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Sample records for mac disease patients

  1. Characteristics of Mycobacterium avium complex (MAC) pulmonary disease in previously treated lung cancer patients.

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    Meier, Erin; Pennington, Kelly; Gallo de Moraes, Alice; Escalante, Patricio

    2017-01-01

    Mycobacterium avium complex (MAC) is responsible for a large portion of non-tuberculous mycobacterial (NTM) infections worldwide. Host factors such as active malignancy, immunosuppression, chronic obstructive pulmonary disease (COPD) and bronchiectasis increase the risk of MAC infection. However, the relationship between previously treated lung cancer with subsequent development of MAC pulmonary disease and treatment outcomes have not been previously studied. We retrospectively identified all patients with lung cancer and MAC pulmonary disease documented in medical records at Mayo Clinic between January 2005 and October 2016. Patients who were diagnosed with MAC pulmonary disease before or at the time of lung cancer diagnosis were excluded. Patients meeting all inclusion criteria underwent chart review for prior oncologic treatments, clinical characteristics, and MAC treatment response. We identified 13 patients with MAC pulmonary disease and prior lung cancer, including 4 men and 9 women. Eight patients had structural lung disease that can predispose to MAC pulmonary disease, including bronchiectasis (23.0%) and COPD (46.2%). Four (30.8%) had no apparent immunosuppression or other risk factor(s) for MAC pulmonary disease. Primary pulmonary malignancies included pulmonary carcinoid, adenocarcinoma, and squamous cell carcinoma. Ten (76.9%) patients were started on antimicrobial treatment for MAC, and 8 (61.5%) patients completed MAC treatment with 6 (46.1%) patients achieving symptomatic improvement. MAC pulmonary disease in previously treated lung cancer can occur without apparent risk factors for this NTM infection. Symptomatic improvement with MAC antimicrobial therapy appears to be lower than expected but comorbidities might influence outcomes in this patient population.

  2. Patients with MAC Lung Disease Have a Low Visceral Fat Area and Low Nutrient Intake

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    Kentaro Wakamatsu

    2015-01-01

    Full Text Available Objective. This study aimed to examine the nutritional status and nutrient intake of patients with MAC lung disease with a focus on visceral fat area. Patients and Methods. Among 116 patients of our hospital with nontuberculous mycobacteriosis who were registered between May 2010 and August 2011, 103 patients with MAC lung disease were included in this study. In all patients, nutritional status and nutrient intake were prospectively examined. Results. Patients were 23 men and 80 women (mean age, 72.3±10.9 years. BMI (kg/m2 at the time of registration was 20.4±2.7 in men and 19.2±2.9 in women. Visceral fat area (cm2 was significantly lower in women (35.7±26.6 than in men (57.5±47.4 (p=0.0111. The comparison with general healthy adults according to age revealed a markedly reduced visceral fat area among patients with MAC lung disease. With respect to nutrient intake, energy adequacy (86.1±15.7%, protein adequacy (82.4±18.2%, lipid adequacy (78.1±21.8%, and carbohydrate adequacy (89.6±19.2% ratios were all low at the time of registration. BMI was significantly correlated with protein adequacy (p=0.0397 and lipid adequacy (p=0.0214 ratios, while no association was found between visceral fat area and nutrient intake. Conclusion. Patients with MAC lung disease had a low visceral fat area and low nutrient intake.

  3. Specific amplification of gene encoding N-terminal region of catalase-peroxidase protein (KatG-N) for diagnosis of disseminated MAC disease in HIV patients.

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    Latawa, Romica; Singh, Krishna Kumar; Wanchu, Ajay; Sethi, Sunil; Sharma, Kusum; Sharma, Aman; Laal, Suman; Verma, Indu

    2014-10-01

    Disseminated Mycobacterium avium-intracellulare complex (MAC) infection is considered as severe complication of advanced HIV/AIDS disease. Currently available various laboratory investigations have not only limited ability to discriminate between MAC infection and tuberculosis but are also laborious and time consuming. The aim of this study was, therefore, to design a molecular-based strategy for specific detection of MAC and its differentiation from Mycobacterium tuberculosis (M. tb) isolated from the blood specimens of HIV patients. A simple PCR was developed based on the amplification of 120-bp katG-N gene corresponding to the first 40 amino acids of N-terminal catalase-peroxidase (KatG) protein of Mycobacterium avium that shows only ~13% sequence homology by clustal W alignment to N-terminal region of M. tb KatG protein. This assay allowed the accurate and rapid detection of MAC bacteremia, distinguishing it from M. tb in a single PCR reaction without any need for sequencing or hybridization protocol to be performed thereafter. This study produced enough evidence that a significant proportion of Indian HIV patients have disseminated MAC bacteremia, suggesting the utility of M. avium katG-N gene PCR for early detection of MAC disease in HIV patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Mycobacterium avium complex (MAC isolated from AIDS patients and the criteria required for its implication in disease Complexo Mycobacterium avium (MAC isolado de pacientes com AIDS e os critérios exigidos para sua implicação em doença

    Directory of Open Access Journals (Sweden)

    David Jamil Hadad

    1995-10-01

    Full Text Available Before the AIDS pandemia, the Mycobacterium avium complex (MAC was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS, MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (5, moderately (26 and little suggestive of disease (43 according to the criteria of DAVIDSON (198910. The various criteria for MAC isolation from sterile and non-sterile specimens are discussed.Anterior a pandemia de AIDS, o Complexo Mycobacterium avium (MAC era responsável pela maioria das vezes, por pneumopatias acometendo pacientes com doença pulmonar crônica de base como enfisema e bronquite crônica36. Em 1981, com o advento da síndrome de imunodeficiência adquirida (SIDA, o MAC passou a representar uma das doenças bacterianas mais frequentes em pacientes com esta síndrome, sendo a doença disseminada a principal forma de manifestação clínica da infecção8. Entre Janeiro de 1989 e Fevereiro de 1991, no Setor de Micobactérias do Instituto Adolfo Lutz em São Paulo, o MAC foi isolado de 103 pacientes a partir do cultivo de diferentes espécimes estéreis e não estéreis processados, coletados de 2.304 pacientes atendidos no Centro de Referência e

  5. The many faces of Mac-1 in autoimmune disease.

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    Rosetti, Florencia; Mayadas, Tanya N

    2016-01-01

    Mac-1 (CD11b/CD18) is a β2 integrin classically regarded as a pro-inflammatory molecule because of its ability to promote phagocyte cytotoxic functions and enhance the function of several effector molecules such as FcγR, uPAR, and CD14. Nevertheless, recent reports have revealed that Mac-1 also plays significant immunoregulatory roles, and genetic variants in ITGAM, the gene that encodes CD11b, confer risk for the autoimmune disease systemic lupus erythematosus (SLE). This has renewed interest in the physiological roles of this integrin and raised new questions on how its seemingly opposing biological functions may be regulated. Here, we provide an overview of the CD18 integrins and how their activation may be regulated as this may shed light on how the opposing roles of Mac-1 may be elicited. We then discuss studies that exemplify Mac-1's pro-inflammatory versus regulatory roles particularly in the context of IgG immune complex-mediated inflammation. This includes a detailed examination of molecular mechanisms that could explain the risk-conferring effect of rs1143679, a single nucleotide non-synonymous Mac-1 polymorphism associated with SLE.

  6. The MacNew Heart Disease health-related quality of life instrument: A summary

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    Guyatt Gordon

    2004-01-01

    Full Text Available Abstract Background The measurement of health, the effects of disease, and the impact of health care include not only an indication of changes in disease frequency and severity but also an estimate of patients' perception of health status before and after treatment. One of the more important developments in health care in the past decade may be the recognition that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. This has lead to the development of instruments to quantify the patients' perception of their health status before and after treatment. Methods We review evidence supporting the measurement properties of the MacNew Heart Disease Health-related Quality of Life [MacNew] Questionnaire which was designed to evaluate how daily activities and physical, emotional, and social functioning are affected by coronary heart disease and its treatment. Results Reliability was demonstrated by using internal consistency and the intraclass correlation coefficients for the three domains in the Dutch, English, Farsi, German, and Spanish versions of the MacNew. With internal consistency and intraclass correlation coefficients =>0.73, reliability is high. Validity of the MacNew was examined with factor analysis and three core underlying factors, physical, emotional, and social, were identified, explaining 63.0 – 66.5% of the observed variance and replicated in the translations with psychometric data. Construct validity of the MacNew was further demonstrated by extensive substantiation of the logical relationships, defined a priori, between items and other comparison tools. The MacNew is responsive and sensitive to changes in HRQL following various interventions for patients with heart disease with 11 of 13 effect size statistics >0.80. Taking an average of 10 minutes or less to complete, the respondent-burden for the MacNew is low and its acceptability is demonstrated by response rates of over 90

  7. Serum Mac-2 binding protein levels as a novel diagnostic biomarker for prediction of disease severity and nonalcoholic steatohepatitis.

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    Kamada, Yoshihiro; Fujii, Hideki; Fujii, Hironobu; Sawai, Yoshiyuki; Doi, Yoshinori; Uozumi, Naofumi; Mizutani, Kayo; Akita, Maaya; Sato, Motoya; Kida, Sachiho; Kinoshita, Noriaki; Maruyama, Nobuhiro; Yakushijin, Takayuki; Miyazaki, Masanori; Ezaki, Hisao; Hiramatsu, Naoki; Yoshida, Yuichi; Kiso, Shinichi; Imai, Yasuharu; Kawada, Norifumi; Takehara, Tetsuo; Miyoshi, Eiji

    2013-10-01

    Mac-2 binding protein (Mac-2 bp) is one of the major fucosylated glycoproteins, which we identified with glycol-proteomic analyses. We previously reported that fucosylated glycoproteins are secreted into bile, but scarcely secreted into sera in normal liver and hypothesized that the fucosylation-based sorting machinery would be disrupted in ballooning hepatocytes due to the loss of cellular polarity. In the present study, we investigated the availability of Mac-2 bp for differential diagnosis of nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver disease (NAFLD) as a biomarker. Serum Mac-2 bp levels were determined with our developed ELISA kit. Our cohort of 127 patients with NAFLD had liver biopsy to make a histological diagnosis of NASH and simple fatty liver. Mac-2 bp levels were significantly elevated in NASH patients compared with non-NASH (simple steatosis) patients (2.132 ± 1.237 vs. 1.103 ± 0.500 μg/mL, p Mac-2 bp was 0.816. Moreover, multivariate logistic regression analyses showed Mac-2 bp levels could predict the fibrosis stage and the presence of ballooning hepatocytes in NAFLD patients. These results support the potential usefulness of measuring Mac-2 bp levels in clinical practice as a biomarker for NASH. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. The MacNew Heart Disease Health-Related Quality of Life Questionnaire: A Scandinavian Validation Study.

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    Alphin, Shan; Höfer, Stefan; Perk, Joep; Slørdahl, Stig; Zwisler, Ann-Dorthe Olsen; Oldridge, Neil

    The aim of this study is to validate the Danish, Norwegian and Swedish versions of the self-administered MacNew Heart Disease Health-related Quality of Life questionnaire in patients with ischemic heart disease. The MacNew questionnaire, the Short Form SF-36, and the Hospital Anxiety and Depression Scale were completed at baseline by 976 patients (Denmark n = 353, Norway n = 328, Sweden n = 295) with a diagnosis of angina (n = 335), myocardial infarction (n = 352), or heart failure (n = 289). Each language version of the MacNew satisfied reliability criteria with Cronbach's α values for the total group data (0.90-0.94) as well as the diagnostic group data (0.91-0.96). The test-retest correlations exceeded the criteria for group comparison (r ≥ 0.70) in Danish and Norwegian patients. The multidimensionality of the MacNew was confirmed although the original three-factor solution did not fully meet the criteria for good fit. Convergent and discriminative validity were confirmed in each language and diagnosis group with the exception of discriminative validity in Swedish angina patients. The psychometric properties of the Danish, Norwegian, and Swedish versions of the MacNew are largely confirmed. The MacNew can be recommended as a specific instrument for assessing and evaluating HRQL in Danish, Norwegian, and Swedish patients with angina, MI, and heart failure. However, the MacNew factor structure needs to be revisited in future studies.

  9. Psychometric properties of the German version of the MacNew heart disease health-related quality of life questionnaire

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    Gramm Lukas

    2012-07-01

    Full Text Available Abstract Background There is a lack of German-language, disease-specific health related quality of life instruments applicable in cardiac rehabilitation. The purpose of this project was to investigate the psychometric properties of the German version of the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew in patients undergoing cardiac rehabilitation. Methods The MacNew was filled out by 5692 inpatients. We analysed acceptance (number of missing values, ceiling and floor effects, reliability (Cronbach’s α, factor structure (confirmatory factor analysis, construct validity (correlation with a generic health-related quality of life instrument, and sensitivity to change. Results Two items had more than 7% missing data. We observed neither floor nor ceiling effects. Cronbach’s α of the scales ranged from 0.78 (physical scale to 0.95 (global scale. Confirmatory factor analysis failed to reproduce the proposed factor structure (CFI = 0.882; TLI = 0.871; RMSEA = 0.074. We therefore drafted our own model (CFI = 0.932; TLI = 0.921; RMSEA = 0.064, and observed a correlation pattern largely conforming to the hypotheses with a generic health-related quality of life instrument. The effect sizes we noted between the start and end of rehabilitation fell between 0.66 and 0.74; at the 6-month follow-up they ranged from 0.69 to 0.92. Conclusions The German version of the MacNew Heart Disease Health-related Quality of Life Questionnaire is a suitable instrument with which to measure the impairment experienced by individuals with heart disease during inpatient cardiologic rehabilitation. The social and the global scale must be interpreted cautiously.

  10. Evaluation of Fucosylated Haptoglobin and Mac-2 Binding Protein as Serum Biomarkers to Estimate Liver Fibrosis in Patients with Chronic Hepatitis C.

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    Tawara, Seiichi; Tatsumi, Tomohide; Iio, Sadaharu; Kobayashi, Ichizou; Shigekawa, Minoru; Hikita, Hayato; Sakamori, Ryotaro; Hiramatsu, Naoki; Miyoshi, Eiji; Takehara, Tetsuo

    2016-01-01

    Fucosylated haptoglobin (Fuc-Hpt) and Mac-2 binding protein (Mac-2 bp) are identified as cancer biomarkers, based on the results from a glyco-proteomic analysis. Recently, we reported that these glyco-biomarkers were associated with liver fibrosis and/or ballooning hepatocytes in patients with nonalcoholic fatty liver disease (NAFLD). We evaluated the ability of these glycoproteins to estimate liver fibrosis in 317 patients with chronic hepatitis C. We measured the serum Fuc-Hpt and Mac-2 bp levels using a lectin-antibody ELISA and ELISA, respectively. The serum levels of both Fuc-Hpt and Mac-2 bp increased with the progression of liver fibrosis. The multivariate analysis revealed that Mac-2 bp was an independent factor associated with moderate liver fibrosis (F ≥ 2). In contrast, Fuc-Hpt was an independent factor associated with advanced liver fibrosis (F ≥ 3). In terms of evaluating liver fibrosis, the serum levels of these glycomarkers were correlated with well-known liver fibrosis indexes, such as the aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis-4 (FIB4) index. An assay that combined the APRI or FIB4 index and the Fuc-Hpt or Mac-2 bp levels increased the AUC value for diagnosing hepatic fibrosis. Interestingly, the cumulative incidence of hepatocellular carcinoma (HCC) was significantly higher in the patients with elevated serum levels of Fuc-Hpt and Mac-2 bp. In conclusion, both Fuc-Hpt and Mac-2 bp could be useful glyco-biomarkers of liver fibrosis and predictors of HCC in patients with chronic hepatitis C.

  11. Overexpression of MAC30 is Resistant to Platinum-Based Chemotherapy in Patients With Non-Small Cell Lung Cancer.

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    Chen, Ruhua; Fen, Yan; Lin, Xubo; Ma, Tieliang; Cai, Hourong; Ding, Hui

    2016-12-01

    Adjuvant platinum-based chemotherapy has developed its stability as the first-line treatment in advanced non-small cell lung cancer (NSCLC). The objective of this study was to investigate the prognostic value of meningioma-associated protein (MAC30) on adjuvant platinum-based chemotherapeutic response and survival in patients with NSCLC. A total of 174 retrospective stage III B to IV Chinese patients with NSCLC were enrolled in the study. Among all cases, 85 patients were given platinum-based chemotherapy and another 89 patients received molecularly targeted therapy. The expression of MAC30 in tumor samples was confirmed via immunohistochemical staining to correlate with the therapeutic response and survival of patients. Patients having NSCLC with MAC30 overexpression showed a poorer response to platinum-based chemotherapy, while there was no prognostic value of MAC30 expression on molecularly targeted therapy. Further, patients receiving platinum-based chemotherapy with enhanced MAC30 expression exhibited shorter survival. A multivariate analysis exhibited that increased MAC30 expression was an independent prognostic factor for overall survival in patients having NSCLC with platinum-based chemotherapy. In conclusion, patients having NSCLC with higher MAC30 expression resisted to platinum-based chemotherapy and exhibited worse survival. © The Author(s) 2015.

  12. [Spanish validation of the MacArthur Competence Assessment Tool for Treatment interview to assess patients competence to consent treatment].

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    Alvarez Marrodán, Ignacio; Baón Pérez, Beatriz; Navío Acosta, Mercedes; López-Antón, Raul; Lobo Escolar, Elena; Ventura Faci, Tirso

    2014-09-09

    To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). MacCAT-T, Mini-Mental Status Examination (MMSE). Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  13. Heterogeneity of the Mac-1 expression on peripheral blood neutrophils in patients with different types of epithelial ovarian cancer.

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    Bednarska, Katarzyna; Klink, Magdalena; Wilczyński, Jacek R; Szyłło, Krzysztof; Malinowski, Andrzej; Sułowska, Zofia; Nowak, Marek

    2016-02-01

    The expression level of Mac-1 on the surface of neutrophils is an important indicator of neutrophil activation. Under pathological conditions, Mac-1 is believed a key adhesion molecule that facilitates cancer progression and mediates the adhesion of tumour cells to the endothelium of blood vessels. Our previous findings indicated that circulating peripheral blood neutrophils in patients with advanced epithelial ovarian cancer (EOC) expressed enhanced levels of Mac-1, which was functionally associated with an increased adhesive function of neutrophils. The objective of the current study was to analyse whether the value of individual components of the differential white cell count, including the neutrophil and lymphocyte ratios, which are markers of blood neutrophil activation, might be associated with certain types of ovarian cancer. We showed the increase in Mac-1 expression along with a parallel decrease of L-selectin and PSGL-1 on peripheral blood neutrophils of patients with EOC of early and advanced FIGO stages, which indicates an activated state of neutrophils in comparison to neutrophils of individuals without cancer. Despite a significant difference between Mac-1 expression in patients with and without cancer, a dramatic increase in Mac-1 expression was observed in the blood of patients with undifferentiated carcinomas compared with patients with other histological types of EOC. Moreover, the expression level of Mac-1 correlated with the number of neutrophils in patients with serous, endometrioid and undifferentiated EOC. The results of an ROC analysis demonstrated that the patients with the undifferentiated type of EOC form a distinct group with regard to Mac-1 expression on blood neutrophils. The results suggested a diverse biological cadre of immune cells in patients with undifferentiated ovarian carcinomas compared with patients with other histological types of EOC.

  14. Electroencephalographic effect of age-adjusted 1 MAC desflurane and sevoflurane in young, middle-aged, and elderly patients.

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    Kanazawa, Shinya; Oda, Yutaka; Maeda, Chika; Okutani, Ryu

    2017-08-08

    We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. One hundred and twenty young (20-30 years), middle-aged (31-65 years), and elderly (66-80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation. Maintenance of anesthesia was started with an end-tidal concentration of desflurane or sevoflurane at age-adjusted 1 MAC and maintained for 10 min, followed by 1-min assessment of bispectral index (BIS), 95% spectral edge frequency (SEF95), and amplitude of the electroencephalogram taken at 10-s intervals. BIS and SEF95 in patients receiving 1 MAC desflurane were significantly lower than those receiving 1 MAC sevoflurane including all age groups [35 (29, 39) vs. 41 (38, 49); 12.53 (10.99, 13.95) Hz vs. 14.42 (12.99, 17.17) Hz median (25, 75 percentile), respectively, P MAC desflurane than those receiving 1 MAC sevoflurane, suggesting that desflurane provides higher depth of anesthesia than sevoflurane at 1 MAC.

  15. Mac Bible

    CERN Document Server

    Spivey, Dwight

    2009-01-01

    This essential guide answers all your questions on using a Macintosh computer, whether you?re unpacking your very first Mac after switching from a PC or upgrading from an older Mac. You?ll walk through all pre-installed Mac applications, including using Mac OS X, browsing the Web using Safari, downloading music from the iTunes store, troubleshooting Mac-specific problems, organizing photos in iPhoto, organizing calendars in iCal, editing digital video in iMovie, and more.

  16. Mycobacterium avium complex (MAC) Immune Reconstitution Syndrome (IRIS) With Reduced Susceptibility to Ethambutol in an HIV-Infected Patient.

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    Adams, Immaculata B; Schafer, Jason J; Roberts, Amity L; Short, William R

    2014-09-01

    To describe a case of Mycobacterium avium complex (MAC) lymphadenitis complicated by immune reconstitution syndrome (IRIS) and reduced susceptibility to ethambutol. A 24-year-old man was diagnosed in October 2012 with advanced HIV infection upon hospitalization for multiple opportunistic infections (OIs). Within 5 months of starting antiretroviral therapy, the patient developed significant cervical lymphadenopathy concerning for MAC/IRIS. Acid-fast bacilli were detected in the primary lymph node biopsy smear, and culture results confirmed the presence of MAC. Susceptibility testing revealed an organism susceptible to azithromycin, with an elevated minimum inhibitory concentration (MIC) to ethambutol (8 µg/mL). Currently, there is no interpretation for an ethambutol MIC of 8 µg/mL for MAC. A review of the primary literature revealed the possibility of decreased ethambutol susceptibility when the MIC is above 1 µg/mL, and therefore, therapy was replaced by rifabutin in combination with azithromycin. Current guidelines recommend a 2-drug regimen for the treatment of MAC, specifically a macrolide plus ethambutol. Guidelines also emphasize MAC susceptibility testing for macrolides only. Susceptibility results from this patient's biopsy prompted an evaluation of the effectiveness of his antimycobacterial regimen. Reduced ethambutol susceptibility in this patient triggered a search of the primary literature that resulted in the decision to replace ethambutol with rifabutin. Additional clinical trials are needed to define susceptibility breakpoints for ethambutol and other antimycobacterial agents used for MAC infection treatment and to direct clinical decisions when elevated MICs to primary agents are identified. © The Author(s) 2014.

  17. Effect of neoadjuvant chemotherapy on sevoflurane MAC-BAR value of patients undergoing radical stomach carcinoma surgery

    OpenAIRE

    Du, Wei; Li, Chao; Wang, Hemei; Zhao, Aihua; Shen, Junmei; Yong, Fangfang; Jia, Huiqun

    2015-01-01

    Objective: To determine the minimum alveolar concentration (MAC) of sevoflurane required for 50% blockade of the adrenergic response (BAR) to surgical incision in patients treated with neoadjuvant chemotherapy prior to radical gastrectomy. Patients and design: Forty-four patients were selected for this study. Patients with preoperative neoadjuvant chemotherapy comprised the NC group (n = 22) and patients without preoperative neoadjuvant chemotherapy were included as the C group (n = 22). Pati...

  18. [Pulmonary Mycobacterium Avium-Complex (MAC) Disease Differentially Diagnosed from Metastasis of Testicular Cancer : A Case Report].

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    Mori, Kohei; Teranishi, Jyn-Ichi; Yoneyama, Shuko; Ishida, Hiroaki; Hattori, Yusuke; Yumura, Yasushi; Miyoshi, Yasuhide; Kondo, Keiichi; Uemura, Hiroji; Noguchi, Kazumi

    2017-01-01

    A 45 year-old-man was admitted to our hospital because of discomfort in his left scrotum. He had a left testicular tumor. We performed high orchiectomy and pathological findings revealed testicular cancer. He was treated with bleomycin, etoposide and cisplatin. Computed tomography showed a new mass in the left lung after 3 cycles of the chemotherapy. Because of its rapid growth, the tumor was thought to be a metastasis lesion of testicular cancer or pulmonary infection. Transbronchial lung biopsy showed an invasion of multinucleated giant cells and granuloma. The culture and polymerase chain reaction of the bronchial sputum were positive for myobacterium avium-complex (MAC). From these findings, the left lung tumor was diagnosed as pulmonary MAC disease. He received partial resection of the left lung and the lesion was diagnosed as granuloma. There was no recurrence of testicular cancer or pulmonary disease after the surgery.

  19. TM6SF2 and MAC30, new enzyme homologues in sterol metabolism and common metabolic disease.

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    Luis eSanchez-Pulido

    2014-12-01

    Full Text Available Carriers of the Glu167Lys coding variant in the TM6SF2 gene have recently been identified as being more susceptible to non-alcoholic fatty liver disease (NAFLD, yet exhibit lower levels of circulating lipids and hence are protected against cardiovascular disease. Despite the physiological importance of these observations, the molecular function of TM6SF2 remains unknown, and no sequence similarity with functionally characterised proteins has been identified. In order to trace its evolutionary history and to identify functional domains, we embarked on a computational protein sequence analysis of TM6SF2. We identified a new domain, the EXPERA domain, which is conserved among TM6SF, MAC30/TMEM97 and EBP (D8,D7 sterol isomerase protein families. EBP mutations are the cause of chondrodysplasia punctata 2 X-linked dominant (CDPX2, also known as Conradi-Hünermann-Happle syndrome, a defective cholesterol biosynthesis disorder. Our analysis of evolutionary conservation among EXPERA domain-containing families and the previously suggested catalytic mechanism for the EBP enzyme, indicate that TM6SF and MAC30/TMEM97 families are both highly likely to possess, as for the EBP family, catalytic activity as sterol isomerases. This unexpected prediction of enzymatic functions for TM6SF and MAC30/TMEM97 is important because it now permits detailed experiments to investigate the function of these key proteins in various human pathologies, from cardiovascular disease to cancer.

  20. Metric properties of the MacDQoL, individualized macular-disease-specific quality of life instrument, and newly identified subscales in French, German, Italian, and American populations

    OpenAIRE

    Berdeaux, G; Mesbah, M; Bradley, Clare

    2011-01-01

    The aims of this analysis were to confirm the UK results in other countries and to explore the possibility of subscales of the 25-Item Macular disease Dependent Quality of Life (MacDQoL) questionnaire.

  1. C-MAC compared with direct laryngoscopy for intubation in patients with cervical spine immobilization: A manikin trial.

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    Smereka, Jacek; Ladny, Jerzy R; Naylor, Amanda; Ruetzler, Kurt; Szarpak, Lukasz

    2017-08-01

    The aim of this study was to compare C-MAC videolaryngoscopy with direct laryngoscopy for intubation in simulated cervical spine immobilization conditions. The study was designed as a prospective randomized crossover manikin trial. 70 paramedics with MAC and C-MAC on the first attempt (95.7% MAC vs. 100% C-MAC), with similar intubation times (16.5s MAC vs. 18s C-MAC). Scenario B: The results with C-MAC were significantly better than those with MAC (pMAC vs. 19 s C-MAC), success of the first intubation attempt (88.6% MAC vs. 100% C-MAC), Cormack-Lehane grade, POGO score, severity of dental compression, device difficulty score, and preferred airway device. Scenario C: The results with C-MAC were significantly better than those with MAC (pMAC vs. 100% C-MAC), overall success rate, intubation time (27 s MAC vs. 20.5 s C-MAC), Cormack-Lehane grade, POGO score, dental compression, device difficulty score and the preferred airway device. The C-MAC videolaryngoscope is an excellent alternative to the MAC laryngoscope for intubating manikins with cervical spine immobilization. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Establishment of mouse Mac-2 binding protein enzyme-linked immunosorbent assay and its application for mouse chronic liver disease models.

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    Iwata, Ayumi; Kamada, Yoshihiro; Ebisutani, Yusuke; Yamamoto, Akiko; Ueda, Yui; Arai, Hitomi; Fujii, Hironobu; Takamatsu, Shinji; Maruyama, Nobuhiro; Maeda, Masahiro; Takehara, Tetsuo; Miyoshi, Eiji

    2017-08-01

    We identified Mac-2 (galectin-3) binding protein (Mac-2bp) as a novel diagnostic and liver fibrosis predicting biomarker for nonalcoholic steatohepatitis in humans. In mouse models, there are no serum biomarkers predicting liver disease severity. In this study, we developed a mouse Mac-2bp enzyme-linked immunosorbent assay (ELISA) system and determined its efficacy for predicting the severity of liver disease in mouse models, especially in non-alcoholic fatty liver disease (NAFLD) models. We established several rat monoclonal antibodies against mouse Mac-2bp, selected two clones for the ELISA, and checked the accuracy and reproducibility of the ELISA, especially for NAFLD models and liver fibrosis models. We also investigated the relationships between serum levels and hepatic gene expression of Mac-2bp in mouse models. Our ELISA system had high accuracy and reproducibility (R(2)  = 0.999). The intra-assay and inter-assay results for the coefficient of variation were 2.0-3.7% and 1.7-6.9%, respectively. The levels of bilirubin, hemoglobin, and chyle did not affect the Mac-2bp serum levels detected by our ELISA kit. In the mouse models, serum Mac-2bp levels increased with liver disease progression (F0/F1/F2/F3, 239.1 ± 36.7 / 259.1 ± 43.0 / 457.5 ± 162.0 / 643.7 ± 116.0 ng/mL; P Mac-2bp (R = 0.42, P Mac-2bp ELISA system effectively predicts severity of NAFLD and liver fibrosis in mouse models. © 2016 The Japan Society of Hepatology.

  3. Generic and disease-specific estimates of quality of life in macular degeneration:Mapping the MacDQoL onto the EQ-5D-3L

    OpenAIRE

    Dixon, Padraig; Dakin, Helen; Wordsworth, Sarah

    2016-01-01

    Purpose The macular degeneration quality of life (MacDQoL) instrument is a validated condition-specific measure of quality of life in patients with macular degeneration. This paper presents the first mapping algorithm to predict EQ-5D from responses to the MacDQoL instrument. Methods Responses to the MacDQoL and EQ-5D-3L instruments from 482 patients were collected from the IVAN multicentre trial of two alternative drug treatments for neovascular age-related macular degeneration. Regression ...

  4. Persimmon-derived tannin has bacteriostatic and anti-inflammatory activity in a murine model of Mycobacterium avium complex (MAC) disease.

    Science.gov (United States)

    Matsumura, Yoko; Kitabatake, Masahiro; Ouji-Sageshima, Noriko; Yasui, Satsuki; Mochida, Naoko; Nakano, Ryuichi; Kasahara, Kei; Tomoda, Koichi; Yano, Hisakazu; Kayano, Shin-Ichi; Ito, Toshihiro

    2017-01-01

    Nontuberculous mycobacteria (NTM), including Mycobacterium avium complex (MAC), cause opportunistic chronic pulmonary infections. Notably, MAC susceptibility is regulated by various factors, including the host immune system. Persimmon (Ebenaceae Diospyros kaki Thunb.) tannin is a condensed tannin composed of a polymer of catechin groups. It is well known that condensed tannins have high antioxidant activity and bacteriostatic properties. However, it is hypothesized that condensed tannins might need to be digested and/or fermented into smaller molecules in vivo prior to being absorbed into the body to perform beneficial functions. In this study, we evaluated the effects of soluble persimmon-derived tannins on opportunistic MAC disease. Soluble tannins were hydrolyzed and evaluated by the oxygen radical absorbance capacity (ORAC) method. The ORAC value of soluble tannin hydrolysate was approximately five times greater than that of soluble tannin powder. In addition, soluble tannin hydrolysate exhibited high bacteriostatic activity against MAC in vitro. Furthermore, in an in vivo study, MAC infected mice fed a soluble tannin-containing diet showed significantly higher anti-bacterial activity against MAC and less pulmonary granuloma formation compared with those fed a control diet. Tumor necrosis factor α and inducible nitric oxide synthase levels were significantly lower in lungs of the soluble tannin diet group compared with the control diet group. Moreover, proinflammatory cytokines induced by MAC stimulation of bone marrow-derived macrophages were significantly decreased by addition of soluble tannin hydrolysate. These data suggest that soluble tannin from persimmons might attenuate the pathogenesis of pulmonary NTM infection.

  5. Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial.

    Science.gov (United States)

    Shravanalakshmi, Dhanyasi; Bidkar, Prasanna U; Narmadalakshmi, K; Lata, Suman; Mishra, Sandeep K; Adinarayanan, S

    2017-01-01

    Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope). Cervical immobilization was maintained with Manual in line stabilization with anterior part of cervical collar removed. First pass intubation success, time for intubation, and glottic visualization (Cormack - Lehane grade and percentage of glottic opening) were noted. Intubation difficulty score (IDS) was used for grading difficulty of intubation. Five-point Likert scale was used for ease of insertion of laryngoscope. First attempt success rate were 100% (45/45), 93.3% (42/45), and 95.6% (43/45) in patients using conventional C-MAC, King Vision, and D blade C-MAC videolaryngoscopes, respectively. Time for intubation in seconds was significantly faster with conventional C-MAC videolaryngoscope (23.3 ± 4.7) compared to D blade C-MAC videolaryngoscope (26.7 ± 7.1), whereas conventional C-MAC and King Vision were comparable (24.9 ± 7.2). Good grade glottic visualization was obtained with all the three videolaryngoscopes. All the videolaryngoscopes provided good glottic visualization and first attempt success rate. Conventional C-MAC insertion was significantly easier. We conclude that all the three videolaryngoscopes can be used effectively in patients with cervical spine injury.

  6. Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial

    Science.gov (United States)

    Shravanalakshmi, Dhanyasi; Bidkar, Prasanna U.; Narmadalakshmi, K.; Lata, Suman; Mishra, Sandeep K.; Adinarayanan, S.

    2017-01-01

    Background: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. Methods: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope). Cervical immobilization was maintained with Manual in line stabilization with anterior part of cervical collar removed. First pass intubation success, time for intubation, and glottic visualization (Cormack – Lehane grade and percentage of glottic opening) were noted. Intubation difficulty score (IDS) was used for grading difficulty of intubation. Five-point Likert scale was used for ease of insertion of laryngoscope. Results: First attempt success rate were 100% (45/45), 93.3% (42/45), and 95.6% (43/45) in patients using conventional C-MAC, King Vision, and D blade C-MAC videolaryngoscopes, respectively. Time for intubation in seconds was significantly faster with conventional C-MAC videolaryngoscope (23.3 ± 4.7) compared to D blade C-MAC videolaryngoscope (26.7 ± 7.1), whereas conventional C-MAC and King Vision were comparable (24.9 ± 7.2). Good grade glottic visualization was obtained with all the three videolaryngoscopes. Conclusion: All the videolaryngoscopes provided good glottic visualization and first attempt success rate. Conventional C-MAC insertion was significantly easier. We conclude that all the three videolaryngoscopes can be used effectively in patients with cervical spine injury. PMID:28217398

  7. [MAC-awake and wake-up time of isoflurane and sevoflurane with reference to the concentration of gas, duration of inhalation and patient's age and obesity].

    Science.gov (United States)

    Tabo, E; Ohkuma, Y; Sakuragi, Y; Arai, T

    1995-02-01

    We evaluated the influence of the concentration of volatile anesthetics, the duration of inhalation time, the patient's age and degree of obesity on MAC-awake (the end-tidal concentration of volatile anesthetics on awakening) and Wake-up time (the period from stopping inhalation to eye-opening in response to verbal command) following isoflurane (Iso) or sevoflurane (Sev) anesthesia in 240 patients (ASA I or II, age 17-84 yr). The patients were anesthetized with 50% oxygen, 50% nitrous oxide and various concentrations of Iso or Sev. They were divided into 6 groups in respect to the end-tidal concentration of Iso or Sev: Iso 0.7% (1 MAC), Iso 1.0% (1.5 MAC), Iso 1.4% (2 MAC), Sev 0.9% (1 MAC), Sev 1.3% (1.5 MAC) and Sev 1.8% (2 MAC). After operation all anesthetics were discontinued and MAC-awake and Wake-up time were measured under 100% oxygen inhalation. MAC-awake value of Iso was 0.14 +/- 0.05% (SD)% in all groups and that of Sev was 0.17 +/- 0.05% in Sev 0.9% group, 0.16 +/- 0.05% in Sev 1.3%, 0.17 +/- 0.06% in Sev 1.8%, respectively. All of them became smaller in aged groups than in younger groups but they were not influenced by the concentration of gas, the duration of inhalation nor the degree of obesity.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Alterações de linguagem em pacientes idosos portadores de demência avaliados com a Bateria MAC Language alterations in elderly patients with dementia assessed with the MAC Battery

    Directory of Open Access Journals (Sweden)

    Cristine Koehler

    2012-03-01

    Full Text Available OBJETIVO: Identificar as alterações de linguagem em um grupo de pacientes idosos portadores de demência nas tarefas de evocação lexical livre, com critério ortográfico e com critério semântico, interpretação de metáforas e discurso narrativo da Bateria Montreal de Avaliação da Comunicação - Bateria MAC, bem como, verificar a frequência de déficits. MÉTODOS: Participaram do estudo 13 pacientes com demência de grau leve a moderada, atendidos no Setor de Neurologia do Ambulatório de Distúrbios do Movimento e Demências do Hospital Santa Clara da Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA. O instrumento neuropsicológico de avaliação foi a Bateria MAC e a aplicação das tarefas seguiu a seguinte ordem: evocação lexical livre, evocação lexical com critério ortográfico, evocação lexical com critério semântico, interpretação de metáforas e discurso narrativo. RESULTADOS: O grupo de pacientes com demência apresentou desempenho deficitário em todas as tarefas da Bateria MAC que foram avaliadas, com diferença significativa. Além disso, os participantes apresentaram maior frequência de déficits, em ordem decrescente, nas tarefas de reconto parcial do discurso narrativo (informações essenciais e presentes, seguidas pelas tarefas de evocação lexical com critério ortográfico e com critério semântico, e reconto integral do discurso narrativo. Pelo menos dois pacientes apresentaram alterações de desempenho em alguma das cinco tarefas realizadas da Bateria MAC. CONCLUSÃO: A avaliação de linguagem através da Bateria MAC permitiu a verificação de alterações do processamento linguístico em idosos com demência, o que caracteriza que tal instrumento também é aplicável para esta população clínica.PURPOSE: To identify language deficits in a group of elderly patients with dementia in tasks of free lexical retrieval, lexical retrieval with orthographic and semantic criteria

  9. Mycobacterium avium complex pulmonary disease: characteristics and treatment in an Irish patient cohort.

    LENUS (Irish Health Repository)

    Judge, EP

    2016-04-01

    The prevalence of Mycobacterium avium complex (MAC) pulmonary disease is increasing globally. However, reliable national and international data relating to its epidemiology and management is lacking. During the period 2003-2014, MAC was isolated from the pulmonary samples of 75 patients at the Irish Mycobacteria Reference Laboratory (IMRL). Most patients (42, 56%) had underlying pulmonary disease, and 37 (49%) had clinical\\/radiographic characteristics consistent with MAC pulmonary disease. However, only 18 patients (24%) fulfilled internationally accepted criteria for diagnosis\\/treatment of this disease. Treatment was started in 13 (72%) of these cases, which is similar to internationally published treatment rates. The diagnosis of significant MAC pulmonary disease can be difficult, and treatment is not always warranted even when diagnostic criteria are met.

  10. Clinical evaluation of C-MAC videolaryngoscope with or without use of stylet for endotracheal intubation in patients with cervical spine immobilization.

    Science.gov (United States)

    Gupta, Nidhi; Rath, Girija Prasad; Prabhakar, Hemanshu

    2013-10-01

    This study was carried out to evaluate the relative efficacy of the C-MAC videolaryngoscope as compared to the conventional Macintosh laryngoscope using both styletted and non-styletted endotracheal tube (ETT) in patients undergoing elective cervical spine surgery with head and neck stabilized by manual in-line stabilization. We randomized 120 consenting adults into four groups (30 each) to undergo tracheal intubation using either the Macintosh laryngoscope or C-MAC videolaryngoscope with styletted and non-styletted ETT. There was no significant difference between the C-MAC videolaryngoscope and Macintosh laryngoscope in Intubation Difficulty Scale (IDS) score using either styletted [median (IQR) 2 (1, 3) vs. 3 (2, 4); p = 0.58] or non-styletted ETT [median (IQR) 4 (2, 6) vs. 3 (2, 8); p = 1.00]. Similarly, when using a similar ETT-stylet assembly, the duration of successful intubation attempt, first attempt success rate, complications, use of airway optimization maneuvers, and adjuncts to facilitate intubation were comparable. The Cormack-Lehane view of the glottis was better with the C-MAC videolaryngoscope (p MAC videolaryngoscope whereas no such effect was observed with the Macintosh laryngoscope. Use of the C-MAC videolaryngoscope and Macintosh laryngoscope resulted in similar levels of intubation difficulty during cervical immobilization when used with a similar ETT-stylet assembly. The inclusion of the stylet significantly reduced the intubation difficulty experienced with the C-MAC videolaryngoscope.

  11. Development of the CoMac Adherence Descriptor™: a linguistically-based survey for segmenting patients on their worldviews

    Directory of Open Access Journals (Sweden)

    Connor UM

    2015-03-01

    Full Text Available Ulla M Connor,1 Robert S Mac Neill Jr,1 Howard R Mzumara,2 Robert Sandy1 1International Center for Intercultural Communication (ICIC, Indiana University – Purdue University, Indianapolis, IN, USA; 2Testing Center – Division of Planning and Institutional Improvement, Indiana University – Purdue University, Indianapolis, IN, USA Abstract: Nonadherence to prescribed medication and healthy behaviors is a pressing health care issue. Much research has been conducted in this area under a variety of labels, such as compliance, disease management and, most recently, adherence. However, the complex factors related to predicting and, more importantly, understanding and explaining adherence, have nevertheless remained elusive. However, through an in-depth linguistic analysis of patient talk, the International Center for Intercultural Communication (ICIC at Indiana University has produced a psycholinguistic coding system that uses patients’ own language to cluster them into distinct groups based on their worldviews. ICIC’s studies have shown, for example, that patients reveal their fundamental perceptions about themselves and their environment in their life narratives; clustering of individual patients based on these different perceptions is possible via the use of differential language in survey questions, and differential language can be used to tailor messages for individual patients in a manner that these individuals prefer over generically worded communication. In grant-funded research, an interdisciplinary team of researchers at the ICIC reviewed the literature and identified three basic psychosocial tenets related to adherence: control orientation, based on locus of control research; agency, based on self-efficacy; and affect or attitude and emotion. These three constructs were selected because, in the published literature, they have been consistently found to be connected to patient adherence. Based on this research, a survey, the CoMac

  12. [Airway Management Using McGrath MAC in a Pediatric Patient with a Laryngeal Saccular Cyst].

    Science.gov (United States)

    Yamada, Rieko; Mitono, Hiroyuki; Sugiyama, Yuki; Kawamata, Mikito

    2015-02-01

    An 18-month-old female infant was scheduled for resection of a laryngeal saccular cyst inducing narrow airway. Since the cyst protruded from the left side of the epiglottis and the vocal cord was compressed to the right side, a difficult airway was anticipated. In addition, there was a risk of tracheal occlusion by rupture of the cyst Awake intubation was considered to be dangerous. Slow induction with sevoflurane and neuromusclar blockade was attempted, preparing reversal of the neuromusclar blockade. Fortunately, mask ventilation was achieved without difficulty. It was necessary to insert a tracheal tube avoiding the cyst We used McGrath MAC (Aircraft Medical Co., UK), which enabled us to manipulate the tracheal tube. A tracheal tube was successfully inserted under McGrath monitor guidance.

  13. Regional ventilation/perfusion mismatch pattern in patient with Swyer James (MacLeod′s syndrome

    Directory of Open Access Journals (Sweden)

    Sait Sager

    2014-01-01

    Full Text Available Swyer James (McLeod′s syndrome (SJMS is an uncommon disease, which occurs as a result of childhood bronchiolitis obliterans. Patients may not be diagnosed until later in their life. A 46-year-old man underwent ventilation/perfusion scintigraphy for acute onset of dyspnea. The scan showed markedly diminished ventilation and perfusion unilaterally on the right middle and inferior lobes. However, mismatched ventilation-perfusion pattern was shown on the upper right lobe, which was consistent with pulmonary embolism. Unilaterally matched ventilation/perfusion defect can see in SJMS in lung scintigraphy; however, when pulmoner embolism may accompany, scintigraphy should be carefully examined.

  14. Nasotracheal intubation of a patient with restricted mouth opening using a McGrath MAC X-Blade and Magill forceps.

    Science.gov (United States)

    Arslan, Zehra İpek; Ozdal, P; Ozdamar, D; Agır, H; Solak, M

    2016-10-01

    We experienced a case of successful nasotracheal intubation using the X-Blade of the McGrath MAC in a 28-year-old woman with a 2.5-cm mouth opening. She had no teeth on the right side, her neck movement was limited, her mandibular protrusion was grade C, and her Mallampati could not be evaluated. Her tongue was fixed to the left wall during a previous surgery. We evaluated the awake glottic view using the McGrath MAC X-Blade and topical oral anesthesia. We obtained a Cormack-Lehane grade II view and then decided to administer general anesthesia. Intubation was attempted with a Macintosh laryngoscope, but we could not insert the scope deeply enough and there was no area in which to insert the Magill forceps or endotracheal tube. We then used the X-Blade 3 of the McGrath MAC and obtained a sufficient area in which to insert the tube and manipulate the Magill forceps. A laryngoscopic view was achieved in 7 s and nasotracheal intubation was performed in 16 s with a 7.0-mm spiral tube using the Magill forceps. McGrath MAC X-Blade can be used with the Magill forceps in patients with restricted mouth opening with careful patient selection, in experienced hands.

  15. Macs for dummies

    CERN Document Server

    Baig, Edward C

    2014-01-01

    Get the most out of your Mac with this comprehensive guide Macs For Dummies, 13th Edition is the ultimate guide to your Mac, fully updated to include information about the latest updates. The book walks you through troubleshooting, syncing mobile devices, integrating Windows, and more, so you can take advantage of everything Macs have to offer. Whether you're a new user, a recent convert, or you just want to get the most out of your Mac, this book puts all the information you need in one place. Discover what makes Macs superior computing machines. Learn the basics, from mastering the Dock and

  16. Windows for Intel Macs

    CERN Document Server

    Ogasawara, Todd

    2008-01-01

    Even the most devoted Mac OS X user may need to use Windows XP, or may just be curious about XP and its applications. This Short Cut is a concise guide for OS X users who need to quickly get comfortable and become productive with Windows XP basics on their Macs. It covers: Security Networking ApplicationsMac users can easily install and use Windows thanks to Boot Camp and Parallels Desktop for Mac. Boot Camp lets an Intel-based Mac install and boot Windows XP on its own hard drive partition. Parallels Desktop for Mac uses virtualization technology to run Windows XP (or other operating systems

  17. Cellular immune responses to ESAT-6 discriminate between patients with pulmonary disease due to Mycobacterium avium complex and those with pulmonary disease due to Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Lein, A D; von Reyn, C F; Ravn, P;

    1999-01-01

    ESAT-6 (for 6-kDa early secreted antigenic target) is a secreted antigen found almost exclusively in organisms of the Mycobacterium tuberculosis complex. We compared in vitro gamma interferon (IFN-gamma) responses by peripheral blood mononuclear cells to this antigen in patients with pulmonary...... disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0...... (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis...

  18. Valvular and perivalvular involvement in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Neelavathi Senkottaiyan; Saad Hafidh; Farrin A. Manian; Martin A. Alpert

    2005-01-01

    Abstract Mitral annular calcification (MAC) and aortic valve alcification (AVC) are the most common valvular and perivalvular bnormalities in patients with chronic kidney disease (CKD). Both MAC and AVC occur at a younger age in CKD patients than in the general population. AVC progresses to aortic stenosis and mild aortic stenosis progresses to severe aortic stenosis at a more rapid rate in patients with CKD than in the general population. The use of calcium-free phosphate binders in such patients may reduce the calcium burden in valvular and perivalvular tructures and retard the rate of progression of aortic stenosis. Despite high rates of morbidity and mortality, the prognosis associated with valve surgery in patients with CKD is better than without valve surgery. Infective endocarditis remains an important complication of CKD, particularly in those treated with hemodialysis.

  19. Enterprise Mac administrators guide

    CERN Document Server

    Smith, William

    2015-01-01

    IT departments everywhere will be integrating Macs and Mac OS X into their IT infrastructure and this book will tell them how to do it. It will serve as an authoritative, useful and frequently referenced book on Mac OS X administration.

  20. Negative correlation between tumour size and cortisol/ACTH ratios in patients with Cushing's disease harbouring microadenomas or macroadenomas.

    Science.gov (United States)

    Machado, M C; Alcantara, A E E; Pereira, A C L; Cescato, V A S; Castro Musolino, N R; de Mendonça, B B; Bronstein, M D; Fragoso, M C B V

    2016-12-01

    Pituitary macroadenomas (MACs) represent 10-30 % of Cushing's disease (CD) cases. The aim of this study was to report the clinical, laboratorial and imaging features and postsurgical outcomes of microadenoma (MIC) and MAC patients. Retrospective study with 317 CD patients (median 32 years old, range 9-71 years) admitted between 1990 and 2014, 74 (23.3 %) of whom had MAC. Hirsutism, plethora facial, muscular weakness and muscular atrophy were more frequent in the MIC patients. Nephrolithiasis, osteopenia, hyperprolactinaemia and galactorrhoea were more prevalent in MAC patients. The morning serum cortisol (Fs), nocturnal salivary cortisol (NSC), nocturnal Fs (Fs 2400 h), low- and high-dose dexamethasone suppression test results and CRH and desmopressin test results were similar between the subgroups. MIC patients showed higher urinary cortisol at 24 h (UC), and MAC patients presented higher ACTH levels but lower Fs/ACTH, Fs 2400 h/ACTH, NSC/ACTH and UC/ACTH ratios. There were negative correlations of tumour size with Fs/ACTH, Fs 2400 h/ACTH, NSC/ACTH and UC/ACTH ratios. Overall, the postsurgical remission and recurrence rates were similar between MIC and MAC. However, patients in remission (MIC + MAC) showed smaller tumour diameters and a lower prevalence of invasion and extension on MRI. Despite exhibiting higher plasma ACTH levels, CD patients with MAC presented lower cortisol/ACTH ratios than did patients with MIC, with a negative correlation between tumour size and cortisol/ACTH ratios. The overall postsurgical remission and recurrence rates were similar between MIC and MAC patients, with those with larger and/or invasive tumours showing a lower remission rate.

  1. Mac at Work

    CERN Document Server

    Sparks, David

    2011-01-01

    Bridge the gap between using a Mac at home and at the office. Now that you love your Mac at home, you want to use one at the office without missing a beat of productivity or professionalism. This unique guide shows you how.  You'll find best Mac business practices for handling word processing, spreadsheet and presentation creation, task and project management, and graphics. The book also explores topics such as hardware maintenance, how to synchronize with multiple computers, data backup, and communication with Windows networks.: Covers the nuts and bolts of using a Mac at work, including sync

  2. Predictive value of mitral annular calcification for the diagnosis of coronary artery disease in patients with dilated cardiomyopathy.

    Science.gov (United States)

    Dincer, I; Ozdol, C; Dandachi, R; Akyurek, O; Atmaca, Y; Kiliçkap, M; Erol, C; Oral, D

    2001-08-01

    Mitral annulus calcification (MAC) is an independent predictor of coronary artery disease (CAD). The present study was designed to determine whether an association exists between MAC and CAD in patients with dilated cardiomyopathy. Among the 286 patients with MAC on echocardiographic examination who underwent coronary angiography, 55 patients with echocardiographic findings of dilated cardiomyopathy (group I) were compared to 60 age-matched controls without MAC and an echocardiographic diagnosis of dilated cardiomyopathy (group II) who underwent coronary angiography during the same time. There were no differences in echocardiographic findings between two groups. The prevalence of CAD was higher in group I when compared to group II (74% vs 28%, pMAC (p=0.001), diabetes mellitus (p=0.048), and history of anginal chest pain (p=0.009) are the independent predictors for the presence of CAD in patients with dilated cardiomyopathy. In conclusion, MAC may be a marker for the presence of coronary artery disease in patients with dilated cardiomyopathy.

  3. Sero-diagnosis of Mycobacterium avium complex lung disease using serum immunoglobulin A antibody against glycopeptidolipid antigen in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chin-Chung Shu

    Full Text Available BACKGROUND: Lung disease (LD due to non-tuberculous mycobacteria is an important clinical concern. Mycobacterium avium complex (MAC is one of the most common causative agents but the diagnosis of MAC-LD remains challenging. Detection of serum IgA antibody against MAC glycopeptidolipid (GPL has recently been shown to improve the diagnosis of MAC-LD, but has yet to be validated worldwide. METHODS: This prospective study was conducted in a tertiary referral center in northern Taiwan and enrolled patients with MAC-LD, MAC contamination, other lung diseases, and control subjects. Serum immunoglobulin A (IgA antibody against MAC-GPL was detected in the participants and its specificity and sensitivity was assessed. RESULTS: There were 56 patients with MAC-LD, 11 with MAC contamination, 13 M. kansasii-LD, 26 LD due to rapidly-growing mycobacteria (RGM, 48 pulmonary tuberculosis, and 42 household contacts of patients with TB. Patients with MAC-LD were older and 32% of them had an underlying co-morbidity. By logistic regression, serum MAC-GPL IgA level was an independent predictor of MAC-LD among the study subjects and those with culture-positive specimens for MAC. By the receiver operating characteristic curve, serum MAC-GPL IgA had a good power to discriminate MAC-LD from MAC contamination. Under the optimal cut-off value of 0.73 U/mL, its sensitivity and specificity were 60% and 91%, respectively. Among MAC-LD patients, presence of co-morbidity was associated with MAC-GPL <0.73 U/ml in logistic regression analysis. CONCLUSIONS: Measurement of serum anti-MAC-GPL IgA level is useful for the diagnosis of MAC-LD. However, its implement in clinical practice for immuno-compromised hosts needs careful consideration.

  4. Enterprise Mac Security Mac OS X Snow Leopard Security

    CERN Document Server

    Edge, Stephen Charles; Hunter, Beau; Sullivan, Gene; LeBlanc, Dee-Ann

    2010-01-01

    A common misconception in the Mac community is that Mac's operating system is more secure than others. While this might be true in certain cases, security on the Mac is still a crucial issue. When sharing is enabled or remote control applications are installed, Mac OS X faces a variety of security threats. Enterprise Mac Security: Mac OS X Snow Leopard is a definitive, expert-driven update of the popular, slash-dotted first edition and was written in part as a companion to the SANS Institute course for Mac OS X. It contains detailed Mac OS X security information, and walkthroughs on securing s

  5. Comparing insertion characteristics on nasogastric tube placement by using GlideScopeTM visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

    Directory of Open Access Journals (Sweden)

    Wan Hafsah Wan Ibadullah

    Full Text Available Abstract Background and objective: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScopeTM visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Methods: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. Results: The results showed success rates of 74.5% in the GlideScopeTM Group as compared to 58.3% in the MacIntosh Group (p = 0.10. For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2 ± 9.3 s as compared to Group B, with a duration of 18.9 ± 13.0 s (p = 0.57. A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p = 0.15. The most common complications, which occurred, were coiling, followed by bleeding and kinking. Conclusion: This study showed that using the GlideScopeTM to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications.

