjunct treatment with Zn failed to reduce the time to recovery from severe pneumonia (hazard ratios (HR)=1·04; 95% CI 0·90, 1·19; I(2)=39%; P=0·58), hospital length of stay (HR=1·04; 95% CI 0·83, 1·33; I(2)=57%; P=0·74), treatment failure (relative risk (RR)=0·95; 95% CI 0·79, 1·14; I(2)=20%; P=0·58) or change of antibiotics (RR=1·07; 95% CI 0·79, 1·45; I(2)=44%; P=0·67). In addition, continuous outcomes were consistent while meta-analysed with standard mean difference, and all outcomes remained stable in intention-to-treat analysis. No significant differences were observed in the two groups between death rate, adverse events or recovery times of severe pneumonia indicators. Our results suggested that adjunct treatment with Zn failed to benefit young children in the treatment of severe pneumonia. Considering the clinical heterogeneity, baseline characteristics of children, definition of severe pneumonia and Zn supplement way should be taken into consideration in future research. This study was registered at PRESPERO as CRD42015019798.

  16. Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: a flexible-dose, open-label pilot trial.

    Science.gov (United States)

    Katzman, M A; Vermani, M; Jacobs, L; Marcus, M; Kong, B; Lessard, S; Galarraga, W; Struzik, L; Gendron, A

    2008-12-01

    Generalized anxiety disorder (GAD) is a chronic disorder associated with significant morbidity and disability. Traditional therapies are associated with poor levels of remission, and often result in troublesome side effects. This was a 12-week, open-label, flexible-dose study to assess the efficacy and tolerability of quetiapine as an adjunctive treatment to traditional medication. 40 outpatients with GAD who had not achieved remission following at least 8 weeks of an adequate dose of traditional therapy were enrolled. The primary endpoint was the mean change from pre-treatment to week 12 in the Hamilton Anxiety Rating Scale (HAM-A) total scores. Secondary endpoints included: the proportion of patients achieving remission (HAM-A total score of Impressions-Severity of Illness (CGI-S), Clinical Global Impressions-Global Improvement (CGI-I), Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Adjunctive quetiapine (mean dose 386mg/day at week 12) significantly reduced the HAM-A total scores from pre-treatment (29.8+/-9.0) to week 12 (9.0+/-10.2) (-20.6; pserious AEs and no clinically significant changes in vital signs, weight (mean gain 0.5kg at week 12) or laboratory assessments. The results of this small pilot trial suggest that quetiapine adjunctive to traditional therapy may be a useful treatment in patients with GAD or treatment-resistant GAD, and warrant further investigation.

  17. Storage and recall capabilities of fuzzy morphological associative memories with adjunction-based learning.

    Science.gov (United States)

    Valle, Marcos Eduardo; Sussner, Peter

    2011-01-01

    We recently employed concepts of mathematical morphology to introduce fuzzy morphological associative memories (FMAMs), a broad class of fuzzy associative memories (FAMs). We observed that many well-known FAM models can be classified as belonging to the class of FMAMs. Moreover, we developed a general learning strategy for FMAMs using the concept of adjunction of mathematical morphology. In this paper, we describe the properties of FMAMs with adjunction-based learning. In particular, we characterize the recall phase of these models. Furthermore, we prove several theorems concerning the storage capacity, noise tolerance, fixed points, and convergence of auto-associative FMAMs. These theorems are corroborated by experimental results concerning the reconstruction of noisy images. Finally, we successfully employ FMAMs with adjunction-based learning in order to implement fuzzy rule-based systems in an application to a time-series prediction problem in industry. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Montie, J E; Stewart, B H; Straffon, R A; Banowsky, L H; Hewitt, C B; Montague, D K

    1977-03-01

    The results of therapy for 78 patients with disseminated renal cell carcinoma are evaluated. Symptoms related to the primary tumor were noted in only 28 per cent of the patients and were not difficult to manage in those patients not undergoing nephrectomy. Adjuctive nephrectomy, therefore, is a more appropriate term than palliative nephrectomy when referring to removal of the primary tumor as part of an aggresive combined therapeutic approach. Of patients receiving an adjunctive nephrectomy those with osseous metastases only had a better 1-year survival rate (36 per cent) than those with metastases to other sites (18 per cent). Complete regression of metastases was noted in 12 per cent of patients treated with medroxyprogesterone acetate and adjunctive nephrectomy. The role of adjunctive nephrectomy combined with embolic infarction, hormonal therapy, chemotherapy and/or immunotherapy is discussed.

  19. Adjunctive therapy in Parkinson’s disease: the role of rasagiline

    Science.gov (United States)

    Gaines, Kathryn D; Hinson, Vanessa K

    2012-01-01

    Parkinson’s disease is the second most common neurodegenerative disorder, currently affecting 1.5 million people in the US. In this review, we describe the diagnostic and pathological features of Parkinson’s disease, as well as its clinical course. We then review pharmacologic treatments for the disease, with a particular focus on therapies adjunctive to levodopa and specifically the role of rasagiline. We review the four pivotal rasagiline trials, and discuss rasagiline and its use as adjunctive therapy for Parkinson’s disease. Finally, we discuss potential side effects, drug interactions, and other practical aspects concerning the use of rasagiline in Parkinson’s disease. PMID:22802692

  20. Erratum to: Sterically Stabilized Phospholipid Micelles Reduce Activity of a Candidate Antimicrobial Healing Adjunct

    Science.gov (United States)

    2012-03-25

    Marucha Center for Wound Healing and Tissue Regeneration, College of Dentistry , University of Illinois at Chicago, Chicago, IL, USA 1 3 Int J Pept Res Ther (2012) 18:205 DOI 10.1007/s10989 012 9296 x ...candidate antimicrobial healing adjunct 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Williams R. L., Lim S. B...Antimicrobial Wound Healing Adjunct Richard L. Williams • Sok Bee Lim • Hayat Onyuksel • Phillip T. Marucha Published online: 25 March 2012 Springer

  1. A mindful eating group as an adjunct to individual treatment for eating disorders: a pilot study.

    Science.gov (United States)

    Hepworth, Natasha S

    2011-01-01

    The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.

  2. Interdisciplinary Treatment of an Adult Patient Using an Adjunctive Orthodontic Approach. Case Report

    Directory of Open Access Journals (Sweden)

    Rugina Roxana

    2017-03-01

    Full Text Available The aim of this case presentation is to outline some of the advantages that an adjunct orthodontic treatment can offer in a comprehensive oral rehabilitation of an adult patient. Adjunctive orthodontic treatment is usually limited to a dental arch or to a group of teeth within an arch. The purpose of dental movements in this case will be to position the teeth in a way that makes the restoration or replacement of damaged or missing teeth as easy as possible and with minimal dental tissue sacrifice. In addition, the improved position of the teeth will create a healthier periodontal environment that is easier to maintain over time.

  3. Cross-Linguistic Variation in the Treatment of Beneficiaries and the Argument vs. Adjunct Distinction

    Directory of Open Access Journals (Sweden)

    Denis Creissels

    2014-01-01

    Full Text Available This paper compares the expression of beneficiaries with that of typical arguments and typical adjuncts in a sample of languages illustrating the variation in the extent to which NPs encoding beneficiaries show a syntactic behavior more or less similar to that of typical arguments or typical adjuncts. The observations support the position according to which semantic argumenthood as a comparative concept must be distinguished from its possible syntactic correlates, and must be defined as a scalar rather than categorical concept reflecting the interaction between the various factors that may contribute to defining the degree of involvement of participants in an event.

  4. Utility of adjunctive macrolide therapy in treatment of children with asthma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Mikailov A

    2013-01-01

    Full Text Available Anar Mikailov,1 Ilona Kane,2 Stephen C Aronoff,3 Raemma Luck,3,† Michael T DelVecchio31Beth Israel Deaconess Medical Center, Boston, MA, 2St Christopher's Hospital for Children, Philadelphia, PA, 3Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA†Raemma Luck is now deceasedBackground: The purpose of this study was to investigate macrolides as an adjunct to an asthma controller regimen in children with asthma.Methods: Prospective clinical trials of macrolide therapy in children with asthma using outcome measures of change in forced expiratory volume in one second (FEV1 and/or oral corticosteroid requirement were searched for in PubMed up to December 2009. The reference lists of studies were also included in the analysis, as well as those listed in published meta-analyses.Results: The literature search yielded 116 studies, six of which were included in this meta-analysis. The change in FEV1 from baseline with adjunctive use of macrolide therapy in all children was not significant (0.25% predicted; 95% confidence interval [CI] −0.37, 0.86 predicted, P = 0.43; however, the change in FEV1 among children receiving daily oral corticosteroids was significant (3.89% predicted; 95% CI −0.01, 7.79, P = 0.05. Addition of macrolide therapy to the treatment of children with oral corticosteroid-dependent asthma resulted in a statistically significant decrease in daily corticosteroid dosage (−3.45 mg/day; 95% CI −5.79, −1.09 mg/day, P = 0.004. This reduction in daily corticosteroid dosage was directly proportional to the duration of macrolide therapy (−0.17 mg methylprednisolone per week of macrolide therapy; 95% CI −0.33, −0.021, P = 0.025.Conclusion: Addition of macrolides to the treatment regimen of children with oral corticosteroid-dependent asthma improves FEV1 and decreases the daily dosage of corticosteroids required for control in these children. The degree of dose reduction is directly related to

  5. The role of adjunctive dexamethasone in the treatment of bacterial meningitis: an updated systematic meta-analysis

    Directory of Open Access Journals (Sweden)

    Shao M

    2016-07-01

    Full Text Available Mei Shao,1 Peng Xu,2 Jun Liu,3 Wenyun Liu,1 Xiujie Wu1 1Department of Neurosurgery, Linyi People’s Hospital, 2Department of Neurosurgery, Linyi Yishui Central Hospital, Linyi, 3Department of Neurosurgery, Binzhou Medical College, Yantai, Shandong, People’s Republic of China Background: Bacterial meningitis is a serious infection in children and adults worldwide, with considerable morbidity, mortality, and severe neurological sequelae. Dexamethasone is often used before antibiotics in cases of this disease, and improves outcomes.Objective: Although several studies have identified the role of adjunctive dexamethasone therapy in the treatment of bacterial meningitis, the results are still inconclusive. The aim of this study was to systematically evaluate the therapeutic and adverse effect of adjunctive dexa­methasone in patients with bacterial meningitis.Materials and methods: Relevant randomized, double-blind, placebo-controlled trials of dexamethasone in bacterial meningitis published between 2000 and 2016 were retrieved from the common electronic databases. The odds ratio (OR and risk ratio (RR with their 95% confidence interval (CI were employed to calculate the effect.Results: A total of ten articles including 2,459 bacterial meningitis patients (1,245 in the dexamethasone group and 1,214 in the placebo group were included in this meta-analysis. Our result found that dexamethasone was not associated with a significant reduction in follow-up mortality (292 of 1,245 on dexamethasone versus 314 of 1,214 on placebo; OR =0.91, 95% CI =0.80–1.03, P=0.14 and severe neurological sequelae (22.4% versus 24.1%, OR =0.84, 95% CI =0.54–1.29, P=0.42. However, dexamethasone seemed to reduce hearing loss among survivors (21.2% versus 26.1%; OR =0.76, 95% CI =0.59–0.98, P=0.03. No significant difference was found between these two groups in adverse events.Conclusion: Our results suggested that adjunctive dexamethasone might not be beneficial in the

  6. Optimization and head-to-head comparison of MISSR-PCR, ERIC-PCR, RAPD and 16S rRNA evolutionary clock for the genotyping of Vibrio cholerae isolated in China.

    Science.gov (United States)

    Mo, Q H; Wang, H B; Tan, H; An, S L; Feng, Z L; Wang, Q; Lin, J C; Yang, Z

    2015-01-01

    To establish a new genotyping method for Vibrio cholerae and compare it with other methods. In the current study, a modified inter simple sequence repeat-polymerase chain reaction (MISSR-PCR) system was developed via several rounds of optimisation. Comparison study was then conducted between MISSR-PCR and three other methods, including enterobacterial repetitive intergenic consensus sequences-based PCR (ERIC-PCR), randomly amplified polymorphic DNA (RAPD) and 16S rRNA evolutionary clock, for the detection and genetic tracing of Vibrio cholerae isolated from seafood in China. The results indicated that the MISSR-PCR system could generate the highest polymorphic fingerprinting map in a single round PCR and showed the best discriminatory ability for Vibrio cholerae genotyping by clearly separating toxigenic/nontoxigenic strains, local/foreign strains, and O1/O139/non-O1/non-O139 serogroup strains, comparing to ERIC-PCR, RAPD and 16S rRNA evolutionary clock. Moreover, the MISSR-PCR is superior to previously described traditional simple sequence repeat based PCR method on genotyping by more clearly separating different clusters. To the best of our knowledge, this is the first head-to-head comparison of four detection and genotyping methods for Vibrio cholerae The MISSR-PCR system established here could serve as a simple, quick, reliable and cost-effective tool for the genotyping and epidemiological study.

  7. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts.

    Science.gov (United States)

    Smiley, Christopher J; Tracy, Sharon L; Abt, Elliot; Michalowicz, Bryan S; John, Mike T; Gunsolley, John; Cobb, Charles M; Rossmann, Jeffrey; Harrel, Stephen K; Forrest, Jane L; Hujoel, Philippe P; Noraian, Kirk W; Greenwell, Henry; Frantsve-Hawley, Julie; Estrich, Cameron; Hanson, Nicholas

    2015-07-01

    Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. A panel of experts convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence. The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers). With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive

  8. Smartphone Cognitive Behavioral Therapy as an Adjunct to Pharmacotherapy for Refractory Depression: Randomized Controlled Trial.

    Science.gov (United States)

    Mantani, Akio; Kato, Tadashi; Furukawa, Toshi A; Horikoshi, Masaru; Imai, Hissei; Hiroe, Takahiro; Chino, Bun; Funayama, Tadashi; Yonemoto, Naohiro; Zhou, Qi; Kawanishi, Nao

    2017-11-03

    In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan. Participants were eligible if they had a primary diagnosis of major depression and were antidepressant-refractory after taking one or more antidepressants at an adequate dosage for four or more weeks. After a 1-week run-in in which participants started the medication switch and had access to the welcome session of the app, patients were randomized to medication switch alone or to medication switch plus smartphone CBT app via the centralized Web system. The smartphone app, called Kokoro-app ("kokoro" means "mind" in Japanese), included sessions on self-monitoring, behavioral activation, and cognitive restructuring presented by cartoon characters. The primary outcome was depression severity as assessed by masked telephone assessors with the Patient Health Questionnaire-9 (PHQ-9) at week 9. The secondary outcomes included the Beck Depression Inventory-II (BDI-II) and Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER). In the total sample (N=164), 81 participants were allocated to the smartphone CBT in addition to medication change and 83 to medication change alone. In the former group, all but one participant (80/81, 99%) completed at least half, and 71 (88%) completed at least six of eight sessions. In the intention-to-treat analysis, patients allocated the CBT app scored 2.48 points (95% CI 1.23-3.72, Psmartphone app, still symptomatic, and adherent to medication with mild or less side effects after run-in), the intervention group (n=60) scored 1.72 points

  9. Tissue - engineering as an adjunct to pelvic reconstructive surgery.

    Science.gov (United States)

    Jangö, Hanna

    2017-08-01

    This PhD-thesis is based on animal studies and comprises three original papers and unpublished data. The studies were con-ducted during my employment as a research fellow at the Department of Obstetrics and Gynecology, Herlev University Hospital, Denmark. New strategies for surgical reconstruction of pelvic organ pro-lapse (POP) are warranted. Traditional native tissue repair may be associated with poor long-term outcome and augmentation with permanent polypropylene meshes is associated with frequent and severe adverse effects. Tissue-engineering is a regenerative strategy that aims at creating functional tissue using stem cells, scaffolds and trophic factors. The aim of this thesis was to investigate the potential adjunctive use of a tissue-engineering technique for pelvic reconstructive surgery using two synthetic biodegradable materials; methoxypolyethyleneglycol-poly(lacticco-glycolic acid) (MPEG-PLGA) and electrospun polycaprolactone (PCL) - with or without seeded muscle stem cells in the form of autologous fresh muscle fiber fragments (MFFs). To simulate different POP repair scenarios different animal models were used. In Study 1 and 2, MPEG-PLGA was evaluated in a native tissue re-pair model and a partial defect model of the rat abdominal wall. We found that the scaffold was fully degraded after eight weeks. Cells from added MFFs could be traced and had resulted in the formation of new striated muscle fibers. Also, biomechanical changes were found in the groups with added MFFs. In Study 3, the long-term degradable electrospun PCL scaffold was evaluated in three rat abdominal wall models representing different loads on the scaffold. Surprisingly, cells from the MFFs did not survive. After eight weeks, a marked inflammatory foreign-body response was observed with numerous giant cells located between and around the PCL fibers which appeared not to be degraded. This response caused a considerable increase in the thickness of the mesh, resulting in a neotissue

  10. A retrospective analysis of the efficacy of Oncept vaccine for the adjunct treatment of canine oral malignant melanoma.

    Science.gov (United States)

    Ottnod, J M; Smedley, R C; Walshaw, R; Hauptman, J G; Kiupel, M; Obradovich, J E

    2013-09-01

    Oral malignant melanoma (OMM) in the dog is often locally aggressive with a high metastatic potential and there are few treatment options that have been demonstrated to improve outcome of this disease. The purpose of this study was to determine whether adjunctive treatment with the Oncept melanoma vaccine affected the outcome of dogs with OMM that had achieved loco-regional cancer control. Medical records from 45 dogs that presented to the Animal Cancer and Imaging Center were reviewed, including 30 dogs with stage II and III disease. Dogs that received the vaccine did not achieve a greater progression-free survival, disease-free interval or median survival time than dogs that did not receive the vaccine. © 2013 John Wiley & Sons Ltd.

  11. Is Photodynamic Therapy with Adjunctive Non-Surgical Periodontal Therapy Effective in the Treatment of Periodontal Disease under Immunocompromised Conditions

    International Nuclear Information System (INIS)

    Javed, F.; Hezaimi, K.A.; Qadri, T.; Ahmed, H.B.; Corbet, F.E.; Romanos, G.E.

    2013-01-01

    The aim was to assess whether or not photodynamic therapy (PDT) with adjunctive scaling-and-root-planing (SRP) is effective in the treatment of periodontitis under immunocompromised conditions. PubMed/Medline and Google-Scholar databases were searched from 1967 to May 2013 using various key words. Six studies (five experimental and one clinical) were included. In the clinical study, SRP with PDT was reported to be ineffective in treating chronic periodontitis in T2DM patients. All experimental studies reported significantly less bone loss in periodontal defects treated with SRP+PDT than those treated with SRP alone. Efficacy of PDT+SRP in the treatment of periodontal disease under immunocompromised conditions remains unclear. (author)

  12. Adjunctive Methylphenidate in the Treatment of Bulimia Nervosa Co-occurring with Bipolar Disorder and Substance Dependence.

    Science.gov (United States)

    Guerdjikova, Anna I; McElroy, Susan L

    2013-02-01

    Bulimia nervosa is associated with bipolar disorder, substance dependence, attention-deficit hyperactivity disorder, and anxiety disorders. Few reports, however, have addressed the treatment of patients with all of these conditions. We describe a young woman with bulimia nervosa, bipolar I disorder, cocaine and alcohol dependence, attention-deficit hyperactivity disorder, and panic disorder who achieved a sustained (>1 year) remission of her bulimia nervosa symptoms and significant improvement of her attention-deficit hyperactivity disorder symptoms with adjunctive methylphenidate after her bipolar, substance use, and panic disorders were successfully treated with hospitalization, intensive psychotherapy, quetiapine, and lamotrigine. Further research into the use of stimulants in bulimia nervosa, including in patients with complex comorbidity, is required.

  13. Effects of Time-Compressed Narration and Representational Adjunct Images on Cued-Recall, Content Recognition, and Learner Satisfaction

    Science.gov (United States)

    Ritzhaupt, Albert Dieter; Barron, Ann

    2008-01-01

    The purpose of this study was to investigate the effect of time-compressed narration and representational adjunct images on a learner's ability to recall and recognize information. The experiment was a 4 Audio Speeds (1.0 = normal vs. 1.5 = moderate vs. 2.0 = fast vs. 2.5 = fastest rate) x Adjunct Image (Image Present vs. Image Absent) factorial…

  14. Fairness & Equity: Standards of Good Practice in the Employment of Part-Time/Adjunct Faculty. Item Number 36-0698

    Science.gov (United States)

    American Federation of Teachers, 2002

    2002-01-01

    Citing a decreased proportion of full-time tenured faculty at American colleges and steady increase of part-time adjunct and other nontenure-track faculty, this American Federation of Teachers' (AFT) document advocates professionalism of the manner in which part-time/adjunct faculty are employed, compensated, supported and treated in higher…

  15. Pump apparatus including deconsolidator

    Energy Technology Data Exchange (ETDEWEB)

    Sonwane, Chandrashekhar; Saunders, Timothy; Fitzsimmons, Mark Andrew

    2014-10-07

    A pump apparatus includes a particulate pump that defines a passage that extends from an inlet to an outlet. A duct is in flow communication with the outlet. The duct includes a deconsolidator configured to fragment particle agglomerates received from the passage.

  16. Adjunctive Systemic Antimicrobial Therapy vs Asepsis in Conjunction with Guided Tissue Regeneration: A Randomized, Controlled Clinical Trial.

    Science.gov (United States)

    Abu-Ta'a, Mahmoud

    2016-01-01

    This randomized clinical trial compares the usefulness of adjunctive antibiotics, while strict asepsis was followed during periodontal surgery involving guided tissue regeneration. Two groups of 20 consecutive patients each with advanced periodontal disease were randomly assigned to treatment. They displayed one angular defect each with an intrabony component ≥3 mm, probing pocket depth and probing attachment level (PAL) ≥7 mm. Test group included 13 males, mean age 60 years, treated with enamel matrix derivative (EMD) and demineralized freeze-dried bone allograft with modified papilla preservation technique, received oral amoxicillin 1 gm, 1 hour preoperatively and 2 gm for 2 days postoperatively. Control group included 10 males, mean age 57 years, treated with EMD and demineralized freeze-dried bone allograft with modified papilla preservation technique, received no antibiotics. Outcome measures were clinical attachment level (CAL) gain, residual periodontal pocket depth (res. PD), gingival recession (GR), bleeding on probing (BOP), adverse events and postoperative complications. Patients were followed up to 12 months after periodontal surgery involving guided tissue regeneration. There were no significant differences between both groups for CAL gain, res. PD, GR, BOP nor other clinical parameters, though patients' subjective perception of postoperative discomfort was significantly smaller in the group receiving antibiotics. Antibiotics do not provide significant advantages concerning clinical periodontal parameters nor concerning postoperative infections in case of proper asepsis. It does, on the contrary, reduce postoperative discomfort. Regarding the results of this study, adjunc-tive systemic antibiotics in combination with guided tissue regeneration may be useful in reducing postoperative discomfort but may not be helpful for improving periodontal regeneration outcomes.

  17. Optical modulator including grapene

    Science.gov (United States)

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  18. Phonological Representations in Visual Word Recognition: The Adjunct Access Model. Technical Report. No. 247.

    Science.gov (United States)

    Kleiman, Glenn M.; Humphrey, Mary M.

    While studies of college-level readers have yielded evidence both for and against the use of phonological or speech recoding in the recognition of written words, no consistent picture of when recoding occurs has yet emerged. However, one model, the adjunct access model, can account for the previous research findings. According to this model,…

  19. Factors Influencing the Integration of Technology by Community College Adjunct Faculty

    Science.gov (United States)

    Paver, Jonathan David

    2012-01-01

    This research examined the factors that predict intention to integrate technology into instruction by community college adjunct faculty. For this study the integration of technology was defined as beyond simple occasional use, within the next academic year. The decomposed theory of planned behavior was tested for its predictive ability with this…

  20. Single‑shot lamina technique of paravertebral block as an adjunct to ...

    African Journals Online (AJOL)

    2014-08-28

    Aug 28, 2014 ... adjunct to GA for modified radical mastectomy with axillary dissection for breast cancer. ... A 61‑year‑old female, trader, American Society of ... procedure. The patient was instructed on the verbal rating scale (VRS) in vernacular (Yoruba language) validated by. Soyannwo et al. as the pain assessment tool; ...

  1. Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis : An Individual Patient Data Metaanalysis

    NARCIS (Netherlands)

    Fox, Gregory J.; Mitnick, Carole D.; Benedetti, Andrea; Chan, Edward D.; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S.; Menzies, Dick; van der Werf, Tjip S.

    2016-01-01

    Background. Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual

  2. Single‑shot lamina technique of paravertebral block as an adjunct to ...

    African Journals Online (AJOL)

    Thoracic paravertebral block can be employed as an alternative or an adjunct to general anesthesia (GA) for breast cancer surgery. There is no report of this new lamina technique for catheter placement in our environment. In low‑resource settings, potent opioids are lacking and the extended postoperative analgesia it ...

  3. Diagnosis of breast cancer: contribution of US as an adjunct to mammography

    NARCIS (Netherlands)

    Zonderland, H. M.; Coerkamp, E. G.; Hermans, J.; van de Vijver, M. J.; van Voorthuisen, A. E.

    1999-01-01

    PURPOSE: To determine the value of ultrasonography (US) as an adjunct to mammography for the diagnosis of breast cancer. MATERIALS AND METHODS: In a 2-year prospective study, 4,811 mammograms were classified according to level of suspicion of malignancy. Targeted US was performed to analyze (a)

  4. Long-Term Maintenance Following Habit Reversal and Adjunct Treatment for Trichotillomania.

    Science.gov (United States)

    Romaniuk, Cathryn; Miltenberger, Raymond G.; Deaver, Cristine

    2003-01-01

    Evaluates behavioral treatment for trichotillomania in an 11-year-old boy. Simplified habit reversal consisting of awareness training, competing response training, and social support decreased the behavior but did not eliminate it. A number of adjunct treatments further decreased and subsequently eliminated the hair pulling. (Contains 20…

  5. Effects of 810-nanometer diode laser as an adjunct to mechanical ...

    African Journals Online (AJOL)

    Effects of 810-nanometer diode laser as an adjunct to mechanical periodontal treatment on clinical periodontal parameters and gingival crevicular fluid ... Plaque index, gingival index (GI), bleeding on probing (BoP), probing depth (PD), clinical attachment level and gingival recession were assessed at baseline and 8 weeks ...

  6. Single dose silodosin prior to voiding cystourethrogram: a pharmacological adjunct to enhance visualization of posterior urethra.

    Science.gov (United States)

    Nagathan, Deepak Sharanappa; Dalela, Divakar; Sankhwar, Satyanarayan; Goel, Apul; Dwivedi, Amod Kumar; Yadav, Rahul

    2014-03-04

    Voiding cystourethrogram (VCUG) is needed to ascertain the upper end of urethral stricture. Occasionally, a patient is unable to open the bladder neck with resultant failure of the test. Realizing the strong and prompt alpha antagonistic action of silodosin, we evaluated single 8 mg dose as a pharmacological adjunct prior to VCUG to overcome this problem.

  7. Hypnosis as an Adjunct Treatment for Distress Associated with Pediatric Cancer Procedures.

    Science.gov (United States)

    White, Jerre Lee

    This paper reviews research literature pertaining to the pain and anxiety associated with pediatric cancer and the use of hypnosis as an adjunct treatment. It is noted that pain and anxiety are most often associated with the procedural treatment of cancer, and that the literature suggests that both pain and anxiety are multi-faceted constructs.…

  8. Resolution of orbitocerebral aspergillosis during combination treatment with voriconazole and amphotericin plus adjunctive cytokine therapy.

    Science.gov (United States)

    Bethell, Delia; Hall, Georgina; Goodman, T Robin; Klein, Nigel; Pollard, Andrew J

    2004-05-01

    Orbitocerebral aspergillosis has a very high fatality rate and cure is unusual. We describe the successful management of a child with cereberal aspergillosis who had a dramatic response to therapy with a combination of liposomal amphotericin and voriconazole with adjunctive cytokine therapy during immunosuppresive chemotherapy for acute lymphoblastic leukaemia.

  9. Experience of Adjunct Novice Clinical Nursing Faculty: An Interpretive Case Study

    Science.gov (United States)

    Mann, Carol

    2013-01-01

    The purpose of this qualitative interpretive case study was to describe the experience of adjunct novice clinical nursing faculty who has less than three years teaching experience or feels novice in this setting. The nursing shortage in the United States is well documented and is forecasted to have significant impacts on the health care delivery…

  10. Egg transfer as an adjunct to twinning in cattle | Neville | South ...

    African Journals Online (AJOL)

    Egg transfer as an adjunct to twinning in cattle. W.J. Neville, I Gordon. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

  11. Exposure to Humorous Stimuli as an Adjunct to Muscle Relaxation Training.

    Science.gov (United States)

    Prerost, Frank J.; Ruma, Christine

    1987-01-01

    Tested 40 male and 40 female college students for level of relaxation and mood state following exposure to three types of humor content or a nonhumorous control. Humor appreciation was found to be effective in aiding relaxation while promoting positive affective mood state in subjects. Humor appreciation may be possible adjunct to biofeedback…

  12. Project LINC: Supporting Lecturers and Adjunct Instructors in Foreign Language Classrooms

    Science.gov (United States)

    Scott, Sally S.; Edwards, Wade

    2012-01-01

    Foreign language learning can pose a barrier to some students with disabilities. This practice brief describes a collaborative process used on one campus to provide professional development for foreign language instructors. Training opportunities were intentionally focused on the needs of adjunct and temporary lecturers in providing inclusive…

  13. Selective Attentional Effects of Adjunct Study Questions on Achievement in Nigerian Secondary School Science

    Science.gov (United States)

    Okoye, Nnamdi S.

    2008-01-01

    The study investigated the selective attentional effects of adjunct study questions inserted before or after the presentation of science flow diagrams. The basic design for the study was a post-test only control group design involving a total of 252 students randomly selected from six secondary schools in Ile-Ife, Oshun State Nigeria. These were…

  14. Adjuncts and Their Din of Inequities: Transforming Complaints into Action and Results.

    Science.gov (United States)

    Huffman, John

    Underlying barriers to adjunct faculty forming effective communities are time and distance; they spend little time on campus, and there is distance, physically and psychologically, from their peers. There can be no hope of challenging and changing the system without the organizing and focusing of energies. Lessons can be learned from big business.…

  15. Career Technical Education Adjunct Faculty Teacher Readiness: An Investigation of Teacher Excellence and Variables of Preparedness

    Science.gov (United States)

    Guerra, Jorge

    2012-01-01

    The purpose of this research was to examine the relationship between teaching readiness and teaching excellence with three variables of preparedness of adjunct professors teaching career technical education courses through student surveys using a correlational design of two statistical techniques; least-squares regression and one-way analysis of…

  16. A Bricolage Exploration in "Genkan" Space: "Tengu" and Adjunct TEFL in the Japanese University Context

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    Whitsed, Craig; Wright, Peter

    2016-01-01

    This paper reports on research focusing on a group of adjunct teachers of English employed in Japanese universities. Grounded in interpretive epistemology foregrounding constructionist traditions, this research employed bricolage as way of inquiring into, then representing, these teacher's experiences utilising multi-perspectival,…

  17. Abdominal aortic bifurcation anatomy and endograft limb size affect the use of adjunctive iliac stenting after bifurcated endograft deployment for abdominal aortic aneurysm.