  6. Comparing insertion characteristics on nasogastric tube placement by using GlideScope™ visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients.

    Science.gov (United States)

    Wan Ibadullah, Wan Hafsah; Yahya, Nurlia; Ghazali, Siti Salmah; Kamaruzaman, Esa; Yong, Liu Chian; Dan, Adnan; Md Zain, Jaafar

    2016-01-01

    This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScope™ visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. The results showed success rates of 74.5% in the GlideScope™ Group as compared to 58.3% in the MacIntosh Group (p=0.10). For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2±9.3s as compared to Group B, with a duration of 18.9±13.0s (p=0.57). A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p=0.15). The most common complications, which occurred, were coiling, followed by bleeding and kinking. This study showed that using the GlideScope™ to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. C-MAC(®) video laryngoscope with D-BLADE™ and Frova introducer for awake intubation in a patient with parapharyngeal mass.

    Science.gov (United States)

    Vinayagam, S; Dhanger, S; Tilak, P; Gnanasekar, R

    2016-01-01

    Parapharyngeal tumors are rare head and neck tumors which can present as an intraoral mass and can pose great challenge to anesthesiologists. The primary concern is the difficult airway due to gross anatomical distortion of the upper airway. Securing the airway in an awake state should be the primary goal of anesthesiologists to avoid catastrophic complications. Herewith, we report the successful use of C-MAC(®) video laryngoscope with the acute-angle D-BLADE™ in combination with Frova introducer for awake intubation in a patient with parapharyngeal mass after multiple attempts of failed fiber-optic intubation.

  8. Quality of Life with Macular Degeneration Is Not as Dark as It May Seem: Patients' Perceptions of the MacDQoL Questionnaire.

    Science.gov (United States)

    Ord, Lisa M; Wright, JoAnne; DeAngelis, Margaret M; Feehan, Michael

    2015-09-22

    To determine the perceived relevance and value of an individualized measure of the impact of macular degeneration on quality of life (QoL) for elderly people with Age-Related Macular Degeneration (AMD) in the USA, through the assessment of the suitability of the measure's domains and by gaining a deeper insight into the impact of AMD on patients' QoL vis-á-vis these domains, community-dwelling older adults in the metropolitan Salt Lake City, Utah area were interviewed using the macular degeneration on quality of life (MacDQoL) instrument. Participants felt that the MacDQoL was a relevant instrument for use in this US study population, though it could be improved by adding items pertaining to transportation, and independent driving, in particular, as an important QoL indicator. The emerging theme from analysis of the respondent's commentary was that, in spite of AMD, these respondents were committed to engage in, and enjoy life. This is an important concept for clinicians and those who offer support programs to integrate into their care planning and reinforce in messaging to patients with the condition.

  9. Diseases of Elderly Patient

    Directory of Open Access Journals (Sweden)

    Eulália Maria Martins da SILVA

    2007-03-01

    Full Text Available Introduction: With the population aging, the number of chronic and degenerative illnesses, own of the old age, it will appear more frequently. Objective: The objective of this study was to do a literature revision in order to approach the illnesses that more they attack the patients of the third age (from the chronic diseases even the degenerative chronic diseases. Para that, a description will be accomplished as the concept and the signs and symptoms of the illnesses observed more frequently in the senior patients that will be depression, stress, loss of the memory, aterosclerose, osteoporosis, arthritis reumatóide and disorder temporomandibular, arterial hypertension, vascular diseases, heart diseases, obesity, diabetes mellitus, urinary incontinence, hearing and visual disturbances, disease of Parkinson and still the disease of Alzheimer. Conclusion: Based on the literature revision, we ended that, not only the professionals of the health, as well as all those that work with the seniors in general, they should have the concern of treating him with larger attention, patience and perseverance, to the point of to minimize the limitations that each one presents.

  10. Mycobacterium avium-Intracellulare Complex (MAC) Producing a Periportal Pseudotumor in a Patient With HIV and a Normal CD4 Count

    Science.gov (United States)

    Johnson, Jessica; Driscoll, Meghan; Cohen, Michael

    2016-01-01

    Mycobacterium avium-intracellulare complex (MAC) is an opportunistic infection typically associated with profound immunosuppression, such as AIDS. The presentation of disseminated MAC can be subtle and mimic systemic symptoms associated with lymphoma; abdominal pseudotumor is an exceptionally rare presentation. In the era of highly active anti-retroviral therapy (HAART), opportunistic infections are increasingly rare, and secondary prophylaxis for MAC may be discontinued after adequate therapy and immune reconstitution. Recurrence of disseminated MAC after adequate therapy may be due to macrolide resistance, but with an adequate CD4 T-cell count and undetectable HIV viral load, recurrence raises questions of more subtle immune dysregulation.

  11. VALIDATION OF THE MACNEW QUESTIONNAIRE FOR THE ASSESSMENT OF HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH ISHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    N. V. Pogosova

    2014-01-01

    Full Text Available Background. Recently, a greater emphasis is being placed on health-related quality of life (HRQL in both global and Russian practice. In many countries HRQL in patients with ischemic heart disease (IHD is assessed by a disease-specific questionnaire – The MacNew Heart Disease HRQL questionnaire (MacNew – that has been validated in many countries, but not yet in Russia.Aim. To validate Russian MacNew questionnaire in patients with different clinical types of ICD.Material and methods. Direct and reverse translation of the MacNew questionnaire was performed in accordance with the protocol of international HeartQol study. The patients (n=322 with angina, myocardial infarction, and heart failure were enrolled into the study and completed the Short-Form 36 (SF-36, the Hospital Anxiety and Depression Scale (HADS and the Mac-New at the baseline; approximately 20% of the patients were reexamined 2 weeks later. The conceptual framework, reliability and validity of the Russian version of MacNew HRQL questionnaire were assessed.Results. The Russian version of MacNew questionnaire demonstrated sufficient internal consistency with Cronbach’s α exceeding 0.80. High test-retest reliability of the questionnaire was established in the total sample of ICD patients (0.949; p<0.01. Factor analysis in general substantiated the conceptual model of the Russian version of MacNew and its satisfactory content validity. Convergent validity was confirmed by strong correlations between the subscales of Russian MacNew questionnaire and conceptually similar subscales of the SF-36 survey (in the total sample and in separated clinical groups. Discriminant validity of the Russian version of MacNew was also confirmed differentiating patients with different SF-36 health transition and patients with and without anxiety and depression (HADS questionnaire.Conclusions. The Russian version of MacNew HRQL questionnaire has demonstrated adequate reliability and validity as compared

  12. The MAC framework: redefining MAC protocols for wireless sensor networks

    NARCIS (Netherlands)

    Parker, T.; Halkes, G.; Bezemer, M.; Langendoen, K.

    2010-01-01

    Most current WSN MAC protocol implementations have multiple tasks to perform—deciding on correct timing, sending of packets, sending of acknowledgements, etc. However, as much of this is common to all MAC protocols, there is duplication of functionality, which leads to larger MAC protocol code size

  13. The MAC framework: redefining MAC protocols for wireless sensor networks

    NARCIS (Netherlands)

    Parker, T.; Halkes, G.; Bezemer, M.; Langendoen, K.

    2010-01-01

    Most current WSN MAC protocol implementations have multiple tasks to perform—deciding on correct timing, sending of packets, sending of acknowledgements, etc. However, as much of this is common to all MAC protocols, there is duplication of functionality, which leads to larger MAC protocol code size

  14. [Phosphorus NMR spectroscopy. Its value in the diagnosis of metabolic myopathies. A case of Mac Ardle's disease].

    Science.gov (United States)

    Kaminsky, P; Melone, M; Brunotte, F; Escanye, J M; Robin, B; Floquet, J; Duc, M L; Robert, J; Duc, M

    1990-06-09

    Phosphorus nuclear magnetic resonance spectroscopy is a non-invasive method used to study muscle bioenergetics in vivo. A new case of Mc Ardle's disease (myophosphorylase deficiency) is reported here. In a context of metabolic myopathy this method can provide a diagnosis of glycogenosis. The spectra obtained at exercise and during recovery determine the degree of enzyme deficiency with satisfactory precision.

  15. Recent results from MAC

    Energy Technology Data Exchange (ETDEWEB)

    MAC Collaboration

    1982-05-01

    Some preliminary results from the MAC detector at PEP are presented. These include measurements of the angular distribution of ..gamma gamma.., ..mu mu.. and tau tau final states, a determination of the tau lifetime, a measurement of R, and a presentation of the inclusive muon p/sub perpendicular/ distribution for hadronic events.

  16. Macs For Seniors For Dummies

    CERN Document Server

    Chambers, Mark L

    2012-01-01

    You're never too old to fall in love—with your Mac! You took a while, but you are now the proud owner of your first Mac computer. Macs For Seniors For Dummies is just for you. This friendly, accessible guide walks you through choosing a Mac and learning how to use it. You'll find yourself falling head over heels for your Mac in no time. Macs For Seniors For Dummies introduces you to all the basics that you need to know: turning the Mac on and getting connected; using the keyboard and mouse; working with files and folders; navigate around the Mac desktop and OS X Lion; setting up an Inter

  17. RIC versus MAC UCBT in adults with AML: A report from Eurocord, the ALWP and the CTIWP of the EBMT

    Science.gov (United States)

    Beohou, Eric; Labopin, Myriam; Sanz, Guillermo; Milpied, Noel; Michallet, Mauricette; Bacigalupo, Andrea; Blaise, Didier; Sierra, Jorge; Socié, Gérard; Cornelissen, Jan J.; Schmid, Christoph; Giebel, Sebastian; Gorin, Norbert-Claude; Esteve, Jordi; Ciceri, Fabio; Savani, Bipin N.; Mohty, Mohamad; Gluckman, Eliane; Nagler, Arnon

    2016-01-01

    Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study. PMID:27250025

  18. iMac pocket genius

    CERN Document Server

    Hart-Davis, Guy

    2010-01-01

    If you want to get the very most out of your iMac, put this savvy Portable Genius guide to work. Want to make the most of the new Magic Mouse and the latest iLife apps? Set up a wireless network using your iMac's AirPort card? Watch television on your iMac, or show iMac videos and movies on your television? You'll find cool and useful Genius tips, full-color screenshots, and pages of easy-to-access shortcuts and tools that will save you time and let you enjoy your iMac to the max.

  19. Monolithic MACS micro resonators

    Science.gov (United States)

    Lehmann-Horn, J. A.; Jacquinot, J.-F.; Ginefri, J. C.; Bonhomme, C.; Sakellariou, D.

    2016-10-01

    Magic Angle Coil Spinning (MACS) aids improving the intrinsically low NMR sensitivity of heterogeneous microscopic samples. We report on the design and testing of a new type of monolithic 2D MACS resonators to overcome known limitations of conventional micro coils. The resonators' conductors were printed on dielectric substrate and tuned without utilizing lumped element capacitors. Self-resonance conditions have been computed by a hybrid FEM-MoM technique. Preliminary results reported here indicate robust mechanical stability, reduced eddy currents heating and negligible susceptibility effects. The gain in B1 /√{ P } is in agreement with the NMR sensitivity enhancement according to the principle of reciprocity. A sensitivity enhancement larger than 3 has been achieved in a monolithic micro resonator inside a standard 4 mm rotor at 500 MHz. These 2D resonators could offer higher performance micro-detection and ease of use of heterogeneous microscopic substances such as biomedical samples, microscopic specimens and thin film materials.

  20. Blind Cognitive MAC Protocols

    CERN Document Server

    Mehanna, Omar; Gamal, Hesham El

    2008-01-01

    We consider the design of cognitive Medium Access Control (MAC) protocols enabling an unlicensed (secondary) transmitter-receiver pair to communicate over the idle periods of a set of licensed channels, i.e., the primary network. The objective is to maximize data throughput while maintaining the synchronization between secondary users and avoiding interference with licensed (primary) users. No statistical information about the primary traffic is assumed to be available a-priori to the secondary user. We investigate two distinct sensing scenarios. In the first, the secondary transmitter is capable of sensing all the primary channels, whereas it senses one channel only in the second scenario. In both cases, we propose MAC protocols that efficiently learn the statistics of the primary traffic online. Our simulation results demonstrate that the proposed blind protocols asymptotically achieve the throughput obtained when prior knowledge of primary traffic statistics is available.

  1. MacBook for dummies

    CERN Document Server

    Chambers , Mark L

    2014-01-01

    Make friends with your MacBook the fun and easy way! Ultra-light, ultra-fast, and ultra-powerful, the MacBook is the coolest laptop in town, and longtime Mac guru Mark L. Chambers is just the guy to help you get to know your MacBook in no time. Take a closer look at the latest features, get the lowdown on OS X, unleash your creative forces with iLife, take care of business with the iWork applications, and sync it all with iCloud with the expert advice in this bestselling MacBook guide. Whether this is your first MacBook or your first laptop, period, you''ll learn to navigate the Mac desktop, c

  2. Macs For Dummies, Pocket Edition

    CERN Document Server

    Baig, Edward C

    2011-01-01

    The fun and easy way to make the most of your wonderful Mac. Simply Mac-nificent — all the cool things your Mac can do! This handy guide helps you figure out the nuts and bolts of your Mac. Navigate the Mac desktop, use the Safari Web browser to surf the Internet, e-mail photos to friends and family, create and print documents, rip audio CDs, and more. The fun begins right here!. Open the book and find: How to set up and configure your Mac; Tips for getting around on the Mac desktop; Steps for setting up an e-mail account and browsing the Internet; Details about the free programs that come wit

  3. iMac portable genius

    CERN Document Server

    Hart-Davis, Guy

    2010-01-01

    The most up-to-date coverage on the latest iMac advice, tools, and shortcuts Cool and useful tips, full-color screenshots, and savvy advice show you how to get the most out of your iMac. Fully updated to cover the iMac's latest features and capabilities, this guide is packed with indispensible information on iLife '09 and Mac OS X Snow Leopard, and shows you how to customize your iMac in a way that it will work best for you.Explores all the bells and whistles of the iMac, including the new Magic Mouse, iLife apps such as iPhoto and iMovie, and Mac OS X Snow LeopardShows yo

  4. PATIENT REGISTRIES FOR RARE DISEASES

    Directory of Open Access Journals (Sweden)

    Mariela Deliverska

    2016-06-01

    Full Text Available Rare diseases are diseases with a particularly low prevalence. The specificities of rare diseases - limited number of patients and scarcity of relevant knowledge and expertise - single them out as a distinctive domain of very high added value. The international reference for classification of diseases and conditions is the International Classification of Diseases (ICD, coordinated by the World Health Organization (WHO. Patient registries and databases constitute key instruments for the development of clinical research in the field of rare diseases. Rare disease registries include not only diseases that are inherently rare, but also common diseases that are rare in specific populations, especially those defined by demographics. Disease registries create the possibility of assessing the long-term safety and benefit of different treatments, perhaps leading to treatment algorithms that allow more choices for patients and clinicians.

  5. Mycobacterium avium Complex Infection in a Patient with Sickle Cell Disease and Severe Iron Overload

    Directory of Open Access Journals (Sweden)

    Kamal Shemisa

    2014-01-01

    Full Text Available A 34-year-old female with sickle cell anemia (hemoglobin SS disease and severe iron overload presented to our institution with the subacute presentation of recurrent pain crisis, fever of unknown origin, pancytopenia, and weight loss. A CT scan demonstrated both lung and liver nodules concerning for granulomatous disease. Subsequent biopsies of the liver and bone marrow confirmed the presence of noncaseating granulomas and blood cultures isolated Mycobacterium avium complex MAC. Disseminated MAC is considered an opportunistic infection typically diagnosed in the immunocompromised and rarely in immunocompetent patients. An appreciable number of mycobacterial infection cases have been reported in sickle cell disease patients without immune dysfunction. It has been reported that iron overload is known to increase the risk for mycobacterial infection in vitro and in vivo studies. While iron overload is primarily known to cause end organ dysfunction, the clinical relationship with sickle cell disease and disseminated MAC infection has not been reported. Clinical iron overload is a common condition diagnosed in the sub-Saharan African population. High dietary iron, genetic defects in iron trafficking, as well as hemoglobinopathy are believed to be the etiologies for iron overload in this region. Patients with iron overload in this region were 17-fold more likely to die from Mycobacterium tuberculosis. Both experimental and clinical evidence suggest a possible link to iron overload and mycobacterial infections; however larger observational studies are necessary to determine true causality.

  6. Illness perception patterns in patients with Coronary Artery Disease.

    Science.gov (United States)

    Kunschitz, E; Friedrich, O; Schöppl, Ch; Maitz, J; Sipötz, J

    2017-09-01

    The purpose of this study is to identify patterns of illness perception in patients with angiografically verified Coronary Artery Disease. A total of 166 patients (age: 64.4 ± 12.1, 80.7% male) were recruited after angiography. Cluster analysis on the items of the Brief Illness Perception Questionnaire was used to identify patterns of illness perception. The resulting groups were characterized with regard to Quality of Life (MacNew), anxiety and depression (GAD-7 and PHQ-9) and resilience (RS-13). The analysis revealed 4 distinct groups differing with regard to the items covering the perception of the physical and emotional impact of disease. Stronger perceptions in these domains were associated with lower Health Related Quality of Life and higher levels of emotional distress. Group 1 (33.1%) reported the strongest perceptions of the physical and emotional impact of disease and expressed low treatment control, high chronic timeline and significantly higher levels of depression than the other groups. Group 2 (27.7%) was characterized by more moderate perceptions of the emotional and physical impact of disease together with low scores on illness coherence and chronic timeline. Groups 3 (25.3%) and 4 (13.9%) reported smaller physical and emotional impact of illness but differed in chronic timeline. Our results correspond largely to recent findings in patients with other chronic diseases. Further research is needed to explore if stratification of patients according patterns of illness perception can help to inform patient-physician communication strategies.

  7. "They just come, pick and go." The Acceptability of Integrated Medication Adherence Clubs for HIV and Non Communicable Disease (NCD) Patients in Kibera, Kenya

    Science.gov (United States)

    Venables, Emilie; Edwards, Jeffrey K.; Baert, Saar; Etienne, William; Khabala, Kelly; Bygrave, Helen

    2016-01-01

    Introduction The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care. Stable NCD and HIV patients can now collect their chronic medication every three months through a club, rather than through individual clinic appointments. Methodology We conducted a qualitative research study to assess patient and health-care worker perceptions and experiences of MACs in the urban informal settlement of Kibera, Kenya. A total of 106 patients (with HIV and/or other NCDs) and health-care workers were purposively sampled and included in the study. Ten focus groups and 19 in-depth interviews were conducted and 15 sessions of participant observation were carried out at the clinic where the MACs took place. Thematic data analysis was conducted using NVivo software, and coding focussed on people’s experiences of MACs, the challenges they faced and their perceptions about models of care for chronic conditions. Results MACs were considered acceptable to patients and health-care workers because they saved time, prevented unnecessary queues in the clinic and provided people with health education and group support whilst they collected their medication. Some patients and health-care workers felt that MACs reduced stigma for HIV positive patients by treating HIV as any other chronic condition. Staff and patients reported challenges recruiting patients into MACs, including patients not fully understanding the eligibility criteria for the clubs. There were also some practical challenges during the

  8. MAC of xenon and halothane in rhesus monkeys.

    Science.gov (United States)

    Whitehurst, S L; Nemoto, E M; Yao, L; Yonas, H

    1994-10-01

    Local cerebral blood flow (LCBF) maps produced by 33% xenon-enhanced computed tomographic scanning (Xe/CT LCBF) are useful in the clinical diagnosis and management of patients with cerebrovascular disorders. However, observations in humans that 25-35% xenon (Xe) inhalation increases cerebral blood flow (CBF) have raised concerns that Xe/CT LCBF measurements may be inaccurate and that Xe inhalation may be hazardous in patients with decreased intracranial compliance. In contrast, 33% Xe does not increase CBF in rhesus monkeys. To determine whether this interspecies difference in the effect of Xe on CBF correlates with an interspecies difference in the anesthetic potency of Xe, we measured the minimum alveolar concentration (MAC) of Xe preventing movement to a tail-clamp stimulus in rhesus monkeys. Using a standard protocol for the determination of MAC in animals, we first measured the MAC of halothane (n = 5), and then used a combination of halothane and Xe to measure the MAC of Xe (n = 7). The halothane MAC was 0.99 +/- 0.12% (M +/- SD), and the Xe MAC was 98 +/- 15%. These results suggest that the MAC of Xe in rhesus monkeys is higher than the reported human Xe MAC value of 71%. Thus the absence of an effect of 33% Xe on CBF in the rhesus monkey may be related to its lower anesthetic potency.

  9. iMac for dummies

    CERN Document Server

    Chambers, Mark L

    2014-01-01

    Do it all with your iMac and this bestselling For Dummies guide! You're still a little giddy from finally scoring your new iMac, and you can't wait to get started. Even if you're already in love with your iMac, it helps to have a little guidance to really get the most out of this ultimate all-in-one computer. This updated edition of iMac For Dummies is the ideal way to learn the iMac fundamentals from setting up and personalizing your machine to importing files, making FaceTime video calls, surfing the web, using your favorite programs and apps, and everything in between. Trusted Mac guru Mark

  10. Learn Excel 2011 for Mac

    CERN Document Server

    Hart-Davis, Guy

    2011-01-01

    Microsoft Excel 2011 for Mac OS X is a powerful application, but many of its most impressive features can be difficult to find. Learn Excel 2011 for Mac by Guy Hart-Davis is a practical, hands-on approach to learning all of the details of Excel 2011 in order to get work done efficiently on Mac OS X. From using formulas and functions to creating databases, from analyzing data to automating tasks, you'll learn everything you need to know to put this powerful application to use for a variety of tasks. What you'll learn * The secrets of the Excel for Mac interface! * How to create effective workbo

  11. A simulation study of TaMAC protocol using network simulator 2.

    Science.gov (United States)

    Ullah, Sana; Kwak, Kyung Sup

    2012-10-01

    A Wireless Body Area Network (WBAN) is expected to play a significant role in future healthcare system. It interconnects low-cost and intelligent sensor nodes in, on, or around a human body to serve a variety of medical applications. It can be used to diagnose and treat patients with chronic diseases such as hypertensions, diabetes, and cardiovascular diseases. The lightweight sensor nodes integrated in WBAN require low-power operation, which can be achieved using different optimization techniques. We introduce a Traffic-adaptive MAC protocol (TaMAC) for WBAN that supports dual wakeup mechanisms for normal, emergency, and on-demand traffic. In this letter, the TaMAC protocol is simulated using a well-known Network Simulator 2 (NS-2). The problem of multiple emergency nodes is solved using both wakeup radio and CSMA/CA protocol. The power consumption, delay, and throughput performance are closely compared with beacon-enabled IEEE 802.15.4 MAC protocol using extensive simulations.

  12. [Remodelling of right heart chambers in patients with occupational respiratory diseases in post-contact period].

    Science.gov (United States)

    2011-01-01

    Clinical manifestations of occupational respiratory diseases and functional cardiorespiratory state in workers were studied in thorough examination of 329 workers including main occupations of refractory metals alloys production, who are exposed to polymetallic highly dispersed aerosols in concentrations exceeding the MACs. The data obtained prove changes in intracardial hemodynamics, lower myocardial contractility and lung hypertension even at early stages of the process, progressing in the advanced disease and in post-contact period. Heart remodelling underlies frequent cardiac arrhythmias in occupational respiratory diseases. With that, intensity of the changes reliably increases with higher degree of bronchial obstruction in the patients and could serve as a marker of respiratory failure severity.

  13. Ellen MacArthur

    Institute of Scientific and Technical Information of China (English)

    Teodora; Lazarova

    2006-01-01

    Just over a year since breaking the round theworld solo record on board her 75 foot trimaranB&O,Ellen MacArthur embarked on a newventure:the Asian Record Circuit 2006,incorpo-rating the ‘Tour Of China’,and bringing a differ-ent set of challenges into new territories.Wespoke to Ellen and her team during their recent(April)stopover in Oingdao.When did you start sailing and what inspiredyou(you grew up in Derbyshire,in the UK,quite far away from the water)?I was introduced to sailing by my Aunt Thea ona small sailing boat called Cabaret.We wentsailing along the east coast of EngLand andbefore I knew it,I was hooked on sailing.I wasso inspired that when I was at school,I saved

  14. Macs for seniors for dummies

    CERN Document Server

    Chambers, Mark L

    2009-01-01

    Over 50 and thinking about getting your first computer? A user-friendly Mac is a great choice, and Macs For Seniors For Dummies walks you through choosing one and learning to use it. You won't even need your grandchildren to help! Macs For Seniors For Dummies introduces you to all the basic things you may not have encountered before-how to use the keyboard and mouse, work with files and folders, navigate around the Mac OS X desktop, set up an Internet connection, and much more. You'll learn to:Choose the Mac that's right for you, set it up, run programs and manage files, and hook up a printerU

  15. iMac for dummies

    CERN Document Server

    Chambers, Mark L

    2012-01-01

    The bestselling guide to the ultimate all-in-one computer—now updated and revised throughout! If you're looking for speed, performance, and power, the iMac is the ultimate all-in-one computer. From its superior performance, powerful operating system, and amazing applications, the iMac is one awesome machine, and the fun, friendly, and approachable style of iMac For Dummies is an ideal way to get started with the basics. You'll learn the fundamentals of the iMac including setting up and customizing your iMac and the software that comes with it, importing files from your old computer, send

  16. The minimum alveolar concentration (MAC) of isoflurane in preterm neonates.

    Science.gov (United States)

    LeDez, K M; Lerman, J

    1987-09-01

    Studies in fetal lambs suggested that the minimum alveolar concentration (MAC) in preterm neonates may be less than that in full-term neonates and older infants. To determine the MAC of isoflurane in preterm neonates, 20 patients less than 32 weeks gestation at birth and 16 patients 32-37 weeks gestation at birth, all less than 1 month post-natal age, were studied. Following tracheal intubation, the neonates were anesthetized with a predetermined end-tidal concentration of isoflurane in oxygen and air. The move-no move responses to skin incision were recorded, and MAC was determined using the "up-and-down" technique. Heart rate and systolic arterial pressure were recorded awake, before skin incision, and after skin incision. MAC (mean +/- SD) of isoflurane in preterm neonates less than 32 weeks gestation was 1.28 +/- 0.17%, and MAC in neonates 32-37 weeks gestation was 1.41 +/- 0.18% (P less than 0.05). Although heart rate did not decrease significantly in either group during the study, systolic arterial pressure decreased between 20 and 30% below awake values both before and after skin incision in both age groups (P less than 0.01). We conclude that the MAC of isoflurane in preterm neonates less than 32 weeks gestation is significantly less than that in preterm neonates 32-37 weeks gestation, and that systolic arterial pressure decreases to a similar extent at approximately 1 MAC isoflurane in both age groups.

  17. Gotcha! Macs lose their innocence

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Still believe your Mac is secure because Microsoft PCs fall prey to viruses and worms but Macs don’t? Time to wake up! This year has seen the first major compromise of Macs worldwide*. How is yours doing?   The “Flashback” Trojan is affecting Apple’s own variant of Java and compromises Macs via so-called drive-by infections, i.e. when you visit an appropriately prepared (infected!) website - and this might not necessarily be a site with questionable contents, but could well be a popular, reputable one. Security Companies worldwide have been monitoring this particular Trojan for a while and have estimated that more than half a million Macs were compromised. Connected to a few central command and control servers, the compromised Macs were then supporting the malicious activity of the bad guys! Fortunately, the security companies have now been able to take over those command and control servers and stop their destructive drive. So, Mac users, face the f...

  18. Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: impact of tyrosine kinase inhibitor and minimal residual disease.

    Science.gov (United States)

    Bachanova, V; Marks, D I; Zhang, M-J; Wang, H; de Lima, M; Aljurf, M D; Arellano, M; Artz, A S; Bacher, U; Cahn, J-Y; Chen, Y-B; Copelan, E A; Drobyski, W R; Gale, R P; Greer, J P; Gupta, V; Hale, G A; Kebriaei, P; Lazarus, H M; Lewis, I D; Lewis, V A; Liesveld, J L; Litzow, M R; Loren, A W; Miller, A M; Norkin, M; Oran, B; Pidala, J; Rowe, J M; Savani, B N; Saber, W; Vij, R; Waller, E K; Wiernik, P H; Weisdorf, D J

    2014-03-01

    The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKIs), mostly imatinib; 39% (RIC) and 49% (MAC) were minimal residual disease (MRD)(neg) pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%; P=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (P=0.058). Overall survival (OS) was similar (RIC 39% (95% confidence interval (CI) 27-52) vs 35% (95% CI 27-44); P=0.62). Patients MRD(pos) pre-HCT had higher risk of relapse with RIC vs MAC (hazard ratio (HR) 1.97; P=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared with a similar MRD population after MAC (33%; P=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; P=0.057), but absence of pre-HCT TKI (HR 1.88; P=0.018), RIC (HR 1.891; P=0.054) and pre-HCT MRD(pos) (HR 1.6; P=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRD(neg) status is preferred pre-HCT.

  19. Java and Mac OS X

    CERN Document Server

    Davis, T Gene

    2010-01-01

    Learn the guidelines of integrating Java with native Mac OS X applications with this Devloper Reference book. Java is used to create nearly every type of application that exists and is one of the most required skills of employers seeking computer programmers. Java code and its libraries can be integrated with Mac OS X features, and this book shows you how to do just that. You'll learn to write Java programs on OS X and you'll even discover how to integrate them with the Cocoa APIs.: Shows how Java programs can be integrated with any Mac OS X feature, such as NSView widgets or screen savers; Re

  20. Mac Programming for Absolute Beginners

    CERN Document Server

    Wang, Wallace

    2011-01-01

    Want to learn how to program on your Mac? Not sure where to begin? Best-selling author Wallace Wang will explain how to get started with Cocoa, Objective-C, and Xcode. Whether you are an experienced Windows coder moving to the Mac, or you are completely new to programming, you'll see how the basic design of a Mac OS X program works, how Objective-C differs from other languages you may have used, and how to use the Xcode development environment. Most importantly, you'll learn how to use elements of the Cocoa framework to create windows, store data, and respond to users in your own Mac programs.

  1. MacBook portable genius

    CERN Document Server

    Miser, Brad

    2008-01-01

    The Genius is in. You don't have to be a genius to use a MacBook. But if you want to get the very most out of yours, put this savvy Portable Genius guide to work. Want to connect your MacBook to other Macs? Use Expose to its fullest potential? Troubleshoot? You'll find cool and useful Genius tips, insider secrets, full-color screenshots, and pages of easy-to-access shortcuts and tools that will save you loads of time and make your MacBook IQ soar. Portable GENIUS Fun, hip, and straightforward, the new Portable Genius series gives forward-thinking Apple users useful informat

  2. Mac mini真体验

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2005年,Mac mini首次登场,众所周知,苹果的模具更换的并不频繁,在外貌没有大幅改变的情况下,迄今为止,Mac mini实际上已经更新了7代。最新的Mac mini的工业设计实际上延续了2008年开始的Unibody一体成型铝合金机身设计与其他Mac在外观上保持了一致的元素。更小的Mac mini看起来更加性感诱人,那么,你需要它么?

  3. Fiverr MacGyver

    Science.gov (United States)

    Hut, Rolf; van de Giesen, Nick; Larson, Martha

    2014-05-01

    Crowdsourcing has become popular over the past years, also for scientific endeavors. There are many Citizen Science projects and crowdfunding platforms, such as Kickstarter, that are make helpful contributions to moving environmental science forward. An interesting underused source of useful crowd-derived contributions to research is the website Fiverr.com. On this platform, thousands of people, acting as small-scale freelance contractors, offer their skills in the form of services. The platform offers a chance for people to take a hobby, skill, or pastime and make it something more by reaching out to a wider audience and by receiving a payment in return for services. As is typical of other crowdsourcing platforms, the tasks are small and usually self contained. As the name Fiverr suggests, offers start at US5 to provide a particular service. Services offered range from graphic design, to messages sung or spoken with various styles or accents, to complete apps for Android or iPhone. Skill providers on the platform can accept a range of variation of definition in the tasks, some can be described in general terms, for others it is more appropriate to provide examples. Fiverr provides a central location for those offering skills and those needing services to find each other, it makes it possible to communicate and exchange files, to make payments, and it provides support for resolving disputes. In all cases, it is important to keep expectations aligned with the nature of the platform: quality can and will vary. Ultimately, the critical contribution of Fiverr is not to replace professional services or otherwise save money, but rather to provide access to a large group of people with specialized skills who are able to make a contribution on short notice. In the context of this session, it can be considered a pool of people with MacGyver skills lying in wait of a MacGyyer task to attack. There are many ways in which Fiverr tasks, which are called 'gigs', can be useful in

  4. MacBook Teach Yourself VISUALLY

    CERN Document Server

    Miser, Brad

    2010-01-01

    Like the MacBook itself, Teach Yourself VISUALLY MacBook, Second Edition is designed to be visually appealing, while providing excellent functionality at the same time. By using this book, MacBook users will be empowered to do everyday tasks quickly and easily. From such basic steps as powering on or shutting down the MacBook, working on the Mac desktop with the Dashboard and its widgets to running Windows applications, Teach Yourself VISUALLY MacBook, Second Edition covers all the vital information and provides the help and support a reader needs—in many ways it's like having a Mac Genius at

  5. Switching to a Mac portable genius

    CERN Document Server

    McFedries, Paul

    2011-01-01

    Switching from a PC to a Mac is a breeze with this book Anyone considering making the move to Mac from the Windows world will find this book smoothes the way. While Macs are famous for ease of use, there are fundamental differences in Mac and PC ways of thinking, plus there?s the hassle of moving files, calendars, and other essential data from one platform to another. This guide lays out all the information, explains basic Mac procedures for the newcomer, offers great tips on data-sharing (including running Windows applications on a Mac), and provides everything the new Mac user needs to move

  6. Switching to a Mac For Dummies

    CERN Document Server

    Reinhold, Arnold

    2011-01-01

    Learn how to make the switch from PC to Mac a completely smooth transition The number of Mac users continues to increase significantly each year. If you are one of those people and are eager but also anxious about making the switch, then fear not! This friendly guide skips the jargon to deliver you an easy-to-read, understandable introduction to the Macintosh computer. Computer guru Arnold Reinhold walks you through the Mac OS, user interface, and icons. You'll learn how to set up your Mac, move your files from your PC to your Mac, switch applications, get your Mac online, network your Mac, se

  7. Mycobacterium avium complex organisms predominantly colonize in the bathtub inlets of patients' bathrooms.

    Science.gov (United States)

    Nishiuchi, Yukiko; Tamura, Aki; Kitada, Seigo; Taguri, Takahiro; Matsumoto, Sohkichi; Tateishi, Yoshitaka; Yoshimura, Mamiko; Ozeki, Yuriko; Matsumura, Narumi; Ogura, Hisashi; Maekura, Ryoji

    2009-05-01

    Medical treatment of pulmonary Mycobacterium avium complex (MAC) disease does not always provide curative effects and is frequently hampered by recurrence. This suggests the presence of a reservoir for MAC in the environment surrounding patients. We previously reported the recovery of MAC isolates from the residential bathrooms of outpatients. In the present study, to ascertain the colonizing sites and the possibility of an MAC reservoir in the bathrooms of patients, we tested the recovery and the genetic diversity of MAC isolates from 6 sites of specimens, including 2 additional sampling sites, inside the showerhead and the bathtub inlet, in the residential bathrooms of patients with pulmonary MAC disease. MAC isolates were recovered from 15 out of the 29 bathrooms (52%), including specimens from 14 bathtub inlets and 3 showerheads. Nearly half of these bathrooms (7/15) contained MAC strains that were identical or similar to their respective clinical isolates Additionally, in 5 out of 15 bathrooms, polyclonal colonization was revealed by pulsed-field gel electrophoresis. The results imply that colonization of MAC organisms in the bathrooms of MAC patients occurs predominantly in the bathtub inlets, and there is thus a risk of infection and/or reinfection for patients via use of the bathtub and other sites in the bathroom.

  8. IgG protease Mac/IdeS is not essential for phagocyte resistance or mouse virulence of M1T1 group A Streptococcus.

    Science.gov (United States)

    Okumura, Cheryl Y M; Anderson, Ericka L; Döhrmann, Simon; Tran, Dan N; Olson, Joshua; von Pawel-Rammingen, Ulrich; Nizet, Victor

    2013-07-30

    The Mac/IdeS protein of group A Streptococcus (GAS) is a secreted cysteine protease with cleavage specificity for IgG and is highly expressed in the GAS serotype M1T1 clone, which is the serotype most frequently isolated from patients with life-threatening invasive infections. While studies of Mac/IdeS with recombinant protein have shown that the protein can potentially prevent opsonophagocytosis of GAS by neutrophils, the role of the protein in immune evasion as physiologically produced by the living organism has not been studied. Here we examined the contribution of Mac/IdeS to invasive GAS disease by generating a mutant lacking Mac/IdeS in the hyperinvasive M1T1 background. While Mac/IdeS was highly expressed and proteolytically active in the hyperinvasive strain, elimination of the bacterial protease did not significantly influence GAS phagocytic uptake, oxidative-burst induction, cathelicidin sensitivity, resistance to neutrophil or macrophage killing, or pathogenicity in pre- or postimmune mouse infectious challenges. We conclude that in the highly virulent M1T1 background, Mac/IdeS is not essential for either phagocyte resistance or virulence. Given the conservation of Mac/IdeS and homologues across GAS strains, it is possible that Mac/IdeS serves another important function in GAS ecology or contributes to virulence in other strain backgrounds. Group A Streptococcus (GAS) causes human infections ranging from strep throat to life-threatening conditions such as flesh-eating disease and toxic shock syndrome. Common disease-associated clones of GAS can cause both mild and severe infections because of a characteristic mutation and subsequent change in the expression of several genes that develops under host immune selection. One of these genes encodes Mac/IdeS, a protease that has been shown to cleave antibodies important to the immune defense system. In this study, we found that while Mac/IdeS is highly expressed in hypervirulent GAS, it does not significantly

  9. Leukocyte integrin Mac-1 regulates thrombosis via interaction with platelet GPIbα.

    Science.gov (United States)

    Wang, Yunmei; Gao, Huiyun; Shi, Can; Erhardt, Paul W; Pavlovsky, Alexander; A Soloviev, Dmitry; Bledzka, Kamila; Ustinov, Valentin; Zhu, Liang; Qin, Jun; Munday, Adam D; Lopez, Jose; Plow, Edward; Simon, Daniel I

    2017-05-30

    Inflammation and thrombosis occur together in many diseases. The leukocyte integrin Mac-1 (also known as integrin αMβ2, or CD11b/CD18) is crucial for leukocyte recruitment to the endothelium, and Mac-1 engagement of platelet GPIbα is required for injury responses in diverse disease models. However, the role of Mac-1 in thrombosis is undefined. Here we report that mice with Mac-1 deficiency (Mac-1(-/-)) or mutation of the Mac-1-binding site for GPIbα have delayed thrombosis after carotid artery and cremaster microvascular injury without affecting parameters of haemostasis. Adoptive wild-type leukocyte transfer rescues the thrombosis defect in Mac-1(-/-) mice, and Mac-1-dependent regulation of the transcription factor Foxp1 contributes to thrombosis as evidenced by delayed thrombosis in mice with monocyte-/macrophage-specific overexpression of Foxp1. Antibody and small-molecule targeting of Mac-1:GPIbα inhibits thrombosis. Our data identify a new pathway of thrombosis involving leukocyte Mac-1 and platelet GPIbα, and suggest that targeting this interaction has anti-thrombotic therapeutic potential with reduced bleeding risk.

  10. IL-32 expression in the airway epithelial cells of patients with Mycobacterium avium complex lung disease.

    NARCIS (Netherlands)

    Bai, X.; Ovrutsky, A.R.; Kartalija, M.; Chmura, K.; Kamali, A.; Honda, J.R.; Oberley-Deegan, R.E.; Dinarello, C.A.; Crapo, J.D.; Chang, L.Y.; Chan, E.D.

    2011-01-01

    Lung disease due to Mycobacterium avium complex (MAC) organisms is increasing. A greater understanding of the host immune response to MAC organisms will provide a foundation to develop novel therapies for these recalcitrant infections. IL-32 is a newly described pro-inflammatory cytokine that enhanc

  11. Monitored Anaesthesia Care (MAC in antalgic surgery

    Directory of Open Access Journals (Sweden)

    Giovanni Maria Pisanu

    2011-09-01

    Full Text Available The use of surgical techniques for pain relief in the treatment of chronic-persistent pain unresponsive to drug therapy is experiencing a growing spread application in algology. These techniques have set themselves the goal of removing the pain after treatment. Therefore, not always, percutaneous or open procedures are carried out with due precaution necessary to alleviate the patient discomfort and suffering during the surgical intervention. We present our personal experience in the use of this technique Monitored Anaesthesia Care (MAC for patients undergoing surgical treatment of pain management at our Regional Center of Pain Management.

  12. Mac OS X Lion在Mac App Store上线

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    2011年7月20日,Apple宣布具有超过250种新功能的世界最先进操作系统的第八个重要版本Mac OS X Lion今天在Mac App StoreTM推出并可进行下载,价格为29.99美元。Lion的诸多超强功能包括:全新Multi-Touch手势;全系统支持全屏应用程序;

  13. Office 2011 for Mac For Dummies

    CERN Document Server

    LeVitus, Bob

    2011-01-01

    Get started with Office 2011 for Mac and discover the creative possibilitiesThe leading suite of productivity software for the Mac, Microsoft Office helps users complete common business tasks, including word processing, e-mail, presentations, financial analysis, and much more. Office 2011 for Mac For Dummies is the perfect companion for Microsoft Office for Mac users upgrading to the newest version, new computer users, and those who may have switched from the Windows version of Office. Written by one of the most popular gurus in the Mac community, Bob "Dr. Mac" LeVitus, the book explains every

  14. Sevoflurane decreases bispectral index values more than does halothane at equal MAC multiples.

    Science.gov (United States)

    Schwab, Hildebrand S; Seeberger, Manfred D; Eger, Edmond I; Kindler, Christoph H; Filipovic, Miodrag

    2004-12-01

    At the minimum alveolar concentration (MAC) of inhaled anesthetics, 50% of subjects move in response to noxious stimulation. Similarly, at MAC-awake, 50% of subjects respond appropriately to command. The bispectral index (BIS) nominally measures the effect of anesthetics on wakefulness or consciousness. We postulated that the use of halothane with a larger MAC-awake/MAC ratio than sevoflurane would produce higher BIS values at comparable levels of MAC. We studied 33 unpremedicated patients anesthetized by inhalation, 18 with sevoflurane and 15 with halothane. We measured BIS before and during anesthesia at 1 MAC, both before and after tracheal intubation facilitated by fentanyl and rocuronium and then at 1.5 MAC. BIS measurements were made after meeting steady-state conditions. No surgery was performed during this study. BIS values in awake patients did not differ between the sevoflurane and halothane groups (96 +/- 2 and 96 +/- 2, mean +/- sd, respectively). At 1 MAC without and with neuromuscular blockade and at 1.5 MAC, BIS values for patients anesthetized with halothane (54 +/- 7, 56 +/- 7, and 49 +/- 7, respectively) exceeded those for patients anesthetized with sevoflurane (34 +/- 6, 34 +/- 6, and 29 +/- 5, respectively) (P < 0.0001). This finding adds to other evidence indicating that BIS is drug specific.

  15. Cerebrovascular disease in pediatric patients

    Directory of Open Access Journals (Sweden)

    Rotta Newra Tellechea

    2002-01-01

    Full Text Available Although rare in childhood, stroke may have a serious impact when it happens in this stage of life. Also, it may be the first sign of a systemic disease. We report 12 cases of patients with stroke treated in the Neuropediatrics Unit of Hospital de Clínicas de Porto Alegre (HCPA from March 1997 to March 2000. All patients, from term infants to 12-year-old children hospitalized in the Pediatrics Unit of HCPA, had clinical suspicion of stroke, which was later confirmed by radiological studies. Patient follow up ranged from 1 to 6 years (mean = 3.4 years. Presenting symptoms were hemiparesis in 9 patients, seizures in 7, deviation of labial commissure in 3, and loss of consciousness in 1. The increase in the number of cases of childhood stroke identified and later confirmed by noninvasive methods had helped in the determination of different ethiologies of stroke: the most frequent being hematologic, cardiac and genetic diseases. However, our study included 6 newborns with stroke whose ethiology was not identified. Seven children with seizures received phenobarbital. Six term infants had neonatal seizures secondary to stroke and restricted to the first 72 hours of life.

  16. Differential effect on TCR:CD3 stimulation of a 90-kD glycoprotein (gp90/Mac-2BP), a member of the scavenger receptor cysteine-rich domain protein family

    DEFF Research Database (Denmark)

    Silvestri, B; Calderazzo, F; Coppola, V;

    1998-01-01

    We studied the effects of a 90-kD glycoprotein (gp90/Mac-2BP) belonging to the scavenger receptor family, present in normal serum and at increased levels in inflammatory disease and cancer patients, on some T cell function parameters. Whereas the lymphocyte proliferative response to non-specific ......We studied the effects of a 90-kD glycoprotein (gp90/Mac-2BP) belonging to the scavenger receptor family, present in normal serum and at increased levels in inflammatory disease and cancer patients, on some T cell function parameters. Whereas the lymphocyte proliferative response to non...

  17. Patient participation in medical and social decisions in Alzheimer's disease.

    Science.gov (United States)

    Hamann, Johannes; Bronner, Katharina; Margull, Julia; Mendel, Rosmarie; Diehl-Schmid, Janine; Bühner, Markus; Klein, Reinhold; Schneider, Antonius; Kurz, Alexander; Perneczky, Robert

    2011-11-01

    To analyze the preferences of people with amnestic mild cognitive impairment (aMCI) and mild dementia in Alzheimer's disease (AD) regarding different aspects of healthcare-related decisions, to correlate these findings with different measures of decision-making capacity, and to explore the views of relatives and referring physicians. Cross-sectional survey. University-based memory clinic in Munich, Germany. One hundred people with aMCI or mild AD, their relatives (N = 99), and their referring physicians (N = 93). Participation preferences and decisional capacity and assessment of these measures according to relatives and physicians. Patients had a preference for participation in healthcare-related decisions, especially in social ones. Overall, individuals wanted their relatives to play a secondary role in decision-making. Relatives and referring physicians performed poorly in predicting the individuals' participation preferences, and relatives wanted to attribute less decision-making power to patients than the patients did themselves. Patients refrained from participation if they had lower Mini-Mental State Examination scores or were unsure about their decisional capacity. There were deficits in decision-making capacity, which mostly related to understanding of the information presented. There was only weak correlation between the different measures (patient's, relative's, and physician's estimate, MacArthur Competence Assessment Tool for Treatment) of the patients' decisional capacity. The combination of marked participation preferences and impairments in the decisional capacity of individuals with aMCI and early AD constitute an ethical and practical challenge. A thorough implementation of structured probes of the patients' decisional capacity combined with interventions that aid patients in their decision-making capability might help to overcome some of these challenges. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

  18. [Care for patients with rare diseases].

    Science.gov (United States)

    Smetsers, Stephanie E; Takkenberg, J J M Hanneke; Bierings, Marc B

    2014-01-01

    A rare disease usually concerns only a handful of patients, but all patients with a rare disease combined represent a significant health burden. Due to limited knowledge and the absence of treatment guidelines, patients with rare diseases usually experience delayed diagnosis and suboptimal treatment. Historically, rare diseases have never been considered a major health problem. However, rare diseases have recently been receiving increased attention. In the Netherlands, a national plan for rare diseases was published in late 2013, with recommendations on how to improve the organisation of healthcare for people with rare diseases. Using the example of the rare disease Fanconi anemia, this paper describes the challenges and opportunities in organising healthcare for rare diseases. Two critical steps in optimising healthcare for rare diseases are developing multidisciplinary healthcare teams and stimulating patient empowerment. Optimal cooperation between patients, patient organisations, multidisciplinary healthcare teams and scientists is of great importance. In this respect, transition to adult healthcare requires special attention.

  19. Gallstones in Patients with Chronic Liver Diseases.

    Science.gov (United States)

    Li, Xu; Guo, Xiaolin; Ji, Huifan; Yu, Ge; Gao, Pujun

    2017-01-01

    With prevalence of 10-20% in adults in developed countries, gallstone disease (GSD) is one of the most prevalent and costly gastrointestinal tract disorders in the world. In addition to gallstone disease, chronic liver disease (CLD) is also an important global public health problem. The reported frequency of gallstone in chronic liver disease tends to be higher. The prevalence of gallstone disease might be related to age, gender, etiology, and severity of liver disease in patients with chronic liver disease. In this review, the aim was to identify the epidemiology, mechanisms, and treatment strategies of gallstone disease in chronic liver disease patients.

  20. Gallstones in Patients with Chronic Liver Diseases

    Directory of Open Access Journals (Sweden)

    Xu Li

    2017-01-01

    Full Text Available With prevalence of 10–20% in adults in developed countries, gallstone disease (GSD is one of the most prevalent and costly gastrointestinal tract disorders in the world. In addition to gallstone disease, chronic liver disease (CLD is also an important global public health problem. The reported frequency of gallstone in chronic liver disease tends to be higher. The prevalence of gallstone disease might be related to age, gender, etiology, and severity of liver disease in patients with chronic liver disease. In this review, the aim was to identify the epidemiology, mechanisms, and treatment strategies of gallstone disease in chronic liver disease patients.

  1. Investigation of Mycobacterium avium complex (MAC) in Australian commercial milk using qPCR.

    Science.gov (United States)

    Adhikari, Shraddha; Caro Tohme, Tanya; Whiley, Harriet

    2017-02-01

    This technical research communication describes the first study to use quantitative polymerase chain reaction (qPCR) to investigate the presence of Mycobacterium avium complex (MAC) in Australian pasteurised milk. MAC is the most common NTM responsible for human illnesses and includes M. avium subspecies paratuberculosis (MAP). MAC is a causative agent of lymphadenitis in children, with contaminated food and water considered as a likely source. As such the presence of MAC in milk would have public health significance. MAP has been linked to Crohn's disease and is also the causative agent of Johne's disease in cattle. Previous studies have detected MAP in pasteurised milk from Brazil, India, Czech Republic, USA, Argentina, UK, Iran, Ireland and the United Kingdom. This study investigated a total of 180 commercially available Australian pasteurised milk samples which were tested for MAC DNA in triplicate using PCR. All samples were negative for MAC DNA. An additional 14 milk samples were tested, incubated for 3 weeks at 37 °C to potentially increase the concentration of any viable MAC that may be present and then retested. All samples were again negative for MAC DNA. This could be due to concentrations below the limit of detection, limited sample size or could be reflective of the Australian biosecurity control protocols and surveillance of Johne's disease in ruminant animals.

  2. Mac OS X Lion Server For Dummies

    CERN Document Server

    Rizzo, John

    2011-01-01

    The perfect guide to help administrators set up Apple's Mac OS X Lion Server With the overwhelming popularity of the iPhone and iPad, more Macs are appearing in corporate settings. The newest version of Mac Server is the ideal way to administer a Mac network. This friendly guide explains to both Windows and Mac administrators how to set up and configure the server, including services such as iCal Server, Podcast Producer, Wiki Server, Spotlight Server, iChat Server, File Sharing, Mail Services, and support for iPhone and iPad. It explains how to secure, administer, and troubleshoot the networ

  3. Take Control of Maintaining Your Mac

    CERN Document Server

    Kissell, Joe

    2009-01-01

    Keep your Mac running smoothly with our easy maintenance program! Regular maintenance is necessary to avoid problems and to ensure your Mac runs at peak performance, but it's hard to know what to do and when to do it. Best-selling author Joe Kissell has now applied his commonsense approach to the task of maintaining your Mac, whether you use Tiger or Leopard! Learn how to start on the right foot; what you should do daily, weekly, monthly, and yearly; and how to prepare for Mac OS X updates. Joe even explains how to monitor your Mac's health and debunks common panaceas. Read this book to lea

  4. Switching to a Mac For Dummies

    CERN Document Server

    Reinhold, Arnold

    2007-01-01

    Thinking of making the switch from your PC to a Mac? Congratulations! You're in for a great, virus-free ride. And Switching to Mac For Dummies makes it smoother than you ever imagined. From buying the Mac that's right for you to transferring your files to breaking your old Windows habits and learning to do things the (much easier) Mac way, it makes the whole process practically effortless. Whether you've been using Windows XP, Vista, or even Linux, you'll find simple, straightforward ways to make your transition go smoothly. That will leave you plenty of time to get familiar with Mac'

  5. Switching to the Mac The Missing Manual

    CERN Document Server

    Pogue, David

    2010-01-01

    Is Windows giving you pause? Ready to make the leap to the Mac instead? There has never been a better time to switch from Windows to Mac, and this incomparable guide will help you make a smooth transition. New York Times columnist and Missing Manuals creator David Pogue gets you past three challenges: transferring your stuff, assembling Mac programs so you can do what you did with Windows, and learning your way around Mac OS X. Learning to use a Mac is not a piece of cake, but once you do, the rewards are oh-so-much better. No viruses, worms, or spyware. No questionable firewalls, inefficien

  6. Cognitive MAC designs for OSA networks

    CERN Document Server

    Derakhshani, Mahsa

    2014-01-01

    This SpringerBrief presents recent advances in the cognitive MAC designs for opportunistic spectrum access (OSA) networks. It covers the basic MAC functionalities and MAC enhancements of IEEE 802.11. Later chapters discuss the existing MAC protocols for OSA and classify them based on characteristic features. The authors provide new research in adaptive carrier sensing-based MAC designs tailored for OSA, which optimize spectrum utilization and ensure a peaceful coexistence of licensed and unlicensed systems. Analytically devised via optimization and game-theoretic approaches, these adaptive M

  7. Neurologic Diseases in Special Care Patients.

    Science.gov (United States)

    Robbins, Miriam R

    2016-07-01

    Neurologic diseases can have a major impact on functional capacity. Patients with neurologic disease require individualized management considerations depending on the extent of impairment and impact on functional capacity. This article reviews 4 of the more common and significant neurologic diseases (Alzheimer disease, cerebrovascular accident/stroke, multiple sclerosis, and Parkinson disease) that are likely to present to a dental office and provides suggestions on the dental management of patients with these conditions.

  8. T-SPOT.TB Test(R) results in adults with Mycobacterium avium complex pulmonary disease.

    Science.gov (United States)

    Adams, Lisa V; Waddell, Richard D; Von Reyn, C Fordham

    2008-01-01

    The tuberculin skin test is limited by its inability to distinguish between infection with Mycobacterium tuberculosis and non-tuberculous mycobacteria (NTM). Newer interferon-gamma release assays using ESAT-6 and CFP-10 antigens should have a higher specificity for tuberculosis but have not been widely tested in adults with pulmonary disease due to NTM. In this study, we tested the T-SPOT.TB Test in patients with pulmonary disease due to Mycobacterium avium complex (MAC), the most common disease-causing NTM. Fourteen patients with prior culture-confirmed pulmonary disease due to MAC, 10 patients with prior culture-confirmed tuberculosis and 4 healthy controls were interviewed and tested with the T-SPOT.TB Test. 13 patients with MAC disease and 4 healthy subjects (negative controls) had non-reactive T-SPOT.TB results and 10 patients with prior tuberculosis (positive controls) had reactive results. One patient with MAC disease had a minimally reactive result on initial testing and a non-reactive result on re-testing. The T-SPOT.TB Test had a specificity of 94% for distinguishing between patients with prior MAC disease and prior tuberculosis disease, and will be useful in low tuberculosis prevalence settings where most mycobacterial infections are due to MAC. Reactions to the T-SPOT.TB Test may persist months to years after treatment of tuberculosis.

  9. Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis.

    Science.gov (United States)

    Takami, Yoshiyuki; Tajima, Kazuyoshi

    2016-02-01

    Limited data exis t on clinical relevance of aortic valve stenosis (AVS) and mitral annular calcification (MAC), although with similar pathophysiologic basis. We sought to reveal the prevalence of MAC and its clinical features in the patients undergoing aortic valve replacement (AVR) for AVS. We reviewed 106 consecutive patients who underwent isolated AVR from 2004 to 2010. Before AVR, CT scans were performed to identify MAC, whose severity was graded on a scale of 0-4, with grade 0 denoting no MAC and grade 4 indicating severe MAC. Echocardiography was performed before AVR and at follow-up over 2 years after AVR. MAC was identified in 56 patients with grade 1 (30 %), 2 (39 %), 3 (18 %), and 4 (13 %), respectively. Patients with MAC presented older age (72 ± 8 versus 66 ± 11 years), higher rate of dialysis-dependent renal failure (43 versus 4 %), and less frequency of bicuspid aortic valve (9 versus 36 %), when compared to those without MAC. No significant differences were seen in short- and mid-term mortality after AVR between the groups. In patients with MAC, progression of neither mitral regurgitation nor stenosis was observed at follow-up of 53 ± 23 months for 102 survivors, although the transmitral flow velocities were higher than in those without MAC. In conclusion, MAC represented 53 % of the patients undergoing isolated AVR for AVS, usually appeared in dialysis-dependent elder patients with tricuspid AVS. MAC does not affect adversely upon the survival, without progression of mitral valve disease, at least within 2 years after AVR.

  10. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  11. Infectious diseases in end-stage liver disease patients.

    Science.gov (United States)

    Mehta, Aneesh K; Lyon, G Marshall

    2010-09-01

    Patients with chronic liver diseases sustain impairment to immune systems, which worsens over time. These defects in their host defense lead to risks of bacterial infections and increased morbidity. Providers should have heightened surveillance for infectious diseases and suspect one with any acute change in status. Patient history may reveal rare infections and allow initiation of early appropriate therapy. There should be a low threshold for obtaining diagnostic cultures and peritoneal fluid samples and discussing possible causes with an infectious diseases consultant or a microbiology laboratory. These maneuvers will maximize therapy in patients at high risk for death due to infectious disease.

  12. Dermatological diseases in patients with chronic kidney disease.

    Science.gov (United States)

    Gagnon1, Amy L; Desai, Tejas

    2013-04-01

    There are a variety of dermatological diseases that are more commonly seen in patients with chronic kidney disease (CKD) and renal transplants than the general population. Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched. Some cutaneous diseases are clearly unique to this population. Of them, Lindsay's Nails, xerosis cutis, dryness of the skin, nephrogenic systemic fibrosis and acquired perforating dermatosis have been described in chronic kidney disease patients. The most common malignancy found in all transplant recipients is non-melanoma skin cancer. It is important for patients and physicians to recognize the manifestations of skin disease in patients suffering from chronic kidney disease to mitigate the morbidity associated with these conditions.

  13. Sevoflurane at 1 MAC provides optimal myocardial protection during off-pump CABG.

    Science.gov (United States)

    Wang, Jiang; Zheng, Hong; Chen, Chun-Ling; Lu, Wei; Zhang, Yong-Qiang

    2013-06-01

    We investigated the myocardial protective effect of sevoflurane in patients receiving off-pump coronary artery bypass grafting (OPCABG) and the role of brain natriuretic peptide (BNP). Forty-eight patients receiving elective OPCABG were randomly assigned to a control group, and to 0.75 MAC, 1.0 MAC and 1.5 MAC sevoflurane groups. Blood samples were collected and levels of BNP and cardiac troponin I (cTnI) were measured before anesthesia, and immediately, 24, 48 and 72 h after surgery. Dopamine was necessary to maintain blood pressure in the sevoflurane groups, but not in the control group (p MAC sevoflurane significantly decreased post-surgical cTnI levels (p MAC had no significant effect, and increasing sevoflurane concentrations to 1.5 MAC caused no further decrease in cTnI concentrations. There was no significant difference in BNP level among the groups (p = 0.227) or between any two groups, although values of BNP showed a significant correlation with cTnI values in control subjects immediately after (r = 0.847) and 24 h after (r = 0.661) surgery. Our results demonstrated that 1.0 MAC and 1.5 MAC sevoflurane can exert a significant myocardial protective effect. BNP cannot be used to predict the myocardial protective effect of sevoflurane in OPCABG.

  14. Hypovitaminosis D in patients with Crohn's disease

    OpenAIRE

    Rebouças,Priscilla Clímaco; NETINHO,João Gomes; Cunrath,Geni Satomi; Ronchi,Luiz Sergio; MELO,Marcelo Maia Caixeta de; Gonçalves Neto,Francisco de Assis; Muniz,Rafaela Cristina Coelho; Martins,Alissonn Teixeira Silva; Oliveira,Rafael Andrade de; Costa Junior,Ricardo Mendonça

    2016-01-01

    Abstract Objective Vitamin D has been widely studied as a mediator of the immune response, becoming evident the prevalence of hypovitaminosis D in patients with Crohn's disease. This work aims at evaluating the serum levels of vitamin D in patients suffering from Crohn's disease in a southeast region of Brazil. Methods It is a prospective study, with statistical analysis of the values of serum vitamin D measured between April 2014 and April 2015 in patients with Crohn's disease. Individuals...

  15. Mac OS X Tiger for Unix Geeks

    CERN Document Server

    Jepson, Brian

    2005-01-01

    If you're one of the many Unix developers drawn to Mac OS X for its Unix core, you'll find yourself in surprisingly unfamiliar territory. Unix and Mac OS X are kissing cousins, but there are enough pitfalls and minefields in going from one to another that even a Unix guru can stumble, and most guides to Mac OS X are written for Mac aficionados. For a Unix developer, approaching Tiger from the Mac side is a bit like learning Russian by reading the Russian side of a Russian-English dictionary. Fortunately, O'Reilly has been the Unix authority for over 25 years, and in Mac OS X Tiger for Unix Gee

  16. Teach yourself visually Mac Mini

    CERN Document Server

    Hart-Davis, Guy

    2012-01-01

    The perfect how-to guide for visual learners Apple?s Mac Mini packs a powerful punch is in a small package, including both HDMI and Thunderbolt ports plus the acclaimed OS X. But if you want to get the very most from all this power and versatility, be sure to get this practical visual guide. With full-color, step-by-step instructions as well as screenshots and illustrations on every page, it clearly shows you how to accomplish tasks rather than burying you in pages of text. Discover helpful visuals and how-tos on the OS, hardware specs, Launchpad, the App Store, multimedia capabilities (such

  17. Web Development with the Mac

    CERN Document Server

    Vegh, Aaron

    2010-01-01

    Learn Web development the Apple way and build a business. With a focus on both coding and creative development, this in-depth guide thoroughly covers what you need to know to build winning websites for clients — from what it takes to bring a business online to how to make your site interactive to how to run a freelance web business. In between, you'll master the technical tools of the trade — such as HTML, CSS, JavaScript, PHP, and Ruby on Rails — and learn how to create beautiful interfaces using Photoshop . This book covers everything a fledgling web developer working on a Mac needs to launc

  18. [Inpatients days in patients with respiratory diseases and periodontal disease].

    Science.gov (United States)

    Fernández-Plata, Rosario; Olmedo-Torres, Daniel; Martínez-Briseño, David; González-Cruz, Herminia; Casa-Medina, Guillermo; García-Sancho, Cecilia

    2017-01-01

    Periodontal disease is a chronic inflammatory gingival process that has been associated with the severity of respiratory diseases. In Mexico a prevalence of 78% was found in population with social security and > 60 years old. The aim of this study is to establish the association between periodontal disease and respiratory diseases according to the inpatient days. A cross-sectional study was conducted from January to December 2011. We included hospitalized patients, ≥ 18 years of age, without sedation or intubated. A dentist classified patients into two groups according to the severity of the periodontal disease: mild-to-moderate and severe. We estimated medians of inpatient days by disease and severity. Negative binomial models were adjusted to estimate incidence rate ratios and predicted inpatient days. 3,059 patients were enrolled. The median of observed and predicted inpatient days was higher in the group of severe periodontal disease (p disease, tuberculosis, and influenza had the highest incidence rates ratios of periodontal disease (p periodontal disease is positively -associated with inpatient days of patients with respiratory diseases.

  19. Radiotherapy in patients with connective tissue diseases.

    Science.gov (United States)

    Giaj-Levra, Niccolò; Sciascia, Savino; Fiorentino, Alba; Fersino, Sergio; Mazzola, Rosario; Ricchetti, Francesco; Roccatello, Dario; Alongi, Filippo

    2016-03-01

    The decision to offer radiotherapy in patients with connective tissue diseases continues to be challenging. Radiotherapy might trigger the onset of connective tissue diseases by increasing the expression of self-antigens, diminishing regulatory T-cell activity, and activating effectors of innate immunity (dendritic cells) through Toll-like receptor-dependent mechanisms, all of which could potentially lead to breaks of immune tolerance. This potential risk has raised some debate among radiation oncologists about whether patients with connective tissue diseases can tolerate radiation as well as people without connective tissue diseases. Because the number of patients with cancer and connective tissue diseases needing radiotherapy will probably increase due to improvements in medical treatment and longer life expectancy, the issue of interactions between radiotherapy and connective tissue diseases needs to be clearer. In this Review, we discuss available data and evidence for patients with connective tissue diseases treated with radiotherapy.

  20. Analysis of 3gpp-MAC and two-key 3gpp-MAC

    DEFF Research Database (Denmark)

    Knudsen, Lars Ramkilde; Mitchell, C.J.

    2003-01-01

    Forgery and key-recovery attacks are described on the 3gpp-MAC scheme, proposed for inclusion in the 3gpp specification. Three main classes of attack are given, all of which operate whether or not truncation is applied to the MAC value. Attacks in the first class use a large number of 'chosen MACs......', those in the second class use a large number of 'known MACs', and those in the third class require a large number of MAC verifications, but very few known MACS and no chosen MACS. The first class yields both forgery and key-recovery attacks, whereas the second and third classes are key-recovery attacks...... only. Both single-key and two-key variants of 3gpp-MAC are considered; the forgery attacks are relevant to both variants, whereas the key-recovery attacks are only relevant to the two-key variant....

  1. Analysis of 3gpp-MAC and two-key 3gpp-MAC

    DEFF Research Database (Denmark)

    Knudsen, Lars Ramkilde; Mitchell, C.J.

    2003-01-01

    Forgery and key-recovery attacks are described on the 3gpp-MAC scheme, proposed for inclusion in the 3gpp specification. Three main classes of attack are given, all of which operate whether or not truncation is applied to the MAC value. Attacks in the first class use a large number of 'chosen MACs......', those in the second class use a large number of 'known MACs', and those in the third class require a large number of MAC verifications, but very few known MACS and no chosen MACS. The first class yields both forgery and key-recovery attacks, whereas the second and third classes are key-recovery attacks...... only. Both single-key and two-key variants of 3gpp-MAC are considered; the forgery attacks are relevant to both variants, whereas the key-recovery attacks are only relevant to the two-key variant....

  2. Mac protocols for cyber-physical systems

    CERN Document Server

    Xia, Feng

    2015-01-01

    This book provides a literature review of various wireless MAC protocols and techniques for achieving real-time and reliable communications in the context of cyber-physical systems (CPS). The evaluation analysis of IEEE 802.15.4 for CPS therein will give insights into configuration and optimization of critical design parameters of MAC protocols. In addition, this book also presents the design and evaluation of an adaptive MAC protocol for medical CPS, which exemplifies how to facilitate real-time and reliable communications in CPS by exploiting IEEE 802.15.4 based MAC protocols. This book wil

  3. Take control of troubleshooting your Mac

    CERN Document Server

    Kissell, Joe

    2009-01-01

    Learn how to solve any Mac problem with Joe Kissell's expert advice! We may love our Macs, but they can still suffer significant problems. In this essential guide from best-selling author Joe Kissell, you'll learn 17 basic troubleshooting procedures and how to solve 9 common problems, along with an easy-to-follow way to troubleshoot novel problems. Whether your Mac won't turn on, experiences kernel panics repeatedly, or is glacially slow, this book has the calm, friendly advice you need to find a solution. Following in the footsteps of his critically acclaimed books Take Control of Mac OS X

  4. Teach yourself visually MacBook Pro

    CERN Document Server

    Hart-Davis, Guy

    2014-01-01

    Clear instructions to help visual learners get started with their MacBook Pro Covering all the essential information you need to get up to speed with your MacBook Pro, this new edition provides you with the most up-to-date information on performing everyday tasks quickly and easily. From basics such as powering on or shutting down the MacBook Pro to more advanced tasks such as running Windows applications, this visual guide provides the help and support you need to confidently use your MacBook Pro to its full potential.Empowers you to perform everyday tasks quickly and easilyCovers new hardwa

  5. Take control the Mac OS X lexicon

    CERN Document Server

    Zardetto, Sharon

    2009-01-01

    This ebook explains a little bit of everything; in fact, it's The Mac OS X (and then some) Lexicon because it's never just you and your Mac. It's you and your Mac and the Web, and your email, and that article you just read that threw 17 new acronyms at you or assumed that you knew all sorts of networking terms. Or it's you and your Mac and Finder features you've never touched, such as burn folders, smart folders, or proxy icons, and that mysterious Services submenu. This book is a great guide for Macintosh users everywhere who have trouble keeping up with the latest jargon, fo

  6. Macs all-in-one for dummies

    CERN Document Server

    Hutsko, Joe

    2014-01-01

    Your all-in-one guide to unleashing your Mac's full potential It's a Mac world out there. But if you haven't read the instruction manual, you may be neglecting some of your computer's coolest features. Turn to Macs All-in-One For Dummies' jam-packed guide to access the incredible tools within your computer. With this fully updated reference, you will learn how to use Launchpad and Mission Control; protect your Mac; back up and restore data with Time Machine; sync across devices in iCloud; import, organize, and share photos; direct in iMovie; compose in GarageBand; and so much more. The possi

  7. Suicide in patients with motor neuron disease

    DEFF Research Database (Denmark)

    Bak, Søren; Stenager, E N; Stenager, Egon

    1994-01-01

    The aim of the present study was to assess, through an epidemiological study, whether suicide risk is increased in patients with motor neuron disease (MND). The study involved 116 patients with MND. In the study period 92 patients died, 47 males and 45 females. No patients committed suicide...

  8. Quicksilver Power Mac G4

    CERN Multimedia

    2001-01-01

    A new generation with a reworked motherboard is launched on 2001 with however the same Graphite box. It also included a processor speed-bump, and brought the DVD-R "SuperDrive" to the mid-level model. The Quicksilver PowerMac was available in three configurations: The 733 MHz model, with 128 MB of RAM, a 40 GB hard drive, and a CD-RW drive, was 1,699 dollars, the 867 MHz configuration, with 128 MB of RAM, a 60 GB hard drive and a DVD-R drive, was 2,499 dollars, and the high-end dual-800 MHz model, with 256 MB of RAM, an 80 GB hard drive and a DVD-R drive, was 3,499 dollars. The 733 MHz model is the first personal computer to have a DVD burner, named SuperDrive at Apple. The design was updated on 2002 with 800 MHz, 933 MHz and dual 1 GHz configurations, becoming the first Mac to reach 1 GHz.

  9. Mycobacterium avium complex--the role of potable water in disease transmission.

    Science.gov (United States)

    Whiley, H; Keegan, A; Giglio, S; Bentham, R

    2012-08-01

    Mycobacterium avium complex (MAC) is a group of opportunistic pathogens of major public health concern. It is responsible for a wide spectrum of disease dependent on subspecies, route of infection and patients pre-existing conditions. Presently, there is limited research on the incidence of MAC infection that considers both pulmonary and other clinical manifestations. MAC has been isolated from various terrestrial and aquatic environments including natural waters, engineered water systems and soils. Identifying the specific environmental sources responsible for human infection is essential in minimizing disease prevalence. This paper reviews current literature and case studies regarding the wide spectrum of disease caused by MAC and the role of potable water in disease transmission. Potable water was recognized as a putative pathway for MAC infection. Contaminated potable water sources associated with human infection included warm water distribution systems, showers, faucets, household drinking water, swimming pools and hot tub spas. MAC can maintain long-term contamination of potable water sources through its high resistance to disinfectants, association with biofilms and intracellular parasitism of free-living protozoa. Further research is required to investigate the efficiency of water treatment processes against MAC and into construction and maintenance of warm water distribution systems and the role they play in MAC proliferation. No claim to Australian Government works Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

  10. Resilience in Patients with Ischemic Heart Disease

    Science.gov (United States)

    de Lemos, Conceição Maria Martins; Moraes, David William; Pellanda, Lucia Campos

    2016-01-01

    Background Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored. Objective The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease. Method This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institute - Cardiology University Foundation, with a diagnosis of ischemic heart disease during the study period. Sixty-seven patients had a history of acute myocardial infarction. The individuals were interviewed and evaluated by the Wagnild & Young resilience scale and a sociodemographic questionnaire. Results Eighty-one percent of patients were classified as resilient according to the scale. Conclusion In the sample studied, resilience was identified in high proportion among patients with ischemic heart disease. PMID:26815312

  11. Heart Valve Disease among Patients with Hyperprolactinaemia

    DEFF Research Database (Denmark)

    Steffensen, Charlotte; Maegbaek, Merete Lund; Laurberg, Peter;

    2012-01-01

    Increased risk of heart valve disease during treatment with certain dopamine agonists, such as cabergoline, has been observed in patients with Parkinson's disease. The same compound is used to treat hyperprolactinemia, but it is unknown whether this also associates with heart valve disease....

  12. Wound healing in Mac-1 deficient mice.

    Science.gov (United States)

    Chen, Lin; Nagaraja, Sridevi; Zhou, Jian; Zhao, Yan; Fine, David; Mitrophanov, Alexander Y; Reifman, Jaques; DiPietro, Luisa A

    2017-05-01

    Mac-1 (CD11b/CD18) is a macrophage receptor that plays several critical roles in macrophage recruitment and activation. Because macrophages are essential for proper wound healing, the impact of Mac-1 deficiency on wound healing is of significant interest. Prior studies have shown that Mac-1(-/-) mice exhibit deficits in healing, including delayed wound closure in scalp and ear wounds. This study examined whether Mac-1 deficiency influences wound healing in small excisional and incisional skin wounds. Three millimeter diameter full thickness excisional wounds and incisional wounds were prepared on the dorsal skin of Mac-1 deficient (Mac-1(-/-) ) and wild type (WT) mice, and wound healing outcomes were examined. Mac-1 deficient mice exhibited a normal rate of wound closure, generally normal levels of total collagen, and nearly normal synthesis and distribution of collagens I and III. In incisional wounds, wound breaking strength was similar for Mac-1(-/-) and WT mice. Wounds of Mac-1 deficient mice displayed normal total macrophage content, although macrophage phenotype markers were skewed as compared to WT. Interestingly, amounts of TGF-β1 and its downstream signaling molecules, SMAD2 and SMAD3, were significantly decreased in the wounds of Mac-1 deficient mice compared to WT. The results suggest that Mac-1 deficiency has little impact on the healing of small excisional and incisional wounds. Moreover, the findings demonstrate that the effect of single genetic deficiencies on wound healing may markedly differ among wound models. These conclusions have implications for the interpretation of the many prior studies that utilize a single model system to examine wound healing outcomes in genetically deficient mice. © 2017 by the Wound Healing Society.

  13. Cystic fibrosis lung disease in adult patients.

    Science.gov (United States)

    Vender, Robert L

    2008-04-01

    As the longevity of all patients with cystic fibrosis (CF) continues to increase (median 2005 survival=36.8 years), more adult patients will be receiving their medical care from nonpediatric adult-care providers. Cystic fibrosis remains a fatal disease, with more than 80% of patients dying after the age of 18 years, and most deaths resulting from pulmonary disease. The changing epidemiology requires adult-care providers to become knowledgeable and competent in the clinical management of adults with CF. Physicians must understand the influence of specific genotype on phenotypic disease presentation and severity, the pathogenic factors determining lung disease onset and progression, the impact of comorbid disease factors such as CF-related diabetes and malnutrition upon lung disease severity, and the currently approved or standard accepted therapies used for chronic management of CF lung disease. This knowledge is critical to help alleviate morbidity and improve mortality for the rapidly expanding population of adults with CF.

  14. A MAC Mode for Lightweight Block Ciphers

    DEFF Research Database (Denmark)

    Luykx, Atul; Preneel, Bart; Tischhauser, Elmar Wolfgang;

    2016-01-01

    , but also allows high-performance parallel implementations. We highlight this in a comprehensive implementation study, instantiating LightMAC with PRESENT and the AES. Moreover, LightMAC allows flexible trade-offs between rate and maximum message length. Unlike PMAC and its many derivatives, Light...

  15. MAC-awake of sevoflurane in children.

    Science.gov (United States)

    Davidson, Andrew J; Wong, Aaron; Knottenbelt, Graham; Sheppard, Suzette; Donath, Susan; Frawley, Geoff

    2008-08-01

    Age influences the potency of anesthetic agents, but there is little information on how age influences MAC-awake. MAC-awake may be an important aspect of anesthesia potency for the prevention of awareness during anesthesia. The aim of this study was to measure MAC-awake in a range of ages in children. After institutional ethics approval and informed parental consent 60 children were enrolled; 20 in each of three age groups (2 to awake. The Dixon up-down method was used to determine progression of subsequent concentrations and MAC-awake (ED50) for the three age groups were obtained using the probit model. This study found evidence for a difference in ED50 between age groups (P = 0.008). The MAC-awake was highest in the youngest group (0.66%) and similar in the older groups (0.45% and 0.43%). Although MAC-awake changes with age, in the ages where awareness has been reported, MAC-awake was found to be relatively low, and therefore it seems unlikely that age-specific changes to MAC-awake are a cause for awareness in children aged 5-12 years.

  16. Nomogram to estimate age-related MAC.

    NARCIS (Netherlands)

    Lerou, J.G.C.

    2004-01-01

    BACKGROUND: In clinical practice it is difficult to estimate rapidly two important values: (i) the total age-corrected MAC multiple from measured end-expired concentrations of volatile agent and nitrous oxide; (ii) the end-expired concentration of volatile agent needed to obtain a given total MAC

  17. VLA-MAC: A Variable Load Adaptive MAC Protocol for Wireless Sensor Networks

    Science.gov (United States)

    Yao, Guoliang; Liu, Hao; Chen, Hao; Shi, Longxin

    This letter presents VLA-MAC, a novel adaptive MAC protocol for wireless sensor networks that can achieve high energy efficiency and low latency in variable load conditions. In VLA-MAC, traffic load is measured online and utilized for adaptive adjustment. VLA-MAC transmits packets via a burst style to alleviate packets accumulation problem and achieve low latency in high load condition. Furthermore, it also saves obvious energy by removing unnecessary listen period in low load condition. Unlike current approach, VLA-MAC does not need to adjust duty-cycle according to load online. Simulation results based on ns-2 show the performance improvements of our protocol.

  18. An Economic Analysis of MAC Versus WALANT: A Trigger Finger Release Surgery Case Study.

    Science.gov (United States)

    Codding, Jason L; Bhat, Suneel B; Ilyas, Asif M

    2017-07-01

    There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon. Total operating room (OR) time, surgical time, recovery time, and anesthesia costs were analyzed. There were 78 patients: 31 MAC and 47 WALANT. The MAC group averaged 27.2 minutes of OR time; the WALANT group averaged 25.2 minutes. The MAC group surgical time was 10.2 minutes versus WALANT of 10.4 minutes. Post-operatively, the MAC group averaged 72.3 minutes in the recovery room compared with WALANT group of 30.2 minutes. Each case performed under MAC had a minimum of excess charges from anesthesia of approximately $105. Patients undergoing single TFR surgery under WALANT trended toward less time in the OR, had similar surgical times, and spent significantly less time in the recovery room, compared with MAC, thereby resulting in less indirect costs. Each MAC case also had minimum direct excess anesthesia charges of $105, which knowingly underestimates overall charges as it excludes material and fixed costs associated with the delivery of anesthesia. Avoiding sedation for high-volume procedures such as TFR may result in significant systemic savings to payers, and in the future with bundling and episode-based payments can become increasingly important to patients, facilities, and surgeons.

  19. Mac OS X Snow Leopard for dummies

    CERN Document Server

    LeVitus, Bob

    2010-01-01

    Get to know Snow Leopard and make the most of your Mac Snow Leopard has a few new tricks up its sleeve, so whether you're new to Mac or a longtime Mac-thusiast, Mac expert Bob LeVitus has tips you'll appreciate. Learn how to start up your Mac, get to know the Dock and Finder, work your way through windows and dialogs, and organize and manage files and folders. Open the book and find: How to navigate around the Finder, Dock, and desktop Tips for opening, closing, resizing, and moving windows Steps for keeping Snow Leopard organized How to back up your system with Time Machine® Troubleshooting a

  20. Alloimmunization in multitransfused liver disease patients: Impact of underlying disease

    Directory of Open Access Journals (Sweden)

    Meenu Bajpai

    2016-01-01

    Full Text Available Introduction: Transfusion support is vital to the management of patients with liver diseases. Repeated transfusions are associated with many risks such as transfusion-transmitted infection, transfusion immunomodulation, and alloimmunization. Materials and Methods: A retrospective data analysis of antibody screening and identification was done from February 2012 to February 2014 to determine the frequency and specificity of irregular red-cell antibodies in multitransfused liver disease patients. The clinical and transfusion records were reviewed. The data was compiled, statistically analyzed, and reviewed. Results: A total of 842 patients were included in our study. Alloantibodies were detected in 5.22% of the patients. Higher rates of alloimmunization were seen in patients with autoimmune hepatitis, cryptogenic liver disease, liver damage due to drugs/toxins, and liver cancer patients. Patients with alcoholic liver disease had a lower rate of alloimmunization. The alloimmunization was 12.7% (23/181 in females and 3.17% (21/661 in males. Antibodies against the Rh system were the most frequent with 27 of 44 alloantibodies (61.36%. The most common alloantibody identified was anti-E (11/44 cases, 25%, followed by anti-C (6/44 cases, 13.63%. Conclusion: Our findings suggest that alloimmunization rate is affected by underlying disease. Provision of Rh and Kell phenotype-matched blood can significantly reduce alloimmunization.

  1. First-Attempt Intubation Success of Video Laryngoscopy in Patients with Anticipated Difficult Direct Laryngoscopy: A Multicenter Randomized Controlled Trial Comparing the C-MAC D-Blade Versus the GlideScope in a Mixed Provider and Diverse Patient Population.

    Science.gov (United States)

    Aziz, Michael F; Abrons, Ron O; Cattano, Davide; Bayman, Emine O; Swanson, David E; Hagberg, Carin A; Todd, Michael M; Brambrink, Ansgar M

    2016-03-01

    Intubation success in patients with predicted difficult airways is improved by video laryngoscopy. In particular, acute-angle video laryngoscopes are now frequently chosen for endotracheal intubation in these patients. However, there is no evidence concerning whether different acute-angle video laryngoscopes can be used interchangeably in this scenario and would allow endotracheal intubation with the same success rate. We therefore tested whether first-attempt intubation success is similar when using a newly introduced acute-angle blade, that is an element of an extended airway management system (C-MAC D-Blade) compared with a well-established acute-angle video laryngoscope (GlideScope). In this large multicentered prospective randomized controlled noninferiority trial, patients requiring general anesthesia for elective surgery and presenting with clinical predictors of difficult laryngoscopy were randomly assigned to intubation using either the C-MAC D-Blade or the GlideScope video laryngoscope. The hypothesis was that first-attempt intubation success using the new device (D-Blade) is no >4% less than the established device (GlideScope), which would determine noninferiority of the new instrument versus the established instrument. The secondary outcomes we observed included intubation success with multiple attempts and airway-related complications within 7 days of enrollment. Eleven hundred patients were randomly assigned to either video laryngoscope. Intubation success rate on first attempt was 96.2% in the GlideScope group and 93.4% in the C-MAC D-Blade group. Although the absolute difference between the 2 groups was only 2.8%, the 90.35% upper confidence limit of the difference exceeded the predefined margin (4.98%), indicating a rejection of the noninferiority hypothesis for first-attempt intubation success. For attending anesthesiologists, and upon multiple attempts, intubation success did not differ between systems. Pharyngeal injury was noted in 1% of the

  2. Periodontal findings in patients with Hansen's disease.

    Science.gov (United States)

    Ranganathan, Aravindhan Thiruputkuzhi; Khalid, Waleed; Saraswathy, Ponnandai Krishnamurthy; Chandran, Chitraa Rama; Mahalingam, Lakshmiganthan

    2014-09-01

    To find out whether there are any relationship between leprosy and periodontitis as evidenced by clinical parameters. Fifteen diagnosed patients with Hansen's disease were selected and compared against 50 healthy individuals. Clinical parameters like probing pocket depth and clinical attachment level were evaluated for both the groups and the results were subjected to statistical analysis. Mean probing depth and attachment loss is seen more in patients with Hansen's disease than the healthy controls which are statistically significant. Patients with Hansen's disease tend to have more periodontal destruction than the healthy controls. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  3. TraPy-MAC: Traffic Priority Aware Medium Access Control Protocol for Wireless Body Area Network.

    Science.gov (United States)

    Ullah, Fasee; Abdullah, Abdul Hanan; Kaiwartya, Omprakash; Cao, Yue

    2017-06-01

    Recently, Wireless Body Area Network (WBAN) has witnessed significant attentions in research and product development due to the growing number of sensor-based applications in healthcare domain. Design of efficient and effective Medium Access Control (MAC) protocol is one of the fundamental research themes in WBAN. Static on-demand slot allocation to patient data is the main approach adopted in the design of MAC protocol in literature, without considering the type of patient data specifically the level of severity on patient data. This leads to the degradation of the performance of MAC protocols considering effectiveness and traffic adjustability in realistic medical environments. In this context, this paper proposes a Traffic Priority-Aware MAC (TraPy-MAC) protocol for WBAN. It classifies patient data into emergency and non-emergency categories based on the severity of patient data. The threshold value aided classification considers a number of parameters including type of sensor, body placement location, and data transmission time for allocating dedicated slots patient data. Emergency data are not required to carry out contention and slots are allocated by giving the due importance to threshold value of vital sign data. The contention for slots is made efficient in case of non-emergency data considering threshold value in slot allocation. Moreover, the slot allocation to emergency and non-emergency data are performed parallel resulting in performance gain in channel assignment. Two algorithms namely, Detection of Severity on Vital Sign data (DSVS), and ETS Slots allocation based on the Severity on Vital Sign (ETS-SVS) are developed for calculating threshold value and resolving the conflicts of channel assignment, respectively. Simulations are performed in ns2 and results are compared with the state-of-the-art MAC techniques. Analysis of results attests the benefit of TraPy-MAC in comparison with the state-of-the-art MAC in channel assignment in realistic medical

  4. A tale of two mitochondrial channels, MAC and PTP, in apoptosis.

    Science.gov (United States)

    Kinnally, Kathleen W; Antonsson, Bruno

    2007-05-01

    The crucial step in the intrinsic, or mitochondrial, apoptotic pathway is permeabilization of the mitochondrial outer membrane. Permeabilization triggers release of apoptogenic factors, such as cytochrome c, from the mitochondrial intermembrane space into the cytosol where these factors ensure propagation of the apoptotic cascade and execution of cell death. However, the mechanism(s) underlying permeabilization of the outer membrane remain controversial. Two mechanisms, involving opening of two different mitochondrial channels, have been proposed to be responsible for the permeabilization; the permeability transition pore (PTP) in the inner membrane and the mitochondrial apoptosis-induced channel (MAC) in the outer membrane. Opening of PTP would lead to matrix swelling, subsequent rupture of the outer membrane, and an unspecific release of intermembrane proteins into the cytosol. However, many believe PTP opening is a consequence of apoptosis and this channel is thought to principally play a role in necrosis, not apoptosis. Activation of MAC is exquisitely regulated by Bcl-2 family proteins, which are the sentinels of apoptosis. MAC provides specific pores in the outer membrane for the passage of intermembrane proteins, in particular cytochrome c, to the cytosol. The electrophysiological characteristics of MAC are very similar to Bax channels and depletion of Bax significantly diminishes MAC activity, suggesting that Bax is an essential constituent of MAC in some systems. The characteristics of various mitochondrial channels and Bax are compared. The involvement of MAC and PTP activities in apoptosis of disease and their pharmacology are discussed.

  5. Perioperative management of patients with Parkinson's disease.

    Science.gov (United States)

    Katus, Linn; Shtilbans, Alexander

    2014-04-01

    Parkinson's disease is the second most common neurodegenerative disease worldwide, leading to a wide range of disability and medical complications. Managing patients with Parkinson's disease in the perioperative hospital setting can be particularly challenging. Suboptimal management can lead to medical complications, prolonged hospital stays, and delayed recovery. This review aims to address the most important issues related to caring for patients with Parkinson's disease perioperatively who are undergoing emergent or planned general surgery. It also intends to help hospitalists, internists, and other health care providers mitigate potential in-hospital morbidity and prevent prolonged recovery. Challenges in managing patients with Parkinson's disease in the perioperative hospital setting include disruption of medication schedules, "nothing by mouth" status, reduced mobility, and medication interactions and their side effects. Patients with Parkinson's disease are more prone to immobility and developing dysphagia, respiratory dysfunction, urinary retention, and psychiatric symptoms. These issues lead to higher rates of pneumonia, urinary tract infections, deconditioning, and falls compared with patients without Parkinson's disease, as well as prolonged hospital stays and a greater need for post-hospitalization rehabilitation. Steps can be taken to decrease these complications, including minimizing nothing by mouth status duration, using alternative routes of drugs administration when unable to give medications orally, avoiding drug interactions and medications that can worsen parkinsonism, assessing swallowing ability frequently, encouraging incentive spirometry, performing bladder scans, avoiding Foley catheters, and providing aggressive physical therapy. Knowing and anticipating these potential complications allow hospital physicians to mitigate nosocomial morbidity and shorten recovery times and hospital stays.

  6. Comparison of CSMA based MAC protocols of wireless sensor networks

    CERN Document Server

    singh, Himanshu

    2012-01-01

    Energy conservation has been an important area of interest in Wireless Sensor networks (WSNs). Medium Access Control (MAC) protocols play an important role in energy conservation. In this paper, we describe CSMA based MAC protocols for WSN and analyze the simulation results of these protocols. We implemented S-MAC, T-MAC, B-MAC, B-MAC+, X-MAC, DMAC and Wise-MAC in TOSSIM, a simulator which unlike other simulators simulates the same code running on real hardware. Previous surveys mainly focused on the classification of MAC protocols according to the techniques being used or problem dealt with and presented a theoretical evaluation of protocols. This paper presents the comparative study of CSMA based protocols for WSNs, showing which MAC protocol is suitable in a particular environment and supports the arguments with the simulation results. The comparative study can be used to find the best suited MAC protocol for wireless sensor networks in different environments.

  7. Mac OS X for Unix Geeks (Leopard)

    CERN Document Server

    Rothman, Ernest E; Rosen, Rich

    2009-01-01

    If you've been lured to Mac OS X because of its Unix roots, this invaluable book serves as a bridge between Apple's Darwin OS and the more traditional Unix systems. The new edition offers a complete tour of Mac OS X's Unix shell for Leopard and Tiger, and helps you find the facilities that replace or correspond to standard Unix utilities. Learn how to compile code, link to libraries, and port Unix software to Mac OS X and much more with this concise guide.

  8. Mac OS X Lion portable genius

    CERN Document Server

    Spivey, Dwight

    2012-01-01

    Two e-books, Mac OS X Lion Portable Genius and MacBook Pro Portable Genius, Third Edition, bundled in one package Books in the Portable Genius series provide readers with the most accessible, useful information possible, including plenty of tips and techniques for the most-used features in a product or software. These e-books will show you what you may not find out by just working with your MacBook Pro and OS X Lion. Genius icons present smart or innovative ways to do something, saving time and hassle. Easy-to-find information gives you the essentials plus insightful tips on how to navigate

  9. Office 2008 for Mac for dummies

    CERN Document Server

    LeVitus, Bob

    2013-01-01

    Office 2008 for Mac is here, with great new enhancements to all your favorite office productivity tools. Who better than "Dr. Mac, "Bob LeVitus, to show you how to load and use them all? From choosing the best version for your needs to managing your life with your online calendar, Office 2008 For Mac For Dummies covers what you need to know. It compares the Student/Teacher Edition, Standard Edition, and Professional Edition, then walks you through installing your preferred version and keeping it up to date. You'll find out all the things you can do with Word, Excel, PowerPoint, and Entourage,

  10. Wireless sensors networks MAC protocols analysis

    CERN Document Server

    Chaari, Lamia

    2010-01-01

    Wireless sensors networks performance are strictly related to the medium access mechanism. An effective one, require non-conventional paradigms for protocol design due to several constraints. An adequate equilibrium between communication improvement and data processing capabilities must be accomplished. To achieve low power operation, several MAC protocols already proposed for WSN. The aim of this paper is to survey and to analyze the most energy efficient MAC protocol in order to categorize them and to compare their performances. Furthermore we have implemented some of WSN MAC protocol under OMNET++ with the purpose to evaluate their performances.

  11. Beginning Mac OS X Snow Leopard programming

    CERN Document Server

    Trent, Michael

    2010-01-01

    Michael Trent is a technical reviewer for numerous books and magazine articles and the coauthor of Beginning Mac OS X Programming with Drew McCormack. Drew McCormack is an experienced computational scientist, founder of the ""The Mental Faculty""-an independent company developing software for the Mac and iPhone-and the coauthor of Beginning Mac OS X Programming with Michael Trent. Wrox Beginning guides are crafted to make learning programming languages and technologies easier than you think, providing a structured, tutorial format that will guide you through all the techniques involved.

  12. Learn Office 2011 for Mac OS X

    CERN Document Server

    Hart-Davis, Guy

    2011-01-01

    Office for Mac remains the leading productivity suite for Mac, with Apple's iWork and the free OpenOffice.org trailing far behind. And now it's being updated with a cleaner interface and more compatibility with Exchange and SharePoint. Learn Office 2011 for Mac OS X offers a practical, hands-on approach to using Office 2011 applications to create and edit documents and get work done efficiently. You'll learn how to customize Office, design, create, and share documents, manipulate data in a spreadsheet, and create lively presentations. You'll also discover how to organize your email, contacts,

  13. [A case of environmental infection with pulmonary Mycobacterium avium complex disease from a residential bathroom of a patient suggested by variable-number tandem-repeat typing of Mycobacterium avium tandem repeat loci].

    Science.gov (United States)

    Taga, Shu; Niimi, Masaki; Kurokawa, Kazuhiro; Nakagawa, Taku; Ogawa, Kenji

    2012-05-01

    A 63-year-old woman was referred to our hospital because of bilateral infiltrations and nodular opacities in her chest radiograph taken in the mass radiography screening in September 2010. The chest computed tomography showed patchy infiltrations with bronchiectasis in the lower lung fields on both sides. She was diagnosed with pulmonary Mycobacterium avium complex (MAC) disease based on the bacteria recovered from the sputum and the bronchoalveolar lavage fluid. To elucidate an environmental MAC source, we investigated her home, and isolated M. avium and M. gordonae from the bathtub and shower tap, respectively, in her residential bathroom. Analysis of the hsp65-PRA variants digested with BamHI and some insertion sequences showed that the clinical strains recovered from sputum and strains from the bathtub were M. avium subsp. hominissuis. A dendrogram of the Mycobacterium avium tandem repeat loci variable-number tandem-repeat (MATR-VNTR) analysis of the MAC strains showed that the bathtub strains formed a polyclonal colonization, and that 1 of the 5 MATR-VNTR patterns was identical to the corresponding pattern of the sputum strain from the patient. In conclusion, we believe that the residential bathroom of the patient was the environmental source of her pulmonary MAC disease, as has been previously reported.

  14. PLEIOTROPHIN, A MULTIFUNCTIONAL CYTOKINE AND GROWTH FACTOR, INDUCES LEUKOCYTE RESPONSES THROUGH THE INTEGRIN MAC-1.

    Science.gov (United States)

    Shen, Di; Podolnikova, Nataly P; Yakubenko, Valentin P; Ardell, Christopher L; Balabiyev, Arnat; Ugarova, Tatiana P; Wang, Xu

    2017-09-22

    Pleiotrophin (PTN) is a multifunctional, cationic, glycosaminoglycan-binding cytokine and growth factor involved in numerous physiological and pathological processes, including tissue repair and inflammation-related diseases. PTN has been shown to promote leukocyte responses by inducing their migration and expression of inflammatory cytokines. However, the mechanisms through which PTN mediates these responses remain unclear. Here, we identified the integrin Mac-1 (αMβ2, CD11b/CD18) as the receptor mediating macrophage adhesion and migration to PTN. We also found that expression of Mac-1 on the surface of human embryonic kidney (HEK) 293 cells induced their adhesion and migration to PTN. Accordingly, PTN promoted Mac-1-dependent cell spreading and initiated intracellular signaling manifested in phosphorylation of Erk1/2. While binding to PTN, Mac-1 on Mac-1-expressing HEK293 cells appear to cooperate with cell-surface proteoglycans, since both anti-Mac-1 function-blocking mAb and heparin were required to block adhesion. Moreover, biolayer interferometry and NMR indicated a direct interaction between the αMI domain, the major ligand-binding region of Mac-1, and PTN. Using peptide libraries, we found that in PTN, the αMI domain bound sequences enriched in basic and hydrophobic residues, indicating that PTN conforms to the general principle of ligand-recognition specificity of the αMI domain toward cationic proteins/peptides. Finally, using recombinant PTN-derived fragments, we show that PTN contains two distinct Mac-1-binding sites in each of its constitutive domains. Collectively, these results identify PTN as a ligand for the integrin Mac-1 on the surface of leukocytes and suggest that this interaction may play a role in inflammatory responses. Copyright © 2017, The American Society for Biochemistry and Molecular Biology.

  15. [Parasitic diseases in pediatric cancer patients].

    Science.gov (United States)

    Bialek, R

    2005-11-01

    Parasitic infections are rare events in pediatric oncology. Transmission routes and diseases of most parasites do not differ significantly from those seen in otherwise healthy children. However, latent asymptomatic infections with Cryptosporidium spp., Leishmania spp., Strongyloides stercoralis and Toxoplasma gondii might exacerbate during immunosuppression. Screening in asymptomatic patients is often unsuccessful due to the low sensitivity of available assays except in toxoplasmosis. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for the appropriate diagnostic procedures and antiparasitic treatment immunocompromised patients.

  16. MAC Layer Hurdles in BSNs

    CERN Document Server

    Ullah, Sana; Choi, Young-Woo; Lee, Hyung-Soo; Kwak, Kyung Sup

    2009-01-01

    The last few decades have seen considerable research progress in microelectronics and integrated circuits, system-on-chip design, wireless communication, and sensor technology. This progress has enabled the seamless integration of autonomous wireless sensor nodes around a human body to create a Body Sensor Network (BSN). The development of a proactive and ambulatory BSN induces a number of enormous issues and challenges. This paper presents the technical hurdles during the design and implementation of a low-power Medium Access Control (MAC) protocol for in-body and on-body sensor networks. We analyze the performance of IEEE 802.15.4 protocol for the on-body sensor network. We also provide a comprehensive insight into the heterogeneous characteristics of the in-body sensor network. A low-power technique called Pattern-Based Wake-up Table is proposed to handle the normal traffic in a BSN. The proposed technique provides a reliable solution towards low-power communication in the in-body sensor network.

  17. [Preoperative assessment of lung disease patients.].

    Science.gov (United States)

    Ramos, Gilson; Ramos Filho, José; Pereira, Edísio; Junqueira, Marcos; Assis, Carlos Henrique C

    2003-02-01

    Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients. Major anesthetic-surgical repercussions in lung function have already been described. Similarly, we tried to select higher-risk patients, submitted or not to lung resection. To that end, clinical and laboratorial propedeutics were used. Finally, a proposal of a preoperative algorithm was presented for procedures with lung resection. Lung disease patients, especially those with chronic evolution, need to be preoperatively thoroughly evaluated. ASA physical status and Goldmans cardiac index are important risk forecasting factors for lung disease patients not candidates for lung resection. Adding to these criteria, estimated postoperative max VO2, FEV1 and diffusion capacity are mandatory for some patients submitted to lung resection. beta2-agonists and steroids should be considered in the preoperative period of these patients.

  18. Psychological assessment of patients with Meniere's disease

    NARCIS (Netherlands)

    van Cruijsen, N.; Jaspers, J. P. C.; van de Wiel, H. B. M.; Wit, H. P.; Albers, F. W. J.

    2006-01-01

    The objective of this study was to evaluate daily stressors, coping, personality, physical and mental health, and quality of life in Meniere patients. 110 consecutive patients with definite Meniere's disease were assessed using the Dutch Daily Hassles List, Coping Inventory for Stressful Situations

  19. Mortality in patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Wermuth, L; Stenager, E; Boldsen, J

    1995-01-01

    INTRODUCTION: After the introduction of L-dopa the mortality rate in Parkinson's disease (PD) patients has changed, but is still higher than in the background population. MATERIAL & METHODS: Mortality, age at death and cause of death in a group of PD patients compared with the background population...

  20. CR-MAC: A multichannel MAC protocol for cognitive radio ad hoc networks

    CERN Document Server

    Kamruzzaman, S M

    2010-01-01

    This paper proposes a cross-layer based cognitive radio multichannel medium access control (MAC) protocol with TDMA, which integrate the spectrum sensing at physical (PHY) layer and the packet scheduling at MAC layer, for the ad hoc wireless networks. The IEEE 802.11 standard allows for the use of multiple channels available at the PHY layer, but its MAC protocol is designed only for a single channel. A single channel MAC protocol does not work well in a multichannel environment, because of the multichannel hidden terminal problem. Our proposed protocol enables secondary users (SUs) to utilize multiple channels by switching channels dynamically, thus increasing network throughput. In our proposed protocol, each SU is equipped with only one spectrum agile transceiver, but solves the multichannel hidden terminal problem using temporal synchronization. The proposed cognitive radio MAC (CR-MAC) protocol allows SUs to identify and use the unused frequency spectrum in a way that constrains the level of interference...

  1. H-MAC: A Hybrid MAC Protocol for Wireless Sensor Networks

    CERN Document Server

    Mehta, S; 10.5121/ijcnc.2010.2208

    2010-01-01

    In this paper, we propose a hybrid medium access control protocol (H-MAC) for wireless sensor networks. It is based on the IEEE 802.11's power saving mechanism (PSM) and slotted aloha, and utilizes multiple slots dynamically to improve performance. Existing MAC protocols for sensor networks reduce energy consumptions by introducing variation in an active/sleep mechanism. But they may not provide energy efficiency in varying traffic conditions as well as they did not address Quality of Service (QoS) issues. H-MAC, the propose MAC protocol maintains energy efficiency as well as QoS issues like latency, throughput, and channel utilization. Our numerical results show that H-MAC has significant improvements in QoS parameters than the existing MAC protocols for sensor networks while consuming comparable amount of energy.

  2. Zoonotic aspects of Mycobacterium bovis and Mycobacterium avium-intracellulare complex (MAC).

    Science.gov (United States)

    Biet, Franck; Boschiroli, Maria Laura; Thorel, Marie Françoise; Guilloteau, Laurence A

    2005-01-01

    Pathogens that are transmitted between the environment, wildlife, livestock and humans represent major challenges for the protection of human and domestic animal health, the economic sustainability of agriculture, and the conservation of wildlife. Among such pathogens, the genus Mycobacterium is well represented by M. bovis, the etiological agent of bovine tuberculosis, M. avium ssp. paratuberculosis (Map) the etiological agent of Johne disease, M. avium ssp. avium (Maa) and in a few common cases by other emergent environmental mycobacteria. Epidemiologic surveys performed in Europe, North America and New Zealand have demonstrated the existence and importance of environmental and wildlife reservoirs of mycobacterial infections that limit the attempts of disease control programmes. The aim of this review is to examine the zoonotic aspects of mycobacteria transmitted from the environment and wildlife. This work is focused on the species of two main groups of mycobacteria classified as important pathogens for humans and animals: first, M. bovis, the causative agent of bovine tuberculosis, which belongs to the M. tuberculosis complex and has a broad host range including wildlife, captive wildlife, domestic livestock, non-human primates and humans; the second group examined, is the M. avium-intracellulare complex (MAC) which includes M. avium ssp. avium causing major health problems in AIDS patients and M. avium ssp. paratuberculosis the etiological agent of Johne disease in cattle and identified in patients with Crohn disease. MAC agents, in addition to a broad host range, are environmental mycobacteria found in numerous biotopes including the soil, water, aerosols, protozoa, deep litter and fresh tropical vegetation. This review examines the possible reservoirs of these pathogens in the environment and in wildlife, their role as sources of infection in humans and animals and their health impact on humans. The possibilities of control and management programmes for

  3. Learn Mac OS X Snow Leopard

    CERN Document Server

    Meyers, Scott

    2009-01-01

    You're smart and savvy, but also busy. This comprehensive guide to Apple's Mac OS X 10.6, Snow Leopard, gives you everything you need to know to live a happy, productive Mac life. Learn Mac OS X Snow Leopard will have you up and connected lickity split. With a minimum of overhead and a maximum of useful information, you'll cover a lot of ground in the time it takes other books to get you plugged in. If this isn't your first experience with Mac OS X, skip right to the "What's New in Snow Leopard" sections. You may also find yourself using this book as a quick refresher course or a way

  4. Current treatments for patients with Alzheimer disease.

    Science.gov (United States)

    Osborn, Gerald G; Saunders, Amanda Vaughn

    2010-09-01

    There is neither proven effective prevention for Alzheimer disease nor a cure for patients with this disorder. Nevertheless, a spectrum of biopsychosocial therapeutic measures is available for slowing progression of the illness and enhancing quality of life for patients. These measures include a range of educational, psychological, social, and behavioral interventions that remain fundamental to effective care. Also available are a number of pharmacologic treatments, including prescription medications approved by the US Food and Drug Administration for Alzheimer disease, "off-label" uses of medications to manage target symptoms, and controversial complementary therapies. Physicians must make the earliest possible diagnosis to use these treatments most effectively. Physicians' goals should be to educate patients and their caregivers, to plan long-term care options, to maximally manage concurrent illnesses, to slow and ameliorate the most disabling symptoms, and to preserve effective functioning for as long as possible. The authors review the various current treatments for patients with Alzheimer disease.

  5. Macintosh Troubleshooting Pocket Guide for Mac OS

    CERN Document Server

    Lerner, David; Corporation, Tekserve

    2009-01-01

    The Macintosh Troubleshooting Pocket Guide covers the most common user hardware and software trouble. It's not just a book for Mac OS X (although it includes tips for OS X and Jaguar), it's for anyone who owns a Mac of any type-- there are software tips going back as far as OS 6. This slim guide distills the answers to the urgent questions that Tekserve's employee's answer every week into a handy guide that fits in your back pocket or alongside your keyboard.

  6. Enhanced Sleep Mode MAC Control for EPON

    DEFF Research Database (Denmark)

    Yan, Ying; Dittmann, Lars

    2011-01-01

    This paper introduces sleep mode operations for EPON. New MAC control functions are proposed to schedule sleep periods. Traffic profiles are considered to optimize energy efficiency and network performances. Simulation results are analyzed in OPNET modeler.......This paper introduces sleep mode operations for EPON. New MAC control functions are proposed to schedule sleep periods. Traffic profiles are considered to optimize energy efficiency and network performances. Simulation results are analyzed in OPNET modeler....

  7. On the Development of Low Power MAC Protocol for WBANs

    CERN Document Server

    Ullah, Sana; Kwak, Kyung Sup

    2009-01-01

    Current advances in wireless communication, microelectronics, semiconductor technologies, and intelligent sensors have contributed to the development of unobtrusive WBANs. These networks provide long term health monitoring of patients without any constraint in their normal activities. Traditional MAC protocols do not accommodate the assorted WBAN traffic requirements in a power efficient manner. In this paper, we present a brief discussion on the development process of a low power MAC protocol for WBANs. We observe the behavior of a beacon-enabled IEEE 802.15.4 for on-body sensor networks. We further propose a low power technique called traffic based wakeup mechanism for a WBAN that exploits the traffic patterns of the BAN Nodes to ensure power efficient and reliable communication.

  8. 42 CFR 405.1120 - Filing briefs with the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Filing briefs with the MAC. 405.1120 Section 405....1120 Filing briefs with the MAC. Upon request, the MAC will give the party requesting review, as well... ending with the date the brief is received by the MAC will not be counted toward the adjudication...

  9. 42 CFR 423.1974 - Medicare Appeals Council (MAC) review.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare Appeals Council (MAC) review. 423.1974..., MAC review, and Judicial Review § 423.1974 Medicare Appeals Council (MAC) review. An enrollee who is dissatisfied with an ALJ hearing decision may request that the MAC review the ALJ's decision or dismissal as...

  10. 42 CFR 423.2130 - Effect of the MAC's decision.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Effect of the MAC's decision. 423.2130 Section 423... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2130 Effect of the MAC's decision. The MAC's decision is final and binding...

  11. 42 CFR 405.1130 - Effect of the MAC's decision.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Effect of the MAC's decision. 405.1130 Section 405....1130 Effect of the MAC's decision. The MAC's decision is final and binding on all parties unless a Federal district court issues a decision modifying the MAC's decision or the decision is revised as the...

  12. 42 CFR 423.2118 - Obtaining evidence from the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Obtaining evidence from the MAC. 423.2118 Section..., MAC review, and Judicial Review § 423.2118 Obtaining evidence from the MAC. An enrollee may request... the costs of providing these items. If an enrollee requests evidence from the MAC and an opportunity...