    Science.gov (United States)

    Bianchini Massoni, Claudio; Gargiulo, Mauro; Freyrie, Antonio; Gallitto, Enrico; DE Matteis, Massimo; Mascoli, Chiara; Stella, Andrea

    2018-04-01

    The aims of the study are: 1) to define the incidence of intraoperative endograft limb stenosis >50% (ELS) after bifurcated EVAR, 2) to find risk factors for ELS considering morphology of aortic bifurcation and structural characteristics of endograft iliac limbs, and 3) to evaluate early and follow-up outcomes of intraoperative adjunctive endograft iliac stenting. Patients treated with bifurcated EVAR for abdominal aortic aneurysm were prospectively collected from 2005 to 2011. Patient demographics, clinical risk factors, preoperative aortic bifurcation morphology (minimum and maximum diameter [ABD], calcification [ABC]), endograft iliac limb parameters (diameters [ELDs], stent material, type of endograft), ratio between ELDs and ABD), perioperative ELS and results during follow-up were analyzed. Primary outcomes were incidence of perioperative ELS and risk factors for its occurrence. Considering adjunctive stenting procedure, secondary outcomes were technical success, 30-day and mid-term iliac endograft leg patency and clinical success. Two hundred and forty-seven patients (men 233; mean age 74±7 years) were included. Mean maximum ABD was 28.9±12.9 mm. ABC was ≥50% in 56 (22.7%) cases. Median sum of ELDs was 31 mm (IQR 13-46). Endograft limb with stainless steel and nitinol stents was deployed in 69 (27.9%) and 178 (72.1%) patients. Median ELDs/ABD ratio was 1.2 (IQR: 0.9-1.5). ELS in aortic bifurcation occurred in 42 (8.5%) endograft limbs in 36 (14.6%) patients. ABD≤20 mm, ABC≥50%, ELDs≥30 mm, nitinol endograft stents and ELDs/ABD>1.4 were identified as possible positive predictive factors. At univariate and multivariate analysis, ELDs/ABD>1.4 resulted a positive prognostic factor for ELS (0.008 and 0.022, respectively). Forty-two adjunctive stents were deployed in 36 (14.6%) patients as intraoperative adjunctive procedure. Technical success, 30-day iliac endograft leg patency was 100%. Mean follow-up was 33 months (range 6-55 months) and mid

  18. Adjunctive armodafinil for major depressive episodes associated with bipolar I disorder: a randomized, multicenter, double-blind, placebo-controlled, proof-of-concept study.

    Science.gov (United States)

    Calabrese, Joseph R; Ketter, Terence A; Youakim, James M; Tiller, Jane M; Yang, Ronghua; Frye, Mark A

    2010-10-01

    To evaluate the efficacy and safety of armodafinil, the longer-lasting isomer of modafinil, when used adjunctively in patients with bipolar depression. In this 8-week, multicenter, randomized, double-blind, placebo-controlled study conducted between June 2007 and December 2008, patients who were experiencing a major depressive episode associated with bipolar I disorder (according to DSM-IV-TR criteria) despite treatment with lithium, olanzapine, or valproic acid were randomly assigned to adjunctive armodafinil 150 mg/d (n = 128) or placebo (n = 129) administered once daily in the morning. The primary outcome measure was change from baseline in the total 30-item Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C₃₀) score. Secondary outcomes included changes from baseline in scores on the Montgomery-Åsberg Depression Rating Scale, among other psychological symptom scales. Statistical analyses were performed using analysis of covariance (ANCOVA), with study drug and concurrent mood stabilizer treatment for bipolar disorder as factors and the corresponding baseline value as a covariate. A prespecified sensitivity analysis was done using analysis of variance (ANOVA) if a statistically significant treatment-by-baseline interaction was found. Tolerability was also assessed. A significant baseline-by-treatment interaction in the total IDS-C₃₀ score (P = .08) was found. Patients administered adjunctive armodafinil showed greater improvement in depressive symptoms as seen in the greater mean ± SD change on the total IDS-C₃₀ score (-15.8 ± 11.57) compared with the placebo group (-12.8 ± 12.54) (ANOVA: P = .044; ANCOVA: P = .074). No differences between treatment groups were observed in secondary outcomes. Adverse events reported more frequently in patients receiving adjunctive armodafinil were headache, diarrhea, and insomnia. Armodafinil was not associated with an increased incidence and/or severity of suicidality, depression, or mania or with

  19. Clobazam as an adjunctive therapy in treating seizures associated with Lennox–Gastaut syndrome

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    Leahy JT

    2011-11-01

    Full Text Available Jennifer T Leahy1, Catherine J Chu-Shore1,2, Janet L Fisher3 1Massachusetts General Hospital, Department of Neurology, Programs in Neurophysiology and Epilepsy, Boston, MA, 2Harvard Medical School, Boston, MA, 3University of South Carolina School of Medicine, Department of Pharmacology, Physiology and Neuroscience, Columbia, SC, USA Abstract: Lennox–Gastaut syndrome (LGS is a devastating childhood epilepsy syndrome characterized by the occurrence of multiple types of seizures and cognitive decline. Most children suffer from frequent seizures that are refractory to current medical management. Recent clinical trials have suggested that addition of clobazam may improve the clinical outcome for some LGS patients. Although clobazam has been available for over five decades, it has only recently been approved by the US Food and Drug Administration for this indication. As a 1,5-benzodiazepine, clobazam is structurally related to the widely used 1,4-benzodiazepines, which include diazepam. Clobazam has been shown to modulate GABAergic neurotransmission by positive allosteric modulation of GABAA receptors, and to increase expression of transporters for both GABA and glutamate. The active metabolite n-desmethylclobazam (norclobazam also modulates GABAA receptors, and the relative importance of these two compounds in the clinical effectiveness of clobazam remains an open question. Clinical trials involving clobazam as an addon therapy in a variety of pediatric epilepsy populations have found a significant improvement in seizure control. In patients with LGS, clobazam may have greatest efficacy for drop seizures. Longstanding clinical experience suggests that clobazam is a safe and well tolerated antiepileptic drug with infrequent and mild adverse effects. These results suggest that adjunctive treatment with clobazam may be a reasonable option for LGS patients, particularly those who are treatment-resistant. Keywords: benzodiazepine, epilepsy, gamma

  20. Pentoxifylline therapy : A new adjunct in the treatment of oral submucous fibrosis

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    Rajendran R

    2006-01-01

    Full Text Available OBJECTIVE : This study was designed to determine the effect of pentoxifylline (Trental on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN : This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets. The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS : Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000, tongue protrusion (t= 3.898, p = 0.002, and relief from perioral fibrotic bands (p = 0.0001554. Subjective symptoms of intolerance to spices (p = 0.0063218, burning sensation of mouth (p = 0.0005797, tinnitus (p=0.000042, difficulty in swallowing (p=0.0000714. and difficulty in speech (p=0.0000020 were also recorded significant improvement at the end of the trial period. CONCLUSION : This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

  1. Cultivating positive emotions: a useful adjunct when working with people who self-harm?

    Science.gov (United States)

    Morris, Charlotte; Simpson, Jane; Sampson, Mark; Beesley, Frank

    2014-01-01

    This narrative review draws upon a broad range of literature, including theory and empirical research, to argue that positive emotions are a useful adjunct to therapy when working with individuals who self-harm. The review highlights how self-harm is often employed as a method of emotion regulation and may be both negatively and positively reinforced. It is suggested that individuals who self-harm have potential difficulty in experiencing positive and negative emotions. The compatibility of an emotion focused approach to therapy for individuals who self-harm is therefore deemed an appropriate one. However, current therapeutic models predominantly focus on unpleasant or negative emotions and largely tend to neglect positive emotions, such as happiness. Broaden and build theory indicates that positive emotions can reduce the effects of negative emotions and aid recovery from intolerable negative emotions that may underpin self-harming behaviours. Therefore, the incorporation of positive emotions into therapy is likely to be helpful. In addition, if cultivated over time, positive emotions can build resilience that may enable individuals to cope better with events that precipitate self-injurious behaviours. The review emphasizes how positive emotions represent a valuable addition to therapeutic work but also highlights that the negatively valenced and painful emotions often experienced by those who self-injure must still be addressed. When working with individuals who self-harm it may be beneficial for practitioners to consider clients' experiences of positive emotions, and how to cultivate these, in addition to targeting the negative emotions which tend to underpin self-harming behaviours. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Immunohistochemical detection of hTERT in urothelial lesions: a potential adjunct to urine cytology

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    Khalbuss Walid

    2006-08-01

    Full Text Available Abstract Background Urine cytology has a critical role in evaluation for bladder carcinoma. Due to the low sensitivity of this technique, ancillary modalities such as the detection of markers of malignancy by immunochemistry are desirable. Promising factors in this context are components of the human telomerase enzyme complex. Telomerase repairs and extend telomeres, which when eroded beyond a critical limit trigger a senescence checkpoint. Accordingly, while absent in normal somatic cells, telomerase activity has been detected in the great majority of malignant tumor specimens tested, and so has potential value for the recognition of malignant cells in clinical specimens. Methods In this study, we investigated whether the immunohistochemical detection of the catalytic subunit of telomerase (hTERT can aid cytology in the diagnosis of bladder lesions. Findings from the retrospective evaluation of over 100 cell blocks, including urine sediments from confirmed malignant and benign conditions, were compared with routine urine cytology data. Results The presence of hTERT protein was indicative of the transformation of urothelia to a malignant phenotype. Nucleolar hTERT was expressed in 27 (93% of 29 samples obtained from patients with confirmed primary bladder cancer. Conversely, hTERT was detectable in only 3 (0.8% of 39 samples from benign conditions. The hTERT assay showed higher diagnostic sensitivity (84.8% than published urine cytology data (~65% for confirmed bladder carcinoma, however, the hTERT assay was less specific than cytology (65.2% vs. ~95% respectively. Conclusion As a highly sensitive marker, immunohistochemical hTERT detection in urine sediments represents a reliable adjunct to cytology in the accurate diagnosis of urothelial neoplasms.

  3. Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy in different age groups.

    Science.gov (United States)

    Kar, Taner; Yildirim, Yildiray; Topal, Tuncay; Çolakoğlu, Kadir; Ünal, Melih Hamdi

    2016-01-01

    To evaluate the efficacy of adjunctive mitomycin C (MMC) in transcanalicular multidiode laser dacryocystorhinostomy (TCL-DCR) in different age groups. Ninety-six eyes of 96 patients who underwent TCL-DCR for the treatment of nasolacrimal duct obstruction were included in this retrospective, comparative study. Patients were divided into 4 groups based on age and intraoperative use of MMC: group 1, TCL-DCR without MMC in the 20- to 44-year age group; group 2, TCL-DCR with MMC in the 20- to 44-year age group; group 3, TCL-DCR without MMC in the 45- to 76-year age group; group 4, TCL-DCR with MMC in the 45- to 76-year age group. The postoperative evaluation consisted of calculating and comparing the success rates between groups. Success rates at the final visit were 50% for group 1, 66.66% for group 2, 79.16% for group 3, and 84.61% for group 4. The differences between group 1 and group 4, and group 1 and group 3, were significant (p = 0.01 and p = 0.038, respectively). Logistic regression showed that age group had significant effect on success rate (p = 0.013). However, use of MMC had no significant effect on success rate (p = 0.23). The success rates of the TCL-DCR with MMC application were found to be higher than those of TCL-DCR without MMC in different age groups. However, the differences did not reach statistical significance. In addition, our study demonstrated that age may be a significant factor influencing the surgical outcome of TCL-DCR.

  4. Histopathology of Keratoacanthoma Revisited: Utility of Orificial Size as a Diagnostic Adjunct.

    Science.gov (United States)

    Aung, Phyu P; Ballester, Leomar Y; Mahalingam, Meera

    2014-06-01

    Given the defining histopathologic architecture of keratoacanthoma (KA), the aim of this study was to measure the crateriform orifice ("orificial size") in histopathologically crateriform lesions to ascertain its utility as an objective diagnostic histopathologic adjunct. This cross-sectional, retrospective study included 97 cases with a histopathologic diagnosis of KA. We measured the "orificial size" using the ocular micrometer in a BH-2 Olympus microscope at 4× magnification, in a blinded manner with respect to information. Frequency of histopathologic features observed was also recorded. The average orificial size for different groups was as follows: 2.3 ± 0.2 mm for cases with a clinical presentation of KA/keratotic papule (KP) (n = 30) versus 2.9 ± 0.3 mm for other (n = 67), P = .18. Histopathologic findings in the 2 groups were as follows: crateriform architecture/epithelial lip and sharp demarcation of tumor from stroma (100% in both groups), fibrosis (29/30 vs 64/67), apoptotic keratinocytes (27/30 vs 56/67), dermal islands of "glassy" keratinocytes (26/30 vs 54/67), entrapped elastic fibers (26/30 vs 49/67), and neutrophilic abscesses (11/30 vs 21/670 [P = not significant for all]. Our findings indicate that, in the appropriate clinical setting, a smaller orificial size, although predictive of a KA, in itself is not sufficient for a definitive diagnosis. Given that a major limitation is that this is a function of age of the lesion as orificial size depends on the evolution stage of the neoplasm with the largest diameter often evident in lesions at early stages of regression, for now correlation with histopathologic features such as presence of an epithelial lip, sharp demarcation of tumor from stroma, and fibrosis (present in >95% of cases of KAs) is required. © The Author(s) 2013.

  5. Tiagabine adjunctive therapy in children with refractory epilepsy: a single-blind dose escalating study.

    Science.gov (United States)

    Uldall, P; Bulteau, C; Pedersen, S A; Dulac, O; Lyby, K

    2000-12-01

    Tiagabine, a specific gamma-aminobutyric acid-uptake inhibitor, has been shown to be reasonably well tolerated and efficacious as adjunctive treatment for partial seizures in adults and is now being investigated in children. This 4-month, single-blind study evaluated the tolerability, safety and preliminary efficacy of ascending doses (0.25-1.5 mg/kg/day) of tiagabine add-on therapy in 52 children over the age of 2 years with different syndromes of refractory epilepsy. Adverse events, mostly mild to moderate, were reported by 39% of children during the single-blind placebo period and by 83% of children during tiagabine treatment. The events predominantly affected the nervous system with asthenia (19%), nervousness (19%), dizziness (17%) and somnolence (17%) being the most common. Only three children (6%) withdrew because of adverse events. Tiagabine appeared to reduce seizures more in localisation-related epilepsy syndromes than in generalised epilepsy syndromes. Twenty-three patients with localisation-related epilepsy syndromes were included and 17 of these patients entered the fourth dosing period. The 17 patients had a median reduction of seizure rate in the fourth month of treatment of 33% compared with baseline. In comparison, 13 of 22 children with seven different generalised epilepsy syndromes entered the fourth dosing period with a median change of seizure rate of 0%. Two patients experienced single episodes of status epilepticus during treatment; both cases resolved. Tiagabine showed efficacy mainly in localisation-related syndromes and was well tolerated by most children in a group of very refractory patients and warrants further study in children with epilepsy.

  6. Demistifikasi Tokoh Don Juan dalam La Nuit De Valognes Karya Eric-Emmanuel Schmitt

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    Talha Bachmid

    2006-10-01

    Full Text Available Don Juan is a myth about a seducer, a man with many love adventures, a women’s heat conqueror, and many other predicates. Don Juan as a myth is well-known world wide over, appearing in about 50 writings such as novels, plays, operas. But a French writer Eric-Emannuel Schmitt proposes a new figure of Don Juan in his play La Nuit de Valognes (Night in Valognes: the seducer is judged by five victims and convicted to marry one of his victims in order to stop his adventures. Surprisingly, Don Juan accepts this verdict without conditions. This sudden change becomes the theme of the play: the demythification of Don Juan. A flash back scene shows the beginning of this change and the interpretations that might arise from here. One possible interpretation is proposed and discussed in this paper: Don Juan found the way to a purer love, which is the union with God, and decides to begin his journey. This play can thus be categorised as a sufi text.

  7. Adjunctive Atypical Antipsychotic Treatment for Major Depressive Disorder: A Meta-Analysis of Depression, Quality of Life, and Safety Outcomes

    Science.gov (United States)

    Spielmans, Glen I.; Berman, Margit I.; Linardatos, Eftihia; Rosenlicht, Nicholas Z.; Perry, Angela; Tsai, Alexander C.

    2013-01-01

    Background Atypical antipsychotic medications are widely prescribed for the adjunctive treatment of depression, yet their total risk–benefit profile is not well understood. We thus conducted a systematic review of the efficacy and safety profiles of atypical antipsychotic medications used for the adjunctive treatment of depression. Methods and Findings We included randomized trials comparing adjunctive antipsychotic medication to placebo for treatment-resistant depression in adults. Our literature search (conducted in December 2011 and updated on December 14, 2012) identified 14 short-term trials of aripiprazole, olanzapine/fluoxetine combination (OFC), quetiapine, and risperidone. When possible, we supplemented published literature with data from manufacturers' clinical trial registries and US Food and Drug Administration New Drug Applications. Study duration ranged from 4 to 12 wk. All four drugs had statistically significant effects on remission, as follows: aripiprazole (odds ratio [OR], 2.01; 95% CI, 1.48–2.73), OFC (OR, 1.42; 95% CI, 1.01–2.0), quetiapine (OR, 1.79; 95% CI, 1.33–2.42), and risperidone (OR, 2.37; 95% CI, 1.31–4.30). The number needed to treat (NNT) was 19 for OFC and nine for each other drug. All drugs with the exception of OFC also had statistically significant effects on response rates, as follows: aripiprazole (OR, 2.07; 95% CI, 1.58–2.72; NNT, 7), OFC (OR, 1.30, 95% CI, 0.87–1.93), quetiapine (OR, 1.53, 95% CI, 1.17–2.0; NNT, 10), and risperidone (OR, 1.83, 95% CI, 1.16–2.88; NNT, 8). All four drugs showed statistically significant effects on clinician-rated depression severity measures (Hedges' g ranged from 0.26 to 0.48; mean difference of 2.69 points on the Montgomery–Asberg Depression Rating Scale across drugs). On measures of functioning and quality of life, these medications produced either no benefit or a very small benefit, except for risperidone, which had a small-to-moderate effect on quality of life (g

  8. Budget impact analysis of adjunctive therapy with lacosamide for partial-onset epileptic seizures in Belgium.

    Science.gov (United States)

    Simoens, Steven

    2011-01-01

    This study aims to compute the budget impact of lacosamide, a new adjunctive therapy for partial-onset seizures in epilepsy patients from 16 years of age who are uncontrolled and having previously used at least three anti-epileptic drugs from a Belgian healthcare payer perspective. The budget impact analysis compared the 'world with lacosamide' to the 'world without lacosamide' and calculated how a change in the mix of anti-epileptic drugs used to treat uncontrolled epilepsy would impact drug spending from 2008 to 2013. Data on the number of patients and on the market shares of anti-epileptic drugs were taken from Belgian sources and from the literature. Unit costs of anti-epileptic drugs originated from Belgian sources. The budget impact was calculated from two scenarios about the market uptake of lacosamide. The Belgian target population is expected to increase from 5333 patients in 2008 to 5522 patients in 2013. Assuming that the market share of lacosamide increases linearly over time and is taken evenly from all other anti-epileptic drugs (AEDs), the budget impact of adopting adjunctive therapy with lacosamide increases from €5249 (0.1% of reference drug budget) in 2008 to €242,700 (4.7% of reference drug budget) in 2013. Assuming that 10% of patients use standard AED therapy plus lacosamide, the budget impact of adopting adjunctive therapy with lacosamide is around €800,000-900,000 per year (or 16.7% of the reference drug budget). Adjunctive therapy with lacosamide would raise drug spending for this patient population by as much as 16.7% per year. However, this budget impact analysis did not consider the fact that lacosamide reduces costs of seizure management and withdrawal. The literature suggests that, if savings in other healthcare costs are taken into account, adjunctive therapy with lacosamide may be cost saving.

  9. Accelerated ripening of Caciocavallo Pugliese cheese with attenuated adjuncts of selected nonstarter lactobacilli.

    Science.gov (United States)

    Di Cagno, R; De Pasquale, I; De Angelis, M; Gobbetti, M

    2012-09-01

    The nonstarter lactic acid bacteria Lactobacillus plantarum CC3M8, Lactobacillus paracasei CC3M35, and Lactobacillus casei LC01, previously isolated from aged Caciocavallo Pugliese cheese or used in cheesemaking, were used as adjunct cultures (AC) or attenuated (by sonication treatment) adjunct cultures (AAC) for the manufacture of Caciocavallo Pugliese cheese on an industrial scale. Preliminary studies on the kinetics of growth and acidification and activities of several enzymes of AAC were characterized in vitro. As shown by the fluorescence determination of live versus dead or damaged cells and other phenotype features, attenuation resulted in a portion of the cells being damaged and a portion of the cells being capable of growing with time. Compared with the control cheese (without adjunct cultures) and the cheese with AAC, the addition of AC resulted in a lower pH after manufacture, which altered the gross composition of the cheese. As shown by plate count and confirmed by random amplification of polymorphic DNA-PCR, the 3 species of nonstarter lactobacilli persisted during ripening but the number of cultivable cells varied between AC and AAC. Slight differences were found between cheeses regarding primary proteolysis. The major differences between cheeses were the accumulation of free amino acids and the activity levels of several enzymes, which were highest in the Caciocavallo Pugliese cheeses made with the addition of AAC. As shown by triangle test, the sensory properties of the cheese made with AAC at 45 d did not differ from those of the control Caciocavallo Pugliese cheese at 60 d of ripening. In contrast, the cheese made with AC at 45 d differed from both the Caciocavallo Pugliese cheese without adjuncts and the cheese made with AAC. Attenuated adjunct cultures are suitable for accelerating the ripening of Caciocavallo Pugliese cheese without modifying the main features of the traditional cheese. Copyright © 2012 American Dairy Science Association

  10. A new perspective of neuromyopathy to explain intractable pancreatic cancer pains; Dry needling as an effective adjunct to neurolytic blocks

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    Lakshmi Vas

    2016-01-01

    Full Text Available We present a new perspective of neuromyopathy in pancreatic cancer pain (PCP referral to bodywall; proposal of new rationale to include ultrasound guided dry needling (USGDN of body wall muscles as an effective adjunct to neurolytic coeliac plexus block (NCPB or splanchnic nerve radiofrequency ablation (SRF for comprehensive interventional management. Methods: PCP response to SRF in 2 patients and NCPB in 3 patients was documented on numerical rating scale (NRS on post procedure days 3 and 15. If the residual pain was >5 NRS on day 15, USGDN of abdominal and back muscles was started on a thrice weekly basis. The response to USGDN documented on day 30 after approximately 6 sessions of DN, showed a significant pain reduction (0-2 NRS with 50% reduction of pre-treatment opioid consumption. This was sustained at 6 months or till their demise. Convergence of visceral and somatic nerves at the dorsal horn (viscerosomatic neurons causes referral of visceral pain to the back and abdominal muscles. This leads to formation of myofascial trigger points (MTrPs in the muscles which sets up a parallel network of sensitized peripheral and central motor nociceptive processing (neuromyopathy. USGDN specifically addressed the MTrPs that develop as an epiphenomenon of self-perpetuating neuromyopathy while SRF/NCPB, analgesics and neuromodulators could address only visceral nociceptive afferents (pain mediated through celiac plexus which forms a meagre 10% of the total spinal cord afferent input. Thus, we conclude that combination of neuromyopathy and viscerosomatic convergence in PCP indicate a specific role for DN as an adjunct to SRF/NCPB in our patients

  11. Adjunctive Platelet-Rich Plasma (PRP in Infrabony Regenerative Treatment: A Systematic Review and RCT’s Meta-Analysis

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    Mubashir Saleem

    2018-01-01

    Full Text Available Background and Objective. The purpose of this study was to highlight the clinical performance of platelet-rich plasma (PRP used as an adjunctive tool for regeneration in infrabony periodontal defects using different biomaterials or performing different surgical flap approaches. Comparative evaluation of main clinical outcomes as probing pocket depth reduction, clinical attachment gain, and recession reduction with and without the use of PRP has been analysed. Materials and Methods. According to the focused question, an electronic and hand searching has been performed up to December 2016. From a batch of 73 articles, the selection strategy and Jadad quality assessment led us to include 15 studies for the meta-analysis. Results. Despite the high heterogeneity found and the lack of complete data regarding the selected clinical outcomes, a comparative analysis has been possible by the categorization of used biomaterials and surgical flap approaches. This method led us to observe the best performance of grafts with the use of adjunctive PRP in CAL gain and PPD reduction. No difference has been outlined with a specific surgical flap. Conclusions. Although PRP is considered a cheap and patient’s derived growth factor, the not conclusive data reported would suggest that its use in addition to bone substitutes could be of some clinical benefit in the regenerative treatment of infrabony defects. Clinical Relevance. This systematic review was intended to sort out the huge controversial debate in the field about the possible use of PRP in regenerative surgery in infrabony defect. The clinical relevance of using blood-borne growth factors to conventional procedures is effective as these could determine a better performance and outcomes despite the surgical approach adopted and limit the use of additional biomaterials for the blood clot stabilization.

  12. Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

    Science.gov (United States)

    Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

    2018-03-25

    This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

  13. Adjunctive avatar therapy for mentalization-based treatment of borderline personality disorder: a mixed-methods feasibility study.

    Science.gov (United States)

    Falconer, Caroline J; Cutting, Penny; Bethan Davies, E; Hollis, Chris; Stallard, Paul; Moran, Paul

    2017-11-01

    Borderline personality disorder (BPD) is characterised by severe instability in emotions, identity, relationships and impulsive behaviour. One contributing factor to BPD is deficient mentalizing-our ability to understand the mental states of others and ourselves. Psychotherapies can be effective at reducing symptoms of BPD but effects are small. Innovative ways of enhancing existing therapies are therefore essential. In a mixed-methods, feasibility and acceptability study, we adjuncted conventional mentalization-based treatment (MBT) for BPD with avatar software (avatar-MBT). We wanted to test whether the enhanced visual narrative afforded by the software would facilitate therapy. We used proprietary avatar software in four group MBT sessions. We collected data on uptake (n=15), dropout (n=4) and self-report measures (n=11) of mentalization and mood and conducted qualitative interviews to assess attitudes and beliefs (n=9). Thematic analysis revealed five themes on the usefulness of avatar-MBT, including facilitating perspective taking, expression, emotional distancing, the big picture and group participation. The sixth theme suggested avatar-MBT is best placed within a group setting. There was no deterioration in symptoms as monitored by self-report measures. Qualitative data suggest that avatar-MBT is acceptable to patients with BPD who described it as enhancing conventional MBT and expressed a wish to continue using it. However, controlled trials are required to assess efficacy. Results suggest that avatar-MBT may be a viable option to enhance existing BPD treatment. Furthermore, we provide initial evidence that it is feasible to implement a digital adjunct within a group therapy setting. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Microbiological, chemical, and sensory characteristics of Swiss cheese manufactured with adjunct Lactobacillus strains using a low cooking temperature.

    Science.gov (United States)

    Kocaoglu-Vurma, N A; Harper, W J; Drake, M A; Courtney, P D

    2008-08-01

    The effect of nonstarter Lactobacillus adjunct cultures on the microbial, chemical, and sensory characteristics of Swiss cheese manufactured using the "kosher make procedure" was investigated. The kosher make procedure, which uses a lower cooking temperature than traditional Swiss cheese making, is used by many American cheese manufacturers to allow for kosher-certified whey. Cheeses were manufactured using a commercial starter culture combination and 1 of 3 non-starter Lactobacillus strains previously isolated from Swiss cheeses, Lactobacillus casei A26, L. casei B21, and Lactobacillus rhamnosus H2, as an adjunct. Control cheeses lacked the adjunct culture. Cheeses were analyzed during ripening for microbial and chemical composition. Adjunct strain L. casei A26, which utilized citrate most readily in laboratory medium, dominated the Lactobacillus population within 30 d, faster than the other adjunct cultures. There were no significant differences in Propionibacterium counts, Streptococcus thermophilus counts, protein, fat, moisture, salt, and pH among the cheeses. Free amino acid concentration ranged from 5 to 7 mmol/100 g of cheese at 90 d of ripening and was adjunct strain dependent. Lactic, acetic, and propionic acid concentrations were not significantly different among the cheeses after a 90-d ripening period; however differences in propionic acid concentrations were apparent at 60 d, with the cheeses made with L. casei adjuncts containing less propionic acid. Citric acid was depleted by the end of warm room ripening in cheeses manufactured with adjunct L. casei strains, but not with adjunct L. rhamnosus. Cheeses made with L. casei A26 were most similar to the control cheeses in diacetyl and butyric/isobutyric acid abundance as evaluated by electronic nose during the first 3 mo of ripening. The 4 cheese types differed in their descriptive sensory profiles at 8 mo of age, indicating an adjunct strain-dependent effect on particular flavor attributes. Adjunct

  15. ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy.

    Science.gov (United States)

    Siemonsen, Susanne; Forkert, Nils D; Bernhardt, Martina; Thomalla, Götz; Bendszus, Martin; Fiehler, Jens

    2017-08-01

    Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery. Study outcome The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator. Sample size estimates Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test). Discussion ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.

  16. Integrative Medicine as an Adjunct to Orthopaedic Surgery.

    Science.gov (United States)

    Ficke, James R; Moroski, Nathan M; Ross, Steven D; Gupta, Ranjan

    2018-01-15

    Patients often seek nontraditional forms of treatment, including alternative/complementary medical options, such as chiropractic care and acupuncture, to meet their personal needs. In the United States, interest has grown in methods to reduce pain and improve function through Ayurvedic medicine, which uses plant-based supplements, such as turmeric. Traditional allopathic medicine attempts to provide patients with evidence-based therapeutic regimens for their musculoskeletal conditions. Integrative medicine often is used to prevent and manage the sequelae associated with injuries and illnesses; however, competitive athletes and military personnel use complementary medicine for performance enhancement. Thus, physicians should be aware of the evolving field of integrative medicine, including the reported benefits as well as any potential drawbacks, to facilitate an educated discussion with their patients.

  17. Low-level laser therapy as an adjunct to connective tissue graft procedure in the treatment of gingival recession defects: A systematic review and meta-analysis.

    Science.gov (United States)

    Akram, Zohaib; Vohra, Fahim; Javed, Fawad

    2018-03-26

    The aim of this study was to systematically evaluate the effectiveness of low level laser therapy (LLLT) as an adjunct to connective tissue graft (CTG) procedure for the treatment of gingival recession (GR). The addressed PICO question was; "In patients with Miller Class I or II recession defects (Population), what is the effect of LLLT as adjunct to CTG (Intervention) in comparison to CTG alone (Comparison) on gingival recession depth (Outcome)" Electronic databases were searched up to December 2017. Primary outcomes included gingival recession depth (GRD), whereas secondary outcomes were width of keratinized tissue (WKT) and relative clinical attachment level gain (RCAL). The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Four randomized clinical studies were included. Two studies showed significantly greater improvements with LLLT whereas, 2 studies showed comparable outcomes between LLLT and CTG group. Considering the effects of adjunctive LLLT as compared to CTG, a high degree of heterogeneity for GRD (Q value = 9.40, P = .02, I 2 =68.11%) and WKT ((Q value = 16.04, P = .001, I 2 =81.31%) was noticed among both the groups. Meta-analysis showed a statistically significant GRD (WMD= -0.61, 95% CI= -1.23 to 0.004, P = .05) for LLLT + CTG treatment versus CTG alone only. LLLT improves clinical and patient-centered outcomes of CTG procedures for the treatment of GR remains debatable. However, due to the small number of included studies and high heterogeneity in the laser parameters, precautions must be exercised when interpreting the results of the present systematic review. Gingival recessions in dentistry are of major esthetic concern. Minimal gingival recessions can be treated by flap operations, but the predictability and stability of the outcomes is debatable. In the present review, low level laser therapy (LLLT) adjunct to connective tissue

  18. Meditation as an Adjunct to the Management of Multiple Sclerosis

    OpenAIRE

    Adam B. Levin; Emily J. Hadgkiss; Tracey J. Weiland; George A. Jelinek

    2014-01-01

    Background. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS. Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, a...

  19. Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee.