  13. 42 CFR 423.2126 - Case remanded by the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Case remanded by the MAC. 423.2126 Section 423.2126... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2126 Case remanded by the MAC. (a) When the MAC may remand a case to the ALJ...

  14. 42 CFR 423.2120 - Filing briefs with the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Filing briefs with the MAC. 423.2120 Section 423... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2120 Filing briefs with the MAC. Upon request, the MAC will give the...

  15. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  16. Musical hallucinations in patients with Lyme disease.

    Science.gov (United States)

    Stricker, Raphael B; Winger, Edward E

    2003-07-01

    Musical hallucinations are poorly understood auditory hallucinations that occur in patients with otologic or neurologic diseases. We report the first cases of musical hallucinations in two patients with neurologic Lyme disease. Both subjects were women with clinical and laboratory evidence of chronic Lyme disease, progressive neurologic dysfunction, and abnormal magnetic resonance imaging of the brain. There was no evidence of hearing loss in either case. Musical hallucinations had a sudden onset and took the form of patriotic or operatic music. The auditory hallucinations disappeared with intravenous (i.v.) antibiotic therapy in both patients, but the hallucinations recurred when i.v. antibiotic therapy was discontinued in one case. Response to therapy was accompanied by an increase in the CD57 lymphocyte subset in one patient, whereas recurrent hallucinations were associated with persistently low CD57 levels in the other case. We conclude that musical hallucinations may be associated with neurologic Lyme disease. These auditory hallucinations appear to respond to i.v. antibiotic therapy. Patients with musical hallucinations of unknown cause should be tested for infection with the Lyme disease spirochete.

  17. Dental profile of patients with Gaucher disease

    Directory of Open Access Journals (Sweden)

    Mann Jonathan

    2003-07-01

    Full Text Available Abstract Background This study was conducted to determine whether patients with Gaucher disease had significant dental pathology because of abnormal bone structure, pancytopenia, and coagulation abnormalities. Methods Each patient received a complete oral and periodontal examination in addition to a routine hematological evaluation. Results Gaucher patients had significantly fewer carious lesions than otherwise healthy carriers. Despite prevalence of anemia, there was no increase in gingival disease; despite the high incidence of thrombocytopenia, gingival bleeding was not noted; and despite radiological evidence of bone involvement, there was no greater incidence loss of teeth or clinical tooth mobility. Conclusions These data represent the first survey of the oral health of a large cohort of patients with Gaucher disease. It is a pilot study of a unique population and the results of the investigation are indications for further research. Based on our findings, we recommend regular oral examinations with appropriate dental treatment for patients with Gaucher disease as for other individuals. Consultation between the dentist and physician, preferably one with experience with Gaucher disease, should be considered when surgical procedures are planned.

  18. Mortality in patients with pituitary disease.

    LENUS (Irish Health Repository)

    Sherlock, Mark

    2010-06-01

    Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing\\'s disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients.

  19. [Sighting dominance in patients with macular disease].

    Science.gov (United States)

    Akaza, Eriko; Fujita, Kyoko; Shimada, Hiroyuki; Yuzawa, Mitsuko

    2007-04-01

    To study sighting dominance by comparing macular disease patients undergoing surgical treatment with controls. We studied visual acuity and sighting dominance in 92 macular disease patients, 27 of whom were assessed for both outcomes. We also studied visual acuity and sighting dominance in 412 controls. Sighting dominance was evaluated using the hole-in-card test. Among the controls, 70% showed right sighting dominance, and 30%, left sighting dominance. On the other hand, in patients with macular disease, right sighting dominance was demonstrated in 51%, and left in 49%; that is, 24% showed sighting dominance of the affected eye and 76%, of the fellow eye. During follow-up, sighting dominance of three of the 27 macular disease patients shifted from the affected eye to the fellow eye, which showed improvement in visual acuity. This study raises the possibility of sighting dominance shifting in patients with macular disease. There were differences among cases in the timing of the shift in sighting dominance, indicating that visual acuity may not be the only factor influencing sighting dominance. Further study is needed to confirm the factors contributing to sighting dominance.

  20. The emergence of Parkinson disease among patients with Gaucher disease.

    Science.gov (United States)

    Elstein, Deborah; Alcalay, Roy; Zimran, Ari

    2015-03-01

    In the last decade, several lines of evidence have been presented that document the clinical manifestations, genetic associations, and sub-cellular mechanisms of the inter-relatedness of β-glucocerebrosidase mutations and the emergence of Parkinson disease among carriers and patients with Gaucher disease. This review is an attempt to apprise the reader of the recent literature with the caveat that this is an area of intensive exploration that is constantly being updated because of the immediate clinical ramifications but also because of the impact on our understanding of Parkinson disease, and finally because of the unexpected inter-reactions between these entities on the molecular level. It has been an unexpected happenstance that it has been discovered that a rare monogenetic disease has an interface at many points with a neurological disorder of the elderly that has both familial and sporadic forms: to date there is no cure for either of these disorders.

  1. Neoplastic pericardial disease. Analysis of 26 patients

    Directory of Open Access Journals (Sweden)

    Helena Nogueira Soufen

    1999-01-01

    Full Text Available PURPOSE: To characterize patients with neoplastic pericardial disease diagnosed by clinical presentation, complementary test findings, and the histological type of tumor. METHODS: Twenty-six patients with neoplastic pericardial disease were retrospectively analyzed. RESULTS: Clinical manifestations and abnormalities in chest roentgenograms and electrocardiograms were frequent, but were not specific. Most patients underwent surgery. There was a high positivity of the pericardial biopsy when associated with the cytological analysis of the pericardial liquid used to determine the histological type of the tumor, particularly when the procedure was performed with the aid of pericardioscopy. CONCLUSION: The correct diagnosis of neoplastic pericardial disease involves suspicious but nonspecific findings during clinical examination and in screen tests. The suspicious findings must be confirmed through more invasive diagnostic approaches, in particular pericardioscopy with biopsy and cytological study.

  2. LOCAL ANESTHETICS IN PATIENTS WITH CARDIOVASCULAR DISEASES.

    Directory of Open Access Journals (Sweden)

    risto Daskalov

    2015-03-01

    Full Text Available A significant problem in the dental medicine is pain alleviation. Many studies in the dental anesthesiology result in the production of new agents for locoregional anesthesia. Objective: This article aim to present the results of the last studies on the effect of the local anesthetics used in the oral surgery on patients with cardiovascular diseases. Material: A general review of the existing literature on the effect of the adrenaline, included as vasoconstrictor in the local anesthetics, used in patients with cardiovascular diseases is made. The benefits of vasoconstrictors for the quality of the anesthetic effect are proven. Conclusion: A small amount of adrenaline in the anesthetic solution does not result in complications development in patients with controlled cardiovascular diseases. Articaine is recommended agent of first choice for local anesthesia in the oral surgery.

  3. Gastrostomy in patients with prion disease.

    Science.gov (United States)

    Iwasaki, Yasushi; Mori, Keiko; Ito, Masumi; Kawai, Yoshinari; Hoshino, Ken-Ichiro; Kawabata, Yuko; Mimuro, Maya; Yoshida, Mari

    2017-05-04

    Patients with prion diseases can live for long periods of time in a state of akinetic mutism given appropriate management of their symptoms. To study symptom support in these cases, we performed gastrostomies on 3 patients with V180I genetic Creutzfeldt-Jakob disease (CJD) who had become akinetic and mute, and compared them to 14 other similar patients being fed by tube. In the 3 gastrostomy cases, there were no direct complications due to the gastrostomy or tube feeding, nor were there episodes of discontinuation of tube feeding or initiation of continuous drip infusion due to severe complications. Antibiotics were administered for mild infections, a complication of CJD, with 0.2% and 8.8% of the total time after gastrostomy being used for intravenous or transluminal administration, respectively. We compared the present patient series with that of our previous report statistically, and found that patients undergoing gastrostomy required significantly fewer discontinuations of tube feeding than those who did not. No significant difference in antibiotic administration was found between groups, however. It is our conclusion that gastrostomy should be allowed for symptom support in akinetic patients with prion disease, but adequate informed consent must be provided to the patient's family.

  4. Cardiovascular disease in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Naranjo, Antonio; Sokka, Tuulikki; Descalzo, Miguel

    2008-01-01

    ABSTRACT: INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross......-sectional cohort of nonselected consecutive outpatients with RA (The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis Program, or QUEST-RA) who were receiving regular clinical care. METHODS: The study involved a clinical assessment by a rheumatologist and a self-report questionnaire...

  5. Exercise for older patients with chronic disease.

    Science.gov (United States)

    Petrella, R J

    1999-10-01

    Coronary artery disease, hypertension, congestive heart failure, type 2 diabetes mellitus, osteoarthritis, osteoporosis, and cognitive disorders become more prevalent as people age. Besides delaying the onset of many of these conditions, regular exercise may improve function and delay disability and morbidity in those who have them. Further, exercise may work synergistically with medication to combat the effects of some chronic diseases. Special adaptations for older patients include lower-intensity exercise (eg, fewer repetitions), low-impact exercise (cycling, exercise while sitting), and modified equipment (smaller weights, special shoes, loose clothing). Unresolved issues include development of optimal strategies for motivating older patients to begin and maintain exercise programs.

  6. Current evidence for the use of C-MAC videolaryngoscope in adult airway management: a review of the literature.

    Science.gov (United States)

    Xue, Fu-Shan; Li, Hui-Xian; Liu, Ya-Yang; Yang, Gui-Zhen

    2017-01-01

    The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation. In patients with predicted or known difficult airways, C-MAC videolaryngoscope can achieve a better laryngeal view, a higher intubation success rate and a shorter intubation time than direct laryngoscopy. Furthermore, the option to perform direct and video laryngoscopy with the same device makes C-MAC videolaryngoscope exceptionally useful for emergency intubation. In addition, the C-MAC videolaryngoscope is a very good tool for tracheal intubation teaching. However, tracheal intubation with C-MAC videolaryngoscope may occasionally fail and introduction of C-MAC videolaryngoscope in clinical practice must be accompanied by formal training programs in normal and difficult airway managements.

  7. Managing coeliac disease in patients with diabetes.

    Science.gov (United States)

    Leonard, M M; Cureton, P A; Fasano, A

    2015-01-01

    The association between coeliac disease and type 1 diabetes has long been established. The combination of genetic susceptibility along with a potential role for gluten in the pathogenesis of autoimmunity makes defining gluten's role in type 1 diabetes extremely important. Evidence supporting the role of a gluten-free diet to improve complications associated with type 1 diabetes is not robust. However there is evidence to support improved growth, bone density and potentially the prevention of additional autoimmune diseases in patients with coeliac disease and type 1 diabetes. The gluten free diet is expensive and challenging to adhere to in people already on a modified diet. Early identification of those who have coeliac disease and would benefit from a gluten-free diet is of utmost importance to prevent complications associated with type 1 diabetes and coeliac disease. © 2014 John Wiley & Sons Ltd.

  8. Crohn disease and the gynecologic patient.

    Science.gov (United States)

    Sides, Cleve; Trinidad, Mari Charisse; Heitlinger, Leo; Anasti, James

    2013-01-01

    Although Crohn disease (CD) is considered an inflammatory bowel disease, extraintestinal gynecologic manifestations are varied, frequent, and oftentimes difficult to manage. Its predilection for young and reproductive-age women makes it an important disease process for the gynecologist to understand, as its complications can have long-term repercussions on the developmental, sexual, reproductive, and psychological health of affected women. Patients may present with a variety of vulvovaginal, perineal, perianal, and urologic complaints. Perianal involvement from an intestinal fistula is the most common skin manifestation seen in CD. Other gynecologic manifestations include metastatic CD and rectovaginal and urovaginal fistulas. Recognition and accurate diagnosis of extraintestinal gynecologic manifestations, as well as a good understanding of the gynecologic effects of chronic disease, are necessary for optimal management. The article provides an overview of CD and highlights the gynecologic considerations in caring for women affected by this disease.

  9. Dysphagia in patients with cerebrovascular disease. Update.

    Directory of Open Access Journals (Sweden)

    Amarilis Barbié Rubiera

    2009-03-01

    Full Text Available An important number of patients with cerebrovascular disease also present dysphagia as a result of damage in cerebral hemispheres or brainstem, which contributes to negative morbility and functional rehabilitation prognosis due to the complications liked with this condition. It is a significant cause of nutritional dysfunctions, including increased in-hospital undernourishment, increased per patient expenditure and longer in-hospital stay. One of the objectives of the Nutritional Support Team of the Neuroscience and Neurology Institute is to reduce undernourishment causes in patients with neurological diseases. A wide review of the subject was performed including experts´ opinions, from the above mentioned institutions, in order to gather an updated report related with the significance of early diagnosis of dysphagia in patients with ictus and the opportune and correct use of therapeutic measures to reduce complication risk.

  10. Fatigue in Patients with Autoimmune Thyroid Diseases

    Directory of Open Access Journals (Sweden)

    Jovanovic Zorica

    2017-03-01

    Full Text Available Fatigue is a common feature in a wide variety of chronic inflammatory and autoimmune diseases, but fatigue in autoimmune thyroid disease (AITD has not been investigated so far. The aim of this study was to examine fatigue in patients with AITD and to analyse the correlation between fatigue and the serum concentrations of thyroid antibodies, thyroid function and depression. This cross-sectional clinical study included 62 patients with increased concentrations of thyroperoxidase antibodies (TPOAbs as confirmation of AITD and 52 healthy individuals who were negative for thyroid antibodies; all controls were euthyroid. Thyroid antibodies, free thyroxine and thyroid-stimulating hormone were measured in the sera of all subjects. The Fatigue Severity Scale was used to measure the severity of fatigue; the level of depression was measured by the Beck Depression Inventory. Eight (12.9% patients had evident fatigue, 7 (11.3% patients had fatigue limit values, and 47 (75.8% patients had no fatigue. The frequency of fatigue was highly significant and almost three times higher in the AITD patients compared to the control group, in which only 2 (3.8% patients had evident fatigue. The majority of patients with fatigue had normal thyroid function, and only one (1.6% patient had overt hypothyroidism. Seven (11.3% patients had both fatigue and depression, whereas one (1.6% patient had fatigue without depression. We did not find significant correlations between fatigue and the concentrations of thyroid antibodies, but we found statistically significant correlations between fatigue and depression in AITD patients.

  11. SA-MAC:Self-Stabilizing Adaptive MAC Protocol for Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    波澄; 韩君泽; 李向阳; 王昱; 肖波

    2014-01-01

    A common method of prolonging the lifetime of wireless sensor networks is to use low power duty cycling protocol. Existing protocols consist of two categories: sender-initiated and receiver-initiated. In this paper, we present SA-MAC, a self-stabilizing adaptive MAC protocol for wireless sensor networks. SA-MAC dynamically adjusts the transmission time-slot, waking up time-slot, and packet detection pattern according to current network working condition, such as packet length and wake-up patterns of neighboring nodes. In the long run, every sensor node will find its own transmission phase so that the network will enter a stable stage when the network load and qualities are static. We conduct extensive experiments to evaluate the energy consumption, packet reception rate of SA-MAC in real sensor networking systems. Our results indicate that SA-MAC outperforms other existing protocols.

  12. Fatigue in disease-free cancer patients

    NARCIS (Netherlands)

    Servaes, Petra

    2003-01-01

    The present thesis consists of 1 literature review and 6 research articles on the subject of fatigue complaints in disease-free cancer patients who have finished curative treatment several years ago. In these articles the prevalence of severe fatigue, the relationship between severe fatigue and

  13. Detection of arousals in Parkinson's disease patients

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Kempfner, Jacob; Jennum, Poul

    2011-01-01

    suffering from Parkinson's disease (PD). The proposed algorithm uses features from EEG, EMG and the manual sleep stage scoring as input to a feed-forward artificial neural network (ANN). The performance of the algorithm has been assessed using polysomnographic (PSG) recordings from a total of 8 patients...

  14. Electrocardiographic characteristics of patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Numans, Mattijs E

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis, but studies comparing ECG characteristics between patients with and without COPD are lacking. We related ECG...

  15. Myopathy in patients with Hashimoto's disease.

    Science.gov (United States)

    Villar, Jaqueline; Finol, Héctor J; Torres, Sonia H; Roschman-González, Antonio

    2015-03-01

    Hashimoto thyroiditis (HT) is an autoimmune disease of the thyroid gland. Patients may present or not a hypothyroid state, and frequently have manifestations of myopathy. The present work was aimed to assess the clinical symptoms and signs of skeletal muscle alterations in HT, describe the muscular pathological changes and relate them to the functional thyroid status and to the autoimmune condition of the patient. Clinical and laboratory studies were performed in ten HT patients and three control subjects (hormonal levels and electromyography). Biopsies from their vastus lateralis of quadriceps femoris muscle were analyzed under light (histochemistry and immunofluorescense) and electron microscopy. All patients showed muscle focal alterations, ranging from moderate to severe atrophy, necrosis, activation of satellite cells, presence of autophagosomes, capillary alterations and macrophage and mast cell infiltration, common to autoimmune diseases. The intensity of clinical signs and symptoms was not related to the morphological muscle findings, the electromyography results, or to the state of the thyroid function. Reactions for immunoglobulin in muscle fibers were positive in 80% of the patients. Fiber type II proportion was increased in all patients, with the exception of those treated with L-thyroxine. In conclusion, autoimmune processes in several of the patients may be associated to the skeletal muscle alterations, independently of the functional state of the thyroid gland; however, fiber II type proportion could have been normalized by L-thyroxine treatment.

  16. Dyslipidemia, kidney disease, and cardiovascular disease in diabetic patients.

    Science.gov (United States)

    Chen, Szu-chi; Tseng, Chin-Hsiao

    2013-01-01

    This article reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy. Different patterns of dyslipidemia are associated with different stages of diabetic nephropathy. Some trials have shown that treatment with statins not only decreased the risk of cardiovascular events, but also delayed the progression of diabetic nephropathy. However, studies using statins as the sole treatment of hyperlipidemia in patients on dialysis have not shown benefits with respect to cardiovascular risk. Diabetic patients with nephropathy have a higher risk of cardiovascular events than those without nephropathy. The degree of albuminuria and the reduction in estimated glomerular filtration rate are also correlated with the risk of cardiovascular events. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to reduce albuminuria in diabetic patients has been shown to decrease the risk of cardiovascular morbidity and mortality.

  17. Inflammatory bowel disease in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Charron, M. [Children`s Hospital of Pittsburgh, Pittsburgh (United States). Dept. of Radiology

    1997-12-01

    Optimal management of chronic idiopathic inflammatory bowel disease requires determination of disease localization and intensity. Scintigraphy with the use of {sup 99m}Tc - HMPAO- White Bloods Cells ({sup 99m}Tc - HMPAO-WBC) is a relatively new noninvasive nuclear medicine procedure. They have evaluated more than 230 children and have found a high correspondence between the disease distribution shown by the {sup 99m}Tc - HMPAO- WBC scan and that shown by endoscopic, radiologic, or surgical methods. Additionally the {sup 99m}Tc - HMPAO-WBC scan has the ability of identifying extra intestinal site of inflammation, such as appendicitis and others. The {sup 99m}Tc - HMPAO-WBC scan is reliable in differentiating Crohn`s disease from ulcerative colitis. Some patients because of unequivocal demonstrable small bowel uptake are reclassified from ulcerative colitis to Crohn`s disease. The medication regimen is frequently altered because of the intensity of uptake displayed by the {sup 99m}Tc - HMPAO-WBC scan. It is a practical and safe study even in an acutely ill patient who may not tolerate endoscopic or radiological study. At their institution, the {sup 99m}Tc - HMPAO-WBC scan is now part of the initial evaluation, and follow-up of patients with inflammatory bowel disease. In conclusion the {sup 99m}Tc - HMPAO-WBC is excellent for the detection, localization and characterization of inflammatory bowel disease in children. Compared with the other methods of investigation this study requires no bowel preparation, is noninvasive and has excellent diagnostic accuracy.

  18. Recovery of Lyme disease spirochetes from patients.

    Science.gov (United States)

    Steere, A. C.; Grodzicki, R. L.; Craft, J. E.; Shrestha, M.; Kornblatt, A. N.; Malawista, S. E.

    1984-01-01

    Since the summer of 1982, we have cultured patient specimens for Lyme disease spirochetes. Of 118 patients cultured, four specimens yielded spirochetes: two from blood, one from a skin biopsy specimen of erythema chronicum migrans (ECM), and one from cerebrospinal fluid. All four isolates appeared identical when examined with a monoclonal antibody. However, attempts to recover the spirochete from synovium or synovial fluid were unsuccessful. In addition, the organism could not be visualized in skin or synovial biopsy specimens using the avidin-biotin peroxidase complex detection system. Thus, the current yield in culturing spirochetes from patients is quite low, and it is not yet known whether the organism is still alive later in the disease when arthritis is present. PMID:6393606

  19. Oral Hygiene in Patients with Parkinson's Disease.

    Science.gov (United States)

    Batista, Leonardo M; Portela de Oliveira, Millena Teles; Magalhaes, Wilrama B; Bastos, Poliana Lima

    2015-11-02

    Parkinson's disease is a chronic progressive neurodegenerative disorder with a multifactorial etiology. The symptoms are characterized by motor disorders - tremor, rigidity, bradykinesia and postural instability, which hinder oral hygiene. Oral and dental health in Parkinson's disease has been under-documented and findings are conflicting. Moreover, a number of dentists have limited experience regarding the management of these patients. This article reviews literature published within the last fifteen years, to better understand the impact of this disease in oral health. A literature search (MEDLINE and PUBMED), using keywords Parkinson Disease and Oral Hygiene, yielded 27 articles, from which 20 were selected. All of the articles were published in English in the last 15 years.

  20. Mac OS X Snow Leopard试用

    Institute of Scientific and Technical Information of China (English)

    大大

    2009-01-01

    苹果新一代操作系统Mac OS X 10.6 Snow Leopard(雪豹)于8月底上市。根据NPD集团的统计数据,该系统在美国市场前两周的销售非常喜人,是2007年Mac OS X 10.5 Leopard上市销量的2倍以上,是2005年的Mac OS X 10.4 Tiger操作系统的售量的4倍。假如你也对升级价格仅需88元雪豹系统感兴趣,就让我们从一起升级安装开始,体验它独特的魅力。

  1. MacBook Pro Portable Genius

    CERN Document Server

    Miser, Brad

    2011-01-01

    Tips and techniques for forward-thinking MacBook Pro users Now that you have a MacBook Pro, you need just one more accessory, your very own copy of MacBook Pro Portable Genius, Third Edition. This handy, compact book lets you in on a wealth of tips and tricks, so you get the very most out of Apple's very popular notebook. Discover the latest on the most recent release of iLife, get the skinny on the new Intel Core i7 and i5 processors in the Pro, see how to go wireless in a smart way, and much more. The book is easy to navigate, doesn't skimp on the essentials, and helps you save time and avoi

  2. MacSelfService online tutorial

    CERN Document Server

    CERN. Geneva

    2016-01-01

    Mac Self-Service is a functionality within the Mac Desktop Service built and maintained to empower CERN users by giving them easy access to applications and configurations through the Self-Service application. This tutorial (text attached to the event page) explains how to install Mac Self-Service and how to use it to install applications and printers. Content owner: Vincent Nicolas Bippus Presenter: Pedro Augusto de Freitas Batista Tell us what you think via e-learning.support at cern.ch More tutorials in the e-learning collection of the CERN Document Server (CDS) https://cds.cern.ch/collection/E-learning%20modules?ln=en All info about the CERN rapid e-learning project is linked from http://twiki.cern.ch/ELearning  

  3. Quinoa Well Tolerated in Patients with Celiac Disease

    Science.gov (United States)

    ... Quinoa Well Tolerated in Patients with Celiac Disease Quinoa Well Tolerated in Patients with Celiac Disease FOR ... 263-9000 Bethesda, Maryland (January 21, 2014) – Adding quinoa to the gluten-free diet of patients with ...

  4. Articular manifestations in patients with Lyme disease.

    Science.gov (United States)

    Vázquez-López, María Esther; Díez-Morrondo, Carolina; Sánchez-Andrade, Amalia; Pego-Reigosa, Robustiano; Díaz, Pablo; Castro-Gago, Manuel

    To determine the percentage of Lyme patients with articular manifestations in NW Spain and to know their evolution and response to treatment. A retrospective study (2006-2013) was performed using medical histories of confirmed cases of Lyme disease showing articular manifestations. Clinical and laboratory characteristics, together with the treatment and evolution of the patients, were analysed. Seventeen out of 108 LD confirmed patients (15.7%) showed articular manifestations. Regarding those 17 patients, 64.7%, 29.4% and 5.9% presented arthritis, arthralgia and bursitis, respectively. The knee was the most affected joint. Articular manifestations were often associated to neurological, dermatological and cardiac pathologies. Otherwise, most patients were in Stage III. The 11.8% of the cases progressed to a recurrent chronic arthritis despite the administration of an appropriate treatment. Lyme disease patients showing articular manifestations should be included in the diagnosis of articular affections in areas of high risk of hard tick bite, in order to establish a suitable and early treatment and to avoid sequels. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  5. Depression Among Sexually Transmitted Disease Patients

    Institute of Scientific and Technical Information of China (English)

    黄长征; 李碧芳; 涂亚庭; 刘志香; 林能兴

    2001-01-01

    Objective: To investigate the depression status of patients with sexually transmitted diseases (STDs).Methods: The depression status of fifty-one hospitalized STD patients was evaluated in a randomized control study using Zung's Quantitative Table. 18 healthy control patients with similar demographic backgrounds were randomly chosen as controls. Patients with scores above or equal to 40 were considered to be suffering from depression.Results: The prevalence rate of depression in the patient group was obviously higher than that of in the control (X2=16.456,P<0.01). Prevalence of depression was found to be significantly related to occupation (P<0.05). Though the prevalence was not found to differ significantly between those with a treatment course less than 2 months and those with one longer or equal to 2 months (X2=0.041, P>0.05), the mean depression scores of the former group were significantly higher than those of the latter (P<0.01). No significant differences were found between new versus relapsing disease, married versus non-married, male versus female, or differing educational backgrounds.Conclusion: STD patients showed significant prevalence of depression.

  6. Mac OS X Snow Leopard pocket guide

    CERN Document Server

    Seiblod, Chris

    2009-01-01

    Whether you're new to the Mac or a longtime user, this handy book is the quickest way to get up to speed on Snow Leopard. Packed with concise information in an easy-to-read format, Mac OS X Snow Leopard Pocket Guide covers what you need to know and is an ideal resource for problem-solving on the fly. This book goes right to the heart of Snow Leopard, with details on system preferences, built-in applications, and utilities. You'll also find configuration tips, keyboard shortcuts, guides for troubleshooting, lots of step-by-step instructions, and more. Learn about new features and changes s

  7. MacBook Pro Portable Genius

    CERN Document Server

    Miser, Brad

    2012-01-01

    Discover loads of tips and techniques for the newest MacBook Pro You're already ahead of the game with a MacBook Pro. Now you can get even more out the popular Apple notebook with the new edition of this handy, compact book. Crammed with savvy insights and tips on key tools and shortcuts, this book will help you increase your productivity and keep your Apple digital lifestyle on track. From desktop sharing and wireless networking to running Windows applications, this book avoids fluff, doesn't skimp on the essentials, saves you time and hassle, and shows you what you most want to know. Include

  8. MAC2: A Multi-Hop Adaptive MAC Protocol with Packet Concatenation for Wireless Sensor Networks

    Science.gov (United States)

    Nguyen, Kien; Meis, Ulrich; Ji, Yusheng

    Wireless sensor network MAC protocols switch radios off periodically, employing the so-called duty cycle mechanism, in order to conserve battery power that would otherwise be wasted by energy-costly idle listening. In order to minimize the various negative side-effects of the original scheme, especially on latency and throughput, various improvements have been proposed. In this paper, we introduce a new MAC protocol called MAC2(Multi-hop Adaptive with packet Concatenation-MAC) which combines three promising techniques into one protocol. Firstly, the idea to forward packets over multiple hops within one operational cycle as initially introduced in RMAC. Secondly, an adaptive method that adjusts the listening period according to traffic load minimizing idle listening. Thirdly, a packet concatenation scheme that not only increases throughput but also reduces power consumption that would otherwise be incurred by additional control packets. Furthermore, MAC2 incorporates the idea of scheduling data transmissions with minimum latency, thereby performing packet concatenation together with the multi-hop transmission mechanism in a most efficient way. We evaluated MAC2 using the prominent network simulator ns-2 and the results show that our protocol can outperform DW-MAC — a state of the art protocol both in terms of energy efficiency and throughput.

  9. Aortocaval Fistula in a Behcet's Disease Patient

    Directory of Open Access Journals (Sweden)

    Yusuf Ata

    2009-01-01

    Full Text Available Behcet's disease (BD is a chronic, recurrent, systemic disease that is characterized by oral and genital ulcers and oculocutaneous inflammatory lesions. Cardiovascular involvement especially large artery involvement is a serious and vital complication of BD. Pseudoaneurysms in the major arteries may be the cause of sudden death in BD. In our case a pulsatile abdominal mass was determined to be an aortic pseudoaneurysm associated with BD and an aortocaval fistula. Here we report this case and a short review of literature because this is the first reported aortocaval fistula in a BD patient in English literature.

  10. Heartworm disease: Case study in dog patient

    Directory of Open Access Journals (Sweden)

    Spasojević-Kosić Ljubica

    2011-01-01

    Full Text Available Dirofilaria immitis is a parasite in a. pulmonalis in domestic and wild carnivora. Partial development and the transfer of this parasite among carnivora takes place through the mosquito, which makes possible the maintaining and spreading of this parasite among populations of susceptible animals. Heartworm disease, which is caused by Dirofilaria immitis, is most often manifested as changes in the respiratory and cardiovascular systems. This paper presents the case of heartworm disease in a dog. The therapy used to treat this disease in the dog was a combination of doxycycline and ivermectin. The blood test results indicated a rapid decrease in the number of microfilaria and lowering of the antigen level of the adult parasite. The conducted general and special clinical examinations of the respiratory and cardiovascular systems registered an improvement in the clinical condition of the patient.

  11. A macrophage activation switch (MAcS)-index for assessment of monocyte/macrophage activation

    DEFF Research Database (Denmark)

    Maniecki, Maciej Bogdan; Lauridsen, Mette; Knudsen, Troels Bygum

    2008-01-01

    of inflammatory markers (IL-1β, IL-6, IL-8, IL-10, and TNF-α) was determined by RT-qPCR. Normalized values of sCD163 and mCD163 were calculated by dividing each value by the median value of the healthy population. The MAcS-index was then calculated as the ratio between normalized sCD163 and normalized mCD163....... A MAcS-index > 1 indicates relative increase in sCD163 as compared to mCD163, suggested to reflect a predominant M1 activation.   RESULTS AND DISCUSSION: The MAcS-index of healthy individuals clustered around 1 (2.5-97.5 percentile: 0.28-3.11), whereas the MAcS-index of the patients varied from 0.......06 to 5139, with 4% below the 2.5 % limit of healthy individuals, and 60% above the 97.5 upper limit of healthy individuals.  The MAcS-index in infected patients (with assumed M1 activation) was clearly elevated. The index was significantly higher in patients with clinical signs of infection (median: 9...

  12. OTHELLO SYNDROME IN PATIENTS WITH PARKINSON'S DISEASE

    OpenAIRE

    Georgiev, Dejan; Danieli, Aljoša; Ocepek, Lidija; Novak, Dominika; Zupančič-Križnar, Nina; Trošt, Maja; Pirtošek, Zvezdan

    2010-01-01

    Background: Othello syndrome (OS) is an organic delusional disorder with prevailing jealousy symptoms presumably appearing as side effect of antiparkinsonian therapy. The clinical spectrum of psychiatric symptoms in Parkinson's disease (PD) is very wide, including symptoms of depresion and anxiety, hallucinations, delusions, with prevalent paranoid symptoms, agitation, delirium and sleep disorders. At our knowledge, just a few cases of patients with PD and OS were reported till now. ...

  13. Anesthesia for patients with renal/hepatic disease.

    Science.gov (United States)

    Weil, Ann B

    2010-05-01

    General anesthesia may be necessary for patients with significant disease processes such as renal disease or hepatic disease. A basic understanding of the effects of general anesthetics on these organs and the anticipated problems of renal and hepatic impairment on the anesthetic process is necessary to optimize conditions for patients with renal or hepatic disease. Patient preparation, drug selection, and monitoring strategies will be discussed for patients with renal and liver disease.

  14. Aquatic therapy for patients with rheumatic disease.

    Science.gov (United States)

    McNeal, R L

    1990-11-01

    Aquatic therapy is justifiably a rapidly expanding, beneficial form of patient treatment. The goals established at the initial and subsequent evaluations usually are met as quickly and as sensibly as possible. Understanding the theory of water techniques is essential in implementing an aquatic therapy program. The success of the program, however, will always depend on the pleasure and benefits achieved by the patients. Remember, rheumatic patients most likely will need to modify their previous daily functioning. Patients need to be aware of the long-term ramifications of the disease process and understand how treatment and care may be altered during various stages of exacerbation and remission. Patient education is critical in ensuring individual responsibility for the changes that must be made when not supervised by a professional. Aquatic therapy is a step in molding a positive lifestyle change for the patient. The patient can be encouraged to be fitness oriented and, at the same time, exercise in a manner that is safe, effective, and biomechanically and physiologically sound. The environment, hopefully, also will be conductive to family and social interaction that ultimately encourages the compliance of long-term exercise programs.

  15. [Vaccinations in patients with autoimmune diseases].

    Science.gov (United States)

    Bühler, Silja; Hatz, Christoph

    2016-01-01

    The number of individuals with autoimmune diseases treated with immunosuppressive drugs is increasing steadily. The variety of immunosuppressive drugs and in particular biological therapies is also rising. The autoimmune disease itself as well as the immunosuppressive therapy increases the risk of infection in this population. Particularly the risk of vaccine-preventable infections is elevated. Thus, preventing infections by the means of vaccination is of utmost importance. The Division of Infectious Diseases of the Epidemiology, Biostatistics and Prevention Institute, University of Zurich, performed a literature search on the topic of vaccinations in patients with autoimmune diseases upon request by the Swiss Federal Commission for Vaccination Issues. Overall, data are scarce. The following main points were retrieved from the literature: Inactivated vaccines are safe, but their immunogenicity may be reduced under immunosuppressive therapy. In addition to the generally recommended basic vaccinations, specific vaccinations, such as influenza and pneumococcal vaccination are indicated in these patient groups. Live vaccines are generally contraindicated under immunosuppressive therapy due to safety concerns. However, specific exceptions apply. Furthermore, certain time intervals for the administration of live vaccines after pausing or ceasing an immunosuppressive therapy should be respected.

  16. [Nephrolithiasis in patients with intestinal diseases].

    Science.gov (United States)

    Cirillo, M; Iudici, M; Marcarelli, F; Laudato, M; Zincone, F

    2008-01-01

    Intestinal diseases may cause the formation of urinary stones through changes in the metabolism of oxalate, calcium, and uric acid. The oxalate that is excreted into urine comes from the catabolism of ascorbic acid and some amino acids or from intestinal absorption of food oxalate. Calcium is absorbed by the gut after the stimulation of active vitamin D and is excreted by the kidney under the control of the bone/parathyroid hormone axis. Uric acid is generated by the oxidation of exogenous and endogenous purine bases, is excreted by the kidney through glomerular filtration/tubular secretion, and is soluble in alkaline urine. Several data indicate that patients with inflammatory bowel diseases are at high risk of urinary stones containing calcium-oxalate salt or uric acid. Calcium-oxalate stones are caused by colonic oxalate hyperabsorption (secondary to intestinal dysfunction) or by parenteral nutrition. Uric acid stones are typical of patients with severe diarrhea and/or intestinal neostomy, that is, in patients with hyperconcentrated acidic urine. Relationships between malabsorptive intestinal diseases and urinary stones are less well defined. Preventive countermeasures are not the same for all disorders. Hyperoxaluria should be controlled by diets with a low content of lipids and oxalate but supplemented with calcium and probiotics. The presence of hyperconcentrated acidic urine should be controlled by correct hydration and administration of citrate.

  17. The MacDQoL individualized measure of the impact of macular degeneration on quality of life: reliability and responsiveness

    OpenAIRE

    Bradley, Clare; Mitchell, Jan; Woodcock, Alison; Wolffsohn, James; Anderson, Stephen; Ffytche, Timothy; Rubinstein, Martin; Amoaku, Winfried

    2008-01-01

    PURPOSE: To investigate the MacDQoL test-retest reliability and sensitivity to change in vision over a period of one year in a sample of patients with age-related macular degeneration (AMD). DESIGN: A prospective, observational study. METHOD: Patients with AMD from an ophthalmologist's list (n = 135) completed the MacDQoL questionnaire by telephone interview and underwent a vision assessment on two occasions, one year apart. RESULTS: Among participants whose vision was stable over one year (n...

  18. Results from the MAC Vertex chamber

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, H.N.

    1987-05-01

    The design, construction, and performance characteristics of a high precision gaseous drift chamber made of thin walled proportional tubes are described. The device achieved an average spatial resolution of 45 ..mu..m in use for physics analysis with the MAC detector. The B-lifetime result obtained with this chamber is discussed.

  19. MacIntyre, Managerialism and Universities

    Science.gov (United States)

    Stolz, Steven A.

    2017-01-01

    MacIntyre's earlier work and concern with social science enquiry not only exposes its limits, but also provides an insight into how its knowledge claims have been put to ideological use. He maintains that the institutional embodiment of these ideological ideas is the bureaucratic manager who has had a negative role to play in social structures…

  20. AH-MAC: Adaptive Hierarchical MAC Protocol for Low-Rate Wireless Sensor Network Applications

    Directory of Open Access Journals (Sweden)

    Adnan Ismail Al-Sulaifanie

    2017-01-01

    Full Text Available This paper proposes an adaptive hierarchical MAC protocol (AH-MAC with cross-layer optimization for low-rate and large-scale wireless sensor networks. The main goal of the proposed protocol is to combine the strengths of LEACH and IEEE 802.15.4 while offsetting their weaknesses. The predetermined cluster heads are supported with an energy harvesting circuit, while the normal nodes are battery-operated. To prolong the network’s operational lifetime, the proposed protocol transfers most of the network’s activities to the cluster heads while minimizing the node’s activity. Some of the main features of this protocol include energy efficiency, self-configurability, scalability, and self-healing. The simulation results showed great improvement of the AH-MAC over LEACH protocol in terms of energy consumption and throughput. AH-MAC consumes eight times less energy while improving throughput via acknowledgment support.

  1. CA-MAC: A Novel MAC Protocol to Alleviate Congestion in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    WU, J.

    2013-11-01

    Full Text Available Even if the traffic pattern is known and the network topology is simple, a strong congestion can take place in wireless sensor networks (WSNs due to the data gathering effect and the duty-cycle operation. In this paper, we propose a novel medium access control (MAC protocol to alleviate the congestion, which is referred to as the congestion alleviation-MAC (CA-MAC. It adopts an adaptive contention window (ACW, which allows the nodes with more buffered packets to transmit with a higher probability, as well as an intelligent burst packet transmission when the congested nodes seize the channel. Simulations are performed in NS-2, and results show that the proposed CA-MAC protocol achieves a good performance in terms of the packet delivery ratio (PDR, power consumption, throughput, and average latency.

  2. Exposure histories of lunar meteorites: ALHA81005, MAC88104, MAC88105, and Y791197

    Energy Technology Data Exchange (ETDEWEB)

    Nishiizumi, K.; Arnold, J.R. (Univ. of California, San Diego, (United States)); Klein, J.; Fink, D.; Middleton, R. (Univ. of Pennsylvania, Philadelphia (United States)); Kubik, P.W.; Sharma, P.; Elmore, D. (Univ. of Rochester, NY (United States)); Reedy, R.C. (Los Alamos National Lab., NM (United States))

    1991-11-01

    The cosmogenic radionuclides {sup 41}Ca, {sup 36}Cl, {sup 26}Al, and {sup 10}Be in the Allan Hills 81005, MacAlpine Hills 88104, MacAlpine Hills 88105,and Yamato 791197 meteorites were measured by accelerator mass spectrometry (AMS). {sup 53}Mn in Allan Hills 81005 and Yamato 791197 was measured by activation. These four lunar meteorites experienced similar histories. They were ejected from near the surface of the Moon ranging in depth down to 400 g/cm{sup 2} and had very short transition times (less than 0.1 Ma) from the Moon to the Earth. A comparison of the cosmogenic nuclide concentrations in MacAlpine Hills 88104 and MacAlpine Hills 88105 clearly indicates that they are a pair from the same fall.

  3. 42 CFR 405.1126 - Case remanded by the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Case remanded by the MAC. 405.1126 Section 405.1126....1126 Case remanded by the MAC. (a) When the MAC may remand a case. Except as specified in § 405.1122(c), the MAC may remand a case in which additional evidence is needed or additional action by the ALJ is...

  4. [Psychopharmacotherapy in patients with cardiovascular diseases].

    Science.gov (United States)

    Cordes, J; Lange-Asschenfeldt, C; Hiemke, C; Kahl, K G

    2012-11-01

    Increased cardiometabolic morbidity and increased overall mortality has been observed in patients with severe mental disorders. Therefore, cardiometabolic safety is an important issue in the treatment of patients with psychiatric disorders, in particular in patients with comorbid cardiometabolic diseases. Frequent adverse side effects include disturbances of lipid and glucose metabolism, body weight changes and alterations of the QTc interval. Dependent on the particular substance used and on factors concerning individual vulnerability, these side effects vary in relative frequency. Therefore, regular monitoring is recommended including ECG. Furthermore, interactions between different medicaments may occur, either leading to enhanced or decreased drug concentrations. Prior to psychopharmacological treatment, proper cardiological treatment is recommended. The management of cardiovascular risks under psychopharmacology requires interdisciplinary cooperation between the cardiologist, general practitioner and psychiatrist.

  5. Serodiagnosis of Mycobacterium avium complex disease in humans: translational research from basic mycobacteriology to clinical medicine.

    Science.gov (United States)

    Kobayashi, Kazuo

    2014-01-01

    Rapid and accurate diagnosis of infectious diseases, including mycobacterial disease such as tuberculosis (TB) and diseases due to nontuberculous mycobacteria (NTM), is a very important element of global health. The gold standard in diagnosis of mycobacterial diseases remains clinical examination, combined with direct microscopic examination of sputum and culture of bacteria. Culture of slowly growing mycobacteria, including Mycobacterium tuberculosis and NTM (such as M. avium complex: MAC), can take up to 4 to 6 weeks, and in 10-20% of cases the bacillus is not successfully cultivated. Diagnosis of MAC pulmonary disease (MAC-PD) is complicated and time-consuming (usually at least 1 month). I have characterized the nature of MAC antigens and immune responses from the aspect of basic mycobacteriology, and then translated to clinical science. My multicenter study in Japan has demonstrated the usefulness of a serodiagnostic test to determine serum IgA antibodies against mycobacterial glycopeptidolipid (GPL) core antigen for diagnosing MAC-PD within a few hours. To validate in a larger number of patients, at diverse geographic locations, and among other races, the test was also assessed the usefulness internationally in the United States and Taiwan. In this review, I discuss development of serodiagnosis of MAC-PD by translational research and international collaboration study.

  6. Reduction in standard MAC and MAC for intubation after clonidine premedication in children.

    Science.gov (United States)

    Inomata, S; Kihara, S; Yaguchi, Y; Baba, Y; Kohda, Y; Toyooka, H

    2000-11-01

    We examined the relative effects of different doses of oral clonidine on the MAC for endotracheal intubation (MACEI) and the MAC for skin incision (MAC) in children. We studied 90 children (15 in each group) (age range 2-8 yr, weight 10-27 kg, height 89-124 cm) who received one of three preanaesthetic medications: placebo (control), oral clonidine 2 micrograms kg-1, or oral clonidine 4 micrograms kg-1 100 min before anaesthesia. Anaesthesia was induced and maintained with sevoflurane in oxygen and air without i.v. anesthetics and neuromuscular relaxants. The end-tidal sevoflurane concentration was kept constant for > or = 15 min before tracheal intubation or skin incision. MACs were determined using Dixon's 'up-and-down method'. Mean (SD) MACEIs of sevoflurane were 2.9 (0.1)%, 2.5 (0.1)% and 1.9 (0.1)% (P clonidine 2 micrograms kg-1 and clonidine 4 micrograms kg-1 groups. The MACEIs and MACs decreased dose-dependently. The MACEI/MAC ratio (1.4) was not affected by clonidine.

  7. CR-MAC: A Multichannel MAC Protocol for Cognitive Radio AD HOC Networks

    Directory of Open Access Journals (Sweden)

    S. M. Kamruzzaman

    2010-09-01

    Full Text Available This paper proposes a cross-layer based cognitive radio multichannel medium access control (MACprotocol with TDMA, which integrate the spectrum sensing at physical (PHY layer and the packetscheduling at MAC layer, for the ad hoc wireless networks. The IEEE 802.11 standard allows for the useof multiple channels available at the PHY layer, but its MAC protocol is designed only for a singlechannel. A single channel MAC protocol does not work well in a multichannel environment, because ofthe multichannel hidden terminal problem. Our proposed protocol enables secondary users (SUs toutilize multiple channels by switching channels dynamically, thus increasing network throughput. In ourproposed protocol, each SU is equipped with only one spectrum agile transceiver, but solves themultichannel hidden terminal problem using temporal synchronization. The proposed cognitive radioMAC (CR-MAC protocol allows SUs to identify and use the unused frequency spectrum in a way thatconstrains the level of interference to the primary users (PUs. Our scheme improves network throughputsignificantly, especially when the network is highly congested. The simulation results show that ourproposed CR-MAC protocol successfully exploits multiple channels and significantly improves networkperformance by using the licensed spectrum band opportunistically and protects PUs from interference,even in hidden terminal situations.

  8. 42 CFR 423.2128 - Action of the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Action of the MAC. 423.2128 Section 423.2128 Public...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2128 Action of the MAC. (a) After it has reviewed all the evidence in the...

  9. 42 CFR 405.1118 - Obtaining evidence from the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Obtaining evidence from the MAC. 405.1118 Section... Council Review § 405.1118 Obtaining evidence from the MAC. A party may request and receive a copy of all... these items. If a party requests evidence from the MAC and an opportunity to comment on that evidence...

  10. 42 CFR 405.1128 - Action of the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Action of the MAC. 405.1128 Section 405.1128 Public... the MAC. (a) After it has reviewed all the evidence in the administrative record and any additional evidence received, subject to the limitations on MAC consideration of additional evidence in § 405.1122...

  11. 42 CFR 422.608 - Medicare Appeals Council (MAC) review.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Medicare Appeals Council (MAC) review. 422.608... and Appeals § 422.608 Medicare Appeals Council (MAC) review. Any party to the hearing, including the MA organization, who is dissatisfied with the ALJ hearing decision, may request that the MAC review...

  12. MAC 700 Wash高亮度灯具

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    马田最新推出的MAC 700 Wash高亮度灯具继承了MAC系列的传统优点.具有与MAC 700 Profile相同的强大功能、模组桔构和出色设计,是MAC 700 Profile的“最佳搭档”。

  13. The international epidemiology of disseminated Mycobacterium avium complex infection in AIDS. International MAC Study Group.

    Science.gov (United States)

    Fordham von Reyn, C; Arbeit, R D; Tosteson, A N; Ristola, M A; Barber, T W; Waddell, R; Sox, C H; Brindle, R J; Gilks, C F; Ranki, A; Bartholomew, C; Edwards, J; Falkinham, J O; O'Connor, G T

    1996-08-01

    To determine rates of disseminated Mycobacterium avium complex (MAC) infection among AIDS patients in developed and developing countries, and to determine whether different rates reflect differences in exposure or immunity, or both. Prospective cohort study. University hospitals and outpatient AIDS programs. HIV-infected subjects with CD4 counts or = 5 mm were present in 20% of patients from Kenya compared to 1% at other sites (P swimming in an indoor pool, history of bronchoscopy, regular consumption of raw or partially cooked fish/shellfish and treatment with granulocyte colony-stimulating factor. Rates of disseminated MAC in AIDS are higher in developed than developing countries and are due to both differences in exposure and differences in immunity. These data provide a rationale for prevention of MAC through both active immunization and reduction in exposure to the organism.

  14. Auditory Dysfunction in Patients with Cerebrovascular Disease

    Directory of Open Access Journals (Sweden)

    Sadaharu Tabuchi

    2014-01-01

    Full Text Available Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

  15. Evoked otoacoustic emissions in patients with Meniere's disease

    NARCIS (Netherlands)

    de Kleine, E; Mateijsen, DJM; Wit, HP; Albers, FWJ

    2002-01-01

    Hypothesis: This study investigated whether otoacoustic emissions (OAEs) in patients with Meniere's disease show abnormal properties. Background: Patients with Meniere's disease experience vertigo. tinnitus, and hearing loss. OAEs are sounds generated in the inner ear. and their presence is associat

  16. Chemokines in CSF of Alzheimer's disease patients

    Directory of Open Access Journals (Sweden)

    Jôice Dias Corrêa

    2011-06-01

    Full Text Available Some studies have linked the presence of chemokines to the early stages of Alzheimer's disease (AD. Then, the identification of these mediators may contribute to diagnosis. Our objective was to evaluate the levels of beta-amyloid (BA, tau, phospho-tau (p-tau and chemokines (CCL2, CXCL8 and CXCL10 in the cerebrospinal fluid (CSF of patients with AD and healthy controls. The correlation of these markers with clinical parameters was also evaluated. The levels of p-tau were higher in AD compared to controls, while the tau/p-tau ratio was decreased. The expression of CCL2 was increased in AD. A positive correlation was observed between BA levels and all chemokines studied, and between CCL2 and p-tau levels. Our results suggest that levels of CCL2 in CSF are involved in the pathogenesis of AD and it may be an additional useful biomarker for monitoring disease progression.

  17. Eliminating the Heart from the Curcumin Molecule: Monocarbonyl Curcumin Mimics (MACs

    Directory of Open Access Journals (Sweden)

    Dinesh Shetty

    2014-12-01

    Full Text Available Curcumin is a natural product with several thousand years of heritage. Its traditional Asian application to human ailments has been subjected in recent decades to worldwide pharmacological, biochemical and clinical investigations. Curcumin’s Achilles heel lies in its poor aqueous solubility and rapid degradation at pH ~ 7.4. Researchers have sought to unlock curcumin’s assets by chemical manipulation. One class of molecules under scrutiny are the monocarbonyl analogs of curcumin (MACs. A thousand plus such agents have been created and tested primarily against cancer and inflammation. The outcome is clear. In vitro, MACs furnish a 10–20 fold potency gain vs. curcumin for numerous cancer cell lines and cellular proteins. Similarly, MACs have successfully demonstrated better pharmacokinetic (PK profiles in mice and greater tumor regression in cancer xenografts in vivo than curcumin. The compounds reveal limited toxicity as measured by murine weight gain and histopathological assessment. To our knowledge, MAC members have not yet been monitored in larger animals or humans. However, Phase 1 clinical trials are certainly on the horizon. The present review focuses on the large and evolving body of work in cancer and inflammation, but also covers MAC structural diversity and early discovery for treatment of bacteria, tuberculosis, Alzheimer’s disease and malaria.

  18. Olfactory training in patients with Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Antje Haehner

    Full Text Available OBJECTIVE: Decrease of olfactory function in Parkinson's disease (PD is a well-investigated fact. Studies indicate that pharmacological treatment of PD fails to restore olfactory function in PD patients. The aim of this investigation was whether patients with PD would benefit from "training" with odors in terms of an improvement of their general olfactory function. It has been hypothesized that olfactory training should produce both an improved sensitivity towards the odors used in the training process and an overall increase of olfactory function. METHODS: We recruited 70 subjects with PD and olfactory loss into this single-center, prospective, controlled non-blinded study. Thirty-five patients were assigned to the olfactory training group and 35 subjects to the control group (no training. Olfactory training was performed over a period of 12 weeks while patients exposed themselves twice daily to four odors (phenyl ethyl alcohol: rose, eucalyptol: eucalyptus, citronellal: lemon, and eugenol: cloves. Olfactory testing was performed before and after training using the "Sniffin' Sticks" (thresholds for phenyl ethyl alcohol, tests for odor discrimination, and odor identification in addition to threshold tests for the odors used in the training process. RESULTS: Compared to baseline, trained PD patients experienced a significant increase in their olfactory function, which was observed for the Sniffin' Sticks test score and for thresholds for the odors used in the training process. Olfactory function was unchanged in PD patients who did not perform olfactory training. CONCLUSION: The present results indicate that olfactory training may increase olfactory sensitivity in PD patients.

  19. [Transition experience of patients with neuromuscular disease].

    Science.gov (United States)

    Greif, Valeria; Ugo, Florencia; de Castro Pérez, M Fernanda; Mozzoni, Julieta; Aguerre, Verónica; Saldías, Milagros; Monges, M Soledad

    2017-02-01

    Neuromuscular diseases are mostly genetic disorders, with chronic and progressive course. Affected people are at high risk of developing physical and emotional disabilities. In the last decades, the advance in technology and science has increased chronic pediatric patients survival rate, thus requiring an ongoing assistance in adult hospitals, making the transition a necessity and a challenge. This article reports the clinical practice designed between Hospital Garrahan and Hospital Ramos Mejía for the transition of 27 adolescents during 2015, setting achievements, findings and challenges resulting from this experience.

  20. Isolation and characterisation of human gingival margin-derived STRO-1/MACS1 and MACS2 cell populations

    Institute of Scientific and Technical Information of China (English)

    Karim M Fawzy El-Sayed; Sebastian Paris; Christian Graetz; Neemat Kassem; Mohamed Mekhemar; Hendrick Ungefroren; Fred Fandrich; Christof Dorfer

    2015-01-01

    Recently, gingival margin-derived stem/progenitor cells isolated via STRO-1/magnetic activated cell sorting (MACS) showed remarkable periodontal regenerative potential in vivo. As a second-stage investigation, the present study’s aim was to perform in vitro characterisation and comparison of the stem/progenitor cell characteristics of sorted STRO-1-positive (MACS1) and STRO-1-negative (MACS2) cell populations from the human free gingival margin. Cells were isolated from the free gingiva using a minimally invasive technique and were magnetically sorted using anti-STRO-1 antibodies. Subsequently, the MACS1 and MACS2 cell fractions were characterized by flow cytometry for expression of CD14, CD34, CD45, CD73, CD90, CD105, CD146/MUC18 and STRO-1. Colony-forming unit (CFU) and multilineage differentiation potential were assayed for both cell fractions. Mineralisation marker expression was examined using real-time polymerase chain reaction (PCR). MACS1 and MACS2 cell fractions showed plastic adherence. MACS1 cells, in contrast to MACS2 cells, showed all of the predefined mesenchymal stem/progenitor cell characteristics and a significantly higher number of CFUs (P,0.01). More than 95%of MACS1 cells expressed CD105, CD90 and CD73;lacked the haematopoietic markers CD45, CD34 and CD14, and expressed STRO-1 and CD146/MUC18. MACS2 cells showed a different surface marker expression profile, with almost no expression of CD14 or STRO-1, and more than 95%of these cells expressed CD73, CD90 and CD146/MUC18, as well as the haematopoietic markers CD34 and CD45 and CD105. MACS1 cells could be differentiated along osteoblastic, adipocytic and chondroblastic lineages. In contrast, MACS2 cells demonstrated slight osteogenic potential. Unstimulated MACS1 cells showed significantly higher expression of collagen I (P,0.05) and collagen III (P,0.01), whereas MACS2 cells demonstrated higher expression of osteonectin (P,0.05;Mann–Whitney). The present study is the first to compare gingival

  1. MacBook All-in-One For Dummies

    CERN Document Server

    Chambers, Mark L

    2011-01-01

    Get comfortable and confident with your MacBook! Combining the fun-but-straightforward content of nine minibooks, this new edition of MacBook All-in-One For Dummies delivers helpful coverage of the rich features and essential tools you need to know to use the MacBook to its fullest potential. You'll learn an array of MacBook basics while veteran author Mark Chambers walks you through setting up your MacBook, running programs, finding files with Finder, searching with Spotlight, keeping track with Address Book, enjoying music with iTunes, creating cool multimedia projects with iLife, and more.

  2. Lower Muscle Endurance in Patients with Alcoholic Liver Disease

    Science.gov (United States)

    Andersen, Henning; Aagaard, Niels K.; Jakobsen, Johannes; Dorup, Inge; Vilstrup, Hendrik

    2012-01-01

    Patients with alcoholic liver disease often complain of restricted physical capacity, which could be due to decreased muscle endurance. The aim of this study was to assess the muscular endurance in patients with alcoholic liver disease. In a cross sectional study, 24 patients with alcoholic liver disease and 22 controls were evaluated using…

  3. Lower Muscle Endurance in Patients with Alcoholic Liver Disease

    Science.gov (United States)

    Andersen, Henning; Aagaard, Niels K.; Jakobsen, Johannes; Dorup, Inge; Vilstrup, Hendrik

    2012-01-01

    Patients with alcoholic liver disease often complain of restricted physical capacity, which could be due to decreased muscle endurance. The aim of this study was to assess the muscular endurance in patients with alcoholic liver disease. In a cross sectional study, 24 patients with alcoholic liver disease and 22 controls were evaluated using…

  4. Cerebral microbleeds in patients with Parkinson's disease.

    Science.gov (United States)

    Ham, Jee Hyun; Yi, Han; Sunwoo, Mun Kyung; Hong, Jin Yong; Sohn, Young H; Lee, Phil Hyu

    2014-08-01

    Cerebral microbleeds (CMBs) are known to be associated with cognitive impairments in the elderly and in patients with various diseases; however, the nature of this association has not yet been evaluated in Parkinson's disease (PD). In the present study, we analyzed the incidence of CMBs in PD according to cognitive status, and the impact of CMBs on cognitive performance was also evaluated. The CMBs in PD with dementia (n = 36), mild cognitive impairment (MCI, n = 46), or cognitively normal (n = 41) were analyzed using conventional T2*-weighted gradient-recalled echo images. Additionally, the relationship between the presence of CMBs and cognitive performance on individual tests of cognitive subdomains was analyzed using a detailed neuropsychological test. CMBs occurred more frequently in PD patients with dementia (36.1 %) compared to those with MCI (15.2 %), those who are cognitively normal (14.6 %), and normal controls (12.2 %, p = 0.025). However, the significant association of CMBs with PD dementia disappeared after adjusting white matter hyperintensities (WMHs) as a covariate. The frequencies of deep, lobar, and infratentorial CMBs did not differ among the four groups. After adjusting for age, sex, years of education, and WMHs, PD patients with CMBs had poorer performance in attention domain compared with those without CMBs (34.9 vs 42.6, p = 0.018). The present data demonstrate that even though CMBs were inseparably associated with the presence of WMHs, CMBs occur more commonly in PD patients with dementia than in those without dementia. Additionally, the burden of CMBs may contribute to further cognitive impairment in PD.

  5. Modeling MAC layer for powerline communications networks

    Science.gov (United States)

    Hrasnica, Halid; Haidine, Abdelfatteh

    2001-02-01

    The usage of electrical power distribution networks for voice and data transmission, called Powerline Communications, becomes nowadays more and more attractive, particularly in the telecommunication access area. The most important reasons for that are the deregulation of the telecommunication market and a fact that the access networks are still property of former monopolistic companies. In this work, first we analyze a PLC network and system structure as well as a disturbance scenario in powerline networks. After that, we define a logical structure of the powerline MAC layer and propose the reservation MAC protocols for the usage in the PLC network which provides collision free data transmission. This makes possible better network utilization and realization of QoS guarantees which can make PLC networks competitive to other access technologies.

  6. Seán MacDiarmada

    Directory of Open Access Journals (Sweden)

    Madden

    2016-12-01

    Full Text Available Seán MacDiarmada: Signatory to Proclamation – Executed after the Rising of 1916 - Leitrim to Kilmainham was written by Tom Madden to coincide with the 1916/2016 centenary commemorations. The play was first performed at the Mullagh Arts Festival in Cavan during September 2016 and provides a lively account of the background and activism of one the seven leaders of the Easter Rising of 1916. The action plays out over twelve scenes taking in MacDiarmada's journey from teacher to revolutionary activist culminating in a deeply flawed court-martial and his subsequent execution by a British Army firing squad on May 12th, 1916.

  7. Earth tides in MacDonald's model

    CERN Document Server

    Ferraz-Mello, S

    2013-01-01

    We expand the equations used in MacDonald's 1964 theory and Fourier analyze the tidal variations of the height at one point on the Earth surface, and also the tidal potential at such point. It is shown that no intrinsic law is relating the lag of the tide components to their frequencies. In other words, no simple rheology is being intrinsically fixed by MacDonald's equations. The same is true of the modification proposed by Singer(1968). At variance with these two cases, the modification proposed by Williams and Efroimsky (2012) fix the standard Darwin rheology in which the lags are proportional to the frequencies and their model is, in this sense, equivalent to Mignard's 1979 formulation of Darwin's theory.

  8. MacBook Pro portable genius

    CERN Document Server

    Gruman, Galen

    2013-01-01

    Learn the skills, tools and shortcuts you need in order to make the most of your MacBook Pro This easy-to-use, compact guide skips the fluff and gets right to the essentials so that you can maximize all the latest features of the MacBook Pro. Packed with savvy insights and tips on key tools and shortcuts, this handy book aims to help you increase your productivity and save you time and hassle. From desktop sharing and wireless networking to running Windows applications and more, this book shows you what you want to know. Includes the latest version of OS X, iCloud, FaceTime, and moreCovers al

  9. Performance Analysis of MAC Layer Protocols in Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Hameeza Ahmed

    2014-10-01

    Full Text Available Media Access Control (MAC layer protocols have a critical role in making a typical Wireless Sensor Network (WSN more reliable and efficient. Choice of MAC layer protocol and other factors including number of nodes, mobility, traffic rate and playground size dictates the performance of a particular WSN. In this paper, the performance of an experimental WSN is evaluated using different MAC layer protocols. In this experiment, a WSN is created using OMNeT++ MiXiM network simulator and its performance in terms of packet delivery ratio and mean latency is evaluated. The simulation results show that IEEE 802.11 MAC layer protocol performs better than CSMA, B-MAC and IEEE 802.15.4 MAC layer protocols. In the considered scenario, IEEE 802.15.4 is ranked second in performance, followed by CSMA and B-MAC.

  10. Famous Stone Patients and Their Disease

    Science.gov (United States)

    Moran, Michael E.

    2007-04-01

    The fact that stone patients have endured much throughout the ages and that prior to our current era, when the ultimate horror, "being cut for the stone" was the only alternative to the repeated episodes of colic, should be recalled from time to time. Urolithiasis has affected humanity throughout the ages and has been indiscriminate to those lives it touched. A full accounting of those who have suffered and recorded their agonies is beyond the scope of this investigation; however, even a partial accounting is valuable for present day physicians who care for those with stone disease. For the present work, the historical accounts of stone disease literature were scrutinized for individual sufferers who could be cross-referenced from other sources as legitimately afflicted by stones. Only those patients that could be documented and were (or are) well known were included, because the internet is now a verdant repository of thousands of "not so well knowns." Reliable historical data was found for a variety of persons from the pre-Christian era to the present, including those remembered as philosophers and scientists, physicians, clergy, leaders and rulers, entertainers, athletes and fictitious/Hollywood-type individuals. Verified accounts of famous stone formers were chosen for this paper, and are presented in chronological order. The list of urolithiasis sufferers presented here is undoubtedly incomplete, but it is not through lack of trying that they are missing. Most often, the suffering do so silently, and that is always allowed.

  11. 关于Mac OS X Lion

    Institute of Scientific and Technical Information of China (English)

    饭桶

    2011-01-01

    Lion是Mac OS X操作系统的第七个版本,第一个版本是2001年发布的Cheetah(猎豹).或许很多Windows用户会认为,Lion不过是一次升级,主版本仍然是Mac OSX.那么我不介意稍微解释一下:Mac OS X对应的层次是Windows,Cheetah或者Lion相当于XP,或者7.因此即使从软件工程的角度看,Lion也是一个全新的操作系统.由于重新编译了核心,Lion的安装文件只有3.6GB大小,比上一代(Snow Leopard)减少了近一半的体积,这种比旧版本体积更小的新操作系统在历史上可不多见.

  12. Spinal Surgery Complications and Failures in Patients with Parkinsons Disease.

    Science.gov (United States)

    Sapkas, George S; Mavrogenis, Andreas F; Papastathis, Elias; Tsiavos, Kostas; Igoumenou, Vasilios; Megaloikonomos, Panayiotis D; Galanopoulos, Ioannis; Soultanis, Konstantinos; Papadopoulos, Elias C; Papagelopoulos, Panayiotis J

    2016-01-01

    Parkinson's disease is a degenerative disorder of the central nervous system affecting the substantia nigra in the midbrain. It accounts for 1.5% of the population in Europe over 60 years of age. Recent advances in the medical treatment of Parkinson's disease have improved the quality of life and life expectancy of the patients. However, it remains a debilitating disease. Spinal disorders are frequent in these patients, and as the population ages, more patients with Parkinson's disease are expected to require spinal surgery. Spinal surgery in patients with Parkinson's disease has been associated with an exceptionally high rate of complications; failures and reoperations are common, and patient outcomes are dismal.

  13. Power Saving MAC Protocols for WSNs and Optimization of S-MAC Protocol

    Directory of Open Access Journals (Sweden)

    Simarpreet Kaur

    2012-11-01

    Full Text Available Low power MAC protocols have received a lot of consideration in the last few years because of their influence on the lifetime of wireless sensor networks. Since, sensors typically operate on batteries, replacement of which is often difficult. A lot of work has been done to minimize the energy expenditure and prolong the sensor lifetime through energy efficient designs, across layers. Meanwhile, the sensor network should be able to maintain a certain throughput in order to fulfill the QoS requirements of the end user, and to ensure the constancy of the network. This paper introduces different types of MAC protocols used for WSNs and proposes S‐MAC, a Medium‐Access Control protocol designed for Wireless Sensor Networks. S‐MAC uses a few innovative techniques to reduce energy consumption and support selfconfiguration. A new protocol is suggested to improve the energy efficiency, latency and throughput of existing MAC protocol for WSNs. A modification of the protocol is then proposed to eliminate the need for some nodes to stay awake longer than the other nodes which improves the energy efficiency, latency and throughput and hence increases the life span of a wireless sensor network.

  14. SR-MAC: A Low Latency MAC Protocol for Multi-Packet Transmissions in Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    Hong-Wei Tang; Jian-Nong Cao; Xue-Feng Liu; Cai-Xia Sun

    2013-01-01

    Event detection is one of the major applications of wireless sensor networks (WSNs).Most of existing medium access control (MAC) protocols are mainly optimized for the situation under which an event only generates one packet on a single sensor node.When an event generates multiple packets on a single node,the performance of these MAC protocols degrades rapidly.In this paper,we present a new synchronous duty-cycle MAC protocol called SR-MAC for the event detection applications in which multiple packets are generated on a single node.SR-MAC introduces a new scheduling mechanism that reserves few time slots during the SLEEP period for the nodes to transmit multiple packets.By this approach,SR-MAC can schedule multiple packets generated by an event on a single node to be forwarded over multiple hops in one operational cycle without collision.We use event delivery latency (EDL) and event delivery ratio (EDR) to measure the event detection capability of the SR-MAC protocol.Through detailed ns-2 simulation,the results show that SR-MAC can achieve lower EDL,higher EDR and higher network throughput with guaranteed energy efficiency compared with R-MAC,DW-MAC and PR-MAC.

  15. Effectiveness of a psychoeducation program on the quality of life in patients with coronary heart disease: A clinical trial.

    Science.gov (United States)

    Valiee, Sina; Razavi, Narges Sadat; Aghajani, Mohammad; Bashiri, Zahra

    2017-02-01

    The present study was conducted to evaluate effectiveness of a psychoeducation program (PEP) on the quality of life in patients with coronary heart disease (CHD). CHD affects patients' quality of life. PEPs may be useful to help patients reach maximum functional health. A pretest-posttest controlled clinical trial was conducted on a study population of 70 CHD patients, who were selected through convenience sampling and randomly allocated to either the intervention or the control group. The MacNew Quality of Life Questionnaire in heart disease was completed by participants twice: first as a pretest, and then in a follow-up posttest. After the intervention, the quality of life (QOL) score was 157.97±25.51 in the intervention group and 105.03±8.38 in the control group, making for a significant difference (pPEPs helped CHD patients improve their quality of life through reducing tension, relieving their negative emotions, and improving their social relationships. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Heerkens, Yvonne; Kuyk-Minis, Marie Antoinette van; Cup, Edith; Engels, Josephine; Engelen, Baziel van; Oostendorp, Rob

    2012-01-01

    To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were emplo

  17. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Minis, M.A.H; Cup, E.H.C.; Heerkens, Y.F.; Engels, J.A.; Engelen, B.G. van; Oostendorp, R.A.B.

    2012-01-01

    Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. OBJECTIVES: To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients

  18. Script representation in patients with Alzheimer's disease.

    Science.gov (United States)

    Allain, Philippe; Le Gall, Didier; Foucher, Céline; Etcharry-Bouyx, Frédérique; Barré, Jean; Dubas, Frédéric; Berrut, Gilles

    2008-03-01

    We examined script representation in 26 patients with Alzheimer's disease (AD) compared to 31 healthy elderly subjects (HE). Participants were asked to sort cards describing actions belonging to eight scripts according to the script to which they belonged and according to their order of execution. Each script included actions which were low in centrality and distinctiveness (non-central actions and non-distinctive actions--NCA & NDA), and which were high in centrality (central actions--CA), distinctiveness (distinctive actions--DA), centrality and distinctiveness (central actions and distinctive action--CA & DA). These actions were presented in three conditions. In the first condition (scripts with headers--SH), the 43 actions belonging to three different scripts were given with each script header written on separate cards. The second condition (scripts without headers--SwH) used 46 actions belonging to three other scripts, but no script header was provided. In the third condition (scripts with distractor header--SDH), the 28 actions belonging to two other scripts were given with each script header and a distractor header written on separate cards. The results showed that performance of subjects with AD was significantly lower in all conditions. Overall, AD patients made significantly more sequencing errors than HE subjects. AD patients also committed significantly more sorting errors than HE subjects for all types of actions (NCA & NDA, CA, DA, CA & DA). These data are consistent with the view that AD produces impairment of both the syntactic and semantic dimensions of script representation.

  19. INTESTINAL PERMEABILITY IN PATIENTS WITH CELIAC-DISEASE AND RELATIVES OF PATIENTS WITH CELIAC-DISEASE

    NARCIS (Netherlands)

    VANELBURG, RM; UIL, JJ; MULDER, CJJ; HEYMANS, HSA

    The functional integrity of the small bowel is impaired in coeliac disease. Intestinal permeability, as measured by the sugar absorption test probably reflects this phenomenon. In the sugar absorption test a solution of lactulose and mannitol was given to the fasting patient and the

  20. INTESTINAL PERMEABILITY IN PATIENTS WITH CELIAC-DISEASE AND RELATIVES OF PATIENTS WITH CELIAC-DISEASE

    NARCIS (Netherlands)

    VANELBURG, RM; UIL, JJ; MULDER, CJJ; HEYMANS, HSA

    1993-01-01

    The functional integrity of the small bowel is impaired in coeliac disease. Intestinal permeability, as measured by the sugar absorption test probably reflects this phenomenon. In the sugar absorption test a solution of lactulose and mannitol was given to the fasting patient and the lactulose/mannit

  1. Expression of periodontal interleukin-6 protein is increased across patients with neither periodontal disease nor diabetes, patients with periodontal disease alone and patients with both diseases

    Science.gov (United States)

    Ross, Jonathan H.; Hardy, Douglas Crane; Schuyler, Corinne A.; Slate, Elizabeth H.; Huang, Yan

    2010-01-01

    Background and objectives Epidemiological studies have established that patients with diabetes have an increased prevalence and severity of periodontal disease. Interleukin (IL)-6, a multifunctional cytokine, plays a role in the tissue inflammation that characterizes periodontal disease. Our recent study has shown a trend of increase in periodontal IL-6 expression at the mRNA level across patients with neither periodontal disease nor diabetes, patients with periodontal disease alone and patients with both diseases. However, the periodontal IL-6 expression at the protein level in these patients has not been investigated. Material and Methods Periodontal tissue specimens were collected from eight patients without periodontal disease and diabetes (group 1), from 17 patients with periodontal disease alone (group 2) and from 10 patients with both periodontal disease and diabetes (group 3). The frozen sections were prepared from these tissue specimens and IL-6 protein expression was detected and quantified. Results The nonparametric Kruskal-Wallis test showed that differences in IL-6 protein levels among the three groups were statistically significant (p = 0.035). Nonparametric analysis using Jonckheere-Terpstra test showed a tendency of increase in periodontal IL-6 protein levels across group 1 to group 2 to group 3 (p = 0.006). Parametric analysis of variance (ANOVA) on IL-6 protein levels showed that neither age nor gender significantly affected the difference of IL-6 levels among the groups. Conclusion Periodontal IL-6 expression at the protein level is increased across patients with neither periodontal disease nor diabetes, patients with periodontal disease alone, and patients with both diseases. PMID:20682019

  2. Advanced glycation end products in patients with peripheral artery disease

    OpenAIRE

    de Vos, Lisanne Carlijn

    2016-01-01

    Peripheral artery disease (PAD) is a disease in which stenosis or occlusion occurs of the arteries of the lower limbs. The most common underlying disease is atherosclerosis. The main presenting symptom of these patients is intermittent claudication, which is typical leg pain during walking that disappears during rest. Patients with progressed disease may suffer from rest pain, ulcers and are at risk for amputation. An estimated prevalence of the patients suffering from PAD is 200 million, whi...

  3. MAC Layer Resource Allocation for Wireless Body Area Networks

    Institute of Scientific and Technical Information of China (English)

    Qinghua Shen; Xuemin Sherman Shen; Tom HLuan; Jing Liu

    2014-01-01

    Wireless body area networks (WBANs) can provide low-cost, timely healthcare services and are expected to be widely used for e-healthcare in hospitals. In a hospital, space is often limited and multiple WBANs have to coexist in an area and share the same channel in order to provide healthcare services to different patients. This causes severe interference between WBANs that could significantly reduce the network throughput and increase the amount of power consumed by sensors placed on the body. There-fore, an efficient channel-resource allocation scheme in the medium access control (MAC) layer is crucial. In this paper, we devel-op a centralized MAC layer resource allocation scheme for a WBAN. We focus on mitigating the interference between WBANs and reducing the power consumed by sensors. Channel and buffer state are reported by smartphones deployed in each WBAN, and channel access allocation is performed by a central controller to maximize network throughput. Sensors have strict limitations in terms of energy consumption and computing capability and cannot provide all the necessary information for channel allocation in a timely manner. This deteriorates network performance. We exploit the temporal correlation of the body area channel in order to minimize the number of channel state reports necessary. We view the network design as a partly observable optimization prob-lem and develop a myopic policy, which we then simulate in Matlab.

  4. The relationship between anthropometric indicators and walking distance in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ho SC

    2015-09-01

    Full Text Available Shu-Chuan Ho,1,* Min-Fang Hsu,2,3,* Han-Pin Kuo,4 Jiun-Yi Wang,2 Li-Fei Chen,4 Kang-Yun Lee,5,6 Hsiao-Chi Chuang11School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, 2Department of Healthcare Administration, Asia University, Wufeng, Taichung, 3Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, 4Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, 5Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, 6Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan*These authors contributed equally to this workBackground: Exercise intolerance is a major issue affecting many people with COPD. Six-minute walking distance (6MWD is a widely used indicator of exercise capacity in patients with COPD. The process is strenuous and time-consuming, especially for patients who have muscle wasting. Anthropometric indicators that reflect body lean mass, such as body mass index (BMI, mid-arm circumference (MAC, and calf circumference (CC, may have value in predicting exercise intolerance.Purpose: This study attempted to determine the abilities of simple anthropometric indicators including BMI, MAC, and CC in reflecting the exercise intolerance of COPD patients.Methods: We recruited 136 nonhospitalized ambulatory COPD patients without acute conditions from a general hospital in Taiwan. Each subject’s BMI, MAC, and CC were measured, and they were examined with pulmonary function tests and a 6-minute walk test.Results: Among the three anthropometric indicators examined, CC showed the strongest correlation with the 6MWD, followed by MAC and BMI. CC was also strongly associated with functional capacity, followed by MAC, according to the receiver operating characteristic curves. CC and MAC, but not BMI, were significantly associated with exercise

  5. W-MAC: a workload-aware MAC protocol for heterogeneous convergecast in wireless sensor networks.

    Science.gov (United States)

    Xia, Ming; Dong, Yabo; Lu, Dongming

    2011-01-01

    The power consumption and latency of existing MAC protocols for wireless sensor networks (WSNs) are high in heterogeneous convergecast, where each sensor node generates different amounts of data in one convergecast operation. To solve this problem, we present W-MAC, a workload-aware MAC protocol for heterogeneous convergecast in WSNs. A subtree-based iterative cascading scheduling mechanism and a workload-aware time slice allocation mechanism are proposed to minimize the power consumption of nodes, while offering a low data latency. In addition, an efficient schedule adjustment mechanism is provided for adapting to data traffic variation and network topology change. Analytical and simulation results show that the proposed protocol provides a significant energy saving and latency reduction in heterogeneous convergecast, and can effectively support data aggregation to further improve the performance.

  6. Notas sobre dois livros de MacIntyre Notes on two books by MacIntyre

    Directory of Open Access Journals (Sweden)

    Isabel Ribeiro de Oliveira

    2005-04-01

    Full Text Available Os conceitos centrais da teoria da justiça desenvolvida por Alasdair MacIntyre - prática, narrativa e tradição - ocupam o núcleo da análise feita acerca de dois de seus livros: Depois da Virtude e Justiça de Quem? Qual racionalidade?. O artigo considera a relação, em MacIntyre, entre ética e história, virtude e relativismo, bem como apresenta seu conceito do Eu, como corretivos à anomia contemporânea.The central concepts of MacIntyre's approach to justice - practice, narrative and tradition - constitute the main trust of the analysis of two of his books: After Virtue and Whose justice? Which rationality? The article elaborates on the relationship of ethics to history, of virtues to relativism as well as his conception of the self as correctives to the pervasive anomie in contemporary societies.

  7. Gallbladder bile composition in patients with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Annika Lapidus; Jan-Erik (A)kerlund; Curt Einarsson

    2006-01-01

    AIM: To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn's disease.METHODS: Gallbladder bile was obtained from patients with Crohn's disease who were admitted for elective surgery (17 with ileallileocolonic disease and 7 with Crohn's colitis). Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids,bile acids, bilirubin, crystals, and crystal detection time (CDT). Cholesterol saturation index was calculated.RESULTS: The biliary concentration of bilirubin was about 50% higher in patients with Crohn's disease than in patients with cholesterol gallstones. Ten of the patients with Crohn's disease involving ileum and three of those with Crohn's colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn's disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn's disease,with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn's colitis probably not due to bile acid malabsorption.CONCLUSION: Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn's disease.

  8. Blood Transfusion Therapy in Patients with Heart Disease.

    Science.gov (United States)

    1982-04-07

    good health will not require the same transfusion therapy as patients with valvular heart disease who have congestive heart failure and...normal red cell volume and normal red cell oxygen transport function. 1 ,13 When the patient has valvular heart disease or myo- cardiopathy with...cardio- pulmonary bypass patients and in patients with severe valvular heart disease . Blood 1978;52:13-23. : 81. 197. Frledenberg WR, Myers WO, Plotka

  9. Role of hepatic resection for patients with carcinoid heart disease

    DEFF Research Database (Denmark)

    Bernheim, A.M.; Connolly, H.M.; Rubin, J.;

    2008-01-01

    OBJECTIVE: To evaluate the effects of resection of hepatic carcinoid metastases on progression and prognosis of carcinoid heart disease. PATIENTS AND METHODS: From our database of 265 consecutive patients diagnosed as having carcinoid heart disease from January 1, 1980, through December 31, 2005...... nonrandomized study, our data suggest that patients with carcinoid heart disease who undergo hepatic resection have decreased cardiac progression and improved prognosis. Eligible patients should be considered for hepatic surgery Udgivelsesdato: 2008/2...

  10. Life style modification for patients with ischemic heart disease.

    Science.gov (United States)

    Mahalingam, V

    2013-01-01

    With a view to assess the effectiveness of lifestyle modification in patients with ischemic heart disease, a quasi-experimental study with quantitative approach was undertaken on 60 patients of ischemic heart disease. Purposive sampling technique was used in selecting the patients. The results showed that educating the patients about cessation of smoking, taking proper diet, anxiety reduction and counselling helped in preventing the progression of ischaemic heart disease.

  11. Time estimation in mild Alzheimer's disease patients

    Directory of Open Access Journals (Sweden)

    Nichelli Paolo

    2009-07-01

    Full Text Available Abstract Background Time information processing relies on memory, which greatly supports the operations of hypothetical internal timekeepers. Scalar Expectancy Theory (SET postulates the existence of a memory component that is functionally separated from an internal clock and other processing stages. SET has devised several experimental procedures to map these cognitive stages onto cerebral regions and neurotransmitter systems. One of these, the time bisection procedure, has provided support for a dissociation between the clock stage, controlled by dopaminergic systems, and the memory stage, mainly supported by cholinergic neuronal networks. This study aimed at linking the specific memory processes predicted by SET to brain mechanisms, by submitting time bisection tasks to patients with probable Alzheimer's disease (AD, that are known to present substantial degeneration of the fronto-temporal regions underpinning memory. Methods Twelve mild AD patients were required to make temporal judgments about intervals either ranging from 100 to 600 ms (short time bisection task or from 1000 to 3000 ms (long time bisection task. Their performance was compared with that of a group of aged-matched control participants and a group of young control subjects. Results Long time bisection scores of AD patients were not significantly different from those of the two control groups. In contrast, AD patients showed increased variability (as indexed by increased WR values in timing millisecond durations and a generalized inconsistency of responses over the same interval in both the short and long bisection tasks. A similar, though milder, decreased millisecond interval sensitivity was found for elderly subjects. Conclusion The present results, that are consistent with those of previous timing studies in AD, are interpreted within the SET framework as not selectively dependent on working or reference memory disruptions but as possibly due to distortions in different

  12. Managing patients for zoonotic disease in hospitals

    Science.gov (United States)

    Warwick, Clifford; Corning, Susan

    2013-01-01

    Zoonoses involve infections and infestations transmissible from animals to humans. Zoonoses are a major global threat. Exposure to zoonotic pathogens exists in various settings including encroachment on nature; foreign travel; pet keeping; bushmeat consumption; attendance at zoological parks, petting zoos, school ‘animal contact experiences’, wildlife markets, circuses, and domesticated and exotic animal farms. Under-ascertainment is believed to be common and the frequency of some zoonotic disease appears to be increasing. Zoonoses include direct, indirect and aerosolized transmission. Improved awareness of zoonoses in the hospital environment may be important to the growing need for prevention and control. We reviewed relevant literature for the years 2000 to present and identified a significant need for the promotion of awareness and management of zoonoses in the hospital environment. This article provides a new decision-tree, as well as staff and patient guidance on the prevention and control of zoonoses associated with hospitals. PMID:24040497

  13. Social support for patients with allergic diseases.

    Science.gov (United States)

    Latalski, Maciej; Makara-Studzińska, Marta; Gajewska, Marzena; Rudnicka-Drozak, Ewa

    2002-01-01

    In recent years special attention has been paid to the issue of social support. So far there has been no special, applied, definition that would explicitly describe what social support is indeed. It results from the fact that the issue of social support has been of interest for numerous disciplines of science that have own fields of research and practical application. These are, among others, psychology, sociology, pedagogy, medicine. The objective of the study is an attempt to analyze the level of social support by people with allergic diseases. The research instrument was a self-structured inquiry sheet consisting of 25 questions and socio-demographic details. The strongest support for the patients was offered by the closest family (84%), followed by friends (51%), further members of the family (28.8%), acquaintances (26%) and institutions (14.4%).

  14. Technology innovation for patients with kidney disease.

    Science.gov (United States)

    Mitsides, Nicos; Keane, David F; Lindley, Elizabeth; Mitra, Sandip

    2014-01-01

    The loss of kidney function is a life-changing event leading to life-long dependence on healthcare. Around 5000 people are diagnosed with kidney failure every year. Historically, technology in renal medicine has been employed for replacement therapies. Recently, a lot of emphasis has been placed on technologies that aid early identification and prevent progression of kidney disease, while at the same time empowering affected individuals to gain control over their chronic illness. There is a shift in diversity of technology development, driven by collaborative innovation initiatives such the National Institute's for Health Research Healthcare Technology Co-operative for Devices for Dignity. This has seen the emergence of the patient as a key figure in designing technologies that are fit for purpose, while business involvement has ensured uptake and sustainability of these developments. An embodiment of this approach is the first successful Small Business Research Initiative in the field of renal medicine in the UK.

  15. LFA-1 and Mac-1 integrins bind to the serine/threonine-rich domain of thrombomodulin

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Eiji [Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 (Japan); Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu 514-8507 (Japan); Okamoto, Takayuki, E-mail: okamotot@doc.medic.mie-u.ac.jp [Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 (Japan); Takagi, Yoshimi [Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 (Japan); Honda, Goichi [Medical Affairs Department, Asahi Kasei Pharma Corporation, 1-105 Kanda Jinbo-cho, Chiyoda-ku, Tokyo 101-8101 (Japan); Suzuki, Koji [Faculty of Pharmaceutical Science, Suzuka University of Medical Science, 3500-3, Minamitamagaki-cho, Suzuka, Mie 513-8679 (Japan); Imai, Hiroshi [Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu 514-8507 (Japan); Shimaoka, Motomu, E-mail: shimaoka@doc.medic.mie-u.ac.jp [Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 (Japan)

    2016-05-13

    LFA-1 (αLβ2) and Mac-1 (αMβ2) integrins regulate leukocyte trafficking in health and disease by binding primarily to IgSF ligand ICAM-1 and ICAM-2 on endothelial cells. Here we have shown that the anti-coagulant molecule thrombomodulin (TM), found on the surface of endothelial cells, functions as a potentially new ligand for leukocyte integrins. We generated a recombinant extracellular domain of human TM and Fc fusion protein (TM-domains 123-Fc), and showed that pheripheral blood mononuclear cells (PBMCs) bind to TM-domains 123-Fc dependent upon integrin activation. We then demonstrated that αL integrin-blocking mAb, αM integrin-blocking mAb, and β2 integrin-blocking mAb inhibited the binding of PBMCs to TM-domains 123-Fc. Furthermore, we show that the serine/threonine-rich domain (domain 3) of TM is required for the interaction with the LFA-1 (αLβ2) and Mac-1 (αMβ2) integrins to occur on PBMCs. These results demonstrate that the LFA-1 and Mac-1 integrins on leukocytes bind to TM, thereby establishing the molecular and structural basis underlying LFA-1 and Mac-1 integrin interaction with TM on endothelial cells. In fact, integrin-TM interactions might be involved in the dynamic regulation of leukocyte adhesion with endothelial cells. - Highlights: • LFA-1 and Mac-1 integrins bind to the anti-coagulant molecule thrombomodulin. • The serine/threonine-rich domain of thrombomodulin is essential to interact with the LFA-1 and Mac-1 integrins on PBMCs. • Integrin-TM interactions might be involved in the dynamic regulation of leukocyte adhesion with endothelial cells.

  16. Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease.

    Science.gov (United States)

    Ammenwerth, E; Woess, S; Baumgartner, C; Fetz, B; van der Heidt, A; Kastner, P; Modre-Osprian, R; Welte, S; Poelzl, G

    2015-01-01

    Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life. A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases. Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor telemonitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (ptelemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes

  17. Invasive Aspergillus infections in hospitalized patients with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Wessolossky M

    2013-05-01

    Full Text Available Mireya Wessolossky,1 Verna L Welch,2 Ajanta Sen,1 Tara M Babu,1 David R Luke21Division of Infectious Diseases, University of Massachusetts Medical School, Worcester, MA, USA; 2Medical Affairs, Pfizer Inc, Collegeville, PA, USABackground: Although invasive pulmonary aspergillosis (IPA is more prevalent in immunocompromised patients, critical care clinicians need to be aware of the occurrence of IPA in the nontraditional host, such as a patient with chronic lung disease. The purpose of this study was to describe the IPA patient with chronic lung disease and compare the data with that of immunocompromised patients.Methods: The records of 351 patients with Aspergillus were evaluated in this single-center, retrospective study for evidence and outcomes of IPA. The outcomes of 57 patients with chronic lung disease and 56 immunocompromised patients were compared. Patients with chronic lung disease were defined by one of the following descriptive terms: emphysema, asthma, idiopathic lung disease, bronchitis, bronchiectasis, sarcoid, or pulmonary leukostasis.Results: Baseline demographics were similar between the two groups. Patients with chronic lung disease were primarily defined by emphysema (61% and asthma (18%, and immunocompromised patients primarily had malignancies (27% and bone marrow transplants (14%. A higher proportion of patients with chronic lung disease had a diagnosis of IPA by bronchoalveolar lavage versus the immunocompromised group (P < 0.03. The major risk factors for IPA were found to be steroid use in the chronic lung disease group and neutropenia and prior surgical procedures in the immunocompromised group. Overall, 53% and 69% of chronic lung disease and immunocompromised patients were cured (P = 0.14; 55% of chronic lung patients and 47% of immunocompromised patients survived one month (P = 0.75.Conclusion: Nontraditional patients with IPA, such as those with chronic lung disease, have outcomes and mortality similar to that in the

  18. Comparison of the C-MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department.

    Science.gov (United States)

    Vassiliadis, John; Tzannes, Alex; Hitos, Kerry; Brimble, Jessica; Fogg, Toby

    2015-04-01

    To investigate the first pass success rate, airway grade and complications in two tertiary EDs with the C-MAC video laryngoscope (VL), when compared with standard direct laryngoscopy (DL). This was a retrospective analysis of prospectively collected data entered into an airway registry database in the EDs of Royal North Shore and St George Hospitals (SGH) over a 30 month period. Doctors had the choice of using either DL using a Macintosh or Miller blade or a C-MAC VL for the intubation. Six hundred and nineteen consecutive patients were recruited. There was no statistical difference between VL and DL in grade of view obtained, P = 0.526. Chance of intubation success increased by more than threefold by using a C-MAC VL in the setting of a grade III/IV (total of 109) on DL (OR = 3.06; 95% CI: 1.52-6.17; P = 0.002). This is the first observational study of airway management comparing the C-MAC VL with DL blades in an Australian ED population. Our findings revealed that although the C-MAC VL overall did not provide an enhanced view of the larynx over the Macintosh DL, it was superior to DL when the grade was at least grade III. Currently we are unable to reliably predict the grade by any algorithm prior to intubation. Findings from this study suggest that the C-MAC VL should be considered as the first line laryngoscope in all ED intubations not just the ones predicted to be difficult. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Mitral annular calcification and aortic valve calcification may help in predicting significant coronary artery disease.

    Science.gov (United States)

    Acartürk, Esmeray; Bozkurt, Abdi; Cayli, Murat; Demir, Mesut

    2003-01-01

    Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.

  20. Thyroid Disease in the Older Patient

    Science.gov (United States)

    ... a brother, sister or child of the patient. HYPERTHYROIDISM IN THE OLDER PATIENT As in all hyperthyroid ... and family. TREATMENT OF THE OLDER PATIENT WITH HYPERTHYROIDISM As with younger patients, treatment of hyperthyroidism in ...

  1. One of the First Portable Macs

    CERN Multimedia

    1989-01-01

    It was one of the first portable macs released. The Portable had many new advances in mobile computing : The display was crispy clear, and looked beautiful when used in daylight ; The Portable came with a Lead-acid gel/cell battery that could run a anywhere from 6 -12 hours ; It supported to internal hard drives, and an external one. The reaction to the laptop was weak because it was slow, it had no capacity for expansion, it weighed heavily, its price was expensive. It has been stayed 1 year and half on the market.

  2. Energy Efficient MAC for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Pekka KOSKELA

    2010-10-01

    Full Text Available This paper considers an overlay solution for asynchronous Medium Access Control (MAC protocols in a duty-cycled wireless sensor network (WSN. The solution extends sleeping times and corrects time drift when the sampling rate is low. The sleeping time is adjusted according to the requisite data sampling rate and the delay requirements of the prevailing application. This and the time drift correction considerably reduced idle listening and thus also decreased power consumption. When the power consumption is reduced, the life of wireless sensor nodes extends.

  3. Celiac disease markers in patients with liver diseases: A single center large scale screening study

    Institute of Scientific and Technical Information of China (English)

    Pavel Drastich; Eva Honsová; Alena Lodererová; Marcela Jare(s)ová; Aneta Pekáriková; Iva Hoffmanová; Ludmila Tu(c)ková

    2012-01-01

    AIM:To study the coincidence of celiac disease,we tested its serological markers in patients with various liver diseases.METHODS:Large-scale screening of serum antibodies against tissue transglutaminase (tTG),and deamidated gliadin using enzyme-linked immunosorbent assay and serum antibodies against endomysium using immunohistochemistry,in patients with various liver diseases (n =962) and patients who underwent liver transplantation (OLTx,n =523) was performed.The expression of tTG in liver tissue samples of patients simultaneously suffering from celiac disease and from various liver diseases using immunohistochemistry was carried out.The final diagnosis of celiac disease was confirmed by histological analysis of small-intestinal biopsy.RESULTS:We found that 29 of 962 patients (3%) with liver diseases and 5 of 523 patients (0.8%) who underwent OLTx were seropositive for IgA and IgG anti-tTG antibodies.However,celiac disease was biopsy-diagnosed in 16 patients:4 with autoimmune hepatitis type Ⅰ,3 with Wilson's disease,3 with celiac hepatitis,2 with primary sclerosing cholangitis,1with primary biliary cirrhosis,1 with Budd-Chiari syndrome,1 with toxic hepatitis,and 1 with non-alcoholic steatohepatitis.Unexpectedly,the highest prevalence of celiac disease was found in patients with Wilson's disease (9.7%),with which it is only rarely associated.On the other hand,no OLTx patients were diagnosed with celiac disease in our study.A pilot study of the expression of tTG in liver tissue using immunohistochemistry documented the overexpression of this molecule in endothelial cells and periportal hepatocytes of patients simultaneously suffering from celiac disease and toxic hepatitis,primary sclerosing cholangitis or autoimmune hepatitis type Ⅰ.CONCLUSION:We suggest that screening for celiac disease may be beneficial not only in patients with associated liver diseases,but also in patients with Wilson's disease.

  4. Implementation of MAC by using Modified Vedic Multiplier

    OpenAIRE

    2013-01-01

    Multiplier Accumulator Unit (MAC) is a part of Digital Signal Processors. The speed of MAC depends on the speed of multiplier. So by using an efficient Vedic multiplier which excels in terms of speed, power and area, the performance of MAC can be increased. For this fast method of multiplication based on ancient Indian Vedic mathematics is proposed in this paper. Among various method of multiplication in Vedic mathematics, Urdhva Tiryagbhyam is used and the multiplication is for 32 X 32 bits....

  5. Managing Acute Complications Of Sickle Cell Disease In Pediatric Patients.

    Science.gov (United States)

    Subramaniam, Sathyaseelan; Chao, Jennifer H

    2016-11-01

    Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management. Patients with sickle cell trait generally have a benign course, but are also subject to serious complications. This issue provides a current review of evidence-based management of the most common acute complications of sickle cell disease seen in pediatric patients in the emergency department.

  6. Dobutamine Stress Echocardiography Safety in Chagas Disease Patients

    Directory of Open Access Journals (Sweden)

    Daniela do Carmo Rassi

    Full Text Available Abstract Background: A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD. As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease. Objectives: To assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam. Methods: Retrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed. Results: Their mean age was 64±10 years and most patients were females (65.4%. No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%. Conclusion: DSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found.

  7. Dobutamine Stress Echocardiography Safety in Chagas Disease Patients

    Science.gov (United States)

    Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Furtado, Rogerio Gomes; Turco, Fabio de Paula; Melato, Luciano Henrique; Hotta, Viviane Tiemi; Nunes, Colandy Godoy de Oliveira; Rassi Jr., Luiz; Rassi, Salvador

    2017-01-01

    Background A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease. Objectives To assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam. Methods Retrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed. Results Their mean age was 64±10 years and most patients were females (65.4%). No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%. Conclusion DSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found. PMID:28099588

  8. Mycosis fungoides - Disease evolution and prognosis of 309 Dutch patients

    NARCIS (Netherlands)

    van Doorn, R; Van Haselen, CW; Vader, PCV; Geerts, ML; Heule, F; de Rie, M; Steijlen, PM; Dekker, SK; van Vloten, WA; Willemze, R

    2000-01-01

    Objectives: To determine the disease course of Dutch patients with mycosis fungoides and to define factors related to disease progression and survival. Design: A multicenter, 13-year, retrospective cohort analysis. Setting: Eight dermatology departments collaborating in the Dutch Cutaneous Lymphoma

  9. Sympathetic hyperactivity in patients with chronic kidney disease

    NARCIS (Netherlands)

    Neumann, N.

    2007-01-01

    Sympathetic hyperactivity in patients with chronic kidney disease Chronic kidney disease (CKD) is often characterized by the presence of sympathetic hyperactivity. This contributes to the pathogenesis of renal hypertension. It is also associated with cardiovascular (CV) morbidity and mortality indep

  10. The effect of light deprivation in patients with Stargardt disease

    NARCIS (Netherlands)

    Teussink, M.M.; Lee, M.D.; Smith, R.T.; Huet, R.A.C. van; Klaver, C.C.; Klevering, B.J.; Theelen, T.; Hoyng, C.B.

    2015-01-01

    PURPOSE: To investigate whether long-term protection from light exposure affects the rate of disease progression in patients with autosomal recessive Stargardt disease (STGD1), measured using fundus autofluorescence imaging. DESIGN: Longitudinal, retrospective, interventional case series. METHODS: F

  11. Cardiovascular disease and cognitive function in maintenance hemodialysis patients

    Science.gov (United States)

    Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with wor...

  12. Essential Mac OS X panther server administration integrating Mac OS X server into heterogeneous networks

    CERN Document Server

    Bartosh, Michael

    2004-01-01

    If you've ever wondered how to safely manipulate Mac OS X Panther Server's many underlying configuration files or needed to explain AFP permission mapping--this book's for you. From the command line to Apple's graphical tools, the book provides insight into this powerful server software. Topics covered include installation, deployment, server management, web application services, data gathering, and more

  13. APC-MAC/TA: Adaptive Power Controlled MAC Protocol with Traffic Awareness for Wireless Sensor Networks

    Science.gov (United States)

    Woo, Seok; Kim, Kiseon

    In this paper, we propose an adaptive power controlled MAC protocol with a traffic-aware scheme specifically designed to reduce both energy and latency in wireless sensor networks. Typically, existing MAC protocols for sensor networks sacrifice latency performance for node energy efficiency. However, some sensor applications for emergencies require rather fast transmissions of sensed data, where we need to consider both energy and latency together. The proposed MAC protocol includes two novel ideas: one is a transmission power control scheme for improving latency in high traffic loads, and the other is a traffic-aware scheme to save more energy in low traffic loads. The transmission power control scheme increases channel utilization by mitigating interference between nodes, and the traffic-aware scheme allows nodes to sleep to reduce idle energy consumption when there are no traffic loads in a network. Simulation results show that the proposed protocol significantly reduces the latency as well as the energy consumption compared to the S-MAC protocol specifically for a large transmission power of nodes and low network traffic.

  14. Chagas' disease and ageing: the coexistence of other chronic diseases with Chagas' disease in elderly patients.

    Science.gov (United States)

    Alves, Rosalía Matera de Angelis; Thomaz, Raquel Prado; Almeida, Eros Antônio de; Wanderley, Jamiro da Silva; Guariento, Maria Elena

    2009-01-01

    This study aimed to identify the main comorbidities in elderly chagasic patients treated in a reference service and identify possible associations between the clinical form of Chagas' disease and chronic diseases. Ninety patients aged 60 years-old or over were interviewed and their clinical diagnoses recorded. The study population profile was: women (55.6%); median age (67 years); married (51.1%); retired (73.3%); up to four years' education (64.4%); and earning less than two minimum wages (67.8%). The predominant forms of Chagas' disease were the cardiac (46.7%) and mixed forms (30%). There was a greater proportion of mild cardiac dysfunction (84.1%), frequently in association with megaesophagus. The mean number of concurrent diseases was 2.856 +/- 1.845, and 33% of the patients had four or more comorbidities. The most frequent were systemic arterial hypertension (56.7%), osteoporosis (23.3%), osteoarthritis (21.2%) and dyslipidemia (20%). Positive correlations were verified between sex and comorbidities and between age group and comorbidities.

  15. Mac OS X Snow Leopard Server For Dummies

    CERN Document Server

    Rizzo, John

    2009-01-01

    Making Everything Easier!. Mac OS® X Snow Leopard Server for Dummies. Learn to::;. Set up and configure a Mac network with Snow Leopard Server;. Administer, secure, and troubleshoot the network;. Incorporate a Mac subnet into a Windows Active Directory® domain;. Take advantage of Unix® power and security. John Rizzo. Want to set up and administer a network even if you don't have an IT department? Read on!. Like everything Mac, Snow Leopard Server was designed to be easy to set up and use. Still, there are so many options and features that this book will save you heaps of time and effort. It wa

  16. Energy-efficient MAC protocols for Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    Li De-liang; Peng Fei

    2009-01-01

    Designing energy-efficient Medium Access Control (MAC) protocols has a significant influence on the energy performance of wireless sensor network (WSN). In this paper we present a survey of the recent typical MAC protocols regarding energy efficiency for WSN. According to channel access policies, we classify these protocols into four categories: contention-based, TDMA-based, hybrid, and cross layer protocols, in which the advantages and disadvantages in each class of MAC protocols are discussed. Finally, we point out open research issues that need to carry on to achieve high energy efficiency for the design of MAC protocols in WSN.

  17. Study on intracellular trafficking of Mac-1 by direct visualization

    Institute of Scientific and Technical Information of China (English)

    YAN Ming; MAO Jifang; WEI Yi; ZHONG Jigen; YANG Shengsheng; XU Renbao

    2004-01-01

    Previously, we constructed DNA vectors containing cDNA of Mac-1 subunits (CD11b or CD18b) fused with fluorescence protein (FP). cDNA fragments and the DNA constructs were then transfected into CHO cells (as CHO-Mac-1-FP). The structure and function of Mac-1-FP obtained from the CHO-Mac-1-FP cells are nearly identical to that expressed in wild type leukocytes. In the present study, the intracellular trafficking of Mac-1 was visualized directly by monitoring the fluorescent intensities of YFP-CD18 and PE-conjugated monoclonal antibody against CD11b under a confocal microscope in CHO-Mac-1-FP cells. The results indicate that: (ⅰ) although Mac-1 was not detected in the cell membrane at resting state, it had been translocated and clustered into the cell membrane by 1 h and internalized 2 h after PMA stimulation, at which point the fluorescence intensity began to diminish gradually, probably due to partial degradation of Mac-1. The fluorescence of CD18 and CD11b reappeared on the cell membrane 1 h after re-treatment with PMA, suggesting the recycling of non-degraded Mac-1. (ⅱ) The adhesion rate of CHO-Mac-1-FP to magnetic beads coupled ICAM-1 increased within 4 h after their initial interaction, accompanied by the clustering of Mac-1-FP. After 8 h,the adhesion rate declined and fluorescence also decreased simultaneously. The pattern of change in fluorescence in CHO-Mac-1-FP cells elicited by ICAM-1 beads was similar to that elicited by PMA, suggesting that endocytosis and degradation of Mac-1 occurred after the interaction with ICAM-1. Thus, we conclude that the intracellular trafficking of Mac-1 after activation is associated with membrane translocation, endocytosis, degradation and recycling. These changes are in parallel with the adhesion of CHO-Mac-1-FP cells with ICAM-1, and may be involved in the adhesion and detachment of leukocytes. The detachment of leukocytes may be caused by endocytosis of Mac-1.

  18. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases

    OpenAIRE

    Peninnah Oberdorfer; Natthida Pongwilairat; Washington, Charles H

    2009-01-01

    Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs). NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1) the incidence of NIs, (2) sites of NIs, (3) causal organisms, and (4) outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were ad...

  19. An Energy Efficient Analysis of S-MAC And H-MAC Protocols for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    P.T.Kalaivaani

    2013-04-01

    Full Text Available Wireless Sensor Networks (WSNs is an interesting topic to the researchers because of its variousapplications. The applications are health monitoring and environmental monitoring, Industrial ProcessMonitoring, Target detection, Target tracking, Energy Efficiency, Disaster Management and MilitarySecurity Systems. The wireless medium requires highly optimized medium Access Protocols to avoidinterferences. Limited resources have driven the research towards energy consumption of MACfunctionalities. Two Medium Access Control (MAC protocol performances are analyzed by using the MAClayer frame work for wireless sensor networks. In this paper an energy efficient analysis of S-MAC and HMACprotocols for wireless sensor networks is proposed with spatial correlation concept. Two MACprotocols such as Sensor MAC (S-MAC and Hybrid MAC (H-MAC protocols are proposed to analyze theperformance of Wireless Sensor Network using four different Parameters such as End to End delay, PacketDelivery Ratio, Packet Drop Rate and Energy Consumption. Performance analysis is carried out by usingthe simulation tool NS2.

  20. Isoflurane and sevoflurane decrease entropy indices more than halothane at equal MAC values.

    Science.gov (United States)

    Prabhakar, Hemanshu; Ali, Zulfiqar; Bithal, Parmod K; Rath, Girija P; Singh, Deepak; Dash, Hari H

    2009-01-01

    Recently, bispectral index (BIS) values were demonstrated to be different for various anesthetics as a result of differential effects on electroencephalographic (EEG) signals. Entropy is similar to the BIS monitor, as both process raw EEG to derive a number. We hypothesized that entropy may also be anesthetic agent-specific. Thirty adult patients undergoing spinal surgery were randomized to receive halothane, isoflurane, or sevoflurane. Entropy indices were recorded at various minimum alveolar concentration (MAC) values-0.5, 0.75, 1.0 and 1.5-both during wash-in and wash-out of the agent. Heart rate (HR), mean arterial blood pressure (MAP), response entropy (RE), and state entropy (SE) were noted. Statistical analysis was done using a one-way analysis-ofvariance test. P values less than 0.05 were considered significant. Ten patients in each group completed the study. The demographics and baseline values of HR, MAP, RE, and SE were comparable in all three groups. During the study period, for a given MAC value, both RE and SE remained low in the isoflurane and sevoflurane groups compared to the halothane group. For a given MAC, the RE and SE were comparable during wash-in and wash-out phases. Halothane produced higher entropy values as compared to isoflurane and sevoflurane at equivalent MAC levels.

  1. Outcomes of Bowel Resection in Patients with Crohn's Disease.

    Science.gov (United States)

    Moghadamyeghaneh, Zhobin; Carmichael, Joseph C; Mills, Steven D; Pigazzi, Alessio; Stamos, Michael J

    2015-10-01

    There is limited data regarding outcomes of bowel resection in patients with Crohn's disease. We sought to investigate complications of such patients after bowel resection. The Nationwide Inpatient Sample databases were used to examine the clinical data of Crohn's patients who underwent bowel resection during 2002 to 2012. Multivariate regression analysis was performed to investigate outcomes of such patients. We sampled a total of 443,950 patients admitted with the diagnosis of Crohn's disease. Of these, 20.5 per cent had bowel resection. Among patients who had bowel resection, 51 per cent had small bowel Crohn's disease, 19.4 per cent had large bowel Crohn's disease, and 29.6 per cent had both large and small bowel Crohn's disease. Patients with large bowel disease had higher mortality risk compared with small bowel disease [1.8% vs 1%, adjusted odds ratio (AOR): 2.42, P Crohn's disease (AOR: 1.90, P Crohn's disease, 20.5 per cent underwent bowel resection during 2002 to 2012. Although colonic disease has a higher mortality risk, small bowel disease has a higher risk of postoperative fistula.

  2. Peripartum cardiomyopathy in a patient with Graves' disease.

    Science.gov (United States)

    Kajiya, Takashi; Lee, Souki; Yamashita, Makoto; Sasaki, Yuichi; Kamizono, Yusuke; Imamura, Masakazu; Toyonaga, Koichi; Toda, Hitoshi; Koriyama, Nobuyuki; Tei, Chuwa

    2010-11-05

    Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown etiology that occurs during the peripartum period in previously healthy women. Autoimmune and viral factors have been suggested to be involved in PPCM. Here we describe a patient with Graves' disease, which is one of the organ-specific autoimmune diseases, who developed acute heart failure due to PPCM at 2 weeks after her first delivery. The patient recovered completely with conservative treatment for heart failure. An association between PPCM and Graves' disease has not been reported before. PPCM may be an organ-specific autoimmune disease, so the coexistence of other autoimmune diseases should be considered in PPCM patients.