    Science.gov (United States)

    Woods, Beth; Manca, Andrea; Weatherly, Helen; Saramago, Pedro; Sideris, Eleftherios; Giannopoulou, Christina; Rice, Stephen; Corbett, Mark; Vickers, Andrew; Bowes, Matthew; MacPherson, Hugh; Sculpher, Mark

    2017-01-01

    There is limited information on the costs and benefits of alternative adjunct non-pharmacological treatments for knee osteoarthritis and little guidance on which should be prioritised for commissioning within the NHS. This study estimates the costs and benefits of acupuncture, braces, heat treatment, insoles, interferential therapy, laser/light therapy, manual therapy, neuromuscular electrical stimulation, pulsed electrical stimulation, pulsed electromagnetic fields, static magnets and transcutaneous electrical nerve Stimulation (TENS), based on all relevant data, to facilitate a more complete assessment of value. Data from 88 randomised controlled trials including 7,507 patients were obtained from a systematic review. The studies reported a wide range of outcomes. These were converted into EQ-5D index values using prediction models, and synthesised using network meta-analysis. Analyses were conducted including firstly all trials and secondly only trials with low risk of selection bias. Resource use was estimated from trials, expert opinion and the literature. A decision analytic model synthesised all evidence to assess interventions over a typical treatment period (constant benefit over eight weeks or linear increase in effect over weeks zero to eight and dissipation over weeks eight to 16). When all trials are considered, TENS is cost-effective at thresholds of £20-30,000 per QALY with an incremental cost-effectiveness ratio of £2,690 per QALY vs. usual care. When trials with a low risk of selection bias are considered, acupuncture is cost-effective with an incremental cost-effectiveness ratio of £13,502 per QALY vs. TENS. The results of the analysis were sensitive to varying the intensity, with which interventions were delivered, and the magnitude and duration of intervention effects on EQ-5D. Using the £20,000 per QALY NICE threshold results in TENS being cost-effective if all trials are considered. If only higher quality trials are considered, acupuncture

  20. Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee.

    Directory of Open Access Journals (Sweden)

    Beth Woods

    Full Text Available There is limited information on the costs and benefits of alternative adjunct non-pharmacological treatments for knee osteoarthritis and little guidance on which should be prioritised for commissioning within the NHS. This study estimates the costs and benefits of acupuncture, braces, heat treatment, insoles, interferential therapy, laser/light therapy, manual therapy, neuromuscular electrical stimulation, pulsed electrical stimulation, pulsed electromagnetic fields, static magnets and transcutaneous electrical nerve Stimulation (TENS, based on all relevant data, to facilitate a more complete assessment of value.Data from 88 randomised controlled trials including 7,507 patients were obtained from a systematic review. The studies reported a wide range of outcomes. These were converted into EQ-5D index values using prediction models, and synthesised using network meta-analysis. Analyses were conducted including firstly all trials and secondly only trials with low risk of selection bias. Resource use was estimated from trials, expert opinion and the literature. A decision analytic model synthesised all evidence to assess interventions over a typical treatment period (constant benefit over eight weeks or linear increase in effect over weeks zero to eight and dissipation over weeks eight to 16.When all trials are considered, TENS is cost-effective at thresholds of £20-30,000 per QALY with an incremental cost-effectiveness ratio of £2,690 per QALY vs. usual care. When trials with a low risk of selection bias are considered, acupuncture is cost-effective with an incremental cost-effectiveness ratio of £13,502 per QALY vs. TENS. The results of the analysis were sensitive to varying the intensity, with which interventions were delivered, and the magnitude and duration of intervention effects on EQ-5D.Using the £20,000 per QALY NICE threshold results in TENS being cost-effective if all trials are considered. If only higher quality trials are

  1. Dos miradas sobre la historia del arte : Las vanguardias artísticas entre Eric Hobsbawn y Walter Benjamin

    OpenAIRE

    Koldobsky, Daniela

    2011-01-01

    En "A la zaga, decadencia y fracaso de las vanguardias del siglo XX" el historiador Eric Hobsbawm plantea el fracaso de las vanguardias artísticas especialmente en el campo de las artes visuales, entendiendo que "fue, primero, un fracaso de la 'modernidad', un término que empezó a usarse hacia mediados del siglo XIX y que sostenía en su programa que el arte contemporáneo debía ser, como Proudhon había dicho del de Courbet, 'una expresión de los tiempos". Sin embargo, considera que "Por supues...

  2. "Innovation and Intellectual Property Policies in European Research Infrastructure Consortia - PART I: The Case of the European Spallation Source ERIC"

    DEFF Research Database (Denmark)

    Yu, Helen; Wested, Jakob; Minssen, Timo

    2017-01-01

    Research and innovation are key pillars of the EU’s strategy to create sustainable growth and prosperity in Europe. Research infrastructures (RIs) are central instruments to implement this strategy. They bring together a wide diversity of expertise and interests to look for solutions to many of t...... need to consider in their IPR policies to balance the core-objectives of multiple stakeholders and achieve sustainability. In Part II, we will analyze and compare the different IPR policies of the various ERICs in a subsequent article....

  3. A more global approach to musculoskeletal pain: expressive writing as an effective adjunct to physiotherapy.

    Science.gov (United States)

    Pepe, Luisa; Milani, Roberta; Di Trani, Michela; Di Folco, Gianluca; Lanna, Vittorio; Solano, Luigi

    2014-01-01

    The aim of this study was to investigate the effects of written emotional disclosure as an adjunct to physiotherapy. Forty outpatients with musculoskeletal pain were treated with Mézières physiotherapy for 10 sessions. Half of the subjects also wrote about difficult life experiences immediately after four of these sessions. Data analysis showed that although both the writing and non-writing groups displayed lower pain scores after physiotherapy, the difference was stronger in the writing group. Pain scores continued to decrease six months after physiotherapy in the writing group alone. The postural evaluation revealed a greater improvement in the writing group than in the non-writing group, while the TAS-20 and SCL-90 scores decreased in the writing group alone. These results indicate that written emotional disclosure is an effective adjunct to physiotherapy insofar as it promotes further health improvements at both the physical and psychological levels.

  4. Is the Noradrenergic Symptom Cluster a Valid Construct in Adjunctive Treatment of Major Depressive Disorder?

    Science.gov (United States)

    Stauffer, Virginia L; Liu, Peng; Goldberger, Celine; Marangell, Lauren B; Nelson, Craig; Gorwood, Philip; Fava, Maurizio

    2017-03-01

    To identify symptoms potentially representative of a noradrenergic symptom cluster as possible predictors of response to the selective norepinephrine reuptake inhibitor (NRI) edivoxetine when used as monotherapy or adjunctive treatment in patients with DSM-IV-TR major depressive disorder (MDD). Pooled data from 4 adjunctive treatment trials (selective serotonin reuptake inhibitor [SSRI] + edivoxetine 6-18 mg/d vs SSRI + placebo; N = 2,066) and data from 1 monotherapy trial (edivoxetine 6-18 mg/d versus placebo; N = 495) were used to identify predictors of response related to noradrenergic symptoms using a resampling-based ensemble tree method. The trials were conducted from 2008 to 2013. In the pooled adjunctive trials, no subgroup was identified that demonstrated a greater edivoxetine-placebo treatment difference than the overall patient cohort. In the edivoxetine monotherapy trial, no subgroup showing greater mean edivoxetine-placebo differences on the Montgomery-Asberg Depression Rating Scale versus the overall patient cohort was identified; a subgroup (67%) with high b​aseline Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) total score (≥ 28) showed statistically significantly (P = .02) greater mean edivoxetine-placebo differences on the Sheehan Disability Scale versus the overall patient cohort, and subgroups with baseline CPFQ total score ≥ 28 (65%), CPFQ cognition dimension score ≥ 16 (63%), or CPFQ physical dimension score ≥ 13 (59%) showed statistically significantly (P ≤ .025) greater mean edivoxetine-placebo differences on the CPFQ total score versus the overall patient cohort. While we could not identify symptoms predictive of response to the selective NRI edivoxetine used as adjunctive treatment, impaired cognition and physical symptoms may predict greater improvement during monotherapy. ClinicalTrials.gov identifiers: NCT00840034, NCT01173601, NCT01187407, NCT01185340, NCT00795821.

  5. Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females.

    Science.gov (United States)

    Dong, Henglei; Huang, Yubei; Song, Fengju; Dai, Hongji; Liu, Peifang; Zhu, Ying; Wang, Peishan; Han, Jiali; Hao, Xishan; Chen, Kexin

    2017-08-15

    Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Adjunctive therapy for cerebral malaria and other severe forms of Plasmodium falciparum malaria

    OpenAIRE

    John, Chandy C; Kutamba, Elizabeth; Mugarura, Keith; Opoka, Robert O

    2010-01-01

    Severe malaria due to Plasmodium falciparum causes more than 800,000 deaths every year. Primary therapy with quinine or artesunate is generally effective in controlling P. falciparum parasitemia, but mortality from cerebral malaria and other forms of severe malaria remains unacceptably high. Long-term cognitive impairment is also common in children with cerebral malaria. Of the numerous adjunctive therapies for cerebral malaria and severe malaria studied over the past five decades, only one (...

  7. Practice guidelines for acupuncturists using acupuncture as an adjunctive treatment for anorexia nervosa.

    Science.gov (United States)

    Fogarty, Sarah; Ramjan, Lucie Michelle

    2015-02-01

    Anorexia nervosa is a potentially life-threatening eating disorder where people intentionally refuse to eat sufficient amounts to maintain a healthy body-weight for fear of becoming fat. The intense preoccupation with restriction of food and control of body weight makes this one of the most complex and confusing conditions for practitioners to treat. While no single treatment has been found to be superior to another in the treatment of anorexia nervosa, general practice guidelines are available to guide mainstream treatment, however there are no guidelines for practitioners of complementary therapies. Complementary therapies such as acupuncture show promise as an adjunctive therapy in improving co-morbidities such as depression and anxiety levels among people with anorexia nervosa, by strengthening mind, body and overall well-being. The aim of this guideline is to assist and support acupuncture practitioners to deliver effective and safe adjunctive acupuncture treatments to people with anorexia nervosa, by providing a practice guideline that is underpinned by an ethical and evidence-based framework. The use of complementary therapies and specifically acupuncture in the treatment of anorexia nervosa may provide important adjunctive care to allow a comprehensive treatment approach that potentially improves quality of life, reduces anxiety and instils hope for recovery. It is hoped that acupuncture practitioners treating patients with anorexia nervosa will refer to these guidelines and apply the guidance (as deemed appropriate). Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Azithromycin as an adjunct to non-surgical periodontal therapy: a systematic review.

    Science.gov (United States)

    O'Rourke, V J

    2017-03-01

    The aim of this study was to investigate the current published work relating to the clinical benefits of the use of systemic azithromycin as an adjunct to non-surgical periodontal therapy. A published work search of PubMed, EMBASE and Cochrane Register of Controlled Trials up to 27 April 2016 was undertaken. The large degree of heterogeneity in the types of studies, treatment protocols, test subjects, sample size and exclusion criteria indicated that the use of narrative synthesis of all relevant studies was a valid method of review. Of the 194 eligible studies, 15 were found to be of relevance. The majority of studies demonstrated an additional clinical benefit when azithromycin is used as an adjunct to non-surgical periodontal therapy, particularly in deeper pockets (≥6 mm). In conclusion, the current body of research on the adjunctive use of systemic azithromycin in non-surgical periodontal therapy suggests there is a clinical benefit and that this benefit is greatest in deeper initial pockets (≥6 mm). The findings also suggest that future studies need to be more careful in subject selection to identify susceptible patients or at risk sites, both the immunoregulatory effects and antibiotic resistance of azithromycin needs to be reported, and that study populations need to be more homogeneous. © 2016 Australian Dental Association.

  9. Adjunctive management of central line-associated bloodstream infections with 70% ethanol-lock therapy.

    Science.gov (United States)

    Kubiak, David W; Gilmore, Erin T; Buckley, Mary W; Lynch, Robert; Marty, Francisco M; Koo, Sophia

    2014-06-01

    Ethanol is bactericidal against most pathogens implicated in central line-associated bloodstream infections (CLABSIs) and biofilms. Current Infectious Diseases Society of America guidelines cite insufficient evidence to support adjunctive ethanol-lock therapy (ELT) for central venous catheter (CVC) salvage in patients with CLABSI in combination with systemic antimicrobial treatment. We evaluated the safety and potential efficacy of 70% ELT for CLABSI at our institution after implementation of a hospital ELT protocol. We collected data on all patients treated with adjunctive 70% ELT for catheter salvage from September 2009 to September 2011 and assessed clinical outcomes and adverse events associated with ELT. Sixty-eight hospitalized patients received 70% ELT for CVC salvage: 45 (66%) met the criteria for CLABSI. Five (11%) had persistent or recurrent bacteraemia triggering CVC removal; 28 (62%) preserved their CVC long term. There were no documented adverse events associated with ELT. Adjunctive 70% ELT is an inexpensive, well-tolerated option for CVC salvage in patients with CLABSI and warrants further investigation. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Adjunctive Treatment of Acute Mania with Risperidone versus Typical Antipsychotics: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jui-Hsiu Tsai

    2005-12-01

    Full Text Available Few studies have directly compared atypical antipsychotics (e.g. risperidone with typical antipsychotics as adjunctive therapy in patients hospitalized for acute mania, especially during a lengthy hospital stay. Our retrospective, case-controlled study is a chart review of 64 patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defined bipolar I disorder (current episode, mania. Patients were divided into two groups according to the adjunctive medications used: the risperidone group (mood stabilizers plus risperidone and the control group (mood stabilizers plus typical antipsychotics. Outcome at discharge, medications, adverse drug effects, and length of hospital stay were compared between groups, controlling for gender, age, number of prior admissions, and duration of illness. Results indicated no statistically significant differences between groups in the controlled factors, Global Assessment of Functioning and Clinical Global Impression-Improvement scores, and adverse drug events. Patients in the risperidone group used significantly lower doses of trihexyphenidyl than those in the control group (p < 0.05. Patients treated with risperidone had a shorter hospital stay than those treated with typical antipsychotics (p < 0.01. In conclusion, antipsychotics are effective as adjunctive agents in the treatment of acute mania. The use of risperidone, in particular, decreases the need for anticholinergics and may lead to a shorter hospital stay compared with typical antipsychotics.

  11. Nutritional support as an adjunct to radiation therapy

    International Nuclear Information System (INIS)

    Donaldson, S.S.

    1984-01-01

    Patients with malignancies which are treated with therapeutic radiation are at risk for nutritional problems, both from their underlying malignancy as well as from their treatment. These effects may be acute or chronic and relate to the site of the tumor and regions irradiated. There is a large experience with nutritional intervention in irradiated patients, including oral feedings and enteral and parenteral nutritional support. The indications for the specific administration of nutritional support during radiotherapy depend on the nutritional status of the patient and the area irradiated, as well as the individual prognosis. Patients who are malnourished at the time of treatment are most likely to profit from nutritional intervention. To date, prospective randomized trials of nutritional support in patients undergoing radiotherapy fail to show a benefit of routine adjuvant nutritional intervention in terms of improved response and tolerance to treatment, improved local control or survival rates, or reduction of complications from therapy

  12. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Chan, Anthony T. C.; Teo, Peter M. L.; Leung, Thomas W. T.; Sing, F. Leung; Wai, Y. Lee; Yeo, Winnie; Choi, Peter H. K.; Johnson, Philip J.

    1995-01-01

    Purpose: A prospective randomized trial was conducted to compare chemoradiotherapy against radiotherapy alone in the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods and Materials: Eighty-two patients with histologically proven nasopharyngeal carcinoma who had either Ho's N3 staging or any N stage with a nodal diameter of ≥ 4 cm were entered. Seventy-seven patients were evaluable for tumor response and survival. The patients were randomized to receive two cycles of cisplatin 100 mg/m 2 Day 1, 5-fluorouracil 1000 mg/m 2 24-h infusion Days 2, 3, and 4 before radical radiotherapy, and four cycles of postradiotherapy chemotherapy (37 patients) or radiotherapy alone (40 patients). All patients received radical radiotherapy to the nasopharynx and neck. The nasopharynx and upper neck were treated to 66 Gy by conventional fractionation and the lower neck to 58 Gy. Booster radiotherapy (7.5 Gy/two fractions/week) was given to any residual nodes after standard radiotherapy. Results: The patient characteristics, including staging, were similar in both arms. The overall response rate to neoadjuvant chemotherapy was 81% (19% complete response, 62% partial response). The rates of radiotherapy for boosting parapharyngeal disease or residual lymph nodes were not significantly different in the two arms. The overall complete response rate to chemoradiotherapy was 100%, and to radiotherapy alone, 95%. Toxicities in the chemoradiotherapy arm were mainly myelosuppression, nephrotoxicity, and nausea and vomiting. The degree of mucositis was not significantly different in the two arms. There was no treatment-related death. The median follow up was 28.5 months. The 2-year overall survival was 80% in the chemoradiotherapy arm and 80.5% in the radiotherapy arm. The 2-year disease-free survival was 68% in the chemoradiotherapy arm and 72% in the radiotherapy arm, without significant difference between the two arms. The locoregional relapse rate, distant metastatic

  13. Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year

    Directory of Open Access Journals (Sweden)

    Bradley Ryan

    2012-04-01

    Full Text Available Abstract Background Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC in primary care patients with inadequately controlled type 2 diabetes. Methods Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight. Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment. Results Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001, diet (P = 0.001, physical activity (P = 0.02, mood (P = 0.001, self-efficacy (P = 0.0001 and motivation to change lifestyle (P = 0.003. Improvements in glucose testing, mood, self-efficacy and

  14. Bone augmentation as an adjunct to dental implant rehabilitation in patients with diabetes mellitus: A review of literature

    OpenAIRE

    Ladha, Komal; Sharma, Ankit; Tiwari, Bhawana; Bukya, Dwaraka N

    2017-01-01

    The aim of the present article is to review the success of bone augmentation performed as an adjunct to dental implant rehabilitation in patients with diabetes mellitus. A literature review was conducted in PubMed on this topic, which yielded a total of 102 publications. For inclusion, publications had to be human studies, written in English language and should report on the success of bone augmentation as an adjunct to dental implant rehabilitation in diabetic patients. After screening the t...

  15. Systemic lycopene as an adjunct to scaling and root planing in chronic periodontitis patients with type 2 diabetes mellitus

    OpenAIRE

    Reddy, Panthula Veerendra Nath; Ambati, Manasa; Koduganti, Rekharani

    2015-01-01

    Background: Patients with type 2 diabetes have an increased prevalence of periodontitis and, in turn, periodontitis adversely affects the diabetic status. Oxidative stress plays a key role in affecting the pathophysiology of both the diseases and adjunctive systemic antioxidant therapy may have beneficial effect on the treatment outcome. This study was planned to compare the efficacy of systemic antioxidant therapy with lycopene as an adjunct to scaling and root planing versus scaling and roo...

  16. Screening and selection of Lactobacillus strains for use as adjunct cultures in production of semi-hard cheese.

    Science.gov (United States)

    Antonsson, Martin; Ardö, Ylva; Nilsson, Bengt Frans; Molin, Göran

    2002-08-01

    Thirty-three Lactobacillus strains were tested as adjuncts in a cheese model system. Eighteen strains originated from cheese (nine Lactobacillus spp. and nine Lb. paracasei/casei) and 15 from human intestinal mucosa (11 Lb. rhamnosus; three Lb. paracasei; one Lb. plantarum). Model cheeses weighing 120 g were made of cheese grains from full-scale production of washed curd semi-hard cheese (Herrgård). The model system was reproducible and similar to full-scale production with respect to moisture, salt content, pH and microbial flora. The model cheeses were sampled for aerobic and anaerobic plate count and viable counts of Lactobacillus and Lactococcus. The presence of adjuncts in the model cheeses was confirmed by typing isolates with Randomly Amplified Polymorphic DNA (RAPD). The sensory properties of model cheeses were described. In a first trial 23 of the 33 adjuncts were re-isolated from the corresponding model cheeses after 9 or 13 weeks. Adjuncts of Lb. paracasei were re-isolated more frequently than adjuncts of Lb. rhamnosus. Nine strains were selected, on the basis of their ability to grow and be a dominating part of the microflora of model cheese with interesting sensory properties. These strains were further studied together with two commercial cultures. The sensory influences on model cheeses of six of the adjuncts were confirmed, and flavour scores were in the range of 2.9-7.1 for model cheeses with different adjuncts while the control had a flavour score of 5.6 (0-10 scale). Survival and growth of seven out of the nine strains correlated with the results of the first trial. Growth and influence on flavour of four adjunct cultures were confirmed in experimental cheese manufactured in a 400-1 open vat.

  17. Chronic eosinophilic pneumonia: Adjunctive therapy with inhaled steroids

    Directory of Open Access Journals (Sweden)

    Christopher Chan

    2017-01-01

    Full Text Available Idiopathic chronic eosinophilic pneumonia (ICEP is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2–4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the “photographic negative of pulmonary edema”, the presence of eosinophils ≥40% on bronchoalveolar lavage or ≥1000/mm3 eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders. A dramatic response is achieved with systemic corticosteroids, which is typically dosed over 6 months to 1 year. Despite this response, approximately 30–50% of patients will relapse upon cessation of steroids or during the taper. Although these patients respond well to another trial of steroids, the side effects of long term steroids are well known, including osteoporosis, diabetes, hypertension and cataracts. Inhaled corticosteroids as monotherapy has been trialed in the past without success. However, we report a case of a patient who underwent treatment with systemic corticosteroids followed by inhaled steroids who has remained in remission for 2 years.

  18. Chamomile an Adjunctive Herbal Remedy for Rheumatoid Arthritis Treatment

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    Afshin Gharakhani

    2013-07-01

    Full Text Available One of the most frequently consumed herbal remedies available today is the chamomile preparations prepared from Matricaria chamomilla (MC. The medicinal preparations of MC are composed of several classes of biological active compounds with inhibitory effects on inflammation including essential oil and flavonoids. Apigenin, quercetin and luteolin are the major flavonoids of MC which exhibit their anti-inflammatory effects through different mechanisms. Apigenin exhibits anti-inflammatory activity via inhibition of proinflammatory cytokines production, whilst luteolin suppresses production of nitric oxide (NO, prostaglandin E2 and expression of inducible NO synthase and cyclooxygenase-2 all of which are associated with inflammatory responses. However, there are also some additional components of the MC preparations which have a role on the anti-inflammatory actions of the plant through other pathways. The mentioned mechanisms are in reference with the authors' concept that MC would be of value in alleviating inflammation and pain in rheumatoid arthritis. Keywords: Essential oil; flavonoids; Matricaria chamomilla; polyphenols; rheumatoid arthritis

  19. Adjunctive extracorporeal carbon dioxide removal in refractory status asthmaticus.

    Science.gov (United States)

    Jiang, Chuan; Galaydick, Jodi; Fernandez, Harold; Caronia, Jonathan

    2017-07-27

    Status asthmaticus (SA) is a life-threatening disorder. Severe respiratory failure may require extracorporeal membrane oxygenation (ECMO). Previous reports have demonstrated utility of ECMO in SA in various patients with varying success. A 25-year-old man was admitted with status asthmatics and severe hypercapnic respiratory failure. Despite tailored ventilator therapies, such as pressure control ventilation and maximal pharmacological therapy, including general anaesthesia, the patient’s condition deteriorated rapidly. Veno-venous ECMO (VV-ECMO) was provided for respiratory support. The patient’s clinical condition improved over the following 72 hours and was discharged from the intensive care unit on day 3. This case report demonstrates the successful use of VV-ECMO in a patient with severe respiratory failure due to SA, who failed to respond to maximal therapy. This case adds support to a growing body of literature that shows that ECMO can be used with success for refractory status asthmaticus. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Survival of probiotic adjunct cultures in cheese and challenges in their enumeration using selective media.

    Science.gov (United States)

    Oberg, C J; Moyes, L V; Domek, M J; Brothersen, C; McMahon, D J

    2011-05-01

    Various selective media for enumerating probiotic and cheese cultures were screened, with 6 media then used to study survival of probiotic bacteria in full-fat and low-fat Cheddar cheese. Commercial strains of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus paracasei, or Bifidobacterium lactis were added as probiotic adjuncts. The selective media, designed to promote growth of certain lactic acid bacteria (LAB) over others or to differentiate between LAB, were used to detect individual LAB types during cheese storage. Commercial strains of Lactococcus, Lactobacillus, and Bifidobacterium spp. were initially screened on the 6 selective media along with nonstarter LAB (NSLAB) isolates. The microbial flora of the cheeses was analyzed during 9 mo of storage at 6°C. Many NSLAB were able to grow on media presumed selective for Lactococcus, Bifidobacterium spp., or Lb. acidophilus, which became apparent after 90 d of cheese storage, Between 90 and 120 d of storage, bacterial counts changed on media selective for Bifidobacterium spp., suggesting growth of NSLAB. Appearance of NSLAB on Lb. casei selective media [de man, Rogosa, and Sharpe (MRS)+vancomycin] occurred sooner (30 d) in low-fat cheese than in full-fat control cheeses. Differentiation between NSLAB and Lactococcus was achieved by counting after 18 to 24h when the NSLAB colonies were only pinpoint in size. Growth of NSLAB on the various selective media during aging means that probiotic adjunct cultures added during cheesemaking can only be enumerated with confidence on selective media for up to 3 or 4 mo. After this time, growth of NSLAB obfuscates enumeration of probiotic adjuncts. When adjunct Lb. casei or Lb. paracasei cultures are added during cheesemaking, they appear to remain at high numbers for a long time (9 mo) when counted on MRS+vancomycin medium, but a reasonable probability exists that they have been overtaken by NSLAB, which also grow readily on this medium. Enumeration using multiple

  1. Effect of adjuncts on sensory properties and consumer liking of Scamorza cheese.

    Science.gov (United States)

    Braghieri, A; Piazzolla, N; Romaniello, A; Paladino, F; Ricciardi, A; Napolitano, F

    2015-03-01

    The present study aimed to evaluate the effect of a peptidolytic adjunct (Lactococcus lactis, Lactobacillus helveticus, and Lactobacillus paracasei), as a tool to accelerate ripening, on sensory properties and acceptability of Scamorza cheese obtained using 2 types of milk (Friesian and Friesian+Jersey) and Streptococcus thermophilus as primary starter. A 10-member panel was trained using a specific frame of references and used a specific vocabulary to assess cheese sensory properties through quantitative descriptive analysis (QDA), whereas 87 consumers were used to evaluate product acceptability. Analysis of variance showed that milk type did not markedly alter cheese sensory properties. Conversely, panelists perceived higher intensities of butter, saltiness, and sweetness flavors in cheese without adjunct culture (ST), whereas the addition of the adjunct culture (ST+A) induced higher and sourness flavors, oiliness and grainy textures, and lower adhesiveness, moisture, springiness, and tenderness. Principal component analysis showed positive relationships between pH and tenderness, sweetness and saltiness and a negative correlation between pH and grainy, oiliness, color and structure uniformity, sourness, and milk. Most of the differences observed in QDA and most of the relationships observed in the principal component analysis were linked to the higher microbial activity induced by the adjunct culture. Independently of milk and starter types, consumers perceived Scamorza cheese as characterized by a good eating quality (mean liking scores were all above the neutral point of the hedonic scale). Although ST cheeses showed higher values for overall liking, 2 homogeneous groups of consumers were identified using partial least squares regression analysis. One group preferred ST cheeses with higher levels of tenderness, adhesiveness, springiness, and moisture in terms of texture, butter in terms of flavor, and sweetness in terms of taste, whereas a second group

  2. Effect of electrical stimulation as an adjunct to botulinum toxin type A in the treatment of adult spasticity: a systematic review.

    Science.gov (United States)

    Intiso, Domenico; Santamato, Andrea; Di Rienzo, Filomena

    2017-10-01

    To investigate whether electrical stimulation (ES) as an adjunct to BTX-A boosts botulinum activity and whether the combined therapeutic procedure is more effective than BTX-A alone in reducing spasticity in adult subjects. A search was conducted in PubMed, EMBASE, Cochrane Central Register, and CINAHL from January 1966 to January 2016. Only randomized controlled studies (RCT) involving the combination of BTX-A and ES were considered. RCTs were excluded if BTX plus ES was investigated in animals or healthy subjects; certain techniques were used as an adjunct to BTX-A, but ES was not used; BTX-A or ES were compared but were not used in combination. ES was divided into neuromuscular stimulation (NMS), functional electrical stimulation (FES), and transcutaneous electrical nerve stimulation (TENS). Two authors independently screened all search results and reviewed study characteristics using the Physiotherapy Evidence Database (PEDro) scale. Fifteen RCTs were pinpointed and nine studies were included. Trials varied in methodological quality, size, and outcome measures used. ES was used in the form of NMS and FES in seven and two studies, respectively. No study investigating BTX-A plus TENS was found. BTX-A plus ES produced significant reduction in spasticity on the Ashworth Scale (AS) and on the modified AS in seven studies, but only four showed high quality on the PEDro scale. Significant reduction in compound muscular action potential (CMAP) amplitude was detected after BTX-A plus ES in two studies. ES as an adjunctive therapy to BTX-A may boost BTX-A action in reducing adult spasticity, but ES variability makes it difficult to recommend the combined therapy in clinical practice. Implications for rehabilitation Electrical stimulation (ES) as adjunct to botulinum toxin type A (BTX-A) injections may boost neurotoxin action in treating adult spasticity. Given the variability of ES characteristics and the paucity of high-quality trials, it is difficult to support

  3. ADJUNCTIVE THERAPY OF COMMUNITY-ACKUIRED PNEUMONIA: NECESSITY AND SUFFICIENCY

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    L. V. Savchenkova

    2016-01-01

    Full Text Available Objective: analysis of pathogenetic and  symptomatic therapy of community-acquired pneumonia in the prehospital and at the stage  of hospital treatment of disease in hospitals of city Khujand of the Republic of Tajikistan.Materials and  methods: A retrospective analysis of 393 case  histories of  patients treated for  community-acquired pneumonia in  the  hospital Khujand from  2011  to  2015  is conducted. The estimation of the scope  and efficiency of the additional medical support for the treatment of communityacquired pneumonia was conducted, take  into  account the drugs  that  given  to patients in an outpatient setting and  in a hospital. Analyzed purpose rationale, adequacy of dose, duration of treatment and  compliance of the  activities with existing international and  national guidelines for the treatment  of community-acquired pneumonia.Results:  the  study found that  in  clinical  practice, 57% of  patients with  community-acquired pneumonia received funds pathogenetic and  symptomatic therapy. It  is  found that  quite  often  prescribed drugs  with  unproven efficiency. Thus,  75%  of patients received expectorants and  mucolytic drugs,   42.2% of  patients  received anti-allergic medicals. Non-steroidal anti-inflammatory medicals received 37.9% of patients with  community-acquired pneumonia, almost  30% of patients receiving infusion therapy. Quite often  (15.7% patients with   community-acquired  pneumonia  prescribed antifungal drugs  and  antiprotozoal drug  – metronidazole (59%  of cases.  Furthermore, in complex treatment of community-acquired pneumonia include vitamin C (23.1% and vitamin B (65.9%.Conclusion: the  analysis of pharmacotherapy community-acquired pneumonia showed that  in the treatment of this disease occurs  unjustified polypharmacy. Quite often  prescribe drugs with unproven efficacy and, as a consequence of a significant frequency of clinical

  4. Adjunctive Taurine in First-Episode Psychosis: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Study.

    Science.gov (United States)

    O'Donnell, Colin P; Allott, Kelly A; Murphy, Brendan P; Yuen, Hok Pan; Proffitt, Tina-Marie; Papas, Alicia; Moral, Jennifer; Pham, Tee; O'Regan, Michaela K; Phassouliotis, Christina; Simpson, Raelene; McGorry, Patrick D

    2016-12-01

    Taurine is an inhibitory neuromodulatory amino acid in the central nervous system that activates the GABA- and glycine-insensitive chloride channel and inhibits the N-methyl-D-aspartate receptor. It also functions as a neuroprotective agent and has a role in neural development and neurogenesis. The aim of this study was to determine the efficacy of adjunctive taurine in improving symptomatology and cognition among patients with a DSM-IV first-episode psychotic disorder. 121 patients with first-episode psychosis, aged 18-25 years, attending early intervention services consented to participate in this randomized, double-blind, placebo-controlled trial conducted from January 2007 to May 2009. Patients taking low-dose antipsychotic medication were randomly assigned to receive once-daily taurine 4 g or placebo for 12 weeks. The coprimary outcomes were change in symptomatology (measured by the Brief Psychiatric Rating Scale [BPRS] total score) and change in cognition (measured by the Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery composite score) at 12 weeks. Secondary outcomes included tolerability and safety and additional clinical and functioning measures. 86 participants (n = 47 taurine; n = 39 placebo) were included in the final analysis. Taurine significantly improved symptomatology measured by the BPRS total score (95% CI, 1.8-8.5; P = .004) and psychotic subscale (95% CI, 0.1-1.5; P = .026) compared to placebo. Additionally, improvements were observed in the Calgary Depression Scale for Schizophrenia (95% CI, 0.1-3.0; P = .047) and Global Assessment of Functioning (95% CI, 0.3-8.8; P = .04) scores. There was no group difference in composite cognitive score (95% CI, -1.7 to 1.0; P = .582). A significant group difference was found on one safety and tolerability item (psychic item 2, asthenia/lassitude/increased fatigability) of the Udvalg for Kliniske Undersogelser, with the taurine group showing a

  5. L-arginine and Vitamin D Adjunctive Therapies in Pulmonary Tuberculosis: A Randomised, Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    Ralph, Anna P.; Waramori, Govert; Pontororing, Gysje J.; Kenangalem, Enny; Wiguna, Andri; Tjitra, Emiliana; Sandjaja; Lolong, Dina B.; Yeo, Tsin W.; Chatfield, Mark D.; Soemanto, Retno K.; Bastian, Ivan; Lumb, Richard; Maguire, Graeme P.; Eisman, John; Price, Ric N.; Morris, Peter S.; Kelly, Paul M.; Anstey, Nicholas M.

    2013-01-01

    Background Vitamin D (vitD) and L-arginine have important antimycobacterial effects in humans. Adjunctive therapy with these agents has the potential to improve outcomes in active tuberculosis (TB). Methods In a 4-arm randomised, double-blind, placebo-controlled factorial trial in adults with smear-positive pulmonary tuberculosis (PTB) in Timika, Indonesia, we tested the effect of oral adjunctive vitD 50,000 IU 4-weekly or matching placebo, and L-arginine 6.0 g daily or matching placebo, for 8 weeks, on proportions of participants with negative 4-week sputum culture, and on an 8-week clinical score (weight, FEV1, cough, sputum, haemoptysis). All participants with available endpoints were included in analyses according to the study arm to which they were originally assigned. Adults with new smear-positive PTB were eligible. The trial was registered at ClinicalTrials.gov NCT00677339. Results 200 participants were enrolled, less than the intended sample size: 50 received L-arginine + active vitD, 49 received L-arginine + placebo vit D, 51 received placebo L-arginine + active vitD and 50 received placebo L-arginine + placebo vitD. According to the factorial model, 99 people received arginine, 101 placebo arginine, 101 vitamin D, 99 placebo vitamin D. Results for the primary endpoints were available in 155 (4-week culture) and 167 (clinical score) participants. Sputum culture conversion was achieved by week 4 in 48/76 (63%) participants in the active L-arginine versus 48/79 (61%) in placebo L-arginine arms (risk difference −3%, 95% CI −19 to 13%), and in 44/75 (59%) in the active vitD versus 52/80 (65%) in the placebo vitD arms (risk difference 7%, 95% CI −9 to 22%). The mean clinical outcome score also did not differ between study arms. There were no effects of the interventions on adverse event rates including hypercalcaemia, or other secondary outcomes. Conclusion Neither vitD nor L-arginine supplementation, at the doses administered and with the power attained

  6. L-arginine and vitamin D adjunctive therapies in pulmonary tuberculosis: a randomised, double-blind, placebo-controlled trial.

    Directory of Open Access Journals (Sweden)

    Anna P Ralph

    Full Text Available Vitamin D (vitD and L-arginine have important antimycobacterial effects in humans. Adjunctive therapy with these agents has the potential to improve outcomes in active tuberculosis (TB.In a 4-arm randomised, double-blind, placebo-controlled factorial trial in adults with smear-positive pulmonary tuberculosis (PTB in Timika, Indonesia, we tested the effect of oral adjunctive vitD 50,000 IU 4-weekly or matching placebo, and L-arginine 6.0 g daily or matching placebo, for 8 weeks, on proportions of participants with negative 4-week sputum culture, and on an 8-week clinical score (weight, FEV1, cough, sputum, haemoptysis. All participants with available endpoints were included in analyses according to the study arm to which they were originally assigned. Adults with new smear-positive PTB were eligible. The trial was registered at ClinicalTrials.gov NCT00677339.200 participants were enrolled, less than the intended sample size: 50 received L-arginine + active vitD, 49 received L-arginine + placebo vit D, 51 received placebo L-arginine + active vitD and 50 received placebo L-arginine + placebo vitD. According to the factorial model, 99 people received arginine, 101 placebo arginine, 101 vitamin D, 99 placebo vitamin D. Results for the primary endpoints were available in 155 (4-week culture and 167 (clinical score participants. Sputum culture conversion was achieved by week 4 in 48/76 (63% participants in the active L-arginine versus 48/79 (61% in placebo L-arginine arms (risk difference -3%, 95% CI -19 to 13%, and in 44/75 (59% in the active vitD versus 52/80 (65% in the placebo vitD arms (risk difference 7%, 95% CI -9 to 22%. The mean clinical outcome score also did not differ between study arms. There were no effects of the interventions on adverse event rates including hypercalcaemia, or other secondary outcomes.Neither vitD nor L-arginine supplementation, at the doses administered and with the power attained, affected TB outcomes

  7. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

    International Nuclear Information System (INIS)

    O’Donoghue, Keelin; O’Regan, Kevin N.; Sheridan, Carmel P.; O’Connor, Owen J.; Benson, Jodie; McWilliams, Sebastian; Moore, Niamh; Murphy, Mary J.; Chopra, Raj; Higgins, John R.; Maher, Michael M.

    2012-01-01

    Introduction: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians’ ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. Study design: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. Results: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. Conclusion: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  8. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians\\' ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. STUDY DESIGN: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. RESULTS: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. CONCLUSION: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

  9. Benefit of adjunct universal rectal screening for Chlamydia genital infections in women attending Canadian sexually transmitted infection clinics.

    Science.gov (United States)

    Thanh, Nguyen X; Akpinar, Ilke; Gratrix, Jennifer; Plitt, Sabrina; Smyczek, Petra; Read, Ron; Jacobs, Philip; Wong, Tom; Singh, Ameeta E

    2017-11-01

    Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only), additional selected (exposure-based) rectal screening (UG+SR), and additional universal rectal screening (UG+UR). The model included two mutually exclusive health states: infected and susceptible. Additionally, the model included two rounds of transmission: male sex partners of women infected with rectal-only CT and female sex partners of those men. CT complications impacting patients' quality of life (QALY) were considered. Alberta and Canadian data were used to estimate model inputs. We used a health care perspective, a time period of 10 years, and a discount rate of 3% for analyses. Compared to UG-only screening, the incremental cost effectiveness ratios (ICERs) were CA$34,000 and CA$49,000 per QALY gained for UG+SR and UG+UR screening strategies, respectively. Compared to UG+SR, the ICER was CA$62,000 per QALY gained for the UG+UR strategy. Both adjunct selected and universal rectal screening strategies are cost effective compared to UG-only screening, and UG+UR screening is cost effective when compared to UG+SR screening.

  10. A Case of Treatment Refractory Hyperemesis Gravidarum in a Patient with Comorbid Anxiety, Treated Successfully with Adjunctive Gabapentin

    Science.gov (United States)

    Webb, Kathryn

    2012-01-01

    Hyperemesis gravidarum occurs in 0.3 to 10 percent of pregnant women, with a 0.8 percent hospital admission rate. While older theories supported the psychosocial model as a cause for hyperemesis gravidarum, more recent studies have shown significant data to support a biological etiology. Hyperemesis gravidarum has serious complications including include increased risk for miscarriage, low birth weight infants, dehydration, Wernicke’s encephalopathy, secondary depression, and negative attitudes toward a consecutive pregnancy. Because of these life-threatening complications and complexity of the disease, it is important to treat both somatic and psychosocial causes of hyperemesis gravidarum to provide the best care for the patient. This paper presents a case of a woman with anxiety symptoms who was experiencing severe nausea and vomiting since Week 2 of pregnancy, with minimal reduction of these symptoms on standard medications utilized in hyperemesis gravidarum. The patient had marked reduction of nausea and vomiting with adjunctive gabapentin. After a brief review of relevant neurogastroenterology, we discuss a possible mechanism for the added gabapentin. PMID:23346516

  11. Genetic diversity study of various β-lactamase-producing multidrug-resistant Escherichia coli isolates from a tertiary care hospital using ERIC-PCR

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    Jayanti Jena

    2017-01-01

    Interpretation & conclusions: At 60 per cent similarity cut-off value, the dendrogram analysis showed that there were a total of 14 unique clusters of ERIC (CL-1 - CL-14 within the 41 E. coli isolates, which revealed the genetic diversity existing between them.

  12. Conference report : 'The status of muon catalysed fusion and fusion with polarized nuclei', Ettore Majorana workshop and school on fusion reactor technology (1987) Erice, Italy

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    A report is given of the Workshop and School on Fusion Reactor Technology held at Erice, Italy, 1987, at which the 44 participants discussed progress towards scientific breakeven in muon catalyzed fusion, and clarified its problems and possibilities. There is a need for continuing theoretical work and a technological study of reactor problems. (U.K.)

  13. 75 FR 26316 - In the Matter of the Designation of Eric Breininger, Also Known as Abdul-Gaffar, Also Known as...

    Science.gov (United States)

    2010-05-11

    ... the Order who might have a constitutional presence in the United States would render ineffectual the... determination who might have a constitutional presence in the United States, because to do so would render... DEPARTMENT OF STATE [Public Notice 6996] In the Matter of the Designation of Eric Breininger, Also...

  14. Significant Effects of Oral Phenylbutyrate and Vitamin D3 Adjunctive Therapy in Pulmonary Tuberculosis: A Randomized Controlled Trial.

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    Akhirunnesa Mily

    Full Text Available Development of new tuberculosis (TB drugs and alternative treatment strategies are urgently required to control the global spread of TB. Previous results have shown that vitamin D3 (vitD3 and 4-phenyl butyrate (PBA are potent inducers of the host defense peptide LL-37 that possess anti-mycobacterial effects.To examine if oral adjunctive therapy with 5,000IU vitD3 or 2x500 mg PBA or PBA+vitD3 to standard chemotherapy would lead to enhanced recovery in sputum smear-positive pulmonary TB patients.Adult TB patients (n = 288 were enrolled in a randomized, double-blind, placebo-controlled trial conducted in Bangladesh. Primary endpoints included proportions of patients with a negative sputum culture at week 4 and reduction in clinical symptoms at week 8. Clinical assessments and sputum smear microscopy were performed weekly up to week 4, fortnightly up to week 12 and at week 24; TB culture was performed at week 0, 4 and 8; concentrations of LL-37 in cells, 25-hydroxyvitamin D3 (25(OHD3 in plasma and ex vivo bactericidal function of monocyte-derived macrophages (MDM were determined at week 0, 4, 8, 12 and additionally at week 24 for plasma 25(OHD3.At week 4, 71% (46/65 of the patients in the PBA+vitD3-group (p = 0.001 and 61.3% (38/62 in the vitD3-group (p = 0.032 were culture negative compared to 42.2% (27/64 in the placebo-group. The odds of sputum culture being negative at week 4 was 3.42 times higher in the PBA+vitD3-group (p = 0.001 and 2.2 times higher in vitD3-group (p = 0.032 compared to placebo. The concentration of LL-37 in MDM was significantly higher in the PBA-group compared to placebo at week 12 (p = 0.034. Decline in intracellular Mtb growth in MDM was earlier in the PBA-group compared to placebo (log rank 11.38, p = 0.01.Adjunct therapy with PBA+vitD3 or vitD3 or PBA to standard short-course therapy demonstrated beneficial effects towards clinical recovery and holds potential for host-directed-therapy in the treatment of TB

  15. Adjunct effect of music therapy on cognition in Alzheimer’s disease in Taiwan: a pilot study

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    Li CH

    2015-02-01

    Full Text Available Chien-Hsun Li,1–3 Ching-Kuan Liu,2,3 Yuan-Han Yang,2–4 Mei-Chuan Chou,2,4 Chun-Hung Chen,2 Chiou-Lian Lai2,3 1Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 2Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 3Department of and Master’s Program in Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan Purpose: Music therapy (MT reviews have found beneficial effects on behaviors and social interaction in Alzheimer’s disease (AD but inconsistent effects on cognition. The purpose of the study was to evaluate the adjunct effect of long-term and home-based MT in AD patients under pharmacological treatment. Patients and methods: Mild AD cases (clinical dementia rating =0.5~1 were consecutively recruited and voluntarily separated into an MT group or control group (CG for 6 months. Outcome assessments included Cognitive Abilities Screening Instrument (CASI, CASI-estimated mini-mental state examination, clinical dementia rating with sum of box scores, and neuropsychiatric inventory. The MT interventions were Mozart’s Sonata (KV 448 and Pachelbel’s Canon, listening with headphones for 30 minutes daily in the morning and before sleep, respectively. Results: Forty-one cases (MT versus CG number =20 versus 21 were analyzed. Adjusted differences of CASI-estimated mini-mental state examination and CASI after 6 months in the MT group were slightly less decreased than the CG without statistical significance. In further analysis of cognitive domains of CASI, the adjusted difference of abstraction domain in the MT group was significantly better than the CG. Conclusion: Although there were no apparent additional benefits of this MT on the global cognition and daily functioning in mild AD patients, it confirms the adjunct

  16. Old Friends With New Faces: Are Sodium Channel Blockers the Future of Adjunct Pain Medication Management?

    Science.gov (United States)

    Thomas, Ashley M; Atkinson, Timothy J

    2018-01-01

    Providers are being asked to decrease the emphasis and overutilization of long-term opioid therapy, but many are left without proper guidance on appropriate utilization of nonopioid therapies. Furthermore, therapeutic options are quite limited and many providers lack confidence in distinguishing available alternatives. When first-line therapy has failed in a patient, there is an apparent lack of knowledge on how to proceed with choosing subsequent therapy. To choose among alternative agents, an understanding of pharmacology, pharmacokinetics, and efficacy in targeting various pain conditions is necessary. This article focuses on the use of the carboxamide class of sodium channel blockers (carbamazepine, oxcarbazepine, eslicarbazepine) for adjunct pain medication management including research updates in pharmacology, pharmacokinetics, and current evidence for pain along with promising areas of research. It is an evidence update for clinical use of sodium channel blockers, clarifies misconceptions regarding their use, and highlights emerging research for improved pain targets that justifies additional study. We performed a complete review of the literature using the search terms, "oxcarbazepine," "carbamazepine," and "eslicarbazepine" in conjunction with "pharmacokinetics," "adverse effects," "pharmacology," "voltage-gated sodium channel subtype," "neuropathic pain," "inflammatory pain," "metabolism," "epoxide metabolite formation," "drug interactions," "CYP450 interactions," "pain phenotype," and "chronic pain management." Databases searched included PubMed and Google Scholar. Package inserts were used for drug structure illustration, adverse reactions, and bioavailability. Pharmacology and pharmacokinetic data were taken from randomized controlled trials evaluating this area as well as in vitro published results. For validity, only peer-reviewed literature was included. Evidence for sodium channel blockers in chronic pain management was limited. This review focuses

  17. Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.

    Science.gov (United States)

    Shirani Bidabadi, Shahrzad; Mehryar, Amirhooshang

    2015-09-15

    Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. Copyright © 2015. Published by Elsevier B.V.

  18. Inhibitory activity of Lactobacillus plantarum LMG P-26358 against Listeria innocua when used as an adjunct starter in the manufacture of cheese

    LENUS (Irish Health Repository)

    2011-08-30

    Abstract Lactobacillus plantarum LMG P-26358 isolated from a soft French artisanal cheese produces a potent class IIa bacteriocin with 100% homology to plantaricin 423 and bacteriocidal activity against Listeria innocua and Listeria monocytogenes. The bacteriocin was found to be highly stable at temperatures as high as 100°C and pH ranges from 1-10. While this relatively narrow spectrum bacteriocin also exhibited antimicrobial activity against species of enterococci, it did not inhibit dairy starters including lactococci and lactobacilli when tested by well diffusion assay (WDA). In order to test the suitability of Lb. plantarum LMG P-26358 as an anti-listerial adjunct with nisin-producing lactococci, laboratory-scale cheeses were manufactured. Results indicated that combining Lb. plantarum LMG P-26358 (at 108 colony forming units (cfu)\\/ml) with a nisin producer is an effective strategy to eliminate the biological indicator strain, L. innocua. Moreover, industrial-scale cheeses also demonstrated that Lb. plantarum LMG P-26358 was much more effective than the nisin producer alone for protection against the indicator. MALDI-TOF mass spectrometry confirmed the presence of plantaricin 423 and nisin in the appropriate cheeses over an 18 week ripening period. A spray-dried fermentate of Lb. plantarum LMG P-26358 also demonstrated potent anti-listerial activity in vitro using L. innocua. Overall, the results suggest that Lb. plantarum LMG P-26358 is a suitable adjunct for use with nisin-producing cultures to improve the safety and quality of dairy products.

  19. An Adjunctive Multi-family Group Intervention with or without Patient Participation during an Inpatient Treatment for Adolescents with an Eating Disorder: A Pilot Study.

    Science.gov (United States)

    Depestele, Lies; Claes, Laurence; Dierckx, Eva; Colman, Roos; Schoevaerts, Katrien; Lemmens, Gilbert M D

    2017-11-01

    This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi-family group with patient (MFT) or in a similar multi-parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post-intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi-informant approach in family interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  20. Selection, application and monitoring of Lactobacillus paracasei strains as adjunct cultures in the production of Gouda-type cheeses.

    Science.gov (United States)

    Van Hoorde, Koenraad; Van Leuven, Isabelle; Dirinck, Patrick; Heyndrickx, Marc; Coudijzer, Kathleen; Vandamme, Peter; Huys, Geert

    2010-12-15

    Raw milk cheeses have more intense flavours than cheeses made from pasteurized milk and harbour strains with potential adjunct properties. Two Lactobacillus paracasei strains, R-40926 and R-40937, were selected as potential adjunct cultures from a total of 734 isolates from good quality artisan raw milk Gouda-type cheeses on the basis of their prevalence in different cheese types and/or over several production batches, safety and technological parameters. Conventional culturing, isolation and identification and a combined PCR-DGGE approach using total cheese DNA extracts and DNA extracts obtained from culturable fractions were employed to monitor viability of the introduced adjuncts and their effect on the cheese microbiota. The control cheese made without adjuncts was dominated by members of the starter, i.e. Lactococcus lactis and Leuconostoc pseudomesenteroides. In the cheeses containing either R-40926 or R-40937, the respective adjuncts increased in number as ripening progressed indicating that both strains are well adapted to the cheese environment and can survive in a competitive environment in the presence of a commercial starter culture. Principal component analysis of cheese volatiles determined by steam distillation-extraction and gas chromatography-mass spectrometry could differentiate cheeses made with different concentrations of adjunct R-40926 from the control cheese, and these differences could be correlated to the proteolytic and lipolytic properties of this strain. Collectively, results from microbiological and metabolic analyses indicate that the screening procedure followed throughout this study was successful in delivering potential adjunct candidates to enrich or extend the flavour palette of artisan Gouda-type cheeses under more controlled conditions. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. Efficacy of diltiazem as an adjunct to lignocaine in intravenous regional anesthesia

    Directory of Open Access Journals (Sweden)

    Puneet Khanna

    2013-01-01

    Full Text Available Background: Various adjuncts have been used with lignocaine to decrease tourniquet pain and prolong post-operative analgesia during intravenous regional anesthesia (IVRA. Calcium-channel blockers potentiate the analgesic effect of local anesthetics. This study was designed to evaluate the efficacy of diltiazem as an adjunct to lignocaine in IVRA with respect to tourniquet tolerance, perioperative analgesia, and quality of anesthesia. Methods: In this prospective, randomized, and double-blind study, 40 patients (American Society for Anesthesiologists grade I/II undergoing elective hand surgery under IVRA were assigned into two groups of 20 each and administered IVRA either with lignocaine 3 mg/kg (group Lignocaine (L or lignocaine 3 mg/kg plus diltiazem 0.2 mg/kg (group Lignocaine-Diltiazem (LD with normal saline (total volume-40 ml. Hemodynamic parameters, onset of the complete sensory blockade, motor blockade, and intraoperative (tourniquet pain and post-operative Visual Analogue Scale scores, total intraoperative and consumption of post-operative fentanyl intraoperative were recorded. Results: Sensory block was established in 2.5±0.688 min in group LD verses 5.60±0.851 min in group L. Motor blockade was established in 8.65±0.933 min in group LD and 13.46±0.604 min in group L. The mean VAS scores >3 were attained early at 30 min (3.1±0.912 in group L. Patients in group L requested early rescue analgesic at 30±8.633 min compared with 49.64±7.958 min in group LD. Conclusions: Diltiazem as an adjunct to lignocaine provided enhanced intraoperative and post-operative analgesia without any significant side effects.

  2. Effect of rasagiline as adjunct therapy to levodopa on severity of OFF in Parkinson's disease.

    Science.gov (United States)

    Stocchi, F; Rabey, J M

    2011-12-01

    The LARGO study demonstrated that rasagiline 1 mg/day as adjunct to levodopa significantly reduces OFF time to the same magnitude as adjunct entacapone. This substudy of LARGO aimed to assess the effect of rasagiline and entacapone on the motor symptoms of PD during the practically defined OFF state. LARGO was a randomized, double-blind, multicenter trial that assessed the efficacy and safety of rasagiline (1 mg/day), entacapone (200 mg with each levodopa dose), and placebo in 687 levodopa-treated PD patients with motor fluctuations. A substudy of LARGO measured UPDRS motor scores in the practically defined OFF state in 32 rasagiline, 36 entacapone, and 37 placebo patients. Treatment with rasagiline produced a significant improvement over placebo of 5.64 units in UPDRS motor OFF score (P = 0.013 vs. placebo). By contrast, the effect of adjunct entacapone was not significant (P = 0.14 vs. placebo). Whereas rasagiline also showed a trend in reducing the UPDRS-ADL OFF score (P = 0.058 vs. placebo), no such trend was noted for entacapone (P = 0.26 vs. placebo). Retrospective analysis, using the Bonferroni correction, of UPDRS motor subdomains further revealed that rasagiline, but not entacapone, significantly improved bradykinesia (P rasagiline 1 mg/day is effective in reducing the severity of motor symptoms in the OFF state. This suggests a continuous effect of rasagiline 1 mg/day throughout the day and night and is consistent with its extended duration of therapeutic action. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

  3. Superior chronic tolerability of adjunctive modafinil compared to pramipexole in treatment-resistant bipolar disorder.

    Science.gov (United States)

    Dell'osso, Bernardo; Timtim, Sara; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W; Hill, Shelley J; Portillo, Natalie; Ketter, Terence A

    2013-08-15

    Suboptimal outcomes are common in bipolar disorder (BD) pharmacotherapy, and may be mitigated with novel adjunctive agents such as modafinil (a low-affinity dopamine transport inhibitor) and pramipexole (a dopamine D2/D3 receptor agonist). While uncontrolled long-term effectiveness data have been reported for these treatments, reports specifically assessing their comparative acute versus chronic tolerability in BD are lacking. Such information, particularly in relation to discontinuation causes, has substantial relevance, providing initial indications to clinicians which treatment may be better tolerated, and to researchers which agent ought to be assessed in longer-term controlled trials. BD outpatients assessed with the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation, and followed with the STEP-BD Clinical Monitoring Form, were naturalistically prescribed adjunctive modafinil or pramipexole, and somatic/psychiatric intolerability discontinuation rates were compared. Among 63 BD outpatients (mean ± SD age 43.5 ± 14.3 years, 60.3% female, 42.9% type I, 44.4% type II, 12.7% type not otherwise specified), taking 3.5 ± 1.5 (median 3) concurrent prescription psychotropics, adjunctive modafinil (n=24) for 626.9 ± 863.9 (286) days versus pramipexole (n=39) for 473.7 ± 613.4 (214; p=0.51) days yielded a 26.0% lower somatic/psychiatric intolerability discontinuation rate (12.5% vs. 38.5%; pstudies are warranted to assess our preliminary observation that modafinil, compared to pramipexole, may be better tolerated for longer-term BD treatment. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

    Science.gov (United States)

    Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

    2015-06-01

    A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

  5. Sodium Valproate as an Adjunctive to Risperidone in Treatment of Schizophrenia

    Directory of Open Access Journals (Sweden)

    V Omrani Fard

    2007-01-01

    Introduction & Objective: Although sodium valproate came to the market as an anticonvulsant drug, nowadays it is wildly used in the management of psychiatric disorders. It is used as a mood stabilizer and as an adjunctive agent in treatment of depression and psychosis. There are controversies regarding sodium valproate efficacy in psychosis. Although some studies have reported that it is effective in the management of positive symptoms and aggression in acute psychosis, others have not found such an association. This study aimed to investigate the effects of adjunctive sodium valproate in the pharmacological management of patients with schizophrenia. Materials & Methods: In a double blind clinical trial, in 2 mental health hospitals (Noor and Farabi in Isfahan during the spring and summer of 2006, 32 schizophrenic patients (aged 18-65 years, who were in immediate need of admission, were randomly allocated into two groups. The first group was treated by combination of sodium valproate and risperidone and the other by combination of placebo and risperidone. A diagnosis of schizophrenia was established based on DSM-IV-TR criteria. All patients were assessed by PANSS on the 1st, 14th and 28th days of the admission. The collected data were analyzed by T Student and Paired T tests and repeated measure of ANOVA through SPSS. Results: Comparison of PANSS mean scores in two groups, before and after the trial, showed statistically significant differences. The reduction in PANSS score was significantly higher in the group treated with sodium valproate than in placebo group (p=0.006. Although, there was a statistically significant reduction in positive symptoms in both groups after 2 weeks of treatment (p=0.048, the difference was not significant in the fourth week. Conclusion: Our study shows that if used as an adjunct to antipsychotic in the management of acute psychosis, sodium valproate will speed up the recovery of positive sysmptoms.

  6. Leadership and Job Satisfaction: Adjunct Faculty at a For-Profit University

    Directory of Open Access Journals (Sweden)

    Donald Barnett

    2017-09-01

    Full Text Available There is a lack of research in the for-profit sector of higher education in the United States. Likewise, there is a lack of research on the factors that affect the job satisfaction of adjunct faculty. To address these gaps in knowledge, a quantitative correlational study was performed to investigate the effect of administrative leadership on the job satisfaction of adjunct faculty who teach online classes at a for-profit university in the United States. The Multifactor Leadership Questionnaire, which measures perceived leadership behaviors, and Spector’s Job Satisfaction Survey, which measures job satisfaction, were used to anonymously collect data from a sample of 77 adjunct faculty. The FullRange Leadership model, which is composed of transformational, transactional, and laissez-faire leadership behaviors, was the theoretical model for leadership. Pearson’s product moment correlational analyses were performed to investigate the bi-variate relationships between the variables. The dependent variable of total satisfaction had a statistically significant, direct and strong correlation with the independent variable of transformational leadership (r = .536, p < .0005. The strength and direction of the relationship indicated that increases in the scores of total satisfaction are associated with increases in scores in transformational leadership. Total satisfaction had a statistically significant, indirect and moderate correlation with the independent variable of laissezfaire leadership (r = -.372, p = .001. The strength and direction of the relationship indicated that lower total satisfaction scores are associated with higher laissez-faire leadership scores. There was no statistically significant relationship between transactional leadership and overall job satisfaction.

  7. Adjunctive use of repetitive transcranial magnetic stimulation in depressed adolescents: a prospective, open pilot study.

    Science.gov (United States)

    Wall, Christopher A; Croarkin, Paul E; Sim, Leslie A; Husain, Mustafa M; Janicak, Philip G; Kozel, F Andrew; Emslie, Graham J; Dowd, Sheila M; Sampson, Shirlene M

    2011-09-01

    Depression is often a serious and debilitating illness in adolescents. Unfortunately, a significant number of adolescents do not respond to antidepressant medications or psychotherapy. Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment intervention shown to benefit depression in adults. This study considered rTMS as an adjunctive treatment in adolescents with major depressive disorder. This prospective, open, multicenter trial of active adjunctive rTMS was conducted with 8 adolescents with DSM-IV-TR major depressive disorder (MDD) that had not responded sufficiently to 2 adequate antidepressant medication trials. All subjects were maintained on a stable dose of a selective serotonin reuptake inhibitor during the trial. Thirty daily rTMS treatments were given 5 days per week over 6 to 8 weeks. rTMS was applied to the left dorsolateral prefrontal cortex (120% of motor threshold; 10 Hz; 4-second trains; 26-second intertrain interval; 75 trains) for a total of 3,000 stimulations per treatment session. Seven of 8 adolescents completed all 30 treatments. rTMS was well tolerated, and no significant safety issues were identified. Suicidal ideation was present at baseline in 3 of the adolescents, and it improved during treatment. The primary outcome measure was the Children's Depression Rating Scale-Revised (CDRS-R); results improved significantly from baseline (mean [SD]) (65.9 [6.6]) to treatment 10 (50.9 [12]), P < .02. The CDRS-R scores continued to improve through the rTMS treatment series at treatment 20 (40.1 [14]), P < .01; treatment 30 (32.6 [7.3]), P < .0001; and at 6-month follow-up (32.7 [3.8]), P < .0001. This prospective open trial suggests that rTMS is a safe, feasible, and potentially effective adjunctive therapy for treatment-resistant MDD in adolescents. clinicaltrials.gov Identifier: NCT00587639. © Copyright 2011 Physicians Postgraduate Press, Inc.

  8. Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a randomized European multicenter open label study

    DEFF Research Database (Denmark)

    Nielsen, T L; Eeftinck Schattenkerk, J K; Jensen, B N

    1992-01-01

    Fifty-nine human immunodeficiency virus type-1-infected patients with a microscopically proven first episode of moderate to severe Pneumocystis carinii pneumonia (PCP) were enrolled into a randomized European multicenter study. The effect of adjunctive corticosteroid (CS) therapy was assessed on (a......) survival to discharge, (b) need for mechanical ventilation, and (c) survival at day 90. CS was given within 24 h of standard therapy as intravenous methylprednisolone 2 mg/kg body weight daily for 10 days. All patients received cotrimoxazole as standard treatment. Inclusion criteria were a PaO2 less than 9...

  9. Omentalisation as adjunctive treatment of an infected femoral nonunion fracture: a case report

    Directory of Open Access Journals (Sweden)

    McAlinden A

    2009-10-01

    Full Text Available Abstract A three-year-old male working border collie with an infected femoral nonunion fracture was managed in a two-stage procedure involving debridement and omentalisation, followed by stabilisation with a bone plate and an autogenous cancellous bone graft. Osseous union was documented radiographically 16 weeks after surgery. Telephone follow-up one year later revealed the dog had returned to full working function without evidence of lameness. To the authors' knowledge, this is the first clinical case described in the veterinary literature using omentalisation as an adjunct to the management of an infected, biologically inactive nonunion fracture.

  10. Adjunctive β2-agonists reverse neuromuscular involvement in murine Pompe disease

    Science.gov (United States)

    Li, Songtao; Sun, Baodong; Nilsson, Mats I.; Bird, Andrew; Tarnopolsky, Mark A.; Thurberg, Beth L.; Bali, Deeksha; Koeberl, Dwight D.

    2013-01-01

    Pompe disease has resisted enzyme replacement therapy with acid α-glucosidase (GAA), which has been attributed to inefficient cation-independent mannose-6-phosphate receptor (CI-MPR) mediated uptake. We evaluated β2-agonist drugs, which increased CI-MPR expression in GAA knockout (KO) mice. Clenbuterol along with a low-dose adeno-associated virus vector increased Rotarod latency by 75% at 4 wk, in comparison with vector alone (PTarnopolsky, M. A., Thurberg, B. L., Bali, D., Koeberl, D. D. Adjunctive β2-agonists reverse neuromuscular involvement in murine Pompe disease. PMID:22993195

  11. Treatment of avoidance behavior as an adjunct to exposure therapy: Insights from modern learning theory.

    Science.gov (United States)

    Treanor, Michael; Barry, Tom J

    2017-09-01

    Pathological avoidance of benign stimuli is a hallmark of anxiety and related disorders, and exposure-based treatments have often encouraged the removal of avoidance, or safety behaviors, due to their negative effects on extinction learning. Unfortunately, empirical evidence suggests that avoidance behaviors can persist following treatment, and the mere availability of avoidance behavior can be sufficient to renew fear following successful extinction learning. The present paper critically examines the function of avoidance behavior through the lens of modern learning theory, and speculates on novel behavioral and pharmacological strategies for targeting avoidance as an adjunct to current evidence-based treatments. Copyright © 2017. Published by Elsevier Ltd.