  3. Prevalence of coeliac disease in Italian patients affected by Addison's disease.

    Science.gov (United States)

    Biagi, Federico; Campanella, Jonia; Soriani, Alessandra; Vailati, Alberto; Corazza, Gino R

    2006-03-01

    It is well known that coeliac disease is associated with autoimmune endocrine diseases, such as autoimmune thyroid disease and insulin-dependent diabetes mellitus. Recently, coeliac disease has been shown in approximately 10% of patients with autoimmune Addison's disease. Addison's disease is the most common cause of primary adrenocortical insufficiency and it shares several clinical features with coeliac disease. Although hyperpigmentation and hypotension are the most specific signs, gastrointestinal symptoms are common and can be the first complaints of the patients. The aim of our study was to investigate the prevalence of coeliac disease in Italian patients with Addison's disease. Seventeen consecutive patients affected by Addison's disease (14 F, mean age 53.9 years, range 26-79 years) were enrolled in the study. Eleven of them were affected by Addison's disease associated with autoimmune thyroid disease and/or insulin-dependent diabetes mellitus; the other 6 patients were suffering from isolated Addison's disease. Diagnosis had been performed at the age of 40.5 years (range 23-55). Steroid treatment had already been started in 16 of the patients. Endomysial antibodies were tested in all of them and a duodenal biopsy was taken in those found to be positive for antiendomysial antibody (EMA). One out of 17 patients was found to be EMA positive. Duodenal biopsy confirmed the diagnosis of coeliac disease by showing subtotal villous atrophy. Although we studied only a small sample, our preliminary results confirmed that Addison's disease is associated with coeliac disease, being present in 5.9% of patients with Addison's disease. Since the symptoms can be similar and treatment of Addison's disease can mask coeliac disease, this association should always be actively investigated.

  4. Additive contribution of nitrous oxide to halothane MAC in infants and children.

    Science.gov (United States)

    Murray, D J; Mehta, M P; Forbes, R B; Dull, D L

    1990-08-01

    Fifty-one infants and small children (14.7 +/- 7.2 mo) were studied to determine the MAC of halothane in O2 (n = 11) and in the presence of three different nitrous oxide (N2O) concentrations (25% [n = 13], 50% [n = 13], and 75% [n = 14]). In the three N2O groups, after randomly assigning patients to an N2O group, anesthesia was induced with halothane and N2O using a pediatric circle system. After endotracheal intubation, halothane and N2O end-expired concentrations were adjusted to predetermined concentrations. The initial halothane concentrations in each group were based on the assumption that each percent N2O reduced halothane concentrations by 0.01 vol % (assumed halothane MAC = 1.0 vol %). Based on the response of the preceding subject in each group, halothane concentrations were increased or decreased depending on whether the response was to move or not to move, respectively, in response to the surgical incision. The mean duration of constant end-tidal concentrations before skin incision was 10 min. End-tidal gases were sampled and measured from a separate distal sampling port of an endotracheal tube during controlled ventilation (Perkin-Elmer Mass Spectrometer). The MAC value for halothane in O2 was 0.94 +/- 0.08 vol % (mean +/- SD). The MAC values of halothane in the presence of 25%, 50%, and 75% N2O were 0.78 +/- 0.12 vol %, 0.44 +/- 0.10 vol %, and 0.29 +/- 0.06 vol %, respectively. All concentrations of N2O significantly reduced the MAC of halothane. A regression analysis through all four data points yielded a linear relationship (r2 = 0.87) with a predicted MAC for N2O of 105 vol %. Unlike halothane and isoflurane, the predicted MAC of N2O in infants and children is similar to that reported by others in adults. Similar to the results of clinical studies in adults, the contribution of N2O to halothane MAC in children is additive.

  5. Broncho-pleural fistula with hydropneumothorax at CT: Diagnostic implications in mycobacterium avium complex lung disease with pleural involvement

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyun Jung; Chung, Myung Jin; Lee, Kyung Soo; Park, Hye Yun; Koh, Won Jung [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung Soo [Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon (Korea, Republic of)

    2016-04-15

    To determine the patho-mechanism of pleural effusion or hydropneumothorax in Mycobacterium avium complex (MAC) lung disease through the computed tomographic (CT) findings. We retrospectively collected data from 5 patients who had pleural fluid samples that were culture-positive for MAC between January 2001 and December 2013. The clinical findings were investigated and the radiological findings on chest CT were reviewed by 2 radiologists. The 5 patients were all male with a median age of 77 and all had underlying comorbid conditions. Pleural fluid analysis revealed a wide range of white blood cell counts (410-100690/µL). The causative microorganisms were determined as Mycobacterium avium and Mycobacterium intracellulare in 1 and 4 patients, respectively. Radiologically, the peripheral portion of the involved lung demonstrated fibro-bullous changes or cavitary lesions causing lung destruction, reflecting the chronic, insidious nature of MAC lung disease. All patients had broncho-pleural fistulas (BPFs) and pneumothorax was accompanied with pleural effusion. In patients with underlying MAC lung disease who present with pleural effusion, the presence of BPFs and pleural air on CT imaging are indicative that spread of MAC infection is the cause of the effusion.

  6. Procedural learning changes in patients with Wilson's disease

    Institute of Scientific and Technical Information of China (English)

    Yumei Jiang; Xiang Shen; Xiaoping Wang; Wenjie Li

    2011-01-01

    In the present study, we compared explicit memory performance, using the Wechsler Memory Scale, and implicit memory performance, using the Nissen software version of the serial reaction time task, in patients with Wilson's disease to normal controls. The Wilson's disease patients exhibited deficits in explicit memory tasks, such as figure recall and understanding memory. Moreover, the Wilson's disease patients exhibited deficits in implicit memory tasks, including significantly prolonged response times. These findings indicate that Wilson's disease patients have explicit and implicit partial memory impairments.

  7. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Vind, Ida; Johansen, J S; Price, P A

    2003-01-01

    BACKGROUND: YKL-40 is secreted by macrophages and neutrophils and is a growth factor for vascular endothelial cells and fibroblasts. Elevated serum concentrations of YKL-40 are found in patients with diseases characterized by inflammation or ongoing fibrosis. The aim of this study was to seek...... association between serum YKL-40 in patients with ulcerative colitis (UC) and Crohn disease (CD) and clinical disease activity. METHODS: One-hundred-and-sixty-four patients with UC and 173 patients with CD were studied. The Simple Clinical Colitis Activity Index (SCCAI) and the Harvey-Bradshaw (H-B) score...... were used to assess disease activity. Serum YKL-40 (determined by ELISA) was related to C-reactive protein (CRP) and disease activity. RESULTS: In patients with UC, the median serum YKL-40 rose with increasing disease activity, and patients with severe active disease had higher serum YKL-40 (median 59...

  8. Involvement of patients' perspectives on treatment with noninvasive ventilation in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Christensen, Helle Marie; Huniche, Lotte; Titlestad, Ingrid L

    2017-01-01

    conduct their everyday lives with chronic obstructive pulmonary disease looking at chronic obstructive pulmonary disease as a basic life condition rather than an illness. This approach had a major impact on chronic obstructive pulmonary disease patients' attitudes to noninvasive ventilation treatment...... a nurse was assigned, was designated for chronic obstructive pulmonary disease patients treated with noninvasive ventilation....

  9. TreeMAC: Localized TDMA MAC protocol for real-time high-data-rate sensor networks

    Science.gov (United States)

    Song, W.-Z.; Huang, R.; Shirazi, B.; LaHusen, R.

    2009-01-01

    Earlier sensor network MAC protocols focus on energy conservation in low-duty cycle applications, while some recent applications involve real-time high-data-rate signals. This motivates us to design an innovative localized TDMA MAC protocol to achieve high throughput and low congestion in data collection sensor networks, besides energy conservation. TreeMAC divides a time cycle into frames and each frame into slots. A parent node determines the children's frame assignment based on their relative bandwidth demand, and each node calculates its own slot assignment based on its hop-count to the sink. This innovative 2-dimensional frame-slot assignment algorithm has the following nice theory properties. First, given any node, at any time slot, there is at most one active sender in its neighborhood (including itself). Second, the packet scheduling with TreeMAC is bufferless, which therefore minimizes the probability of network congestion. Third, the data throughput to the gateway is at least 1/3 of the optimum assuming reliable links. Our experiments on a 24-node testbed show that TreeMAC protocol significantly improves network throughput, fairness, and energy efficiency compared to TinyOS's default CSMA MAC protocol and a recent TDMA MAC protocol Funneling-MAC. Partial results of this paper were published in Song, Huang, Shirazi and Lahusen [W.-Z. Song, R. Huang, B. Shirazi, and R. Lahusen, TreeMAC: Localized TDMA MAC protocol for high-throughput and fairness in sensor networks, in: The 7th Annual IEEE International Conference on Pervasive Computing and Communications, PerCom, March 2009]. Our new contributions include analyses of the performance of TreeMAC from various aspects. We also present more implementation detail and evaluate TreeMAC from other aspects. ?? 2009 Elsevier B.V.

  10. How might physical activity benefit patients with Parkinson disease?

    NARCIS (Netherlands)

    Speelman, A.D.; Warrenburg, B.P.C. van de; Nimwegen, M.L. van; Petzinger, G.M.; Munneke, M.; Bloem, B.R.

    2011-01-01

    Parkinson disease (PD) is a neurodegenerative disorder characterized by progressive motor and nonmotor impairments. These impairments incline many patients towards a sedentary lifestyle, which has many deleterious consequences. Accumulating evidence suggests that patients with PD might benefit from

  11. pregnancy outcome among patients with sickle cell disease in jos ...

    African Journals Online (AJOL)

    Zamzar

    Conclusion: Pregnancy in sickle cell disease patients is associated with high maternal and perinatal morbidity and ... presentation was 19.3 +/- 7.7 weeks with only ... *Some patients had multiple complications. ... Intrauterine fetal death. 7. 20.0.

  12. Factors associated with gastro-duodenal disease in patients ...

    African Journals Online (AJOL)

    Factors associated with gastro-duodenal disease in patients undergoing ... recruit patients referred with upper gastro-intestinal symptoms for endoscopy. ... 64 had duodenal ulcer, 66 gastric ulcer, 27gastric cancer and 64 non-ulcer dyspepsia.

  13. How might physical activity benefit patients with Parkinson disease?

    NARCIS (Netherlands)

    Speelman, A.D.; Warrenburg, B.P.C. van de; Nimwegen, M.L. van; Petzinger, G.M.; Munneke, M.; Bloem, B.R.

    2011-01-01

    Parkinson disease (PD) is a neurodegenerative disorder characterized by progressive motor and nonmotor impairments. These impairments incline many patients towards a sedentary lifestyle, which has many deleterious consequences. Accumulating evidence suggests that patients with PD might benefit from

  14. Aldosterone assessment in patients with Meniere's disease

    NARCIS (Netherlands)

    Mateijsen, DJM; Kingma, CM; De Jong, PE; Wit, HP; Albers, FWJ

    2001-01-01

    Since 1938 endolymphatic hydrops has generally been accepted as the basic histopathological substrate of Meniere's disease. In animal studies it has been found that exogenous administration of aldosterone resulted in endolymphatic hydrops. Manifestations of Meniere's disease are frequently observed

  15. 42 CFR 405.1122 - What evidence may be submitted to the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false What evidence may be submitted to the MAC. 405.1122... Council Review § 405.1122 What evidence may be submitted to the MAC. (a) Appeal before the MAC on request for review of ALJ's decision. (1) If the MAC is reviewing an ALJ's decision, the MAC limits its review...

  16. 42 CFR 423.2122 - What evidence may be submitted to the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false What evidence may be submitted to the MAC. 423.2122..., MAC review, and Judicial Review § 423.2122 What evidence may be submitted to the MAC. (a) Appeal before the MAC on request for review of ALJ's decision. (1) If the MAC is reviewing an ALJ's decision...

  17. Elvis is back: musical hallucinations in a Parkinson disease patient.

    Science.gov (United States)

    Mittal, Manoj; Giron, Louis T

    2010-08-01

    Hallucinations are common among patients with Parkinson disease (PD). Hallucinations, typically transitory and occurring at night, are classically visual and occur in 30% of treated patients; auditory hallucinations are rare. A musical hallucination (MH) is a rare type of complex auditory hallucination reported in only six PD patients so far. To the best of our knowledge, we present the first reported case of a patient with Parkinson disease who experienced auditory and visual MH.

  18. Cardiac transplantation for pediatric patients. With inoperable congenital heart disease.

    OpenAIRE

    Shaffer, K M; Denfield, S W; Schowengerdt, K O; Towbin, J A; Radovancević, B; Frazier, O. H.; Price, J K; Gajarski, R J

    1998-01-01

    Recent studies have reported the expanding use of transplantation as the definitive option for pediatric patients with inoperable congenital heart disease. This study compares perioperative risk factors and outcomes in pediatric patients who received heart transplants for congenital heart disease with those in pediatric patients who received heart transplants for cardiomyopathy. Retrospective data collected on 40 consecutive pediatric patients undergoing cardiac transplantation from 1 January...

  19. A very low power MAC (VLPM) protocol for Wireless Body Area Networks.

    Science.gov (United States)

    Ullah, Niamat; Khan, Pervez; Kwak, Kyung Sup

    2011-01-01

    Wireless Body Area Networks (WBANs) consist of a limited number of battery operated nodes that are used to monitor the vital signs of a patient over long periods of time without restricting the patient's movements. They are an easy and fast way to diagnose the patient's status and to consult the doctor. Device as well as network lifetime are among the most important factors in a WBAN. Prolonging the lifetime of the WBAN strongly depends on controlling the energy consumption of sensor nodes. To achieve energy efficiency, low duty cycle MAC protocols are used, but for medical applications, especially in the case of pacemakers where data have time-limited relevance, these protocols increase latency which is highly undesirable and leads to system instability. In this paper, we propose a low power MAC protocol (VLPM) based on existing wakeup radio approaches which reduce energy consumption as well as improving the response time of a node. We categorize the traffic into uplink and downlink traffic. The nodes are equipped with both a low power wake-up transmitter and receiver. The low power wake-up receiver monitors the activity on channel all the time with a very low power and keeps the MCU (Micro Controller Unit) along with main radio in sleep mode. When a node [BN or BNC (BAN Coordinator)] wants to communicate with another node, it uses the low-power radio to send a wakeup packet, which will prompt the receiver to power up its primary radio to listen for the message that follows shortly. The wake-up packet contains the desired node's ID along with some other information to let the targeted node to wake-up and take part in communication and let all other nodes to go to sleep mode quickly. The VLPM protocol is proposed for applications having low traffic conditions. For high traffic rates, optimization is needed. Analytical results show that the proposed protocol outperforms both synchronized and unsynchronized MAC protocols like T-MAC, SCP-MAC, B-MAC and X-MAC in terms

  20. Moyamoya Disease with Coexistent Hypertriglyceridemia in Pediatric Patient

    Science.gov (United States)

    Sahni, Deepank; Boucher-Berry, Claudia

    2016-01-01

    Moyamoya disease is a rare chronic and progressive cerebrovascular disease of the arteries of the circle of Willis that can affect children and adults. It has been associated with multiple diseases, including immunologic, like Graves' disease, diabetes mellitus, and SLE. Hyperlipidemia has been recognized in patients with Moyamoya disease with an incidence of 27–37%. However, no case in pediatric patients has been reported of the coexistence of Moyamoya disease and hyperlipidemia. Here we present a case of a 9-year-old female diagnosed with Moyamoya disease after a stroke with incidental finding of familial hypercholesterolemia. This finding will make our patient a very unique case, since there has not been any reporting of Moyamoya disease and hypercholesterolemia association. PMID:27843655

  1. Moyamoya Disease with Coexistent Hypertriglyceridemia in Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Jacqueline Chan

    2016-01-01

    Full Text Available Moyamoya disease is a rare chronic and progressive cerebrovascular disease of the arteries of the circle of Willis that can affect children and adults. It has been associated with multiple diseases, including immunologic, like Graves’ disease, diabetes mellitus, and SLE. Hyperlipidemia has been recognized in patients with Moyamoya disease with an incidence of 27–37%. However, no case in pediatric patients has been reported of the coexistence of Moyamoya disease and hyperlipidemia. Here we present a case of a 9-year-old female diagnosed with Moyamoya disease after a stroke with incidental finding of familial hypercholesterolemia. This finding will make our patient a very unique case, since there has not been any reporting of Moyamoya disease and hypercholesterolemia association.

  2. Cardiovascular Dysfunction in Patients with End-stage Liver Disease

    Directory of Open Access Journals (Sweden)

    Merceds Susan Mandell

    2008-07-01

    Full Text Available Most patients with advanced liver disease have a normal or even supernormal ejection fraction judged by echocardiogra-phy. Thus, physicians previously assumed that cardiac function was normal in most patients with liver disease. However, further investigation has uncovered multiple problems in cardiac performance that place patients at risk of heart failure. Patients with liver disease have defects in both systolic and diastolic function that only become obvious with physiologic stress such as liver transplantation. In addition there are additional defects in the electromechanical coupling of the heart that can have significant clinical consequences. These collective pathologic changes are termed “cirrhotic cardiomyopathy” and occur to some degree in all patients with liver disease. This review will explore the pathophysiology of cardiovascular changes in patients with end-stage liver disease.

  3. Is Mitral Annular Calcification Associated With Atherosclerotic Risk Factors and Severity and Complexity of Coronary Artery Disease?

    Science.gov (United States)

    Bhatt, Hemal; Sanghani, Dharmesh; Julliard, Kell; Fernaine, George

    2015-08-01

    We assessed the association of mitral annular calcification (MAC) with atherosclerotic risk factors and severity and complexity of coronary artery disease (CAD). Cardiac catheterization reports and electronic medical records from 2010 to 2011 were retrospectively reviewed. A total of 481 patients were divided into 2 groups: MAC present (209) and MAC absent (272). All major cardiovascular risk factors, comorbidities, and coronary lesion characteristics were included. On linear regression analysis, age (P = .001, β 1.12) and female gender (P = .031, β 0.50) were the independent predictors of MAC. Mitral annular calcification was not independently associated with the presence of lesions with >70% stenosis (P = .283), number of obstructive vessels (P = .469), lesions with 50% to 70% stenosis (P = .458), and Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score (P = .479). Mitral annular calcification is probably a benign marker of age-related degenerative changes in the heart independent of the severity and complexity of CAD.

  4. Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients

    Energy Technology Data Exchange (ETDEWEB)

    Applefeld, M.M.; Wiernik, P.H.

    1983-06-01

    Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable.

  5. Mini-mac - escala de ajustamento mental para o câncer: estrutura fatorial Mini-mac - the mental adjustment to cancer scale: factorial structure

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Gandini

    2008-03-01

    psicométrica del instrumento. Las diferencias entre las estructuras factoriales del instrumento original y de este estudio pueden ser atribuidas a las diferencias cultural y educacional entre las muestras.The factorial validation of the Mini MAC - The Mental Adjustment to Cancer Scale, that measures mental adjustment to cancer, is investigated. After semantic validation, the scale was applied to a sample of 283 patients, average age 54 years old, suffering from cancer of different types and in various stages of the disease, and attended to at a university hospital. The factorability of the sample was appropriate (The Kaiser-Meyer-Olkin was 0.88; data were submitted to principal components analysis, oblique rotation, due to interdependence of factors. Seven factors attained eigenvalue greater than 1.0. Two factors showed good reliability ("Anxious Preoccupation" with Cronbach's Alpha = 0.87 and "Helpless/Hopeless" with Cronbach's Alpha = 0.74, with 13 items with loadings 0.40 or more, which explained 30% of total variance. Results suggested good psychometric quality. Difference between the factor structure of the original scale and that in current study explains the cultural and educational differences among samples.

  6. Inflammation, but not recruitment, of adipose tissue macrophages requires signalling through Mac-1 (CD11b/CD18) in diet-induced obesity (DIO).

    Science.gov (United States)

    Wolf, Dennis; Bukosza, Nora; Engel, David; Poggi, Marjorie; Jehle, Felix; Anto Michel, Nathaly; Chen, Yung-Chih; Colberg, Christian; Hoppe, Natalie; Dufner, Bianca; Boon, Louis; Blankenbach, Hermann; Hilgendorf, Ingo; von Zur Muhlen, Constantin; Reinöhl, Jochen; Sommer, Björn; Marchini, Timoteo; Febbraio, Mark A; Weber, Christian; Bode, Christoph; Peter, Karlheinz; Lutgens, Esther; Zirlik, Andreas

    2017-01-26

    Cell accumulation is a prerequisite for adipose tissue inflammation. The leukocyte integrin Mac-1 (CD11b/CD18, αMβ2) is a classic adhesion receptor critically regulating inflammatory cell recruitment. Here, we tested the hypothesis that a genetic deficiency and a therapeutic modulation of Mac-1 regulate adipose tissue inflammation in a mouse model of diet-induced obesity (DIO). C57Bl6/J mice genetically deficient (Mac-1(-/-)) or competent for Mac-1 (WT) consumed a high fat diet for 20 weeks. Surprisingly, Mac-1(-/-) mice presented with increased diet-induced weight gain, decreased insulin sensitivity in skeletal muscle and in the liver in insulin-clamps, insulin secretion deficiency and elevated glucose levels in fasting animals, and dyslipidaemia. Unexpectedly, accumulation of adipose tissue macrophages (ATMs) was unaffected, while gene expression indicated less inflamed adipose tissue and macrophages in Mac-1(-/-) mice. In contrast, inflammatory gene expression at distant locations, such as in skeletal muscle, was not changed. Treatment of ATMs with an agonistic anti-Mac-1 antibody, M1/70, induced pro-inflammatory genes in cell culture. In vivo, treatment with M1/70 induced a hyper-inflammatory phenotype with increased expression of IL-6 and MCP-1, whereas accumulation of ATMs did not change. Finally, inhibition of Mac-1's adhesive interaction to CD40L by the peptide inhibitor cM7 did not affect myeloid cell accumulation in adipose tissue. We present the surprising finding that adhesive properties of the leukocyte integrin Mac-1 are not required for macrophage accumulation in adipose tissue. Instead, Mac-1 modulates inflammatory gene expression in macrophages. These findings question the net effect of integrin blockade in cardio-metabolic disease.

  7. Influence of prior determination of baseline minimum alveolar concentration (MAC) of isoflurane on the effect of ketamine on MAC in dogs.

    Science.gov (United States)

    Gianotti, Giacomo; Valverde, Alexander; Johnson, Ron; Sinclair, Melissa; Gibson, Thomas; Dyson, Doris H

    2014-07-01

    The objective of this study was to determine if prior measurement of the minimum alveolar concentration (MAC) of isoflurane influences the effect of ketamine on the MAC of isoflurane in dogs. Eight mixed-breed dogs were studied on 2 occasions. Anesthesia was induced and maintained using isoflurane. In group 1 the effect of ketamine on isoflurane MAC was determined after initially finding the baseline isoflurane MAC. In group 2, the effect of ketamine on isoflurane MAC was determined without previous measure of the baseline isoflurane MAC. In both groups, MAC was determined again 30 min after stopping the CRI of ketamine. Plasma ketamine concentrations were measured during MAC determinations. In group 1, baseline MAC (mean ± SD: 1.18 ± 0.14%) was decreased by ketamine (0.88 ± 0.14%; P MAC after stopping ketamine was similar (1.09 ± 0.16%) to baseline MAC and higher than with ketamine (P MAC with ketamine (0.79 ± 0.11%) was also increased after stopping ketamine (1.10 ± 0.17%; P MAC values with ketamine were different between groups (P MAC determination. The MAC of isoflurane during the CRI of ketamine yielded different results when methods of same day (group-1) versus separate days (group-2) are used, despite similar plasma ketamine concentrations with both methods. However, because the magnitude of this difference was less than 10%, either method of determining MAC is deemed acceptable for research purposes.

  8. On the orthogonality of the MacDonald s functions

    Energy Technology Data Exchange (ETDEWEB)

    Passian, Ali [ORNL; Simpson, Henry [University of Tennessee, Knoxville (UTK); Koucheckian, Sherwin [University of South Florida, Tampa; Yakubovich, Semyon [University of Porto, Portugal

    2009-01-01

    A proof of an orthogonality relation for the MacDonald's functions with identical arguments but unequal complex lower indices is presented. The orthogonality is derived first via a heuristic approach based on the Mehler-Fock integral transform of the MacDonald's functions, and then proved rigorously using a polynomial approximation procedure.

  9. SuperMacLang: Development of an Authoring System.

    Science.gov (United States)

    Frommer, Judith; Foelsche, Otmar K. E.

    1999-01-01

    Describes the development of "SuperMacLang, the 1990s version of the MacLang authoring system. An analysis of various features of the program explains the ways in which certain aspects of collaboration and funding affected developer and programming decisions. (Author/VWL)

  10. Steven MacCall: Winner of LJ's 2010 Teaching Award

    Science.gov (United States)

    Berry, John N., III

    2010-01-01

    This article profiles Steven L. MacCall, winner of "Library Journal's" 2010 Teaching Award. An associate professor at the School of Library and Information Studies (SLIS) at the University of Alabama, Tuscaloosa, MacCall was nominated by Kathie Popadin, known as "Kpop" to the members of her cohort in the online MLIS program at SLIS. Sixteen of…

  11. Intel-Based Mac Computers Improve Teaching and Learning

    Science.gov (United States)

    Technology & Learning, 2007

    2007-01-01

    Today, Mac computers offer schools an easy and powerful way to engage students in learning, foster 21st century skills and leverage existing software assets. Innovative software and hardware built into the Mac allows students to demonstrate their individual strengths--empowering them to be creators of content, rather than just consumers. Judging…

  12. Intel-Based Mac Computers Improve Teaching and Learning

    Science.gov (United States)

    Technology & Learning, 2007

    2007-01-01

    Today, Mac computers offer schools an easy and powerful way to engage students in learning, foster 21st century skills and leverage existing software assets. Innovative software and hardware built into the Mac allows students to demonstrate their individual strengths--empowering them to be creators of content, rather than just consumers. Judging…

  13. Multi-channel MAC Protocol in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Yongli Sun

    2013-11-01

    Full Text Available Since cognitive wireless network (CRN has the characteristic of secondary use, it can enable the device to dynamically access available spectrum without interference to primary users (PUs, which can effectively alleviate contradiction between the lack of spectrum resources and the growing demand for wireless access. However, Medium Access Control (MAC protocol as CRN core components, can achieve competition access of the licensed spectrum and coordination control, which will maximize spectrum utilization efficiency and network throughput. The contribution of this survey is threefold. First, we analyze the characteristics of the existed multi- channel MAC protocol in CRN; Second, according to the different ways of spectrum access in CRNs, the multi-channel MAC protocols are classified into time-slotted based MAC protocol, control channel based MAC protocol and hybrid MAC protocol, and the paper emphatically analyzed the advantages and disadvantages of these multi-channel MAC protocols; Finally, the paper explores the difficulties and the challenges of multi-channel MAC protocols design in cognitive wireless network.

  14. Steven MacCall: Winner of LJ's 2010 Teaching Award

    Science.gov (United States)

    Berry, John N., III

    2010-01-01

    This article profiles Steven L. MacCall, winner of "Library Journal's" 2010 Teaching Award. An associate professor at the School of Library and Information Studies (SLIS) at the University of Alabama, Tuscaloosa, MacCall was nominated by Kathie Popadin, known as "Kpop" to the members of her cohort in the online MLIS program at SLIS. Sixteen of…

  15. A case of Mac Tel 2 with an unusual sub macular vitelliform lesion.

    Science.gov (United States)

    Lekha, T; Sarwate, Nikit; Sarwate, Renuka

    2015-01-01

    Observational case report describing the clinical, FFA, OCT and mfERG findings in an elderly female patient with atypical features of macular telangiectasia (Mac Tel 2) RESULTS: A 71-year-old lady was detected to have characteristic features of Mac Tel 2 in the left eye (LE) and a yellowish sub macular vitelliform like lesion in the right eye (RE). FFA showed ill defined hyper fluorescence in the RE and telangiectasia and parafoveal leakage typical of Mac Tel 2 in the LE. On OCT RE had hyper reflective clump of echoes subfoveally with an intact RPE and LE had foveal thinning with hypo reflective intraretinal cavities. mfERG responses were normal in the RE and reduced in the LE. During the course of 3 years LE showed natural progression while RE remained unchanged. Structural and functional evaluation of an unusual sub macular vitelliform lesion seen in association with Mac Tel 2 and its course over a period of 3 years is described. The differentiating features of this lesion from adult onset foveomacular vitelliform dystrophy (AFMD) are discussed.

  16. Hepatic lipogranulomas in patients with chronic liver disease: Association with hepatitis C and fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Henry; C; Bodenheimer; David; J; Clain; Albert; D; Min; Neil; D; Theise

    2010-01-01

    AIM: To study the significance and clinical implication of hepatic lipogranuloma in chronic liver diseases, including fatty liver disease and hepatitis C. METHODS: A total of 376 sequential, archival liver biopsy specimens were reviewed. Lipogranuloma, steatosis and steato-fibrosis were evaluated with combined hematoxylin and eosin and Masson’s trichrome staining. RESULTS: Fifty-eight (15.4%) patients had lipogranuloma, including 46 patients with hepatitis C, 14 patients with fatty liver disease, and 5 pati...

  17. Self management for patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Zwerink, M.; Brusse-Keizer, M.; Valk, P.D.L.P.M. van der; Zielhuis, G.A.; Monninkhof, E.M.; Palen, J.A.M. van der; Frith, P.A.; Effing, T.

    2014-01-01

    BACKGROUND: Self management interventions help patients with chronic obstructive pulmonary disease (COPD) acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable patients to control their

  18. The medical, social, and functional profile of Parkinson's disease patients.

    Science.gov (United States)

    Lee, K S; Merriman, A; Owen, A; Chew, B; Tan, T C

    1994-06-01

    The study looked at the medical, social, and functional aspects of 34 patients with idiopathic Parkinson's Disease (PD). Eighty-five percent were above 55 years and 35% were over 70 years. Twenty-four (71%) were males. Most patients had Stage II disease. Overall functional state of the patient correlated closely with the stage of Parkinson's disease. Patients were likely to be dependent if their disease severity was stage III or more. Eighteen (53%) patients would require a carer to be present at least part of the day and 3 (9%) patients would require a carer most of the time. Domestic chores such as meal preparation, housework, and shopping were also affected in most of those who were previously active in these tasks. Ten patients had given up work due to their Parkinson's disease. The lack of knowledge of the disease was shown both in the carers and the patients. Twenty-nine of the patients had no knowledge of the disease, and only one carer had superficial knowledge of the disease. The major social problems associated with the disease were loss of social contact, behavioural problems, family members under strain and communication problems within the family. Since Parkinson's Disease is a chronic illness, with associated disabilities, it is important that the physician should aim for a multidisciplinary approach. Patient and carer education should be given emphasis, and the many everyday functional problems addressed. Advice on life-style management and aids to overcome disabilities may help improve quality of life of the patient and reduce carer's stress.

  19. Cardiovascular disease in patients with osteogenesis imperfecta

    DEFF Research Database (Denmark)

    Folkestad, Lars; Hald, Jannie Dahl; Gram, Jeppe

    2016-01-01

    BACKGROUND: Osteogenesis imperfecta (OI) is a hereditary connective tissue disease often due to mutations in genes coding for type 1 collagen. Collagen type 1 is important in the development of the heart and vasculature. Little is known about the risk of cardiovascular disease (CVD) in OI...... to development of these diseases. Our results suggest that the collagenopathy seen in OI may be part of the pathogenesis of CVD in OI....

  20. Periodontal disease in diabetic patients - clinical and histopathological aspects.

    Science.gov (United States)

    Corlan Puşcu, Dorina; Ciuluvică, Radu Constantin; Anghel, Andreea; Mălăescu, Gheorghe Dan; Ciursaş, Adina Nicoleta; Popa, Gabriel Valeriu; Agop Forna, Doriana; Busuioc, Cristina Jana; Siloşi, Izabela

    2016-01-01

    Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.

  1. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  2. Screening, diagnosis, and management of patients with Fabry disease

    DEFF Research Database (Denmark)

    Schiffmann, Raphael; Hughes, Derralynn A; Linthorst, Gabor E

    2017-01-01

    Patients with Fabry disease (FD) are at a high risk for developing chronic kidney disease and cardiovascular disease. The availability of specific but costly therapy has elevated the profile of this rare condition. This KDIGO conference addressed controversial areas in the diagnosis, screening, a...

  3. Advanced glycation end products in patients with peripheral artery disease

    NARCIS (Netherlands)

    de Vos, Lisanne Carlijn

    2016-01-01

    Peripheral artery disease (PAD) is a disease in which stenosis or occlusion occurs of the arteries of the lower limbs. The most common underlying disease is atherosclerosis. The main presenting symptom of these patients is intermittent claudication, which is typical leg pain during walking that disa

  4. Incidence of RET mutations in patients with Hirschsprung's disease

    NARCIS (Netherlands)

    Sancandi, M; Ceccherini, [No Value; Costa, M; Fava, M; Chen, B; Wu, Y; Hofstra, R; Laurie, T; Griffths, M; Burge, D; Tam, PKH

    2000-01-01

    Background: RET mutations have been reported variously to affect 7% to 41% of Hirschsprung's disease (HSCR) patients depending on familial or sporadic occurrence of the disease, length of aganglionosis and possible association with other disease phenotypes. The authors report a study of the incidenc

  5. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  6. Mid-arm and calf circumferences are stronger mortality predictors than body mass index for patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ho SC

    2016-08-01

    Full Text Available Shu-Chuan Ho,1,2 Jiun-Yi Wang,3,4 Han-Pin Kuo,5 Chien-Da Huang,5 Kang-Yun Lee,2,6 Hsiao-Chi Chuang,1,2 Po-Hao Feng,2,6 Tzu-Tao Chen,2,* Min-Fang Hsu7,* 1School of Respiratory Therapy, College of Medicine, 2Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 3Department of Healthcare Administration, Asia University, Wufeng, 4Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 5Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 6Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 7Department of Nursing, Yuanpei University of Medical Technology, Hsinchu City, Taiwan *These authors contributed equally to this work Background: Chronic obstructive pulmonary disease (COPD is currently the third most common cause of death in the world. Patients with COPD experience airflow obstruction, weight loss, skeletal muscle dysfunction, and comorbidities. Anthropometric indicators are risk factors for mortality in geriatric assessment. Purpose: This study examined and compared the associations of anthropometric indicators, such as low body mass index (BMI, low mid-arm circumference (MAC, and low calf circumference (CC, with the prediction of a 3-year follow-up mortality risk in patients with COPD. Methods: We recruited nonhospitalized patients with COPD without acute conditions from a general hospital in Taiwan. The BMI, MAC, and CC of all patients were measured, and they were followed for 3 years through telephone interviews and chart reviews. The Kaplan–Meier survival curves stratified by BMI, MAC, and CC were analyzed. Variables univariately associated with survival were entered into a multivariate Cox regression model. The Bayesian information criterion was used to compare the predictive ability of the three anthropometric

  7. Prevalence and overlap of Disease Management Program diseases in older hospitalized patients

    DEFF Research Database (Denmark)

    Juul-Larsen, Helle Gybel; Petersen, Janne; Sivertsen, Ditte Maria

    2017-01-01

    Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as "program diseases" (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess....... The range of the cumulative incidence of being readmitted within 90 days was between 28.8% for patients without a PD and 46.6% for patients with more than one PD. PDs overlapped in many combinations, and all patients had a high probability of being readmitted. Hence, developing strategies to create a new...

  8. Hormones and arterial stiffness in patients with chronic kidney disease.

    Science.gov (United States)

    Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

    2013-01-01

    Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population.

  9. Factors contributing to malnutrition in patients with Parkinson's disease.

    Science.gov (United States)

    Kim, Sung R; Chung, Sun J; Yoo, Sung-Hee

    2016-04-01

    Our objective in this study was to evaluate the nutritional status and to identify clinical, psychosocial, and nutritional factors contributing to malnutrition in Korean patients with Parkinson's disease. We used a descriptive, cross-sectional study design. Of 102 enrolled patients, 26 (25.5%) were malnourished and 27 (26.5%) were at risk of malnutrition based on Mini-Nutritional Assessment scores. Malnutrition was related to activity of daily living score, Hoehn and Yahr stage, duration of levodopa therapy, Beck Depression Inventory and Spielberger's Anxiety Inventory scores, body weight, body weight at onset of Parkinson's disease, and body mass index. On multiple logistic regression analysis, anxiety score, duration of levodopa therapy, body weight at onset of Parkinson's disease, and loss of body weight were significant factors predicting malnutrition in Parkinson's disease patients. Therefore, nutritional assessment, including psychological evaluation, is required for Parkinson's disease patients to facilitate interdisciplinary nutritional intervention for malnourished patients.

  10. Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases.

    Science.gov (United States)

    Jang, Bohyun; Han, Ji Won; Sung, Pil Soo; Jang, Jeong Won; Bae, Si Hyun; Choi, Jong Young; Cho, Young I; Yoon, Seung Kew

    2016-12-01

    Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient's history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (P chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.

  11. A Sensing Error Aware MAC Protocol for Cognitive Radio Networks

    CERN Document Server

    Hu, Donglin

    2011-01-01

    Cognitive radios (CR) are intelligent radio devices that can sense the radio environment and adapt to changes in the radio environment. Spectrum sensing and spectrum access are the two key CR functions. In this paper, we present a spectrum sensing error aware MAC protocol for a CR network collocated with multiple primary networks. We explicitly consider both types of sensing errors in the CR MAC design, since such errors are inevitable for practical spectrum sensors and more important, such errors could have significant impact on the performance of the CR MAC protocol. Two spectrum sensing polices are presented, with which secondary users collaboratively sense the licensed channels. The sensing policies are then incorporated into p-Persistent CSMA to coordinate opportunistic spectrum access for CR network users. We present an analysis of the interference and throughput performance of the proposed CR MAC, and find the analysis highly accurate in our simulation studies. The proposed sensing error aware CR MAC p...

  12. McCay ("Mac") Vernon (1928-2013).

    Science.gov (United States)

    Sherman, William A

    2014-09-01

    McCay ("Mac") Vernon, the founding and preeminent psychologist in the field of deafness. Mac was born at Walter Reed Hospital in Washington, DC, into a military family on October 14, 1928 and died on August 28, 2013, at the age of 84. Prior to Mac, research and clinical direction in the field were sparse. Mac became the icon for psychological services for deaf people, and his work extended into the education of deaf children, forensic and ethical practices with the deaf, and public understanding of deafness as a disability and of deaf persons as a psychosocial minority group. Mac will also be remembered for his sharp intellect, good humor, compassion, and advocacy for those who are misunderstood.

  13. [Comorbid autoimmune pathology in patients treated with disease modifying drugs].

    Science.gov (United States)

    Goncharova, Z A; Sizyakina, L P; Belovolova, R A; Megeryan, V A

    2016-01-01

    Because of intensive growth of the prevalence of multiple sclerosis (MS) and other autoimmune diseases (AID) during the last years, the comorbidity of MS and AID is not a rarity. In this literature review, the development of comorbid AID in patients with MS is considered to be the probable complication of disease modifying therapy with drugs of different groups. The authors present the own data on the prevalence of comorbid autoimmune pathology in patients with MS treated with disease modifying drugs.

  14. Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care.

    Directory of Open Access Journals (Sweden)

    Tam H Ho

    Full Text Available OBJECTIVE: To assess the impact of individualised, reconciled evidence-based recommendations (IRERs and multidisciplinary care in patients with chronic heart failure (CHF on clinical guideline compliance for CHF and common comorbid conditions. DESIGN AND SETTING: A retrospective hospital clinical audit conducted between 1st July 2006 and February 2011. PARTICIPANTS: A total of 255 patients with a diagnosis of CHF who attended the Multidisciplinary Ambulatory Consulting Services (MACS clinics, at the Royal Adelaide Hospital, were included. MAIN OUTCOME MEASURES: Compliance with Australian clinical guideline recommendations for CHF, atrial fibrillation, diabetes mellitus and ischaemic heart disease. RESULTS: Study participants had a median of eight medical conditions (IQR 6-10 and were on an average of 10 (±4 unique medications. Compliance with clinical guideline recommendations for pharmacological therapy for CHF, comorbid atrial fibrillation, diabetes or ischaemic heart disease was high, ranging from 86% for lipid lowering therapy to 98% anti-platelet agents. For all conditions, compliance with lifestyle recommendations was lower than pharmacological therapy, ranging from no podiatry reviews for CHF patients with comorbid diabetes to 75% for heart failure education. Concordance with many guideline recommendations was significantly associated if the patient had IRERs determined, a greater number of recommendations, more clinic visits or if patients participated in a heart failure program. CONCLUSIONS: Despite the high number of comorbid conditions and resulting complexity of the management, high compliance to clinical guideline recommendations was associated with IRER determination in older patients with CHF. Importantly these recommendations need to be communicated to the patient's general practitioner, regularly monitored and adjusted at clinic visits.

  15. Non-surgical periodontal management in scleroderma disease patients.

    Science.gov (United States)

    Laforgia, A; Corsalini, M; Stefanachi, G; Tafuri, S; Ballini, A; Pettini, F; Di Venere, D

    2016-01-01

    The aim of the present study is to investigate the periodontal status of people with scleroderma and their response to non-surgical treatment protocol aimed at controlling the evolution of the disease. The response to non-surgical periodontal treatment was tested on patients belonging to a scleroderma group and a control group: the data show an improvement of the periodontal conditions of all these patients in response to treatment. When compared on the same diagram, a slight remission of the periodontal disease was obtained in both scleroderma and healthy patients. This highlights the benefit to soft tissues produced by non-surgical periodontal treatment also in patients affected by systemic diseases.

  16. Epiretinal membrane removal in patients with Stargardt disease

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2015-01-01

    Full Text Available Epiretinal membranes (ERMs in Stargardt disease have been known to undergo spontaneous separation in children. Results of surgical intervention in adult patients with Stargardt disease have rarely been reported. A retrospective review of results of surgical intervention for ERM causing visual impairment in two adult patients of Stargardt disease was carried out. Both patients developed ERM in one eye during their follow-up period with the resultant drop in their preexisting visual acuity. Postsurgery, restoration of foveal contour with some improvement in visual acuity was observed in both patients. No adverse effect of surgery was noted.

  17. Motility Evaluation in the Patient with Inflammatory Bowel Disease.

    Science.gov (United States)

    Abdalla, Sherine M; Kalra, Gorav; Moshiree, Baha

    2016-10-01

    Patients with inflammatory bowel disease (IBD) suffer frequently from functional bowel diseases (FBD) and motility disorders. Management of FBD and motility disorders in IBD combined with continued treatment of a patient's IBD symptoms will likely lead to better clinical outcomes and improve the patient's quality of life. The goals of this review were to summarize the most recent literature on motility disturbances in patients with IBD and to give a brief overview of the ranges of motility disturbances, from reflux disease to anorectal disorders, and discuss their diagnosis and specific management.

  18. Vascular Disease in Patients with Nonalcoholic Fatty Liver Disease

    NARCIS (Netherlands)

    Potze, Wilma; Siddiqui, M. Shadab; Sanyal, Arun J.

    2015-01-01

    Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed and is considered to be the most frequent chronic liver disorder in Western countries. It represents a histopathological spectrum ranging from simple hepatic steatosis to steatohepatitis and finally cirrhosis. NAFLD is consider

  19. Facilitators and Threats to the Patient Dignity in Hospitalized Patients with Heart Diseases: A Qualitative Study

    OpenAIRE

    Fariba Borhani; Abbas Abbaszadeh; Roghayeh Mehdipour Rabori

    2016-01-01

    Background: Patient’s dignity is an important issue which is highlighted in nursing It is an issue that is highly dependent on context and culture. Heart disease is the most common disease in Iran and the world. Identification of facilitator and threatening patient dignity in heart patients is vital. This study aimed to explore facilitator and threatening patient dignity in hospitalized patients with heart disease. Methods: This qualitative content analysis study was performed in 2014 in ...

  20. Alasdair MacIntyre, joven lector de Freud

    Directory of Open Access Journals (Sweden)

    Ramis Barceló, Rafael

    2010-06-01

    Full Text Available This article tries to show the reading of Freud that MacIntyre made from 1955 to 1970. For this purpose, it summarizes the ideas of MacIntyre in the intellectual context, mainly the use of philosophical ideas of Freud against the Enlightenment project. MacIntyre criticises Marxist interpreters and the mixing between Marx and Freud. MacIntyre uses the philosophical ideas of Freud for answering two problems on determinism: the links between determinism and reasons for action and determinism and Marxism. The main conclusion is that MacIntyre used Freud in his own advantage: as an ally in the criticism of the Enlightenment.

    Este artículo trata de mostrar la lectura que MacIntyre hizo de Freud desde 1955 hasta 1970. Con este fin, se resumen las ideas de MacIntyre en el contexto intelectual, principalmente el uso de las ideas filosóficas de Freud contra el proyecto de la Ilustración. MacIntyre critica a los intérpretes de Marx y a la mezcla entre Marx y Freud. MacIntyre usa las ideas filosóficas de Freud para contestar dos problemas sobre el determinismo: los vínculos entre el determinismo y las razones para la acción y el determinismo y el marxismo. La conclusión principal es que MacIntyre usó a Freud en su propio beneficio: como un aliado en la crítica de la Ilustración.

  1. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  2. Revascularization options in patients with chronic kidney disease.

    Science.gov (United States)

    Ashrith, Guha; Elayda, MacArthur A; Wilson, James M

    2010-01-01

    Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revascularization are merely a matter of opinion. Several small, retrospective studies have shown that coronary artery bypass grafting is associated with higher procedural death but better long-term survival than is percutaneous coronary intervention. This difference appears to result from poor long-term results of percutaneous coronary intervention in patients who have chronic kidney disease or end-stage renal disease.Because randomized trials comparing percutaneous coronary intervention and coronary artery bypass grafting have included patients undergoing balloon angioplasty and placement of bare-metal stents, their conclusions are suspect in the era of drug-eluting stents. In this review, we discuss different revascularization options for patients with chronic kidney disease, the outcomes of revascularization procedures, and the risk factors for adverse outcomes.

  3. Neoplastic Disorders in 100 Patients with Adult Celiac Disease

    Directory of Open Access Journals (Sweden)

    HUGH J Freeman

    1996-01-01

    Full Text Available Previous reports have suggested that the incidence of some neoplastic disorders, particularly malignant lymphoma, is increased in patients with celiac disease. In this study, the type and number of neoplastic disorders detected in 100 consecutive celiac disease patients were explored. Sixty-five patients were initially diagnosed with celiac disease before, and 35 after, age 60 years. Ten elderly celiac patients had lymphoma or small intestinal adenocarcinoma. Although the overall incidence of malignant lymphoma was 8%, similar to that in other centres, the incidence in elderly celiac patients was 23% in this study. Celiac disease was detected before or after the diagnosis of lymphoma or small intestinal adenocarcinoma. In some patients, epithelial lymphocytosis was evident in the gastric, colonic or biliary tract epithelium. In addition, other immune-mediated disorders, dermatitis herpetiformis and autoimmune thyroiditis, were common. Finally, other malignant disorders of the esophagus, stomach and colon were not detected.

  4. Prevalence of cholelithiasis in patients with chronic inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Wolfgang Kratzer; Mark M Haenle; Richard A Mason; Christian von Tirpitz; Volker Kaechele

    2005-01-01

    AIM: To investigate the effect of chronic inflammatory bowel disease (CIBD) specific risk factors for cholecystolithiasis,as duration and involvement pattern of the disease and prior surgery in patients with Crohn's disease (CD) and ulcerative colitis (UC).METHODS: A total of 222 patients with CD (135 females,87 males; average age, 35.8±11.8 years; range 17-81 years)and 88 patients with UC (39 females, 49 males; average age, 37.2±13.6 years; range 16-81 years) underwent clinical and ultrasound examinations. Besides age, sex and degree of obesity, patients' CIBD specific parameters, including duration and extent of disease and prior operations were documented and evaluated statistically using logistic regression.RESULTS: The overall prevalence of gallbladder stone disease in patients with CD was 13% (n = 30). Only age could be shown to be an independent risk factor (P = 0.014).Compared to a collective representative for the general population in the same geographic region, the prevalence of cholecystolithiasis was higher in all corresponding age groups. Patients with UC showed an overall prevalence of gallbladder stone disease of only 4.6%.CONCLUSION:Only age but not disease-specific factors such as duration and extent of disease, and prior surgery are independent risk factors for the development of cholecystolithiasis in patients with CIBD.

  5. TreeMAC: Localized TDMA MAC protocol for real-time high-data-rate sensor networks

    Science.gov (United States)

    Song, W.-Z.; Huang, R.; Shirazi, B.; Husent, R.L.

    2009-01-01

    Earlier sensor network MAC protocols focus on energy conservation in low-duty cycle applications, while some recent applications involve real-time high-data-rate signals. This motivates us to design an innovative localized TDMA MAC protocol to achieve high throughput and low congestion in data collection sensor networks, besides energy conservation. TreeMAC divides a time cycle into frames and frame into slots. Parent determines children's frame assigmnent based on their relative bandwidth demand, and each node calculates its own slot assignment based on its hop-count to the sink. This innovative 2-dimensional frame-slot assignment algorithm has the following nice theory properties. Firstly, given any node, at any time slot, there is at most one active sender in its neighborhood (includ ing itself). Secondly, the packet scheduling with TreelMAC is bufferless, which therefore minimizes the probability of network congestion. Thirdly, the data throughput to gateway is at least 1/3 of the optimum assuming reliable links. Our experiments on a 24 node test bed demonstrate that TreeMAC protocol significantly improves network throughput and energy efficiency, by comparing to the TinyOS's default CSMA MAC protocol and a recent TDMA MAC protocol Funneling-MAC[8]. ?? 2009 IEEE.

  6. TR-MAC: an energy-efficient MAC protocol exploiting transmitted reference modulation for wireless sensor networks

    NARCIS (Netherlands)

    Morshed, S.; Heijenk, Geert

    2014-01-01

    The medium access control (MAC) protocol determines the energy consumption of a wireless sensor node by specifying the listening, transmitting or sleeping time. Therefore MAC protocols play an important role in minimizing the overall energy consumption in a typical wireless sensor network (WSN).

  7. TR-MAC: an energy-efficient MAC protocol exploiting transmitted reference modulation for wireless sensor networks

    NARCIS (Netherlands)

    Morshed, Sarwar; Heijenk, Geert

    2014-01-01

    The medium access control (MAC) protocol determines the energy consumption of a wireless sensor node by specifying the listening, transmitting or sleeping time. Therefore MAC protocols play an important role in minimizing the overall energy consumption in a typical wireless sensor network (WSN). Usi

  8. Frequency of craniofacial pain in patients with ischemic heart disease

    OpenAIRE

    Bakhshi, Mahin; Rezaei, Rezvan; Baharvand, Maryam; Bakhtiari, Sedigheh

    2017-01-01

    Background Referred craniofacial pain of cardiac origin might be the only symptom of ischemic heart accidents. This study aimed to determine the frequency of craniofacial pain in patients with ischemic heart disease. Material and Methods This cross-sectional study was accomplished on 296 patients who met the criteria of having ischemic heart disease. Data regarding demographics, medical history and referred craniofacial pain were recorded in data forms. In addition, patients underwent oral ex...

  9. [The physician-patient relationship in chronic disease management].

    Science.gov (United States)

    Ginies, P

    2008-07-01

    The relationship between patients and clinicians is a key element in the management of chronic diseases. With the objective of a more efficient communication, the clinician should know his own personality but also the patient personality. The organisation of the consultation, of the waiting room and of the secretary has to facilitate this relationship. The amelioration of this relationship is usefulness only for the clinician in particularly complicated cases but also for the patients suffering from chronic diseases.

  10. Study of pulp microflora in patients with cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    M.A. Safarov

    2010-06-01

    Full Text Available 335 patients aged 20 to 60 years with various parodontitis inflammatory diseases have been selected for research. All patients have been divided into four groups of different age: with rheumatism - 96 persons, with heart ischemic illness - 82 persons, with arterial hypertension - 89 persons, with neurocirculatory dystonia - 68 persons. The presented results of supervision show diagnostic significant changes of pulp microflora with odontogenic infection in patients, suffering cardiovascular diseases

  11. Linking SNPs to CAG repeat length in Huntington's disease patients.

    Science.gov (United States)

    Liu, Wanzhao; Kennington, Lori A; Rosas, H Diana; Hersch, Steven; Cha, Jang-Ho; Zamore, Phillip D; Aronin, Neil

    2008-11-01

    Allele-specific silencing using small interfering RNAs targeting heterozygous single-nucleotide polymorphisms (SNPs) is a promising therapy for human trinucleotide repeat diseases such as Huntington's disease. Linking SNP identities to the two HTT alleles, normal and disease-causing, is a prerequisite for allele-specific RNA interference. Here we describe a method, SNP linkage by circularization (SLiC), to identify linkage between CAG repeat length and nucleotide identity of heterozygous SNPs using Huntington's disease patient peripheral blood samples.

  12. Precision medicine in patients with allergic diseases

    DEFF Research Database (Denmark)

    Muraro, Antonella; Lemanske, Robert F; Hellings, Peter W

    2016-01-01

    , and design of disease-modifying strategies. Progress has been made in profiling the type 2 immune response-driven asthma. The endotype driven approach for non-type 2 immune response asthma, rhinitis, and atopic dermatitis is lagging behind. Validation and qualification of biomarkers are needed to facilitate...... their translation into pathway-specific diagnostic tests. Wide consensus between academia, governmental regulators, and industry for further development and application of precision medicine in management of allergic diseases is of utmost importance. Improved knowledge of disease pathogenesis together with defining...

  13. Approach to the patient with Parkinson disease.

    Science.gov (United States)

    Johnson, Kevin E

    2015-06-01

    Parkinson disease (PD) is a progressive neurodegenerative disease with motor, nonmotor, and behavioral findings. Imaging technology advances have allowed the characterization of the underlying pathologic changes to the brain and identification of specific lesions in dopaminergic neurons. Although certain imaging techniques allow for detection up to 20 years before the onset of motor symptoms, these advances have yet to produce meaningful treatments to halt the disease or reverse its course. Current treatments are directed at optimizing symptomatic management. Referral to a movement disorder specialist familiar with PD should be considered for providers with limited familiarity in diagnosis or treatment.

  14. A Very Low Power MAC (VLPM Protocol for Wireless Body Area Networks

    Directory of Open Access Journals (Sweden)

    Kyung Sup Kwak

    2011-03-01

    Full Text Available Wireless Body Area Networks (WBANs consist of a limited number of battery operated nodes that are used to monitor the vital signs of a patient over long periods of time without restricting the patient’s movements. They are an easy and fast way to diagnose the patient’s status and to consult the doctor. Device as well as network lifetime are among the most important factors in a WBAN. Prolonging the lifetime of the WBAN strongly depends on controlling the energy consumption of sensor nodes. To achieve energy efficiency, low duty cycle MAC protocols are used, but for medical applications, especially in the case of pacemakers where data have time-limited relevance, these protocols increase latency which is highly undesirable and leads to system instability. In this paper, we propose a low power MAC protocol (VLPM based on existing wakeup radio approaches which reduce energy consumption as well as improving the response time of a node. We categorize the traffic into uplink and downlink traffic. The nodes are equipped with both a low power wake-up transmitter and receiver. The low power wake-up receiver monitors the activity on channel all the time with a very low power and keeps the MCU (Micro Controller Unit along with main radio in sleep mode. When a node [BN or BNC (BAN Coordinator] wants to communicate with another node, it uses the low-power radio to send a wakeup packet, which will prompt the receiver to power up its primary radio to listen for the message that follows shortly. The wake-up packet contains the desired node’s ID along with some other information to let the targeted node to wake-up and take part in communication and let all other nodes to go to sleep mode quickly. The VLPM protocol is proposed for applications having low traffic conditions. For high traffic rates, optimization is needed. Analytical results show that the proposed protocol outperforms both synchronized and unsynchronized MAC protocols like T-MAC, SCP-MAC, B-MAC

  15. Alzheimer's disease care management plan: maximizing patient care.

    Science.gov (United States)

    Treinkman, Anna

    2005-03-01

    Nurse practitioners have the potential to significantly impact the care of patients with dementia. Healthcare providers can now offer patients medications that will control symptoms and prolong functioning. As a result of ongoing contact with patients, NPs play an important role in assessing and screening patients for AD and educating the patients, families, and caregivers about the disease. Alzheimer's disease is a chronic, progressive illness that requires long-term management. Nurse practitioners should be familiar with available medications and appreciate the need to individualize therapy to maximize efficacy and minimize potential adverse drug reactions.

  16. Treatment options for patients with Gaucher disease

    African Journals Online (AJOL)

    Rabah M. Shawky

    2016-02-28

    Feb 28, 2016 ... treatment – was approved for Gaucher disease. ... pharmacological chaperon and possibly gene therapy. The aim of .... physical and psychological development However, it comes .... pathologic fractures or osteonecrosis [51].

  17. Predictive factors of small bowel patency in Crohn's disease patients

    Directory of Open Access Journals (Sweden)

    Andreia Albuquerque

    2016-02-01

    Full Text Available Background: Patency capsule was developed to avoid small bowel video capsule endoscopy retention, namely in patients with Crohn's disease. Aims: To evaluate the predictive factors of small bowel patency in Crohn's disease patients. Patients and methods: Retrospective analysis including 151 Crohn's disease patients submitted to patency capsule (Agile® Patency Capsule from 2011 to 2012. Patients that excreted the intact patency capsule were classified as having a patent small bowel (without patency capsule retention, other patients were considered to have negative patency of the small bowel (patency capsule retention. Results: Patients had a mean age of 41±14 years, 54% were female and 25% had been previously submitted to surgery. Stricturing disease was seen in 20% of cases and penetrating disease in 16% of cases. Left-sided colonic lesions and ileal strictures were observed at colonoscopy in 13% and 9% of patients, respectively. In our sample, 28% of patients had negative patency of the small bowel (patency capsule retention. In multivariate analysis, independent factors that were associated with negative patency of the small bowel in Crohn's disease patients were stricturing (OR 10.16, p < 0.001 and penetrating phenotypes (OR 11.73, p = 0.001, left-sided colonic lesions (OR 3.77, p = 0.038, ileal stricture (OR 9.76, p = 0.003; previous intestinal surgery was found to be protective (OR 0.16, p = 0.006. Conclusions: Stricturing or penetrating disease, ileal strictures, no previous surgery and left-sided colonic lesions were the factors associated with negative small bowel patency in Crohn's disease patients.

  18. Risk of primary biliary cirrhosis in patients with coeliac disease

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Thulstrup, Ane Marie; Blomqvist, P

    1999-01-01

    BACKGROUND: Several case reports, but only a few studies, have examined the coexistence of coeliac disease and primary biliary cirrhosis. AIM: To estimate the risk of primary biliary cirrhosis in two national cohorts of patients with coeliac disease in Denmark and Sweden. METHODS: Through record...... linkage all Danish patients hospitalised with coeliac disease were followed for possible occurrence of primary biliary cirrhosis from 1 January 1977 until 31 December 1992. All patients hospitalised with coeliac disease in Sweden from 1987 to 1996 were also followed in a separate analysis. RESULTS......: A total of 896 patients with coeliac disease were identified in Denmark with a median follow up period of 9.1 years for a total of 8040 person-years at risk. Two cases of primary biliary cirrhosis were observed where 0.07 were expected, giving a standardised incidence ratio of 27.6 (95% confidence...

  19. Survival Analysis of Patients with End Stage Renal Disease

    Science.gov (United States)

    Urrutia, J. D.; Gayo, W. S.; Bautista, L. A.; Baccay, E. B.

    2015-06-01

    This paper provides a survival analysis of End Stage Renal Disease (ESRD) under Kaplan-Meier Estimates and Weibull Distribution. The data were obtained from the records of V. L. MakabaliMemorial Hospital with respect to time t (patient's age), covariates such as developed secondary disease (Pulmonary Congestion and Cardiovascular Disease), gender, and the event of interest: the death of ESRD patients. Survival and hazard rates were estimated using NCSS for Weibull Distribution and SPSS for Kaplan-Meier Estimates. These lead to the same conclusion that hazard rate increases and survival rate decreases of ESRD patient diagnosed with Pulmonary Congestion, Cardiovascular Disease and both diseases with respect to time. It also shows that female patients have a greater risk of death compared to males. The probability risk was given the equation R = 1 — e-H(t) where e-H(t) is the survival function, H(t) the cumulative hazard function which was created using Cox-Regression.

  20. Increased incidence of Parkinson disease among relatives of patients with Gaucher disease.

    Science.gov (United States)

    Halperin, Assaf; Elstein, Deborah; Zimran, Ari

    2006-01-01

    In a previous study of 99 Ashkenazi Jewish patients with Parkinson disease from Israel who were tested for the six most common mutations for Gaucher disease, 31.3% had at least one Gaucher disease mutation, implying that carrier status per se my be a risk for Parkinson disease. The purpose of this survey was to ascertain the presence of Parkinson disease among Ashkenazi Jewish obligate carriers of Gaucher disease relative to its incidence in a comparable cohort of Ashkenazi Jews who are putatively non-carriers. There was no statistically significant difference in gender or age between the groups (n>100). Among patients, 27.3% reported having a relative with Parkinson disease while among the controls there was a reported 12.3% which was statistically significant (P=0.05). While based completely on subjective reports in a paper-base questionnaire, the results of this survey implicate a high rate of Parkinson disease among individuals with Gaucher disease mutations.

  1. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Lazović Biljana

    2013-01-01

    Full Text Available Introduction. Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. Material and Methods. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. Results. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36% low QRS (50% and p pulmonale (14.54%. Left axis deviation was observed in 27.27% patients. Conclusion. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  2. HIV disease. Psychosocial issues for patients and doctors.

    OpenAIRE

    Gibson, G.; Saunders, D. E.

    1994-01-01

    How a patient responds to a diagnosis of HIV disease depends on personality and coping skills learned throughout life. Health care professionals are seriously challenged to meet the psychosocial needs of HIV patients and their networks of partners, families, and friends. We find great satisfaction in being able to help these patients.

  3. Sentence Comprehension in Slovak-Speaking Patients with Alzheimer's Disease

    Science.gov (United States)

    Marková, Jana; Horváthová, Lubica; Králová, Mária; Cséfalvay, Zsolt

    2017-01-01

    Background: According to some studies, sentence comprehension is diminished in Alzheimer's disease (AD) patients, but they differ on what underlies the sentence comprehension impairment. Sentence comprehension in AD patients has been studied mainly in the English language. It is less clear how patients with AD speaking a morphologically rich…

  4. HIV disease. Psychosocial issues for patients and doctors.

    OpenAIRE

    Gibson, G.; Saunders, D. E.

    1994-01-01

    How a patient responds to a diagnosis of HIV disease depends on personality and coping skills learned throughout life. Health care professionals are seriously challenged to meet the psychosocial needs of HIV patients and their networks of partners, families, and friends. We find great satisfaction in being able to help these patients.

  5. Review article: hepatitis vaccination in patients with chronic liver disease.

    Science.gov (United States)

    Reiss, G; Keeffe, E B

    2004-04-01

    Evidence regarding the outcomes of viral super-infection in patients with chronic liver disease and practical strategies for hepatitis A and B vaccination of these individuals are reviewed. Patients with acute hepatitis A and chronic hepatitis B have a more severe clinical course and a higher death rate compared with otherwise healthy individuals with hepatitis A, and these differences are most pronounced in older patients and those with histological evidence of chronic hepatitis or cirrhosis, rather than in asymptomatic hepatitis B carriers. Patients with acute hepatitis A super-infection and chronic hepatitis C have an increased risk of fulminant hepatitis and death. In addition, patients with other chronic liver diseases also appear to be at increased risk for more severe disease with superimposed hepatitis A. Patients with chronic hepatitis B and hepatitis C virus co-infection have more severe laboratory abnormalities, more severe histological disease, a greater frequency of cirrhosis and complications of cirrhosis, and a higher incidence of hepatocellular carcinoma. Vaccines for both hepatitis A and B are safe and effective if used early in the course of chronic liver disease. Hepatitis A and B vaccination should be part of the routine management of patients with chronic liver disease, preferably as early as possible in the natural course of their disease.

  6. Nephrolithiasis in patients with inflammatory bowel disease in the community

    Directory of Open Access Journals (Sweden)

    Cury DB

    2013-07-01

    Full Text Available Dídia Bismara Cury,1,2 Alan C Moss,2 Nestor Schor3 1Scope Clinic, Campo Grande, Brazil; 2Center for Inflammatory Bowel Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 3Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil Background: Inflammatory bowel disease (IBD has been associated with renal stone formation. The objective of this study was to determine prospectively the prevalence of nephrolithiasis in a community-based population of patients with IBD and to analyze factors associated with renal calculus formation. Methods: Screening renal ultrasound was performed in a well characterized cohort of patients seen between 2009 and 2012 at an IBD clinic. We enrolled 168 patients, including 93 with Crohn’s disease and 75 with ulcerative colitis. Clinical and phenotypic variables associated with asymptomatic nephrolithiasis were determined. Results: Nephrolithiasis was detected in 36 patients with Crohn’s disease and in 28 patients with ulcerative colitis (38% for both. Although none of the patients had been previously hospitalized for symptomatic nephrolithiasis, nine with Crohn’s disease and five with ulcerative colitis had recurrent urinary tract infections or hydronephrosis. In patients with Crohn’s disease, ileocolonic (L3 disease was associated with a greater risk of nephrolithiasis than was ileal (L1 or colonic (L2 disease (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.8–7. Active ulcerative colitis (regardless of severity represented a significant risk factor for formation of renal calculi (OR 4.2, 95% CI 1.1–15, P = 0.02. Conclusion: In surgery-naïve patients with IBD in the community, asymptomatic nephrolithiasis is common and should be considered when renal dysfunction or infection is detected. Keywords: clinical activity indices, Crohn’s disease, inflammatory bowel disease, nephrolithiasis, ulcerative colitis

  7. Splenectomy for hematologic disease. The UCLA experience with 306 patients.

    Science.gov (United States)

    Musser, G; Lazar, G; Hocking, W; Busuttil, R W

    1984-07-01

    Between 1956 and 1981, 306 splenectomies for hematologic diseases were performed at the UCLA Medical Center. Of these operations, more than 75% were performed for therapeutic reasons to control anemia, thrombocytopenia, neutropenia, or painful symptoms of splenomegaly. Of the 65 patients who had idiopathic thrombocytopenic purpura, 77% showed an excellent response, and of the 39 patients who had hereditary spherocytosis, 90% responded. Other diseases with predictably good response rates were autoimmune hemolytic anemias, Felty's syndrome, and hairy cell leukemia. Forty patients with Hodgkin's disease had splenectomies for diagnostic purposes the last 10 years. The overall morbidity and mortality were 24% and 6%, respectively, the most common complications being pneumonia, wound infections, and local postoperative bleeding, and the most common cause of death being sepsis. The review supports the thesis that in carefully selected patients, therapeutic splenectomy can have desirable palliative effects and that diagnostic splenectomy has a sufficiently low risk to warrant its consideration in patients with Hodgkin's disease.

  8. Coronary artery disease in patients with chronic kidney disease: a brief literature review

    Directory of Open Access Journals (Sweden)

    Mostafa Dastani

    2015-09-01

    Full Text Available Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication among patients with chronic kidney disease and end-stage renal disease before the renal replacement therapy. Due to the strong association between chronic kidney disease and the incidence of coronary artery disease, accurate screening, diagnosis, and management of cardiovascular complications would be essential in patients at different stages of renal dysfunction. Despite the need for the comprehensive knowledge about different aspects of coronary artery disease in patients with renal failure, there is not sufficient evidence regarding the pathophysiology, ideal diagnosis, and treatment strategies for coronary heart disease in population with chronic kidney disease. In this study, we briefly reviewed the existing literatures about the possible screening, diagnosis, and the treatment approaches of risk of coronary heart disease in patients with kidney dysfunction.

  9. Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease

    NARCIS (Netherlands)

    Brouwer, Beate G.; Visseren, Frank L. J.; Stolk, Ronald P.; van der Graaf, Yolanda

    2007-01-01

    Objective: We investigated whether the presence of concomitant coronary heart disease (CHD) in patients with peripheral arterial disease (PAD) can be explained by intra-abdominal fat accumulation and compared different measures of adiposity as predictors of CHD in patients with PAD. Research Methods

  10. Poikilocapnic hypoxic ventilatory response in humans during 0.85 MAC isoflurane anesthesia.

    Science.gov (United States)

    Sjögren, D; Sollevi, A; Ebberyd, A; Lindahl, S G

    1994-02-01

    Ventilatory responses to hypoxia (HVR) were investigated using poikilocapnic conditions (i.e. end-tidal CO2's allowed to seek it's own level) in 15 cardio-pulmonary healthy patients who were first studied awake and then at 0.85 MAC isoflurane. The influence of hypercapnia (HyperCapnic Ventilatory Response, HCVR) was also elucidated. Pneumotachography, capnography and airway occlusion pressures at 0.1 s (P degree 0.1) were used before and during both mild hypoxia (end-tidal O2 tension 8.7 kPa) and hypercapnia achieved by an inspired CO2 concentration of 5%. HCVR was attenuated by 60% during anesthesia (P awake state, five of the 15 patients decreased HVR during hypoxia as compared with during normoxia. This resulted in a VE that on average increased by 0.6 l.min-1 (P MAC isoflurane.

  11. Clostridium difficile infection in a patient with Crohn disease.

    Science.gov (United States)

    Hsu, Chien-Hui; Jeng, Yung-Ming; Ni, Yen-Hsuan

    2012-06-01

    Crohn disease is a chronic inflammatory disorder, which is rare in pediatric patients. The definite etiology and mechanism to induce an acute exacerbation of Crohn disease remains mostly unknown. The authors report on a 14-year-old girl with Crohn disease who has acute gastrointestinal symptoms caused by toxin A-producing Clostridium difficile, which mimicked a flare-up of Crohn disease. There was no preceding antibiotic prescription before the episode. The disease activity did not improve after steroid treatment, which is unusual for Crohn disease. However, all symptoms were dramatically relieved after eradication of C difficile, and led to a symptom-free period for more than 3 years. This case report aims to address the unusual presentation of a usual pathogen, C difficile, in a pediatric patient with Crohn disease.

  12. Functional assesment of patients with AIDS disease

    Directory of Open Access Journals (Sweden)

    Marise Bueno Zonta

    2003-10-01

    Full Text Available We documented the types and degree of functional disability in 74 patients with AIDS at the Hospital de Clínicas of the Federal University of Paraná, Brazil. Few of these patients are referred for rehabilitation services and there is only a limited team approach in their care. We found that 91% of the patients had some degree of functional impairment; in 81% the complaint was weakness and in 47% it was neurological involvement. According to the Barthel Index, 79% were considered functionally independent, 14% partially dependent and 7% dependent. For most of them, independence requires effort and their quality of life is reduced. Severe disability was rather unusual, while mild or moderate disability levels were not. The functional physical disability found in 21% of the patients required management by a rehabilitation team. We conclude that it is important to focus attention on the quality of life of patients with AIDS.

  13. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study

    Directory of Open Access Journals (Sweden)

    Kultigin Turkmen

    2016-12-01

    Full Text Available Background/Aims: Fabry disease is a treatable cause of chronic kidney disease (CKD characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. Methods: This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Results: Three (all males of 313 CKD patients (0.95% were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%, tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%, heat intolerance (71%, and abdominal pain (57%. The most frequent manifestations in female patients were fatigue and cornea verticillata (50%, and tinnitus, vertigo and angiokeratoma (25%. Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. Conclusions: The prevalence of Fabry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin.

  14. Cardiovascular disease in patients with end-stage renal disease on hemodialysis in a developing country

    Directory of Open Access Journals (Sweden)

    Leila S. V. Silva

    2012-01-01

    Full Text Available Cardiovascular disease is the main cause of death among patients with end-stage renal disease (ESRD. The present study was undertaken to identify the main cardiovascular diseases and their risk factors in 160 patients with ESRD on hemodialysis (HD in Brazil. Their mean age was 47 ± 39 years. The main risk factors for cardiovascular diseases were arterial hypertension (89.4%, dyslipidemia (78.3%, low high-density lipoprotein levels (84.2% and low physical activity (64.1%. Family history of coronary insufficiency and high low-density lipoprotein levels were significantly associated with coronary artery disease (P = 0.005 and P = 0.029, respectively. Sedentary life style, diabetes mellitus, secondary hyperparathyroidism and hyperglycemia also showed a significant association with the underlying vascular disease (P = 0.017, P = 0.039, P = 0.037 and P = 0.030, respectively. Hypercalcemia, hypertension and black race were factors significantly associated with left ventricular systolic dysfunction (P = 0.01, P = 0.0013 and P = 0.024, respectively. Our study shows that the most prevalent cardiovascular diseases in patients with ESRD were left ventricular hypertrophy, atherosclerotic disease, valvular disease and coronary artery disease. Hypertension and dyslipidemia were the common risk factors associated with cardiovascular diseases. The present study was undertaken to identify the main cardiovascular diseases and their risk factors in 160 patients with ESRD on HD in a single center in Brazil.

  15. Development of Hodgkin's disease in a patient with leprosy.

    Science.gov (United States)

    Weshler, Z; Leviatan, A; Gordon, R; Kopolovic, J

    1978-01-01

    We present a patient with leprosy who developed Hodgkin's disease of the nodular sclerosing type. There are two previous reports describing the combination of leprosy and Hodgkin's disease in a single patient [3, 9]. Hodgkin's disease was diagnosed 14 months after the complete disappearance of mycobacterium leprae from the skin lesions, under treatment with DDS (diamino-diphenyl-sulfone). Hodgkin's disease was treated by irradiation and chemotherapy. Obstructive jaundice developed which resolved under treatment by irradiation of the hilar area of the liver, chemotherapy and hormones. During two years of immuno-suppressive therapy, without DDS, no exacerbation of the leprosy occurred.

  16. Budesonide in the management of patients with Crohn's disease.

    Science.gov (United States)

    Thomson, A B; Sadowski, D; Jenkins, R; Wild, G

    1997-04-01

    Modern medical therapy is increasingly based on evidence. The evidence presented here is that budesonide (Entocort, Astra Pharma) 9 mg/day is superior to placebo and equivalent to systemically active glucocorticosteroids in achieving disease remission in patients with active Crohn's disease, and in prolonging the recurrence time of symptomatic disease. Budesonide causes less disturbance to adrenal function than prednisone or prednisolone and may cause fewer steroid-associated symptoms. Thus, budesonide is the safer, more effective steroid of choice to treat patients with Crohn's disease.

  17. Evaluation of malnutrition in patients with nervous system disease.

    Science.gov (United States)

    Li, Feng; Liu, Yao-wen; Wang, Xue-feng; Liu, Guang-wei

    2014-10-01

    Nutritional deficiencies are independent risk factors for adverse outcomes in patients with nervous system disease. Patients with nervous system disease can often become malnourished due to swallowing difficulties or unconsciousness. This malnourishment increases hospitalization duration; average total hospital cost; occurrence of infection, pressure ulcers, and other complications. These problems need to be addressed in the clinic. In this paper, we review the relevant literature, including studies on influencing factors, evaluations, indexes, and methods: Our aim is to understand the current status of malnutrition in patients with nervous system disease and reasons associated with nutritional deficiencies by using malnutrition evaluation methods to assess the risk of nutritional deficiencies in the early stages.

  18. Subjective experience of the disease in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Bertha Kaliksztein Fihman

    2001-06-01

    Full Text Available This descriptive investigation explores experimentation of the disease in 15 schizophrenic patients from the perspective of the patients themselves through semistructured interviews. The most significan! testimonies were the attribution of the disease to a lack of orientation from the parents, the perception of difficulties in learning and attention abilities in class and the scarce and conflictive interpersonal relationships. Having an occupation, psychological support and stability in their Ji ves were mentioned as aspects that contribute to significan! improvement. Feelings like fear, depression, lack of peace among others are inherent aspects of the disease. In our opinion listening to the patient helps to better understand the experiencing of schizophrenia.

  19. [Blood pressure control in patient with chronic kidney disease].

    Science.gov (United States)

    Halimi, J-M

    2014-06-01

    Several epidemiological studies have indicated that high blood pressure is associated with deterioration of renal function in patients with renal disease. Target blood pressures in patients with renal diseases have been defined and proposed to the community in several national and international guidelines. However, some of these targets have been recently changed to take into account results of studies, including randomized clinical trials. The aim of this paper is to put into perspective the history of ideas regarding adequate blood pressure control in patients with renal disease in the light of these results, and explain how these trials have changed our perception, practice and guidelines. Copyright © 2014. Published by Elsevier SAS.

  20. A case of phrynoderma in a patient with Crohn's disease.

    Science.gov (United States)

    Cobos, Gabriela; Cornejo, Christine; McMahon, Patrick

    2015-01-01

    Phrynoderma is a type of follicular hyperkeratosis associated with nutritional deficiencies. It is rarely seen in developed countries, although cases have been reported in patients with severe malnutrition or malabsorption secondary to various causes. This report describes a 19-year-old patient with poorly controlled Crohn's disease and malnutrition who developed the characteristic hyperkeratotic papules and plaques on his trunk and extremities in the setting of low serum vitamin A levels. To our knowledge, there are no reports of phrynoderma associated with Crohn's disease. It is likely that our patient's low vitamin A level and subsequent phrynoderma was the result of increased Crohn's disease activity and malnutrition.

  1. The relationship between different information sources and disease-related patient knowledge and anxiety in patients with inflammatory bowel disease.

    Science.gov (United States)

    Selinger, C P; Carbery, I; Warren, V; Rehman, A F; Williams, C J; Mumtaz, S; Bholah, H; Sood, R; Gracie, D J; Hamlin, P J; Ford, A C

    2017-01-01

    Patient education forms a cornerstone of management of inflammatory bowel disease (IBD). The Internet has opened new avenues for information gathering. To determine the relationship between different information sources and patient knowledge and anxiety in patients with IBD. The use of information sources in patients with IBD was examined via questionnaire. Anxiety was assessed with the hospital anxiety and depression scale and disease-related patient knowledge with the Crohn's and colitis knowledge score questionnaires. Associations between these outcomes and demographics, disease-related factors, and use of different information sources were analysed using linear regression analysis. Of 307 patients (165 Crohn's disease, 142 ulcerative colitis) 60.6% were female. Participants used the hospital IBD team (82.3%), official leaflets (59.5%), and official websites (53.5%) most frequently in contrast to alternative health websites (9%). University education (P information websites (P = 0.005) were associated with higher disease-related patient knowledge. Female sex (P = 0.004), clinically active disease (P information sources are associated with better knowledge or worse anxiety levels. Face-to-face education and written information materials remain the first line of patient education. Patients should be guided towards official information websites and warned about the association between the use of alternative health websites or random links and anxiety. © 2016 John Wiley & Sons Ltd.

  2. Increased NMDA receptor inhibition at an increased Sevoflurane MAC

    Directory of Open Access Journals (Sweden)

    Brosnan Robert J

    2012-06-01

    Full Text Available Abstract Background Sevoflurane potently enhances glycine receptor currents and more modestly decreases NMDA receptor currents, each of which may contribute to immobility. This modest NMDA receptor antagonism by sevoflurane at a minimum alveolar concentration (MAC could be reciprocally related to large potentiation of other inhibitory ion channels. If so, then reduced glycine receptor potency should increase NMDA receptor antagonism by sevoflurane at MAC. Methods Indwelling lumbar subarachnoid catheters were surgically placed in 14 anesthetized rats. Rats were anesthetized with sevoflurane the next day, and a pre-infusion sevoflurane MAC was measured in duplicate using a tail clamp method. Artificial CSF (aCSF containing either 0 or 4 mg/mL strychnine was then infused intrathecally at 4 μL/min, and the post-infusion baseline sevoflurane MAC was measured. Finally, aCSF containing strychnine (either 0 or 4 mg/mL plus 0.4 mg/mL dizocilpine (MK-801 was administered intrathecally at 4 μL/min, and the post-dizocilpine sevoflurane MAC was measured. Results Pre-infusion sevoflurane MAC was 2.26%. Intrathecal aCSF alone did not affect MAC, but intrathecal strychnine significantly increased sevoflurane requirement. Addition of dizocilpine significantly decreased MAC in all rats, but this decrease was two times larger in rats without intrathecal strychnine compared to rats with intrathecal strychnine, a statistically significant (P  Conclusions Glycine receptor antagonism increases NMDA receptor antagonism by sevoflurane at MAC. The magnitude of anesthetic effects on a given ion channel may therefore depend on the magnitude of its effects on other receptors that modulate neuronal excitability.

  3. Increased NMDA receptor inhibition at an increased Sevoflurane MAC.

    Science.gov (United States)

    Brosnan, Robert J; Thiesen, Roberto

    2012-06-06

    Sevoflurane potently enhances glycine receptor currents and more modestly decreases NMDA receptor currents, each of which may contribute to immobility. This modest NMDA receptor antagonism by sevoflurane at a minimum alveolar concentration (MAC) could be reciprocally related to large potentiation of other inhibitory ion channels. If so, then reduced glycine receptor potency should increase NMDA receptor antagonism by sevoflurane at MAC. Indwelling lumbar subarachnoid catheters were surgically placed in 14 anesthetized rats. Rats were anesthetized with sevoflurane the next day, and a pre-infusion sevoflurane MAC was measured in duplicate using a tail clamp method. Artificial CSF (aCSF) containing either 0 or 4 mg/mL strychnine was then infused intrathecally at 4 μL/min, and the post-infusion baseline sevoflurane MAC was measured. Finally, aCSF containing strychnine (either 0 or 4 mg/mL) plus 0.4 mg/mL dizocilpine (MK-801) was administered intrathecally at 4 μL/min, and the post-dizocilpine sevoflurane MAC was measured. Pre-infusion sevoflurane MAC was 2.26%. Intrathecal aCSF alone did not affect MAC, but intrathecal strychnine significantly increased sevoflurane requirement. Addition of dizocilpine significantly decreased MAC in all rats, but this decrease was two times larger in rats without intrathecal strychnine compared to rats with intrathecal strychnine, a statistically significant (P MAC. The magnitude of anesthetic effects on a given ion channel may therefore depend on the magnitude of its effects on other receptors that modulate neuronal excitability.

  4. What do Patients with Alopecia Areata Think About Their Diseases?

    Directory of Open Access Journals (Sweden)

    Müzeyyen Gönül

    2013-12-01

    Full Text Available Objective: Alopecia areata (AA is a non-scarring disorder characterized by sudden loss of hairs. There is only one study that investigated the concepts of AA patients about their diseases. In this study self concepts about the causes and course of their disorder and their learning sources were asked to AA patients. Methods: 51 AA patients were enrolled to the study. The causes and the exacerbating factors of their disorders, how they have been directed to dermatology section, their concepts about the course of the disease and information sources were asked to the patients. Results: 30 of AA patients were male 21 were female. The ages of the patients varied between 15 and 63 years. While 49% of the patients accused stress as the cause, 18% was worried that it was a possible sign of cancer. 63% patients thought that stress played a role in exacerbating their disease. 60% of the patients thought that AA might improve completely but 16% did not have hope of improvement. While 39% patients received information from dermatologist, 28% did not investigate their disorder. The patients' answers to the questionaire were not different according to sex, education status, family history of the patients, recurrence of the disorder and if there was associated diseases but it was found significant that as the ages of the patients increased they more frequently thought that stress might be the possible exacerbating factor. Conclusion: AA patients blamed stress as the inducing and exacerbating factor of the disorder. However, as about 1/5 patients had worry of cancer and important rate of them had inadequate information about their disorder, dermatologists should give more information to the patients. Also listening and reducing the concern of the patients may positively effect the treatment.

  5. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases

    Directory of Open Access Journals (Sweden)

    Peninnah Oberdorfer

    2009-01-01

    Full Text Available Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs. NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1 the incidence of NIs, (2 sites of NIs, (3 causal organisms, and (4 outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were admitted to the Chiang Mai University Hospital, Thailand. Results. A total of 707 pediatric patients with neoplastic diseases were admitted. Forty-six episodes of NIs in 30 patients were reported (6.5 NIs/100 admission episodes and 7 NIs/1000 days of hospitalization. Patients with acute lymphoblastic leukemia had the highest number of NIs (41.3%. The most common causal organisms were gram-negative bacteria (47.1%. Patients who had undergone invasive procedures were more likely to develop NIs than those who had not (P<.05. The mortality rate of patients with NIs was 19.6%. Conclusion. Pediatric patients with neoplastic diseases are more likely to develop NIs after having undergone invasive procedures. Pediatricians should be aware of this and strictly follow infection control guidelines in order to reduce morbidity and mortality rates related to NIs.

  6. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases.

    Science.gov (United States)

    Oberdorfer, Peninnah; Pongwilairat, Natthida; Washington, Charles H

    2009-01-01

    Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs). NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1) the incidence of NIs, (2) sites of NIs, (3) causal organisms, and (4) outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were admitted to the Chiang Mai University Hospital, Thailand. Results. A total of 707 pediatric patients with neoplastic diseases were admitted. Forty-six episodes of NIs in 30 patients were reported (6.5 NIs/100 admission episodes and 7 NIs/1000 days of hospitalization). Patients with acute lymphoblastic leukemia had the highest number of NIs (41.3%). The most common causal organisms were gram-negative bacteria (47.1%). Patients who had undergone invasive procedures were more likely to develop NIs than those who had not (P < .05). The mortality rate of patients with NIs was 19.6%. Conclusion. Pediatric patients with neoplastic diseases are more likely to develop NIs after having undergone invasive procedures. Pediatricians should be aware of this and strictly follow infection control guidelines in order to reduce morbidity and mortality rates related to NIs.

  7. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Vind, Ida; Johansen, J S; Price, P A;

    2003-01-01

    BACKGROUND: YKL-40 is secreted by macrophages and neutrophils and is a growth factor for vascular endothelial cells and fibroblasts. Elevated serum concentrations of YKL-40 are found in patients with diseases characterized by inflammation or ongoing fibrosis. The aim of this study was to seek...... association between serum YKL-40 in patients with ulcerative colitis (UC) and Crohn disease (CD) and clinical disease activity. METHODS: One-hundred-and-sixty-four patients with UC and 173 patients with CD were studied. The Simple Clinical Colitis Activity Index (SCCAI) and the Harvey-Bradshaw (H-B) score...

  8. [Pregnancy in patients with underlying renal disease].

    Science.gov (United States)

    Golshayan, D; Mathieu, C; Burnier, M

    2007-03-07

    Pregnancy has generally been regarded as very high risk in women with chronic renal insufficiency. In this review, we describe the physiologic changes in systemic and renal haemodynamics during pregnancy, as well as the nature and severity of possible maternal and foetal complications in the setting of underlying renal disease. The risks are proportional to the degree of functional renal impairment, the presence or not of proteinuria and/or arterial hypertension at the time of conception, and are related to the type of underlying nephropathy or systemic disease in the mother. Furthermore, if the renal disease has been diagnosed before pregnancy, a better planning of the moment of conception, as well as a tight follow-up, allow for a better maternal and obstetrical outcome.

  9. Nonmotor symptoms in patients suffering from motor neuron diseases

    Directory of Open Access Journals (Sweden)

    Rene Günther

    2016-07-01

    Full Text Available Background: The recently postulated disease spreading hypothesis has gained much attention, especially for Parkinson’s disease (PD. The various nonmotor symptoms (NMS in neurodegenerative diseases would be much better explained by this hypothesis than by the degeneration of disease-specific cell populations. Motor neuron disease (MND is primarily known as a group of diseases with a selective loss of motor function. Recent evidence, however, suggests disease spreading into nonmotor brain regions also in MND. The aim of this study was to comprehensively detect NMS in patients suffering from MND.Methods: We used a self-rating questionnaire including 30 different items of gastrointestinal, autonomic, neuropsychiatric and sleep complaints (NMSQuest which is an established tool in PD patients. 90 MND patients were included and compared to 96 controls.Results: In total, MND patients reported significantly higher NMS scores (median: 7 points in comparison to controls (median: 4 points. Dribbling, impaired taste/smelling, impaired swallowing, weight loss, loss of interest, sad/blues, falling and insomnia were significantly more prevalent in MND patients compared to controls. Interestingly excessive sweating was more reported in the MND group. Correlation analysis revealed an increase of total NMS score with disease progression.Conclusions: NMS in MND patients seemed to increase with disease progression which would fit with the recently postulated disease spreading hypothesis. The total NMS score in the MND group significantly exceeded the score for the control group, but only 8 of the 30 single complaints of the NMSQuest were significantly more often reported by MND patients. Dribbling, impaired swallowing, weight loss and falling could primarily be connected to motor neuron degeneration and declared as motor symptoms in MND.

  10. Clinical Analysis of Algerian Patients with Pompe Disease

    Science.gov (United States)

    Medjroubi, M.; Froissart, R.; Taghane, N.; Sifi, K.; Benhabiles, A.; Lemai, S.; Semra, S.; Benmekhebi, H.; Bouderda, Z.; Abadi, N.; Hamri, A.

    2017-01-01

    Pompe's disease is a metabolic myopathy caused by a deficiency of acid alpha-glucosidase (GAA), also called acid maltase, an enzyme that degrades lysosomal glycogen. The clinical presentation of Pompe's disease is variable with respect to the age of onset and rate of disease progression. Patients with onset of symptoms in early infancy (infantile-onset Pompe disease (IOPD)) typically exhibit rapidly progressive hypertrophic cardiomyopathy and marked muscle weakness. Most of them die within the first year of life from cardiac and/or respiratory failure. In the majority of cases of Pompe's disease, onset of symptoms occurs after infancy, ranging widely from the first to sixth decade of life (late-onset Pompe's disease or LOPD). Progression of the disease is relentless and patients eventually progress to loss of ambulation and death due to respiratory failure. The objective of this study was to characterize the clinical presentation of 6 patients (3 with EOPD and the other 3 with LOPD) of 5 families from the East of Algeria. All our patients were diagnosed as having Pompe's disease based on biochemical confirmations of GAA deficiency by dried blood spots (DBS) and GAA gene mutations were analyzed in all patients who consented (n = 4). Our results are similar to other ethnic groups. PMID:28265479

  11. Elective Thoracolumbar Spine Fusion Surgery in Patients with Parkinson Disease.

    Science.gov (United States)

    Puvanesarajah, Varun; Jain, Amit; Qureshi, Rabia; Carstensen, S Evan; Tyger, Rosemarie; Hassanzadeh, Hamid

    2016-12-01

    Few data are available concerning clinical outcomes in patients with Parkinson disease who undergo elective thoracolumbar spine fusion surgery. The goal of this study is to elucidate complication and revision rates after posterior thoracolumbar fusion surgery in patients with Parkinson disease, with a focus on how Parkinson disease modifies these rates. The PearlDiver database (2005-2012) was queried for patients who underwent posterior approach thoracolumbar fusion from 2006 to 2011. Cohorts of patients with a previous diagnosis of Parkinson disease (n = 4816) and without (n = 280,702) were compared. Multivariate analysis that included various comorbidities and demographics was used to calculate effects of Parkinson disease on development of postoperative infection and major medical complications within 90 days and revision surgery within 1 year. For analyses, significance was set at P Parkinson disease was significantly associated with an increased risk for medical complications (adjusted odds ratio, 1.22; 95% confidence interval, 1.11-1.34; P Parkinson disease are more likely to require revision surgery and have higher rates of adverse medical events postoperatively. Patients with Parkinson disease should be appropriately selected to ensure favorable clinical outcomes. Copyright © 2016. Published by Elsevier Inc.

  12. Clinical Analysis of Algerian Patients with Pompe Disease

    Directory of Open Access Journals (Sweden)

    Y. Sifi

    2017-01-01

    Full Text Available Pompe’s disease is a metabolic myopathy caused by a deficiency of acid alpha-glucosidase (GAA, also called acid maltase, an enzyme that degrades lysosomal glycogen. The clinical presentation of Pompe’s disease is variable with respect to the age of onset and rate of disease progression. Patients with onset of symptoms in early infancy (infantile-onset Pompe disease (IOPD typically exhibit rapidly progressive hypertrophic cardiomyopathy and marked muscle weakness. Most of them die within the first year of life from cardiac and/or respiratory failure. In the majority of cases of Pompe’s disease, onset of symptoms occurs after infancy, ranging widely from the first to sixth decade of life (late-onset Pompe’s disease or LOPD. Progression of the disease is relentless and patients eventually progress to loss of ambulation and death due to respiratory failure. The objective of this study was to characterize the clinical presentation of 6 patients (3 with EOPD and the other 3 with LOPD of 5 families from the East of Algeria. All our patients were diagnosed as having Pompe’s disease based on biochemical confirmations of GAA deficiency by dried blood spots (DBS and GAA gene mutations were analyzed in all patients who consented (n=4. Our results are similar to other ethnic groups.

  13. Chronic Inflammatory Periodontal Disease in Patients with Human Immunodeficiency Virus.

    Directory of Open Access Journals (Sweden)

    Vania López Rodríguez

    2009-07-01

    Full Text Available Background: The Chronic Inflammatory Periodontal Disease is related with multiple risk factors. Those patients with human immunodeficiency virus have higher risk of presenting this disease and it is usually more serious in these cases. Objective: To describe the prevalence of Chronic Inflammatory Periodontal Disease in patients with HIV. Methods: Descriptive, observational, cross-sectional study including patients with HIV in Sancti Spiritus province. The occurrence of the disease was determined after the Periodontics Cuban Standards, and oral hygiene was assessed through the simplified oral hygiene index. Other variables were measured, such as smoking habits, T CD4+ lymphocyte counting and virus load. The independent association of each risk factor with the disease was determined through a logistic regression model. Results: The 56, 5 % of the 154 patients presented Chronic Inflammatory Periodontal Disease; 60 (39.0% gingivitis and 27 (17,5% periodontitis. Gingivitis was associated with poor oral hygiene (OR: 3,71 and periodontitis with smoking habit (OR: 5,20. The severe forms of periodontitis occurred mainly in patients with lymphocyte counting lower than 500 cells/mm3 . Conclusions: The prevalence of Chronic Inflammatory Periodontal Disease in patients with HIV in Sancti Spiritus province is linked to known risk factors such as smoking habits and oral hygiene.

  14. Thyroid gland diseases in adult patients with diabetes mellitus.

    Science.gov (United States)

    Vondra, K; Vrbikova, J; Dvorakova, K

    2005-12-01

    This review concerns the relation between most frequent thyroid gland diseases and diabetes mellitus in adult patients. Special attention is paid to autoimmune thyroiditis, Graves' disease, thyroid autoimmunity in pregnant diabetic women, and iodine metabolism. We focused on mechanisms leading to coexistence of both endocrine disorders, and on distinctions in the prevalence, diagnosis, clinical course and treatment of thyroid diseases in diabetic patients. The prevalence of thyroid diseases in diabetic patients is 2-3 times higher than in nondiabetic subjects; it raises with age, and is strongly influenced by female gender and autoimmune diabetes. Clinical relevance of thyroid diseases, especially in diabetic patients, significantly increases if it is associated with deteriorated function, which always cause a number problems with metabolic compensation of diabetes. Most serious consequences are increased frequency of hypoglycaemia in hypothyroidism and development of potentially life-threatening ketoacidosis in thyrotoxicosis. In spite of that, little attention is paid to the diagnosis of thyroid diseases in diabetics, as they are diagnosed in only about half of the patients. At the end, we provide recommendations for the thyroid disease screening and diagnosis in patients with diabetes mellitus based on our experience.

  15. Multichannel MAC Layer In Mobile Ad—Hoc Network

    Science.gov (United States)

    Logesh, K.; Rao, Samba Siva

    2010-11-01

    This paper we presented the design objectives and technical challenges in Multichannel MAC protocols in Mobile Ad-hoc Network. In IEEE 802.11 a/b/g standards allow use of multiple channels, only a single channel is popularly used, due to the lack of efficient protocols that enable use of Multiple Channels. Even though complex environments in ad hoc networks require a combined control of physical (PHY) and medium access control (MAC) layers resources in order to optimize performance. And also we discuss the characteristics of cross-layer frame and give a multichannel MAC approach.

  16. MacRuby Ruby and Cocoa on OS X

    CERN Document Server

    Aimonetti, Matt

    2011-01-01

    Want to build native Mac OS X applications with a sleek, developer-friendly alternative to Objective-C? MacRuby is an ideal choice. This in-depth guide shows you how Apple's implementation of Ruby gives you access to all the features available to Objective-C programmers. You'll get clear, detailed explanations of MacRuby, including quick programming techniques such as prototyping. Perfect for programmers at any level, this book is packed with code samples and complete project examples. If you use Ruby, you can tap your skills to take advantage of Interface Builder, Cocoa libraries, the Objec

  17. Handling Deafness Problem of Scheduled Multi-Channel Polling MACs

    Science.gov (United States)

    Jiang, Fulong; Liu, Hao; Shi, Longxing

    Combining scheduled channel polling with channel diversity is a promising way for a MAC protocol to achieve high energy efficiency and performance under both light and heavy traffic conditions. However, the deafness problem may cancel out the benefit of channel diversity. In this paper, we first investigate the deafness problem of scheduled multi-channel polling MACs with experiments. Then we propose and evaluate two schemes to handle the deafness problem. Our experiment shows that deafness is a significant reason for performance degradation in scheduled multi-channel polling MACs. A proper scheme should be chosen depending on the traffic pattern and the design objective.

  18. Cooperative energy harvesting-adaptive MAC protocol for WBANs.

    Science.gov (United States)

    Esteves, Volker; Antonopoulos, Angelos; Kartsakli, Elli; Puig-Vidal, Manel; Miribel-Català, Pere; Verikoukis, Christos

    2015-05-28

    In this paper, we introduce a cooperative medium access control (MAC) protocol, named cooperative energy harvesting (CEH)-MAC, that adapts its operation to the energy harvesting (EH) conditions in wireless body area networks (WBANs). In particular, the proposed protocol exploits the EH information in order to set an idle time that allows the relay nodes to charge their batteries and complete the cooperation phase successfully. Extensive simulations have shown that CEH-MAC significantly improves the network performance in terms of throughput, delay and energy efficiency compared to the cooperative operation of the baseline IEEE 802.15.6 standard.

  19. A Hybrid MacCormack-type Scheme for Computational Aeroacoustics

    Science.gov (United States)

    Yazdani, Soroush

    A new type of MacCormack scheme, using a modified Low Dissipation and Dispersion Runge-Kutta time marching method, is presented. This scheme is using two stages in every step which implements biased spatial differencing stencils and for the remaining stages uses non-dissipative central differencing stencils. Because of using the MacCormack-type scheme in this method, the new scheme carries an inherent artificial dissipation which uses the ease of implementing boundary condition specifications of a two-stage MacCormack scheme.

  20. iMac G3 Blueberry 350MHz

    CERN Multimedia

    2000-01-01

    The iMac G3 is an all-in-one personal computer, encompassing both the monitor and the computer in one package. It allowed to revitalize the Apple brand that was in decline and close to financial ruin. Originally released in striking bondi blue and later a range of other translucent plastic envelopes in bright colors. The iMac comes with a keyboard and mouse matching the color of the case. The iMac G3 was sold from 1998 to 2003 and has been updated many times.

  1. Micronutrients in Chilean Inflammatory Bowel Disease patients: Crosssectional study

    Directory of Open Access Journals (Sweden)

    Patricio Ibáñez

    2017-01-01

    Full Text Available Background Inflammatory Bowel Disease (IBD patients often present with nutritional disorders that affect both macronutrient and micronutrient levels. Vitamin and mineral deficiencies are typically more frequent in Crohn's disease (CD patients than other IBD patients. However, some studies have shown that these deficiencies can also be present in ulcerative colitis (UC patients, even in those in remission. Aims To describe the prevalence of micronutrient deficiencies in patients diagnosed with IBD and to correlate these micronutrient deficiencies with demographic, clinical and disease characteristics. Methods A cross-sectional study of patients in the IBD program who were 18 years and older was completed. Clinical characteristics and disease activity indexes were assessed. Body Mass Index (BMI, haematocrit, serum albumin, serum iron profile, serum 25(OH D, vitamin B12, folate, zinc and copper were measured. Results Ninety-one patients with IBD were included: 46 patients (50.5 per cent with UC and 45 patients (49.5 per cent with CD. At least one micronutrient deficiency was found in 39.5 per cent of patients, 35.1 per cent had two deficiencies, and 12 per cent had three or more deficiencies. Iron, zinc, copper, and vitamin B12 deficiencies were found in 33 per cent, 22 per cent, 11 per cent and 10 per cent of patients, respectively. No folate deficiencies were found. Low levels of serum 25(OH D were detected in 76 per cent of patients. The mean BMI was 24.3 (SD 3.4, and the mean serum albumin level was 4.0g/l (SD 0.4. Conclusion Micronutrient deficiencies were frequent in our study cohort and did not correlate with macronutrient status. Measurement of macronutrients and micronutrients should become a routine assessment in IBD patients to improve patient care and to avoid negative repercussions on disease activity

  2. PREVALENCE OF CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Hiranya Kumar Saharia

    2016-07-01

    Full Text Available BACKGROUND Heart disease is a growing problem, particularly in developing countries. India has quoted to have 12.2% and 12% prevalence of coronary artery disease and rheumatic valvular heart disease respectively. Some older reports suggest that rheumatic fever, in addition to producing specific injuries to small coronary arterial branches may accelerate the development of coronary atherosclerosis. AIM To assess the prevalence of Coronary Artery disease in patients with Valvular Heart disease in some selected hospitals of Guwahati, Assam. SETTING AND DESIGN It was conducted in Gauhati Medical College and Hospital and Hayat Hospital, Guwahati. Explorative approach, survey design was selected for the study. MATERIALS AND METHODS Purposive sampling technique was used to select 126 patients who were diagnosed with valvular heart disease. Data was collected through a self-structured interview scheduled on prevalence of coronary artery disease. RESULTS Of the total 126 patients of valvular heart disease, 108 (85.71% cases were rheumatic valvular heart disease and 18 (14.29% were non-rheumatic valvular heart disease. Majority (56.34% of cases with CAD and RHD were in the range of 45 to 54 years. The prevalence of typical angina was significantly high among men (41.18%. Most of the rheumatic patients (72.22% did not complain about angina. Diabetes mellitus, hypertension and dyslipidaemia are significantly high among non-rheumatic group and Coronary artery disease group. In our study, the overall prevalence of significant coronary artery disease in patients with valvular heart disease was 14.28%. CONCLUSION Coronary artery disease prevalence is very high in this part of the country. Health professionals should actively participate in health promotion activities, apply the findings of the study to identify high risk individuals and prevent the occurrence of coronary artery disease.

  3. Transvascular lipoprotein transport in patients with chronic renal disease

    DEFF Research Database (Denmark)

    Jensen, Trine Krogsgaard; Nordestgaard, Børge Grønne; Feldt-Rasmussen, Bo

    2004-01-01

    BACKGROUND: While increased plasma cholesterol is a well-established cardiovascular risk factor in the general population, this is not so among patients with chronic renal disease. We hypothesized that the transvascular lipoprotein transport, in addition to the lipoprotein concentration in plasma......: Transvascular LDL transport may be increased in diabetic patients with chronic renal disease, suggesting that lipoprotein flux into the arterial wall is increased. A similar mechanism does not operate in nondiabetic patients with chronic renal disease.......BACKGROUND: While increased plasma cholesterol is a well-established cardiovascular risk factor in the general population, this is not so among patients with chronic renal disease. We hypothesized that the transvascular lipoprotein transport, in addition to the lipoprotein concentration in plasma......, determines the degree of atherosclerosis among patients with chronic renal disease. METHODS: We used an in vivo method for measurement of transvascular transport of low-density lipoprotein (LDL) in 21 patients with chronic renal disease and in 42 healthy control patients. Autologous 131-iodinated LDL...

  4. Knowledge, Beliefs and Attitudes of Psoriasis Patients About the Disease

    Directory of Open Access Journals (Sweden)

    Aslı Küçükünal

    2013-05-01

    Full Text Available Background and Design: This study evaluates the patients’ knowledge, opinions and attitudes about psoriasis.Materials and Methods: A total of 111 patients over the age of 18, clinically and histopathologically diagnosed with chronic plaque-type psoriasis were included in the study. Patients who have psychiatric illness and inadequate intelligence were excluded. A questionnaire including items on knowledge, opinions and attitudes on psoriasis were filled out by the patients and the results were analyzed statistically.Results: One hundred-eleven (45 female, 66 male patients were included in our study. 6.3% of patients did not know the diagnosis of their disease. 68.5% of patients thought that psoriasis was a contagious disease while18% thought that psoriasis was a hereditary condition. 88.3% of patients declined that they were informed about the disease by the doctor. 62.2% of patients believed that they had adequate information about psoriasis. 51.4% of patients believed that doctors gave them enough information about psoriasis. 44.1% of patients knew that psoriasis was aggravated by stress while 38.7% did not know any of the aggravating factors of psoriasis. 70.3% of patients believed that psoriasis would spread if not treated. Patients mostly (98.2% had idea about topical treatment options. 82% of patients were afraid of having psoriasis on their face. 5.4% of patients were uncomfortable with the idea of their partners’ having psoriasis. 72.1%, 88.3%, 72.1% of patients reported no negative effect of psoriasis on their relations with friends, family members, work or school life, respectivelyDiscussion: Our results showed that psoriasis patients do not have adequate knowledge about the disease. We think that dermatologists should pay more attention to inform and raise awareness of patie

  5. Local anesthesia selection algorithm in patients with concomitant somatic diseases.

    Science.gov (United States)

    Anisimova, E N; Sokhov, S T; Letunova, N Yu; Orekhova, I V; Gromovik, M V; Erilin, E A; Ryazantsev, N A

    2016-01-01

    The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

  6. Quality of life in chronic disease patients

    Directory of Open Access Journals (Sweden)

    Kalliopi Megari

    2013-09-01

    Full Text Available During the past decades there was an increasing predominance of chronic disorders, with a large number of people living with chronic diseases that can adversely affect their quality of life. The aim of the present paper is to study quality of life and especially Health-related quality of life (HRQoL in chronic diseases. HRQOL is a multidimensional construct that consists of at least three broad domains − physical, psychological, and social functioning − that are affected by one’s disease and/or treatment. HRQoL is usually measured in chronic conditions and is frequently impaired to a great extent. In addition, factors that are associated with good and poor HRQoL, as well as HRQoL assessment will be discussed. The estimation of the relative impact of chronic diseases on HRQoL is necessary in order to better plan and distribute health care resources aiming at a better HRQoL.[«All the people perceive the concept of living good or being well, that is the same as being happy». (Aristotle. 384-322 BC. Ethica Nichomachea

  7. Wolman disease in patients with familial hemophagocytic ...

    African Journals Online (AJOL)

    Solaf Elsayed

    2015-09-26

    Sep 26, 2015 ... b CEDI, Hoˆpital Necker Enfants Malades, Paris, France ... function, neurological dysfunction and hemophagocytic cells ... sites or in association with lymphoma, autoimmune disease, ... the age of one month with a provisional diagnosis of FHL .... is not prominent and is associated with relatively huge.

  8. Management of patients with hepatitis C infection and renal disease.

    Science.gov (United States)

    Bunchorntavakul, Chalermrat; Maneerattanaporn, Monthira; Chavalitdhamrong, Disaya

    2015-02-27

    Hepatitis C virus (HCV) infection in patients with end-stage renal disease (ESRD) is associated with more rapid liver disease progression and reduced renal graft and patients' survival following kidney transplantation. Evaluations and management of HCV in patients with renal disease are challenging. The pharmacokinetics of interferons (IFN), ribavirin (RBV) and some direct acting antiviral (DAA), such as sofosbuvir, are altered in patients with ESRD. With dose adjustment and careful monitoring, treatment of HCV in patients with ESRD can be associated with sustained virological response (SVR) rates nearly comparable to that of patients with normal renal function. DAA-based regimens, especially the IFN-free and RBV-free regimens, are theoretically preferred for patients with ESRD and KT in order to increase SVR rates and to reduce treatment side effects. However, based on the data for pharmacokinetics, dosing safety and efficacy of DAA for patients with severe renal impairment are lacking. This review will be focused on the evaluations, available pharmacologic data, and management of HCV in patients with severe renal impairment, patients who underwent KT, and those who suffered from HCV-related renal disease, according to the available treatment options, including DAA.

  9. Patient web portals, disease management, and primary prevention.

    Science.gov (United States)

    Coughlin, Steven S; Prochaska, Judith J; Williams, Lovoria B; Besenyi, Gina M; Heboyan, Vahé; Goggans, D Stephen; Yoo, Wonsuk; De Leo, Gianluca

    2017-01-01

    Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals. Although findings have not been uniformly positive, several studies of the effectiveness of health care system patient portals in chronic disease management have shown promising results with regard to patient outcomes. Patient web portals have also shown promising results in increasing adherence with screening recommendations. Racial and ethnic minorities, younger persons, and patients who are less educated or have lower health literacy have been found to be less likely to use patient portals. Additional studies are needed of the utility and effectiveness of different elements of web portals for different patient populations. This should include additional diseases and health topics such as smoking cessation and weight management.

  10. Clinical presentation and mutations in Danish patients with Wilson disease

    DEFF Research Database (Denmark)

    Møller, Lisbeth Birk; Horn, Nina; Jeppesen, Tina Dysgaard

    2011-01-01

    This study describes the clinical presentation and diagnosis in all Danish patients (49, 41 unrelated) with Wilson disease (WND). On the basis of the number of diagnosed patients from 1990-2008, the prevalence was estimated to be 1:49¿500. Among routinely used diagnostic tests, none were consiste......This study describes the clinical presentation and diagnosis in all Danish patients (49, 41 unrelated) with Wilson disease (WND). On the basis of the number of diagnosed patients from 1990-2008, the prevalence was estimated to be 1:49¿500. Among routinely used diagnostic tests, none were...

  11. Clinical presentation and mutations in Danish patients with Wilson disease

    DEFF Research Database (Denmark)

    Møller, Lisbeth Birk; Horn, Nina; Jeppesen, Tina Dysgaard

    2011-01-01

    This study describes the clinical presentation and diagnosis in all Danish patients (49, 41 unrelated) with Wilson disease (WND). On the basis of the number of diagnosed patients from 1990-2008, the prevalence was estimated to be 1:49 500. Among routinely used diagnostic tests, none were consiste......This study describes the clinical presentation and diagnosis in all Danish patients (49, 41 unrelated) with Wilson disease (WND). On the basis of the number of diagnosed patients from 1990-2008, the prevalence was estimated to be 1:49 500. Among routinely used diagnostic tests, none were...