  12. Long-Term, Open-Label, Safety Study of Edivoxetine 12 to 18 mg Once Daily as Adjunctive Treatment for Patients With Major Depressive Disorder Who Are Partial Responders to Selective Serotonin Reuptake Inhibitor Treatment.

    Science.gov (United States)

    Ball, Susan G; Atkinson, Sarah; Sparks, JonDavid; Bangs, Mark; Goldberger, Celine; Dubé, Sanjay

    2015-06-01

    Long-term safety, tolerability, and efficacy of adjunctive edivoxetine hydrochloride (hereafter edivoxetine), a highly selective and potent norepinephrine reuptake inhibitor, was assessed in patients with major depressive disorder (MDD) experiencing partial response to selective serotonin reuptake inhibitor treatment. Data are from a multicenter, 54-week, open-label trial of adjunctive edivoxetine 12 to 18 mg once daily in patients with MDD who had experienced partial response by history to 6 or more weeks of current selective serotonin reuptake inhibitor therapy and who had a 17-item GRID Hamilton Rating Scale for Depression total score 16 or higher at study entry. Safety measures included discontinuation rate, treatment-emergent adverse events, serious adverse events, and vital signs. Efficacy measures included the Montgomery-Åsberg Depression Rating Scale. Of 608 patients, 328 (54%) completed the open-label adjunctive treatment. Study discontinuation due to adverse events occurred in 17.0%, and there were 13 serious adverse events (1 death). Treatment-emergent adverse events 5% or higher were nausea, hyperhidrosis, constipation, headache, dry mouth, dizziness, vomiting, insomnia, and upper respiratory tract infection. Mean increases were observed in systolic blood pressure (range, 0.0-2.3 mm Hg), diastolic blood pressure (range, 1.9-3.3 mm Hg), and pulse (range, 5.9-8.4 beats per minute). Mean improvements on the Montgomery-Åsberg Depression Rating Scale (-17.0) were observed from baseline to week 54. The safety profile from this study provides an overview of outcomes associated with edivoxetine and norepinephrine reuptake inhibition as an adjunctive treatment in patients with MDD who were treated up to 1 year.

  13. Camel Milk: Potential Utility as an Adjunctive Therapy to Peg-IFN/RBV in HCV-4 Infected Patients in Egypt.

    Science.gov (United States)

    Mohamed, Walid A; Schaalan, Mona F; El-Abhar, Hanan S

    2015-01-01

    The present prospective study aims to investigate the potential therapeutic effect and the underlying mechanisms of drinking camel milk for 60 days as an adjunctive therapy to the standard treatment PEG/RBV. Twenty-five hepatitis C virus (HCV)-infected Egyptian patients, with mild to moderate parenchymal affection to mild cirrhosis were enrolled in this study after proper history taking and clinical examination. Their biomarkers were evaluated before and after the addition of camel milk. The improving effect of camel milk was reflected on the marked inhibition of the serum levels of the proinflammatory markers, viz., tumor necrosis factor-α, monocyte chemotactic protein-1, hyaluronic acid, and TGF-β1, besides PCR, AST, ALT, GGT, bilirubin, prothrombin time, INR, and alpha-fetoprotein. In addition, camel milk elevated significantly (P camel milk on multiple parameters of inflammatory mediators, immunomodulators, antiapoptosis, and antioxidants, giving insight into the potential therapeutic benefit underlying the anti-HCV actions of camel milk. The limitations of the current study include the small sample size recruited and the failure to test it on cohorts with severe stages of hepatitis; like Child-Pugh stage C, and hepatocellular carcinoma.

  14. Cooperative Exploration of Rough Martian Terrains with the "Scorpion" Legged Robot as an Adjunct to a Rover.

    Science.gov (United States)

    Colombano, Silvano P.; Kirchner, Frank; Spenneberg, Dirk; Starman, Jared; Hanratty, James; Kovsmeyer, David (Technical Monitor)

    2003-01-01

    NASA needs autonomous robotic exploration of difficult (rough and/or steep) scientifically interesting Martian terrains. Concepts involving distributed autonomy for cooperative robotic exploration are key to enabling new scientific objectives in robotic missions. We propose to utilize a legged robot as an adjunct scout to a rover for access to difficult - scientifically interesting - terrains (rocky areas, slopes, cliffs). Our final mission scenario involves the Ames rover platform "K9" and Scorpion acting together to explore a steep cliff, with the Scorpion robot rappelling down using the K9 as an anchor as well as mission planner and executive. Cooperation concepts, including wheeled rappelling robots have been proposed before. Now we propose to test the combined advantages of a wheeled vehicle with a legged scout as well as the advantages of merging of high level planning and execution with biologically inspired, behavior based robotics. We propose to use the 8-legged, multifunctional autonomous robot platform Scorpion that is currently capable of: Walking on different terrains (rocks, sand, grass, ...). Perceiving its environment and modifying its behavioral pattern accordingly. These capabilities would be extended to enable the Scorpion to: communicate and cooperate with a partner robot; climb over rocks, rubble piles, and objects with structural features. This will be done in the context of exploration of rough terrains in the neighborhood of the rover, but inaccessible to it, culminating in the added capability of rappelling down a steep cliff for both vertical and horizontal terrain observation.

  15. Design, Implementation, and Evaluation of a Simulation-Based Clinical Correlation Curriculum as an Adjunctive Pedagogy in an Anatomy Course.

    Science.gov (United States)

    Coombs, Carmen M; Shields, Ryan Y; Hunt, Elizabeth A; Lum, Ying Wei; Sosnay, Patrick R; Perretta, Julianne S; Lieberman, Rhett H; Shilkofski, Nicole A

    2017-04-01

    Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine). The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions. A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention. Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

  16. Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies.

    LENUS (Irish Health Repository)

    Kerley, Conor P

    2015-03-05

    Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence\\/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.

  17. Mobilization with movement as an adjunct intervention in a patient with complicated de Quervain's tenosynovitis: a case report.

    Science.gov (United States)

    Backstrom, Karen Maloney

    2002-03-01

    Case study. To describe the use of conventional physical therapy interventions together with Mobilization With Movement (MWM) techniques in the treatment of an individual with a complicated scenario of de Quervain's tenosynovitis. The patient was a 61-year-old woman who presented with signs and symptoms consistent with de Quervain's tenosynovitis of the right hand. Range limitations in all motions of the right wrist and first carpometacarpal joint complicated her presentation. Physical therapy included conventional intervention with superficial heat, ice, iontophoresis, and transverse friction massage directed to the first dorsal tunnel. Conventional joint mobilization techniques addressed the motion limitations of the first carpometacarpal, radiocarpal, and midcarpal joints. In addition, MWM techniques were utilized to promote pain-free wrist and thumb mobility. The specific MWM techniques used with this patient involved active movements of the thumb and wrist superimposed on a passive radial glide of the proximal row of carpal bones. The described treatment regime, which involved conventional physical therapy interventions, along with MWM, aided in the complete resolution of this patient's impairments and functional limitations. The combination of conventional physical agents, exercise, and manual therapy, and the less conventional MWM techniques, proved successful with this patient. MWM involving the correction of minutejoint malalignments, coupled with active motion of the wrist and first carpometacarpal joints, was an effective and efficient adjunct physical therapy intervention. Because subtle changes injoint alignment may contribute to painful syndromes in the tendon complexes that cross a malaligned joint, use of MWM as a treatment technique warrants continued research.

  18. Use of recombinant human bone morphogenetic protein-2 as an adjunct for instrumented posterior arthrodesis in the occipital cervical region: An analysis of safety, efficacy, and dosing

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    D Kojo Hamilton

    2010-01-01

    Full Text Available Background: There have been few reports on the use of recombinant human bone morphogenetic protein (rhBMP-2 in posterior spine. However, no study has investigated the dosing, safety, and efficacy of its use in the posterior atlantoaxial, and/or craniovertebral junction. Recent case report of the cytokine-mediated inflammatory reaction, following off label use of rhBMP-2 as an adjunct for cervical fusion, particularly in complex cases, has increased concern about complications associated with the product. Objective: To assess the safety, efficacy, and dosing of rhBMP-2 as an adjunct for instrumented posterior atlantoaxial and/or craniovertebral junction arthrodesis. Materials and Methods: We included all patients treated by the senior author that included posterior atlantoaxial and/or craniovertebral junction instrumented fusion using rhBMP-2 from 2003 to 2008 with a minimum two year follow-up. Diagnosis, levels fused, rhBMP-2 dose, complications, and fusion were assessed. Results: Twenty three patients with a mean age of 60.9 years (range 4 - 89 years and an average follow-up of 45 months (range 27 to 84 months met inclusion criteria. The indications for surgery included, atlantoaxial instability (n = 16, basilar invagination (n = 6, and kyphoscoliosis (n = 1. The specific pathologic diagnosis included type 2 dens fracture (n = 7, complex C1 and C2 ring fracture (n = 2, chordoma (n = 2, degenerative/osteoporosis (n = 3, rheumatoid disease (n = 8, and pseudogout (n = 1. The average rhBMP-2 dose was 2.38 mg/level, with a total of 76 levels treated (average 3.3 levels, SD= 1.4 levels. There were no complications. During the most recent follow-up, all patients had achieved fusion. Conclusions: In a series of patients with complex pathology and/or rheumatoid arthritis, 100% fusion rate was achieved with adjunct use of rhBMP-2, with a safe and effective average rhBMP-2 dose of 2.38 mg per level.

  19. Chinese Circulations. Capital, Commodities, and Networks in Southeast Asia, Eric Tagliacozzo & Wen-Chin Chang (éds

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    Jean Baffie

    2012-09-01

    Full Text Available Cet ouvrage est une contribution majeure à l’étude des activités commerciales des Chinois d’Asie du Sud-Est, particulièrement du commerce entre les Chinois installés en Asie du Sud-Est et la Chine. Il est publié sous la direction d’un historien de l’université de Cornell aux États-Unis, Eric Tagliacozzo, spécialiste de l’Asie du Sud-Est musulmane, de l’Insulinde, principalement, et de Wen-Chin Chang, anthropologue au CAPAS de l’Academia Sinica et spécialiste des Chinois yunnanais de la Thaïla...

  20. La investigación en Educación Musical en la base de datos ERIC

    OpenAIRE

    Galera, María; Pérez, Jesús

    2008-01-01

    En este artículo se describe un análisis bibliométrico de los artículos de investigación en Educación Musical indexados en la base ERIC y publicados durante el período de 1995 a 2007. Estos artículos constituyen el 54% del total de artículos censados en la base relacionados con la Educación Musical. Como resultado se ofrece un listado con las 10 revistas que contienen más de 20 artículos sobre Educación Musical del total censado; La suma de los artículos publicados por las cuatro ...

  1. Lactobacilli isolated from Algerian goat's milk as adjunct culture in dairy products

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    Ahmed Marroki

    2014-06-01

    Full Text Available In this study, nineteen Lactobacillus isolated from Algerian goat's milk, 13 belonging to L. plantarum, three to L. pentosus, two to L. rhamnosus and one to L. fermentum, were examined in vitro in order to be used as adjunct culture in dairy products. The strains were tested for their proteolytic activity, sensory and safety properties. Strains LbMS16 and LbMS21 L. plantarum and LbMF25 L. rhamnosus presented the highest proteolytic activity. All the tested lactobacilli were able to grow on MRS agar containing 0.5 and 1% (W/V of oxgall, whereas none produced biogenic amine (BA from the four tested amino acids and were resistant to pH 2.0 and 3.0, but some strains were able to grow at pH 3.5. None of examined strains were β-haemolytic when grown in hors blood agar. Result of antibiotic resistance showed that all the strains were susceptible to penicillin, erythromycin and resistant to vancomycin. Diacetyl production was observed for two strains of L. plantarum and one of L. rhamnosus. Most of strains were able to produce pleasant flavours in fermented milk and gave a good acceptance. According to these results, the strains LbMS16, LbMS21and LbMF25 could be good candidates to be used as adjunct culture, playing a probiotic role in dairy products manufacture in Algeria.

  2. Endovascular Treatment of Left Iliofemoral Deep Vein Thrombosis Using Urokinase Thrombolysis and Adjunctive Aspiration Thrombectomy

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    Suh, Sang Hyun; Lee, Do Yun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    To evaluate the efficacy of adjunctive aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis (DVT). 24 patients (9 males and 15 females; mean age, 53 years), treated by aspiration thrombectomy were enrolled in this study. The day after undergoing urokinase (UK) thrombolysis, any residual thrombus over a long segment was treated by aspiration thrombectomy using a 12 Fr long sheath. Residual short-segment (< 10 cm) iliac vein thrombus and/or stenosis were treated with a stent. The evaluation of venous patency was conducted by color Doppler ultrasonography, venography and/or computed tomography. The technical and clinical success rates were 100% and 92%, respectively. Twenty-three patients were treated by UK thrombolysis and iliac stent. The overall patency rate at 1, 2 and 3 years was 85%, 82% and 81%, respectively. Over the course of the follow-up period, occlusion was observed in 4 cases (1 acute and 3 chronic cases). Periprocedural complication occurred in 4 cases (17%) in the form of a minimal hematoma or pain on the puncture site as well as a case of pulmonary embolism at one month after treatment. The adjunctive aspiration thrombectomy with conventional thrombolysis and stent placement can be an effective and safe method in the treatment of left iliofemoral DVT

  3. Adjunctive Subantimicrobial Dose Doxycycline in the Treatment of Chronic Periodontitis in Type 2 Diabetic Patients: A Unique Combination Therapy

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    Gomaa Marwa Abdelhakim

    2018-03-01

    Full Text Available Background/Aim: To evaluate the effectiveness of combination therapy including subantimicrobial dose doxycycline (SDD and locally delivered doxycycline (LD as adjuncts to scaling and root planing (SRP in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus (T2DM. Material and Methods: Forty patients with controlled T2DM (HbA1c ≤7% and chronic periodontitis were selected. They were randomly divided into two groups, twenty patients each: Test group (TG, n=20 patients was treated with combination therapy of full mouth SRP, LD gel 10% and SDD 20 mg twice daily for 6 months. Control group (CG, n=20 patients was treated with full mouth SRP only. The periodontal parameters were recorded at baseline, 3, 6 and 9 months and included periodontal probing depth (PD, clinical attachment level (CAL, and bleeding on probing (BOP. Gingival crevicular fluid (GCF samples were collected and a quantitative measurement of matrix metalloproteinase-8 (MMP-8 was carried out by using Enzyme-Linked Immunosorbent Assay (ELIZA at baseline, 3, 6 and 9 months. Results: Statistically significant reduction in all clinical parameters (PPD, CAL, and BOP was observed at TG over CG at 3, 6, and 9 months (p<0.05. Moreover, combination therapy provided significant reductions in the amount of GCF MMP-8 for the TG compared to CG at 3, 6, and 9 months evaluation period (p<0.05. Conclusions: Combination therapy including SRP, SDD, and LD, provided significantly greater clinical benefits than SRP alone in the treatment of chronic periodontitis in patients with controlled T2DM.

  4. Rasagiline: time to onset of antiparkinson effect is similar when used as a monotherapy or adjunct treatment.

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    Wilson, Ronald E; Seeberger, Lauren C; Silver, Dee; Griffith, Alida; Conner, Jill B; Salzman, Phyllis M

    2011-11-01

    Rasagiline, a monoamine oxidase type B inhibitor, is indicated for both the initial treatment of Parkinson disease (PD) and as adjunctive (add-on) treatment for patients already taking dopaminergic therapy. This open-label prospective community-based clinical trial was designed to determine the time-to-onset and the magnitude of the beneficial effects of rasagiline in PD patients. Patients received rasagiline of 1.0 mg once daily as monotherapy or 0.5 mg once daily as adjunct therapy (adjunct therapy dose could be increased to 1 mg/d if clinically indicated) for 12 weeks. Dietary restrictions and recommendations regarding concurrent antidepressant treatment consistent with the Food and Drug Administration (FDA) regulations were in keeping with typical usage. Effectiveness was measured as change from baseline in bradykinesia scores and physicians' and patients' global impression. Patients were prospectively monitored for treatment emergent dopaminergic side effects, tyramine reactions, and possible interactions with commonly used antidepressants. Objective and subjective measures of symptom severity improved at 1 week in 272 PD patients treated with once-daily rasagiline (n=123 monotherapy, n=149 adjunct therapy). The magnitude of beneficial effect was similar in monotherapy and adjunct therapy patients. No significant dopaminergic side effects, tyramine reactions, or interactions with antidepressants were observed in the 12-week trial. Rasagiline has a measurable beneficial effect on PD symptoms within 1 week of treatment. Rasagiline has a similar magnitude of benefit in monotherapy and adjunct therapy patients. Adverse interactions between antidepressants and rasagiline were not observed in patients in this trial. The usual use of rasagiline in community neurology practice, consistent with the FDA labeling, seems safe and effective.

  5. The Effectiveness of Adjunct Class on The Mastery of Vocabulary And Course Content of Students of Accounting Department

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    Patrisius Istiarto Djiwandono

    2014-05-01

    Full Text Available The paper reports a classroom action research that aimed to determine the impact of a Content and Language Integrated Learning on the mastery of vocabulary and of course contents of a group of students in the Accounting Department of Universitas Ma Chung. It also intended to identify their opinions about the effectiveness of such approach. To achieve these objectives, a Time Series Design was used in a Classroom Action Research framework to introduce an adjunct class to the accounting class. The baseline data in the form of their vocabulary mastery and knowledge of the course contents were gained before the adjunct session was given. Then, the adjunct sessions were given for a period of two months. A few tests were administered to measure their progress in the mastery of vocabulary and course contents. A comparison was then drawn between the scores of the baseline data and the subsequent measures. In general, although they gained better mastery of new words, they failed to utilize them to increase their mastery of the course contents. Further exploration into the interview data reveals that most of them did not feel any significant assistance in mastering the course contents, although many of them admitted the benefit of mastering new vocabulary. There are some possible causes of the results. First, the limited duration of the adjunct sessions was felt to hinder the effectiveness. Second, the explanation in the adjunct sessions were not matched quite well with the focus during the main content course. On the basis of the results, the recommended points are the matching between the emphasis of both classes, and the lengthening of the duration of the adjunct sessions.

  6. Pregabalin as adjunct in a multimodal pain therapy after traumatic foot amputation - A case report of a 4-year-old girl.

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    Wössner, Stephanie; Weber, Kirsten; Steinbeck, Anna C; Oberhauser, Markus; Feuerecker, Matthias

    2017-10-01

    The purpose of this case report is to describe a multimodal pain therapeutic concept including the adjunct use of pregabalin in a 4.5 year-old child after forefoot amputation. Phantom limb pain and sensation is a complex pain syndrome that is difficult to treat and prevent. 70-75% of all children develop such a pain syndrome after amputation. We describe here a paediatric patient who underwent forefoot amputation following traumatic foot injury and received multimodal pain therapy including pregabalin. A 4.5 year-old otherwise healthy girl suffered severe injuries of the right foot and lower leg during a motor vehicle accident. Due to development of severe necrosis, forefoot amputation had to be performed during the hospital stay. Initial pain therapy included paracetamol, ibuprofen, metamizol, morphine and fentanyl. With mounting pain and anxiety, regional anaesthesia of the distal sciatic nerve was administered in combination with a ketamine and morphine patient controlled analgesia pump (PCA). The peripheral blockade of the distal sciatic nerve was placed with the guidance of ultrasound and nerve stimulator. The PCA concept included a continuous basal rate combined with a bolus function. Although the regional anaesthesia was well positioned and functioning, there was inadequate pain control. The pain was described by the patient as short, highly intense and sharp sensations with intensity on the visual analogue scale (VAS) of 10 (out of 10). Furthermore, she suffered from anxiety episodes and sleep disturbance. The medical team decided to treat with pregabalin to resolve these issues while awaiting amputation (Lisfranc line). She received psychological counselling as adjunct treatment. This multimodal concept enabled an early and efficient pain reduction pre- and post-amputation and allowed for the possibility of a hospital discharge without any opioid pain medication. The multimodal pain therapy including pregabalin was well tolerated, safe and highly effective

  7. Role of diode lasers (800-980 nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review.

    Science.gov (United States)

    Qadri, Talat; Javed, Fawad; Johannsen, Gunnar; Gustafsson, Anders

    2015-11-01

    The purpose of this study was to systematically review currently available evidence regarding the role of diode lasers (810-980 nm) as adjuncts to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). Mechanical instrumentation of periodontal tissues followed by diode laser application leads to complete removal of pocket epithelium compared with conventional SRP. To address the focused question "Is SRP with adjunct diode lasers (810-980 nm) therapy more effective in the treatment of CP than when CP is treated by SRP alone?" databases were searched using the following key words: chronic periodontitis, diode laser, surgical, AND scaling and root planing, periodontal diseases, periodontal therapy, AND periodontal treatment. Original studies were included. Letters to the editor, case reports, commentaries, and reviews were excluded. Ten clinical studies were included. In all studies, patients were systemically healthy, and cigarette smokers were included in two studies. In five studies, SRP plus diode laser application was more effective in the treatment of CP than SRP, and three studies showed no difference. In two studies, there was a moderate reduction in periodontal inflammation using SRP plus diode laser. The diameter of optic fiber, laser wavelengths, power, pulse repetition rate, and duration of laser exposure ranged between 300 μm and 2 mm, 810-980 nm, 0.8-2.5 W, 10-60 Hz, and 10-100 ms, respectively. In CP patients with probing depths ≤5 mm, diode lasers, SRP plus diode laser (800-980 nm) is more effective in the treatment of CP than when SRP is used alone.

  8. Effect of adjunctive loperamide in combination with antibiotics on treatment outcomes in traveler's diarrhea: a systematic review and meta-analysis.

    Science.gov (United States)

    Riddle, Mark S; Arnold, Sarah; Tribble, David R

    2008-10-15

    A previous Cochrane Collaboration review established an effective advantage of antibiotic therapy, compared with placebo, for treatment of traveler's diarrhea. The goal of the present study was to conduct a systematic review of the literature to establish the effect on treatment outcomes of using antimotility agents in conjunction with antibiotic therapy. The meta-analysis was conducted through searches of electronic databases and pertinent reference lists (including other review articles) and consultation with experts in the field. Clinical trials on therapy of infectious diarrhea in adult populations that met eligibility criteria were studied. Data were extracted and verified by 2 independent investigators and were analyzed for outcomes of clinical cure at 24 h, 48 h, and 72 h and time to last unformed stool. Study quality, heterogeneity, and publication bias were assessed. When appropriate, effect estimates among studies were pooled and sensitivity analyses were performed. Nine studies consisting of 12 different adjunctive loperamide antibiotic regimens were included for analysis. Among 6 paired studies comparing antibiotics alone versus antibiotics in combination with loperamide, the odds of clinical cure at 24 h and 48 h favored combination therapy, with summary odds ratios of 2.6 (95% confidence interval, 1.8-3.6; P = .20 by chi(2) heterogeneity statistic) and 2.2 (95% confidence interval, 1.5-3.1; P = .20, by chi(2) heterogeneity statistic), respectively, with no evidence of heterogeneity. Factors that possibly affect advantage of combination therapy over solo therapy included increased frequency of pretreatment diarrhea and higher prevalence of noninvasive pathogens. Antibiotic therapy with adjunctive loperamide offers an advantage over antibiotics alone by decreasing the illness duration and increasing the probability of early clinical cure.

  9. Adjunctive dexamethasone therapy in unconfirmed bacterial meningitis in resource limited settings: is it a risk worth taking?

    Science.gov (United States)

    Gudina, Esayas Kebede; Tesfaye, Markos; Adane, Aynishet; Lemma, Kinfe; Shibiru, Tamiru; Wieser, Andreas; Pfister, Hans-Walter; Klein, Matthias

    2016-08-26

    Bacterial meningitis is associated with significant morbidity and mortality despite advances in medical care. The main objective of this study was to assess the association of adjunctive dexamethasone treatment with discharge outcome of patients treated as bacterial meningitis in low income setting. A retrospective study was conducted at four teaching hospitals across Ethiopia. Patients of age 14 years and older treated as cases of bacterial meningitis between January 1, 2011 and April 30, 2015 were included in this study. Information regarding sociodemographic data, clinical presentations, laboratory data, treatments given and status at hospital discharge were retrieved from patients' medical records using a structured questionnaire. Predefined outcome variables at discharge were analysed using descriptive statistics. Multivariable logistic regression was used to identify factors independently associated with poor outcome. A total of 425 patients treated with the presumptive clinical diagnosis of bacterial meningitis were included in this study (lumbar puncture done in 56 %; only 19 % had CSF findings compatible with bacterial meningitis, and only 3 % had proven etiology). The overall in hospital mortality rate was 20.2 %. Impaired consciousness, aspiration pneumonia, and cranial nerve palsy at admission were independently associated with increased mortality. Adjuvant dexamethasone, which was used in 50.4 % of patients, was associated with increased in-hospital mortality (AOR = 3.38; 95 % CI 1.87-6.12, p bacterial meningitis. Most patients treated for suspected bacterial meningitis did not receive proper diagnostic workup. Adjuvant dexamethasone use in clinically suspected but unproven cases of bacterial meningitis was associated with an increased mortality and poor discharge GOS. These findings show that there are potential deleterious effects in unconfirmed cases in this setting. Physicians practising under such circumstances should thus abide with

  10. Rationale for an adjunctive therapy with fenofibrate in pharmacoresistant nocturnal frontal lobe epilepsy.

    Science.gov (United States)

    Puligheddu, Monica; Melis, Miriam; Pillolla, Giuliano; Milioli, Giulia; Parrino, Liborio; Terzano, Giovanni Mario; Aroni, Sonia; Sagheddu, Claudia; Marrosu, Francesco; Pistis, Marco; Muntoni, Anna Lisa

    2017-10-01

    Nocturnal frontal lobe epilepsy (NFLE) is an idiopathic partial epilepsy with a family history in about 25% of cases, with autosomal dominant inheritance (autosomal dominant NFLE [ADNFLE]). Traditional antiepileptic drugs are effective in about 55% of patients, whereas the rest remains refractory. One of the key pathogenetic mechanisms is a gain of function of neuronal nicotinic acetylcholine receptors (nAChRs) containing the mutated α4 or β2 subunits. Fenofibrate, a common lipid-regulating drug, is an agonist at peroxisome proliferator-activated receptor alpha (PPARα) that is a ligand-activated transcription factor, which negatively modulates the function of β2-containing nAChR. To test clinical efficacy of adjunctive therapy with fenofibrate in pharmacoresistant ADNFLE\\NFLE patients, we first demonstrated the effectiveness of fenofibrate in a mutated mouse model displaying both disease genotype and phenotype. We first tested the efficacy of fenofibrate in transgenic mice carrying the mutation in the α4-nAChR subunit (Chrna4S252F) homologous to that found in humans. Subsequently, an add-on protocol was implemented in a clinical setting and fenofibrate was administered to pharmacoresistant NFLE patients. Here, we show that a chronic fenofibrate diet markedly reduced the frequency of large inhibitory postsynaptic currents (IPSCs) recorded from cortical pyramidal neurons in Chrna4S252F mice, and prevented nicotine-induced increase of IPSC frequency. Moreover, fenofibrate abolished differences between genotypes in the frequency of sleep-related movements observed under basal conditions. Patients affected by NFLE, nonresponders to traditional therapy, by means of adjunctive therapy with fenofibrate displayed a reduction of seizure frequency. Furthermore, digital video-polysomnographic recordings acquired in NFLE subjects after 6 months of adjunctive fenofibrate substantiated the significant effects on control of motor-behavioral seizures. Our preclinical and

  11. Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia

    DEFF Research Database (Denmark)

    Frandsen, Christian S.; Dejgaard, Thomas F.; Andersen, Henrik U.

    2017-01-01

    significantly between groups (P =.96), with no significant changes from baseline, whether evaluated from AUCs or time to peak. The secondary endpoints, glycaemic recovery, counter-regulatory hormone responses, systolic blood pressure and GLP-1 and PP responses, were also similar. Heart rate increased......). Secondary endpoints included changes in glycaemic recovery, counter-regulatory hormones, pancreatic polypeptide (PP), GLP-1, blood pressure and heart rate. Results: During the period June 2013 to October 2014, 20 patients were enrolled. After 12 weeks of treatment, changes in GE rates did not differ......Aim: Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy is a potential treatment as adjunct to insulin in type 1 diabetes (T1D). However, GLP-1RAs inhibit glucagon secretion and delay the gastric emptying (GE) rate and may impair recovery from hypoglycaemia. We evaluated the effect...

  12. Clinical Efficacy of a Mouth-Exercising Device Adjunct to Local Ointment Intra-Lesional Injections and Surgical Treatment for Oral Submucous Fibrosis: a Randomized Controlled Trial.

    Science.gov (United States)

    Patil, Pravinkumar; Hazarey, Vinay; Chaudhari, Rekha; Nimbalkar-Patil, Smita

    2016-01-01

    Oral physiotherapy or mouth exercise is considered to be an adjunct but mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. A total of 231 OSMF patients were selected and treated with basic regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IIDoral opening in OMSF patients in conjunction with local, injection and/or surgical treatment.

  13. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital.

    Science.gov (United States)

    Gajić, Gordana Mandić

    2013-11-01

    The schizophrenics are frequently disinterested and resistant to standard care. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original "Synallactic collective image technique" (Vassiliou G, Vassiliou V.). The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) scales on admission with minimal improvement at discharge was rated. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  14. Preclinical assessment of adjunctive tPA and DNase for peritoneal dialysis associated peritonitis.

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    Amanda L McGuire

    Full Text Available A major complication of peritoneal dialysis is the development of peritonitis, which is associated with reduced technique and patient survival. The inflammatory response elicited by infection results in a fibrin and debris-rich environment within the peritoneal cavity, which may reduce the effectiveness of antimicrobial agents and predispose to recurrence or relapse of infection. Strategies to enhance responses to antimicrobial agents therefore have the potential to improve patient outcomes. This study presents pre-clinical data describing the compatibility of tPA and DNase in combination with antimicrobial agents used for the treatment of PD peritonitis. tPA and DNase were stable in standard dialysate solution and in the presence of antimicrobial agents, and were safe when given intraperitoneally in a mouse model with no evidence of local or systemic toxicity. Adjunctive tPA and DNase may have a role in the management of patients presenting with PD peritonitis.

  15. Sentinel node biopsy as an adjunct to limb salvage surgery for epithelioid sarcoma of the hand

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    Hammond Alex

    2005-06-01

    Full Text Available Abstract Background Epithelioid sarcomas of the hand are rare, high-grade tumors with a propensity for regional lymphatic spread approaching 40%. Case presentation A 54-year-old male with an epithelioid sarcoma of the palm was treated with neoadjuvant radiation, wide excision, and two-stage reconstruction. Sentinel lymph node biopsy was used to stage the patient's axilla. Sentinel node biopsy results were negative. The patient has remained free of local, regional and distant disease for the follow-up time of 16 months. Conclusion The rarity of this tumor makes definitive conclusions difficult but SLN biopsy appears to be a useful adjunct in the treatment of these sarcomas.

  16. Hypnotherapy: A useful adjunctive therapeutic modality in hansen′s disease

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    E N Abdul Latheef

    2014-01-01

    Full Text Available Hypnotherapy is a useful adjunctive psychotherapeutic procedure used in various conditions such as pain disorders, atopic dermatitis, and alopecia areata. However, it is less utilized in the field of dermatology. Only limited data exist on its role in the management of various skin diseases. There is dearth of literature on the role of hypnotherapy in Hansen′s disease (HD. We report two cases of HD, one with very resistant neuralgia and the other with recurrent erythema nodosum leprosum (ENL. Both the patients were assessed using hospital anxiety and depression scale, dermatology life quality index and the neuralgia was assessed using the visual analog scale. Three sessions of hypnotherapy were given to both the patients. There was dramatic improvement in the incidence of ENL and neuralgia and we could rapidly reduce the dose of drugs used for both conditions.