  12. Identification of MAC1: A Small Molecule That Rescues Spindle Bipolarity in Monastrol-Treated Cells.

    Science.gov (United States)

    Al-Obaidi, Naowras; Mitchison, Timothy J; Crews, Craig M; Mayer, Thomas U

    2016-06-17

    The genetic integrity of each organism is intimately tied to the correct segregation of its genome during mitosis. Insights into the underlying mechanisms are fundamental for both basic research and the development of novel strategies to treat mitosis-relevant diseases such as cancer. Due to their fast mode of action, small molecules are invaluable tools to dissect mitosis. Yet, there is a great demand for novel antimitotic compounds. We performed a chemical genetic suppression screen to identify compounds that restore spindle bipolarity in cells treated with Monastrol, an inhibitor of the mitotic kinesin Eg5. We identified one compound-MAC1-that rescued spindle bipolarity in cells lacking Eg5 activity. Mechanistically, MAC1 induces the formation of additional microtubule nucleation centers, which allows kinesin Kif15-dependent bipolar spindle assembly in the absence of Eg5 activity. Thus, our chemical genetic suppression screen revealed novel unexpected insights into the mechanism of spindle assembly in mammalian cells.

  13. Somatostatin receptor scintigraphy in patients with cat-scratch disease

    Energy Technology Data Exchange (ETDEWEB)

    Krause, R.; Schnedl, W.J.; Hoier, S. [Div. of Infectious Diseases, Dept. of Internal Medicine, Univ. Graz (Austria); Piswanger-Soelkner, C.; Lipp, R.W. [Div. of Nuclear Medicine, Dept. of Internal Medicine, Univ. Graz (Austria); Daxboeck, F. [Clinical Inst. for Hygiene and Medical Microbiology, Div. of Hospital Hygiene, Univ. of Vienna (Austria); Reisinger, E.C. [Div. of Infectious Diseases and Tropical Medicine, Dept. of Internal Medicine, Univ. Rostock (Germany)

    2006-07-01

    Aim: somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immun diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. Patients, methods: twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. Results: eleven of 12 patients showed IgG antibodies against B. henselea. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. Conclusion: somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD. (orig.)

  14. Duodopa pump treatment in patients with advanced Parkinson's disease

    DEFF Research Database (Denmark)

    Karlsborg, Merete; Korbo, Lise; Regeur, Lisbeth

    2010-01-01

    Patients with advanced Parkinson's disease (PD) often develop motor complications including fluctuations and involuntary movements (dyskinesias). In Denmark, treatment has comprised Deep Brain Stimulation (DBS) since the late 1990s, and as from 2002 use of a subcutaneous apomorphine pump...

  15. Quadriceps exercise intolerance in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Gifford, Jayson R; Trinity, Joel D; Layec, Gwenael

    2015-01-01

    This study sought to determine if qualitative alterations in skeletal muscle mitochondrial respiration, associated with decreased mitochondrial efficiency, contribute to exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). Using permeabilized muscle fibers from the ...

  16. pseudoxanthoma elasticum in a patient with sickle cell disease

    African Journals Online (AJOL)

    2008-02-12

    Feb 12, 2008 ... This is a well recognised complication of sickle cell disease which has not ... manifestations, occurring in 80% of patients with. PXE (3). ... complications are due to this defect. .... This was a complication of long standing sickle.

  17. EULAR recommendations for vaccination in paediatric patients with rheumatic diseases

    NARCIS (Netherlands)

    Heijstek, M. W.; de Bruin, L. M. Ott; Bijl, M.; Borrow, R.; van der Klis, F.; Kone-Paut, I.; Fasth, A.; Minden, K.; Ravelli, A.; Abinun, M.; Pileggi, G. S.; Borte, M.; Wulffraat, N. M.

    2011-01-01

    Evidence-based recommendations for vaccination of paediatric patients with rheumatic diseases (PaedRD) were developed by following the EULAR standardised procedures for guideline development. The EULAR task force consisted of (paediatric) rheumatologists/immunologists, one expert in vaccine

  18. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Chertow, Glenn M; Block, Geoffrey A; Correa-Rotter, Ricardo

    2012-01-01

    Disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute to extraskeletal (including vascular) calcification among patients with chronic kidney disease. It has been hypothesized that treatment with the calcimimetic agent cinacalcet might reduce the risk...

  19. Generalized Vitiligo Associated Autoimmune Diseases in Japanese Patients Their Families

    Directory of Open Access Journals (Sweden)

    Tomohiko Narita

    2011-01-01

    Conclusions: Among Japanese vitiligo patients, there is a subgroup with strong evidence of genetically determined susceptibility to not only vitiligo, but also to autoimmune thyroid disease and other autoimmune disorders.

  20. Interdisciplinary Management of Patient with Advanced Periodontal Disease.

    Science.gov (United States)

    Kochar, Gagan Deep; Jayan, B; Chopra, S S; Mechery, Reenesh; Goel, Manish; Verma, Munish

    2016-01-01

    This case report describes the interdisciplinary management of an adult patient with advanced periodontal disease. Treatment involved orthodontic and periodontal management. Good esthetic results and dental relationships were achieved by the treatment.

  1. Role of Myeloperoxidase in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Bojana Kisic

    2016-01-01

    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem. Patients with CKD have a number of disorders in the organism, and the presence of oxidative stress and systemic inflammation in these patients is the subject of numerous studies. Chronic inflammation joined with oxidative stress contributes to the development of numerous complications: accelerated atherosclerosis process and cardiovascular disease, emergence of Type 2 diabetes mellitus, development of malnutrition, anaemia, hyperparathyroidism, and so forth, affecting the prognosis and quality of life of patients with CKD. In this review we presented the potential role of the myeloperoxidase enzyme in the production of reactive/chlorinating intermediates and their role in oxidative damage to biomolecules in the body of patients with chronic kidney disease and end-stage renal disease. In addition, we discussed the role of modified lipoprotein particles under the influence of prooxidant MPO intermediates in the development of endothelial changes and cardiovascular complications in renal failure.

  2. Steroid allergy in patients with inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Malik, M

    2007-11-01

    Background: Contact allergy to a steroid enema leading to worsening of inflammatory bowel disease (IBD) has recently been reported. This study was designed to look for evidence of steroid allergy in patients with IBD.

  3. Priority Settings in patients with Chronic Diseases and Cancer

    DEFF Research Database (Denmark)

    Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Søndergaard, Jens

    datasets: 1) video recordings of consultations in general practice, 2) semi-structured interviews with patients who have a chronic disease and who have recently finished primary treatment for a non-metastatic cancer, 3) semi-structured interviews with general practitioners. Video recordings......Priority setting in patients with cancer and comorbidities Background and aim As both the cancer incidence and the number of patients diagnosed with chronic diseases are increasing, a growing population of cancer survivors will also deal with comorbid chronic diseases. The period after completed...... cancer treatment, where patients are transitioning to survivorship, might be a vulnerable time. Uncertainty about health status, physical- and emotional symptoms from cancer disease and treatment, and perhaps uncertainty about which doctor to consult, might influence patients’ priorities and attention...

  4. Orofacial granulomatosis in a patient with Crohn's disease.

    NARCIS (Netherlands)

    Scheur, van de M.R.; Waal, van der RI; Volker - Dieben, H.J.M.; Knol, E.C.; Starink, T.M.; Waal, van der I.

    2003-01-01

    Orofacial granulomatosis encompasses the previously recognized clinical entities Melkersson-Rosenthal syndrome and cheilitis granulomatosa. We report the case of a 39-year-old patient with cheilitis granulomatosa, intestinal Crohn's disease, and optic neuropathy. Cheilitis granulomatosa and optic ne

  5. PAD-MAC: primary user activity-aware distributed MAC for multi-channel cognitive radio networks.

    Science.gov (United States)

    Ali, Amjad; Piran, Md Jalil; Kim, Hansoo; Yun, Jihyeok; Suh, Doug Young

    2015-03-30

    Cognitive radio (CR) has emerged as a promising technology to solve problems related to spectrum scarcity and provides a ubiquitous wireless access environment. CR-enabled secondary users (SUs) exploit spectrum white spaces opportunistically and immediately vacate the acquired licensed channels as primary users (PUs) arrive. Accessing the licensed channels without the prior knowledge of PU traffic patterns causes severe throughput degradation due to excessive channel switching and PU-to-SU collisions. Therefore, it is significantly important to design a PU activity-aware medium access control (MAC) protocol for cognitive radio networks (CRNs). In this paper, we first propose a licensed channel usage pattern identification scheme, based on a two-state Markov model, and then estimate the future idle slots using previous observations of the channels. Furthermore, based on these past observations, we compute the rank of each available licensed channel that gives SU transmission success assessment during the estimated idle slot. Secondly, we propose a PU activity-aware distributed MAC (PAD-MAC) protocol for heterogeneous multi-channel CRNs that selects the best channel for each SU to enhance its throughput. PAD-MAC controls SU activities by allowing them to exploit the licensed channels only for the duration of estimated idle slots and enables predictive and fast channel switching. To evaluate the performance of the proposed PAD-MAC, we compare it with the distributed QoS-aware MAC (QC-MAC) and listen-before-talk MAC schemes. Extensive numerical results show the significant improvements of the PAD-MAC in terms of the SU throughput, SU channel switching rate and PU-to-SU collision rate.

  6. Infecting Windows, Linux & Mac in one go

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Still love bashing on Windows as you believe it is an insecure operating system? Hold on a second! Just recently, a vulnerability has been published for Java 7.   It affects Windows/Linux PCs and Macs, Internet Explorer, Safari and Firefox. In fact, it affects all computers that have enabled the Java 7 plug-in in their browser (Java 6 and earlier is not affected). Once you visit a malicious website (and there are plenty already out in the wild), your computer is infected… That's "Game Over" for you.      And this is not the first time. For a while now, attackers have not been targeting the operating system itself, but rather aiming at vulnerabilities inherent in e.g. your Acrobat Reader, Adobe Flash or Java programmes. All these are standard plug-ins added into your favourite web browser which make your web-surfing comfortable (or impossible when you un-install them). A single compromised web-site, however, is sufficient to prob...

  7. Prior determination of baseline minimum alveolar concentration (MAC) of isoflurane does not influence the effect of ketamine on MAC in rabbits.

    Science.gov (United States)

    Gianotti, Giacomo; Valverde, Alexander; Sinclair, Melissa; Dyson, Doris H; Gibson, Thomas; Johnson, Ron

    2012-10-01

    The objective of this study was to compare the effect on the minimum alveolar concentration (MAC) of isoflurane when ketamine was administered either after or without prior determination of the baseline MAC of isoflurane in rabbits. Using a prospective randomized crossover study, 8 adult, female New Zealand rabbits were allocated to 2 treatment groups. Anesthesia was induced and maintained with isoflurane. Group 1 (same-day determination) had the MAC-sparing effect of ketamine [1 mg/kg bodyweight (BW) bolus followed by a constant rate infusion (CRI) of 40 μg/kg BW per min, given by intravenous (IV)], which was determined after the baseline MAC of isoflurane was determined beforehand. A third MAC determination was started 30 min after stopping the CRI. Group 2 (separate-day determination) had the MAC-sparing effect of ketamine determined without previous determination of the baseline MAC of isoflurane. A second MAC determination was started 30 min after stopping the CRI. In group 1, the MAC of isoflurane (2.15 ± 0.09%) was significantly decreased by ketamine (1.63 ± 0.07%). After stopping the CRI, the MAC was significantly less (2.04 ± 0.11%) than the baseline MAC of isoflurane and significantly greater than the MAC during the CRI. In group 2, ketamine decreased isoflurane MAC (1.53 ± 0.22%) and the MAC increased significantly (1.94 ± 0.25%) after stopping the CRI. Minimum alveolar concentration (MAC) values did not differ significantly between the groups either during ketamine administration or after stopping ketamine. Under the study conditions, prior determination of the baseline isoflurane MAC did not alter the effect of ketamine on MAC. Both methods of determining MAC seemed to be valid for research purposes.

  8. Driving performance in patients with chronic obstructive lung disease, interstitial lung disease and healthy controls

    DEFF Research Database (Denmark)

    Prior, Thomas Skovhus; Troelsen, Thomas Tværmose; Hilberg, Ole

    2015-01-01

    INTRODUCTION: Cognitive deficits in patients suffering from chronic obstructive pulmonary disease (COPD) have been described and hypoxaemia has been addressed as a possible cause. Cognitive functions in patients with interstitial lung disease (ILD) are not well studied. These patients are taking....... METHODS: 16 patients with COPD (8 receivers and 8 non-receivers of long-term oxygen therapy (LTOT)), 8 patients with ILD (consisting of idiopathic interstitial pneumonias) and 8 healthy controls were tested in a driving simulator. Each test lasted 45 min. In the oxygen intervention part of the study...

  9. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  10. Motivational Interviewing to Engage Patients in Chronic Kidney Disease Management

    OpenAIRE

    Martino, Steve

    2011-01-01

    Patients with chronic kidney disease (CKD) must manage numerous medical treatments and lifestyle changes that strain their treatment adherence. An important strategy to improve adherence is to activate the patients’ motivation to manage their CKD. This article describes an approach for enhancing patients’ motivation for change, called motivational interviewing (MI), a treatment that is increasingly being used in health care settings to counsel patients with chronic diseases. Its basic princip...

  11. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics.......Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  12. Orofacial function and oral health in patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Bakke, Merete; Larsen, Stine L; Lautrup, Caroline

    2011-01-01

    prevalent, mastication and jaw opening poorer, and impact of oral health on daily life more negative, in patients with PD than in controls. The results indicate that mastication and orofacial function are impaired in moderate to advanced PD, and with progression of the disease both orofacial and dental...... problems become more marked. It is suggested that greater awareness of the special needs in PD patients and frequent dental visits are desirable to prevent dental diseases and decay and to support masticatory function....

  13. Discussing sexuality with patients in a motor neurone disease clinic.

    Science.gov (United States)

    Marsden, Rachael; Botell, Rachel

    Sexual relationships remain an important aspect of life for people living with motor neurone disease. This article explores the use of the Extended-PLISSIT model when discussing relationships and sexual function with patients and their partners in a motor neurone disease clinic. The model provides a structured approach to assist discussions with patients as well as promoting reflection and exchange of knowledge in the multidisciplinary team. It is a useful model when addressing issues that are sometimes difficult to discuss.

  14. Modified pterional craniotomy without "MacCarty keyhole".

    Science.gov (United States)

    Moscovici, Samuel; Mizrahi, Cezar José; Margolin, Emil; Spektor, Sergey

    2016-02-01

    Pterional craniotomy is one of the most widely used approaches in neurosurgery. The MacCarty keyhole has remained the preferred means of beginning the craniotomy to achieve a low access point; however, the bone opening may result in a residual defect and an aesthetically unpleasant depression in the periorbital area. We present our modification of the traditional technique. Instead of drilling the keyhole in the frontoperiorbital area, the classical location, we perform a 5 × 15 mm strip craniectomy at the lowest accessible point in the infratemporal fossa, corresponding to the projection of the most lateral point of the sphenoid ridge. The anterior half of this opening exposes the basal frontal dura, while the posterior half brings the temporal dura into view. This modified technique was applied in 48 pterional craniotomies performed for removal of a variety of neoplasms during 2014-2015. There were no approach-related complications. Aesthetic outcomes and patient acceptance have been good; no patient developed skin depression in the periorbital area. In our experience, craniotomy for a pterional approach with the lowest possible access to the frontotemporal skull base may be performed by drilling a narrow oblong opening, without the use of any keyhole or burr hole, to create a smaller skull defect and achieve optimal aesthetic outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Eosinophilic heart disease in a paediatric patient.

    Science.gov (United States)

    Dedieu, Natalie; Giardini, Alessandro; Khambadkone, Sachin; Marek, Jan

    2011-01-01

    A 12-year-old child with no previous medical history was referred with a 4-day history of cough, shortness of breath, and peripheral blood eosinophilia. Transthoracic echocardiography showed a soft tissue infiltrating the left ventricular free wall, the lateral mitral annulus, and the mitral valve leaflets. A soft tissue strand connecting the lateral left atrial wall and mitral leaflets across the mitral valve orifice was also identified, causing reduced opening and functional mitral stenosis. The diagnosis of Löeffler endocarditis was made, and after 10 weeks of treatment with oral prednisolone, there was complete resolution of symptoms and of the infiltrative tissue with normalization of mitral valve function. The present case highlights some atypical features of eosinophilic heart disease-like occurrence in paediatric age, the complete preservation of the right ventricle and left ventricular apex, and the presentation with mitral stenosis compared with mitral regurgitation typically observed in the late phase of the disease.

  16. [Orthopaedic neurological diseases in patient with diabetes].

    Science.gov (United States)

    Natsume, Tadahiro; Hirata, Hitoshi

    2014-02-01

    Individuals with diabetes are at a greater risk for microvascular complications, such as retinopathy, neuropathy, and nephropathy, than are individuals without diabetes. Diabetic neuropathies are complex heterogeneous disorders that include both focal neuropathies and diffuse polyneuropathy. Entrapment neuropathy is an example of a focal neuropathy, while distal symmetric polyneuropathy is the most common type of diffuse polyneuropathy. Entrapment neuropathies are highly prevalent in the diabetic population, but they develop insidiously and progressively, making it difficult to determine their true prevalence. Entrapment neuropathies are suspected to be a more common complication of diabetes than is polyneuropathy. For example, carpal tunnel syndrome (CTS)-one of the most common entrapment neuropathies encountered in patients with diabetes-results from median nerve compression, and has been shown to occur three times more frequently in a diabetic population than in a normal healthy population. Entrapment neuropathies should be actively screened for in patients showing the signs and symptoms of neuropathy, because such patients may require surgical treatment.

  17. Mutation analysis of Australasian Gaucher disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, P.V.; Carey, W.F.; Morris, C.P.; Lewis, B.D. [Women`s and Children`s Hospital, North Adelaide, South Australia (Australia)

    1995-09-25

    We have previously reported phenotype and genotype analyses in 28 Australasian Gaucher patients who were screened for several of the common Gaucher mutations: N370S, L444P, 84GG, and R463C. Horowitz and Zimran have reported that the complex alleles recNciI and recTL, which contain several point mutations including L444P, are relatively common, especially in non-Jewish Gaucher patients. Zimran and Horowitz have also stated that these recombinant alleles could easily be missed by laboratories testing only for the common Gaucher point mutations. Failure to correctly identify these mutations would influence any attempt to correlate genotype with phenotype. We have therefore retested our Gaucher patients for recNciI (L444P, A456P, and V46OV) and recTL (D409H, L444P, A456P, and V46OV) by PCR amplification, followed by hybridization with allele-specific oligonucleotides. 4 refs.

  18. Aggregation of red blood cells in patients with Gaucher disease.

    Science.gov (United States)

    Adar, Tomer; Ben-Ami, Ronen; Elstein, Deborah; Zimran, Ari; Berliner, Shlomo; Yedgar, Saul; Barshtein, Gershon

    2006-08-01

    Gaucher disease is associated with increased red blood cell (RBC) aggregation, but the pathophysiological significance of this phenomenon and its correlation with disease manifestations are unclear. RBC aggregation was evaluated in 43 patients with Gaucher disease and 53 healthy controls. Dynamic RBC aggregation was examined in a narrow-gap flow chamber at varying shear stress. Compared with the controls, RBC aggregation in Gaucher disease was increased by 25%. Comparison of RBC aggregation in autologous plasma and in dextran (500 kDa) showed an increase both in plasma-dependent (extrinsic) and -independent (intrinsic) RBC aggregation. Subgroup analysis revealed that increased RBC aggregation was limited to patients with an intact spleen. RBC aggregation in patients did not correlate with plasma fibrinogen concentration, disease severity, enzyme replacement therapy or genotype. We conclude that RBC aggregation is increased in patients with Gaucher disease and an intact spleen, possibly reflecting the accumulation of glucocerebroside and other substances in the plasma and RBC membranes of these patients. Our results do not support a role for RBC aggregation in the pathogenesis of vascular complications of Gaucher disease.

  19. Mitochondrial Diseases: Clinical Features- Management of Patients

    Directory of Open Access Journals (Sweden)

    Filiz Koc

    2003-02-01

    Full Text Available Mitochondria are unique organells which their own DNA in cells. Human mitochondrial DNA is circular, double-stranded molecule and small. Because all mitochondria are contributed by the ovum during the formation of the zygote, the mitochondrial genom is transmitted by maternal inheritance. Multisystem disorders such as deafness, cardiomyopathy, miyopathy can be seen in mitochondrial diseases. [Archives Medical Review Journal 2003; 12(0.100: 14-31

  20. Mitochondrial Diseases: Clinical Features- Management of Patients

    OpenAIRE

    Filiz Koc; Yakup Sarica

    2003-01-01

    Mitochondria are unique organells which their own DNA in cells. Human mitochondrial DNA is circular, double-stranded molecule and small. Because all mitochondria are contributed by the ovum during the formation of the zygote, the mitochondrial genom is transmitted by maternal inheritance. Multisystem disorders such as deafness, cardiomyopathy, miyopathy can be seen in mitochondrial diseases. [Archives Medical Review Journal 2003; 12(0.100): 14-31

  1. Corpus callosum atrophy in patients with mild Alzheimer's disease

    DEFF Research Database (Denmark)

    Frederiksen, Kristian Steen; Garde, Ellen; Skimminge, Arnold

    2011-01-01

    Several studies have found atrophy of the corpus callosum (CC) in patients with Alzheimer's disease (AD). However, it remains unclear whether callosal atrophy is already present in the early stages of AD, and to what extent it may be associated with other structural changes in the brain......, such as age-related white matter changes (ARWMC) and progression of the disease....

  2. Small bowel ultrasound in patients with celiac disease

    Energy Technology Data Exchange (ETDEWEB)

    Bartusek, D. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: dbartusek@fnbrno.cz; Valek, V. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: v.valek@fnbrno.cz; Husty, J. [Department of Radiology, Masaryk University hospital Brno (Czech Republic)], E-mail: jhusty@fnbrno.cz; Uteseny, J. [Department of Pediatric Internal Medicine, Masaryk University hospital Brno (Czech Republic)], E-mail: juteseny@fnbrno.cz

    2007-08-15

    Objective: Celiac disease (CD) is a common, lifelong disease with small bowel malabsorption based on genetically conditioned gluten intolerance. The clinical manifestation could be very heterogeneous. The proof of celiac disease is now based mainly on clinical and laboratory (antibodies and enterobiopsy) signs, which are in some cases problematic and inconvenient. Materials and methods: In our study we have examined 250 patients with suspection or with proven celiac disease and we evaluated specific ultrasound small bowel changes in this group. In the next step, we chose 59 patients with laboratory proved celiac disease and we statistically compared ultrasound, other laboratory and clinical findings in different forms and stages of the disease. Results: Specific small bowel pathologies in patients with celiac disease (like changes of intestinal villi in different parts of small bowel, abnormal peristalsis and mesenterial lymphadenopathy) can be well visualized by ultrasound and in combination with clinical and laboratory signs ultrasound examination could have an important role in screening, determination of diagnosis and monitoring of patients with different forms of celiac disease.

  3. Collection of hematopoietic stem cells from patients with autoimmune diseases

    NARCIS (Netherlands)

    Burt, RK; Fassas, A; Snowden, JA; Kozak, T; Wulffraat, NM; Nash, RA; Dunbar, CE; Arnold, R; Prentice, G; Bingham, S; Marmont, AM; McSweeney, PA; van Laar, J.M.

    We reviewed data from 24 transplant centers in Asia, Australia, Europe, and North America to determine the outcomes of stem cell collection including methods used, cell yields, effects on disease activity, and complications in patients with autoimmune diseases. Twenty-one unprimed bone marrow

  4. Sublingual Microvascular Changes in Patients With Cerebral Small Vessel Disease

    NARCIS (Netherlands)

    M. Khalilzada; K. Dogan; C. Ince; J. Stam

    2011-01-01

    Background and Purpose-It is unknown whether changes in cerebral small vessel disease (SVD) are limited to the brain or part of a generalized vascular disorder. Methods-We examined the sublingual microcirculation of 10 healthy controls, 10 patients with large vessel disease, and 8 with SVD, with sid

  5. Coronary collaterals improve prognosis in patients with ischemic heart disease

    NARCIS (Netherlands)

    J.J. Regieli; J.W. Jukema; H.M. Nathoe; A.H. Zwinderman; S. ng; D.E. Grobbee; Y. van der Graaf; P.A. Doevendans

    2009-01-01

    BACKGROUND: The recruitment of coronary collateral vessels results from an endogenous adaptation to ischemic heart disease (IHD). Presence of collaterals may exert protection at the time of acute or chronic obstructive coronary disease. The protective role of collaterals in patients with extensive c

  6. Collection of hematopoietic stem cells from patients with autoimmune diseases

    NARCIS (Netherlands)

    Burt, RK; Fassas, A; Snowden, JA; Kozak, T; Wulffraat, NM; Nash, RA; Dunbar, CE; Arnold, R; Prentice, G; Bingham, S; Marmont, AM; McSweeney, PA; van Laar, J.M.

    2001-01-01

    We reviewed data from 24 transplant centers in Asia, Australia, Europe, and North America to determine the outcomes of stem cell collection including methods used, cell yields, effects on disease activity, and complications in patients with autoimmune diseases. Twenty-one unprimed bone marrow harves

  7. Competition at the Wireless Sensor Network MAC Layer: Low Power Probing interfering with X-MAC

    Science.gov (United States)

    Zacharias, Sven; Newe, Thomas

    2011-08-01

    Wireless Sensor Networks (WSNs) combine sensors with computer networks and enable very dense, in-situ and live measurements of data over a large area. Since this emerging technology has the potential to be embedded almost everywhere for numberless applications, interference between different networks can become a serious issue. For most WSNs, it is assumed today that the network medium access is non-competitive. On the basis of X-MAC interfered by Low Power Probing, this paper shows the danger and the effects of different sensor networks communicating on a single wireless channel of the 2.4 GHz band, which is used by the IEEE 802.15.4 standard.

  8. Osteoprotegerin and mortality in hemodialysis patients with cardiovascular disease

    DEFF Research Database (Denmark)

    Winther, Simon; Christensen, Jeppe Hagstrup; Flyvbjerg, Allan

    2013-01-01

    Abstract BACKGROUND: Patients treated with hemodialysis (HD) have an increased mortality, mainly caused by cardiovascular disease (CVD). Osteoprotegerin (OPG) is a glycoprotein involved in the regulation of the vascular calcification process. Previous studies have demonstrated that OPG.......08; in the adjusted analyses, the p-value for trend was 0.03. CONCLUSIONS: In a high-risk population of hemodialysis patients with previously documented cardiovascular disease, a high level of OPG was an independent risk marker of all-cause mortality....... is a prognostic marker of mortality. The aim of this study was to investigate if OPG was a prognostic marker of all-cause mortality in high-risk patients with end-stage renal disease and CVD. METHODS: We prospectively followed 206 HD patients with CVD. OPG was measured at baseline and the patients were followed...

  9. Managing the lipid profile of coronary heart disease patients.

    Science.gov (United States)

    Drakopoulou, Maria; Toutouzas, Konstantinos; Stathogiannis, Konstantinos; Synetos, Andreas; Trantalis, George; Tousoulis, Dimitrios

    2016-11-01

    Lipid profile management is even more critical in patients treated for secondary prevention, since patients with established coronary heart disease are at higher risk of developing events. Current guidelines encourage lifestyle modification and patient engagement in disease prevention. However, the American College of Cardiology/American Heart Association guidelines seem to differ considerably from their predecessors, having an impact on clinical practice of lipid management. Area covered: This review article discusses and provides a summary of the current recommendations for lipid profile management in patients with coronary heart disease, with a view to present lifestyle modification and novel treatment strategies, and to indicate areas of dispute among recent guidelines. Expert commentary: Existing controversies between current guidelines concerning treatment goals and therapeutic decisions may have potential implications on the clinical management of patients. In the meantime, we eagerly wait for the results of randomized controlled trials evaluating promising, potent, safe and prolonged drugs that are in progress.

  10. Social Media Use in Patients with Inflammatory Bowel Disease.

    Science.gov (United States)

    Guo, Ling; Reich, Jason; Groshek, Jacob; Farraye, Francis A

    2016-05-01

    Patients with chronic illnesses such as Inflammatory Bowel Disease (IBD) have been more keen to utilize the Internet and in particular, social media to obtain patient educational information in recent years. It is important for the gastroenterologist to be aware of these modalities and how they might affect information exchange and ultimately, disease management. This article addresses the current prevalence of social media use, advent of mobile health applications, social media usage in patients with chronic conditions, usage amongst providers, and most notably, the usage and preferences in IBD patients. Over the last decade there has been an increasing desire from patients to receive educational material about their disease through social media. We reviewed the medical literature on the quality of IBD-related information on social media. Given the disparity of information available on the Internet, we remark on the quality of this information and stress the need for further research to assess the validity of IBD information posted on social media.

  11. Hypoadrenalism in patients with fatigue and rheumatic disease

    Directory of Open Access Journals (Sweden)

    Dimitra Methiniti

    2010-01-01

    Full Text Available Many patients with rheumatic disease complain of fatigue. Clinicians may interpret this as part of the disease process in the absence of anaemia or hypothyroidism, and sometimes respond with the empiric addition of steroids to therapy. The possibility of true hypoadrenalism is only occasionally considered, and little data exists on the frequency with which it coexists with rheumatic disease. Random serum cortisol may be requested by clinicians to help exclude hypoadrenalism as a factor in fatigue. We undertook a survey to assess how frequently this test was of clinical relevance, what was done in patients with low results, and which patients were most likely to have true adrenal failure. All random cortisol assays requested by the members of a rheumatological team over one year were identified and the notes examined retrospectively. The indication for the request, the result, the ultimate clinical diagnosis and all prior diagnoses were recorded. Where further investigations were undertaken, these too were noted. The results were compared to those in an age and gender matched population of patients with general medical conditions (excluding endocrine disorders for whom cortisol assays had also been requested. Random cortisol was requested by a team of four consultants in 74 patients with a variety of rheumatic disorders over 12 months, usually because of unexplained fatigue. Among the control group of 75 medical patients, the commonest reasons for requesting cortisol assay were fatigue, low sodium and unexplained anaemia. Mean cortisol levels were significantly higher in medical patients (512 nmol/L than those with rheumatic disease (351 nmol/L [P=0.04]. The results were low (<200 nmol/L in 14 rheumatic patients and 7 medical patients. Among these 21 individuals, synacthen tests were performed in 16 and were indicative of hypoadrenalism in 6 cases. Further investigations revealed primary hypoadrenalism in 3 patients, with tertiary adrenal

  12. After MacIntyre : Kaasaegsest vooruseetikast / Meego Remmel

    Index Scriptorium Estoniae

    Remmel, Meego

    2006-01-01

    Alasdair MacIntyre panus 20. sajandi eetikasse. Tema käsitlus vooruseetikast ja vooruseetilisest perspektiivist, mida on võimalik näha komplekselt, vaadeldes voorust, praktikat, narratiivi ja traditsiooni mõisteid

  13. After MacIntyre : Kaasaegsest vooruseetikast / Meego Remmel

    Index Scriptorium Estoniae

    Remmel, Meego

    2006-01-01

    Alasdair MacIntyre panus 20. sajandi eetikasse. Tema käsitlus vooruseetikast ja vooruseetilisest perspektiivist, mida on võimalik näha komplekselt, vaadeldes voorust, praktikat, narratiivi ja traditsiooni mõisteid

  14. Design and Implementation of an Efficient 64 bit MAC

    Directory of Open Access Journals (Sweden)

    Mohammad Shabber Hasan Khan

    2015-08-01

    Full Text Available The design of optimized 64 bit multiplier and accumulator (MAC unit is implemented in this paper. MAC unit plays major role in many of the digital signal processing (DSP applications. The MAC unit is designed with the combinations of multipliers and adders. In the proposed method MAC unit is implemented using Vedic multiplier and the adder is done with ripple carry adder .The components are reduced by implementing Vedic multiplier using the techniques of Vedic mathematics that have been modified to improve performance. a high speed processor depends significantly on the multiplier as it is one of the key hardware blocks in most digital signal processing systems as well as in general processors. The area is optimized effectively using Vedic multiplier .The total design implemented using Xilinx.

  15. Beamforming in Ad Hoc Networks: MAC Design and Performance Modeling

    National Research Council Canada - National Science Library

    Fakih, Khalil; Diouris, Jean-Francois; Andrieux, Guillaume

    2009-01-01

    .... Our proposition performs jointly channel estimation and radio resource sharing. We validate the fruitfulness of the proposed MAC and we evaluate the effects of the channel estimation on the network performance...

  16. Aeronautical Mobile Airport Communications System (AeroMACS)

    Science.gov (United States)

    Budinger, James M.; Hall, Edward

    2011-01-01

    To help increase the capacity and efficiency of the nation s airports, a secure wideband wireless communications system is proposed for use on the airport surface. This paper provides an overview of the research and development process for the Aeronautical Mobile Airport Communications System (AeroMACS). AeroMACS is based on a specific commercial profile of the Institute of Electrical and Electronics Engineers (IEEE) 802.16 standard known as Wireless Worldwide Interoperability for Microwave Access or WiMAX (WiMax Forum). The paper includes background on the need for global interoperability in air/ground data communications, describes potential AeroMACS applications, addresses allocated frequency spectrum constraints, summarizes the international standardization process, and provides findings and recommendations from the world s first AeroMACS prototype implemented in Cleveland, Ohio, USA.

  17. Rating of new outlet structures for MacFarlane Reservoir

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Memorandum explaining the new work on the outlet structure at MacFarlane Reservoir. Flow measurements were taken at different staff gage elevations and this data is...

  18. Big Mac arvestab raha ostujõudu / Harli Uljas

    Index Scriptorium Estoniae

    Uljas, Harli

    2005-01-01

    The Economist võrdleb maailma valuutade suhestamiseks Big Mac'i burgeri hindu 120 riigis, kuna see meetod võimaldab saada ülevaate riikide elanikkonna tegelikust ostujõust. Tabel: Hamburgeri standard

  19. Big Mac arvestab raha ostujõudu / Harli Uljas

    Index Scriptorium Estoniae

    Uljas, Harli

    2005-01-01

    The Economist võrdleb maailma valuutade suhestamiseks Big Mac'i burgeri hindu 120 riigis, kuna see meetod võimaldab saada ülevaate riikide elanikkonna tegelikust ostujõust. Tabel: Hamburgeri standard

  20. MAC layer security issues in wireless mesh networks

    Science.gov (United States)

    Reddy, K. Ganesh; Thilagam, P. Santhi

    2016-03-01

    Wireless Mesh Networks (WMNs) have emerged as a promising technology for a broad range of applications due to their self-organizing, self-configuring and self-healing capability, in addition to their low cost and easy maintenance. Securing WMNs is more challenging and complex issue due to their inherent characteristics such as shared wireless medium, multi-hop and inter-network communication, highly dynamic network topology and decentralized architecture. These vulnerable features expose the WMNs to several types of attacks in MAC layer. The existing MAC layer standards and implementations are inadequate to secure these features and fail to provide comprehensive security solutions to protect both backbone and client mesh. Hence, there is a need for developing efficient, scalable and integrated security solutions for WMNs. In this paper, we classify the MAC layer attacks and analyze the existing countermeasures. Based on attacks classification and countermeasures analysis, we derive the research directions to enhance the MAC layer security for WMNs.

  1. Mac OS X : Tiger edition the missing manual

    CERN Document Server

    Pogue, David

    2005-01-01

    You can set your watch to it: As soon as Apple comes out with another version of Mac OS X, David Pogue hits the streets with another meticulous Missing Manual to cover it with a wealth of detail. The new Mac OS X 10.4, better known as Tiger, is faster than its predecessors, but nothing's too fast for Pogue and Mac OS X: The Missing Manual. There are many reasons why this is the most popular computer book of all time. With its hallmark objectivity, the Tiger Edition thoroughly explores the latest features to grace the Mac OS. Which ones work well and which do not? What should you look for? Th

  2. Rare disease policies to improve care for patients in Europe.

    Science.gov (United States)

    Rodwell, Charlotte; Aymé, Ségolène

    2015-10-01

    Rare diseases are those with a particularly low prevalence; in Europe, diseases are considered to be rare when they affect not more than 5 in 10000 persons in the European Union. The specificities of rare diseases make the area a veritable public health challenge: the limited number of patients and scarcity of knowledge and expertise single rare diseases out as a distinctive domain of high European added-value. The Orphan Medicinal Product Regulation of 1999 was the first European legislative text concerning rare diseases, followed by many initiatives, including recommendations by the Council of Ministers of the European Union in 2009. These initiatives contributed to the development of rare diseases policies at European and national level aimed at improving care for patients with rare diseases. A review of the political framework at European level and in European countries is provided to demonstrate how legislation has created a dynamic that is progressively improving care for patients with rare diseases. This article is part of a Special Issue entitled: "Current Research on the Neuronal Ceroid Lipofuscinoses (Batten Disease)".

  3. Illness behavior in patients with musculoskeletal disease

    NARCIS (Netherlands)

    Bot, A.G.J.

    2013-01-01

    This PhD thesis studies the influence of psychological factors in illness behavior in different hand and upper extremity conditions encountered in the practice of a hand surgeon. The importance of the language used by the patient and the amount of shared decision making in an orthopaedic practice is

  4. Medical management of the patient with cardiovascular disease.

    Science.gov (United States)

    Mask, A G

    2000-06-01

    Cigarette smoking, hypertension, hypercholesterolemia, and periodontal disease have been established as major risk factors for cardiovascular disease. Dentists and physicians should work aggressively to educate periodontitis patients about this relationship in an effort to improve the quality of health and contribute to their long-term survival. Blood pressure should be checked at the initial dental visit and at each subsequent visit in patients whose blood pressure is found to be high and/or has a history of hypertension. Dental and medical assistants should receive in-service training to assure competency in measuring blood pressures. All staff should be certified in basic cardiopulmonary resuscitation. Emergency protocol procedures should be in writing and rehearsed regularly. Patients should take their blood pressure medication as usual on the day of the dental procedure. It is helpful for the patients to bring all medications to the office for review at the time of the dental procedure. Good communication should be established between the dentist and physician to maximize good dental and physical health. Because the patient with periodontal disease is at an increased risk for cardiovascular disease, a standardized form should be developed for the convenient exchange of vital information, including but not limited to: blood pressure, medications, allergies, medical conditions and pertinent highlights of dental procedures. Minimize stress in patients with coronary artery disease. This includes providing solid local anesthesia, avoidance of intravascular medication injections, and encouraging relaxation techniques. Antibiotic prophylaxis is indicated in patients with valvular heart disease but does not guarantee the prevention of endocarditis. These patients should be alerted to monitor any symptoms such as fever, chills or shortness of breath. It has also been documented that toothbrushing, flossing and home plaque removers can cause transient bacteremia in

  5. Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: Impact of tyrosine kinase inhibitor and minimal residual disease

    Science.gov (United States)

    Bachanova, Veronika; Marks, David I.; Zhang, Mei-Jie; Wang, Hailin; de Lima, Marcos; Aljurf, Mahmoud D.; Arellano, Martha; Artz, Andrew S.; Bacher, Ulrike; Cahn, Jean-Yves; Chen, Yi-Bin; Copelan, Edward A.; Drobyski, William R.; Gale, Robert Peter; Greer, John P; Gupta, Vikas; Hale, Gregory A.; Kebriaei, Partow; Lazarus, Hillard M.; Lewis, Ian D.; Lewis, Victor A.; Liesveld, Jane L.; Litzow, Mark R.; Loren, Alison W.; Miller, Alan M.; Norkin, Maxim; Oran, Betul; Pidala, Joseph; Rowe, Jacob M.; Savani, Bipin N.; Saber, Wael; Vij, Ravi; Waller, Edmund K.; Wiernik, Peter H.; Weisdorf, Daniel J.

    2014-01-01

    The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Ph+ acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type, and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKI), mostly imatinib; 39% (RIC) and 49% (MAC) were MRDneg pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%;p=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (p=0.058). Overall survival was similar (RIC 39% [95% CI:27–52] vs. 35% [95% CI:270–44];p=0.62). Patients MRDpos pre-HCT had higher risk of relapse with RIC versus MAC (HR 1.97;p=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared to a similar MRDneg population after MAC (33%; p=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; p=0.057), but absence of pre-HCT TKI (HR 1.88;p=0.018), RIC (HR 1.891;p=0.054) and pre-HCT MRDpos (HR 1.6; p=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRDneg status is preferred pre-HCT. PMID:23989431

  6. Persistent Reactive Thrombocytosis May Increase the Risk of Coronary Artery Disease Among Inflammatory Bowel Disease Patients.

    Science.gov (United States)

    Thapa, Sudeep Dhoj; Hadid, Hiba; Imam, Waseem; Hassan, Ahmad; Usman, Muhammad; Jafri, Syed-Mohammed; Schairer, Jason

    2015-10-01

    IBD patients are at increased risk of coronary artery disease in the absence of traditional risk factors. However, the disease-related risk factors remain poorly understood although increased inflammation seems to increase cardiovascular disease risk in IBD. Thrombocytes are involved in the pathogenesis of coronary artery disease, and a subset of IBD patients have reactive thrombocytosis. The aim of our study was to investigate the effect of persistent reactive thrombocytosis on the development of coronary artery disease in IBD. We evaluated a retrospective cohort of 2525 IBD patients who were evaluated at the Henry Ford hospital from 2000 to 2004. We performed a case-control study comparing patients with persistent thrombocytosis and patients without persistent thrombocytosis. Cases (n = 36) and controls (n = 72) were matched for age and gender. Coronary artery disease incidence was compared between the two groups. Cases (n = 36) and controls (n = 72) were matched for age and gender. Cases and controls were similar in age at onset of IBD (41.5 vs. 35.5, p value 0.11) and smoking status (33.3 vs. 27.8%, p value 0.66). Persistent thrombocytosis was less common among Caucasian patients (44.44 vs. 62.5%, p value 0.09) and more common in patients who had exposure to steroids during the study follow-up period. Coronary artery disease occurred in 13 (36.1%) patients with persistent thrombocytosis compared to only seven (9.7%) patients in the control group. Persistent reactive thrombocytosis among IBD patients is associated with increased risk of coronary artery disease. Further studies should characterize the clinical and molecular associations of this phenomenon and determine appropriate therapeutic measures.

  7. A tribute to Lloyd D. MacLean.

    Science.gov (United States)

    Keith, Roger G

    2015-08-01

    Dr. Lloyd D. MacLean, long-time co-editor of the Canadian Journal of Surgery passed away earlier this year at the age of 90. In order to appreciate the contributions of Dr. MacLean to the journal, this commentary recognizes him as a humble surgeon–scientist who was one of — if not the — most outstanding Canadian ambassadors to academic surgery in North America.

  8. Conformal holonomy in MacDowell-Mansouri gravity

    Energy Technology Data Exchange (ETDEWEB)

    Reid, James A., E-mail: j.a.reid@abdn.ac.uk [SUPA Department of Physics, University of Aberdeen, Aberdeen, AB24 3UE (United Kingdom); Wang, Charles H.-T., E-mail: c.wang@abdn.ac.uk [SUPA Department of Physics, University of Aberdeen, Aberdeen, AB24 3UE (United Kingdom); STFC Rutherford Appleton Laboratory, Chilton, Didcot, Oxon, OX11 0QX (United Kingdom)

    2014-03-15

    The MacDowell-Mansouri formulation of general relativity is based on a gauge theory whose gauge algebra depends on the sign of the cosmological constant. In this article, we show that the gauge algebra is uniquely determined by the conformal structure of spacetime itself. Specifically, we show that in vacuum: the spacetime conformal holonomy algebra coincides with the MacDowell-Mansouri gauge algebra for both signs of the cosmological constant, in both Lorentzian and Euclidean metric signatures.

  9. Some Problems of Alasdair MacIntyre’s "Emotivism Thesis"

    OpenAIRE

    2016-01-01

    In this article Alasdair MacIntyre’s thesis concerning emotivist use of moral utterances in contemporary liberal societies is analysed. One tries to show that it needs further clarification since at least three elements of MacIntyre’s argument seem to pose certain problems; these are: ‘discussion halt’ as the source of emotivism, comprehensive doctrines as premises of respective arguments in liberal debates and the problem of incommensurability. These three problematic eleme...

  10. Evaluation of an automated connective tissue disease screening assay in Korean patients with systemic rheumatic diseases.

    Science.gov (United States)

    Jeong, Seri; Yang, Heeyoung; Hwang, Hyunyong

    2017-01-01

    This study aimed to evaluate the diagnostic utilities of the automated connective tissues disease screening assay, CTD screen, in patients with systemic rheumatic diseases. A total of 1093 serum samples were assayed using CTD screen and indirect immunofluorescent (IIF) methods. Among them, 162 were diagnosed with systemic rheumatic disease, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and mixed connective tissue disease (MCT). The remaining 931 with non-systemic rheumatic disease were assigned to the control group. The median ratios of CTD screen tests were significantly higher in the systemic rheumatic disease group than in the control group. The positive likelihood ratios of the CTD screen were higher than those of IIF in patients with total rheumatic diseases (4.1 vs. 1.6), including SLE (24.3 vs. 10.7). The areas under the receiver operating characteristic curves (ROC-AUCs) of the CTD screen for discriminating total rheumatic diseases, RA, SLE, and MCT from controls were 0.68, 0.56, 0.92 and 0.80, respectively. The ROC-AUCs of the combinations with IIF were significantly higher in patients with total rheumatic diseases (0.72) and MCT (0.85) than in those of the CTD screen alone. Multivariate analysis indicated that both the CTD screen and IIF were independent variables for predicting systemic rheumatic disease. CTD screen alone and in combination with IIF were a valuable diagnostic tool for predicting systemic rheumatic diseases, particularly for SLE.

  11. Patterns of cortical thinning in nondemented Parkinson's disease patients

    Science.gov (United States)

    Uribe, Carme; Segura, Barbara; Baggio, Hugo Cesar; Abos, Alexandra; Marti, Maria Jose; Valldeoriola, Francesc; Compta, Yaroslau; Bargallo, Nuria

    2016-01-01

    ABSTRACT Background Clinical variability in the Parkinson's disease phenotype suggests the existence of disease subtypes. We investigated whether distinct anatomical patterns of atrophy can be identified in Parkinson's disease using a hypothesis‐free, data‐driven approach based on cortical thickness data. Methods T1‐weighted 3‐tesla MRI and a comprehensive neuropsychological assessment were performed in a sample of 88 nondemented Parkinson's disease patients and 31 healthy controls. We performed a hierarchical cluster analysis of imaging data using Ward's linkage method. A general linear model with cortical thickness data was used to compare clustering groups. Results We observed 3 patterns of cortical thinning in patients when compared with healthy controls. Pattern 1 (n = 30, 34.09%) consisted of cortical atrophy in bilateral precentral gyrus, inferior and superior parietal lobules, cuneus, posterior cingulate, and parahippocampal gyrus. These patients showed worse cognitive performance when compared with controls and the other 2 patterns. Pattern 2 (n = 29, 32.95%) consisted of cortical atrophy involving occipital and frontal as well as superior parietal areas and included patients with younger age at onset. Finally, in pattern 3 (n = 29, 32.95%), there was no detectable cortical thinning. Patients in the 3 patterns did not differ in disease duration, motor severity, dopaminergic medication doses, or presence of mild cognitive impairment. Conclusions Three cortical atrophy subtypes were identified in nondemented Parkinson's disease patients: (1) parieto‐temporal pattern of atrophy with worse cognitive performance, (2) occipital and frontal cortical atrophy and younger disease onset, and (3) patients without detectable cortical atrophy. These findings may help identify prognosis markers in Parkinson's disease. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement

  12. Risk of ulcerative colitis and Crohn's disease among offspring of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Orholm, Marianne; Fonager, Kirsten; Sørensen, Henrik Toft

    1999-01-01

    ) and Crohn's disease (CD) among first-degree relatives of patients with these diseases. To give more precise risk estimates we conducted a nationwide study using population-based data from the Danish National Registry of Patients (NRP). METHODS: All patients from the entire Danish population (5.2 million......OBJECTIVE: The incidence of inflammatory bowel disease (IBD) varies among and within countries, but several studies have indicated that genetic factors may play an important role in the etiology of IBD. A Danish regional study has observed an almost 10-fold increased risk for ulcerative colitis (UC...

  13. [Comparison and outcome of prevalence of concurrent diseases in patients with urological malignant diseases].

    Science.gov (United States)

    Yoshinaga, Atsushi; Hayashi, Tetsuo; Yoshida, Soichiro; Ohno, Rena; Ishii, Nobuyuki; Terao, Toshiya; Watanabe, Toru; Yamada, Takumi

    2006-07-01

    We compared the prevalence of concurrent diseases (diabetes mellitus, hypertension, ischemic heart diseases and apoplexy) in patients with renal cell carcinoma, bladder carcinoma and prostatic carcinoma diagnosed in our department with that in all patients in our department analyzed using Mantel-Haenszel regression. In hypertension, there was a significantly high prevalence of patients with renal cell carcinoma (p diabetis mellitus, ischemic heart diseases and apoplexy, no apparent characteristic of prevalence was recognized. The close relationship between renal cell carcinoma, prostatic carcinoma and hypertension in this study corresponded with previous reports.

  14. Neurohumoral relationship in patients with rheumatic diseases

    Directory of Open Access Journals (Sweden)

    I. V. Dryazenkova

    2004-01-01

    Full Text Available Objective. To assess neurohumoral relationship state in pts with systemic vasculitis (SV and systemic connective tissue diseases. Material and Methods. 54 pts with rheumatic diseases (RS were included: 18 with systemic lupus erythematosus (SLE, 16 with systemic sclerosis, 20 with systemic vasculitis (SV. Mean age was 49,3 5,4 years. Disease duration varied from 5 to 10 years. Control group consisted of 20 healthy persons. 24- hours ECG monitoring, heart rate variability (HRV spectral analysis, functional (clinoorthostatic sign and exercise ECG testing (isometric exercise, dynamic load, veloergometry were performed. Plasma histamine level, histaminase activity, plasma serotonin, tryptophan-5-hydrolase, oxytriptophandecar- boxylase, MAO levels were examined to assess vasoactive amine system state. Vasoactive amine system slate was assessed on histamine/serotonin ratio. Histamine/histaminase, serotonin/MAO, histaminase/MAO ratios were used to judge inhibitory activity. Results. Compared with control pts with RS showed marked and significant decrease of ergotropic mediators (noradrenaline, adrenaline and their metabolites concentration which correlated with HRV. Increase of histaminase that processes appropriate biogenic amine excess quantity was found in all forms of RS. More intensive than in healthy persons monoamine metabolism accompanied by their degradation acceleration resulted in enhanced MAO activity (significant in polyarteritis. LF/HF index reflecting summated activity of autonomic influences on heart rate showed significant prevalence of sympathetic effect in SV (3,46 0,31, p<0,05, CRV analysis showed adequate autonomic supply only in 11,7% of pts with RS. Conclusion. Exercise testing in dynamic analysis of quantitative HRV indices should be performed to determine autonomic reactivity ю assess homeostatic possibilities and adaptation reserve in pts with RS.

  15. Limited Knowledge of Acetaminophen in Patients with Liver Disease.

    Science.gov (United States)

    Saab, Sammy; Konyn, Peter G; Viramontes, Matthew R; Jimenez, Melissa A; Grotts, Jonathan F; Hamidzadah, Wally; Dang, Veronica P; Esmailzadeh, Negin L; Choi, Gina; Durazo, Francisco A; El-Kabany, Mohamed M; Han, Steven-Huy B; Tong, Myron J

    2016-12-28

    Background and Aims: Unintentional acetaminophen overdose remains the leading cause of acute liver failure in the United States. Patients with underlying liver disease are at higher risk of poor outcomes from acetaminophen overdose. Limited knowledge of acetaminophen may be a preventable contributor to elevated rates of overdose and thus acute liver failure. The purpose of this study is to assess knowledge of acetaminophen dosing and presence of acetaminophen in common combination products in patients with liver disease. Methods: We performed a cross-sectional study of patients with liver disease at the Pfleger Liver Institute at the University of California, Los Angeles between June 2015 and August 2016. Patients completed a demographic questionnaire and an acetaminophen knowledge survey. Additional information was obtained from the medical record. Results: Of 401 patients with liver disease, 30 (15.7%) were able to correctly identify that people without liver disease can safely take up to 4 g/day of acetaminophen. The majority of patients (79.9%-86.8%) did not know that Norco® (hydrocone/acetaminophen), Vicodin® (hydrocone/acetaminophen) and Percocet® (oxycodone/acetaminophen) contained acetaminophen. Only 45.3% of the patients knew that Tylenol® #3 contained acetaminophen. Conclusions: We conclude that patients with liver disease have critically low levels of knowledge of acetaminophen, putting them at risk both of acetaminophen overdose, as well as undermedication, and inadequate management of chronic pain. We recommend an increase in education efforts regarding acetaminophen dosage and its safety in the setting of liver disease. Increasing education for those at risk of low acetaminophen knowledge is essential to minimizing acetaminophen overdose rates and optimizing pain management.

  16. [Physician-patient relations and stress caused by coloscopy in patients with chronic inflammatory bowel disease].

    Science.gov (United States)

    Frenzer, A; Binek, J; Hammer, B

    1996-01-01

    The relationship between doctors and patients with inflammatory bowel disease is usually considered complex and difficult. We analyzed the quality of this relationship and the stress inflicted on the patients by endoscopy. 76 patients with Crohn's disease or ulcerative colitis answered a questionnaire. More than three quarters considered their relationship to their doctors good or very good. The patients expressed a wish for more information on the pathophysiology and treatment options of their disease. The stress placed on the patients by endoscopy was considered severe or very severe by 57%. We conclude that the relationship between doctor and patients with inflammatory bowel disease is generally considered good or very good. Endoscopies are highly stressful for most patients and we recommend appropriate sedation.

  17. 42 CFR 423.2102 - Request for MAC review when ALJ issues decision or dismissal.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Request for MAC review when ALJ issues decision or... Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2102 Request for MAC review when ALJ issues decision or dismissal. (a)(1) An enrollee to the ALJ hearing may request a MAC review if the enrollee files...

  18. 42 CFR 423.2062 - Applicability of policies not binding on the ALJ and MAC.

    Science.gov (United States)

    2010-10-01

    ... and MAC. 423.2062 Section 423.2062 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2062 Applicability of policies not binding on the ALJ and MAC. (a) ALJs and the MAC are not bound by CMS program guidance, such as program...

  19. 42 CFR 423.2110 - MAC reviews on its own motion.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false MAC reviews on its own motion. 423.2110 Section 423... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2110 MAC reviews on its own motion. (a) General rule. The MAC may decide on...

  20. 42 CFR 423.2050 - Removal of a hearing request from an ALJ to the MAC.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Removal of a hearing request from an ALJ to the MAC..., ALJ Hearings, MAC review, and Judicial Review § 423.2050 Removal of a hearing request from an ALJ to the MAC. If a request for hearing is pending before an ALJ, the MAC may assume responsibility for...