  17. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital

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    Mandić-Gajić Gordana

    2013-01-01

    Full Text Available Introduction. The schizophrenics are frequently disinterested and resistant to standard care. Case report. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original “Synallactic collective image technique” (Vassiliou G, Vassiliou V.. The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI and Global Assessment of Functioning (GAF scales on admission with minimal improvement at discharge was rated. Conclusion. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  18. Silver-containing Hydrofiber Dressing is an Effective Adjunct in the Treatment of Pemphigus Vulgaris

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    Chieh-Shan Wu

    2009-11-01

    Full Text Available Pemphigus vulgaris is a life-threatening autoimmune bullous dermatosis and its management represents a major challenge to medical teams. The primary treatments for pemphigus vulgaris are oral steroids and immunosuppressants, but topical approaches also play a role in disease management. Here, we report a patient with pemphigus vulgaris involving 62% of the total body surface area, with initial poor clinical response to systemic steroids and topical silver sulfadiazine therapy. However, a marked improvement in wound healing and decreased patient discomfort were observed after application of silver-containing hydrofiber dressings (Aquacel-Ag®. Therefore, silver-containing hydrofiber dressings may offer an effective adjunct in the treatment of patients with pemphigus vulgaris with extensive skin involvement. Our encouraging experience with these dressing patches may be extended to manage other large exudation wounds.

  19. Effect of adjunctive perampanel on the quality of sleep and daytime somnolence in patients with epilepsy

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    Montserrat González-Cuevas

    2017-01-01

    Full Text Available This prospective uncontrolled study evaluated the effect of low-dose adjunctive perampanel therapy (4 mg/day for 3 months on the sleep-wake cycle and daytime somnolence in adult patients (n = 10 with focal seizures. A >50% reduction in the number of seizures was reported in 80% of the study patients; treatment had no significant effect on any sleep parameters as evident by the Maintenance of Wakefulness Test, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale scores. Two patients reported dizziness with treatment. In conclusion, low-dose perampanel may improve seizure control without affecting the sleep characteristics or daytime somnolence in patients with epilepsy.

  20. Case report of adjunctive use of olanzapine with an antidepressant to treat sleep paralysis.

    Science.gov (United States)

    Duan, Jingfeng; Huang, Wanli; Zhou, Mincong; Li, Xujuan; Cai, Wei

    2013-10-01

    Sleep paralysis (SP) is a condition of unknown etiology that usually occurs when falling asleep or when awakening in which the individual remains conscious but is unable to control their voluntary movements. This case report is about a 68-year-old man with a 40-year history of symptoms of SP and associated panic attacks upon awakening. Neurological examination and neuroimaging identified no abnormalities. Five years before the current evaluation he had been diagnosed with depression and treated with various anti-depressants which ameliorated, but did not cure, his SP. However, this 40-year history of SP was abruptly terminated - and did not return over the subsequent two years - after adjunctive treatment with 2.5 mg olanzapine each night was added to his antidepressant.

  1. Latex particle agglutination test as an adjunct to the diagnosis of bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Surinder K

    2007-01-01

    Full Text Available The present study aimed to review the results of microscopic examination, routine culture and antigen detection by latex particle agglutination test (LPAT, in order to evaluate the diagnostic value of the LPAT in establishing the aetiological diagnosis of bacterial meningitis. LPAT was done in 65 clinically suspected meningitis cases ranging from 5 days to 60 years of age and was compared with culture and Gram stain. Using LPAT, an aetiological diagnosis could be done in 10 out of 65 (15.4% cases of bacterial meningitis. In contrast, Gram stain and culture showed 16.9 and 23.1% positivity, respectively. LPAT correlated well with Gram stain and culture and can be recommended as an adjunct laboratory test for rapid aetiological diagnosis of bacterial meningitis for prompt institution of proper antibiotics.

  2. Adjunctive drug therapies for treatment of respiratory diseases in the newborn: based on evidence or habit?

    Science.gov (United States)

    Sinha, Sunil; Tin, Win

    2014-04-01

    Respiratory distress syndrome is a disease of prematurity and is caused by a relative deficiency of endogenous surfactant production. Respiratory distress syndrome is the most common cause of mortality and morbidity in the newborn population and the standard of care is to provide exogenous surfactant therapy. This saves lives and reduces respiratory complications but, despite treatment, a significant proportion of these infants go onto develop chronic lung disease, the severest form of which is bronchopulmonary dysplasia. Once developed, this is a multisystem disease and treatment is mostly supportive by using various therapeutic adjuncts. Some of these have been proven to be safe and effective in large randomized, controlled trials but similar evidence for other drugs is lacking. The aim of this paper is to provide an overview and critically appraise the available scientific evidence for or against their use in routine practice.

  3. Study protocol to investigate the effects of testosterone therapy as an adjunct to exercise rehabilitation in hypogonadal males with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Mathur Atish

    2006-11-01

    Full Text Available Abstract Background Testosterone deficiency is a common occurrence in men with chronic heart failure (CHF and may underpin features of advanced disease, including reduced skeletal muscle mass and fatigue. It is positively correlated with cardiac output and exercise capacity in patients with CHF, whereas a significant improvement in both these parameters has been observed following testosterone replacement therapy. Testosterone therapy has also been shown to reduce circulating levels of inflammatory markers, (TNF-α, sICAM-1 and sVCAM-1 in patients with established coronary artery disease and testosterone deficiency. This pilot study will assess the feasibility of a combined exercise rehabilitation and adjunctive testosterone therapy intervention for evoking improvements in exercise capacity, circulating inflammatory markers, cardiac and skeletal muscle function, indices of psychological health status and quality of life in hypogonadal males with chronic heart failure. Methods/design Following ethical approval, 36 patients will be randomly allocated to one of two groups: testosterone or placebo therapy during exercise rehabilitation. A combined programme of moderate intensity aerobic exercise and resistance (strength training will be used. The primary outcome measure is exercise capacity, assessed using an incremental shuttle walk test. Secondary outcome measures include measures of peak oxygen uptake, cardiac function, lower-limb skeletal muscle contractile function and oxygenation during exercise, circulating inflammatory markers, psychological health status and quality of life. Discussion Exercise rehabilitation can safely increase exercise capacity in stable CHF patients but there is a need for studies which are aimed at evaluating the long-term effects of physical training on functional status, morbidity and mortality. This pilot study will provide valuable preliminary data on the efficacy of testosterone therapy as an adjunct to exercise

  4. Molecular characterization of Salmonella enterica serotype Enteritidis isolates from food and human samples by serotyping, antimicrobial resistance, plasmid profiling, (GTG5-PCR and ERIC-PCR

    Directory of Open Access Journals (Sweden)

    F. Fardsanei

    2016-11-01

    Full Text Available In recent years, Salmonella enterica serovar Enteritidis has been a primary cause of human salmonellosis in many countries. The major objective of this study was to investigate genetic diversity among Salmonella Enteritidis strains from different origins (food and human by Enterobacterial Repetitive Intergenic Consensus (ERIC -PCR, as well as to assess their plasmid profiling and antimicrobial resistance. A total of 30 Salmonella Enteritidis isolates, 15 from food samples (chicken, lamb, beef and duck meats and 15 from clinical samples were collected in Tehran. Identification of isolates as Salmonella was confirmed by using conventional standard biochemical and serological tests. Multiplex-PCR was used for serotyping of isolates to identify Salmonella Enteritidis. Antimicrobial susceptibility testing to 16 agents founds drug resistance patterns among Salmonella Enteritidis isolates. No resistance was observed to cephalexin, ceftriaxone, ceftazidime and cefotaxime, ciprofloxacin, imipenem or meropenem, chloramphenicol and gentamicin. The highest resistance (96.7% was observed to nitrofurantoin. Seven plasmid profiles (P1–P7 were detected, and a 68-kb plasmid was found in all isolates. Two different primers; ERIC and (GTG5 were used for genotyping, which each produced four profiles. The majority of clinical and food isolates fell into two separate common types (CTs with a similar percentage of 95% by ERIC-PCR. Using primer (GTG5, 29 isolates incorporated in three CTs with 70% of isolates showing a single banding pattern. Limited genetic diversity among human and food isolates of Salmonella Enteritidis may indicate that contaminated foods were possibly the source of human salmonellosis. These results confirmed that ERIC-PCR genotyping has limited discriminatory power for Salmonella Enteritidis of different origin.

  5. ERIC-PCR fingerprinting-based community DNA hybridization to pinpoint genome-specific fragments as molecular markers to identify and track populations common to healthy human guts.

    Science.gov (United States)

    Wei, Guifang; Pan, Li; Du, Huimin; Chen, Junyi; Zhao, Liping

    2004-10-01

    Bacterial populations common to healthy human guts may play important roles in human health. A new strategy for discovering genomic sequences as markers for these bacteria was developed using Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting. Structural features within microbial communities are compared with ERIC-PCR followed by DNA hybridization to identify genomic fragments shared by samples from healthy human individuals. ERIC-PCR profiles of fecal samples from 12 diseased or healthy human and piglet subjects demonstrated stable, unique banding patterns for each individual tested. Sequence homology of DNA fragments in bands of identical size was examined between samples by hybridization under high stringency conditions with DIG-labeled ERIC-PCR products derived from the fecal sample of one healthy child. Comparative analysis of the hybridization profiles with the original agarose fingerprints identified three predominant bands as signatures for populations associated with healthy human guts with sizes of 500, 800 and 1000 bp. Clone library profiling of the three bands produced 17 genome fragments, three of which showed high similarity only with regions of the Bacteroides thetaiotaomicron genome, while the remainder were orphan sequences. Association of these sequences with healthy guts was validated by sequence-selective PCR experiments, which showed that a single fragment was present in all 32 healthy humans and 13 healthy piglets tested. Two fragments were present in the healthy human group and in 18 children with non-infectious diarrhea but not in eight children with infectious diarrhea. Genome fragments identified with this novel strategy may be used as genome-specific markers for dynamic monitoring and sequence-guided isolation of functionally important bacterial populations in complex communities such as human gut microflora.

  6. Psychiatric and cognitive adverse events: A pooled analysis of three phase III trials of adjunctive eslicarbazepine acetate for partial-onset seizures.

    Science.gov (United States)

    Andermann, Eva; Biton, Victor; Benbadis, Selim R; Shneker, Bassel; Shah, Aashit K; Carreño, Mar; Trinka, Eugen; Ben-Menachem, Elinor; Biraben, Arnaud; Rocha, Francisco; Gama, Helena; Cheng, Hailong; Blum, David

    2018-03-28

    To evaluate the nature and incidence of psychiatric and cognitive adverse events (AEs) reported with eslicarbazepine acetate (ESL) used as adjunctive treatment for refractory partial-onset seizures (POS) in adults. This was a post-hoc analysis of data pooled from three randomized double-blind, placebo-controlled trials (BIA-2093-301, -302, -304). After an 8-week baseline period, patients received placebo or adjunctive ESL 400mg (studies 301 and 302 only), 800mg, or 1200mg once daily (QD) for 14weeks (2-week titration period, 12-week maintenance period). Psychiatric and cognitive AEs were identified from individual patient data. Suicidality was also evaluated using the Columbia-Classification Algorithm of Suicide Assessment (C-CASA), or the Columbia-Suicide Severity Rating Scale (C-SSRS). P-values were obtained using the chi-square test of independence or Fisher's exact test, without correcting for multiplicity. The analysis population included 1447 patients (ESL, n=1021; placebo, n = 426). Psychiatric treatment-emergent AEs (TEAEs) occurred in 10.8% of patients receiving ESL, and in a comparable proportion (10.3%) of patients receiving placebo (p=0.802). The incidence of depression and suicidality-related TEAEs was higher for ESL (7.4%) vs. placebo (3.8%) (p=0.009). The occurrence of these TEAEs differed between treatment groups (p = 0.010), but there was no notable trend between increasing ESL dose and increasing incidence of depression and suicidality-related TEAEs. Aggression/hostility-related TEAEs occurred in ESL vs. 0.9% taking placebo. The incidence of cognitive TEAEs was higher for ESL (7.1%) vs. placebo (4.0%) (p=0.023); incidences of memory impairment, attention disturbance, apathy, and aphasia were higher for ESL 1200mg than for other treatment groups. Incidences of psychiatric and cognitive serious AEs were (0.6% and 0.2% with ESL, and 0.5% and 0% with placebo, respectively. Psychiatric and cognitive TEAEs leading to discontinuation occurred in 1.9% and

  7. Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.

    Science.gov (United States)

    Cieplik, Fabian; Buchalla, Wolfgang; Hellwig, Elmar; Al-Ahmad, Ali; Hiller, Karl-Anton; Maisch, Tim; Karygianni, Lamprini

    2017-06-01

    For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Traditional Chinese medicine as adjunctive therapy improves the long-term survival of lung cancer patients.

    Science.gov (United States)

    Liao, Yueh-Hsiang; Li, Chia-Ing; Lin, Cheng-Chieh; Lin, Jaung-Geng; Chiang, Jen-Huai; Li, Tsai-Chung

    2017-12-01

    Traditional Chinese medicine is one of the popular alternative treatments for cancer, mainly enhancing host immune response and reducing adverse effect of chemotherapy. This study first explored traditional Chinese medicine treatment effect on long-term survival of lung cancer patients. This study evaluated whether traditional Chinese medicine combined with conventional cancer treatment improved overall survival of lung cancer patients. We had conducted a retrospective cohort study on 111,564 newly diagnosed lung cancer patients in 2000-2009 from National Health Insurance Program database. A total of 23,803 (21.31%) patients used traditional Chinese medicine for lung cancer care. Eligible participants were followed up until 2011 with a mean follow-up period of 1.96 years (standard deviation 2.55) for non-TCM users and 3.04 years (2.85) for traditional Chinese medicine users. Patients with traditional Chinese medicine utilization were significantly more likely to have a 32% decreased risk of death [hazard ratio = 0.62; 95% confidence interval = 0.61-0.63], compared with patients without traditional Chinese medicine utilization after multivariate adjustment. We also observed a similar significant reduction risk across various subgroups of chronic lung diseases. Qing Zao Jiu Fei Tang was the most effective traditional Chinese medicine agent for mortality reduction both in the entire lung cancer (0.81; 0.72-0.91) and matched populations (0.86; 0.78-0.95). This study demonstrated adjunctive therapy with traditional Chinese medicine may improve overall survival of lung cancer patients. This study also suggested traditional Chinese medicine may be used as an adjunctive therapy for cancer treatment. These observational findings need being validated by future randomized controlled trials to rule out the possibility of effect due to holistic care.

  9. Inhibition of DAMP signaling as an effective adjunctive treatment strategy in pneumococcal meningitis.

    Science.gov (United States)

    Masouris, Ilias; Klein, Matthias; Dyckhoff, Susanne; Angele, Barbara; Pfister, H W; Koedel, Uwe

    2017-11-02

    Pneumococcal meningitis remains a potentially lethal and debilitating disease, mainly due to brain damage from sustained inflammation. The release of danger-associated molecular patterns (DAMPs), like myeloid-related protein 14 (MRP14) and high mobility group box 1 protein (HMGB1), plays a major role in persistence of inflammation. In this study, we evaluated if paquinimod, an MRP14-inhibitor, and an anti-HMGB1 antibody can improve clinical outcome as adjunctive therapeutics in pneumococcal meningitis. We tested the adjuvant administration of paquinimod and the anti-HMGB1 antibody in our pneumococcal meningitis mouse model assessing clinical (clinical score, open-field-test, temperature) and pathophysiological parameters (intracranial pressure, white blood cell count in CSF, bleeding area) as well as bacterial titers in blood and brain 24 h after administration and 48 h after infection. Furthermore, we explored the interactions of these two agents with dexamethasone, the standard adjuvant treatment in pneumococcal meningitis (PM), and daptomycin, a non-bacteriolytic antibiotic preventing pathogen-associated molecular pattern (PAMP) release. Adjunctive inhibition of MRP14 or HMGB1 reduced mortality in mice with PM. This effect was lost when the two anti-DAMP agents were given simultaneously, possibly due to excessive immunosuppression. Combining anti-PAMP (daptomycin) and anti-DAMP treatments did not produce synergistic results; instead, the anti-DAMP treatment alone was sufficient and superior. The combination of anti-HMGB1 with dexamethasone did not diminish the effect of the former. DAMP inhibition possesses good potential as an adjuvant treatment approach in PM, as it improves clinical outcome and can be given together with the standard adjuvant dexamethasone without drug effect loss in experimental PM.

  10. Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis

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    P K Debnath

    2012-01-01

    Full Text Available Background: Pulmonary tuberculosis (PTB is an age old disease described in Vedic Medicine as ′Yakshma′. Later on, in Ayurveda it earned a prefix and found way into mythology as ′Rajayakshma′. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947. Objectives: To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs. Materials and Methods: In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment. Results: The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded. Conclusion: This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

  11. Evaluation of the efficacy and safety of topiramate as adjunctive drug in the treatment of refractory partial seizures with Meta-analysis

    Directory of Open Access Journals (Sweden)

    Dai LI

    2014-12-01

    Full Text Available Background Epilepsy is a chronic neurological condition characterized by paroxysm of seizures due to abnormal electrical discharge from central nervous system neurons. Several new antiepileptic drugs (AEDs were listed over the past two decades, and they were believed to be equally effective and have better tolerability and side effect profiles. This paper aims to evaluate the efficacy and safety of adjunctive topiramate in refractory partial seizures.  Methods Relevant research articles about randomized controlled trials of adjunctive topiramate in refractory partial seizures, with topiramate, Topamax, add-on treatment, adjunctive treatment, add-on therapy, adjunctive therapy, refractory partial seizure, refractory partial epilepsy both in Chinese and English as retrieval words, were retrieved from PubMed (1995-2014, Cochrane Central Register of Controlled Trials (CENTRAL, 1995-2014, The Cochrane Database of Systematic Reviews (CDSR, 1995-2014, China National Knowledge Infrastructure (CNKI, 1995-2014 and Wanfang Data (1999-2014. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted using RevMan 5.0 software.  Results According to the enrollment criteria, 13 prospective, randomized controlled clinical trials with a total of 1622 patients were finally selected. The proportions of patients with reduction in seizure frequency ≥ 50% (OR = 3.710, 95% CI: 2.870-4.810; P = 0.000, ≥ 75% (OR = 7.220, 95% CI: 3.310-15.750; P = 0.000 and seizure free (OR = 3.380, 95%CI: 1.720-6.640; P = 0.000 in topiramate group were significantly higher than that in control group. The treatment withdrawal ratio was significantly higher compared to placebo in 600 mg/d and 800 mg/d subgroups, but not in 200 mg/d subgroup (200 mg/d: OR = 2.170, 95%CI: 0.470-9.950, P = 0.320; 600 mg/d: OR = 2.090, 95%CI: 1.020-4.270, P = 0.040; 800 mg/d: OR = 8.000, 95%CI: 1.390-46.140, P = 0.020. The common

  12. Evaluation of the efficacy of adjunctive lamotrigine in the treatment of epilepsy and depression with Meta-analysis

    Directory of Open Access Journals (Sweden)

    Juan CAO

    2016-01-01

    Full Text Available Objective To evaluate the efficacy of adjunctive lamotrigine in the treatment of patients with epilepsy and comorbid depressive symptoms. Methods Relevant clinical trials were searched via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL, China National Knowledge Infrastructure (CNKI and Wanfang Data from January 1998 to June 2014 using the following retrieval words: lamotrigine, epilepsy and depressive both in Chinese and English. The Cochrane Handbook for Systematic Reviews of Interventions (Version 5.0.2 was used to evaluate the quality of randomized controlled trials (RCTs. Two reviewers independently evaluated the quality of included articles and abstracted the data. Meta-analysis was conducted using RevMan 5.1.1 software. Results According to the inclusion criteria, 3 prospective clinical trials with a total of 668 patients were finally selected. The Meta-analysis showed the Beck Depression Inventory-Ⅱ (BDI-Ⅱ score (MD = - 8.400, 95%CI: - 10.890— - 5.920; P = 0.000, Cornell Dysthymia Rating Scale (CDRS score (MD = - 8.240, 95% CI: - 11.180— - 5.290; P = 0.000 and Profile of Mood States (POMS score (MD = - 24.210, 95%CI: - 30.740— - 17.680; P = 0.000 in lamotrigine group were significantly improved compared to those in control group. As for 6 mood states in POMS, the scores of tension-anxiety (MD = - 3.360, 95%CI: - 4.620— - 2.100; P = 0.000, depression-dejection (MD = - 5.490, 95%CI: - 7.420— - 3.560; P = 0.000, anger-hostility (MD = - 3.870, 95%CI: - 5.510— - 2.230; P = 0.000, fatigue-inertia (MD = - 4.480, 95%CI: - 5.630— - 3.320; P = 0.000, confusion-bewilderment (MD = - 2.720, 95%CI: - 3.730— - 1.720; P = 0.000 in lamotrigine group were all significantly lower than those in control group, while the score of vigor-activity (MD = 3.970, 95% CI: 2.870-5.070; P = 0.000 was significantly higher than that in control group. Conclusions The effect of adjunctive lamotrigine in the

  13. Statistical analysis plan for the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial

    DEFF Research Database (Denmark)

    Billot, Laurent; Venkatesh, Balasubramanian; Myburgh, John

    2017-01-01

    BACKGROUND: The Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial, a 3800-patient, multicentre, randomised controlled trial, will be the largest study to date of corticosteroid therapy in patients with septic shock. OBJECTIVE: To describe a statistic...

  14. Love, Honor, and "Light Bulbs": Investigating Adjunct Faculty Identity and Preparation for Online Teaching at a Southeastern Research University

    Science.gov (United States)

    Yates, Steven D.

    2017-01-01

    The increasing number of adjunct, part-time instructors in higher education continues to be discussed in the literature and trade publications. The increased adoption of online degree programs in higher education institutions across the United States has contributed to the enhanced need for flexible faculty employment options. This study provided…

  15. Theoretical role of adjunctive implant positional support in stress distribution of distal-extension mandibular removable partial dentures.

    Science.gov (United States)

    Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Wang, Yining; Wang, Jiawei

    2014-01-01

    This preliminary study evaluated the adjunctive supporting role of diverse implant positions on stress distribution in a Class I removable partial denture (RPD) design. Nine three-dimensional finite element models were prepared to simulate mandibular RPD designs with three different loading conditions applied. Implant supported designs demonstrated lower stress value concentrations and mucosal displacement.

  16. Prediction of Job Satisfaction Based on Workplace Facets for Adjunct Business Faculty at Four-Year Universities

    Science.gov (United States)

    Lewis, Vance Johnson

    2012-01-01

    The purpose of this study was to examine the job satisfaction of adjuncts in the curriculum area of business at four-year universities and to determine the roles that individual job facets play in creating overall job satisfaction. To explore which job facets and demographics predict job satisfaction for the population, participants were asked to…

  17. REAL TIME PCR IDENTIFICATION FOR TARGET ADJUNCTIVE ANTIBIOTIC THERAPY OF SEVERE CHRONIC PERIODONTITIS. PART I - CLINICAL RESULTS.

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2014-10-01

    Full Text Available INTRODUCTION: The periodontal pathology is of great social importance due to the vast distribution in the human population. The adjunctive antibiotic administration could improve the healing in such cases but the latest data of the continuingly growing antibiotic resistance requires more precise approaches of antibiotic selection. The contemporary molecular diagnostic methods could offer the required precision for the microbiological identification in order to achieve better control of the periodontitis. OBJECTIVE: The aim of this study is to compare the microbiological effectiveness of adjunctive antibiotic administration with the mechanical periodontal therapy. METHODS: 30 patients with severe chronic periodontitis were enrolled in this study and were divided in 3 groups: Control group – with mechanical debridement only. Test group 1 – with combined adjunctive antibiotic administration using Amoxicillin+ Metronidazole. Test group 2 – with target antibiotic administration according to the resuts from the Real Time PCR identification. RESULTS: A considerable improvement of the periodontal status was reported in all treatment groups. The most positive results were in the group with target antibiotic administration were all tested clinical parameters showed the best improvement with statistically significant changes in sites with PD7mm and CAL>5mm. CONCLUSION: The adjunctive antibiotic administration demonstrates better clinical effectiveness concerning the reduction of the severely affected sites in cases with severe generalized chronic periodontitis compared to the mechanical therapy alone. From all examined groups the target approach has statistically significant better results. These results suggest that this approach is recommended in cases with high prevalence of deep pockets.

  18. Oily calcium hydroxide suspension (Osteoinductal) used as an adjunct to guided bone regeneration: an experimental study in rats.

    NARCIS (Netherlands)

    Stavropoulos, A.; Geenen, C.; Nyengaard, J.R.; Karring, T.; Sculean, A.

    2007-01-01

    OBJECTIVES: To evaluate whether an oily calcium hydroxide suspension (OCHS) promotes bone healing when used as an adjunct to guided bone regeneration (GBR). MATERIAL AND METHODS: Rigid, hemispherical, teflon capsules were placed with their open part facing the lateral surface of the ramus on both

  19. The role of ziprasidone in adjunctive use with lithium or valproate in maintenance treatment of bipolar disorder.

    Science.gov (United States)

    Bowden, Charles L

    2011-01-01

    This article addresses the clinical role for ziprasidone used adjunctively with a mood stabilizer in maintenance treatment of bipolar disorder. This review also addresses the strengths and limitations of design features in adjunctive studies of second-generation antipsychotic drugs added to mood stabilizers. The principal study relevant to this review enrolled subjects who were ≥18 years of age, experiencing a recent or current manic or mixed bipolar I episode, with at least moderately severe current manic symptoms. To meet criteria for randomization to 6 months maintenance treatment, patients had to have failed a short course of treatment with either lithium or valproate and achieved benefit with added ziprasidone for 8 consecutive weeks. Time to intervention for a new mood episode as well as time to discontinuation for any reason was significantly longer with adjunctive ziprasidone treatment than with monotherapy treatment with mood stabilizer. Three dosages of ziprasidone augmentation were studied. Patients treated with 120 mg/day had better efficacy and overall outcomes than did patients who received 80 or 160 mg/day of ziprasidone. Good evidence exists that adjunctive ziprasidone will likely provide greater overall efficacy coupled with good tolerability for at least a 6-month period than a strategy of continued monotherapy with a mood stabilizer. Changes in open phases of maintenance studies to reduce study enrichment, in study endpoints, and in statistical approaches to analysis of data are warranted.

  20. Mechanical evaluation of adjunctive fixation for prevention of periprosthetic femur fracture with the Zurich cementless total hip prosthesis.

    Science.gov (United States)

    Pozzi, Antonio; Peck, Jeffrey N; Chao, Peini; Choate, Christina J; Barousse, Dan; Conrad, Bryan

    2013-06-01

    To evaluate whether cerclage wire or a lateral plate increases the peak-torque load to failure, compared to femora without adjunctive fixation, in femora implanted with Zurich Cementless stems. In vitro biomechanical study. Paired femora from adult dogs (n = 24) weighing 28-35 kg. Pairs of femora were implanted with a stem and randomly assigned to 2 treatment groups: cerclage or plate. Within each pair, either 3 loop cerclage wires or a laterally applied 12-hole Advanced Locking Plate System 10-mm plate (ALPS 10) were implanted in a femur, whereas the contralateral femur acted as control with no adjunctive fixation. After application of a static axial load each specimen was loaded to failure in torsion. Peak torque load at failure was compared between femora with each adjunctive fixation and the control using a paired t-test; P plated group (P plates and with cerclage were 13.9% and 7.2% stronger in torsion than the femora without fixation, respectively. Adjunctive fixation with a laterally applied ALPS 10 may aid in the prevention of peri-prosthetic fractures associated with Zurich Cementless medium stems. © Copyright 2013 by The American College of Veterinary Surgeons.

  1. Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

    Science.gov (United States)

    Waltz, Thomas J; Powell, Byron J; Matthieu, Monica M; Damschroder, Laura J; Chinman, Matthew J; Smith, Jeffrey L; Proctor, Enola K; Kirchner, JoAnn E

    2015-08-07

    Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy's relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.

  2. Genotypic Characterization of Yersinia enterocolitica Biotype 4/O:3 Isolates from Pigs and Slaughterhouses Using SE-AFLP, ERIC-PCR, and PFGE

    Directory of Open Access Journals (Sweden)

    Renata Paixão

    2013-01-01

    Full Text Available Yersinia enterocolitica is a foodborne pathogen that causes illness in humans and animals. The biotype 4/O:3 has been commonly associated with yersiniosis and is characterized by the presence of chromosomal and extra-chromosomal virulence genes. Molecular typing methods have been successfully used to characterize Y. enterocolitica genetic heterogeneity and to study the epidemiology of the bacteria from different origins. In this study, 320 Y. enterocolitica biotype 4/O:3 isolates originating in pigs and slaughterhouses were characterized according to the virulence profile, and 61 isolates were typified through SE-AFLP, ERIC-PCR, and PFGE techniques. The majority of the isolates originated from pigs, and the predominant virulence profile was ail+ virF+ rfbC+ ystA+, representing 83.4% of the tested isolates. All of the Y. enterocolitica 4/O:3 isolates were positive for at least ystA gene. The SE-AFLP and ERIC-PCR patterns were highly homogeneous. The SE-AFLP was more discriminative than the ERIC-PCR and tended to cluster isolates according to the slaughterhouse. Despite the limited genetic diversity of Y. enterocolitica 4/O:3, PFGE was shown to be the most discriminative technique considering one band of difference. Fattening pigs proved to be an important reservoir of Y. enterocolitica biotype 4/O:3 carrying virulence genes.

  3. Genotipificación de aislamientos de Bartonella bacilliformis por amplificación de elementos repetitivos mediante el uso de REP-PCR y ERIC-PCR

    Directory of Open Access Journals (Sweden)

    Carlos Padilla R

    2003-07-01

    Full Text Available Objetivos: Genotipificar los aislamientos de Bartonella bacilliformis a través de la amplificación de elementos repetitivos mediante el uso de ERIC-PCR y REP-PCR, y determinar si existe variabilidad genética entre aislamientos de varias zonas endémicas. Materiales y Métodos: Se evaluaron mediante el uso del ERIC-PCR y REP-PCR 17 aislamientos de B. bacilliformis de Lima, Cusco y Ancash. Los aislamientos fueron realizados durante los años 1998 y 1999. Para el análisis de los patrones de bandas se usó el software GelCompar 4,0. Resultados: Fueron identificados en los 17 aislamientos 10 genotipos. Los genotipos D, E y H fueron detectados en Cusco; mientras que los genotipos B, C, G, J e I en Lima; y el genotipo F en Ancash. Conclusiones: Nuestros resultados sugieren que REP-PCR y ERIC-PCR son métodos útiles para genotipificar aislamientos de B. bacilliformis. La variabilidad genética debe ser tomada en cuenta en estudios epidemiológicos y clínicos de Bartonelosis; así como el desarrollo de nuevas técnicas diagnósticas y de vacunas.

  4. Zinc as an adjunct to the treatment of severe pneumonia in Ecuadorian children: a randomized controlled trial.

    Science.gov (United States)

    Sempértegui, Fernando; Estrella, Bertha; Rodríguez, Oswaldo; Gómez, Dinor; Cabezas, Myryam; Salgado, Gilda; Sabin, Lora L; Hamer, Davidson H

    2014-03-01

    Studies of zinc as an adjunct to treatment of severe pneumonia in children have shown mixed results, possibly because of poor information on zinc status and respiratory pathogens. We evaluated the effect of zinc given with standard antimicrobial treatment on the duration of respiratory signs in children with severe pneumonia. Zinc status and pathogens were assessed. Children aged 2-59 mo with severe pneumonia who were admitted to the main children's hospital in Quito, Ecuador, were given standard antibiotics and randomly allocated to receive zinc supplements twice daily or a placebo. Measurements included anthropometric variables, breastfeeding, hemoglobin, plasma zinc, and common bacteria/viral respiratory pathogens. The primary outcome was time to resolution of respiratory signs. The secondary outcome was treatment failure. We enrolled 225 children in each group. There was no difference between groups in time to resolution of respiratory signs or treatment failure; pathogens were not associated with outcomes. Tachypnea and hypoxemia resolved faster in older children (P = 0.0001) than in younger ones. Higher basal zinc concentration (P = 0.011) and better height-for-age z score (HAZ) (P = 0.044) were associated with faster resolution of chest indrawing. Better weight-for-height z score (WHZ) (P = 0.031) and HAZ (P = 0.048) were associated with faster resolution of tachypnea. Increased C-reactive protein was associated with a longer duration of tachypnea (P = 0.044). Zinc did not affect time to pneumonia resolution or treatment failure, nor did type of respiratory pathogens affect outcomes. Higher basal zinc and better HAZ and WHZ were associated with reduced time to resolution of respiratory signs. These results suggest the need for prevention of chronic zinc deficiency and improvement of general nutritional status among Ecuadorian children.

  5. Use of abdominal binder as anti-shock garment; an adjunct to uterine tamponade in uterine atony

    International Nuclear Information System (INIS)

    Kallue, U.R.; Chughtai, F.; Chaudry, A.; Shamin, Z.

    2017-01-01

    Objective: Aim of the study was to control life threatening post partum haemorrhage (PPH) in women till blood and blood products were made available or the women transferred to a better equipped centre. Study Design: A prospective interventional consecutive case series. Place and Duration of Study: It was conducted in three hospitals; Heavy Industries Taxila (HIT) hospital Apr 2005 to Sep 2010, Pakistan Ordinance Factories (POF) hospital Wah cantt Oct 2011 to Dec 2014 and Combined Military Hospital (CMH) Tarbela Dec 2014 to Dec 2015. Material and Methods: Abdominal binder was used in 22 consecutive women, having moderate to severe primary PPH due to uterine atony, where despite uterotonics (i.v oxytocin, rectal misoprostol) and bimanual compression, uterine tamponade was performed but complete control of haemorrhage was not achieved. Protocols for the treatment of obstetric haemorrhage and hypotensive shock were observed, including administration of intravenous crystalloid fluids and blood transfusion. If required, surgery was performed in the form of uterine arteries ligation or B-Lynch sutures. Obstetric hysterectomy was performed to save the woman's life if conservative procedures failed. Results: Bleeding and hypotension were controlled successfully in 19 (86.4%) of these women. In 03 (14.6%) women, bleeding persisted and so hysterectomy had to be resorted to. There was no maternal mortality. At 06 weeks postnatal follow up, none of the patients were found to suffer from long term debility; physical or psychological. Conclusion: Abdominal binder was found to be very effective in controlling bleeding and hypotensive crisis due to significant PPH due to uterine atony, as an adjunct to uterine tamponade. (author)

  6. Using A Facebook Group As An Adjunct To A Pilot mHealth Physical Activity Intervention: A Mixed Methods Approach.

    Science.gov (United States)

    Pumper, Megan A; Mendoza, Jason A; Arseniev-Koehler, Alina; Holm, Matthew; Waite, Alan; Moreno, Megan A

    2015-01-01

    In the United States, most adolescents do not obtain the recommended amounts of physical activity for optimal health. Around 80% of adolescents own a mobile device, and social media is frequently used by adolescents on mobile devices. Few studies have examined the use of social media as part of an intervention to promote physical activity. The purpose of this study was to evaluate the use of a Facebook group as part of a mHealth physical activity intervention trial. Adolescents, ages 14-18 years, were recruited for a four week physical activity intervention using the FitBit Flex. Participants were also given the option to join a private Facebook group where they could interact and were given badges for fitness accomplishments. The research assistant moderator posted on the Facebook group an average of 25.3 times (SD=7.2). Post-intervention, participants completed a phone interview about their experience. Of 30 intervention participants (avg age 16.0 (SD=1.1), 60.0% female), 17 opted to join the Facebook group (avg age 16.3 (SD=1.2), 47.0% female) of which 10 completed a qualitative interview. Participants averaged 4.9 interactions (SD=8.7) on the Facebook group wall throughout the intervention. From the interview responses, major themes included enjoying the badge feature of the Facebook group and wanting more content and interaction. In conclusion, participants used and enjoyed having the Facebook group, particularly the badge feature of the group, as an adjunct to the physical activity intervention.

  7. Anterior greater trochanteric muscle pedicle bone grafting: a viable graft option adjunct to hip osteotomy or fracture surgery.

    Science.gov (United States)

    Limpaphayom, Noppachart; Osateerakun, Phatcharapa; Wilairatana, Vajara; Prasongchin, Pairatch

    2017-05-12

    The objectives were to evaluate a technique, outcome and complications following anterior greater trochanteric with gluteus medius muscle pedicle bone graft (AMG) procedure in the treatment of adolescent and active adult hip disorders. 20 patients (20 hips) with a mean age of 22.7 ± 15.6 (range 10.0-63.5) years who had undergone AMG and been followed up more than 12 months postoperative were retrospectively enrolled in our study. The AMG procedure was performed in conjunction with subcapital osteotomy for slipped capital femoral epiphysis in 12 and open reduction for fracture/dislocation in 8 hips. At the most recent evaluation, patient functional status was rated by the Harris Hip Score (HHS) and radiographic changes were graded according to Tönnis criteria. Complications were defined as Tönnis grade >2 or hip requiring further surgery. Univariate analysis was used to explore factors associated with complications. Spearman's rank correlation coefficient was calculated between HHS and Tönnis grading. At mean follow-up of 4.4 ± 2.6 (range 1.1-9.5) years, mean HHS was 87.4. Tönnis grading was rated as 0 in 10 hips, 1 in 5 hips, 2 in 2 hips, and 3 in 3 hips. Avascular necrosis of the femoral head as a complication developed in 3 hips (15%). Clinical parameters including age at surgery, duration of follow-up and diagnosis were not significantly associated with postoperative complications. A negative correlation between HHS and Tönnis grade was shown by Spearman's rank correlation (rs = -0.49, p = 0.03). The AMG can be safely recommended as an adjunct bone graft procedure when performing anterior open reduction of adolescent and active adult hip disorders.

  8. Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Naida Zanini ASSEM

    2017-07-01

    Full Text Available Abstract The aim of this study was to perform a systematic review and meta-analysis to examine the effect of systemic antibiotics in the periodontal treatment of smokers. The selection criteria were as follows: controlled randomized clinical trials; studies published in English; studies with smoker patients diagnosed with chronic periodontitis; patients without systemic diseases; studies that used systemic antibiotic therapy associated with periodontal treatment; studies that presented results for the test and control groups and assessments of clinical periodontal parameters, such as probing depth (PD, bleeding on probing (BOP, and clinical attachment level (CAL. The differences in average weights were calculated with a confidence interval (CI of 95% for PD reduction, CAL gain and BOP. The means of the periodontal clinical parameters were compared between the baseline and post-treatment periods between the test groups and the control groups. The heterogeneity was assessed using the Cochran Q test (Q (df = 3, α = 5%. A total of 67 articles were found, and after the selection process, three randomized controlled trials were included in the meta-analysis. The results indicate that SRP associated with systemic antibiotics promoted additional benefits when compared to SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01 and a gain of CAL (p = 0.0161, CI = -0.39, -0.04. There was a modest PD reduction (PD, DM -0.21 and a modest CAL gain (CAL, DM -0.22. The results of our meta-analysis reveal the clinical benefits of systemic antibiotics as an adjunct to the non-surgical periodontal treatment of smokers. These clinical improvements, although statistically significant, appeared to be of little clinical relevance.

  9. Efficacy of Combined Treatment with Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment for Parkinson's Disease.

    Science.gov (United States)

    Cho, Seung-Yeon; Lee, Young-Eun; Doo, Kyeong-Hee; Lee, Ji-Hyun; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Kim, Ho; Rhee, Hak Young; Park, Hi-Joon; Park, Seong-Uk

    2018-01-01

    The aim of this study was to evaluate the efficacy of acupuncture and bee venom acupuncture (BVA) for idiopathic Parkinson's disease (IPD) through a sham-controlled trial. We also investigated whether there is a sustained therapeutic effect by completing follow-up assessments after treatment completion. A single center, double-blind, three-armed randomized controlled trial. This study was performed at a university hospital in Seoul, Republic of Korea. Seventy-three (73) patients with IPD were the subjects. They were randomly assigned to the active treatment group, sham treatment group, or conventional treatment group. The active treatment group received acupuncture and BVA and the sham group received sham acupuncture and normal saline injections, twice a week for 12 weeks. The conventional treatment group maintained anti-parkinsonian drugs without additional intervention. The Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III score, postural instability and gait disturbance (PIGD) score, gait speed and number, Parkinson's Disease Quality of Life Questionnaire, Beck Depression Inventory, and postural stability at baseline and at 12, 16, and 20 weeks. Sixty-three (63) patients provided a complete data of assessments, including a final follow-up. After 12 weeks of treatment, a significant difference was observed between the active treatment group and the conventional treatment group. After the end of the treatment, the treatment effects were maintained significantly in the active treatment group only. It is suggested that the combined treatment of acupuncture and BVA might be safe and useful adjunctive treatment for patients with IPD.

  10. Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia: testing a device as an adjunct to colposcopy

    Science.gov (United States)

    Cantor, Scott B.; Yamal, Jose-Miguel; Guillaud, Martial; Cox, Dennis D.; Atkinson, E. Neely; Benedet, J. L.; Miller, Dianne; Ehlen, Thomas; Matisic, Jasenka; van Niekerk, Dirk; Bertrand, Monique; Milbourne, Andrea; Rhodes, Helen; Malpica, Anais; Staerkel, Gregg; Nader-Eftekhari, Shahla; Adler-Storthz, Karen; Scheurer, Michael E.; Basen-Engquist, Karen; Shinn, Eileen; West, Loyd A.; Vlastos, Anne-Therese; Tao, Xia; Beck, J. Robert; MacAulay, Calum; Follen, Michele

    2010-01-01

    Testing emerging technologies involves the evaluation of biologic plausibility, technical efficacy, clinical effectiveness, patient satisfaction, and cost-effectiveness. The objective of this study was to select an effective classification algorithm for optical spectroscopy as an adjunct to colposcopy and obtain preliminary estimates of its accuracy for the detection of CIN 2 or worse. We recruited 1000 patients from screening and prevention clinics and 850 patients from colposcopy clinics at two comprehensive cancer centers and a community hospital. Optical spectroscopy was performed and 4864 biopsies were obtained from the sites measured, including abnormal and normal colposcopic areas. The gold standard was the histologic report of biopsies, read 2–3 times by histopathologists blinded to the cytologic, histopathologic, and spectroscopic results. We calculated sensitivities, specificities, receiver operating characteristic (ROC) curves, and areas under the ROC curves. We identified a cutpoint for an algorithm based on optical spectroscopy that yielded an estimated sensitivity of 1.00 [95% confidence interval (CI) = 0.92 – 1.00] and an estimated specificity of 0.71 [95% CI = 0.62 – 0.79] in a combined screening and diagnostic population. The positive and negative predictive values were 0.58 and 1.00, respectively. The area under the ROC curve was 0.85 (95% CI 0.81 – 0.89). The per-patient and per-site performance were similar in the diagnostic and poorer in the screening settings. Like colposcopy, the device performs best in a diagnostic population. Alternative statistical approaches demonstrate that the analysis is robust and that spectroscopy works as well as or slightly better than colposcopy for the detection of CIN 2 to cancer. PMID:20830707

  11. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: A systematic review.

    Science.gov (United States)

    Yeend, Tracey; Robinson, Kai; Lockwood, Craig; McArthur, Alexa

    2012-01-01

    The objective of this review is to synthesise the best available evidence on effectiveness of fermented wheatgerm extract (Avemar) as an adjunct therapy to conventional cancer treatments such as surgery, chemotherapy, radiotherapy and hormone therapies, in the treatment of haematological and non-haematological cancers. Cancer is a public health issue with an incidence rate and prevalence that has wide societal implications and impacts. Data from The World Health Organisation (WHO) indicate that cancer is a leading cause of death and accounts for about 13% of all deaths. The WHO estimate that this number will more than double within the next 18 years, with diagnosis of cancer of the lung, liver, stomach, breast and colon all expected to rise in conjunction with growth of middle class societies, increasing affluence and changes in lifestyle that are associated with rising socioeconomic status.Large amounts of money are invested annually in cancer research and new diagnostic methods and treatments are rapidly evolving. Surgery, chemotherapy and radiotherapy remain the forefront interventions and are all linked to improved prognostic outcomes. The improvement in outcomes can however, be limited by the type cancer, its stage, the location of the cancer, the treatment implemented and timing and continuity of treatment. The treatments can also have a range of ramifications and debilitating side effects. These include: hair loss, depleted immune system, nausea, vomiting and fatigue. As a result, for some patients, treatment may raise as many concerns as the diagnosis. Rarely, until faced with a diagnosis of cancer, does a person recognise the seriousness of the disease or consider the impact and experience of treatment interventions. The high level of cancer awareness across society is a reflection of the significance of the associated burden of disease associated with cancer diagnosis, cancer care and the social impact on families when a diagnosis is made.The prevalence

  12. A brief motivational interviewing as an adjunct to periodontal therapy-A potential tool to reduce relapse in oral hygiene behaviours. A three-year study.

    Science.gov (United States)

    Stenman, J; Wennström, J L; Abrahamsson, K H

    2018-05-01

    To evaluate (ii) whether inclusion of a single motivational interviewing (MI) session, as an adjunct to periodontal therapy, might be beneficial for preventing relapse in oral hygiene behaviours among patients treated for chronic periodontitis and (ii) whether individual and clinical characteristics can be of predictive value for retention of sufficient oral hygiene behaviours. This 3-year follow-up of a previously reported randomized controlled trial (RCT) study of 6-month duration included 26 patients. Patients in the test group had received one MI session by a clinical psychologist before initiation of the periodontal treatment. Otherwise, all patients followed the same treatment protocol for conventional educational intervention and non-surgical periodontal therapy. Efficacy variables assessed for evaluation of the standard of self-performed periodontal infection control were marginal bleeding index (MBI; primary efficacy variable) and plaque score (PI). The patterns of change in MBI and PI scores were similar for test and control groups over the observation period. At 3 years, both groups showed a desirable mean full-mouth MBI of 15%, a figure that was comparable to that at the short-term evaluation after active periodontal treatment. The post-treatment MBI was the only variable identified as a predictor of retained adequate oral hygiene behaviours. A single MI session as an adjunct to conventional periodontal therapy could not be proven to be of long-term beneficial additive effect with regard to prevention of relapse in oral hygiene behaviour. Desirable standard of self-performed infection control after active periodontal treatment predicted the retention of sufficient oral hygiene behaviour over time. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer

    International Nuclear Information System (INIS)

    Aruoma, Okezie I.; Somanah, Jhoti; Bourdon, Emmanuel; Rondeau, Philippe; Bahorun, Theeshan

    2014-01-01

    Highlights: • Cancer incidence and mortality is linked to hyperglycemia and some anti-diabetes drugs. • FPP is a safe nutraceutical adjunct for augmenting therapeutic regimens in diabetes and cancer management. • FPP through its hypoglycemic and antioxidant sensing may impact and mitigate the side effects of anticancer drugs. • FPP can diminish the intensity of side effects associated with acute radiation therapy. • FPP can maintain the integrity of erythrocyte during cancer chemotherapy augmenting compliance of treatment. - Abstract: Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of

  14. Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer

    Energy Technology Data Exchange (ETDEWEB)

    Aruoma, Okezie I., E-mail: oaruoma@auhs.edu [Department of Pharmaceutical Sciences, School of Pharmacy, American University of Health Sciences, Signal Hill, CA (United States); Somanah, Jhoti [ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit (Mauritius); Bourdon, Emmanuel; Rondeau, Philippe [Groupe d’Etude sur l’Inflammation Chronique et l’Obésité (GEICO), Université de La Réunion, Plateforme CYROI, Saint Denis (France); Bahorun, Theeshan, E-mail: tbahorun@uom.ac.mu [ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit (Mauritius)

    2014-10-15

    Highlights: • Cancer incidence and mortality is linked to hyperglycemia and some anti-diabetes drugs. • FPP is a safe nutraceutical adjunct for augmenting therapeutic regimens in diabetes and cancer management. • FPP through its hypoglycemic and antioxidant sensing may impact and mitigate the side effects of anticancer drugs. • FPP can diminish the intensity of side effects associated with acute radiation therapy. • FPP can maintain the integrity of erythrocyte during cancer chemotherapy augmenting compliance of treatment. - Abstract: Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of

  15. Inhibitory activity of Lactobacillus plantarum LMG P-26358 against Listeria innocua when used as an adjunct starter in the manufacture of cheese

    Science.gov (United States)

    2011-01-01

    Lactobacillus plantarum LMG P-26358 isolated from a soft French artisanal cheese produces a potent class IIa bacteriocin with 100% homology to plantaricin 423 and bacteriocidal activity against Listeria innocua and Listeria monocytogenes. The bacteriocin was found to be highly stable at temperatures as high as 100°C and pH ranges from 1-10. While this relatively narrow spectrum bacteriocin also exhibited antimicrobial activity against species of enterococci, it did not inhibit dairy starters including lactococci and lactobacilli when tested by well diffusion assay (WDA). In order to test the suitability of Lb. plantarum LMG P-26358 as an anti-listerial adjunct with nisin-producing lactococci, laboratory-scale cheeses were manufactured. Results indicated that combining Lb. plantarum LMG P-26358 (at 108 colony forming units (cfu)/ml) with a nisin producer is an effective strategy to eliminate the biological indicator strain, L. innocua. Moreover, industrial-scale cheeses also demonstrated that Lb. plantarum LMG P-26358 was much more effective than the nisin producer alone for protection against the indicator. MALDI-TOF mass spectrometry confirmed the presence of plantaricin 423 and nisin in the appropriate cheeses over an 18 week ripening period. A spray-dried fermentate of Lb. plantarum LMG P-26358 also demonstrated potent anti-listerial activity in vitro using L. innocua. Overall, the results suggest that Lb. plantarum LMG P-26358 is a suitable adjunct for use with nisin-producing cultures to improve the safety and quality of dairy products. PMID:21995443

  16. Cerclage Wiring as an Adjunct for the Treatment of Femur Fractures: Series of 11 Cases.

    Science.gov (United States)

    Agarwala, Sanjay; Menon, Aditya; Chaudhari, Sameer

    2017-01-01

    Cerclage wiring has been used in the past for osteosynthesis of femoral fractures. However, the technique went into disrepute as extensive soft tissue dissection, and periosteal stripping increased the risk of bone necrosis and delayed union. Advent of new instrumentation and minimally invasive technique has significantly reduced these complications. In spite of the limited indications for its application, reduction and stabilization with cerclage wiring can supplement osteosynthesis especially in spiral or oblique fracture morphology or those with a butterfly fragment instead of interfragmentary screw fixation. This series attempts to describe the feasibility and evaluate outcomes of cerclage wiring as an adjunct to osteosynthesis and reestablish its place in reduction and fixation of femur fractures. This is a retrospective case series of patients (January 2011 to October 2015) in whom cerclage wiring was used as an adjunct to osteosynthesis of primary and periprosthetic fractures of femur. Patient demographics, number of wires used, implant used for osteosynthesis, number of days to union, union rate and complications were recorded and analyzed. The patients were followed up for a minimum of 6 months. 11 patients (7 female and 4 male) with a mean age of 67.10 ± 21.64 years were studied. The number of patients with intertrochanteric, subtrochanteric, diaphyseal, and periprosthetic fractures of the femur was two, five, one, and three, respectively. Internal fixation was done with plates in six and cephalomedullary nails in five patients. Mean total number of wires used was 2.10 ± 0.70. Mean duration of follow-up was 15.91 ± 10.03 months. Union was achieved in all cases with a mean duration of 86.63 ± 22.44 days. There were no complications in our study. Cerclage wiring technique helps to achieve stable reduction of femoral fractures which can then be supplemented with a nail or a plate. The minimally invasive technique and instrumentation offer the advantage

  17. Supervised exercise training as an adjunctive therapy for venous leg ulcers: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Tew, Garry A; Michaels, Jonathan; Crank, Helen; Middleton, Geoff; Gumber, Anil; Klonizakis, Markos

    2015-10-06

    Venous leg ulcers are common, chronic wounds that are painful and reduce quality of life. Compression therapy is known to assist in the healing of venous leg ulceration. Supervised exercise training that targets an improvement in calf muscle pump function might be a useful adjunctive therapy for enhancing ulcer healing and other aspects of physical and mental health. However, the evidence of exercise for individuals with venous ulcers is sparse. Here, we describe the protocol for a study that aims to assess the feasibility of undertaking a randomised controlled trial of a supervised exercise programme in people who are receiving compression for venous ulceration. This is a randomised, controlled, assessor-blinded, two-centre, feasibility trial with two parallel groups. Eighty adults who are receiving lower-limb compression for a venous leg ulcer will be randomly assigned to receive usual care (compression only) or usual care plus a 12-week supervised exercise programme. Participants in the exercise group will be invited to undertake three, 60-minute sessions of supervised exercise each week, and each session will involve a combination of treadmill walking, upright cycling and strength and flexibility exercises for the lower limbs. Participants will be assessed before randomisation and 3, 6 and 12 months after randomisation. Primary outcomes include rates of recruitment, retention and adherence. Secondary outcomes include time to ulcer healing, proportion of participants healed, percentage and absolute change in ulcer size, health-related quality of life (EQ-5D-5L and VEINES-QOL/Sym), lower-limb cutaneous microvascular function (laser Doppler flowmetry coupled with iontophoresis) and physical fitness (30-second sit-to-stand test, chair sit and reach test, 6-minute walk test and ankle range of motion). The costs associated with the exercise programme and health-care utilisation will be calculated. We will also complete interviews with a sub-sample of participants to

  18. Perioceutics: Matrix metalloproteinase inhibitors as an adjunctive therapy for inflammatory periodontal disease

    Directory of Open Access Journals (Sweden)

    Esther Nalini Honibald

    2012-01-01

    Full Text Available Matrix metalloproteinases (MMPs form a group of more than 20 zinc-dependent enzymes that are crucial in the degradation of the main components in the extracellular matrix, and thereby play important roles in cell migration, wound healing, and tissue remodeling. MMPs have outgrown the field of extracellular matrix biology and have progressed toward being important regulatory molecules in inflammation, and hence are key components in the pathogenesis of periodontitis. This rise in status has led to the development of MMP inhibitors which can act as switches or delicate tuners in acute and chronic inflammation and the regenerative phase after inflammation. The new challenge in MMP research is to better understand the complex role these enzymes play in periodontal disease and to design inhibitors that are successful in the clinic. Perioceutics or the use of the pharmacological agents specifically developed to manage periodontitis is an interesting and emerging aid in the management of periodontal diseases along with mechanical debridement. The purpose of this review is to provide an introduction to MMPs and their inhibitors, the pathologic effects of a disturbance in the functions of enzyme cascades in balance with natural inhibitors, and highlight on the adjunctive use of MMP inhibitors in periodontal therapy and some of the current challenges with an overview of what has been achieved till date.

  19. Adjunctive graded body image exposure for eating disorders: A randomized controlled initial trial in clinical practice.

    Science.gov (United States)

    Trottier, Kathryn; Carter, Jacqueline C; MacDonald, Danielle E; McFarlane, Traci; Olmsted, Marion P

    2015-07-01

    Graded body image exposure is a key component of CBT for eating disorders (EDs). However, despite being a highly anxiety-provoking intervention, its specific effectiveness is unknown. The aims of this initial study were to investigate the feasibility and preliminary effectiveness of individualized graded body image exposure to a range of feared/avoided body image-related situations in a sample of partially remitted ED patients. Forty-five female adult participants were randomly assigned to maintenance treatment as usual (MTAU) only or MTAU plus five sessions of graded body image exposure. The graded body image exposure intervention led to large improvements in body avoidance as measured by two different methods. In addition, there was evidence of a significant impact of body image exposure on the overvaluation of shape, but not weight, 5 months after treatment. Taken together, the current results provide evidence of the feasibility of adjunctive individualized graded body image exposure within a clinical treatment program and suggest that graded body image exposure reduces body avoidance behaviors in partially remitted ED patients. Our findings suggest that individualized graded body image exposure shows promise as an intervention targeting the overvaluation of shape in EDs. © 2014 Wiley Periodicals, Inc.

  20. Adjunctive use of essential oils following scaling and root planing -a randomized clinical trial.

    Science.gov (United States)

    Azad, Mohammad Fallah; Schwiertz, Andreas; Jentsch, Holger F R

    2016-06-07

    Hitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis. Forty-six patients (aged 40-65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n  =  23) or placebo (n  =  23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis. AL, PD, BOP and SBI were significantly improved in both groups after three (p   essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm. 332-12-24092012, DRKS 00009387, German Clinical Trials Register, Freiburg i. Br., 16.09.2015.

  1. Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative Adjunct "iCon".

    Science.gov (United States)

    Ahmed, Osman Hassan; Schneiders, Anthony G; McCrory, Paul R; Sullivan, S John

    2017-04-01

      Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated.   To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion.   Observational study.   Facebook group containing interactive elements, with moderation and support from trained health care professionals.   Eleven participants (n = 9 men, n = 2 women; range, 18 to 28 years old) completed the study.   The study was conducted over a 3-month period, with participant questionnaires administered preintervention and postintervention. The primary focus was on the qualitative experiences of the participants and the effect of iCon on their RTP. Usage data were also collected.   At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others. Their supporting quotes all indicated that iCon has the potential to improve the management of concussion among this cohort. Most participants (n = 9, 82%) stated they were better informed with regard to their RTP due to participating in iCon.   This interactive adjunct to traditional concussion management was appreciated among this participant group, which indicates the feasibility of a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sport concussion.

  2. Adjunctive Application of Antimicrobial Photodynamic Therapy in Nonsurgical Periodontal Treatment: A Review of Literature

    Directory of Open Access Journals (Sweden)

    Takeshi Kikuchi

    2015-10-01

    Full Text Available Periodontal disease is caused by dental plaque biofilms, and the removal of these biofilms from the root surface of teeth plays a central part in its treatment. The conventional treatment for periodontal disease fails to remove periodontal infection in a subset of cases, such as those with complicated root morphology. Adjunctive antimicrobial photodynamic therapy (aPDT has been proposed as an additional treatment for this infectious disease. Many periodontal pathogenic bacteria are susceptible to low-power lasers in the presence of dyes, such as methylene blue, toluidine blue O, malachite green, and indocyanine green. aPDT uses these light-activated photosensitizer that is incorporated selectively by bacteria and absorbs a low-power laser/light with an appropriate wavelength to induce singlet oxygen and free radicals, which are toxic to bacteria. While this technique has been evaluated by many clinical studies, some systematic reviews and meta-analyses have reported controversial results about the benefits of aPDT for periodontal treatment. In the light of these previous reports, the aim of this review is to provide comprehensive information about aPDT and help extend knowledge of advanced laser therapy.

  3. Isotonic saline nasal irrigation is an effective adjunctive therapy to intranasal corticosteroid spray in allergic rhinitis.

    Science.gov (United States)

    Nguyen, Shaun A; Psaltis, Alkis J; Schlosser, Rodney J

    2014-01-01

    This study was designed to determine if the addition of large-volume, low-positive pressure nasal irrigations delivered with isotonic sodium chloride (hereinafter "saline") added to intranasal corticosteroid therapy improves quality of life and objective measures of nasal breathing in patients with allergic rhinitis when compared with intranasal corticosteroid alone. A prospective, unblinded, single-arm pilot study was performed of patients with allergic rhinitis already on intranasal corticosteroid pharmacotherapy. Patients added large-volume low-pressure saline irrigation twice daily for 8 weeks to their ongoing regiment of nasal corticosteroid. Mini-Rhinoconjunctivitis Quality of life Questionnaire (mRQLQ) assessment and nasal peak inspiratory flow (NPIF) were performed at baseline and at 4 and 8 weeks. A total of 40 patients were enrolled. Twice-daily nasal irrigation with isotonic saline significantly (p irrigation with isotonic saline is an effective adjunctive therapy to improve quality of life in patients with allergic rhinitis already on intranasal corticosteroid therapy. This study was a part of the clinical trial NCT01030146 registered at clinicaltrials.gov.

  4. Perfluorochemical emulsions as adjuncts to radiation therapy: a review of preclinical studies

    International Nuclear Information System (INIS)

    Rockwell, S.

    1989-01-01

    Oxygen is a potent radiosensitizer. As virtually complete radiosensitization is observed at 0 2 levels similar to those in venous blood, most healthy normal tissues exhibit an aerobic radiosensitivity. In contrast, solid tumors contain avascular areas and blood vessels which are subject to transient and persistent interruptions in blood flow; as a result, tumors contain viable cells existing under acute and chronic hypoxia. These hypoxic cells are resistant to radiation and to many drugs used in cancer therapy, and can limit the curability of tumors by conventional therapeutic regimens. Many laboratory and clinical studies are examining ways to circumvent the problem of hypoxic cells in cancer therapy. Studies reviewed here examine the effects of infusion of perfluorochemical emulsions (PFC-E) combined with the administration of 0 2 at ambient or hyperbaric pressures on the radiation responses of solid tumors and of the normal tissues which limit the intensity of therapy. Appropriate regimens of treatment with a PFC-E and oxygen-enriched atmospheres increase the radiation response of solid tumors, without causing severe host toxicities and without producing equivalent increases in radiation injury to normal tissues. These studies show that PFC-E's have significant potential as adjuncts to radiotherapy and provide a basis for the design and initiation of clinical trials testing these agents [fr

  5. Safety of adjunct pre-emptive intravenous tramadol with midazolam sedation for third molar surgery.

    Science.gov (United States)

    Eriksson, Lars B; Tegelberg, Åke

    2015-12-01

    The purpose of this study was to evaluate patient safety, in terms of adverse events, alterations in blood pressure or oxygen saturation (SpO2) in two routine sedation procedures, with and without intravenous analgesia. Patients referred for surgical removal of mandibular third molars were treated in a randomized, controlled, single-blinded procedure. Eighty-seven men and women, aged 18 to 44 years, were allotted to either of two treatment groups, midazolam + tramadol (M + T) and midazolam + saline (M + S) or to a control group (C), given no sedation. Tramadol at 1 mg/kg body weight resulted in a higher frequency of oxygen desaturation (SpO2 surgery. In both the test groups, there was a significant decrease in diastolic blood pressure (p surgery. The results confirm that pre-emptive intravenous tramadol, administered at 1 mg/kg body weight as an adjunct to midazolam sedation for third molar surgery, offers a safe method. But, it should be noted that our previous study shows that it is not a particularly effective analgesic. Further testing is therefore warranted, using other doses or other drugs, to find a better intravenous protocol for postoperative analgesia, with maximum effect and minimal risk, in outpatient oral and maxillofacial surgery procedures.

  6. Adjunctive effect of chlorhexidine in ultrasonic instrumentation of aggressive periodontitis patients: a pilot study.

    Science.gov (United States)

    Guarnelli, Maria Elena; Franceschetti, Giovanni; Manfrini, Roberta; Trombelli, Leonardo

    2008-04-01

    The aim of the present pilot randomized clinical trial was to evaluate the effects of ultrasonic mechanical instrumentation (UMI) associated with the professional use of chlorhexidine (CHX) formulations compared with UMI alone during periodontal supportive therapy in patients with generalized aggressive periodontis (G-AgP). Nine patients (test group) received a single session of UMI associated with subgingival irrigation under cavitation with CHX 0.02%. A 0.2% CHX solution was used for professional tongue brushing and mouthrinsing. Ten patients (control group) received a similar session of UMI associated with subgingival irrigation and professional tongue brushing and mouthrinsing with a control formulation. Clinical and microbiological parameters were assessed pre-treatment at 3, 6 and 12 weeks post-treatment. UMI either with or without additional CHX use determined a significant reduction of supragingival plaque and gingival inflammation as well as a significant reduction of subgingival bacterial pathogens. The additional use of CHX did not result in any additional clinical and microbiological benefit with respect to mere UMI. The adjunctive professional use of CHX formulations to UMI seems to produce no additional effects over UMI alone during supportive therapy in G-AgP patients.

  7. High capacity embedding with indexed data recovery using adjunctive numerical relations in multimedia signal covers

    Science.gov (United States)

    Collins, James C.; Agaian, Sos S.

    2013-05-01

    We introduce a technique for covertly embedding data throughout an audio file using redundant number system decomposition across non-standard digital bit-lines. This bit-line implementation integrates an index recoverable embedded algorithm with an extended bit level representation that achieves a high capacity data channel within an audio multimedia file. It will be shown this new steganography method has minimal aural distortive affects while preserving both first and second order cover statistics, making it less susceptible to most steganalysis attacks. Our research approach involves reviewing the common numerical methods used in common binary-based algorithms. We then describe basic concepts and challenges when attempting to implement complex embedding algorithms that are based on redundant number systems. Finally, we introduce a novel class of numerical based multiple bit-line decomposition systems, which we define as Adjunctive Numerical Representations. The system is primarily described using basic PCM techniques in uncompressed audio files however extended applications for alternate multimedia is addressed. This new embedding system will not only provide the statistical stability required for effective steganography but will also give us an improvement in the embedding capacity in this class of multimedia carrier files. This novelty of our approach is demonstrated by an ability to embed high capacity covert data while simultaneously providing a means for rapid, indexed data recovery.

  8. High-resolution ultrasound biomicroscopy as an adjunctive diagnostic tool for anterior scleral inflammatory disease.

    Science.gov (United States)

    Zur, Dinah; Neudorfer, Meira; Shulman, Shiri; Rosenblatt, Amir; Habot-Wilner, Zohar

    2016-09-01

    To study high-resolution ultrasound biomicroscopy (UBM) findings in anterior scleral inflammatory disease and evaluate the efficacy of high-resolution UBM as an adjunctive diagnostic tool. A cross-sectional study. The medical records of 30 patients (33 eyes) with episcleritis or anterior scleritis were reviewed for clinical features and high-resolution UBM findings. Ultrasound biomicroscopy (UBM) examination was performed using 50 MHz Aviso S (Quantel Medical, Clermont-Ferrand, France). Seventeen eyes had episcleritis [nodular (12), simple (five)], and 16 eyes had anterior scleritis [nodular (14), diffuse (two)] as classified by UBM. The use of high-resolution UBM allowed high-resolution imaging of the sclera and episclera and showed characteristic patterns of episcleritis and anterior scleritis. The clinical classification matched UBM findings in 25 (76%) eyes. In the other eight eyes (24%), UBM analysis led to a change in the final classification: four eyes with suspected episcleritis were classified with scleritis, and four eyes with suspected scleritis were classified with episcleritis. Eleven patients (36.7%) had an associated systemic disease. High-resolution UBM enabled visualization of distinct imaging findings of episcleritis and anterior scleritis, indicating its usefulness in the classification of challenging cases of anterior scleral inflammatory disease. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. Aerobic Exercise as an Adjunct Therapy for Improving Cognitive Function in Heart Failure

    Directory of Open Access Journals (Sweden)

    Rebecca A. Gary

    2014-01-01

    Full Text Available Persons with heart failure (HF are typically older and are at a much higher risk for developing cognitive impairment (CI than persons without HF. Increasingly, CI is recognized as a significant, independent predictor of worse clinical outcomes, more frequent hospital readmissions, and higher mortality rates in persons with HF. CI can have devastating effects on ability to carry out HF effective self-care behaviors. If CI occurs, however, there are currently no evidence based guidelines on how to manage or improve cognitive function in this population. Improvement in cognition has been reported following some therapies in HF and is thought to be the consequence of enhanced cerebral perfusion and oxygenation, suggesting that CI may be amenable to intervention. Because there is substantial neuronal loss with dementia and no effective restorative therapies, interventions that slow, reverse, or prevent cognitive decline are essential. Aerobic exercise is documented to increase cerebral perfusion and oxygenation by promoting neuroplasticity and neurogenesis and, in turn, cognitive functioning. Few studies have examined exercise as a potential adjunct therapy for attenuating or alleviating cognitive decline in HF. In this review, the potential benefit of aerobic exercise on cognitive functioning in HF is presented along with future research directions.

  10. Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: network meta-analysis.

    Science.gov (United States)

    Chatterton, Mary Lou; Stockings, Emily; Berk, Michael; Barendregt, Jan J; Carter, Rob; Mihalopoulos, Cathrine

    2017-05-01

    Background Few trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies. Aims To combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA). Method Systematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF). Results Carer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive-behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores. Conclusions Only interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required. © The Royal College of Psychiatrists 2017.

  11. Prevention of late blowing defect by reuterin produced in cheese by a Lactobacillus reuteri adjunct.

    Science.gov (United States)

    Gómez-Torres, Natalia; Ávila, Marta; Gaya, Pilar; Garde, Sonia

    2014-09-01

    In this study, reuterin-producing Lactobacillus reuteri INIA P572 was added to cheese as an adjunct culture together with 50 or 100 mM glycerol (required for reuterin production), with the aim of controlling Clostridium tyrobutyricum CECT 4011 growth and preventing the late blowing defect (LBD) of cheese caused by this strain. L. reuteri survived cheese manufacture and produced reuterin in situ, detected at 6 and 24 h. However, the produced reuterin was enough to inhibit the growth of Clostridium, showing undetectable spore counts from day 30 onward and, therefore, to prevent cheese LBD during ripening (60 d, 14 °C). The acidification of these cheeses was not affected, although from day 14 they showed significantly lower lactococci counts than cheese made only with the starter (control cheese). Cheeses with LBD showed lower levels of lactic acid than control cheese and the formation of propionic and butyric acids, but cheeses with reuterin showed the same organic acids profile than control cheese. The cheese made with L. reuteri and 100 mM glycerol showed a light pink colour, not observed in the cheese made with L. reuteri and 50 mM glycerol. These results demonstrated a potent anti-clostridial activity of reuterin produced in an actual food product like cheese, and proved to be a novel approach to prevent LBD of cheese. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Maxillomandibular plane angle bisector (MM) adjunctive to occlusal plane to evaluate anteroposterior measurement of dental base.

    Science.gov (United States)

    Ganiger, Chanamallappa R; Nayak, U S Krishna; Cariappa, K U; Ahammed, A R Yusuf

    2012-07-01

    This study was undertaken to analyze the clinical usefulness of the maxillomandibular bisector, its reproducibility, its validity and its relationship to the functional occlusal plane, the bisecting occlusal plane and the nature of its cant. Thirty pretreatment lateral cephalograms, each of adolescents (above 18 years of age) and children (10- 12 years), seeking orthodontic treatment were randomly selected and the Wits technique of anteroposterior measurement was used to compare A-B values measured to the new plane with those measured to the functional occlusal plane (FOP) and to the traditional or bisecting occlusal plane (BOP). Present study showed that MM bisector plane is more reproducible and valid reference plane, than the FOP and BOP. A new plane, geometrically derived from the dental base planes, has been tested as an occlusal plane substitute for the measurement of anteroposterior jaw relationships. It lies close to but at an angle and inferior to the traditional occlusal planes and is highly reproducible at all times. Maxillomandibular planes angle bisector may be a useful adjunct for the cephalometric assessment of sagittal relationship of the patient.

  13. Evaluation of the effect of magnesium sulphate vs. clonidine as adjunct to epidural bupivacaine

    Directory of Open Access Journals (Sweden)

    Tanmoy Ghatak

    2010-01-01

    Full Text Available For treatment of intra and postoperative pain, no drug has yet been identified that specifically inhibits nociception without associated side effects. Magnesium has antinociceptive effects in animal and human models of pain. The current prospective randomised double-blind study was undertaken to establish the effect of addition of magnesium or clonidine, as adjuvant, to epidural bupivacaine in lower abdominal and lower limb surgeries. A total of 90 American Society of Anesthesiology (ASA grade I and II patients undergoing lower abdominal and lower limb surgeries were enrolled to receive either magnesium sulphate (Group B or clonidine (Group C along with epidural bupivacaine for surgical anaesthesia. All patients received 19 ml of epidural bupivacaine 0.5% along with 50 mg magnesium in group B, 150 mcg clonidine in Group C, whereas in control group (Group A, patients received same volume of normal saline. Onset time, heart rate, blood pressure, duration of analgesia, pain assessment by visual analogue score (VAS and adverse effects were recorded. Onset of anaesthesia was rapid in magnesium group (Group B. In group C there was prolongation of duration of anaesthesia and sedation with lower VAS score, but the incidence of shivering was higher. The groups were similar with respect to haemodynamic variables, nausea and vomiting. The current study establishes magnesium sulphate as a predictable and safe adjunct to epidural bupivacaine for rapid onset of anaesthesia and clonidine for prolonged duration of anaesthesia with sedation.

  14. Spray-dried adjunct cultures of autochthonous non-starter lactic acid bacteria.

    Science.gov (United States)

    Peralta, Guillermo H; Bergamini, Carina V; Audero, Gabriela; Páez, Roxana; Wolf, I Verónica; Perotti, M Cristina; Hynes, Erica R

    2017-08-16

    Spray-drying of lactic cultures provides direct-to-vat starters, which facilitate their commercialization and use. However, this process may alter the metabolic activity and deteriorate technological features. In this work, we assessed the influence of spray-drying on the survival and aroma production of two strains of mesophilic lactobacilli: Lactobacillus paracasei 90 and Lactobacillus plantarum 91, which have already been characterized as good adjunct cultures. The spray-drying was carried out using a laboratory scale spray and the dried cultures were monitored during the storage for the survival rate. The dried cultures were applied to two cheese models: sterile cheese extract and miniature soft cheese. The influence on the carbohydrate metabolism and the production of organic acids and volatile compounds was determined. Both strains retained high levels of viable counts in the powder after drying and during the storage at 5°C for twelve months. In addition, they also remained at high level in both cheese models during incubation or ripening. Similar profiles of carbohydrate fermentation and bioformation of volatile compounds were observed in the cheese extracts for each of the strains when tested as both fresh and dried cultures. In addition, the ability of Lb. paracasei 90 to increase the production of acetoin and diacetyl remarkably in cheese models was also confirmed for the spray-dried culture. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Optical imaging as an adjunct to sonograph in differentiating benign from malignant breast lesions

    Science.gov (United States)

    Zhu, Quing; Conant, Emily F.; Chance, Britton

    2000-04-01

    The role of near infrared (NIR) diffusive light imaging as an adjunct to ultrasound in differentiating benign from malignant lesions was evaluated in 27 mammography patients with infiltrating ductal carcinomas, apocrine metaplasia, fibroadenomas, radial scar and ductal hyperplasia, cysts, and normal tissues. Conventional ultrasound/mammography images were graded based on BI-RADS assessment categories. The spatial NIR measurements were made at wavelengths of 750 and 830 nm. Functional images, such as relative changes of deoxyhemoglobin (deoxyHb) and total blood concentration, were estimated from the dual wavelength measurements. Maximum relative deoxyHb and blood concentration changes were measured, and spatial correlation of masses in relative deoxyHb and blood concentration images for each breast were calculated. For the five biopsy proven benign lesions, ultrasound/mammography diagnoses were suspicious for malignancy (four cases) and highly suspicious for malignancy (one case). Four lesions showed less than 1.0 V maximum deoxyHb and less than 1.5 V maximum blood concentration levels on average and spatial image correlation showed no correlated masses in both deoxyHb and blood concentration images. For the four biopsy proven malignant lesions, ultrasound/mammography diagnoses were highly suspicious for malignancy. Maximum deoxyHb and blood concentration changes were greater than 2.9 V on average except one lesion which showed smaller deoxyHb signal (maximum 0.85 V) but the deoxyHb mass and blood concentration mass were highly correlated.

  16. Evaluation of isoprinosine to be repurposed as an adjunct anti-tuberculosis chemotherapy.

    Science.gov (United States)

    Mishra, Alok K; Yabaji, Shivraj M; Dubey, Rikesh K

    2018-06-01

    Isoprinosine (Inos) or immunovir is a synthetic purine derivative with immune-modulatory and antiviral properties. The drug shows apparent in vivo enhancement of host immune responses by inducing pro-inflammatory cytokines and rapid proliferation of T-cell subsets. Strikingly, the cytokines induced by Inos also play crucial roles in providing immune resistance against Mycobacterium tuberculosis (Mtb). Inos has been licensed for several antiviral diseases; however, its efficacy against Mtb has not been tested yet. Since Mtb subverts the host immune system to survive within the host. Therefore, we hypothesized that the immune-stimulatory properties of Inos can be explored as an adjunct therapy for the management of tuberculosis. We have also outlined a systematic direction of study to evaluate if Inos could be repurposed for tuberculosis. The in vivo studies for therapeutic evaluation of Inos alone or in combination with the first line anti-TB drugs in a suitable TB disease model would provide a clearer picture of its utility as a host-directed anti-TB drug and may endow us with a new application of an existing drug to combat tuberculosis. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. The Effectiveness of an Attention Bias Modification Program as an Adjunctive Treatment for Post-Traumatic Stress Disorder

    Science.gov (United States)

    Kuckertz, Jennie M.; Amir, Nader; Boffa, Joseph W.; Warren, Ciara K.; Rindt, Susan E. M.; Norman, Sonya; Ram, Vasudha; Ziajko, Lauretta; Webb-Murphy, Jennifer; McLay, Robert

    2014-01-01

    Attention bias modification (ABM) may be an effective treatment for anxiety disorders (Beard, Sawyer, & Hofmann, 2012). As individuals with PTSD possess an attentional bias towards threat-relevant information ABM may prove effective in reducing PTSD symptoms. We examined the efficacy of ABM as an adjunct treatment for PTSD in a real-world setting. We administered ABM in conjunction with prolonged exposure or cognitive-processing therapy and medication in a community inpatient treatment facility for military personnel diagnosed with PTSD. Participants were randomized to either ABM or an attention control condition (ACC). While all participants experienced reductions in PTSD symptoms, participants in the ABM group experienced significantly fewer PTSD and depressive symptoms at post-treatment when compared to the ACC group. Moreover, change in plasticity of attentional bias mediated this change in symptoms and initial attentional bias moderated the effects of the treatment. These results suggest that ABM may be an effective adjunct treatment for PTSD. PMID:25277496

  18. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

    DEFF Research Database (Denmark)

    Lund, S.S.; Tarnow, L.; Astrup, A.S.

    2008-01-01

    . Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment...... = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9), pbody weight, -1.74 kg (-3.32; -0.17), p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated. CONCLUSIONS/SIGNIFICANCE: In patients with poorly controlled T......1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects...

  19. Reaction-Based Reactive Transport Modeling of Iron Reduction and Uranium Immobilization at Area 2 of the NABIR Field Research Center, Subproject to Co-PI Eric E. Roden. Final Report

    International Nuclear Information System (INIS)

    Roden, Eric E.

    2011-01-01

    This report summarizes research conducted in conjunction with a project entitled 'Reaction-Based Reactive Transport Modeling of Iron Reduction and Uranium Immobilization at Area 2 of the NABIR Field Research Center', which was funded through the Integrative Studies Element of the former NABIR Program (now the Environmental Remediation Sciences Program) within the Office of Biological and Environmental Research. Dr. William Burgos (The Pennsylvania State University) was the overall PI/PD for the project, which included Brian Dempsey (Penn State), Gour-Tsyh (George) Yeh (Central Florida University), and Eric Roden (formerly at The University of Alabama, now at the University of Wisconsin) as separately-funded co-PIs. The project focused on development of a mechanistic understanding and quantitative models of coupled Fe(III)/U(VI) reduction in FRC Area 2 sediments. The work builds on our previous studies of microbial Fe(III) and U(VI) reduction, and was directly aligned with the Scheibe et al. ORNL FRC Field Project at Area 2.

  20. Effect of supragingival oral irrigation as an adjunct to toothbrushing on plaque accumulation in chronic generalized gingivitis patients

    OpenAIRE

    Manish Khatri; Aamir Shams Malik; Mansi Bansal; Komal Puri; Geeti Gupta; Ashish Kumar

    2017-01-01

    Aim: The aim of this study was to evaluate the efficacy of supragingival oral irrigation either with water or different concentrations of chlorhexidine (CHX) digluconate as an adjunct to toothbrushing on plaque accumulation in chronic generalized gingivitis patients. Materials and Methods: Fifty patients were randomly allocated into five groups. Group 1: toothbrushing alone, Group 2: toothbrushing with mouthwash, Group 3: toothbrushing with water irrigation, Group 4: toothbrushing with 0.0075...

  1. Ketamine as an Adjunct to Postoperative Pain Management in Opioid Tolerant Patients After Spinal Fusions: A Prospective Randomized Trial

    OpenAIRE

    Urban, Michael K.; Ya Deau, Jacques T.; Wukovits, Barbara; Lipnitsky, Jane Y.

    2007-01-01

    Management of acute postoperative pain is challenging, particularly in patients with preexisting narcotic dependency. Ketamine has been used at subanesthetic doses as a N-methyl d-aspartate (NMDA) receptor antagonist to block the processing of nociceptive input in chronic pain syndromes. This prospective randomized study was designed to assess the use of ketamine as an adjunct to acute pain management in narcotic tolerant patients after spinal fusions. Twenty-six patients for 1–2 level poster...

  2. The Adjunctive Role of Nutritional Therapy in the Management of Phlegmon in Two Children with Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Andrew S. Day

    2017-09-01

    Full Text Available Crohn’s disease may be complicated by the development of penetrating (fistulizing or structuring complications. The presentation of an intra-abdominal phlegmon or abscess with or without an associated fistula has traditionally required surgical intervention. This series of two cases illustrates a beneficial role of non-surgical management, with parenteral and then enteral nutrition playing central roles. This report further elaborates the potential adjunctive role of enteral nutrition in the management of this complication of CD.

  3. The role of ziprasidone in adjunctive use with lithium or valproate in maintenance treatment of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Charles L Bowden

    2011-03-01

    Full Text Available Charles L BowdenMood & Anxiety Disorder Division, Department of Psychiatry, UT Health Science Center, San Antonio, TX, USAObjectives: This article addresses the clinical role for ziprasidone used adjunctively with a mood stabilizer in maintenance treatment of bipolar disorder. This review also addresses the strengths and limitations of design features in adjunctive studies of second-generation antipsychotic drugs added to mood stabilizers.Methods: The principal study relevant to this review enrolled subjects who were ≥18 years of age, experiencing a recent or current manic or mixed bipolar I episode, with at least moderately severe current manic symptoms. To meet criteria for randomization to 6 months maintenance treatment, patients had to have failed a short course of treatment with either lithium or valproate and achieved benefit with added ziprasidone for 8 consecutive weeks.Results: Time to intervention for a new mood episode as well as time to discontinuation for any reason was significantly longer with adjunctive ziprasidone treatment than with monotherapy treatment with mood stabilizer. Three dosages of ziprasidone augmentation were studied. Patients treated with 120 mg/day had better efficacy and overall outcomes than did patients who received 80 or 160 mg/day of ziprasidone.Conclusions: Good evidence exists that adjunctive ziprasidone will likely provide greater overall efficacy coupled with good tolerability for at least a 6-month period than a strategy of continued monotherapy with a mood stabilizer. Changes in open phases of maintenance studies to reduce study enrichment, in study endpoints, and in statistical approaches to analysis of data are warranted.Keywords: bipolar disorder, mania, maintenance, prophylaxis, ziprasidone, mood stabilizer

  4. Valuing clients' perspective and the effects on the therapeutic alliance: A randomized controlled study of an adjunctive instruction.

    OpenAIRE

    Flückiger Christoph; Del Re Ac; Wampold Bruce E; Znoj Hansjörg; Caspar Franz; Jörg Urs

    2012-01-01

    The patterns of growth and development of the therapeutic alliance over the course of therapy have been of continued interest to psychotherapy researchers. The purpose of this study was to investigate whether a simple institutional metacommunication intervention with clients had an effect on the development of the alliance. This adjunctive instruction involved inviting therapy clients to take a proactive role in their treatment by encouraging feedback to their therapist about various aspects ...

  5. Efficacy of Mycobacterium indicus pranii immunotherapy as an adjunct to chemotherapy for tuberculosis and underlying immune responses in the lung.

    Directory of Open Access Journals (Sweden)

    Ankan Gupta

    Full Text Available BACKGROUND: The 9-month-long chemotherapy of tuberculosis often results in poor compliance and emergence of drug-resistant strains. So, improved therapeutic strategy is urgently needed. Immunotherapy could be beneficial for the effective management of the disease. Previously we showed the protective efficacy of Mycobacterium indicus pranii (MIP when given as prophylactic vaccine in animal models of tuberculosis. METHODS: We sought to investigate whether MIP can be used as an adjunct to the chemotherapy in guinea pig models of tuberculosis. Efficacy of MIP was evaluated when given subcutaneously or by aerosol. RESULTS: MIP-therapy as an adjunct to the chemotherapy was found to be effective in accelerating bacterial killing and improving organ pathology. MIP-immunotherapy resulted in higher numbers of activated antigen-presenting cells and lymphocytes in the infected lungs and also modulated the granulomatous response. Early increase in protective Th1 immune response was observed in the immunotherapy group. Following subsequent doses of MIP, decrease in the inflammatory response and increase in the immunosuppressive response was observed, which resulted in the improvement of lung pathology. CONCLUSION: MIP immunotherapy is a valuable adjunct to chemotherapy for tuberculosis. Aerosol route of immunotherapy can play a crucial role for inducing immediate local immune response in the lung.

  6. Are anti-inflammatory agents effective in treating gingivitis as solo or adjunct therapies? A systematic review.

    Science.gov (United States)

    Polak, David; Martin, Conchita; Sanz-Sánchez, Ignacio; Beyth, Nurit; Shapira, Lior

    2015-04-01

    Systematically review the scientific evidence for efficiency of anti-inflammatory agents against gingivitis, either as solo treatments or adjunctive therapies. A protocol was developed aimed to answer the following focused question: "Are anti-inflammatory agents effective in treating gingivitis as solo or adjunct therapies?" RCTs and cohort studies on anti-inflammatory agents against gingivitis studies were searched electronically. Screening, data extraction and quality assessment were conducted. The primary outcome measures were indices of gingival inflammation. A sub-analysis was performed dividing the active agents into anti-inflammatory and other drugs. The search identified 3188 studies, of which 14 RCTs met the inclusion criteria. The use of anti-inflammatory or other agents, in general showed a higher reduction in the test than in the control in terms of gingival indexes and bleeding scores. Only two RCTs on inflammatory drugs could be meta-analysed, showing a statistically significant reduction in the GI in the experimental group [WMD = -0.090; 95% CI (-0.105; -0.074); p = 0.000]. However, the contribution of both studies to the global result was unbalanced (% weight: 99.88 and 0.12 respectively). Most of the tested material showed beneficial effect as anti-inflammatory agents against gingivitis, either as a single treatment modality or as an adjunctive therapy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. (including travel dates) Proposed itinerary

    Indian Academy of Sciences (India)

    Ashok

    31 July to 22 August 2012 (including travel dates). Proposed itinerary: Arrival in Bangalore on 1 August. 1-5 August: Bangalore, Karnataka. Suggested institutions: Indian Institute of Science, Bangalore. St Johns Medical College & Hospital, Bangalore. Jawaharlal Nehru Centre, Bangalore. 6-8 August: Chennai, TN.

  8. The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review

    NARCIS (Netherlands)

    Haps, S.; Slot, D.E.; Berchier, C.E.; van der Weijden, G.A.

    2008-01-01

    Objective: To review the literature concerning cetylpyridinium chloride (CPC) containing mouth rinses as effective adjuncts to toothbrushing in the prevention of plaque accumulation and gingival inflammation. Materials and methods: Medline and the Cochrane Central Register of Controlled Trials were

  9. Evaluating the Effect of a Mechanical Adjunct to Improve the Installation of Child Restraint Systems to Vehicles.

    Science.gov (United States)

    Mirman, Jessica H; Seifert, Sara J; Zonfrillo, Mark R; Metzger, Kristi; Durbin, Dennis R; Arbogast, Kristy B

    2015-01-01

    We explored if an alternative CRS design that utilized a mechanical adjunct to amplify the force applied to the adult seat belt (intervention CRS) results in more accurate and secure attachment between the CRS and the vehicle compared to similar CRS models that use LATCH or the existing adult seat belt. We conducted three separate studies to address this question and additionally explored: (1) the contribution of prior CRS installation experience (Study 1), (2) the value-added of CRS labeling (Study 2), and (3) paper-based vs. video instructions (Study 3). In Studies 1 and 2 we assessed a forward facing combination CRS design (intervention CRS) compared to a commercially available LATCH equipped model (control CRS) and in Study 3 we conducted a similar study using a convertible model of both the intervention and control CRS. Participants installed both CRS in a contemporary minivan and could choose which type of attachment to use for the control CRS (LATCH or seat belt); order of installation was counter-balanced. Evaluators systematically examined installations for accuracy and security. Study 1: A greater proportion of participants in both the experienced and inexperienced groups was able to securely install the intervention CRS compared to the control CRS: (45% vs. 16%, p =.0001 for experienced) and (37% vs. 6%, p =.003 for inexperienced). No differences between the CRS were observed for accuracy of installation in either user group. Study 2: A greater proportion of participants were able to securely install the enhanced intervention CRS compared to the control CRS: (62% vs. 9%, p =.001). The intervention CRS demonstrated reduced installation accuracy: (30% vs. 61%, p =.001). Study 3: A greater proportion of participants was able to securely install the intervention CRS compared to the control CRS: 79% vs. 66% p =.03, but this effect was smaller than in the previous studies. Participants were less likely to achieve an accurate installation with the intervention

  10. Cryotherapy and Topical Minocycline as Adjunctive Measures to Control Pain After Third Molar Surgery: An Exploratory Study

    Science.gov (United States)

    Gelesko, Savannah; Long, Leann; Faulk, Jan; Phillips, Ceib; Dicus, Carolyn; White, Raymond P.

    2013-01-01

    Purpose To assess the impact of cryotherapy or topical minocycline on patients’ perceptions of recovery from pain after third molar surgery in an exploratory comparative-effectiveness study. Patients and Methods Subjects aged at least 14 years who were having all 4 third molars removed were enrolled in 3 separate institutional review board–approved studies. Study groups included subjects treated with a passively applied cold wrap for 24 hours postoperatively, subjects treated with topical minocycline during surgery, and subjects enrolled in a nonconcurrent comparison group who had received neither topical minocycline nor directed cryotherapy. Third molar surgery was performed in all cases by trained surgeons using the same protocol. An exact Kruskal-Wallis test was used to compare the distributions of the worst and average pain scores and a Fisher exact test to compare verbal responses from Gracely pain scales among the 3 groups for postsurgical days (PSDs) 1 to 3. Results This study comprised 51 cryotherapy subjects (2005–2009), 63 minocycline subjects (2003–2004), and 92 comparison-group subjects (2002–2006) who were treated at academic centers and in community practices across the United States (N = 206). Demographic descriptors were similar among all groups. For PSDs 1 through 3 (unadjusted), the highest scores for worst pain (6–7 [out of 7] on Likert-type scale) were reported less frequently in each of the study groups than in subjects in the comparison group, although the numbers of subjects reporting the highest scores were few. The distribution of pain outcomes was significantly different among the 3 groups for worst pain and affective words on PSD 1 (P = .04 for both). However, the small number of subjects who reported the highest pain scores precluded adequate multivariate statistical analyses for all outcomes on PSD 1 to 3. Conclusions Data from this exploratory study suggest that adjunctive therapy to decrease postoperative pain

  11. Technological performance of the enterocin A producer Enterococcus faecium MMRA as a protective adjunct culture to enhance hygienic and sensory attributes of traditional fermented milk `Rayeb?

    OpenAIRE

    Rehaiem, Amel; Martínez Fernández, Beatriz; Manai, Mohamed; Rodríguez González, Ana

    2012-01-01

    Enterococcus faecium MMRA is an enterocin A producer isolated from ‘Rayeb’, a Tunisian fermented milk drink. In this work, safety aspects and its behaviour in raw milk were investigated to assess its suitability as a protective adjunct culture. E. faecium MMRA showed interesting features such as the absence of several virulence traits, susceptibility to vancomycin and other clinically relevant antibiotics, and lack of haemolytic activity. To evaluate its performance as an adjunct culture for ...

  12. Dynamics of starter, adjunct non-starter lactic acid bacteria and propionic acid bacteria in low-fat and full-fat Dutch-type cheese

    OpenAIRE

    Porcellato, Davide; Østlie, Hilde Marit; Brede, Mona Elise; Martinovic, Aleksandra; Skeie, Siv Borghild

    2013-01-01

    The microbial dynamics of Dutch-type cheeses differing in starter (commercial DL starter or single strain of Lactococcus lactis ssp. cremoris), adjunct (Lactobacillus or Propionibacterium) and fat contents (10% or 28% fat) were investigated by culture-dependent and culture-independent analysis. The cheese microbiota was dominated by the adjunct Lactobacillus after 4 weeks of ripening and the fat content did not influence the microbial diversity. The Leuconostoc sp., presumably from the DL sta...

  13. Malignant lymphomas (including myeloproliferative disorders)

    International Nuclear Information System (INIS)

    Todd, I.D.H.

    1985-01-01

    This chapter deals with the radiotherapy and cytotoxic chemotherapy of the malignant lymphomas. Included within this group are Hodgkin's disease, non-Hodgkin's lymphoma, mycosis fungoides, and chronic lymphatic leukaemia. A further section deals with the myeloproliferative disorders, including granulocytic leukaemia, polycythaemia vera, and primary thrombocythaemia. Excluded are myeloma and reticulum cell sarcoma of bone and acute leukaemia. With regard to Hodgkin's disease, the past 25 years have seen general recognition of the curative potential of radiotherapy, at least in the local stages, and, more recently, awareness of the ability to achieve long-term survival after combination chemotherapy in generalised or in recurrent disease. At the same time the importance of staging has become appreciated and the introduction of procedures such as lymphography, staging laparotomy, and computer tomography (CT) has enormously increased its reliability. Advances have not been so dramatic in the complex group of non-Hodgkins's lymphomas, but are still very real

  14. The Future of Family Life. Overview: ERIC Fact Sheet No. 13.

    Science.gov (United States)

    Thompson, Catherine

    This fact sheet presents an overview of current and projected changes in American family life, along with implications of those changes for home economics educators. Topics which are covered include: (1) changing family structures; (2) working women and homemakers; (3) family problems such as divorce, adolescent sexuality and pregnancy, violence…

  15. Elderly Parents and Adult Children as Caregivers. Highlights: An ERIC/CAPS Digest.

    Science.gov (United States)

    Libert, Anne Blanford

    This digest presents a contemporary description of the American elderly and adult children's caregiving to their parents. It includes a profile of the American elderly; a description of caregiving tasks performed by their adult children; and the impact of longer life expectancy, divorce rates, and employed daughters on caregiving. Caregiver strain…

  16. Learning and Earning: The Value of Working for Urban Students. ERIC/CUE Digest Number 128.

    Science.gov (United States)

    Stern, David

    This digest briefly reviews the ways that working affects students, and describes ways that schools can partner with businesses to increase the educational benefits of working. The economic payoff for students who work in high school is well-established, including a positive association between the amount of high school work experience and…

  17. Liderazgo para la cultura escolar (Leadership for School Culture). ERIC Digest.

    Science.gov (United States)

    Stolp, Stephen

    The concept of school culture offers principals and other leaders a broader framework for understanding problems and relationships within the school. School culture can be defined as the historically transmitted patterns of meaning that include the norms, values, beliefs, and myths understood by members of the school community. Researchers have…

  18. Online Support Groups: Nuts and Bolts, Benefits, Limitations and Future Directions. ERIC/CASS Digest.

    Science.gov (United States)

    Gary, Juneau M.; Remolino, Linda

    Online support groups provide an alternative vehicle of support for people in distress by linking people who have similar problems. They have the potential to improve the access and delivery of support to a wide range of people, including some who would not seek face-to-face support at all. Online support groups reduce the sense of isolation…

  19. Credit Card Usage and Debt among College and University Students. ERIC Digest.

    Science.gov (United States)

    Holub, Tamara

    Since the late 1990s, lawmakers, college officials, consumer advocacy groups, and higher education practitioners have become increasingly concerned about the rising use of credit cards among college students. Some recent studies have provided information about credit card use among college students. These studies include: (1) a study conducted by…

  20. The Supply and Demand of Elementary and Secondary School Teachers in the United States. ERIC Digest.

    Science.gov (United States)

    Yasin, Said

    This Digest examines U.S. teacher supply and demand, including projections for the next 10 years. For the past 10 years, the supply of public elementary and secondary school teachers has grown. Currently, the number of teachers in the United States is 3.1 million, 2,666,034 of whom teach in public schools. The number is projected to increase by…